DEPARTMENT OF MEDICINE UPDATE | DECEMBER 2, 2020
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The SHORT Report
COVID-19:
- Nova Scotia COVID-19 Cases
- Rapid Testing Pop-Up Locations
- Potential COVID Exposures
- New Admission Pathway
- Aerosol Generating Medical Procedures (AGMPs)
- Regional Care Unit (RCU) Sites
- Addition of Face / Eye Protection
- Self-isolation requirements for Health Care Workers
- Restrictions to Reduce Spread
- Perioperative Services and COVID-19 Clinical Networks
- StatsCan Questionnaire
Nova Scotia Health:
- Nova Scotia Health vs NSH
- 2021 Making Waves Nominations
- Let’s Talk Informatics
- QEII New Generation Project Update
Research
- Excellence Awards
- Research Day Awards
- Dr. Melissa Andrew in The Lancet
- Call for applications – Clinician Investigator Program (CIP)
- DMRF Breakthrough Breakfast
Welcome & Farewell
DoM Billing
The Wild Horses of Sable Island
Standing items
- Videos - PPE and Masks
- Websites to Reference
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Hi everyone,
Hope you are all keeping well and keeping your distance when you can. Unfortunately we are moving into our second wave of COVID-19 activity. As we continue planning and reacting to disease activity we need to continue to do all we can to contain and minimize the spread of this disease. As Drs. McNeil and Johnston mentioned at our Departmental COVID update this week, people are getting tired, but it is more important than ever to be diligent in following the recommendations and rules. We had 16 cases reported on Monday and a total of 204 cases in November. Since our peak last week at 37 cases, in one day, cases have been in the low to mid-teens with a couple of single digit days. This gives us cautious optimism that the strict shut down that our province has enforced is starting to help.
A few key messages have come out from the health authority this week:
- One is to remind all staff to monitor the daily public announcements for COVID exposures (http://www.nshealth.ca/covid-exposures) and if you have had an exposure or have symptoms you need to contact Occupational Health Safety and Wellness (OHSW) for further direction (1-833-750-0632).
- If you have symptoms or a high risk exposure you need to be booked for a PCR test. Don’t go directly to a testing centre. Please use OHSW to get this arranged.
- The pop-up rapid testing clinics are not a substitute for definitive PCR testing and staff cannot use these to substitute for a PCR test.
- We are asking that formal meetings should be virtual unless absolutely necessary. We are also discouraging informal gatherings. This has been a significant source of staff to staff transmission, so we should not be gathering in break rooms or hallways, outside of work etc.
- There are guidelines in place for formal education gatherings limiting numbers to 10 in Central Zone with proper PPE. We ask for a limit of 5 people wherever/whenever possible.
I know people are getting fatigued from these messages, but we have done well to get through the last 9 months and a vaccine is on the horizon.
Stay safe everyone. Take care of yourselves, so we can all take care of our patients and families.
Christine
Christine Short, MD, FRCP(C), FACP
Associate Professor & Head/Chief, Department of Medicine
Dalhousie University / Central Zone, Nova Scotia Health
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"Stay safe everyone. Take care of yourselves, so we can all take care of our patients and families."
Dr. Christine Short
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NOVA SCOTIA COVID-19 CASES
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0
currently in hospital
due to COVID-19
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1,315
total positive
226 since October 1
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65
deaths
0 since October 1
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1,108
total resolved
78 since October 1
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66,263
negative tests since October 1
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Reported on December 1, 2020
(Test results from November 30, 2020)
Please note: October 1, 2020 has been identified as the start of Wave 2 in Nova Scotia (as per Dr. Robert Strang on Nov. 27). This is the reason why you'll see recent data reported as of October 1.
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RAPID TESTING POP-UP LOCATIONS
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From novascotia.ca news releases (up to and including Nov. 30):
Starting November 21
5,450
Rapid Tests
21
positive results
Pop-up locations:
- Halifax
- Dartmouth
- Wolfville
All individuals with a positive result were directed to self-isolate and referred for a standard PCR test.
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Rapid testing is for asymptomatic individuals wanting to know whether they are carrying the virus.
Thank you to Drs. Lisa Barrett and Todd Hatchette for spearheading this initiative.
