Hastings Prince Edward Public Health
Online Bulletin for Health Care Providers December 21, 2021 From:
Dr. Ethan Toumishey
Acting Medical Officer of Health
Hastings Prince Edward Public Health | HPEPH 2021/2022 holiday season office closures All HPEPH office locations will be closed for the following dates: - December 24, 2021,12:00pm-4:30pm
- December 27, 2021
- December 28, 2021
- December 31, 2021,12:00pm-4:30pm
- January 3, 2022
| COVID-19 vaccine news & updates | Response to the Omicron variant HPEPH began implementing the Ministry of Health COVID-19 Case, Contact and Outbreak Management Interim Guidance: Omicron Surge Model as of yesterday. Key points of the surge model include: -
Health units (or a representative on behalf of public health) will continue to contact individuals who test positive. -
Public Health will provide positive cases with self-isolation instructions, along with a virtual handout to be provided to their household members and other high-risk contacts with testing and self-isolating information. -
Household members of cases will be asked to self-isolate, regardless of vaccination status. -
Exposures in high-risk settings (hospitals and healthcare settings, congregate living settings, schools and child care centres) will be continue to be managed by Public Health. All high-risk contacts will be required to self-isolate for 10 days (regardless of vaccination status). The province has launched a holiday testing blitz to offer rapid antigen tests to individuals free of charge at pop-up sites across the province, as well as at select LCBO stores across Ontario. This initiative is part of the government’s enhanced COVID-19 testing strategy to mitigate the increased risk of transmission over the holiday season. | Reminder: mild symptoms in fully vaccinated individuals may be due to COVID-19 infection Recent COVID-19 case investigations have identified that fully vaccinated people can have very mild symptoms which are often attributed to alternative diagnoses such as a cold or allergies. These cases can unknowingly transmit COVID-19 to others. HPEPH recommendations: -
All individuals should continue to self-screen or follow their school or workplaces' COVID-19 screening checklist. -
Individuals with symptoms compatible with COVID-19 should not work or attend school while ill and should be tested for COVID-19, even if fully vaccinated. | Comirnaty (Pzifer-BioNTech COIVD-19 vaccine) now available for children 5-11 years of age NACI released its recommendations on the use of this vaccine stating a complete series may be offered to children 5-11 years old who do not have contraindications to the vaccine. The Pfizer-BioNTech Comirnaty product monograph has been updated for 5-11 years of age. Pediatric Pfizer-BioNTech COVID-19 Vaccine (10 µg) Information: -
Compared with current Pfizer product, dosage has been reduced by 1/3, to 10 µg -
Ten doses per vial -
Once removed from freezer may be refrigerated up to ten weeks -
Once reconstituted, must be administered within 12 hours -
Dosing interval of at least 8 weeks recommended between first and second dose -
Unlike adolescent and adult populations, NACI has recommended that COVID-19 vaccine for children 5-11 years old should be given at least 14 days before or after another vaccine (live or inactivated), though this is a precaution not a contraindication and at discretion of HCP Children aged 5 to 11 (born in 2016 and earlier) are now eligible to schedule a COVID-19 vaccine appointment. To book an appointment for a 5-11 year old, visit https://covid-19.ontario.ca/book-vaccine/. | Pfizer-BioNTech (30 µg) and Moderna COVID-19 vaccine lot expiration extension Health Canada authorized an update to the Pfizer-BioNTech COVID-19 Vaccine Product Monograph (30ug) to allow a 3-month extension to the expiry date for all Pfizer-BioNTech Covid-19 Vaccine vials with expiry dates of August 2021 through February 2022 printed on the vial and carton labels. Health Canada has authorized a 2-month shelf life extension (from 7 months to 9 months) for certain lots of the SPIKEVAX (previously COVID-19 Moderna vaccine). This extension applies to lots of US-labelled vaccine supplies with English-only vial and carton labels. The 2-month extension applies for all vials except those originally labelled as expiring on November 10, 2021. | Booking a COVID-19 vaccination appointment using the provincial booking system without an OHIP number Residents born 2016 or earlier without OHIP cards can still receive a vaccination at a local clinic for first, second and if eligible, third/booster dose. Individuals who do not have an Ontario health card must contact HPEPH Information Line at 613-966-5500. HPEPH staff will assign a COVID ID (a unique number to be used in place of an Ontario health card number). Individuals with a COVID ID may book an appointment through the Provincial Vaccine Contact Centre by phone at 1-833-943-3900. | Ontario expands eligibility for COVID-19 booster vaccine Starting on Monday, December 20, 2021, individuals aged 18 and over became eligible to schedule their booster dose appointment through the COVID-19 vaccination portal, by calling the Provincial Vaccine Contact Centre, through Indigenous-led vaccination clinics, select pharmacies and primary care settings. Appointments will be booked for approximately three months (84 days) after a second dose. There is currently a very high demand for COVID-19 vaccines in the region, and HPEPH is working diligently with participating community partners to administer available vaccines as quickly as possible. Please consider assisting with the administration of vaccines. To indicate your readiness to support this important initiative, please complete HPEPH’s COVID-19 Vaccination Order Form. | PPE auditing resources from Public Health Ontario A set of PPE resources is available through Public Health Ontario to assist health care settings establish, improve, and maintain a PPE auditing and feedback program to support implementation of infection prevention and control best practices. | Enhanced screening for HPE schools and childcare centres COVID-19 case investigations show that children are attending school while they have symptoms of illness, which is contributing to the spread of the virus. To reduce the risk of COVID-19 exposure within schools, enhanced screening will require that students stay home from school if they have any of the symptoms listed below. | Symptoms listed on provincial school screener | HPEPH additional symptoms | - Fever (37.8°C/100°F) and/or chills
- Cough or barking cough
- Shortness of breath
- Decrease or loss of taste or smell
- Nausea, vomiting and/or diarrhea
- Fatigue
