No images? Click here In This Issue - May 2020
MESSAGE: Dr. Andrea Feller, Associate Medical Officer of HealthIn the face of this unprecedented public health crisis, with its social isolation, school closures, income insecurity and uncertainty for many families, the risk of Adverse Childhood Experiences (ACEs) increases. Secondary impacts of COVID-19, such as ACEs, will affect the health and well-being of the Niagara community in the weeks, months, and years ahead. In addition, patients with their own history of ACEs are particularly vulnerable to negative secondary health impacts of the pandemic. Along those lines, I want to share an article by Dr. Robin Williams and Dr. Jean Clinton that offers great insight into the widespread stress and anxiety that many family units are experiencing and how important it is to encourage good mental health among families during this time. Primary care providers are encouraged to continue conversations about ACEs and to link parents and their children to local supports. Reiterating the importance of maintaining social connections during periods of physical distancing, with supportive problem solving discussion, may help mitigate some of the negative impacts of this ongoing pandemic. In this newsletter, you will find further resources and information to help you and your patients to prevent and mitigate the impacts of ACEs. Thank you, as always, for all of your work to support Niagara's residents in health and well-being. UPDATE: Adverse Childhood Experiences During COVID-19As it has been well-established and previously shared, Adverse Childhood Experiences (ACEs) are the stressful and traumatic events experienced during childhood with known long-term and negative consequences into adulthood. ACEs have been categorized into 3 groups: As a primary care provider, trusted by families and parents during this time, you are well positioned to:
For further information relating to ACEs please review the following:
Use the Child & Family Support referral form to connect patients with our programs and services. You can also order Niagara Parents tear-off pads to distribute in your practice to connect patients with a Public Health nurse directly through email, Facebook, live chat, or by phone (905-684-7555 or 1-888-505-6074 ext.7555). UPDATE: Screening and Referring to COVID-19 Testing CentresEffective May 25, Niagara Health opened up access to their two assessment centres to allow for patient self-referrals and walk-in appointments for COVID-19 testing. Their news release can be found here. We recognize that patients talking to their trusted health care provider is the optimal approach; you have relationships with your patients, know their medical history and can best assess their symptoms. All primary care providers can now screen their own patients over the phone and directly refer those who are symptomatic to a COVID-19 testing location. A toolkit is available to support your office in setting up your clinic and notifying your patients, should you choose to offer this to your patient roster. Contact Jennifer.Ryder@niagararegion.ca, primary care & stakeholder engagement advisor for a copy of the toolkit and referral form. Public Health’s COVID-19 Information Line is still available for physicians, health care providers and patients. Please call 905-688-8248, and follow the prompts. UPDATE: COVID-19 Has Slowed Human Activities But Not RabiesRabies was nearly eliminated from the Niagara Region but has since returned. Raccoon strain rabies (endemic in the southern USA) surfaced for the first time in Niagara in 2016, and is now endemic here. Bat strain rabies continues to remain active here too. As it is spring time now, bats are out of hibernation, and young raccoons are venturing out on their own. Rabies will be moving through their populations. As it does, the rabies virus can spill over to other wild animal populations, sometimes to our outdoor pets, and even to us as well. The Niagara Region Public Health & Emergency Services rabies prevention program is fully active through the COVID-19 pandemic. Public health staff are available 24/7 to assist you with your risk assessment, and advise on rabies Post Exposure Prophylaxis (PEP). Wherever possible, in order to minimize the strain on our hospital emergency and urgent care departments, please arrange for any rabies PEP to be done at your clinic or office. For more information, please call 905-688-8248 ext. 7590 between 8:30 a.m. and 4:30 p.m. After hours call 905-984-3694. REVIEW: Information During COVID-19Health Care Provider Frequently Asked Questions During COVID-19 Niagara Region Public Health and Emergency Services continues to closely monitor the COVID-19 pandemic. This is an evolving situation and we continue to update information as it becomes available. Check the Frequently Asked Questions page for Health Care Provider's often for updates. If you have any questions, please call our COVID-19 Info Line for physician's and health care providers. Calls are answered Monday to Friday, 9:15 a.m. - 7:30 p.m. and weekends until 4:15 p.m. Call 905-688-8248, press 7, then press 1. REVIEW: Tips for Managing Tick BitesIdentifying the species of tick during COVID-19 With our offices currently closed to public access, patients can do a few things to have their ticks identified:
If more information is required once the tick has been identified, patients can contact a Duty Officer directly at 905-688-8248 ext. 7590. Tick identification services will resume when our offices reopen to the public. Assess the client for symptoms of Lyme disease Lyme disease has an incubation period of approximately 3-30 days. Symptoms of early localized disease include:
Lyme disease is reportable to the Medical Officer of Health under the Health Protection and Promotion Act. If you have a suspected and / or laboratory confirmed case of Lyme disease, please report it to Public Health. Consider post-exposure prophylaxis Routine use of antimicrobials or serologic testing is not recommended for clients exposed to a tick bite. The Infectious Disease Society of America guidelines recommend that the client should be assessed clinically and if there is no clinical evidence of Lyme disease, prophylaxis can be considered if all of the following criteria are met:
Diagnostics and/or treatment for Lyme disease
Additional Resources
If you have any questions, please contact the Environmental Health program at 905-688-8248 ext. 7330. REVIEW: The Nurse-Family PartnershipThe Nurse-Family Partnership (NFP) is an evidence-based home visiting program for young, socially and/or economically disadvantaged, first-time mothers. The home visits are conducted by trained public health nurses and occur throughout pregnancy and until the child’s second birthday. The program goals are:
Participants must be under the age of 25, and less than 28 weeks gestation in their first pregnancy at the time of enrollment. How is NFP supporting participants during Covid-19? During this critical time, public health nurses are connecting with vulnerable young moms to provide support by phone or virtual visits. The public health nurses will also drop off resources to the participants’ front door or mailbox as needed. To refer your patient to NFP, please use the Child & Family Support referral form. For more information, please contact the Program Manager amanda.hicks@niagararegion.ca or Team Lead rose.burns@niagararegion.ca. FREE CME OPPORTUNITY: COVID-19 Academic Detailing Service The Centre for Effective Practice (CEP) is offering free Mainpro+ virtual COVID-19 academic detailing visits! The CEPs' virtual one-on-one educational visits are provided by trained pharmacists and based on physicians’ expressed needs. They cover balanced, evidence-based information on anything from the management of patients with COVID-19 to primary care operations and maintaining a practice in the COVID-19 context. For more information or to sign up for a virtual visit, contact your local academic detailer, silvana.ferrara@cep.health. You can also review the continuously updated CEP COVID-19 Toolkit. For further information on other CME opportunities, please visit our health care professionals site. MEDICAL ADVISORIES & MEMOS Refer to Public Health's Health Care Professionals website to access the most recent medical advisories and memos. Receive medical advisories and memos electronically from Niagara Region Public Health - subscribe here. |