COVID-19: Important updates

Posted Sunday March 15, 2020

Posted By: Julie Rutherford

Category: General

To: Ottawa Physicians, Nurse Practitioners, Walk-In Clinics, Travel Clinics, Community Health Centres, Emergency Departments, Acute Care ? IPAC, HEPCO, Pharmacists, Midwives

From: March 15, 2020

Date: Dr. Robin Taylor, Associate Medical Officer of Health, Ottawa Public Health (OPH)

Dear Colleagues,

For the latest COVID-19 information see OPH?s Physician and Health Care Professionals COVID-19 Physician and Health Care Professionals Coronavirus web page (www.ottawapublichealth.ca/ncov) or call 613-580-6744.

Thank-you for your understanding that guidance on COVID-19 is evolving rapidly.

As of March 15, 2020 at 10:30am there have been 10 cases of COVID-19 reported in Ottawa. We expect this number to increase. OPH is actively conducting contact management and will be reaching out directly to identified close contacts. Please note the following key updates:

1. OPH Recommending Social Distancing in Ottawa

In order to decrease community transmission of COVID-19 in Ottawa, OPH is now recommending social distancing, for all residents of Ottawa. Social distancing measures include, but are not limited to:

  • Working from home where possible.
  • Avoiding sending children to daycare, if possible.
  • Avoiding visits to Long-Term Care Homes, Retirement Homes, Supportive Housing, Hospices and other congregate care settings unless the visit is essential.
  • Avoiding non-essential trips in the community.
  • If you have to go into the community for an essential trip via taxi or rideshare, be sure to keep the windows down.
  • Limiting or consider cancelling group gatherings, if possible.
  • Consider conducting essential meetings virtually instead of in person.
  • Whenever possible, spend time outside and in settings where people can maintain a 1-2 metre (3-6 feet) distance from each other

2. *NEW* Online Reporting of COVID-19

In order to facilitate the mandatory reporting of COVID-19, OPH has developed a new online reporting form. If you suspect a patient in Ottawa may be infected with COVID-19, report the suspected case to OPH immediately by completing this online form. Due to high demand, please reserve the OPH reporting phone line (613-580-6744, open 24 hours per day) for critical calls only.

  • This form is only to report symptomatic patients suspected of having COVID-19 AND live in the City of Ottawa. If your patient lives outside of Ottawa please report to their local health unit.
  • Laboratory confirmation is not required to report a suspected COVID-19 case.
  • All other notifiable diseases should be reported through the usual methods.

3. Personal Protective Equipment

  • The Ministry of Health has issued a directive that droplet and contact precautions should be used for clinical encounters with suspected COVID-19 patients, including testing.
  • Airborne precautions, including the use of N95 respirators, are only required for aerosolgenerating medical procedures.
  • Please see Public Health Ontario's COVID-19 IPAC Recommendations for more details.

4. Assessing Patients

  • Health care providers can help decrease the burden on the emergency department and the assessment centre by providing COVID-19 assessments of their own patients, inperson only if you have the required IPAC supplies and processes.
  • The Ministry of Health has approved new physician billing codes for telephone assessments (K080, K081, K082, and K083). Please refer to the Ministry website for more information on the requirements for these billing codes.
  • The Ministry of Health has published an online self-assessment tool for patients.

5. Instructions for Patients

OPH is now recommending the following instructions be provided to patients:

  • Those with any travel outside of Canada (including the USA): Self-isolation for 14 days from the date of return to Canada, even if asymptomatic.
  • Those with mild/moderate symptoms compatible with COVID-19, regardless of travel history: who can manage symptoms reasonably at home should NOT call OPH and they should self-isolate until 24 hours AFTER symptoms have FULLY resolved.
  • Those with moderate but escalating symptoms compatible with COVID-19 AND have either travelled outside of Canada or been in contact with someone who has been diagnosed with COVID-19 in the past 14 days:
    • Do NOT call OPH
    • Children under 6 months of age should be taken to CHEO
    • Visit the COVID-19 Assessment Centre (see below) or call your health care provider (if available). If neither are available, go to the hospital emergency department and pay attention to special signage.
  • Those with severe symptoms compatible with COVID-19, regardless of travel history: should seek emergency medical care and identify any COVID-19 concerns immediately so appropriate personal protective equipment can be used.
  • Confirmed case of COVID-19: Self-isolation until symptoms have resolved and there have been two negative tests for COVID-19.
  • Close contact of a confirmed or suspected case of COVID-19: Self-isolation for 14 days after last contact with the confirmed case. Close contact is someone you live with, provide care for, or spent extensive time with.
  • Close contact with a traveller returning from outside Canada who has symptoms compatible with COVID-19 that started within 14 days of their return: Self-Isolation for 14 days after last contact with suspected case.

OPH has prepared Home Isolation PDF handouts in EnglishFrench, and Simplified Chinese.

Public Health Ontario has prepared Home Isolation PDF handouts in FarsiItalian , and Korean.

OPH has created a sick note on our website that can be provided to patients on self-isolation.

6. Criteria for Laboratory Testing

Guidance on who requires testing for COVID-19 is quickly evolving. Please stay tuned to OPH?s Information on Novel Coronavirus (COVID-19) for Physician and Health Care Professionals website.

Currently, OPH recommends testing individuals who have symptoms compatible with COVID-19 (fever, new cough, or difficulty breathing) AND they meet at least one of the following:

  • Returning from travel outside of Canada within 14 days prior to their illness onset, OR
  • Returning from an area in Canada with established local transmission within 14 days prior to their illness onset, OR
  • A close contact of a confirmed or probable case of COVID-19 in the last 14 days. A close contact is defined as:
  • A person who provided care for the patient, including healthcare workers, family members or other caregivers, or who had other similar close physical contact OR
  • A person who lived with or otherwise had close prolonged contact with a probable or confirmed case while the case was symptomatic.

Testing for COVID-19 is NOT recommended if a person has no symptoms, regardless of their travel or exposure history.

  • Additional information on how to test for COVID-19 is available on the OPH website.
  • Please do not refer patients to the OPH phone line to access their test results.

7. Brewer Arena COVID-19 Assessment Centre

The COVID-19 Assessment Centre is an out-of-hospital clinic where people will be assessed by a health-care provider and tested for COVID-19 if required.

  • The Assessment Centre is located at the Brewer Arena (151 Brewer Way) and is open from 9 am to 8 pm, daily.
  • Patients do not require an appointment or coordination with OPH to be assessed.
  • The Assessment Centre is only testing individuals for COVID-19 if they have a new or worsening cough and/or fever AND have either travelled outside of Canada or been in contact with someone who has been diagnosed with COVID-19 in the past 14 days.
  • Asymptomatic individuals will NOT be tested.
  • Please advise your patients NOT to bring well children or other healthy members of the community (e.g. friends, neighbours, drivers) into the Assessment Centre.

8. Information to Follow

  • A new Clinical Care Command Centre with co-Chairs of Dr. Andrew Willmore and Joanne Read has been established with the objective to adapt the health care sector to respond to COVID-19. Please stay tuned for further details.

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