Face coverings now recommended when physical distancing is a challenge
TORONTO — As the Ontario government carefully and gradually reopens the province, those taking public transit, returning to work or going out shopping are being urged to continue to adhere to public health advice as the best line of defence against COVID-19. To assist the public, the Ministry of Health today released specific recommendations on how to choose, wear and care for appropriate face coverings used in public where physical distancing is not possible, along with additional safety measures for provincial transit agencies.
The details were released today by Premier Doug Ford, Christine Elliott, Deputy Premier and Minister of Health, and Caroline Mulroney, Minister of Transportation.
“Now that we are in Stage 1 of our Framework for Reopening the Province, more people will be returning to workplaces, going to stores and parks, and using public transit,” said Premier Ford. “I strongly urge everyone to continue following the public health advice, such as physical distancing and restricting gatherings to five people or less. Although we are making progress, COVID-19 is still a risk that we must guard against. Please stay safe and protect yourself and others.”
Since the beginning of the outbreak, Dr. David Williams, Ontario’s Chief Medical Officer of Health, has advised people to wash their hands often, stay at home if feeling ill, and practise physical distancing by staying at least two metres apart from anyone outside their household. Now that the province is reopening, the Chief Medical Officer of Health and other health experts are recommending that individuals wear a face covering where physical distancing is not possible, such as on public transit or in a small grocery store or pharmacy. In order to assist people and reduce the risk of transmission of COVID-19, the Ministry of Health released the following face covering recommendations:
- Wear your face covering safely and snugly to cover your nose and mouth, without any gaps. Ensure your face covering is made of at least two layers of tightly woven material and can be cleaned multiple times without losing its shape;
- Medical masks, such as surgical and N95 masks, should be reserved for use by health care workers, those providing direct care, first responders and individuals who are ill and must leave their home for essential reasons such as seeking medical care, picking up medication or groceries;
- Face coverings should not be placed on or used by children under the age of two; anyone who has trouble breathing; and anyone who is unable to remove it without assistance.
“If you need a face covering, it is critically important people wear one that is appropriate for the situation,” said Minister Elliott. “Those taking transit or going out who can’t physically distance should wear non-medical grade cloth masks. We need to reserve all of the medical masks to protect our frontline health care workers, first responders and people who are ill.”
Workers and employers may also consider using face coverings as an additional public health measure in addition to mandatory occupational health and safety measures.
To assist provincial transit agencies in protecting transit staff and riders in this new environment, the Ministry of Health is also recommending the following measures be put in place:
- Physical distancing of at least two metres by admitting fewer passengers and using physical markers between seats;
- The use of face coverings, particularly when physical distancing is not feasible;
- Ensuring the availability of alcohol-based hand rub upon entering and exiting the vehicle;
- Implementing engineering controls like plexiglass windows between drivers and passengers; and
- Enhanced cleaning, particularly of high-touch surfaces.
“Ontario’s public transit systems are critical to supporting the economy and getting people where they need to go as the province begins to reopen,” said Minister Mulroney. “The health and well-being of all transit workers and passengers is a top priority for our government and we will be working with transit agencies to ensure that public transit can continue to operate safely.”
All Canadians continue to be legally required to self-isolate for 14 days when returning home from international travel.
In the meantime, Ontario and public health experts will carefully monitor the key public health indicators outlined in A Framework to Reopening our Province at each stage of reopening and will adjust public health measures if necessary.
