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March 24, 2020 - Dr. Archer's Update on COVID-19 response from the DOM and Medicine Program

COVID-19 update: There are 9 cases and 9/9 are in people who have travelled internationally. There remains only 1 patient in hospital with COVID-19. Community spread has not yet occurred in Kingston/ 

KHSC IPAC recommendations vs professional society recommendations: In a crisis like the COVD-19 pandemic an organized chain of command and clear communications are critical. We are dealing with a plethora of pronouncements from virtually all professional organizations (e.g. Canadian Cardiovascular Society, Multiple Sclerosis society, etc). These well-intentioned recommendations are almost uniformly more conservative than KHSC policies (which reflect the local reality and are based on IPAC and Incident command decisions). In the event that there is a difference in policy between our KHSC policies and a professional organization/society our policies trump their suggestions. Likewise, we are subject to regulation from the provincial and federal governments. A reminder to DOM staff to work through your Division Chair and Dept Head and for trainees to work through their Training Program director. 

Visitors accompanying clinic patients: We need to reduce visitors to the clinics to an absolute minimum. However there are some patients who because of physical or other limitations must be accompanied by a family member/care giver. Here is what has been arranged to allow these accompanying visitors access to the clinic. You may, as the clinic doctor, determine that an accompanying person is absolutely required for a visit (using your good judgement). If a patient scheduled for an appointment/procedure tells the screener that the clinic doctor has requested them to attend the appointment with one family member, the family member must also be screened and only if they pass screening, will they be allowed to proceed with the patient. You are being asked to limit this very strictly to patients who truly must be seen soon and who require an accompanying person. Thanks to Ms Elizabeth Bardon and Dr. Mike Fitzpatrick for their help with this. Jordan Pike will communicate this policy to the Hotel Dieu screeners.

Unmasking controversy: We are using masks and PPE more widely in the Emergency Department at KHSC as of today, since they are the community interface. You will note that some Toronto hospitals have already liberalized PPE use, reflecting their higher incidence of COVID-19 infection. At KHSC we continue to use the PPE policy I have previously summarized. This is based on our current low local case prevalence and lack of community spread. Our policy will certainly evolve as the epidemic changes. A nice lay article on the use of masks in various situations is available from the CBC: What you need to know about masks and protecting yourself against COVID-19

Testing symptomatic faculty/medical residents who are quarantined: COVID-19 testing at the moment is only for symptomatic people (e.g. those with acute respiratory illness). If you are a Physician (faculty or trainee) please report your quarantine/symptoms to your Division Chair. We are assembling a list of doctors at home on quarantine with ARI to expedite testing and return them to work (for those who are COVID-19 negative) as soon as is safe. Occupational Health and Dr. Gerald Evans will review the list and expedite testing/return to work of these doctors.

Thanking the team: The DOM has started a program of thanking the frontline staff on our wards for their care, courage and optimism. Food baskets from Bursta Baskets are being delivered by Drs Smith and Archer and Michelle Matthews to wards over the next week. We began with Davies 5 and Kidd 10 today.

Virtual meetings: The DOM DAC had a virtual meeting today with a report from PGME and all Division Chairs, as well as Research leaders (Drs. Smith and Vanner). Tomorrow the entire DOM will have a ZOOM meeting to summarize implementation of e-health and to update all embers on our progress in dealing with COVID-19. This meeting is scheduled for 0800.

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