Hastings Prince Edward Public Health
Online Bulletin for Health Care Providers May 7, 2021 From:
Dr. Piotr Oglaza
Medical Officer of Health
Hastings Prince Edward Public Health | Gonorrhea (GC) Outbreak Continues in HPE As stated in our media release on April 27, 2021, Hastings Prince Edward Public Health (HPEPH) has continued to declare a state of GC outbreak in the local area. We are seeing an increase of over 200% in GC locally over the last year and a half compared to the previous 5 year average. 79 cases of GC were reported in 2020, and 25 cases have been reported in the first 4 months of 2021 alone. In response to the continued GC outbreak, HPEPH is encouraging healthcare providers to: - Lower your threshold for suspicion of STIs in ALL sexually active individuals, regardless of age, sex and relationship status;
- In GC symptomatic persons, test using BOTH culture and NAAT methods;
- Consider GC testing rectal and pharyngeal sites, especially for men who have sex with men (MSM), sex workers and their sexual contacts;
- Treat GC with first-line dual therapy due to compelling evidence of efficacy and current antimicrobial susceptibility patterns in Ontario:
- Ceftriaxone 250 mg IM with Azithromycin 1 gm po given at the same visit;
- Ensure test of cure by culture (preferred) for all GC positive patients who are pregnant, treated with second line or alternative therapy or if there are concerns about compliance with treatment, potential re-exposure or concern about antimicrobial resistance;
- Order publicly funded STI medications, including first line GC treatment, from Public Health using the HPEPH Vaccine/STI form available online at HPE Public Health;
- Refer to HPEPH Sexual Health webpage for current and evidence-based resources, reporting forms and sexual health resources.
We appreciate the assistance of our local healthcare providers during this time to ensure the sexual health needs of our communities continue to be met. For more information, please visit hpePublicHealth.ca or call the Sexual Health Program at 613-966-5500 x 418. | COVID-19 Vaccine News & Updates | NACI Statement on mRNA Vaccines and HPEPH Recommendations In their statement released on May 3, 2021, the National Advisory Committee on Immunization (NACI) “Continues to preferentially recommend authorized mRNA COVID-19 vaccines due to the excellent protection they provide and the absence of safety signals of concern". At this time and based on current evidence, NACI recommends a complete series with viral vector COVID-19 vaccine (AstraZeneca, Janssen) may be offered to individuals 30 years of age and older without contraindications if the individual prefers an earlier vaccine rather than wait for an mRNA vaccine and if the following conditions apply: - A benefit-risk analysis determines that the benefit of earlier vaccination with the viral vector COVID-19 vaccine outweighs the risk of the individual getting COVID-19 while waiting for an mRNA COVID-19 vaccine;
- The individual provides informed consent once the benefits and risks of VITT compared to COVID-19 are clearly outlined, including how long the individual will have to wait for an mRNA vaccine, and public health measures the individual is able to take to minimize their exposure to the COVID-19 virus; and
- The individual will have to wait in order to receive an mRNA vaccine. (NACI, 2021)
HPEPH continues to advise: - The best vaccine is the first vaccine you are offered.
- All COVID-19 vaccines available in Ontario have been determined to be safe and effective by Health Canada.
- For the vast majority of the population, the benefits of all Health Canada approved COVID-19 vaccines outweighs the risks of getting COVID-19.
| New Multilingual COVID-19 Vaccine Resources Health Canada and the Public Health Agency of Canada have passed along the following multilingual COVID-19 educational resources to provincial partners, which may be helpful in your practice: These resources will be updated regularly as more products are developed in non-official languages. Languages chosen were based off of 2016 Census results. They are: Simplified Chinese, Traditional Chinese, Punjabi, Tagalog, Spanish, Arabic, Urdu, Farsi, Vietnamese, Korean, Tamil, Hindi, Cree (Plains Cree), and Ojibwe Eastern. | COVID-19 Vaccine Eligibility May 6, 2021 Pharmacies: The following are eligible to book a COVID-19 appointment at participating pharmacies. Please visit covid-19.ontario.ca/vaccine-locations for location and registration information. - People age 40 or older in 2021
HPEPH Community Clinics: The following groups are now eligible to book COVID-19 vaccination appointments at ontario.ca/bookvaccine or by phone at 1-833-943-3900. They do not need to contact HPEPH. - Individuals turning 50 and over in 2021
- Healthcare or personal support workers
- Licensed childcare workers
- Education workers (including special education)
- Residents and staff in care homes and group living settings (including essential caregivers)
- People with high risk health conditions and their caregivers (for example, BMI of over 40, chemotherapy, Down syndrome)
- People with highest-risk health conditions and their caregivers (for example, pregnancy, organ transplant, multiple sclerosis)
- Chronic home health care recipients
- First Nations, Inuit and Métis individuals, including members of their household
- People who cannot work from home (Group One), which includes:
- Agriculture and farm workers
- Education workers in elementary and secondary schools
- Enforcement, inspection and compliance roles (by-law enforcement, building inspectors, food inspectors, border inspection officers, labour inspectors, and WSIB field workers)
- Foster care agency workers (including customary care providers)
- Food manufacturing and distribution workers
- Funeral, crematory, and cemetery workers
- Workers responding to critical events (police, fire, special constables, children’s aid society workers, infrastructure restoration workers)
| COVID-19 Vaccine-related Billing Codes The Ontario Medical Association (OMA) has released an overview of the billing codes available for activities related to COVID-19 vaccination including counselling, contacting patients to support registration, booking and documentation, administering COVID-19 vaccines, and vaccination events coordinated by a hospital or the Public Health Unit. For further information about the H409/H410 fee codes, please see the following resources: If you have questions regarding these codes, contact the OMA response centre at info@oma.org, Ontario’s Service Support Contact Centre (SSCC) by email at SSContactCentre.MOH@ontario.ca, or by phone at 1-800-262-6524. For more information and updates on COVID-19 Vaccines in HPE, visit hpePublicHealth.ca/covid-19-vaccines/ | COVID-19 Resource & Guidance Document Updates | COVID-19 Specialist Consultation for Healthcare Providers The Ontario eConsult Service is a secure, web-based tool that gives primary care providers access to specialist advice in a timely manner, including questions about COVID-19 management in specific patient populations and public health practice. eConsult Services may be accessed at www.OTNhub.ca. The following 2 PDF resources explain consultation services available to HCPs: | Updated Directive #2 for Health Care Providers On April 20, 2021 the Ministry updated Directive #2 for Health Care Providers. To accompany this update, the Ministry released a Question & Answer support document on April 30, 2021. In short, the updated Directive stipulates that all regulated healthcare providers must complete the following: - All non-emergent and non-urgent surgeries and procedures should cease, except for pediatric specialty hospitals.
