On March 19, 2020, the Chief Medical Officer of Health released Directive #2 for health care providers in response to the novel coronavirus (COVID-19) pandemic. The Directive required that all non-essential and elective services be ceased or reduced to minimal levels until further notice.
On May 26, 2020, Directive #2 was amended to “support the gradual restart of all non-essential and elective services provided by Health Care Providers,” thus giving clearance to resume full services within current public safety requirements, given the ongoing pandemic and continuing risk to patients and health care providers.
Providers of echocardiographic services are now faced with the dual challenges of modifying service provision in a manner that ensures compliance with public health requirements, while engaging the accumulated backlog of deferred examinations.
The following document has been developed with the intention of providing recommendations to guide the resumption of activity within this environment and rational engagement of deferred examinations.
For more information, contact the OAC office:
34 Eglinton Ave. West, Suite 410
Toronto, Ontario M4R 2H6
E-mail: [email protected]
Ontario Moving More Regions into Stage 2 on Friday
TORONTO — More people will be able to get back to work as additional businesses and services in certain regions across Ontario can begin reopening this Friday. The Ontario government, in consultation with the Chief Medical Officer of Health and local medical officers of health, is enabling more regions of the province to enter Stage 2 of the government’s reopening framework. These regions are able to reopen due to positive trends of key public health indicators at the local level, including lower transmission of COVID-19, sufficient hospital health system capacity, local public health capacity to assist with rapid case and contact management, and a significant increase in testing provincially.
The details were provided today by Premier Doug Ford, Christine Elliott, Deputy Premier and Minister of Health, Rod Phillips, Minister of Finance, Vic Fedeli, Minister of Economic Development, Job Creation, and Trade, and Lisa MacLeod, Minister of Heritage, Tourism, Culture, and Sport Industries.
Informed by public health advice and workplace safety guidance, and supported by the collective efforts of businesses, workers and families to limit the potential spread of the virus, the latest public health unit regions allowed to move into Stage 2 on Friday, June 19, 2020 at 12:01 a.m. are:
- Durham Region Health Department;
- Haldimand-Norfolk Health Unit;
- Halton Region Health Department;
- Hamilton Public Health Services;
- Lambton Health Unit;
- Niagara Region Public Health Department; and
- York Region Public Health Services.
These regions are in addition to the 24 public health regions that entered Stage 2 on June 12, 2020. Before opening, business owners need to review the workplace safety guidelines and public health advice.
“Thanks to the collective efforts of our frontline health care workers and the people in these regions to stop the spread of COVID-19, more businesses will be able to open their doors and thousands of people will be able to go back to work and put food on the table,” said Premier Ford. “With the public health trends improving day by day across the province, I am hopeful all regions of Ontario will enter Stage 2 very soon. But we must remain on our guard to prevent any potential surge or secondary wave by continuing to follow the sound advice of our public health officials.”
The following regions will remain in Stage 1 under ongoing assessment until trends of key public health indicators demonstrate readiness to move into Stage 2:
- Peel Public Health;
- Toronto Public Health; and
- Windsor-Essex County Health Unit.
“Opening more regions of Ontario is another positive sign that we are making steady progress in our collective efforts to contain this deadly virus,” said Minister Elliott. “As many more Ontarians begin to work, shop and interact with others, it’s never been more important that we continue to follow public health advice, especially physical distancing with anyone outside of our social circle, so we can soon successfully and safely move into Stage 3.”
Public health remains the government’s top priority. All Ontarians must continue to follow public health advice, including practising physical distancing, wearing a face covering if physical distancing is a challenge, washing hands frequently and thoroughly, and avoiding touching your eyes, nose and mouth. If you think you have COVID-19 or have been in contact with someone who has COVID‑19, get tested.
The Chief Medical Officer of Health and health experts will continue to closely monitor the evolving situation to advise when public health restrictions can be gradually loosened or if they need to be tightened.
- At the beginning of each week, the government is providing an update on the ongoing assessment of Ontario’s regions, and whether they are ready to move into Stage 2 at the end of the week.
