COVID-19 Blog

ArtMed’s Response to COVID-19: Update

As our society-wide isolation continues, one of the most common questions I’m asked is how long will we need to practice social distancing? The short answer is – we don’t know. New infections and diagnosis of COVID-19 is still rising in Ontario and in Canada. Until we see significant plateauing of infections the only effective measure we have to fight the pandemic is social distancing. There is also the wildcard of what is happening in the United States which may influence decisions made by our own government.

I have been getting a lot of questions about social distancing versus self isolation. I am also getting a lot of questions about COVID itself and what to do if a person believes they may have COVID. Also questions about testing etc. I’m going to try to summarize the key information in this blog and also provide links to useful instruction sheets and websites.

This past week the government enacted stricter measures for self-isolation after travel. If you have returned to Canada from outside the country you must enter into mandatory 14 days of isolation under the Quarantine Act. If you do not respect the quarantine you could face heavy fines or jail time. It doesn’t matter when you returned to Canada, your 14 day quarantine starts when you arrive.

When you are under quarantine you cannot leave your residence. If you need anything – groceries, medications, they must be brought to you. If you just arrived in Canada you cannot use public transport (buses, subways or trains) to get from the airport to your home. You must go via a private vehicle and if you do not have access to one you must contact Public Health and they will arrange transport. Returning travellers will not be able quarantine anywhere they can come in contact with vulnerable people; those who, for example, live with an elderly person or someone with a compromised immune system. Again, if the traveller doesn’t have a place to quarantine due to these restrictions they are to consult Public Health for residential arrangements.

The government is increasing restrictions in an effort to limit the spread as over 1,000,000 Canadians have returned from abroad in the past week and many travellers may have COVID-19 and be unaware that they are infected. Limiting the seeding of infections across the country is a priority for the government at this juncture. Social distancing alone is insufficient to prevent spread from returning travellers.

The Ontario Medical Association provides excellent information with respect to what’s involved in social distancing. A great deal of up to date information can be found at: https://www.virusfacts.ca/ Everyone in the province should practice social distancing and also monitor themselves for signs of illness. This link provides information on how to self monitor:

cocovid-self-monitor-fact-sheet-en-3

At this time the only people who can work out in the community are those deemed ‘essential’. Here is the link to a government list of essential workplaces: https://www.ontario.ca/page/list-essential-workplaces

Self-Isolating is the next step after social distancing. It means you must not leave your home for any reason. The only difference between quarantine and self-isolating is that quarantine is not voluntary, it is a legal requirement and will be enforced by the government. If you are sick you should self-isolate. If you are not sick but fall under quarantine (recent travellers or identified by Public Health as having to quarantine or suspect you have been exposed to COVID) then you are self isolating as well. Even if you are on the list of essential workplaces if you are sick you absolutely must self isolate.

How to self isolate or quarantine if you are not sick:

factsheet-covid-19-how-to-self-isolate

How to self isolate or quarantine if you are sick:

https://content.oma.org/wp-content/uploads/private/covid-19-self-isolation-fact-sheetenglish.pdf

If you are a caregiver of someone who is sick, how to self-isolate and care for sick individual:

covid-19-caregiver-self-isolation-fact-sheet-english-6

What are the symptoms of COVID? Symptoms can be very mild through to severe in rare cases. The majority of people develop symptoms around 5 days after exposure to COVID but it can take up to 14 days for a few people to become symptomatic. Most people are infectious for 2 days before they become symptomatic. Children tend to have very mild illness.

Symptoms of COVID:

• fever ~90% of people get this (80% typically have fever above 38 degrees)

• fatigue ~70% of people

• dry cough ~60% of people get this

• shortness of breath ~30% of people

• runny nose, headache, sore throat, nausea and diarrhea are much less common symptoms

Symptoms can range from mild (80%+ infections) to severe (less then 20%) to critical (less than 5%). If you are sick and you suspect you may have COVID then notify your primary care provider or if you cannot reach them then contact Public Health (this to make sure health care providers know where there may be cases of COVID). If you have mild symptoms and do not live or work in a high risk environment (nursing home, care home, medical facility) it is unlikely you will be tested for COVID. Follow the instructions for self-isolation and STAY HOME. If your symptoms become severe then you should go to your local Emergency Department.

