In today’s message you will find:
- COVID Update
- Changes to Prescribing Paxlovid
- Don’t miss today’s AGM!
- Fighting Red Tape for Doctors
- Join us at PRIDE, June 5
- Order your Pronoun cards
- US Mass Shootings
- CME Grant Deadline soon!
- Changes in swabbing protocol
- Fantastic Physicians
- ICYMI — recent updates
- Upcoming Events
Public Health now posts weekly COVID-19 Surveillance Reports on Thursdays. This week’s report, which is again showing“decreased activity,” covers the week ending May 14. Highlights include:
- Severe outcomes from COVID-19“decreased compared to the previous week.” There were 149 hospital admissions, down from 213 the week before. Hospital admissions have trended down the last couple of weeks, peaking most recently at 264 the week ending April 16. This includes 16 ICU admissions, up slightly from 14 the week before.
- There were 16 deaths recorded, down from 26 recorded the previous week. There have now been 1,913 deaths related to COVID-19.
- There were 728 lab-confirmed cases reported in Manitoba over the week, down from 902 the previous week. The test positivity rate was 18.5%, up slightly from 17.6%
Updated wastewater monitoring trends were also released, with data ending May 2. The monitoring continues to show ongoing COVID-19 activity but with“a decrease in activity” according to Public Health. A new wastewater surveillance dashboard, however, shows more recent data that finds an uptick in Winnipeg’s South end, but not in the North or West end surveillance.
Doctors Manitoba has seen fewer physicians reporting isolation or illness due to COVID-19 over the last two weeks. If you miss work due to COVID-19, please review our Physician Isolation Support Benefit and apply if you are eligible.
As Manitoba is in a 6th wave, it is important to reinforce with patients the need for continued precautions. You can refer patients to our resource, NewCOVIDNormal.ca.
Webinar on Vaccine Safety (Watch Anytime)
The COVID-19 Immunity Task Force recently held a webinar on vaccine safety, which is available to watch anytime online. The study looked at results of ongoing vaccine safety monitoring in Canada and details of serious adverse events.
The researchers found that of the 82 million doses administered in Canada (as of April):
- Adverse events following immunization: 0.054%, though the vast majority were classified as “non-serious”.
- Serious adverse events following immunization: 0.011%
Watch the webinar for more information about vaccine safety, the types of reactions and adverse events among adults and children.
Important Paxlovid Prescribing Changes
Shared Health announced changes yesterday that would allow physicians to prescribe Paxlovid for eligible patients, replacing the need to complete and fax a lengthy referral form. The change is effective this Friday, May 20, meaning physicians can start prescribing then. The existing referral process will remain in place until June 1 in Winnipeg to offer a transition period for physicians not yet ready to prescribe.
We have a summary of the changes for you below, a link to key resources, and we’ve arranged for a webinar to offer rapid education on the change.
→ Join a short webinar this Friday, May 20, at 12:15PM to learn more about Paxlovid and prescribing. A recording will be available after for on-demand streaming. See details below.
What is changing?
In a memo released yesterday, Shared Health confirmed that effective May 20 (this Friday), the following changes are being made to improve access to Paxlovid for Manitobans, as COVID continues to circulate in Manitoba:
- Physicians will now be able to prescribe Paxlovid rather than being required to complete a referral form and obtain approval. The referral process will remain in place until June 1 as a transition.
- Participating community pharmacies will begin dispensing Paxlovid. A list of participating pharmacies will be maintained on this government web page. Pharmacists have been asked to support physicians as needed in assessing complex drug interactions.
- Paxlovid will continue to be available for free. Further, Manitoba Health coverage is not required for dispensing.
What is not changing?
- COVID treatments continue to be time sensitive, so prompt prescribing and dispensing is vital to ensuring treatments are as effective as possible.
- Centralized referral is still in place for Remdesivir, which requires infusion. The Remdesivir referral form is available here.
We’ve worked with Paxlovid experts in Manitoba to plan a webinar to support physicians with the change to prescribing.
Up until now, Paxlovid was distributed in Manitoba using a centralized approach, requiring referrals rather than prescriptions. Starting Friday, May 20, access to Paxlovid will be expanded to allow more prescribers to write prescriptions for patients who meet the eligibility criteria for Paxlovid. In addition, dozens of community pharmacies have agreed to screen for drug interactions and dispense Paxlovid to patients.
This webinar will review the new process for expanded access for Paxlovid and patient eligibility. The webinar will provide an overview of Paxlovid and information needed to prescribe it safely, including indications, mechanism of action, dosing, supportive clinical data, contraindications, use in pregnancy and breastfeeding, adverse effects and drug interactions. Practical tips for prescribing Paxlovid will also be provided. A Q&A will follow.
Our Panel includes:
- Dr. Grant Goldberg, a family physician who also serves as the community COVID Medical Lead in Winnipeg and Site Medical Lead for ACCESS Fort Garry.
- Alfred Gin, PharmD, who works as a clinical pharmacist at HSC specializing in infectious diseases.