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POTENTIAL COVID EXPOSURES
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Specific information on COVID Hub
- for healthcare workers / physicians
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List of potential COVID exposures
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Nova Scotia Health news releases
- reports exposures as identified by Public Health
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Occupational Health Safety and Wellness (OHSW) reminds all health care workers and physicians of the following testing requirements for COVID-19:
1)
Any health care worker or physician experiencing symptoms of COVID must:
- self-isolate
- call 811 to be screened AND call OHSW 1-833-750-0632 for tracking purposes
2)
- NOT REPORT TO WORK
- Immediately self-isolate. Household members are not required to self-isolate if they have not been at the identified location.
- CALL 811 to arrange for testing AND call 1-833-750-0632 for tracking purposes (select option 5 - please be patient as we are experiencing higher than normal call volumes).
- These health care workers CANNOT return to work, even with a negative swab, for 14 days after the known exposure.
- Return to work dates will vary depending on the identified location and are listed below. A health care worker present at more than one location should use the return to work date based on the most recent potential exposure notification.
3)
Any health care worker who was in a bar within the Halifax Regional Municipality after 10:00 p.m. can complete the online assessment tool for an asymptomatic swab. These individuals are NOT required to self-isolate and can return to work while waiting for the swab results.
4)
Any health care worker who does not have COVID symptoms, has no known COVID contact, hasn’t worked in a bar after 10:00 p.m., hasn’t travelled, and has no known exposures can get tested at a pop-up site for rapid testing.
Please note: Pop-up testing (rapid testing) sites do NOT replace standard PCR testing at COVID assessment locations.
From:
Occupational Health
November 28, 2020
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- updated to reflect NEW PPE and COVID-19 testing recommendations for admitted patients.
Key associated resources available the COVID Hub:
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AEROSOL GENERATING MEDICAL PROCEDURES
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Effective Wednesday, December 2, 2020, patients residing in a community cluster who require a planned outpatient Aerosol Generating Medical Procedures (AGMPs) should have a COVID-19 PCR 48-72 hours prior to the procedure, irrespective of the facility in which the procedure is being performed.
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REGIONAL CARE UNIT (RCU) SITES
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As part of government’s commitment to protect the health and safety of seniors in long-term care, six Regional Care Units will be established across the province to reduce and manage the spread of COVID-19.
- Ocean View Continuing Care Centre, Dartmouth
- Colchester East Hants Health Centre, Truro
- Cape Breton Regional Hospital, Sydney
- St. Martha’s Regional Hospital, Antigonish
- Valley Regional Hospital, Kentville
- Yarmouth Regional Hospital, Yarmouth
Quick Facts:
- NS has 133 licensed LTC facilities (about 8,000 beds)
- 58% are single rooms with private bathrooms
Excerpts from
NS Health & Wellness news release
November 19, 2020
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6 RCUs announced to protect health & safety of seniors in LTC
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ADDITION OF FACE / EYE PROTECTION
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Effective November 24, universal pandemic precautions (UPP) in Central Zone include the addition of face/eye protection.
The enhanced measures are for front line health care workers due to community transmission of the virus.
The epidemiology will be reviewed weekly to determine whether this policy continues and if there is a need to extend it to other zones and care settings.
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SELF-ISOLATION REQUIREMENTS FOR HEALTH CARE WORKERS
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All healthcare workers (HCWs) who have travelled outside of the Atlantic bubble or who have household contact with someone following non-essential travel outside of the Atlantic bubble, must self-isolate for 14 days after the individual enters the household. This includes HCWs whose children return to Nova Scotia from outside of the Atlantic bubble for the holidays.
This requirement is independent of the requirements for the general public set by the Office of the Chief Medical Officer of Health and applies to all HCWs working in acute care, primary care, and long-term care settings.
For clarity, if Nova Scotia Public Health alters its requirement for 14 day self-isolation of household contacts in order to facilitate return home of students from outside of the Atlantic bubble for the holidays, the requirement will remain in effect for HCWs given the consequences of transmission of COVID-19 between a HCW and patients and vulnerable residents of long-term care facilities. Additional information can be found here.
November 20, 2020
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RESTRICTIONS TO REDUCE SPREAD
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Gathering limits and social circles in Halifax Regional Municipality (HRM) and Hants County effective Nov 23 to Dec 21.