- Muscle aches and pain
| - Sore throat
- Difficulty swallowing
- Runny or stuffy nose
- Abdominal pain
- Headache
- Conjunctivitis (pink eye)
- Decreased or lack of appetite
| Staff and students will not be permitted to attend school if they do not pass both the provincial and HPEPH screening tools. To return to school, the symptomatic person must: -
have received a negative COVID-19 test result and their symptoms have been improving significantly for at least 24 hours (48 hours for gastrointestinal symptoms); -
OR they have received an alternative diagnosis from a health care professional; -
OR have isolated for a minimum of 10 days since symptoms started; and -
pass the daily screener. | Ontario is enhancing proof of vaccination requirements and strengthening the verification of medical exemptions Effective January 4, 2022, Ontario will begin requiring the use of the enhanced vaccine certificate with QR code and the Verify Ontario app in settings where proof of vaccination is required. The QR code can be used digitally or by printing a paper copy. Individuals can visit their local library or can call the Provincial Vaccine Contact Centre at 1-833-943-3900 to have their vaccine certificate mailed to them. They can also visit a Service Ontario centre to receive a printed copy. Starting on December 15, 2021, Ontario will begin a new process to provide an enhanced COVID-19 vaccine certificate with QR code for individuals who have an eligible medical exemption. To obtain an enhanced vaccine certificate with QR code, individuals who have an eligible medical exemption must ask an Ontario physician or registered nurse in the extended class to submit their exemption directly to the public health unit where the issuer’s practice is located. Once an individual’s exemption is reviewed and entered into COVaxON by the public health unit, they will be able to access their enhanced vaccine certificate with QR code through the COVID-19 vaccination portal. Organizations and businesses that are required to take part in Ontario’s proof-of-vaccination system will be advised to no longer accept physician notes beginning January 10, 2022. | Ontario taking further action to protect long-term care and retirement homes The Ontario government, in consultation with the Chief Medical Officer of Health, is taking further action to protect the health and safety of residents, staff and caregivers in long-term care and retirement homes from COVID-19 and the Omicron variant. The following measures at long-term care homes will also go into effect on Friday, December 17, 2021: - Testing of all staff, students, volunteers, and caregivers, regardless of vaccination status, at least twice a week prior to entry into the home as part of enhanced active screening practices.
- Requiring a negative test upon entry to a long-term care home for all visitors and support workers who provide essential services to a resident or to the facility, unless they had a negative test the day before.
- Requiring caregivers to be fully vaccinated, unless they have a valid medical exemption or are attending to a resident in a palliative end-of-life situation. Caregivers will be required to have a first dose by December 20, 2021 and all required doses to be considered fully vaccinated by February 21, 2022. In the interim, designated caregivers who are not fully vaccinated would need to restrict their visit to the resident’s room.
To further protect retirement home residents and staff from the spread of COVID-19 and the Omicron variant, Ontario is also enhancing its COVID-19 policies in retirement homes effective December 22, 2021 to keep residents safe, including: -
Requiring rapid antigen testing for staff, volunteers, contractors and essential caregivers, regardless of vaccination status, two times per week prior to entry into the home as part of enhanced active screening practices. -
Requiring rapid antigen testing for general visitors and support workers entering a retirement home, regardless of vaccination status. -
Strongly encouraging retirement homes to restrict general visitors to only those who are fully vaccinated and implementing additional requirements for essential visitors and general visitors who are not fully vaccinated when entering a retirement home. | Case of lead toxicity in Ontario from ayurvedic medicine A recent case of lead toxicity in Ontario has been linked to the use of unlicensed Ayurvedic medicinal products (pills and incense) located at Kerela Ayurvedic & Natural Herbal Consultation in Toronto, ON. The health products seized from this clinic are not authorized for sale by Health Canada, which means they have not been evaluated for safety, effectiveness, and quality. Ayurveda is a form of traditional medicine originating in India and South Asia. In addition to lifestyle modification and other therapies, Ayurvedic medicine can also involve the ingestion of pills that may contain lead, mercury, and other heavy metals. -
Some Ayurvedic medicines, as in the current investigation and previously in Ontario, have been found to contain harmful levels of lead, mercury, and arsenic. -
Clinicians should be alert to the use of Ayurvedic medicines and symptoms in their patients and order a venous blood lead level (BLL) if lead toxicity is suspected. -
Lead toxicity should be considered in patients presenting with the following symptoms: abdominal, fatigue, anemia, and neurological dysfunction. -
Mercury related health effects may include peripheral vision loss, ataxia, tremors, and renal dysfunction. Clinicians may consult the following for guidance on health assessment and management: | Educational opportunities | COVID-19 Vaccination in Canada: An Educational Series for Primary Care Professionals This self-learning series from Department of Family and Community Medicine and the Ontario College of Family Physicians is designed to provide primary care professionals with the knowledge and skills to support Canada’s COVID-19 vaccination effort. | New and Updated COVID-19 Resources | Contact Information: To give us your comments: hart.sara@hpeph.ca To report communicable diseases:613-966-5500 x349 To report AEFI or DOPHS: Online / Fax: 613-966-1813 or CDCFAX1@hpeph.ca You have received this email at from Hastings Prince Edward Public Health as a result of a request you have made or due to a service/subscription that you are registered for. While you may discontinue your subscription to this mailing at any time by pressing the unsubscribe button below, please note that this bulletin will be used to provide important updates about infectious and communicable disease. | | | | |
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