If you think that you were exposed to a person with COVID then self-isolate for 14 days. If you are an essential service worker and you are sick but did not get tested for COVID you must not return to work until at least 3 days after your last symptoms and a minimum of 7 days after your first symptoms.

Who is being for tested for COVID in Ontario?

At the time of writing the Ministry of Health is prioritizing testing in the following groups:

• symptomatic health care workers and staff who work in healthcare facilities

• symptomatic residents and staff in Long Term Care facilities and retirement homes

• hospitalized patients admitted with respiratory symptoms (new or worsening)

• symptomatic members of remote, isolated, rural and /or indigenous communities

• symptomatic travellers identified at a point of entry to Canada

Eventually the government may seek to do wider community testing. But at the moment given the number of days it takes to process tests and the availability of tests, testing is being limited to individuals who must be identified if they have

COVID because it impacts treatment decisions (eg. ER/hospitalized patients) or they could put vulnerable people at risk (residential situations like retirement/nursing homes/ prisons/ reserves) or they are health care workers.

That’s the update! I know that all this information is rather dense, but I’ve done my best to collate and organize it in a way that is easy to follow. I’m receiving updates all the time and it can be dizzying to keep track of all the information.

I hope this blog helps a little bit.

Stay well! Stay home.

ArtMed’s Response to COVID-19: Extended Clinic Closure

By: Jane Watson

Due to the closure of all non-essential businesses as of yesterday for 14 days, as mandated by the provincial government, we have extended our closure to Tuesday April 14th. The current return date for businesses according to the official shut down for businesses is April 7th, however, we anticipate the closure to be extended to at least April 14th. Regardless, if the closure is not extended, we hope to be back in full swing to serve you on the Tuesday the 14th, right after Easter Weekend.

Stay home. Stay safe.

We will continue to update our closure and re-opening dates here. Please watch for follow-up posts. Thanks for your patience everyone!

From Jane and the whole ArtMed Team

ArtMed’s Response to COVID-19: Information

Hello ArtMed Community!

I’d like to pass on a few COVID related pieces of information. I have been receiving a constant stream of updates from government agencies, professional organizations, public health, hospitals and more.  I’m happy to pass on key pieces of information and I hope you find it useful.

First and foremost, STAY HOME.  Social distancing is the key to preventing the spread of COVID in Ontario.  But what does that really mean? It means the people you live with should be the only people you are spending time with.  If you absolutely must venture out into the public realm stay 6 ft  away from others and don’t interact with them for more than a couple minutes.  Do what you need to do, keep on the move, and then go home.  If you are continuing to work outside the home carefully adhere to workplace policies related to social distancing and avoid socializing with co-workers.

No, you do not need a mask.  It has been proven that masks are not useful to prevent spread among the general population.  HAND WASHING is the key to preventing spread.  Wash for at least 20 seconds with soap (any kind) and water. The virus has a fatty exterior coating which means that SOAP kills the virus by breaking down its outer coating.  If you must go out your hands before you go anywhere and immediately on your return.  Wash down door knobs, counters (especially plastic or stainless steel as the virus lives longer on these surfaces) light switches, toilets and faucets.  Anything people touch is a source of infection. DO NOT TOUCH YOUR FACE, this is the most common way people acquire COVID.  They touch a surface that is infected and touch their mouth, nose or eyes.

Absolutely avoid contact with people outside your residence who have travelled outside Canada in the past month.  If you have travelled outside Canada in the past month yourself self-isolate.  DO NOT GO OUT.  If you need things have them delivered to you. If you’re going stir crazy get familiar with video technology to meet up with friends and family.  Yes, you can go outside for a walk but don’t stop to chat at length with others.  Yes, you can walk your dog.  Going outside to get some exercise is fine for now.

Most people who are infected with COVID will not experience symptoms until at least 5 days after exposure to the virus.  Research shows that individuals who have COVID are infectious to others 2 days before they show symptoms.  Most community based infections occur during those 2 days when COVID infected asymptomatic individuals are interacting with others.  But it can take up to 14 days for some people to show symptoms.  This is why if you’ve travelled outside Canada in the past month, or have been in contact with someone who may have COVID you must SELF-ISOLATE FOR 14 days.