Safe Reintroduction of Cardiovascular Services during the COVID-19 Pandemic: Guidance from North American Societies
The Canadian Journal of Cardiology has published an article entitled, “Safe Reintroduction of Cardiovascular Services during the COVID-19 Pandemic: Guidance from North American Societies”. The Societies represented include:
– American College of Cardiology
– American Heart Association
– Canadian Cardiovascular Society
– Canadian Association of Interventional Cardiology
– Society for Cardiovascular Angiography and Interventions
– Heart Valve Society
– American Society of Echocardiography
– Society of Thoracic Surgeons
– Heart Rhythm Society
– Society of Cardiovascular Computed Tomography
– American Society of Nuclear Cardiology
– Society of Nuclear Medicine and Molecular Imaging
– Society for Cardiovascular Magnetic Resonance
– Society of Nuclear Medicine
– Canadian Heart Failure Society
– Canadian Society of Cardiac Surgeons
To review the document, click here: https://www.onlinecjc.ca/article/S0828-282X(20)30428-1/fulltext
Canadian Cardiovascular Society: Don’t Ignore Heart Symptoms, Especially if You Have a Heart Condition
The Ontario Association of Cardiologists joins with the Canadian Cardiovascular Society in reminding the public, do not ignore heart symptoms during the COVID-19 pandemic.
Canadian Cardiovascular Society: Tips, pitfalls and red flags for family physicians caring for patients with cardiovascular disease during the COVID-19 pandemic
On April 15, 2020, the Canadian Cardiovascular Society released the following guidance statement:
To access the guidance document, click here: http://www.ccs.ca/images/Images_2020/Tips_Pitfalls__Red_Flags_FINAL.pdf
Ontario Association of Cardiologists
34 Eglinton Ave West, Suite 410
Tel: 416-487-0054 / 1-877-504-1239
E-mail: [email protected]
The Canadian Cardiovascular Society (CCS) has issued the following clinical and advocacy documents related to the COVID-19 pandemic:
1. Guidance on hospital-based care and cardiac procedures during the COVID-19 crisis: Guidance_on_hospital-based_care_and_cardiac_procedure_use_19Mar2020
2. Guidance on ambulatory management and diagnostic testing during the COVID-19 crisis: CCS_Guidance_for_Ambulatory_and_Diagnostic_Testing
3. COVID-19 and cardiac device patients: A message from the Canadian Heart Rhythm Society: CHRS_COVID-19_Update_EN
4. COVID-19 and use of ACEi/ARB/ARNi medications for heart failure or hypertension: CCS_CHFS_statement_regarding_COVID_EN
5. Joint letter to the Deputy Ministers of Health and Public Safety offering expert guidance on a coordinated strategy regarding the use of ECMO during the COVID-19 pandemic:ECMO Coord Resp Team CCS CSCS CANCARE 17Mar2020
The Ontario Association of Cardiologists supports the work of the CCS and will provide onging support and information to Ontario cardiologists and their patients during the COVID-19 pandemic.
The Ontario Association of Cardiologists is offering practice management advice and support to all of its members during the COVID-19 global pandemic to ensure that high quality patient care continues to be accessible to all cardiac patients in the province. This support will be made available via email updates and regularly scheduled information webinars. More information to follow.
New Fee Codes Will Help Limit the Spread of COVID-19 in Ontario While Maintaining Patient Access to High Quality, Cardiologist-Led Care
The Minister of Health has made an Order under the authority of subsection 45(2.1) of the Health Insurance Act to temporarily list as insured services the provision of assessments of or counselling to insured persons by telephone or video, or advice and information to patient representatives by telephone or video, as well as a temporary sessional fee code. These codes come into effect March 14, 2020. For more information, see OHIP INFOBulletin #4745 here: OHIP INFOBulletin #4745.
Province Also Investing in Critical Hospital Upgrades and Repairs
KITCHENER — As part of the comprehensive plan to end hallway health care, Ontario is expanding access to cardiac care for patients in the Kitchener-Waterloo region by making increased investments in hospital infrastructure.
Today, Christine Elliott, Deputy Premier and Minister of Health, was at St. Mary’s General Hospital to announce that Ontario is investing a total of up to $7.4 million to redevelop the Heart Rhythm Program. Through this project, the hospital will add new cardiac services that treat abnormal heart rhythms to the existing cardiac program to reduce wait times.
“Our comprehensive plan to end hallway health care includes building additional capacity for specialized services in communities like Kitchener-Waterloo,” said Elliott. “This project will enable the hospital to offer a full continuum of cardiac services and provide patients and families with better access to the quality care they expect and deserve closer to home.”