- five people can gather in a close social group without physical distancing, down from 10
- a household may have more than five members but they may only go outside the home in groups of five
- households can only have a maximum of five visitors at a time
- onsite gatherings at long-term care facilities can have a maximum of five people (including residents and staff), down from 10
- adult day programs for seniors who live in the community will not be allowed
- 25 people, down from 50, can gather with physical distancing for informal indoor and outdoor social events like a neighbourhood street party
- indoor events run by a recognized business or organization can have 50 per cent of the venue’s capacity to a maximum of 100 people with physical distancing, down from 200
- outdoor events run by a recognized business or organization can have 150 people with physical distancing, down from 250
Long-term care facility restrictions will apply across the province from Nov. 23, at 12:01 a.m., to Dec. 21:
- residents can only leave their facilities for medical/dental appointments
- a registered designated caregiver can take a resident for a sight-seeing car ride but they cannot include additional passengers or stops for shopping, visits, etc., of any kind or use drive-thrus
- a facility can continue sight-seeing outings using their vehicles, but physical distancing is required, no other passengers are permitted in the vehicle and there are no stops of any kind including use of drive-thrus
Full-service restaurants and licensed establishments
Starting on Nov. 23, at 12:01 a.m., full-service restaurants and licensed establishments across the province must collect accurate contact information on each patron, including date and time of visit, name and phone number. This data must be retained for four weeks from date of visit for contact-tracing purposes. There is no end date for this requirement.
Excerpts from:
Health and Wellness / COVID - 19
November 20, 2020
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PERIOPERATIVE SERVICES AND COVID-19 CLINICAL NETWORKS
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Perioperative Services
The Perioperative Services network is being co-led by Dr. Greg Hirsch, senior medical director, Perioperative Services Network and Cindy Connolly, director, Policy & Planning, Perioperative Services.
COVID-19 Clinical Network
The COVID-19 Network is being co-led by Dr. Shelly McNeil, Chief, Division of Infectious Diseases, Central Zone and Cindy MacQuarrie, Senior Director, Interprofessional Practice and Learning, Nova Scotia Health.
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RE: COVID-19 impacts on HCWs
Statistics Canada is conducting a survey to understand the impacts of COVID-19 on Canadian health care workers (HCWs), with particular focus on access to personal protective equipment (PPE) and infection prevention and control (IPC) measures in the workplace. The information will help to inform the delivery of health care services, and to better understand what health care workers need in terms of equipment, training and support.
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To participate click here.
30+ questions in survey
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NOVA SCOTIA HEALTH vs. NSH
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Please refer to Nova Scotia Health rather than NSH
While Nova Scotia Health Authority is still our legal name, our preference is that we refer to ourselves as Nova Scotia Health.
It’s tempting to use the abbreviation “NSH” as we previously used “NSHA”, however, we discourage the use of this abbreviation and encourage the use of our full name.
from
Nova Scotia Health News - November 24, 2020
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Please use
"Nova Scotia Health"
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2021 MAKING WAVES NOMINATIONS
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These awards, sponsored by Johnson Insurance, recognize individuals and groups who have made outstanding contributions to the health and well-being of Nova Scotians.
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Nomination packages due December 18.
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View past presentations, go to:
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Series was developed to inform and excite people about clinical systems and information, which lead to positive patient outcomes.
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QEII NEW GENERATION PROJECT UPDATE
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Summary of projects by building/site.
Video: 1 min 30 secs
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Research Excellence Awards
Congratulations to the 2020 recipients of the DoM Research Excellence Awards:
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Dr. Ciorsti MacIntyre
Assistant Professor
Division of Cardiology
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Dr. Karthik Tennankore
Associate Professor
Division of Nephrology
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Dr. Peter Hull
Professor
Division of Clinical Dermatology & Cutaneous Science
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DoM Research Day Awards 2020
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Please join us in congratulating the recipients of the 2020 DoM Research Day awards:
Best Core Resident Presentation
Dr. George Worthen
- “Frailty on the Kidney Transplant Waitlist”
Best Subspecialty Resident Presentation
Dr. Ahmed Mokhtar
- “Pre-Operative Predictors of Acute Kidney Injury Following Elective and In-Hospital Cardiac Surgery”
Best Undergraduate Student Presentation
Alicia Malone
- “Validation of the Systemic Lupus International Collaborating Clinics Frailty Index (SLICC-FI) in the Dalhousie Lupus Clinic Registry”
Best Case Report Presentation
Dr. Teresa Rodriguez
- “Diffuse Pulmonary Ossification Diagnosed by Transbronchial Needle Biopsy: A Case Report”
Best Graduate Student Presentation
Lindsay Wallace
- "Frailty Trajectory Related to Cognitive Status After Controlling for Neuropathological Burden”
Best Research Fellow Presentation
Dr. Michael Thorne
- “Imaging Butyrylcholinesterase in Multiple Sclerosis”
Best Research Staff Presentation
Katherine Eckert
- “Meal Regularity is Associated with Self-Esteem among Nova Scotian Children”
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Thank you to all of our presenters, judges, and participants for taking part in this virtual event!