- Coralie Buhler, a nurse practitioner who is the clinical operations lead for primary health care in Winnipeg and part of the COVID-19 incident command team.
→ Join us live this Friday, May 20, at 12:15PM. If you can’t join live, a recording will available early next week for on-demand streaming.
COVID Treatment Resources
Shared Health maintains a resource page for providers about COVID treatments. Below you’ll find quick links to some of the resources on their page, as well as other resources that may be helpful.
- Clinical guidelines to support clinicians in determining appropriateness of Paxlovid therapy for their patients (Shared Health)
- Patient Fact Sheet on Paxlovid (Shared Health)
- Paxlovid Drug Interactions (Shared Health) — There are numerous potential interactions. Some EMRs (e.g. Accuro) have been updated with Paxlovid, but be sure to confirm with your EMR vendor. Pharmacists have been requested to support prescribers in assessing potential drug interactions. You can also access the Liverpool COVID-19 Interaction Tracker for more information.
- COVID treatment options (Shared Health) — see a quick overview of the differences between Paxlovid and Remdesivir, and see a more detailed overview of treatment recommendations for inpatients and outpatients.
- Ontario Science Table Paxlovid ‘need to know’
Join our AGM at 5PM Today!
It’s our 114th Annual General Meeting today (Thursday) at 5PM. You can join in person or virtually. The AGM is open to all Doctors Manitoba members. You will hear our current President Dr. Kristjan Thompson’s farewell message, a year-in-review update from CEO Theresa Oswald, the unveiling of our new President-Elect, and other important updates. Details and reports will be posted online here.
- Attending In-Person - As a member, you can attend in person with no advance registration. The AGM will be held in the Presentation Theatre, on the 2nd floor of the RBC Convention Centre (old, North building).
- Joining Virtually or By Phone - If you would like to register to join us virtually instead of in-person, you can register here in advance.
Fighting New Red Tape for Doctors
Thank you to the many physicians who took the time to submit their concerns about the provincial government’s proposed Records Keeping Regulation. Doctors Manitoba submitted a comprehensive position explaining how the regulations appear singularly focused on making the job easier for physician billings auditors, and more difficult for physicians. With no apparent benefit to patient care, the new regulation appears to create more administrative burden, or red tape, for physicians, meaning more time for paperwork, and less time for your patients and family.
Our President, Dr. Kristjan Thompson, has also contacted the government to express physicians’ concerns. You can see his letter here. We are remaining hopeful they will withdraw the regulation, but we are preparing to escalate our advocacy if they do not.
You’re Invited to the Pride Parade!
Doctors Manitoba will be joining the Winnipeg Pride Parade this June, for the first time ever, and you’re invited to join in!
The Pride Parade celebrates the diverse community that supports LGBTQ2S+ (lesbian, gay, bisexual, transgender, queer, and two-spirit) people. This year is the 35th Pride event and Winnipeg is also hosting the national Fierté Canada Pride parade.
The Doctors Manitoba Board is supporting Doctors Manitoba’s participation to support physicians and learners who identify as members of the LGBTQ2S+ community, and to demonstrate doctors’ commitment to allyship and inclusiveness.
Support Inclusiveness: Order Pronoun ID Badges
You can now order a special pronoun badge extender, which hangs behind your work ID badge to display your pronouns.
A physician displaying their pronouns is an important display of allyship and fosters an open and inclusive environment for your patients, especially transgender or nonbinary people. Sharing or displaying your pronouns can be especially impactful in making people of all genders feel safe and welcome.
Adding pronouns to email signatures, name tags, and business cards helps normalize the importance of using correct pronouns. That’s why Doctors Manitoba has created these new ID badge extenders. Inspired by the Civility Saves Lives pronoun campaign for medical learners, and in support of fostering a more inclusive environment for members, their colleagues, and their patients, we are offering all physicians and medical learners a free pronoun badge extender to wear behind other ID tags. The extender also provides quick QR code access to important physician and learner health programs.
A recent Institute for Healthcare Improvement article focuses on how gender-affirming language, like using proper pronouns, can improve psychological safety and patient care. In the story, a patient explains that “using more inclusive language won’t harm your average person… but it will mean absolutely everything to someone like me.” They explain how simple actions like doctors using correct pronouns translates into better care. “I feel comfortable telling them the truth. I feel safe enough to talk to them.”
US Mass Shootings
There have been another series of mass shootings in the US over the last week. In California, a physician intervened during a shooting at a church just south of Los Angeles, losing his life trying to stop the assailant. Dr. John Cheng, 52, was killed on Sunday. A local sheriff said Dr. Cheng’s actions likely saved the lives of nearly a dozen people.
This followed another mass shooting in Buffalo, New York, on Saturday where 10 Black people were killed, and others injured, in a racist attack that the assailant live streamed on social media.
