Dear Doctor,
Today, Premier Stephen McNeil and Chief Medical Officer Dr. Robert Strang called a state of emergency for the province of Nova Scotia in response to COVID-19. Dr. Strang said that there is still no indication of community spread but expects that it will happen soon.
- Seven new presumptive cases were announced, all related to travel or close contact, and are spread across the province. Nova Scotia has nine confirmed cases and 19 presumptive cases, bringing the total to 28 cases of COVID-19
- The QEII microbiology lab in Halifax is now able to report positive and negative tests as confirmed. Tests no longer must be sent to a national lab in Winnipeg
- Gatherings are limited to no more than five people
- All provincial and municipal parks and beaches are now closed. Travel to these locations is prohibited.
- Police are now authorized to enforce orders under the Protection Act related to self-isolation and social distancing, and can issue summary offence tickets for people who are not adhering to those orders.
- The fine for individuals who fail to follow the advice of the public health office is $1,000; the fine for businesses that fail to comply with the advice of the public health office is $7,500, with increased costs daily.
- Effective 6:00 a.m. on Monday, March 23 anyone entering Nova Scotia will be checked at the border. Anyone who arrives in the province, no matter where they travel from, must self-isolate for 14 days. This includes travel within Canada.
On Saturday, March 21, in addition to prevention measures put in place by government and the chief medical officer of health, the Nova Scotia Health Authority (NSHA) and the IWK Health Centre announced steps to ensure the health system is ready to respond to COVID-19, including:
- Making changes to non-essential services so staff are available to focus on COVID-19 and essential services, such as cancer care
- Providing options for virtual care and telehealth care so doctors and other health-care providers can reduce face-to-face visits but also help patients regardless of where they are based
- Restricting visitors to protect the vulnerable patients in our hospitals
- Providing support to public health as they give advice on measures to slow the spread of the virus
- Ensuring facilities are prepared to meet the health care needs of Nova Scotians during the pandemic
- Opening new assessment centres to meet the need for assessments (there are now 14 centres around the province)
Improvements coming to virtual care fee code
In conversation with DNS President Dr. Gary Ernest late Friday evening in response to the widespread concern of physicians across the province, Health Minister Randy Delorey recognized the importance of expeditiously addressing the issues of non-face-to-face fee codes, including
- Addressing the comparability concerns of specialists; and
- Clarifying the common family physician fee codes that weren’t clear or included in the March 18 MSI Physicians’ Bulletin (e.g. counselling, long-term care facility visits, opioid agonist treatment, psychotherapy, whether residents can bill, limitations around prescribing, among other issues).
Dr. Ernest and Minister Delorey also discussed how government will support physicians who are currently or may soon experience a loss of income due to government and public health’s response to COVID-19. We hope to have clarification and details on this, as well as the above issues early this week. We will communicate these updates as soon as possible.
COVID-19 webinars
Join Dr. Claudia Sarbu, medical officer of health (MOH), and her NSHA colleagues on Monday, March 23 from 6:30 p.m. to 8:00 p.m. for an information webinar. The webinar is confidential and a chance to hear from physicians in public health and the NSHA on the latest protocols and recommendations. Each webinar includes a Q&A session, giving physicians an opportunity to ask questions and share concerns.
Register here for the webinar
Thanks to Drs. Claudia Sarbu, Ryan Sommers and Mark McKelvie for producing the webinar. Find webinar recordings on the DNS COVID-19 information hub.
Doctors Nova Scotia is working to have the webinars continue throughout the pandemic and is seeking continuing professional development accreditation for them.
Feeling overwhelmed?
During this difficult time, you may be experiencing fatigue, worry and anxiety. If you’re feeling exhausted and anxious—or just want someone to talk to—contact the Professional Support Program. Confidential support is available to you 24-7 and is just a call or email away. Call 902-468-8215 or 1-855-275-8215 (toll-free) or email professionalsupport@doctorsns.com.
DNS COVID-19 information hub
Find COVID-19 webinar recordings on the DNS COVID-19 information hub.*
The hub also lists all DNS coronavirus emails and includes a list of frequently asked questions on all aspects of the pandemic, including advice on self-isolation, virtual care, personal protective equipment, plus much more.
* Login is required to ensure your confidentiality. The content is password protected to ensure the public uses the government website for updates. If you need help logging in, email cat.henderson@doctorsns.com.
