COVID-19 Physician Information Update
April 29, 2020
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Updated Clinical Documents
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Order Sets, Procedures, Clinical Pathways, Guidelines and Policies
COVID Primary Assessment Centres and Secondary Assessment Centres
Cancer Care Updates
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A Message from Dr. Gary Earnst, President of DNS in Advance of Doctors Day
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*Updated* Glaucoma Treatment for Patients in
Northwood Long Term Care Facility
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Recently, a local facility directed care teams to temporarily discontinue glaucoma treatment for their patients during COVID-19 pandemic.
In some cases, a temporary pause in treatment is safe. In other cases, it could create irreversible deleterious outcomes to the patient’s vision.
There is some concern that assessment of these patients, and triage for those who would require treatment, might not be within the scope of practice for the staff members involved in patient care.
The following direction should be followed:
- Allow all patients who are capable to self-administer drops
- Those patients who can’t self-administer drops, the attending ophthalmologist should be consulted to advise if the patient can safely discontinue drops on a temporary basis.
- Once a decision has been made to temporally discontinue or alter the patient’s treatment, it should not be for longer than 1 month. The onus would be for the staff of the long term care facility to re-start treatment after that period and inform the office of the consulting ophthalmologist that this was done.
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*Updated* COVID Risk Assessment and Expanded Community/Facility Clusters
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The COVID-19 Risk Assessment tool was created to ensure uniform, mandatory assessment of all patients presenting for care. The Risk Assessment tool also outlines recommended PPE to be used in each clinical setting in order to ensure safety of staff and patients. It has been recently updated as the community and facility cluster areas have expanded.
- The PAC Referral Fax Form should be used to expedite testing in a PAC without requiring the patient to call 811.
The Clinical Medical Advisory Committee (CMAC) will work with Zone Medical Directors and Primary Care leads to ensure that the Community/Facility Cluster information is disseminated to physicians to ensure that this information is readily available to those who do not have access to the information on the NSHA COVID-19 Hub.
Update: Poster Code cluster information is changing regularly, and only currently accessible on the NSHA Intranet (as per links in documents above). We are aware that it is not easily accessible to all family practices in NS as not every physician has an NSHA account. Primary Health Care will regularly distribute the cluster information to all physicians in areas or facilities impacted. If you would like a copy of the cluster report each time it is updated, sign up
here.
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Physician Reassignment Opportunities
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In response to the unique demands of providing care during COVID-19, NSHA is organizing opportunities for physician redeployment or reassignment. These opportunities are shared to physicians by your local leadership (ZMED, Department/Division Heads, Chiefs, Network Leads, and Site Leads).
The intent in all reassignment is to match physicians to the areas and needs that best match their skills, interests, and abilities. Physicians will be matched as needs arise across the province.
To date, the following areas have provided opportunity for physician reassignment:
- Long term care
- Inpatient care
- Secondary assessment centers
- Access Clinics – Primary Care
- Emergency Medicine
- ICU/Critical Care
- Primary Assessment Center
- Virtual Care
Current needs are met but we expect these needs to fluctuate in the future. It is important to build a robust roster of available resources in the event that care needs change quickly. However, in some cases, physicians who volunteer for redeployment may not be matched as there is no current need identified.
The following guiding principles are to be considered:
- All programs will endeavour to continue current service delivery (reduced/unchanged/increased) and assist with COVID-19 care.
- Each physician has the ability to contribute to our combined effort to support pandemic response.
- Clinical work for COVID-19 patients will be performed by physicians who best meet the required skillsets and who would typically provide this level of care.
- Physicians reassignment is a voluntary program.
- Department Head (s), Site Lead(s), Zone Medical Executive Director will make every effort to fairly and equitably reassign work between departments when required.
- Reassignment request (s) may exist to provide support in another zone and will only occur if there is a critical need. Participation in these opportunities is voluntary.
- Physicians who are quarantined or ill, they may be requested to support virtual care assignments or COVID-19 planning if they are well enough to contribute.
- Please see Occupational Health guidelines for staff with chronic conditions as well as pregnant staff. These will be considered in reassignment opportunities.
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Zoom Healthcare Website and Resources Update
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To support patient care and health care providers (HCPs) in Nova Scotia during the current COVID-19 pandemic, Zoom for Healthcare has been approved as a virtual care platform for use on an interim basis for all health care providers (physicians, nurse practitioners and allied health professionals). There are a number of important updates related to Zoom for Healthcare including:
- Website Reorganization and Rebranding
- Software Privacy and Security
- Resources (including Frequently Asked Questions)
- Training
For the detailed update, please visit:
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DNS Webinar on Income Stabilization
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To ensure you have an opportunity to ask your questions before signing onto the income stabilization program, DNS is hosting a physician webinar on
Thursday, April 30 at 7:00 p.m.
Register for the webinar and join us to learn more about the details and implementation plan for the province's physician income stabilization program. Doctors Nova Scotia staff will present the details of the program, outline the enrollment process and take your questions.
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Join Dr. Gord Gubitz for a Virtual Information Session on Medical Assistance in Dying (MAiD).
Friday May 1, 9:00 a.m. to 10:00 a.m.
Dr. Gubitz will review federal legislation, the referral / intake process, assignment of assessments, patient eligibility criteria, MAiD procedure, clinical documentation, as well as Federal reporting requirements.
We are working toward building additional clinical capacity within the MAiD team, and this session is therefore directed at Physicians and Nurse Practitioners. However, anyone who wishes to learn more about MAiD may take part.
