COVID-19 Update: ArtMed is Reopening on June 10th
COVID-19 Update: Regarding ArtMed’s Reopening (Date Coming Soon)
COVID-19 Update: Regarding ArtMed’s Reopening (Date TBD)
This is an acronym you’ll want to know.
It stands for Infection Prevention And Control. Hospitals have entire departments responsible for IPAC. Every institution should have IPAC policies and procedures in place including every health care office and facility, every community business or agency that offers personal care services (manicures, mass age, tattoo etc) and every organization or business that treats water or supplies food (grocery stores, restaurants etc).
Prior to COVID-19, preventing the spread of infection was always important to keep people healthy and to prevent unnecessary risk of illness. But as we look to reopening our economy during a pandemic we’ll be entering a higher level of IPAC readiness. To borrow from military parlance, we’re entering into defcon 1 for IPAC level (‘defcon’ = defense condition). We’ve never been at this level of IPAC requirement for businesses in modern history.
As many of you know, I worked in Public Health for over 20 years. I am extremely well versed in IPAC and a real stickler about safety. When we renovated our new office at 381 Woolwich Street, IPAC was foremost in my mind. Consequently, ArtMed is already well placed to provide the highest level of IPAC due to our clinic infrastructure. Nonetheless, in addition to our usual protections, we’ll be taking it to another level when we reopen.
Some of you who may have attended medical appointments during the COVID lockdown. You may be familiar with the process involved when visiting a medical office during a pandemic. There is advanced screening of patients – if they are symptomatic with potential COVID symptoms they will not be attending the clinic in person but assessed through virtual care. Appointments are widely spaced to allow for disinfection of treatment rooms between appointments. Patients must wait in their cars on arrival and staff will call them in when ready. There are no waiting rooms full of people. Visiting a clinic means wearing a mask for both patients and medical staff. Medical staff are in medical clothing – no street clothes. Full face shields are worn if staff are getting closer to patients. Hand-washing is required when entering and leaving the facility. Acrylic barriers have been put up at reception areas. And the list goes on.
ArtMed has been working diligently in the past month and continues to work daily toward implementing the IPAC processes we’ll need to safely reopen during the pandemic. In the coming weeks we will let you know what visiting ArtMed will look like and what you can expect. Each day I receive dozens of emails with pertinent information from medical experts around the world. This information informs our decisions with respect to IPAC. There are a lot of things we don’t know about COVID-19 and so our IPAC processes need to adapt continually according to new information when becomes available. Fortunately, in North America we’re weeks behind Europe. They’ll be reopening ahead of us and so we’ll benefit from their experiences in the coming weeks.
As with most businesses, ArtMed will undertake a graduated opening. What does this mean? It means that we will offer the safest services first to the highest need clients first and at a lower volume of appointments than usual. It means we can’t go from fully closed to fully open all at once. We will bring things back in a graduated way and monitor our processes every day to be sure we’ve optimized safety for our clients and staff. We will offer more options around virtual visits for consults, and also chat function on our website so that clients can communicate with us in real time.
As you may be aware this new way of doing things may persist for some time, possibly 12 to 18 months. We cannot go back to our pre-COVID processes until there is a viable treatment for COVID or a vaccine to prevent it.
In Ontario we look forward to restarting our economy and partially relaxing the lock down in the coming weeks to months. In healthcare, medically necessary or urgent care will come online first – this will be the first tier and the first to reopen. First tier includes the backlog of surgeries that were postponed, cancer care, cardiac care etc. Second tier medical will come next which includes elective, non-urgent care and this is where ArtMed fits in.
We have been told that by the end of this week or the beginning of next week the government of Ontario will provide more detailed tier 1 and tier 2 opening dates. Armed with that information we hope to project an actual reopening date for ArtMed very soon.
As most of you know, Ontario is taking a more cautious approach to reopening the economy than Quebec. I believe Ontario is making the right choice. We need to be sure we’re ready to lift the stay-at-home orders. We need to be sure we have the infrastructure in place to monitor for coronavirus once the general public has more freedom to move about in the community. We need to be able to identify new COVID cases quickly and complete contact tracing within 24 hrs. We need to avoid a surge in hospitalizations. When restrictions are lifted it’s inevitable we’ll see further spread of COVID-19. Monitoring and controlling that spread is essential if we want to avoid another shutdown.
Measure twice, cut once.
ArtMed has the measuring tape in hand. We have our clients’ health and welfare in hand. And when we get the green light from the government of Ontario we’ll be ready to provide care at a defcon 1 level of IPAC readiness. We look forward to seeing you then.
ArtMed’s Response to COVID-19: Update
It’s been three weeks since I last updated our COVID blog. In many ways very little has changed, but in fact much has changed. With each passing day and week we learn about COVID-19 and how best to manage in the time of global pandemic. What has become very clear is the fact that the most effective weapon we have in our arsenal is social distancing. But why is this? There are basically 2 ways to extinguish a virus that is spreading like wildfire in a community:
- Allow the virus to spread unchecked throughout the community until it infects enough people (around 70-80%) so as to provide ‘herd’ immunity. Herd immunity means so many people have become immune to an infection that the virus can no longer effectively spread in that community.