In addition, Minister Elliott announced that Ontario is providing St. Mary’s General Hospital with nearly $750,000 in additional funding to help support roof replacements and upgrades to generators. This is part of the government’s investment of $175 million this year through the Health Infrastructure Renewal Fund to help hospitals across the province maintain their infrastructure and ensure a safe and comfortable environment for patients to receive care.
“Investments in hospital infrastructure will help ensure that patients in Kitchener-Waterloo and across Ontario can receive the care they need in a safe and comfortable setting,” said Elliott. “Maintaining hospital infrastructure is one more example of how we are working towards ensuring that Ontarians have the health care services they can depend on while building the capacity we need to end hallway health care.”
As the government continues to work toward bringing Ontario’s world-class health care system into the 21st century, this funding will help hospitals to address urgent issues, including upgrades or replacements of roofs, windows, heating and air conditioning systems, fire alarms and backup generators.
“We are thrilled to bring these important services to St. Mary’s General Hospital, one of Canada’s top three centres for cardiac patient outcomes,” said Dr. Thomas Stewart, CEO of St. Joseph’s Health System and Niagara Health. “We are extremely grateful for the commitment by the Ontario government to support this important program that will reduce wait times and bring new cardiac services to the Waterloo region.”
- Construction of the project is expected to begin in the spring of 2020 and will include a new electrophysiology lab, adding 3,500 square feet of patient recovery space and expanded cardiac diagnostic clinic space.
- St. Mary’s Regional Cardiac Care Centre is one of Canada’s top three cardiac centres for patient outcomes.
- Ontario is investing $175 million in repairs and upgrades to 131 hospitals this year through the Health Infrastructure Renewal Fund.
- In addition, Ontario is investing $7.2 million to address ongoing urgent and/or emergent infrastructure renewal needs for community health service providers who met specific criteria on a priority basis, through the Community Infrastructure Renewal Fund.
Report Provides Recommendations on Building a Sustainable Health Care System
TORONTO -The Premier’s Council on Improving Healthcare and Ending Hallway Medicine today released its second report, providing advice on how to build a modern, sustainable and integrated health care system and solve the problem of hallway medicine.
“The Council is encouraged by the government’s vision and progress being made to build a connected and sustainable public health care system in Ontario,” said Special Advisor and Chair of the Council Dr. Rueben Devlin. “By speaking with Ontarians from across the province, the Council has heard support and enthusiasm for meaningful change in health care.”
Developed in consultation with more than 1,500 health care providers, patients and caregivers, the Council’s report – A Healthy Ontario: Building a Sustainable Health Care System – provides advice and makes key recommendations focused on:
- Integration – Putting patients at the centre of all interactions within the health care system, making it easier to access and navigate the system while providing better digital access to personal health information.
- Innovation – Improving options for health care delivery with more virtual care options, modernizing the home care sector and providing a more flexible mix of health care and community supports.
- Efficiency and Alignment – Strengthening partnerships between health and social services and providing open and transparent data to improve health outcomes.
- Capacity – Addressing wait times for specialist and community care by maximizing existing assets and skills, making strategic investments in health care, designing financial incentives to promote better health outcomes for patients and populations and championing collaborative and interprofessional leadership.
The Council will provide advice on the development of Ontario Health Teams and the Ontario Health agency, which are key components of the government’s plan to modernize and integrate health care. Future reports from the Council will focus on the progress being made in delivering better health care services and recommendations on long-term planning for the health care system.
“Health care should be organized around each patient’s individual needs,” said Dr. Devlin. “Health providers must work collaboratively, and services should be more readily available and accessible within our communities. These are the changes that matter to Ontarians and this is what the health care system of the future should look like.”
