COVID19 UPDATES: Returning to school in the Maritime provinces

Vendredi, Septembre 25, 2020

 

Returing to school in the Maritime provinces:  Guidance for children who are immunocompromised from the IWK Health Centre

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3 May 2020

Dear Colleagues,

COVID update. Division of Pediatric Hematology Oncology, IWK Health Centre.

I hope this finds you all well and coping with the tremendous changes that have overtaken our health care system over the last two months. This note is an update to my previous communication about 4 weeks ago.

  1. The Division of Pediatric Hematology Oncology continues to accept referrals and see urgent and semi-urgent patients under the rules established by the IWK Health Centre.  At the present time, restrictions on seeing less urgent patients are in effect until the end of May. These restrictions are being reassessed on a regular basis.
  2. Children who screen positive for COVID symptoms who are scheduled for a visit or procedure at the IWK should be discussed with the oncologist on call.  All patients with COVID symptoms must have a negative COVID swab prior to undergoing a procedure that requires sedation.
  3. To reduce the risk of COVID to our clinic health care providers, the offices have been restructured and most of our out-patient nursing staff and oncologists are rotating between working at home and at the hospital. They will continue to respond to voice mail and emails. 
  4. We have developed an active telehealth program and will continue to “see” suitable patients by phone or videoconference.  Please direct patients to the Zoom Telehealth information sheet on the APPHON website.
  5. We have encountered several patients with delayed presentation of their illness for fear of coming to a health centre with possible COVID illness in the institution. Please take the opportunity to remind patients not to delay in presentation with concerning symptoms or fever.
  6. There has been conflicting advice from a variety of organizations regarding vaccines. The IWK Infectious Disease and Hem/Onc services recommend that children should continue to receive their vaccines as close to on schedule as possible. 
  7. As day care and school setting begin to open in the Maritimes, the present recommendation from the IWK Infection Control and Infectious Disease services is that immunocompromised children should NOT be going back to day care or school even if these settings are open to the general public. Advice on this issue will be updated as available.
  8. The resources document has been updated with information directed at patients, working parents and health care professionals; posted on the APPHON website. For those who may require professional assistance the Canadian Psychological Association is providing free care for front line health care professionals:  https://cpa.ca/corona-virus/psychservices
  9. We will continue to provide out of province patients with a travel letter to assist them in crossing the provincial border. 
  10. At the present time, the one care giver rule remains in effect at the IWK. Only one caregiver may accompany the child into the hospital for out-patient or in-patient services.
  11. All patients should enter the IWK through the University Avenue Women’s site entrance. Free parking remains in effect.
  12. Please continue to reach out to myself, Elizabeth Schurman (Hematology Oncology service manager) (Elizabeth.schurman@iwk.nshealth.ca) or Carol Digout Executive Director APPHON (carol.digout@iwk.nshealth.ca), if you have any regional concerns that may impact the care of the pediatric hematology oncology patients we serve. 

Updated Resources:

a. IWK Screening Questions (17April)

b. Coping with Covid for Cancer Patients

c. Patient information Zoom Telehealth 

d. Algorithm for managing immunocompromised patients with fever - updated (3 May 2020)

e. Resources for Families and Health Care Providers - updated (3 May 2020)

Best wishes,

 

Conrad Fernandez MD, FRCPC

Professor and Head

Pediatric Hematology/Oncology

IWK Health Centre and Dalhousie University

5850 University Avenue

Halifax, NS, B3K 6R8 Canada

office: 902-470-6839

fax: 902-470-7216 (administrative)

fax: 902-470-7208 (clinical)

conrad.fernandez@iwk.nshealth.ca

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6 April 2020

Dear Colleagues,

Memo: COVID Service Delivery Planning

Two messages:

A.  Service Delivery.  We recognize that COVID related challenges to health care delivery will continue to evolve in the coming weeks and months.  The IWK pediatric hematology oncology service will continue to support the diagnosis, management and follow up of all pediatric hematology oncology patients with our Maritime regional partners.