Please register with
John McCarthy, Medical Affairs Advisor by 12:00 noon, Thursday, April 30th. Those who register will receive a link and login credentials for the Zoom meeting. If you have any questions, please call John McCarthy at 902-220-2968.
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Thanks to a generous donation from Michelin, the provincial stockpile of surgical masks grew by 75,000. This donation will be followed by an additional 50,000 masks from Michelin in the coming weeks.
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Provincial COVID-19 Status Update
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Today, April 29, Nova Scotia is reporting one additional death related to COVID-19, bringing the total to 28. The death occurred at the Northwood long-term care home in Halifax Regional Municipality.
"On behalf of all Nova Scotians, I extend my heartfelt condolences to the family and loved ones of this individual. We will continue to work diligently with our partners to make sure we do everything we can to protect residents and staff at Northwood and all of our long-term care homes from this terrible disease," said Premier Stephen McNeil.
As of today, Nova Scotia has 935 confirmed cases of COVID-19. Twenty new cases were identified Tuesday, April 28.
The QEII Health Sciences Centre's microbiology lab completed 905 Nova Scotia tests on April 28 and is operating 24-hours.
As of April 28, there were 10 licensed long-term care homes and unlicensed seniors' facilities in Nova Scotia with cases of COVID-19, involving 227 residents and 97 staff.
If you have two or more of the following symptoms, visit
https://811.novascotia.ca to determine if you should call 811 for further assessment:
- fever
- new or worsening cough
- sore throat
- runny nose
- headache
To date, Nova Scotia has 27,486 negative test results, 935 positive COVID-19 test results and 28 deaths. Confirmed cases range in age from under 10 to over 90. Eleven individuals are currently in hospital, three of those in ICU. Five-hundred and twenty-nine individuals have now recovered and their cases of COVID-19 are considered resolved. Cases have been identified in all parts of the province. A map and graphic presentation of the case data is available at
https://novascotia.ca/coronavirus/data .
Public health is working to identify and test people who may have come in close contact with the confirmed cases. Those individuals who have been confirmed are being directed to self-isolate at home, away from the public, for 14 days.
Anyone who has travelled outside Nova Scotia must self-isolate for 14 days. As always, any Nova Scotian who develops symptoms of acute respiratory illness should limit their contact with others until they feel better.
It is now more important than ever for Nova Scotians to strictly adhere to the public health orders and directives - practise good hygiene, maintain a physical distance of two metres or six feet from others, limit essential gatherings to no more than five people and stay at home as much as possible.
Quick Facts:
- testing numbers are updated daily at https://novascotia.ca/coronavirus
- a state of emergency was declared under the Emergency Management Act on March 22 and extended to May 3
Additional Resources:
Government of Canada toll-free information line 1-833-784-4397
The Mental Health Provincial Crisis Line is available 24/7 to anyone experiencing a mental health or addictions crisis, or someone concerned about them, by calling 1-888-429-8167 (toll free)
Kids Help Phone is available 24/7, by calling 1-800-668-6868 (toll-free)
For help or information about domestic violence 24/7, call 1-855-225-0220 (toll-free)
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This section of our update is a list of helpful resources updated daily for physicians.
Please reach out to
Shawn Jolemore with your suggestions for additional content.
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Leadership and Wellness Poster
Updated for Week of April 27- May 3
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Individual Executive Coaching for Physician Leaders with Executive Coach Lorie Campbell
Are you struggling to lead yourself or your team(s) well during this pandemic?
Take advantage of 30 or 60-minute focused, one-to-one virtual executive coaching sessions for formal physician leaders only. Email
Lorie Campbell to book a time for this free service, provided by NSHA Medical Affairs Leadership Development.
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Canadian Society of Physician Leaders
Bulletin 7
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Self-compassion: cultivating physician resilience during the pandemic
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Daily Physician Wellness Check In - COVID-19 What's Normal?
Join Drs. Jaqueline Kinley and John Chiasson for daily online meetings to chat about coping strategies and mental health concerns. Meetings are daily M-F at 12 NOON. and are open to all physicians. Click here for the
*updated* Zoom -
Join Zoom Meeting Link
Addressing Grief within our Healthcare Community: Mine, Yours & Ours
Weekly on Thursdays from 9:30 a.m. to 10:30 a.m.
Join Serena Lewis and Roy Ellis (NSHA Bereavement & Grief Coordinators) as we begin the conversation of grief in our current and future workplace. This discussion will provide information on recognizing and understanding how loss is intertwined in our lives, as well as the current landscape of our community of care providing. Roy and Serena want to hear what topics will benefit you in the upcoming weeks that will support you - as you care for yourselves, your own families and within patient care.
DNS Professional Support Program
Feeling overwhelmed or need to talk to someone?
As we try to wrap our heads around the weekend’s tragic events and the senseless loss of so many innocent lives, I want to remind you that help is available. Whether you were directly connected to it or not, the tragedy intensifies the stress of the pandemic and the pressure on our lives due to the measures we are all following.
Contact the Doctors Nova Scotia (DNS)
Professional Support Program at 902-468-8215 or 1-855-275-8215 (toll-free) mail or via
email. LifeWorks by Morneau Shepell is also available to members and their families affected by the events in Portapique and surrounding communities. The crisis support line is open 24-7. Call 1-844-751-2133.
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Physician Screening for COVID-19
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Call 1-833-750-0632 to speak to Occupational Health and Safety for your screening options.
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