Dr. Marcia Anderson, Vice-Dean, Indigenous Health, Social Justice and Anti-Racism, Rady Faculty of Health Sciences, sent a message to faculty and staff about the Buffalo shooting, reminding them of how incidents like this in another country can have traumatic impacts here in Manitoba. This is also a valuable reminder for physicians as you provide patient care.
“We need to be aware of, understand and support people in our community who may experience this as a collective experience of grief and trauma,” Dr. Anderson noted. “We need to be cautious about assuming people will be ready or want to engage in conversations about this: ask for consent first and accept “no” without requesting further explanation. We may falsely assume that this could not/has not happened in Canada, that anti-Black racism is somehow not as bad on our side of the border. This is factually incorrect, and erases experiences of anti-Black racism in our country, province, city and university. This perspective can cause further harm.”
An important recent research article, suggested by Dr. Anderson, looks at how racial trauma occurs, even in Canada, as a result of an event of racism or cumulative events over time causing stress and mental health concerns.
Doctors Manitoba joins with the broader medical community in offering our support to the family of a physician lost too soon. We condemn these mass shootings and the racism that too often causes them, and stand with the families and communities left grieving.
Group CME Grant Deadline is Coming
We have introduced a new grant initiative, offering up to $20,000 for projects that deliver continuing medical education to a group or team of physicians in Manitoba. Any eligible physician in Manitoba can apply.
The first call for grant applications is now open, with applications due by May 23, 2022.
The grants can cover eligible expenses for accredited education that occurs in Manitoba before the end of 2022. Funds can be used to cover accreditation costs, speaker fees and accommodation or travel or other expenses necessary to deliver the education to a group or team of physicians.
You can learn more about the new CME grant initiative here, and contact Barry Hallman at firstname.lastname@example.org for more information.
Changing Swabbing Protocol at Shared Health Labs
Shared Health has issued a change to the type of swab used for most tests submitted to Shared Health Clinical Microbiology Labs. Starting May 30, labs will no longer accept red top Copan M40 swabs for most tests where a swab is appropriate. Instead, the Copan eSwab should be used instead in most tests where a swab is required. This change does not include Cadham Provincial Lab. See the full Clinical Practice Change bulletin from Shared Health here.
Congratulations to Doctors Manitoba outgoing President, Dr. Kristjan Thompson on being awarded a Canadian Association of Emergency Physicians (CAEP) Physician of the Year Award.
Dr. Denise Koh was distinguished as one of the Top Women in Safety in Canada. As the Chief Occupational Medical Officer (COMO) for Manitoba since late 2014, she has helped steer the province’s pandemic response and ensure workers are as healthy and safe as possible. Dr. Koh uses her occupational medicine and public health expertise to perform workplace health risk assessments, recommending measures to minimize risk and optimize wellness at work and is known as “The Workplace MD.” Congratulations Dr. Koh!
Congratulations to Chief Medical Officer for St. Boniface Hospital, Dr. C. Scott Brudney on receiving his CCPE designation.
Dr. Lisa Monkman received an MCFP Award of Excellence for her work improving the quality of care for rural Manitobans and the Indigenous community with her career in Family Medicine, teaching, community care, and service to the structurally disadvantaged. Congratulations Dr. Monkman!
Congratulations to Dr. Camisha Mayes on her MCFP Award of Excellence. Dr. Mayes is committed to the structurally disadvantaged populations that she serves and much of her work is focused on the Downtown/Point Douglas population in Winnipeg.
The Elemental Professional Health Centre, lead by Dr. Stanley Eng, received the MCFP Dr. Gary Beazley Patient’s Medical Home Award. Congratulations Dr. Eng and team!
Dr. Myron Thiessen won the MCFP Family Physician of the Year. Before his retirement at the end of 2021 his leadership has helped many physicians make IERHA their home and brought the community of IERHA physicians to work together collaboratively. Congratulations Dr. Thiessen.
In Case You Missed It
Here are some important and popular recent updates, in case you missed them:
- CIHI’s report confirmed growing wait times in Manitoba.
- A case of severe acute hepatitis in children was found in Manitoba last week. Get more details.
- There is an updated version of the endoscopy referral form.
- A reminder we have created a new COVID-19 Testing and Treatment resource page to help physicians with the transition of testing to primary care. This includes clinical guidance, supply ordering instructions, patient resources and billing information.
- Hospital capacity remains strained across all departments, disciplines and programs.
- Practicing physicians should have received your 2021 CME Expenses email or letter last week.
- The Price of Advocacy: Sowing Moral Courage in Medicine — May 24, 2022 — Learn more and register.
- Choosing Wisely Canada’s National Meeting May 25 & 26 — Register now!
- Leadership Through Connection — Perspectives from student, resident and late career physician — May 30, 2022 — Learn more and register.
- Legends of Pride Virtual Series — May 30 (Phil Graham he/him), May 31 (Syndee Thibert she/her), June 1 (Barbara Bruce, O.M. she/her), June 2 (Shandi Strong she/her), and June 3 (Allen Morrison he/him).
- July 5th is National Injury Prevention Day — Learn more and help spread awareness.