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March 25, 2020
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To all staff and physicians
Current situation
As of today, March 25, Nova Scotia has 68 positive cases of COVID-19 in people ranging in age from under 10 to mid-70s. One case remains hospitalized. All are travel-related or connected to an earlier case. Read the news release here. There have been 2,772 negative test results. Testing numbers are updated daily at https://novascotia.ca/coronavirus.
Our response
Message from NSHA Board of Directors
On behalf of NSHA’s Board of Directors, board chair Frank van Schaayk extends the following message to employees, physicians and partners:
It is at times of our society’s greatest challenges that our greatest strengths are illuminated. To the employees, physicians and partners of the Nova Scotia Health Authority we say thank you for yourunwavering dedication, your strength and resilience, your selfless sacrifice and your skill. Healthcare has always been work of great purpose but that is never more evident than when we need it most. You have our thanks and support for what has already been done and for what is to come.
CEO Message to our partners
President and CEO Dr. Brendan Carr shared a message with our partners today. You can read the message here.
CORRECTION to Operational update
In a March 24 Operational Update item, it incorrectly stated that Northside General Hospital was closed until further notice. The hospital remains open however its emergency department is closed until further notice to redirect physician and nurses to other health care needs during the pandemic. Sorry for any confusion or anxiety this may have caused.
Updated – Occupational health information and guidelines for staff
Occupational Health information & guidelines for NSHA healthcare workers has changed. PLEASE CONTACT Occupational Health at 1-833-750-0632 if you are a NSHA healthcare worker who has returned to Canada in the past 14 days and is now symptomatic or has been in contact with an individual who has returned from travel in the past 14 days who is now symptomatic and you are now symptomatic. You may also call if you have no personal travel history, but you have been in contact with a known, or suspected case (symptomatic person) and you are now symptomatic. Symptoms include fever with a temperature of 38°C or higher and/or new or worsening cough.
Primary Assessment Centre update
If you are a Lead in one of the NSHA Primary Assessment Sites, below is some important information to help keep you up-to-date:
1) List of Primary Assessment Sites with Fax numbers and locations
Please check this link daily for the most up-to-date information. This is the same information that gets sent to 811 each day. If you print the Primary Assessment Site Information document, be sure to do so daily as the information changes frequently. We try to update this site each morning by 10 a.m. If you note any errors, please communicate them @email or @email.
2) Fax Referral Form
Please check this link (same link as above) to access the Fax Referral form that is used by primary care providers to make referrals to the Primary Assessment Sites. Please note that there is a new revision to this form as of today, March 25, 2020.
3) Care Directives for Swab Collection
Policies and Care Directives are currently housed on the OP3 site. There has been a new update (March 24 at 4:30 p.m.) to the Care Directive for Swab Collection. Please review.
4) Virtual Care
To help support patient care and health care providers in the current COVID-19 pandemic, Telehealth Zoom has been approved as a virtual care platform for use on an interim basis for all health care providers (physicians, nurse practitioners, allied health professionals and staff). Telehealth Zoom is a secure, web-based virtual care video conferencing platform. For more information, please visit https://www.cdha.nshealth.ca/telehealth-zoom. Questions can be directed @email.
Construction Update
As the ongoing safety of our patients, families, staff and workers remains our top priority, NSHA is temporarily pausing all construction activity that is taking place in active clinical areas within our hospitals. Projects that must be completed to assist with treatment of COVID-19 cases will continue. Facilities Management will continue to support projects essential to patient care and maintenance of all hospital facilities and equipment as required.
