What’s new?

To monitor data on a daily basis, see the Nova Scotia and Canadian data pages.

• There were potential COVID-19 exposures:
  • On WestJet flight WS 232 on Sept. 7 from Calgary to Halifax. It departed Calgary at 9:30 a.m. and arrived in Halifax at 5:14 p.m. Passengers in rows 4 to 10, seats D, E and F are more likely to have had close contact
  • In the fitness centre at Canada Games Centre, 26 Thomas Raddall Drive, Halifax on Aug. 28, 29 and 30 from 10 a.m. – 1 p.m. and on Aug. 31 and Sept. 1 from 5 – 8 p.m.
• The phone number to make lab (blood) collection appointments for Strait Richmond Hospital is unavailable this week due to renovations. The phone number is expected to be back in service on Monday, Sept. 21.
• Nova Scotia Health has announced changes to their visitor restrictions. Beginning Thursday, Sept. 17:
  • All hospital inpatients (adult and children) may have two support people/family caregivers visit at the same time. These individuals may change daily. Additional family members may be permitted for patients approaching end of life based on discussion with the care team
  • Patients needing cancer care, emergency, outpatient and ambulatory care clinics, appointments or procedures may have one primary support person or family caregiver accompany them
  • Appointments are no longer required for primary support persons/family caregivers
  • Primary support persons or family caregivers may have contact with the patient, but maintain physical distancing with staff and other patients
  • Primary support persons or family caregivers may be permitted to stay overnight based on public health requirements and in consultation with unit manager
  • Gifts and cards are now permitted
  • Children under the age of 16 may visit with an adult and can be reviewed on case-by-case basis

Free personal protective equipment extended until Oct. 31
The Department of Health and Wellness (DHW) is providing community-based physicians and their staff with personal protective equipment (PPE) at no cost until Oct. 31. Click here to submit a request to DHW for PPE. Your organization will be notified by email of the approved supply and instructions for online ordering. For more information, email PPErequest@novascotia.ca.

Nova Scotia Health, IWK rolling out online booking service
Nova Scotia Health is expanding its online appointment booking service and the IWK Health Centre will add services in the coming weeks. On Sept. 16, online booking for blood collection will be available for appointments at Dartmouth General Hospital and the Lloyd E. Matheson Centre in Elmsdale.

Reminders

Special bulletin from Dr. Rob Strang
The revised 811 screening criteria for testing now includes if in the past 48 hours a person has had or is currently experiencing fever or cough (new or worsening) or two or more of the following symptoms (new or worsening): sore throat, runny nose, headache, shortness of breath. Dr. Strang emphasized the need to screen patients virtually for illness before in-person visits and to screen people who should be self-isolating to ensure they are compliant. He also provided information for office-based infection prevention and control. Read the memo

Seasonal flu and COVID-19 clinic considerations
Public health has provided preliminary information to help physicians plan to immunize patients for seasonal flu:

• Everyone six-months of age and older is eligible for influenza vaccine
• Vaccine should be available the week after Thanksgiving (Oct. 12) barring any vaccine supply delivery issues from manufacturers. Public health suggests starting the program after Thanksgiving and holding larger clinics towards November to ensure the majority of Nova Scotia’s supply is available. Vaccine could be late and public health indicates the initial supply will be equitably distributed to all providers
• Vaccine will be available from public health over several months (shipments have not arrived yet for the publicly funded program). In the new year, physicians may order vaccine from local public health offices if needed.
• Patients should wait 15 minutes after receiving the flu vaccine in case of syncope (fainting). This must be taken into consideration due to space needed to accommodate social distancing and potential plans for drive-up clinics, where drivers and passengers will need parking space to wait. Consider having family bubbles attend flu shot clinics together so that shots can be administered and they can wait together

Federal recommendations
The federal government has released guidance for influenza vaccine delivery in the presence of COVID-19. It includes recommendations for safely holding flu vaccine clinics, such as:

• Hold multiple smaller public clinics instead of large clinics with many attendees
• Consider extending clinic hours to avoid crowding
• In primary care settings, designate specific times for immunization clinics to ensure that only well people are in the area at the time, such as at the start or end of the day
• Cooperation between several medical practices to operate a joint influenza vaccine clinic in a dedicated space with dedicated staff
• Administer vaccines outdoors (weather permitting), such as in a provider’s parking lot or via a drive-through clinic
• Establish mobile clinics in vans or buses to visit neighbourhoods
• Develop an outreach strategy to administer influenza vaccine to vulnerable persons, housebound individuals and seniors who are sheltering in place
• Provide immunization during home care visits
• Administer flu shots at congregate living centres, such as retirement homes, group homes, homeless shelters, student residences and correctional facilities
• Have health care organizations, including long-term care facilities, provide their own immunization clinics for staff, volunteers and patients/clients (usual practice)
• Encourage workplaces to organize their own on-site immunization programs

CDC guide, Considerations for Planning Curbside/Drive-Through Vaccination Clinics

Webinars
Doctors Nova Scotia-hosted webinars and physician support sessions via Zoom have ended for the time being.

DNS webinar recordings
Check out recordings of previous webinars on the DNS COVID-19 info hub.

ICYMI
Doctors Nova Scotia has created a guide to help family physicians respond to work exemption requests.

Virtual care survey​​​​​​​
Nova Scotia Health and the IWK Health Centre are surveying care providers on their experience using virtual care tools made available as a result of COVID-19. The information gathered from the survey will be used in a rapid review study led by Dr. Tara Sampalli (NSH) and Dr. Jordan Sheriko (IWK).  The information collected for the review will help inform future planning as it relates to virtual care. Complete the survey

Physician resilience COVID-19 study 
Drs. Jackie Kinley and John Chiasson provided daily support sessions and webinars to help physicians cope during the COVID-19 pandemic. Physicians are invited to complete a brief survey about the experience to help guide the response for the next wave of COVID-19. Take the survey

ECHO Coping with COVID program available across Canada
This free program is intended for Canadian health-care providers and residents responding to the COVID-19 pandemic. The goal is to promote resilience, connection and wellness at a time that many people are experiencing isolation, burnout and stress. Sessions run twice per week on Wednesdays 12:30-1:30 p.m. (EST) and Fridays 2-3 p.m. (EST). Learn more

NEW Addictions Medicine Consult Service
Nova Scotia Health’s Addictions Medicine Consult Service provides rapid addictions medicine consultant advice. The service is available weekdays 8:30a.m.-4:30 p.m. by calling 1-855-970-0234. Learn more: FAQ or information card.

CMA Wellness Support Line
The Canadian Medical Association (CMA) has launched a Wellness Support Line. The line is linked with the DNS Professional Support Program (PSP) and is available 24-7. Call the PSP at 902-468-8215 or 1-855-275-8215 (toll-free).

DNS staff, meetings and events
All DNS meetings and events are cancelled or have moved to a virtual meeting. You may reach staff by email or by calling 902-468-1866 or toll free at 1-800-563-3427.

Resources

Note: See the DNS COVID-19 hub for a complete list of COVID-19 resources.

• Navigating work exemption requests during COVID-19[BJ15] 
• COVID-19 Signs, Symptoms and Severity of Disease – A Clinician Guide – June 18, 2020
• Nova Scotia Health guidelines for re-introduction of in-office primary care
• Updated: Guidance for physician employers (legal information)
• Medical students provide companionship to isolated patients - The Rural and Isolated Support Endeavor (RISE)

Information hubs to watch

• Nova Scotia Health updates and service cancellations
• IWK updates and service cancellations
• Doctor Nova Scotia updates and information
• Dalhousie CPD COVID-19 webpage
• Department of Health and Wellness
• 811 assessment – when to call
• Government of Canada
• Canadian Medical Association
• Canadian Pediatric Society COVID-19 resources for the care of children