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Dr. Melissa Andrew in The Lancet
Check out Dr. Melissa Andrew's
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Dr. Melissa Andrew's invited commentary is in response to this study:
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Call for applications -
Clinician Investigator Program (CIP)
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The Dalhousie Clinician Investigator Program (CIP) is designed to provide a combined research and clinical training stream for residents in Clinical Specialty Programs at Dalhousie.
The aim is to encourage young physicians to pursue careers as clinician-scientists and to renew the clinical academic faculty at Dalhousie and other Canadian Medical Schools through at least two years of protected research training.
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DMRF Breakthrough Breakfast
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On November 25, DMRF's Breakthrough Breakfast recognized outstanding local health research and the philanthropy that supports it.
The virtual breakfast was hosted by Tom Murphy (CBC Nova Scotia News) with live entertainment and two panel discussions concerning COVID-19 pandemic-related issues.
The DoM had two members on the panel discussions:
Dr. Ashley Miller
Assistant professor and Division Head, Division of General Internal Medicine, Department of Medicine
Dr. Sam Searle
Geriatric Medicine Fellow, Dalhousie University
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We welcome Mary Toote, Administrative Assistant, to the Division of Hematology.
Two physicians join the Division of Infectious Diseases as locums from November 1, 2020 until March 31, 2021:
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Dr. Ahmed Ghaly, Assistant Professor, Division of Infectious Diseases
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Dr. Melanie Di Quinzio, Assistant Professor, Division of Infectious Diseases
We say farewell and best wishes to:
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Dr. Robin Grant, Division of Palliative Medicine (last day will be December 14)
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Dr. Mark Sadler, Division of Neurology (last day will be December 31)
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A reminder that all shadow billing needs to be sent to our DOM Physician Services office. As you know we are no longer physically picking up billing from divisions.
Here are the options for sending the billing:
- Via email to our new shared billing email address: DOM Billing
- Fax to 902-473-7387
- Send via inter-departmental mail to: DOM Billing, room 322 Bethune Building
Remember that the deadline is 90 days from date of service for the billing submission to MSI so please allow enough time for the DOM Physician Services staff to process the claims.
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THE WILD HORSES OF SABLE ISLAND
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QEII Acute Stroke Unit Holiday Fundraiser
Proceeds from the 2021 Sable Island calendar will benefit the Acute Stroke Team Trust Fund, which is used to support clinical care and educational activities for the unit.
The calendar features stunning photographs of the wild horses that inhabit Sable Island, taken by physician and photographer Dr. Stephen Phillips, as he visited the island earlier this year.
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Nova Scotia Health / Dr. Lynn Johnston
Uploaded: March 13, 2020
Video: 10 min
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Nova Scotia Health / Dr. Glenn Patriquin
Uploaded: April 3, 2020
Video: 3 min
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Canada.ca
Uploaded: June 15, 2020
Video: 1 min 25 seconds
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Canada.ca
Uploaded: July 20, 2020
PDF – 8.5" x 14" poster
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My Personal Directive
(Legal Information Society of Nova Scotia)
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Complete online then download or email document. Once signed and witnessed, it is valid.
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Spectrum MD
(Antimicrobial Stewardship)
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Nova Scotia Health logo needs to be visible in the upper left corner of the home screen to ensure you are accessing local content.
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A list of some neighbourly businesses offering convenient, discounted or free services.
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NSHA workers experiencing COVID-19 symptoms, contact:
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Government of Nova Scotia
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World Health Organization
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When you take care of yourself, you take care of others.
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