New/Updated guidance documents and resources
Ordering and Labelling COVID-19 Sample at a Primary Assessment Site
COVID-19 IPAC Guide for Home and Community Care (updated: March 24, 2020)
COVID-19 Screening Sign (updated: March 24, 2020)
COVID-19 Screening Sign-French(updated: March. 24, 2020)
COVID-19 IPAC Guide for Long-term care (updated: March 24, 2020)
Quick Reference Guide to Screening Ambulatory Care Clinics (updated March 24, 2020)
COVID-19 Screening and Management of Patients (updated: March 24, 2020)
Guidelines for Inpatient Passes during COVID-19 (March 25, 2020)
COVID-19 Assessment clinic cost centres(updated: March 25, 2020)
Guidance for PPE during endoscopy(March 25, 2020)
Upcoming facilitated health and well-being opportunities through EFAP provider
The emotional health and well-being of employees as we move through the coming days and weeks is extremely important to NSHA. We have arranged with our employee and family assistance program (EFAP) provider to provide two facilitated opportunities per day, to log onto ZOOM in a group format, and discuss techniques and strategies that will help navigate these uncertain times.
The first sessions will be Friday, March 27 at 10 a.m. and 9 p.m.
To join:
Morning Session 10 a.m.
Recurring meeting every week day at 10 a.m.beginning Friday, March 27- Join Zoom Meeting
https://lwatmorneaushepell.zoom.us/j/595167030 - Meeting ID: 595 167 030
Evening Session 9 p.m.
Recurring meeting every week day at 9 p.m.beginning Friday, March 27 –Join Zoom Meeting
https://lwatmorneaushepell.zoom.us/j/468482275 - Meeting ID: 468 482 275
REMINDER: Lab orders restricted
Physicians and nurse practitioners are reminded to restrict laboratory orders to urgent or testing required for immediate diagnosis, management of chronic illness and time sensitive prenatal screening. If a patient in self-isolation requires out-patient blood work, physicians and nurse practitioners are asked to direct them to contact the laboratory to book an appointment for blood collection and indicate that they are self-isolating. This will ensure staff are prepared to take the extra precautions necessary to protect themselves and other members of the public. Information about NSHA Blood Collection clinics, including hours of operation and contact information, can be found on the NSHA website: http://www.nshealth.ca/blood-collection.
Update on Lopinavir/ritonavir and hydroxychloroquine
Lopinavir/ritonavir (Kaletra) and hydroxychloroquine (Plaquenil) are being investigated in an experimental/off label capacity for patients with confirmed COVID-19 in the setting of clinical trials. These are NOT proven to have any effect in prophylaxis or treatment at this time. Supportive care is the mainstay of therapy. Both lopinavir/ritonavir (Kaletra) and hydroxychloroquine (Plaquenil) are currently available in limited supply and efforts are underway to preserve our supply for individuals that may require experimental treatment for COVID-19. Read more.
Reporting ADRs and MDIs during COVID-19 pandemic
In light of the current situation, Health Canada is clarifying expectations regarding the requirement for hospitals to report medical device incidents (MDIs) and serious adverse drug reactions (ADRs) during the COVID-19 pandemic.
During the pandemic, reporting expectations and timelines will not change for some high-priority products or those that may be used in a pandemic. These include antivirals, vaccines, medicines for outbreak symptom management, medical devices related to the diagnosis and management of patients with COVID-19, blood and blood components, cells, tissues and organs (CTOs) and drug identification number-assigned (DIN) manufactured blood products. Furthermore, reports with death as an outcome should also be treated as priority.
If a patient has been identified as having COVID-19, this should be indicated in section B field 9 of the Medical Device Problem Report Form for Health Care Professionals or section B field 6 of the Serious Adverse Drug Reaction Reporting Form for Hospitals. These reports should be identified as priority and submitted in timeframes in accordance with the Food and Drug Regulations and Medical Device Regulations.
For all other reports, regulatory reporting of MDIs and serious ADRs should be maintained to the maximum extent possible. However, due to pandemic-related employee and personnel shortages, Health Canada accepts if the submission of MDI and serious ADR reports to Health Canada does not occur within the timeframes stipulated under the Food and Drug Regulations and Medical Devices Regulations, provided that any delayed submissions are sent as soon as feasible. Hospitals should maintain records to identify what has been delayed. Read full message from Health Canada for more details.
