Did you know that?

Are you confused about COVID and all the recommendations that seem to change so rapidly? Chances are your patients may be confused about COVID also. Here is a document, prepared by the OCFP and Department of Family Medicine at the University of Toronto, that clarifies the answers to a number of questions such as those below: Confused about COVID? Family doctors answer your questions | Department of Family & Community Medicine (utoronto.ca)

Do I need a PCR test?
How do I use a Rapid Antigen Test?
What do I do if I have been exposed to someone with COVID?

Hot Topics in Family Medicine:

More on Vaccination: More and more evidence is emerging about how effective the third dose, (booster dose), of any mRNA vaccine is against transmission of Omicron, risk of hospitalization and death. Data from the UK has shown that after two doses of the vaccine there is little protection against becoming infected with Omicron, but three doses of vaccine boost that effectiveness to 60% against infection with Omicron and 90% against infection with Delta. With the third dose of vaccine, you are 80% protected against hospitalization with Omicron and 90% protected against admission to ICU and death. So, third doses matter and the more we can deliver third doses to our patients and to ourselves the better we will all be.

The jury is still out on third doses for 12–18-year-old. Their immunity against Omicron is very good after two doses and a third dose does not boost that very much. So, for now, let’s concentrate on at least two doses for young people and three doses for everyone over 18.

Clinical Assessment Centres, (CAC):

Ontario Health has designated certain assessment centres in various cities around Ontario as Clinical Assessment Centres, (CACs), and are requiring that they see and assess patients, who are suspected or confirmed COVID-19 positive and thus keep them out of the Emergency Room.

Family physicians should be able to manage COVID -19 infected patients with mild symptoms in their offices or clinics without referral to the ER or CAC. However, not all primary care settings are set up to do that and some patients may be more complex such as with co-morbid conditions, immune deficiency, and the elderly. Such patients, depending on symptoms and their individual situation, may need to go to the ER or may be referred to the CAC for assessment and initial management. Helpful guidelines for family physicians have been developed by the Centre for Effective Practice and help to define the options for management of patients seen at the CACs. COVID-19: Clinical Guidance for Primary Care Providers | Centre for Effective Practice - Digital Tools (cep.health)

Following assessment, they may be sent back to the primary care doctor and monitored at home or sent to the ER.

Here in London, the Carling Assessment Centre will become the local CAC. Patients may self-refer or be referred by their doctor by calling 519 685 8500 x 72256

Associate Chief, Family Medicine, LHSC:

I am pleased to welcome Dr. Laura Lyons to role of Associate Chief of Family Medicine at LHSC, effective Feb 1 2022.

Dr. Lyons has served in a number of hospital leadership roles, most recently as the Medical Director, Family Medicine Obstetrics, London Health Sciences Centre; is a member of the perinatal collaborative counsel; the Citywide Department of Obstetrics committee; and the Obstetrics and Gynecology Executive Committee.

In addition, Dr. Lyons is an addiction medicine consultant at London Health Sciences Centre and participates in the Palliative Care and Family Medicine Obstetrics HOCC on call groups at University Hospital and Victoria Hospital respectively.

Chair/Chief Transition:

This Chief’s Notes is the last that I will deliver to you as your Chair/Chief since I am at the end of my term and am retiring from clinical practice in a few days, January 31, 2022.

It has been an honour and pleasure for me to lead the Citywide Department during this past 10 years. I could not have done it without the support and assistance of Sheena Blasing, Administrative Partner, and I am so grateful for her outstanding work. Sheena essentially runs the department, coordinates all our events, including the highly successful Annual Clinical Day, and has an amazing depth of knowledge of the hospital department. Thank you, Sheena!

Finally, I am leaving you in very good hands as the new Chair/Chief, Scott McKay, takes over, effective February 1, 2022. Scott has been the Associate Chair of the academic department and Associate Chief at LHSC, has a deep knowledge of the Department and outstanding leadership skills. He is well connected within the hospital and community primary care. I predict a bright future for local primary care and the Citywide Department of Family Medicine under his leadership.

Thank you for All That You Do:

At this time, I want to acknowledge the tremendous work provided by our faculty members in the Department of Family Medicine. Thank you for the excellent care you provide to your patients, for the excellence in teaching our students and residents, and for those of you engaged in research and quality improvement. Your work is all that more remarkable during the pandemic circumstances in which we are living. I do hope that your strength, resilience, and dedication will carry you through; however, assistance is available if you need it through our department and the medical school. Please contact susan.mcnair@sjhc.london.on.ca or faculty.wellbeing@schulich.uwo.ca for questions or assistance.

As always, I welcome your comments and thoughts @DOCSJW, or swetmore@uwo.ca