- To get tested, people should visit Ontario’s website to find their local assessment centre and whether they need to call ahead to make an appointment.
The province has developed a practical step-by-step guide to help Ontarians as they safely develop and join a social circle.Read More
Ontario Health Recommendations for Regional Health Care Delivery During the COVID-19 Pandemic: Outpatient Care, Primary Care, and Home and Community Care
Ontario Health has released Recommendations for Regional Health Care Delivery During the COVID-19 Pandemic: Outpatient Care, Primary Care, and Home and Community Care to assist health care organizations and providers in home and community care, primary care, and outpatient care initiate planning for a gradual return to their full scope of services during the COVID-19 pandemic.
To access the document, click here: Recommendations for Regional Health Care Delivery During the COVID-19 Pandemic – Outpatient Care Primary Care and Home and Com
For more information, contact the OAC office.
Ontario Association of Cardiologists
34 Eglinton Ave. West, Suite 410
Toronto, Ontario M4R 2H6
E-mail: [email protected]
Restrictions Being Eased in Communities Where It Is Safe to Do So
TORONTO — Today, the Ontario government announced that it is getting more people back to work and more recreational activities open by moving forward with a regional approach to Stage 2 of reopening the province.
In consultation with the Chief Medical Officer of Health and local health officials, the government is easing restrictions in communities where it is safe to do so, based on trends of key public health indicators such as lower rates of transmission, increased capacity in hospitals, and progress made in testing.
Effective Friday, June 12, 2020 at 12:01 a.m., the province will increase the limit on social gatherings from five to 10 people across the province, regardless of whether a region has moved to Stage 2. Additionally, all places of worship in Ontario will also be permitted to open with physical distancing in place and attendance limited to no more than 30 per cent of the building capacity to ensure the safety of worshippers.
Public health unit regions allowed to move into Stage 2 on Friday, June 12 at 12:01 a.m. include:
- Algoma Public Health
- Brant County Health Unit
- Chatham-Kent Public Health
- Eastern Ontario Health Unit
- Grey Bruce Health Unit
- Haliburton, Kawartha, Pine Ridge District Health Unit
- Hastings Prince Edward Public Health
- Huron Perth Public Health
- Kingston, Frontenac and Lennox & Addington Public Health
- Leeds Grenville & Lanark District Health Unit
- Middlesex-London Health Unit
- North Bay Parry Sound District Health Unit
- Northwestern Health Unit
- Ottawa Public Health
- Peterborough Public Health
- Porcupine Health Unit
- Public Health Sudbury & Districts
- Region of Waterloo Public Health and Emergency Services
- Renfrew County and District Health Unit
- Simcoe-Muskoka District Health Unit
- Southwestern Public Health
- Thunder Bay District Health Unit
- Timiskaming Health Unit
- Wellington-Dufferin-Guelph Public Health
Details of the Stage 2 reopening were provided by Premier Doug Ford, Christine Elliott, Deputy Premier and Minister of Health, Rod Phillips, Minister of Finance, Vic Fedeli, Minister of Economic Development, Job Creation and Trade, and Monte McNaughton, Minister of Labour, Training and Skills Development.
“We are able to make this announcement today because of the extraordinary effort of our frontline workers and every other person in the province who helped to stop the spread of this deadly virus,” said Premier Ford. “Entering Stage 2 means parts of the province will see more people back on the job and an opportunity to get back together with friends and family. Although this is extremely encouraging, I urge everyone to exercise caution and continue to follow public health advice as we are not out of the woods yet.”
