January has been an incredibly difficult month, and we want to thank you and your teams for all that you have done, and continue to do, for your patients. Encouragingly, the latest update on COVID-19 projections from the Science Table indicates that while hospital and ICU admissions continues to be high, Ontario data shows that vaccination (including third doses) is providing strong protection against serious illness.
The Ministry of Health issued a memo on the gradual resumption of selected clinical activities on February 1st, in addition to updated COVID-19 Directive #2 for Healthcare Providers and accompanying Q&A. The Ministry notes that latest modelling for hospitalizations and new admissions indicates that we have likely reached the peak of the current wave and will see a gradual decline in new hospitalizations in the coming weeks, and the revised Directive #2 allows the cautious and gradual resumption of diagnostic imaging, cancer screening and scheduled ambulatory clinics, and non-urgent and nonemergent surgeries as operationally feasible.
See the Ministry of Health’s Provincial testing guidance and the implementation of antivirals in Ontario slide deck, released February 2nd, for an overview of Ontario’s COVID-19 testing strategy, expanded use of Rapid Antigen Tests (RATs), antiviral pathway within 5 days of symptom onset, and other important information.
Please find below for additional resources to aid your teams as we look forward with cautious optimism to the end of the Omicron wave.
COVID-19 Outpatient Therapies
- From the Ontario Science Table: Fluvoxamine, What Prescribers and Pharmacists need to know:
- Antiviral treatment for COVID-19 - eligibility and where to get it.
- Ontario Health information package for primary care providers on access to outpatient therapies from January 31st:
- Memo to primary care providers on access to outpatient therapies,
- Guidance for primary care providers on these therapies (sotrovimab and Paxlovid)
- List of sites distributing Paxlovid, and
- A referral form for COVID-19 Monoclonal Antibody (mAb) EUA Treatment
This template patient script from the OCFP, updating on available COVID-19 treatments, can be adapted for community-based practices. The OCFP has also updated their Considerations for Balancing Demands, including more info on caring for symptomatic and COVID +ve patients.
Referral forms in Telus PS, Accuro and OSCAR
The North York Family Health Team has kindly digitized the referral form and made it available for all Telus PS and Accuro users in the province. Special thanks to Suja Arackal, Data Manager at the North York FHT.
- For Accuro users:
- Both the forms (“Ontario COVID-19 Monoclonal Antibody(mAb) EUA Treatment Referral” & “List of sites distributing Paxlovid”) are available in Accuro cloud.
- Please follow this link for instructions on how to download a form from Accuro cloud.
- For PSS users:
Thank you to Lisa Hawkins, QIDSS with the Champlain Region FHTs and Dr. Kevin Lai in North York for their assistance in developing the form for OSCA users.
- For OSCAR users:
- There are two options for you to choose from depending on your EMR compatibility. Please click here for more details.
You can also find the OCFP summary of the OH Guidance for Primary Care Providers – Access to Sotrovimab and Paxlovid for outpatient therapies for COVID-19 here.
- Memo from Alison Blair, Associate Deputy Minister on January 25th noted that “As the province now has confirmed stable supply of the adult Pfizer-BioNTech Comirnaty vaccine over the coming weeks, we are eliminating the requirement to prioritize its use for the 12-29 age group at this time.”
- Public Health Agency of Canada (PHAC) released updated advice on January 25th from the National Advisory Committee on Immunization (NACI) regarding the use of COVID-19 vaccines in children 5 to 11 years of age.
- Updated “I am pregnant or breastfeeding. Should I get the COVID-19 vaccine?” from The Provincial Council for Maternal and Child Health (PCMCH)
- New “I’m pregnant. How can I keep safe? What should I do if I get COVID?” from ConfusedAboutCOVID.ca
All about RATs
The provincial stock of Rapid Antigen Tests (RATs) is now in good supply and can be used for staff and patients. Primary care will see their backordered RATs from provincial stockpile in the next week or two and can also order additional tests from the provincial stockpile. ConfusedAboutCOVID.ca has a good fact sheet on “When should I use Rapid Antigen Test?” you can share with your patients. You can order the RATs here.
*NEW: note that symptomatic household members of patient-facing healthcare workers (includes primary care) are now eligible for PCR testing.
- COVID-End Canada's update on "What is the best-available evidence about the management of long COVID symptoms and care models for long COVID patients”
COVID-19 Clinical Assessment Centres
A reminder that clinical assessment centres have been stood up to support assessment, diagnosis, and disposition planning for people whose symptoms cannot be safely self-monitored at home but are also not experiencing severe symptoms that would require emergency care.
- COVID-19 Clinical Assessment Centres (CACs): Information for Primary Care Providers from the Centre for Effective Practice
- Frequently Asked Questions (FAQs) document that also explains the difference between the COVID-19 clinical assessment centres and COVID-19 assessment centres
Ontario Health Community of Practice
- Primary Care and COVID-19 Support Community of Practice January 12th Ontario Health CoP meeting recording can be accessed online. In this recording you will hear Dr. Chris Simpson speak about COVID Clinical Assessment Centres and Dr. Mangin provides updates to the COVID Monitoring pathways for primary care.
- The next CoP meeting is on February 9th from 8:00 a.m. to 9:00 a.m. and will focus on further discussions on monitoring and Post COVID-19 Condition clinical guidance for primary care. Katie Hogue, NPLCA President, will speak to her experience up in Parry Sound. Register here.
Ontario College of Family Physicians Community of Practice
- The OCFP COVID-19 CoP February 4th session on Responding to the Omicron Surge – Part 2 can be accessed here. The slide deck from the session is also available here.
- The next CoP session will be Friday, February 18th from 7:55 a.m. to 9:15 a.m. and registration details coming soon.
Ontario Medical Association and OCFP Town Hall
- On February 3rd the OMA and OCFP hosted a Town Hall on COVID-19 and children with Dr. Kieran Moore, Ontario’s chief medical officer of health, and other experts. Watch the recording here.
In the next week we are expecting the updated Primary Care Guidance document which will provide updated guidance on how to manage in-person care with updated IPAC, screening and testing guidance. We will ensure we share that as soon as it is available.
Once again thank you for all you are doing to keep your patients and the community safe. If you need any assistance or have any questions, please do not hesitate to contact us.
Yours in Good Health,
The AFHTO Team
(in collaboration with the Primary Care Collaborative)