How long will this last?  The jury is out.  But the Prime Minister said our border will be closed for at least a month and it could be closed for months.  So it could be a while, we just don’t know at this point.  China is just starting to let Hubei province lift its restrictions and Wuhan itself has another 14 days of lock down.  In total that means Wuhan will have had 70 days of lock down (and that’s assuming no new cases in the next 2 weeks).  We will be able to see how things go in Europe which will also inform strategies for Canada.

What about testing?  Countries which have employed aggressive COVID testing have seen the best control of the virus.  In those countries they are testing widely including asymptomatic health care workers and often asymptomatic residents too.  At this time we do not have the resources in Canada to test in this way (not enough test kits, not enough lab capacity).  At present, the only people being considered for testing are individuals who have COVID symptoms (high fever, cough, shortness of breath) and the symptoms are MODERATE to SEVERE.  Mostly this means people who may need to be hospitalized.

So what to do?  In summary, stay home unless required to work, don’t be tempted to socialize, self-isolate for 14 days if you’ve travelled outside Canada in the past 14 days or live with someone who travelled, self-isolate if you have symptoms of COVID, and wash your hands and surfaces regularly and don’t touch your face.

It’s a brave new world!  On the upside, the environment is very happy.  An extended break from human activity has really improved the earth’s atmosphere and coastal waters.  Always look for the silver lining, and as the British say, keep calm and carry on.

Mary Peirson, M.D., C.C.F.P.

Medical Director, ArtMed

ArtMed’s Response to COVID-19: Clinic Closure

ArtMed’s Response to COVID-19 – Clinic Closure

As many of you know, I worked in Public Health for about 20 yrs. Communicable disease prevention and treatment has always been a concern and interest to me. As you know, the World Health Organization has declared COVID-19 to be a pandemic which means that we are seeing worldwide community-based spread of this severe respiratory illness. In the world of Public Health protecting the health and well-being of the entire community is paramount and this means that in unusual times we must take unusual measures.

Thus far Canada has been relatively unaffected by the severity of this epidemic. But it is becoming clear from what we are seeing around the world and especially in Italy that an abundance of caution and preventive measures are necessary to prevent spread. South Korea, for example, has taken a very strong pre-emptive stand against COVID-19 and they have managed to severely curtail the spread of this illness in their country despite an early outbreak. We should all learn from their example.

Consequently, ArtMed has chosen to close starting Monday March 16th. We will be closing for two weeks but will reassess the length of closure as events unfold. We are shutting down the clinic at 381 Woolwich in a bid to protect our clients and staff from possible unnecessary exposure. Procedures at ArtMed are elective, and it is my position at this time that elective medical appointments, like elective surgeries, conferences, public sporting matches etc. should be avoided in a bid to limit the community wide spread of this illness.

Like influenza, COVID-19 is particularly severe in the elderly. Mortality rates in those aged 70-80 are around 8% and in those 80 years and older closer to 15%. By comparison younger people often have mild symptoms and the mortality rate is much lower. Newly infected individuals can be incubating the virus for a week or more before developing symptoms. We have observed around the world that the unchecked spread among the young and healthy eventually leads to severe illness in the elderly and in those with pre-existing medical conditions.

It is impossible for us to know whether we have asymptomatic or minimally symptomatic COVID-19 cases in our community already. From a public health prevention perspective, and based on what we’ve learned worldwide, the best approach is to limit COVID-19 spread among the entire population before we see an outbreak in our own community in order to protect the most vulnerable. Therefore, closing now will be most effective.

In summary, it’s ArtMed’s position that preventing spread in the first place is the best way to limit the pandemic. Because we are an elective medical facility, we feel it is responsible to shut down before illness starts spreading in our region. As a physician well versed in public health, I strongly endorse that old adage – an ounce of prevention is worth a pound of cure.

ArtMed staff will be working remotely to answer emails and phone calls and will be available through our social media channels. We will update our website and social media regularly to keep you appraised of when we will reopen. If you have scheduled appointments in the coming weeks, we will be available to reschedule your appointments. At this time, we are recommending booking at least 1 month from your previous appointment.

We understand and recognize this may be inconvenient for some. We hope to be open again in the very near future. For updates regarding COVID-19 please find below links to two reliable sources of information.

Mary Peirson, M.D., C.C.F.P.

Medical Director, ArtMed

https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19.html

https://www.who.int/news-room/q-a-detail/q-a-coronaviruses

https://ipac-canada.org/coronavirus-resources.php

 

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