Please let us know as soon as possible if the ability of your centre or clinical practice is changing for any reason, in particular during the COVID-19 pandemic. 

For minor patient protocol related issues: These can continue to be discussed with the patient’s Family Care Coordinator.

For major or anticipated ongoing changes: Please contact myself, Elizabeth Schurman and/or Carol Digout at APPHON to discuss what changes are needed.  It may result in a temporary change in your Levels of Care Designation.  We will inform the Family Care Coordinators and IWK physicians of these changes so planning can be put into place in a timely manner. 

We will strive to have the patient cared for in the appropriate Levels of Care environment but to also avoid unnecessary travel for the patient. Depending upon travel restrictions and community spread, this may include care at another designated regional center or travel to the IWK.

The IWK is very much planning and willing to accept children for care as long as we have capacity but early planning will be enormously helpful.  

B.  Support persons.   The IWK has implemented a strict one support person policy for pediatric patients coming to the out-patient clinics AND for in-patients, as well. The designated support person is not allowed to rotate with others. This includes one person only for patients with a new diagnosis or relapse.  There will be exceptions only under rare circumstances approved by leadership. 

 

Please contact us if you have any questions.  Contact information below:

Conrad Fernandez MD, FRCPC

Pediatric Hematologist/Oncologist

Professor and Head, Division of Pediatric Hematology/Oncology

Dalhousie University and the IWK Health Centre

phone: 902-470-6839/fax: 902-470-7208 (clinical)

conrad.fernandez@iwk.nshealth.ca

 

Elizabeth Schurman BScN, RN, MN

Manager, Hematology/ Oncology, Nephrology & PACT

Children's Health Program
IWK Health Centre
Tel 902-470-6378 | Cell 902-229-8739
elizabeth.schurman@iwk.nshealth.ca

 

Carol Digout, Executive Director APPHON/ROHPPA

IWK Health Centre – Room 610/6 Link

5850/5980 University Ave, Halifax, NS  B3K 6R8

Phone: 902-470-7429  Fax: 902-470-6510

carol.digout@iwk.nshealth.ca

www.apphon-rohppa.com

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March 27, 2020

Dear Maritime Colleagues,

This is a follow up note with the Pediatric Hematology Oncology COVID Pandemic Response Plan.

We continue to provide ongoing care for all urgent patients and patients on chemotherapy.  It is important to continue rapid assessment and treatment of patients with fever and possible neutropenia, or possible hyposplenism.

The attached documents describe in detail our plans for out-patient and in-patient care.

We will be cancelling non-urgent patients for the next three weeks but will be doing telephone visits with them in the meantime and coordinating with you where it is feasible to do local visits or investigations.  The duration of this will be assessed again weekly.

We have been working closely with Jeannette Comeau, Medical Director, Infection Prevention & Control at the IWK Health Centre.  I have included a number of information sheets we have developed that you may consider adapting for local use after consultation with your local COVID response team. These are considered appendices to the Pandemic Response plan:

1.  IWK Screening Questions Corona Virus (version 23 March 2020)

2.  IWK Algorithm for Triage to Emergency Department (version 17 March 2020)

3.  IWK  COVID Provincial Border Crossing Family Note Template (version 26 March 2020)

4.  IWK  Quick References COVID (version 26 March 2020)

5.  IWK Health Centre PEDIATRIC IMMUNOCOMPROMISED PATIENT (version 26 March 2020)

6.  COVID Resources for Patients and Families

 

We appreciate that the current situation is evolving for all.  These resources will be updated on a regular basis as needed and posted to the APPHON website.

Please contact me  or the oncologist on call if you have any questions.

 

Best regards and safe health to you and your families.

 

Conrad Fernandez MD, FRCPC

Pediatric Hematologist/Oncologist

Professor, Departments of Pediatrics and Bioethics Head, Division of Pediatric Hematology/Oncology Dalhousie University and the IWK Health Centre

5850 University Avenue, Halifax, NS, B3K 6R8

phone: 902-470-6839

fax: 902-470-7216 (administrative)

fax: 902-470-7208 (clinical)