Medical Assistance in Dying (MAiD) policy revised
The NSHA policy on Medical Assistance in Dying (MAiD) [NSHA CL-AP-010 Medical Assistance in Dying (MAiD)] has been revised due to the current situation involving COVID-19. Learn more.
Mindwell U now available across Nova Scotia
NSHA Mental Health and Addictions Program is continuing to work on a series of online resources and tools to support individuals and families. Mindwell U is now available across Nova Scotia. Mindwell U is a free online program that takes just five minutes a day, and can be accessed anywhere and on any device. This self-guided program challenges you to take five minutes out of your day to learn the basics in mindfulness; the practice of paying attention to thoughts, feelings and bodily sensations in the present moment through a gentle and nurturing lens. Each day you will complete a “Take 5” session during which you learn new mindfulness skills to improve your mental health. This practice lowers stress and increases resilience. The challenge also teaches ‘mindfulness-in-action’ so you don’t have to stop what you are doing to become calmer, present and more focused. To access this program please visit: https://app.mindwellu.com/novascotia
ICAN program launched
Earlier this week, Mental Health and Addictions Program launched ICAN (Conquer Anxiety and Nervousness) – Anxiety Program (18+ years of age) free of charge for people looking for help for anxiety and depression. The interactions are private and confidential and the program is offered through the Strongest Families Institute.
Strongest Families Institute also available
Strongest Families Institute is a charity that provides proven services to adults and families seeking help for mental health and other issues impacting health and well-being. We provide timely care by teaching skills through our unique distance coaching approach – supporting clients over the phone and Internet in the comfort and privacy of their own home. Strongest Families provides client-centered care that is customized to their needs. To self-refer, go to: https://login.strongestfamilies.com/folder/1963/
Social distancing in photo submissions
We’ve received a few photos from staff sharing messages of thanks, words of wisdom and encouragement during the pandemic. We LOVEreceiving these photos and sharing them in this update and on our social media channels. Just a quick reminder that if you are taking a photo to send to us, be sure that you and/or your colleagues are practicing social distancing. We know it’s natural for people to huddle up (or run away!) when there’s a camera around so ignore the urge to huddle and keep some distance between you and/or your colleagues. Also, remember to have the consent of those in the photo if you’re sending a photo for this update or for use on our social media channels.
Hearts for health care
We’ve been hearing some truly positive and up-lifting stories these past weeks, and we wanted to take this opportunity to share some of them with you. From NSHA and everyone across the province, thank you for all that you do.
“I realize with everything going on, that you have a lot on your plate… and I know all of our staff that are here are going above and beyond, however I would like a spotlight shone on our housekeeping staff and their managers. When we think of the tasks they are required to do on a daily basis, most people would have a hard time doing. Now in the midst of the pandemic, the same staff, are still doing everything within their power to ensure we have a clean, safe workplace to be able to still do our jobs and to be mentioned, their manager could be working from home, but is in everyday to provide the support and logistics that is required. They are providing front line care to the first degree! And hopefully when this all passes, their efforts are not forgotten.”
“We thank you for sticking with us during these stressful times, in spite of your risks. We wish you good health and hope we don’t need to visit you at the emergency.” [Rae]
“I just want you to know that everyone ‘behind the scenes’ of long-term care are very much appreciated. We know you are working 24/7. This long-term care resident has a message of thanks. Please feel free to share her message with your teams. Thank you from our residents at Rosecrest Communities!”
Additional information
As a reminder, staff and physicians can engage a trained interpreter via Language Services to support patients and clients who do not speak English fluently or understand it fully. VisitLanguage Services for tools and information that will help you determine when and how to access an interpreter.
For up-to-date information, please visit NSHA’s coronavirus intranet page.
Questions can be directed to @email.