COVID-19 – March 10, 2020

This email provides an update on the COVID-19 (coronavirus) situation and offers further guidance to family medicine clinics.

We know physicians across the province have a lot of questions and concerns about getting ready for COVID-19, knowing that Manitoba may confirm its first case any day. We have been raising your concerns with the Minister of Health, Seniors and Active Living as well as senior provincial health officials. While we don’t have all of the answers you seek, we do have several updates in the message below.

Situation Update

At this time, no confirmed cases have been identified in Manitoba and provincial health officials continue to assess the risk of acquiring COVID-19 in Manitoba as low.

Today, the Minister of Health, Seniors and Active Living Cameron Friesen confirmed they have an adequate (60-day) supply of personal protective equipment (PPE) such as masks and other supplies, and he announced they have ordered more through a joint provincial-federal coordinated procurement effort. More information about the types of PPE recommended and how community-based physicians can order supplies through the province can be found below.

The Minister and officials also offered reassurance that they have plans to add more critical care, step-down and other hospital capacity should the situation evolve, and will monitor this closely.

Shared Health and MHSAL are co-leading a coordinated incident management response which includes participation of all regional health authorities. This will ensure rapid assessment and response to the situation as it evolves. We have requested a role for Doctors Manitoba in this structure to ensure physician concerns are quickly escalated and resolved, particularly those who work outside of the RHA system.

You can view the latest memo (Mar 10) to health care providers from Shared Health and MHSAL here.

Where can you get current information and resources?

Please see Doctors Manitoba’s COVID-19 page, which includes links to MHSAL and Shared Health resources for health care professionals.

GUIDANCE TO FAMILY MEDICINE CLINICS

Most family medicine clinics are operated independently from the RHA system and have unique questions and needs. This guidance is intended to connect clinics and family physicians with the information and resources they need to prepare for the potential emergence of COVID-19 in Manitoba.

Clinics should take the following steps to ensure they are prepared:

  • Screen patients over the phone when calling to schedule appointments, and redirect patients who meet screening criteria to your local ED, Urgent Care Centre or COVID-19 Assessment Centre
    • Provincial COVID-19 screening guide
    • COVID-19 testing and assessment locations: patient should go to their urgent care centre, or ED outside of Winnipeg. More information is expected on testing locations in the coming days.
  • If you are directing a patient to another facility for testing please have the client or the clinic call Health Links or call ahead to the receiving facility to ensure proper precautions can be taken.
  • Display signage at clinic door and reception to advise patients with cold or flu symptoms to clean hands and wear a mask. Shared Health has bilingual posters available here and here, and we have requested additional languages that we understand should be coming shortly.
  • Ensure you have personal protective equipment (PPE) on site
    • You can view the equipment and other precautions recommended by provincial officials here, and you can view the standard infection prevention and control manual here.
    • If you need PPE supplies, MHSAL has stockpiled equipment. We have asked for contact information for clinics to use to order and we will share info as soon as we receive it.
  • Ensure all clinic staff and physicians know what to do, including
    • How to screepatients who present with cold or flu symptoms or relevant travel history,
    • How to protect themselves using appropriate protective equipment, routine practices and contact and droplet precautions (see above section on PPE), and
    • Proper protocols to employ following a visit by a suspected or confirmed COVID-19 case. Provincial officials have advised there is no need to close a clinic. We have asked for specific guidance for clinics and will share this as soon we we receive it from provincial officials.
  • Report potential COVID-19 cases to MHSAL using their instructions
  • Review clinic policies, such as cancellation fees, which may actually encourage COVID-19 patients to visit to your office rather than seeking testing and care elsewhere.
  • As an employer, ensure you have a plan in place should staff meet screening criteria as a potential case or your clinic faces a disruption in operations due to COVID-19.
    • Review MHSAL’s tips for workplaces
    • Review tips and information for employers, compiled by Doctors Manitoba
    • Stay tuned for answers to your questions about special billing codes related to COVID-19 testing and treatment, virtual care and disruptions in clinic operations. We have met with provincial officials and hope to have definitive guidance very soon.
  • Stay up-to-date by visiting MHSAL and SH resource pages. You can find links for these on Doctors Manitoba’s COVID-19 page.

We will continue to monitor the situation closely to ensure physicians have the information and supports they need.