What’s new?

To monitor data on a daily basis, see the Nova Scotia and Canadian data pages.

• Further easing of restrictions in long-term care will allow residents to enjoy off-site day visits with family in their homes. Learn more

New federal modelling announced today indicates:

• Modelling predicts up to 155,795 total cases and 9,300 deaths by Oct. 2, unless Canadians remain vigilant by avoiding risks and taking precautions throughout fall and winter
• The reproduction number (Rt) in Canada is trending above 1 nationally and in heavily impacted areas. When Rt is consistently >1, the epidemic is growing
• Incidence has remained highest among young adults since late June
• Rapid detection and response to outbreaks is key to controlling the rate and extent of COVID-19 spread
• Hospitalizations lag behind increases in reported cases but show early signs of increase. COVID-19-related deaths remain low
• Long-range forecast: Canada is at a crossroads and individual action to reduce contact rates will decide our path
• The experiences of other countries show resurgence can exceed the initial wave

Medical appointments for rotational workers
Last week a modified 14-day self isolation for rotational workers came into effect. A rotational worker is someone who has a set schedule where they alternate between living in Nova Scotia and working outside the province, such as an Alberta oil worker. Section 2.4 on Medical Appointments states:

• Rotational workers may attend urgent and routine medical appointments. This includes medical appointments with physicians and nurse practitioners, dentists, optometrists and other regulated health professionals where in-person treatment is required
• Rotational workers must wear a mask and coordinate with their care provider to determine additional precautions. If rotational workers are feeling unwell, they must contact 811 prior to booking an appointment

New T4 codes for 2020 tax year
The Canada Revenue Agency has new reporting requirements for all employers to help validate payments under the Canada Emergency Wage Subsidy, the Canada Emergency Response Benefit and the Canada Emergency Student Benefit.

Now, in addition to reporting employment income in Box 14 or Code 71 on the T4 slip, employers must use the following new information codes when reporting employment income and retroactive payments in a new section of the T4 called Statement of Remuneration Paid:

• Code 57: Employment income paid between March 15 to May 9
• Code 58: Employment income paid between May 10 to July 4
• Code 59: Employment income paid between July 5 to Aug. 29
• Code 60: Employment income paid between Aug. 30 to Sept. 26

For the 2020 tax year, all employers must ensure that the new reporting requirements for the T4 slip are in place. Learn more 

Physicians’ use of social media during the time of COVID-19
COVID-19 has impacted physicians’ use of social media, specifically how they cross boundaries virtually. This study aims to better understand how COVID-19-initiated changes are impacting physicians’ practices and their use of social media tools and platforms. Take the survey

Reminders

CMA Physician Wellness Hub
The Canadian Medical Association (CMA) has launched the CMA Physician Wellness Hub, a searchable collection of nearly 300 resources, tools and studies on topics such as physician burnout, depression, peer support and organizational wellness. It’s also a place for physicians, residents and medical students to connect with colleagues interested in wellness.

Webinars

Doctors Nova Scotia-hosted webinars and physician support sessions via Zoom have ended for the time being.

Seasonal flu and COVID-19
Understand the complexities of seasonal flu during the pandemic and receive an overview of flu vaccine supply and distribution. Join Dr. Shelly McNeil, division of infectious diseases, Departments of Medicine and Pediatrics and Stacey Dunphy, Nova Scotia Health provincial immunization coordinator. When: Tuesday, Oct. 6 from 7 – 9 p.m. Register today

Family medicine in the new normal
Reopening a family practice safely can be daunting. In this session, infectious disease experts Drs. Lynn Johnston and Jeannette Comeau will discuss what is known about COVID-19 in both adults and children, how COVID-19 is the new normal and considerations for safe care of patients in person. When: Tuesday, Oct. 27 from 7 – 9 p.m. Register today

DNS webinar recordings
Check out recordings of previous webinars on the DNS COVID-19 info hub.

