COVID-19 Primary Care Information Session Q&A | March 17

COVID-19 Primary Care Information Session, Q+A Summary | March 17

  • Dr. Dee Hoyano, Medical Health Officer
  • Dr. William Cunningham, Department of Primary Care Head
  • Dr. Steve Goodchild, Medical Director of Primary Care
  • Shelly Tice, Interim Director of Primary Care

There are two sources of information to go to for COVID-19 updates, the BC CDC website and the Island Health medical staff website. Both are updated daily as the information is changing by the minute, in particular screening guidelines and testing recommendations.

Who are we testing?

Please always go to the medial staff website for the latest updates of the screening criteria. We are focused on testing high-risk people: People who are hospitalized or at-risk to be hospitalized, health-care workers, emergency care workers and support staff that keep our system going, residents of long-term care facilities, and people who are part of an investigation of a cluster or outbreak. Screening criteria may change everyday as it is fine tuned. Specific guidelines will be coming out for specific medical indications.

We are now in pandemic. People with mild symptoms will not be tested and should self-isolate for 14 days. This is our most effective tool and medically safe to do.

Health-care workers (who provide essential patient care) returning from travel do not have to self-isolate, they must self-monitor and use PPE. They should reduce social contact in their practice as much as possible.  If a health-care worker develops symptoms, they should immediately leave work, self-isolate and seek testing if they cannot remain off work for an extended period of time.

What are we doing about limited physician capacity?

We acknowledge that this may be an issue and are encouraged to be contacted by retired physicians to offer to help out. Please contact your local Division of Family Practice to volunteer. Volunteers may be needed to help at screening facilities, fill-in at GP offices where our colleagues cannot work or virtual clinics.

Is there a swab shortage? Why aren’t we testing more?

We have finite capacity at our labs and are trying to scale up capacity. We cannot test everyone who has symptoms and it is not medically indicated except for small numbers of patients where it will make a difference to outcomes. We will follow clusters as directed by public health and test those people. The majority of people will have mild symptoms and they should self-isolate.   

The screening clinic in Victoria has been open since March 11, 2020.  Screening clinics are planned for Cowichan, Nanaimo, Campbell River, Comox, Port Alberni. These will open very soon, will be by-appointment, and volumes can be scaled up and down quickly. There will be an island-wide 1-800 number available to access those clinics very soon.  In communities where there will not be screening clinics other local arrangements will be made.  Contact your local medical leader.

Why isn’t the public informed of cases in each community?

We are considering adding a section on our medical staff website that will list daily case counts and locations. Patient confidentiality is important and details will not be shared in smaller communities.

When should a GP not work?

If you have respiratory symptoms of any kind, you should limit social contact and you should stay home until tested. This is an evolving situation. Health-care workers will get expedited tests at screening centres in such situations, with results in 24 hours.

What is done with positive COVID-19 patients?

People with positive test results are contacted by public health, their contact history is examined, they are instructed to self-monitor at home, and have home health monitoring daily by our island-wide HHM service. Also, please note that the regular home health monitoring continues exactly like before.  

How do we get PPE supplies?

The province now manages PPE inventory; there is a shortage of PPE supplies. The backorder is significant. We must use our current supplies diligently and still remain safe.

What do we do if we run out of PPE and cannot test?

Community testing sites will be set-up shortly. Island Health is working to solve this problem especially in areas that will not have screening centres. Remember, if patients are really sick they need to go to emergency departments.

How do I shift my WIC practice?

See medical staff website for principles and ideas.  Wherever possible, try Virtual Care.  Billing for this service has changed (e.g. Telephone consults can be billed as Telehealth visits and there’s no limit to the number of daily telehealth visits one can bill). See the Doctors of BC page for more information.

What are we doing for the homeless?

Public Health officials have met with shelters and there are a variety of communications coming from BC Housing, but this is a challenging group. The main challenge is asking someone to self-isolate in a shelter. Island Health is working on this.

Which Telehealth platform should I use?

A Provincial task force is working on solutions through Doctors of BC and Island Health. More details will be announced soon. See the Doctors of BC page for more information.

Why do the testing sites require referral from GP?

To make sure that the screening criteria are met.  See daily update on the medical staff website.  By doing so, this significantly increases the screening of the correct people and minimizes screening of people who should be self-isolating at home.   

Please always go to the medical staff website for information and updates.