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 provide you a further update on COVID19. The changes we are undergoing are happening fast. We will continue to update you and try to keep you informed, and to help you understand how best to work with us on your care.
 
Canada is beginning to adopt some aggressive measures to limit the spread of this virus. Other countries are being much more aggressive still. We are getting very frequent updates from our public health department (sometimes more than once a day). We are very actively monitoring numerous other sources of information on how to manage this. As a team, all the physicians at North Shore Medical Group are actively engaged and communicating with each other to optimize our collective approach.
 
There are three key recommendations you need to follow:

1. Take social distancing seriously. Other countries are suffering a lot, largely because this step came too late. The time, is right now. At our office, we will be making much more extensive use of video consultations to enable this, beginning immediately. More details on this below.
2.  It is absolutely critical that if you will be coming in, and have ANY infectious type symptoms (this includes ANY of the following: fever, cough, shortness of breath, runny nose, body aches, sore throat, or even diarrhea), then you MUST call the office on the phone before you come in. We will likely have you wait in your car, or in an open space outside the office until we have a room clear for you. We have had a few patients tell us after they are already in the room that “I’m here for a refill, but by the way, I’ve also had a cough”. This is absolutely unacceptable, and puts us, our staff, and other patients at risk. Always, always call.
3. Be aware that most people will not be getting swabbed/tested for this. Those with mild illnesses should self-isolate at home. We have specific testing criteria, and will not be doing tests ‘on-demand’. The criteria are, respiratory symptoms in those who are:

• Hospitalized, or likely to be hospitalized
• Health care workers
• Residents of long term care facilities
• Part of an investigation of a cluster or outbreak.

 
As we have told you previously, the majority of people have a mild illness and fully recover at home, this should not be taken to mean that this condition is benign. The other 20% of cases are severe. Many patients are in the ICU. While older patients with other health conditions are more at risk, France is reporting that right now, 50% of the patients in the ICU are under the age of 50. Countries are not putting themselves under ‘lockdown’ and destroying their economies for fun. People under the age of 20 continue to fare well, with only 2 serious cases reported world-wide, so
parents should not panic about the well-being of their children who are sick. Young people with the illness can spread it around however, and this can be critically dangerous for other people. So social distancing for everyone is very important.
 
With all that in mind, we are going to be making video consults widely available for the coming weeks. Video consults are very useful whenever a physical exam is not needed. The most likely time a physical exam is needed, is when you have a new, or worsening symptom. However, there is a lot the can be done by video, including reviewing most results, most follow up visits, many refills (which are really about reviewing the health condition the refill is for), and more. Staff will be strongly encouraging video consults instead of an in-office ones. We will be quite liberal with these for the next while, and at worst, if it is determined during a video consult that a physical exam is needed, we can bring you in at a separate time for this. All this will keep the office environment safer for when you do have to come in. The online booking system will gradually start showing many more video consult slots in place of in-office ones, over the next 24-48 hrs. Some in-office spots will remain available each day.
 
Lastly, for the short term (probably about 2-4 weeks, but it is hard to tell), we will be deferring all routine (annual) checkups, and paps. Children due for checkups will have a video consult as an initial visit, and it will be determined whether a subsequent in-office visit will be done. We will be ensuring their vaccines are kept up to date, as vaccination should NOT be delayed with this.
 
If you have not already created a Medeo account:
Please go to www.medeohealth.com, click ‘sign in’ at the top right, then click ‘patient’ on the next screen, then click ‘create account’. Once your account is created, you may then call the office to book an appointment, or use our
online booking site https://booking.medeohealth.com/north-shore-medical-group/. Make sure you pick “video consult” for appointment type. You will receive an email confirmation once the appointment request has been
accepted.
 
A few very important steps for a video consult:

1. Please sign in to Medeo 5 minutes before your appointment time. 
   1. Click the ‘start appointment’ button.
   2. Check the information shown, scroll down and click ‘Continue’.
   3.  You will now have an audio/video check, if all looks well, click ‘continue’.
   4. If you have done everything right, you will see a split screen, with yourself on 1 half, and black, or a message stating “Waiting for the provider” on the other. Please be patient. When the doctor is ready to see you, they will appear. Just like in the office, sometimes things run behind, and you may have to wait a bit.
2. If you are using a computer for the video consult you MUST use Google Chrome as your browser. DO NOT click on the link in the confirmation email and assume it opened in Google Chrome. Open Google Chrome from your desktop, go to www.medeohealth.com, and sign-in that way.
   
3. If you are using a mobile device (smartphone, iphone, ipad, etc), you MUST use the free Medeo app, which you can download from the Apple or Google store. You cannot use any browser on your phone.

We will continue to send you additional updates as we go along. I am hoping to provide some anticipatory guidance on what to expect with this situation, and when we will know if it is resolving. I will try to do that in the next couple of days.

Keep well, we will get through this! While it is a dramatic change in our way of life in the short term, and the effect on the economy is profound, Canada has an opportunity to fare far better than many other countries have. We can (and will) overcome this, and it doesn't have to take that long.