Ontarians can provide feedback on this report by visiting the following website or email address:
- Read the Premier’s Council second report: A Healthy Ontario: Building a Sustainable Health Care System
- Read the Premier’s Council first report: Hallway Health Care: A System Under Strain
- Premier’s Council on Improving Health Care and Ending Hallway Medicine Member Biographies
Health Quality Ontario (HQO) is developing a new quality standard outlining what quality care looks like for hypertension.
HQO is seeking volunteers to help support and drive the development of this work. If you or someone you know is interested, it is taking applications from people who have hypertension, their family members, health care professionals, community service providers and researchers from across Ontario.
Apply by June 21, 2019 to be considered.
To apply, click here: APPLY NOW
The Ontario Legislature’s Standing Committee on Estimates has begun its consideration of the Ontario governnment’s 2019-20 spending plans in the Ministry of Health and Long-Term Care.
The committee met on two days earlier this month to discuss health care and will resume for another 3hrs and 15min when MPPs return to Queen’s Park after the summer intercession.
To review the committee’s health care discussion transcripts , click here: https://www.ola.org/en/legislative-business/committees/estimates/parliament-42/transcripts
On April 11, 2019, Ontario Finance Minister Hon. Vic Fedeli tabled the 2019 Ontario Budget. Following is an excerpt from the Budget document:
The government’s vision for creating a truly patient-centred health care system
Every part of the government’s plan to end hallway health care and build a modern, sustainable, and integrated health care system, starts with the patient. Today, the system is disconnected, leaving it up to patients and families to figure it out on their own. This fragmented approach to care is failing Ontario’s families and, in particular, seniors.
Together, the Province will create a connected system of care where every Ontarian is truly supported throughout their health care journey.
To read the Budget’s health care plans and commitments, click here: http://budget.ontario.ca/2019/chapter-1c.html#section-2
The Premier’s Council on Improving Healthcare and Ending Hallway Medicine is releasing its first report, providing an overview of the problem of hallway health care in Ontario.
“There’s much to be proud of in our health care system. However, there are also many barriers that make the system difficult to navigate for patients and providers,” said Special Advisor and Chair of the Council Dr. Rueben Devlin. “This report is a first step in advising the government on how to transform Ontario’s health care system.”
The goal of this Council is to provide strategic advice to the Premier and Minister of Health and Long-Term Care that will help to ensure Ontarians have a health care system that has the right mix of health care professionals, the right number of hospital and long-term care beds, and that care is available when and where it’s needed.
The Council is comprised of health system leaders, including senior administrators and frontline health care professionals, and is also informed by stakeholder groups and patients. During its first four months, the Council heard from over 340 patients, health care stakeholders, and members of its six sub-committees.
Hallway Health Care: A System Under Strain identifies three key findings:
- Difficulty navigating the health care system and long wait times have a negative impact on patients’ health and on family, provider and caregiver well-being.
- The system is already facing capacity pressures and it does not have the appropriate mix of services, beds or digital tools to be ready for the expected increase in complex care needs.
- More effective coordination at the system level and at the point-of-care would make the system more efficient and achieve better value for taxpayer money.
The Council will now begin developing advice for the government on how to fix the problem of hallway health care. Recommendations will explore opportunities for improvement in digital health care, integrated health care delivery and finding efficiencies in the system to improve health outcomes for Ontarians.
“I encourage Ontarians to participate in the Council’s work by providing feedback on our first report. This will keep us accountable and help us reach our goal of improving healthcare in Ontario and ending hallway medicine,” said Dr. Devlin.
Ontarians can provide feedback on the report by visiting the following website and email address:
- On an average day in 2018, there were approximately 1000 patients waiting for a hospital bed in an unconventional space or emergency department stretcher.
- According to the 2018 Health Care Experience Survey, 41 per cent of Ontarians who went to the emergency department received care for a condition that could have been treated by their primary care provider.
- Currently in Ontario, less than 1 per cent of health care appointments are conducted virtually.
- Read the Premier’s Council report: Hallway Health Care: A System Under Strain
- Premier’s Council on Improving Health Care and Ending Hallway Medicine Member Biographies