Remember:
- No community spread in Nova Scotia is known at this time but is becoming more likely
- Nova Scotia can process 200-250 COVID-19 tests each day. Plans are underway to boost lab capacity to 400-500 per day
- Personal protective equipment and ventilators are on order through a national procurement program.
- N-95 masks are not needed to provide routine care for patients with COVID-19 because it’s a respiratory disease spread by droplets and is not airborne. N-95 masks are only required when doing aerosol generating medical procedures
- As of 12:20 p.m. (EST) on March 22, there are 1302 confirmed and 69 presumptive cases of COVID-19 in Canada. The virus continues to spread globally.
Information hubs to watch
- Stay current with NSHA updates and services cancellations, including:
- Previously circulated forms/documents:
- Stay current with IWK updates and service cancellations
- Stay current with DNS updates and information
REMINDERS
Repatriating retired physicians
Doctors who have retired in the past three years may be eligible to return to practise. Contact Katrina Philopoulos at Katrina.Philopoulos@nshealth.ca if you are interested.
March 18, 2020 letter to Nova Scotia Health Authority (NSHA) Central Zone physicians
To prepare for COVID-19 infections, the Division of General Internal Medicine will not be accepting non-urgent ambulatory referrals at this time given the urgent need to reallocate its workforce capacity to acute inpatient management. This will be re-evaluated on April 15, 2020 with high likelihood of a prolonged extension. The division is also cancelling all non-urgent follow-up appointments. Read the letter.
Posters, public education
Self-monitoring vs. self-isolation vs. isolation for COVID-19
How to care for person with COVID-19 at home: advice for caregivers
Personal protective equipment
The OMA has created an infographic to show the recommendations for this pandemic. Check out the infographic.
Insurance for lost time
Doctors Nova Scotia benefits with Canada Life cover health and dental only. For those members with private disability insurance through OMA, your coverage has at least a 30-day (and in most cases a 60-day) waiting period. If you have coverage through other plans, please consult your plan providers about things like waiting periods and eligibility for quarantine versus illness.
Travel
Anyone who has travelled outside of Nova Scotia (including physicians) must self-isolate for 14 days when they return to Nova Scotia. Effective 6:00 a.m. on Monday, March 23 this includes travel from other Canadian provinces. If you have been in close contact with someone who has travelled and are experiencing fever (above 38°C) and/or new cough, you should complete the online questionnaire before calling 811.
MD and Scotiabank: Here to support physicians during COVID-19
MD Financial Management (MD) and Scotiabank clients are on the front lines of the COVID-19 pandemic. In light of this, the companies are implementing new precautionary measures. Regarding the markets, MD portfolios were designed to achieve long-term financial goals with respect to clients’ comfort level with risk and volatility. Learn more: “Staying in control: How to avoid emotional investing” blog.
DNS meetings and events
- All Board of Director meetings, E-health Committee meetings, section meetings or other meetings scheduled between March 18 and June 30 will be conducted virtually, supported by the GoToMeeting or GoToWebinar platforms.
- Physician Leadership Institute (PLI) and the Section of Physician Leader activities scheduled for April and May are cancelled.
- DNS’s annual conference is cancelled.
- If you’ve already registered, you’ll receive a full refund. Please cancel your hotel reservation as soon as possible.
- Register here for the free virtual annual general meeting and members’ forum on June 6, 2020.
- Doctors Nova Scotia staff will not be visiting physicians in clinics and hospital facilities on Doctors Day. We will send you messages from your patients, via DNS email, on May 1 to help lift your spirits during this difficult time.
If you have any questions about an upcoming meeting with DNS, please reach out to the meeting organizer for more details.
DNS staff and organizational preparedness
All DNS employees are working from home until April 8. The main phone line is being monitored during regular business hours. For physicians with upcoming meetings scheduled, staff will be in touch to offer solutions. If you call, please leave a message and someone will get back to you as soon as possible. You may reach us by email or by phone 902-468-1866 or toll free at 1-800-563-3427.
Additional Resources:
Department of Health and Wellness (public)
Nova Scotia Health Authority (physician and provider hub)
811 assessment – when to call (advice for patients)
Government of Canada
Nova Scotia Public Health offices
Canadian Medical Association