Businesses and services permitted to reopen with proper health and safety measures in place in regions entering Stage 2 include:
- Outdoor dine-in services at restaurants, bars and other establishments, including patios, curbside, parking lots and adjacent properties;
- Select personal and personal care services with the proper health and safety measures in place, including tattoo parlours, barber shops, hair salons and beauty salons;
- Shopping malls under existing restrictions, including food services reopening for take-out and outdoor dining only;
- Tour and guide services, such as bike and walking, bus and boat tours, as well as tasting and tours for wineries, breweries and distilleries;
- Water recreational facilities such as outdoor splash pads and wading pools, and all swimming pools;
- Beach access and additional camping at Ontario Parks;
- Camping at private campgrounds;
- Outdoor-only recreational facilities and training for outdoor team sports, with limits to enable physical distancing;
- Drive-in and drive-through venues for theatres, concerts, animal attractions and cultural appreciation, such as art installations;
- Film and television production activities, with limits to enable physical distancing; and
- Weddings and funerals, with limits on social gatherings to 10 people.
As more people return to work, the services they rely on will need to be available regardless of the stage a region is in. The province will soon release more details on:
- Child care;
- Summer camps;
- Post-secondary education pilots to help people graduate;
- Training centres; and
- Public transit.
“The health and long-term economic well-being of the people of Ontario has guided every decision we have made in response to COVID-19,” said Rod Phillips, Minister of Finance and Chair of the Ontario Jobs and Recovery Committee. “The people and employers of Ontario have demonstrated responsible behaviour throughout the global pandemic. I’m confident that will continue in Stage 2 and beyond. Our collective health and the economic recovery of the province depend on it.”
At the beginning of each week, the government will provide an update on the ongoing assessment of these regions, and whether they are ready to move into Stage 2 at the end of the week.
Everyone, regardless of where they live in the province, must continue to follow public health advice, including to practise physical distancing, wear a face covering if physical distancing is a challenge, wash hands frequently and thoroughly, and avoid touching your eyes, nose and mouth. The Chief Medical Officer of Health and health experts will continue to closely monitor the evolving situation to advise when public health restrictions can be gradually loosened or if they need to be tightened.
“As a result of efforts of all Ontarians to stop the spread of COVID-19, many regions have met the criteria to move into the next stage of our reopening plan, including a decrease in new daily cases and sufficient hospital capacity in the event of any spikes in cases or outbreaks,” said Minister Elliott. “Our regional approach recognizes that different regions in the province are experiencing COVID-19 differently and can safely and gradually ease restrictions and reopen local businesses. We will continue to monitor any shifts in the spread and take decisive action to contain any outbreaks.”
The government, in partnership with health and safety associations, has released more than 100 health and safety guidance documents at Ontario.ca/COVIDsafety to help employers in multiple sectors ― including retail, restaurant and food services and child care ― keep spaces safe for workers and customers. As they prepare to reopen, employers are strongly advised to review these guidance documents and implement appropriate measures to help protect their workers and customers.
“Ontario employers have the information and the tools they need to keep workers safe,” said Minister McNaughton. “That includes safety guidelines, posters and tip sheets to promote safe workplaces and help stop the spread of COVID-19. I strongly advise everyone to visit Ontario.ca/COVIDsafety to read, download, print and post them, for your sake and the sake of those around you.”
“Since the beginning of this pandemic, our government has worked together with Ontario’s business community to mobilize our manufacturing and innovation might to develop made-in-Ontario solutions,” said Minister Fedeli. “As we proceed into Phase 2 of the reopening process, we will continue to support both businesses and workers as we move forward on the path to economic recovery together.”
- For questions about what is currently able to open during Stage 1, or what will be open or impacts to your business or employment when we enter Stage 2, call the Stop the Spread Business Information Line at 1-888-444-3659.
- The Ontario Jobs and Recovery Committee wants to hear directly from people and organizations from all regions and sectors to help inform the next steps in Ontario’s Action Plan in response to COVID-19. You can provide your input here.
- Visit Ontario.ca/reopen to learn how you can provide your feedback on the impacts of COVID-19 on personal finances, business supports and government relief measures.
- On April 1, 2020, the government launched the $50 million Ontario Together Fund to support the development of proposals submitted by businesses and individuals through the Ontario Together web portal and help businesses retool their operations.
- The government has launched the Workplace PPE Supplier Directory to provide businesses with information on personal protective equipment (PPE) suppliers. The directory can be accessed here.
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.Read More
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.