ICYMI

Virtual care survey
Nova Scotia Health and the IWK Health Centre are surveying care providers on their experience using virtual care tools made available as a result of COVID-19. The information gathered from the survey will be used in a rapid review study led by Dr. Tara Sampalli (NSH) and Dr. Jordan Sheriko (IWK).  The information collected for the review will help inform future planning as it relates to virtual care. Complete the survey

Special bulletin from Dr. Rob Strang
The revised 811 screening criteria for testing now includes if in the past 48 hours a person has had or is currently experiencing fever or cough (new or worsening) or two or more of the following symptoms (new or worsening): sore throat, runny nose, headache, shortness of breath. Dr. Strang emphasized the need to screen patients virtually for illness before in-person visits and to screen people who should be self-isolating to ensure they are compliant. He also provided information for office-based infection prevention and control. Read the memo

Free personal protective equipment extended until Oct. 31
The Department of Health and Wellness (DHW) is providing community-based physicians and their staff with personal protective equipment (PPE) at no cost until Oct. 31. Click here to submit a request to DHW for PPE. Your organization will be notified by email of the approved supply and instructions for online ordering. For more information, email PPErequest@novascotia.ca.

Physician resilience COVID-19 study 
Drs. Jackie Kinley and John Chiasson provided daily support sessions and webinars to help physicians cope during the COVID-19 pandemic. Physicians are invited to complete a brief survey about the experience to help guide the response for the next wave of COVID-19. Take the survey

Seasonal flu and COVID-19 clinic considerations
Public health has provided preliminary information to help physicians plan to immunize patients for seasonal flu:

• Everyone six-months of age and older is eligible for influenza vaccine
• Vaccine should be available the week after Thanksgiving (Oct. 12) barring any vaccine supply delivery issues from manufacturers. Public health suggests starting the program after Thanksgiving and holding larger clinics towards November to ensure the majority of Nova Scotia’s supply is available. Vaccine could be late and public health indicates the initial supply will be equitably distributed to all providers
• Vaccine will be available from public health over several months (shipments have not arrived yet for the publicly funded program). In the new year, physicians may order vaccine from local public health offices if needed.
• Patients should wait 15 minutes after receiving the flu vaccine in case of syncope (fainting). This must be taken into consideration due to space needed to accommodate social distancing and potential plans for drive-up clinics, where drivers and passengers will need parking space to wait. Consider having family bubbles attend flu shot clinics together so that shots can be administered and they can wait together

Federal recommendations on flu vaccine delivery
The federal government has released guidance for influenza vaccine delivery in the presence of COVID-19.

Addictions Medicine Consult Service
Nova Scotia Health’s Addictions Medicine Consult Service provides rapid addictions medicine consultant advice. The service is available weekdays 8:30a.m.-4:30 p.m. by calling 1-855-970-0234. Learn more FAQ or information card.

DNS staff, meetings and events
All DNS meetings and events are cancelled or have moved to a virtual meeting. You may reach staff by email or by calling 902-468-1866 or toll free at 1-800-563-3427.

Resources

Note: See the DNS COVID-19 hub for a complete list of COVID-19 resources.

• Navigating work exemption requests during COVID-19
• COVID-19 Signs, Symptoms and Severity of Disease – A Clinician Guide – June 18, 2020
• Nova Scotia Health guidelines for re-introduction of in-office primary care
• Updated: Guidance for physician employers (legal information)
• Medical students provide companionship to isolated patients - The Rural and Isolated Support Endeavor (RISE)

Information hubs to watch

• Nova Scotia Health updates and service cancellations
• IWK updates and service cancellations
• Doctor Nova Scotia updates and information
• Dalhousie CPD COVID-19 webpage
• Department of Health and Wellness
• 811 assessment – when to call
• Government of Canada
• Canadian Medical Association
• Canadian Pediatric Society COVID-19 resources for the care of children