COVID-19 Update

Please Note: Our knowledge about best practices for COVID19 is changing all the time as new information becomes available. Please refer to our most recent update for the most up to date information.

Dear Patients,
I wanted to update you further regarding the COVID19 pandemic, provide you some important feedback, and give you a sense of where we need to go from here. I will begin again with a summary of key points, with the details following.
 
Summary

1. We are now well set up for providing care for you EITHER by video, or telephone (we prefer video, but both are available).
2. We ARE available for you, and if you have a health concern, do NOT keep it to yourself. We want to know, and you should NOT be afraid that you are troubling us, or that we are too busy. Our capacity is good, and we want you to tell us about health issues as they come up.
3. Continue to stay home nearly all the time! It may be a bit soon to say still, but there seems to have been a leveling off in BC of new serious cases. This is working. Let’s nail it!! (by staying home)
4. Homemade masks are controversial, but an option (details below). You should NOT be wearing medical grade masks, such as surgical masks, and especially N95 masks. We are happy to discuss specific cases/any questions as part of a telephone/video appointment.
5. If you have routine lab work that is due, please contact us FIRST before you go in, so we can decide whether it can be deferred. We will determine whether it’s safer for you to stay at home.
6. For either video or phone appointments:
   1. Be sure to have your phone on and nearby for EITHER type of appointment
   2. Be sure that your phone is not set to block unknown numbers
   3. Ensure you are completely set up for a video call the day BEFORE your appointment
   4. Log in to the video platform 5 minutes BEFORE your appointment 
   5. Be patient if we don’t come on right away. Just like at the office, there is sometimes a wait. If we think there is a technical issue, we WILL call you. Every time.

As most of you have noticed by now, we have quickly completely re-organized our offices capabilities. We are now able to provide video appointments or telephone consults as needed. You may book these using our online booking site, or simply call the office to book an appointment. Please do NOT show up at the office if you do not have a booked appointment. Always call the office first. Any patients who do have appointments at the office, will likely have some very specific instructions to follow. Your cooperation with this is essential so that we can keep everyone safe.

We have noticed a lot of feedback from patients expressing concern about ‘bothering us unnecessarily’. Everyone is afraid that we are getting overwhelmed. Your concern is of course much appreciated, and touching. At the same time, we want to emphasize, very clearly, that if you have a health concern, do NOT keep it to yourself. We want to know! We CAN handle the load we have. There are some growing concerns that in a number of places in the world, patients are desperately trying to avoid overburdening the system. While this is perhaps valiant, evidence is
starting to show that this is leading to unintended poor outcomes. Italy for example reports a large number of deaths of people in their homes who were not diagnosed with coronavirus. It is not completely clear what this is from – it could be undiagnosed cases of coronavirus, but there is a significant concern that it is non-coronavirus health issues that were left unattended, leading to deaths. So please get in touch with us AS issues arise. Do NOT wait. Waiting can unquestionably lead to conditions that become MORE complex to treat and actually add burden to the health care system rather than lessening it. Furthermore, if everybody keeps waiting on everything, when physical distancing rules do finally relax, we may be facing a real tsunami of concerns. Let’s keep attending to issues as they come up. This doesn’t mean we will be sending you for tests where that creates an inappropriate risk. We will use careful judgment for this. Also, we will let you know, and find a way to adapt, if we start getting overwhelmed. We may tell you the issue can wait, but let us use our clinical judgment to guide you, and ensure something serious isn’t missed! It’s what we’re there for.
 
So how are we doing with the pandemic? We want to be cautious about jumping to conclusions, but there are definitely some good signs for the situation in BC. The number of patients getting hospitalized has been stable. If the number of admissions start to drop over the next week, this will be a very good sign. We are hopeful for this. The Health Ministry is currently expecting the current physical distancing measures to remain in place for some weeks to come. It remains very difficult to predict how long this may be necessary. Keep staying at home. Go out only when
you really really need to. If you go for a walk/some exercise, keep at least 6 feet away from others ALL the time. Try not to touch anything. Wash your hands when you get home (and consider bringing hand gel with you if you expect to have to touch things while you are out). It looks like this may be turning in the right direction, so lets keep it up!!
 
What about masks? Well, this has certainly been controversial. The World Health Organization and the USA CDC have updated their recommendations to recommend wearing homemade masks when you are out. Many are taking this to be a reversal from their previous position, although it’s actually not. The BC CDC recommends wearing a mask IF YOU are sick, or will be in proximity to people who are known to be sick. So what to do? Why is this even controversial? The issue is that the average individual does not use masks properly, and completely defeats the benefit of wearing it. This usually occurs by touching their mask/face while wearing it. In research studies, masks provide very very limited protection to untrained individuals. So basically, it becomes a waste. For this reason, medical grade masks should not be worn by the general public. The recent change in recommendation is specifically regarding homemade masks. These probably offer even less benefit than medical masks to the person wearing it. However, what they can do, is protect other people FROM you.  It has become clear that many people are spreading the virus for a couple of days after they are infected, but before they have symptoms. Wearing any kind of mask, will likely reduce the risk to everyone else. So if you are going to wear a mask, that is the primary motivation. This is only necessary if you are out, and perhaps of greatest value if you need to go into a store. Due to the severe shortage of medical masks, please leave those for health care workers, who are under constant exposure, and are trained to get the benefit of wearing it. What this pandemic is showing more than anything else, is how critical it is for all of us to work as a team.
 
 Lastly, thank-you all for your patience and efforts to enable the video consults to work. While phone consults are available, there is no question that seeing you by video helps us assess your health, and how you are managing. So if you have not set yourself up for video consults, and you have the time, please consider doing so. One way or another, video consults are here to stay. Even when the pandemic is over, video consults are extremely efficient, and save you time, driving risks, parking frustration and costs, and are more environmentally friendly.
 
A few quick but important tips about video consults.

1. It’s important to make sure you are set up the day before. A number of you have started setting your software etc up at the last minute, but then been unable to finish this on time and missed your appointment. Set it up the day before to avoid wasting this time.
   
2. Always set yourself an alert/reminder to login 5 minutes ahead of time. It’s easy to forget when you are at home, and then miss your appointment.
   
3. Please be patient if we don’t immediately connect. We can see if you are logged in from our side. Just like in the office, we may still be busy with the previous patient. If we sense there is a technical issue, we will call you.

​That is all for now. Keep well, and we’ll update you again soon!