Travel Advisory and Request for All Physician Currently or Planning Travel
As per the release from Public Health earlier today, all physicians currently returning from travel outside Canada or who are planning travel to outside Canada are asked to follow self-isolation for 14 days upon their return. This directive started at 12 pm today. All physicians planning travel or who are returning from travel are asked to report these details to their local ZMED office through the following contacts. We ask that department also note and share system impacts that may come as a result of the isolation directive.
Remuneration for Physicians in Isolation
Government has assured Doctors Nova Scotia (DNS) that physician compensation will not be affected, if physicians need to self-isolate due to travel. This includes fee-for-service physicians. Doctors Nova Scotia is working with the Department of Health and Wellness to understand the details. You can expect an update from DNS soon.
Request for Physicians to cancel or postpone all non-essential Travel
Because we need and value your service, we are asking all physicians who have near term non urgent travel to consider postponing or canceling that travel. I acknowledge this may have significant financial and family ramifications but the decisions we make today will greatly impact our ability to respond to the changing environment tomorrow.
Locum and Medical Learner
Screening Process
All out of province locum physicians that are starting after March 13, 2020 will require COVID-19 Screening prior to entering NSHA workplaces, until otherwise notified. We are working with Dalhousie to discuss planned medical learner arrivals for electives or other opportunities. We are asking that physicians who have international medical residents arriving to share this information
with
physicianrecruit@nshealth.ca
.
Once received, a representative from the Medical Affairs team will contact each locum
physician
to begin pre-screening protocol.
Medical Learner Electives
Dalhousie Medical School has cancelled all international electives. Planned electives within Canada will continue until otherwise notified.
Medical Council of Canada Exams Postponed
MCC has advised that it will be postponing some spring examinations. It is expected that the College of Family Physicians of Canada and the Royal College of Physicians of Canada may also follow suit.
Dr. Gus Grant of the Nova Scotia College of Physicians and Surgeons has assured us that any changes in examination schedule will not negatively affect the licensure of physicians. Those who are provisionally licensed will remain provisionally licensed pending the examinations. Those who are to enter independent practice will be provisionally licensed pending the examinations.
Fit Testing for Physicians
Only physicians who are providing aerosol generating procedures (
positive pressure ventilation (BiPAP and CPAP), endotracheal intubation, airway suction, high frequency oscillatory ventilation, tracheostomy, chest physiotherapy, nebulizer treatment, sputum induction, and bronchoscopy
) should be participating in fit testing at this time.
For information about fit testing in your area, contact your zone Occupational Health and Safety Lead:
Physician Recruitment
All physician recruitment missions and conferences have been suspended until further notice. Any physicians who were booked to attend these missions in support should cancel their travel. All site visits have been suspended and postponed for 30 days and will be re-evaluated at this time. NSHA physician recruitment staff will be re-deployed to support medical affairs needs as required.
Physician Referrals to Coronavirus Assessment Centres
The incident management teams are continuing to stand up a process for primary care, ambulatory clinics, public health and EHS to directly refer patients to assessment centres without going through 811. This will be accomplished by completing the assessment form to ensure they meet the screening criteria then faxing to the nearest assessment centre who will then contact patient (who has been sent home to self-isolate) to arrange an appointment. If the patient is seen in a location with an assessment centre it may be possible, depending on # patients waiting to be assessed just to walk the patient and screen form to the assessment centre. Otherwise fax as above. The goal for future is centralized referral process, and updates will come when this is in place.
For patients who live far from an assessment centre the plan will be to provide swabs to rural EDs, more information on those EDs will follow.
Process for Swabbing Patients Who Can’t Present to Assessment Centre (Immunocompromised, or other factors)
If the patient is seen in an ambulatory care setting where there is an assessment centre or a lab that is stocking swabs in the zones, the physician seeing the patient can request a swab from the lab and do the Swab in clinic.
During limited supply of Viral Transport Media for Nasopharyngeal, please follow the alternate collection process. Click
here
to read.
For patients seen in primary care settings that are near an assessment centre, the physician can request a swab and do it in the office or call the local emergency department and arrange for the swab to be done there.
Process for Long Term Care Facility Support
Public Health has indicated that they would be managing possible cases in Long Term Care Facilities per their routine flu and outbreak management protocols.
PPE Conservation Message
Dr. Brendan Carr has prepared a
video
that includes important messages about the protection of our patients and staff, and the role our staff and physicians have in preserving personal protective supplies. This is important to continue to respond to the evolving situation regarding the coronavirus (COVID-19).
Business Continuity for CZ Laboratory Operations/ Provincial Microbiology
Although we do not have any cases of COVID 19 in NS to date, the rapidly evolving situation requires Central Zone Department of Pathology and Laboratory Medicine to implement the first phase of our business continuity plan to ensure we have sufficient resources to support immediate and critical care (e.g transplant patients) and the new demand of COVID19 testing. It is also important to reduce the number of patients visiting our blood collection centers so we can prioritize those patients requiring urgent care.
The following is a list of testing that has been temporarily suspended:
- Routine blood work.
- HCV and VZV from genital and skin specimen (eye and CSF samples will continue to be processed)
- Stool samples for viral pathogens (norovirus, adenovirus and rotavirus)
- Routine urinalysis.
- Stool samples for calprotectin and stool fats.
Please note turnaround times for routine testing may be delayed during this period.
As the situation evolves further changes may become necessary. We appreciate your understanding and support at this difficult time.
Other zones are working on their plans and we will update as information is received.