- Clinicians are to determine which emergent surgeries and procedures are urgent in their specific health practice, and should be fair and transparent with all patients, relying on evidence, and guided by their regulatory College and the principles outlined in Directive #2.
- All patients should continue to have access to services that are peripheral to surgical services, such as diagnostic services related directly to the provision of emergent or urgent surgical and procedural care, and pain management services.
- All healthcare providers should be sourcing the PPE they need through their regular supply chain.
| Long-Term Care and Retirement Home Ministry Updates | Updated Directive #3 for LTCH/RH On April 23, 2021 and May 4, 2021, the Ministry released an updated Directive #3 for Long-Term Care Homes. Highlights of the Directive updates include: - Admissions and transfers to a home:
- Fully immunized* residents with a negative COVID-19 PCR test, are not required to isolate. If the resident has test results pending, then they must be placed in isolation until a negative test result is received.
- For partially immunized or unimmunized residents, a laboratory-based PCR test is required at the time of admission/transfer. The resident must be placed in isolation for a minimum of 10 days. To discontinue isolation on day 10, the individual must have a negative test result on day 8 of isolation.
- Recently recovered residents who are within 90 days of the date their positive laboratory test was taken are not required to be tested or placed in isolation.
- Fully immunized* LTCH and retirement home staff are now able to work in more than one LTC home, healthcare setting, or retirement home (unless otherwise directed by a local Medical Officer of Health).
- A clear definition of "essential absences", which will permit residents to leave on absences for groceries, pharmacies, and outdoor physical activity during the Stay-at-Home order that is currently in place. These absences are not permitted when the resident is in isolation under Droplet and Contact Precautions or when the home is in an outbreak.
In addition, Directive #3 now also permits: - Physical contact, such as hand holding and hugs, between fully immunized residents and their fully immunized caregivers;
- Resumption of communal dining without enhanced precautions, including physical distancing, in homes that have met the sector-specific immunization thresholds; and
- Resumption of organized indoor activities without enhanced precautions, including physical distancing, in homes that have met the sector-specific immunization thresholds.
Immunization thresholds for LTCHs and RHs are established by MLTC and MSAA, respectively, and are as follows: - For LTCHs, minimum resident coverage of 85% AND minimum staff coverage of 70%
- For RHs, minimum resident coverage of 85% AND minimum home (resident + staff) coverage of 70%
*Fully immunized means a person has received the total number of required doses of vaccine approved by Health Canada and it has been at least 14 days since they received the final dose was received. | Professional Development Opportunity | Child and Youth Eating Disorders: Information for Primary Care (3 Part Series) “The COVID-19 pandemic has not been easy on children, youth and families. Many are reporting increased stress, anxiety and depression during this time. Learn more about strategies to support primary care providers in assessing, monitoring and supporting a young person with an eating disorder.” - Eating Disorders, Part 1: Understanding Eating Disorders and Assessment of Children and Youth with Eating Disorders. Tuesday, May 18, 2021 12:00 p.m. to 1:00 p.m. EST
- Eating Disorders, Part 2: Understanding Medical Implications and Monitoring for Children and Youth with Eating Disorders. Tuesday, June 1, 2021 12:00 p.m. to 1:00 p.m. EST
- Eating Disorders, Part 3: Supporting a Young Person with an Eating Disorder in Primary Care - Tips and Tricks for the Primary Care Provider. Tuesday, June 15, 2021 12:00 p.m. to 1:00 p.m. EST
For more information including learning objectives, presenter bios, and how to register: please visit cheo.echoontario.ca/register/sies/ | | ------------------------------------------- HPEPH is offering services by appointment only. We remain dedicated to protecting our community by providing local HCPs and community members with new information as it becomes available. Current information on COVID-19 specifically for health care providers can be found at hpePublicHealth.ca, Ontario Ministry of Health and at publichealthontario.ca. | | Contact Information: To give us your comments: etubbs@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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