- Undertake social distancing which isolates individuals from each other so that the virus is unable to spread from infected individuals to the uninfected. Wait for those already infected to recover thereby extinguishing the virus. Once the virus is extinguished you can end social isolation.
In the first scenario we must accept most people will get sick and a significant number would die. The virus has a mortality rate of 1-2%. Projections in Canada suggest that unchecked spread would lead to more than 300,000 deaths.
With social distancing, if done effectively, we would reduce the mortality rate to somewhere between 4,000-44,000. Effective social distancing is hard. Really hard. It requires everyone to really sign onto that social agreement. We can’t bend the rules, cheat at the edges. COVID-19 is infectious. But not terribly much so staying 6 feet away from someone and passing them in the grocery store should be quite a low risk for catching the virus. However researchers have shown that if you do that again and again, that is to say increase the volume of those contacts, you markedly increase your risk of acquiring the virus. Thus, the less contact with the rest of the world the more effective social distancing is. If you can reduce your visits to the grocery store, drug store, LCBO, hardware store etc. to the very least you can do (and not view them as an opportunity for an outing) the better you protect yourself and the people who are working on those front lines (volume of contact applies to them as well). If one person can shop for a group of people, and drop deliveries to their doorstep, or if you can order online – all the better.
By practising strict social distancing not only will less people become infected (and thus less people die), but the shorter this time of social isolation will be. If our social restrictions are lax or too short the virus will come roaring back and we’ll be right back in it. A single longer period of social distancing is better than two medium length periods of social distancing and would wreak less havoc on the economy and on jobs. By being strict now, and extending the shutdown until we’ve really extinguished the virus, the less likely this fire will be reignited.
Does anything else work? We hear so much about testing, or our lack of testing in Ontario. While it would be nice to have more tests available, we’re still suffering under supply shortages. There’s also the problem of testing asymptomatic people – just because their test is negative today, doesn’t mean it will be negative tomorrow. We know that asymptomatic spread in the community is the most common way COVID-19 is spread. Nonetheless, keeping track of asymptomatic individuals who may have COVID is very difficult unless we plan to test everyone, every day and that’s not feasible. Certainly testing symptomatic people would be helpful to know who has it and where they’re located. Are they at risk of spreading it to others? Do they live in a high risk environment such as a nursing home or retirement home? Presently, if someone is symptomatic but not severely ill we assume they have COVID and will advise quarantine at home. Testing won’t change that. For health care workers testing someone who is symptomatic does matter because if they test negative they will be able to return to work as soon as they are well. IF they test positive for COVID they cannot return to work until it has been at least 14 days since symptoms appeared and they have two negative COVID tests on two separate days.
This little video from Ohio public health does a great job illustrating why social distancing is so effective:
So what are we talking about? Weeks more? Months more?
The truth is we’re not entirely sure. Public health officials often say that we’ll know when we can reduce social distancing when we look back and we’re happy. That is to say, they won’t be able to predict a future date for when social distancing might end. They’ll know it when they get there and they’re happy with what they see in the rear view mirror.
So what does this mean for us? Patience. Commitment. Solidarity.
What does it mean for ArtMed? Patience. Commitment. Solidarity with other businesses. ArtMed will be here when social distancing measures end. We’re strong, we’re healthy (yes very stressed like other businesses). We’ll be able to weather the storm.
We want to thank all our loyal customers who have purchased product through our parking lot pick-ups. This has helped bring in a little money and reduce our inventory. You can continue to purchase AlumierMD from the online store (you’ll need the store code to access the online shop so if you don’t have it please message us on Instagram or email us and we’ll send it to you). Vivier will launch their new online store in the next couple weeks which will operate in much the same way. We want to shout out to Vivier and Alumier for supporting independent businesses through their online platforms.
And we’re planning for our return. You might have noticed that we changed our return date to ‘indefinite.’ We’re rolling with the punches and since no one can predict when social distancing will end we’ll see you in person when we see you and we hope that’s in the not too distant future. Meanwhile, we’re recording podcasts for The ArtMed Zone, we’re doing weekly Instagram live broadcast on Fridays at noon, we will continue to do some contests and giveaways and we’ll continue to be active on all our media platforms.
For now, I’m working for Ontario Telehealth providing virtual primary care clinics. Our staff are participating in advanced educational opportunities so that we can bring you even greater expertise when we reopen our doors. We’re also planning special events to kick start our reopening when the time comes. We’ll be here for all our clients and better than ever!
But just for right now, visit ArtMed online via Facebook, Instagram or our website and stay home so that we can all go out safely sometime soon.
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:
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:
How to self isolate or quarantine if you are sick:
If you are a caregiver of someone who is sick, how to self-isolate and care for sick individual:
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
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
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