Information for Medical Staff

NEW Update from Dr. Janet Kow - April 7, 2020
  1. A charter plane with 19 pallets of masks ordered by the province from China arrived yesterday at YVR!! We are also getting smaller shipments in.
  2. Sterilization of N95s has started at SPH and I'll update you as we see how usable they are.
  3. Our numbers are still stable and low, no significant increase in patients and still 50-60% occupancy.
  4. We anticipate a new regional testing guideline, our MSA has advocated for increased sampling especially in our vulnerable populations.
  5. We are seeing some unintended consequences such as increased overdoses, domestic violence and some people waiting too long at home for both Covid and non-covid issues. Need to encourage our patients to continue to seek out health care when appropriate.
COVID-19: Updated Guidance for Physicians - March 27, 2020
View the document here.
PREVIOUS Updates from Dr. Janet Kow

March 27, 2020

  • We did receive a large shipment of NP swabs on Tues!
  • A shipment of 1200 N95s arrived yesterday. We continue to receive other donations of masks. Also collection has begun for N95s for the VCH sterilization plan.
  • Every one of the 19 ICU beds are now negative pressure! Amazing work from Facilities. Ongoing work to make other areas negative pressure.
  • Message going out from Med affairs today for MD volunteers for COVID teams. Thank you for continuing to support our patients in this scary and tough time!

March 25, 2020

  • One order of procedure masks arrived yesterday! Also many many orders put in by us and VCH.
  • VCH actively working on sterilization and reusing procedure N95 masks, for now we are going to be collecting them and sending on to VCH. Look for bins where you work collecting N95s only. They are working with 3M on ensuring the process is safe.
  • Province working with a company in BC to see if can mass produce 3D printing of visors.
  • Scott Harrison reports multiple community supports being directed to Covid, including one pod of STOP HIV working only on supporting patients. BC housing and City of Vancouver also part of planning, Hope for announcements in coming days.

March 24, 2020

  • You are free and encouraged to take your temperature at home daily, but will be asked again when you get to your unit. If your temp is over 38 and/or you have a cough find a replacement and present for testing.
  • Don't forget to SHOW your ID if you use the main Burrard or Thurlow entrances, or use the staff only entrances: Code orange entrances off Thurlow or the alley behind Davie, parkade Burrard entrance which are ID swipe only.
  • Scott Harrison is back and now on the EOC for the DTES. He will be keeping us up to date on their actions and needs.
  • A hotel for patients who are positive is going to be opened soon. One of our patients may be the first resident! VCH also looking at a shelter option which would house more people too.

March 23, 2020

  • Progress on lab – approved for high volume testing and also rapid turnaround testing (pictures below of work over the weekend to make it happen!)

  • Long term care sites – moving staff to work at one site only, assessing all staff (inc temperature check) at start of every shift

  • Acute site access – closed to visitors except compassionate end of life / assistance with care. Staff health checks to start. Reminder to PLEASE wear and display your staff ID so we do not have to question why you're on site.

  • Supplies – at all levels (PHC, VCH/PHC, PHSA, MoH) every effort being made to secure supplies and orders being placed, all types of masks on order and await shipment.

  • Reminder that pharmacists can provide refills without doctors prescription: https://www.bcpharmacists.org

  • Acute care response plan well under way, equipment such as scrubs and tablets for patient assessment to be acquired.

  • Although if you are tested at SPH/MSJ ED you will be called, you can also sign up for eHealth to access your own results regardless of which lab takes your swab: https://myehealth.ca/

March 18, 2020

  • The UPCCs are still quite busy, the freestanding tent for Staff testing is still planning to be up by end of the week. Details will be confirmed by end-of-day Thursday.

  • 7A and 3B are designated wards for Persons Under Investigations (PUI) or COVID-19 positive. This will help the medical teams who are designated to gain expertise with COVID-19 to maintain continuity. We also know we don't want to move patients around too much, that is also a risk. So we will need to work on the actual mechanics of patient placement and transfers.

  • We are redeploying all corporate and research staff that are not able to work into other areas of need.

  • Occupational Health & Safety will be helping all staff whether medical, allied, nursing etc. to navigate testing and when to return to work. Once they sort out the process they will start to contact Health Care Workers directly.

  • We are aware everyone wants to wear scrubs but people have been taking scrubs from the change rooms including taking them home. This is NOT APPROPRIATE our scrubs are to stay within our walls and need to be laundered here to ensure they are appropriately clean. Laundering them at home is probably not enough, and it really doesn't make sense to wear scrubs if you're taking dirty/infected clothing home! Certain departments have started having issues ensuring there are enough scrubs for staff. THIS IS NOT ACCEPTABLE. We will be reviewing our scrubs processes, looking at buying more, but will get back to you. There is no solid scientific evidence for using scrubs on the general wards if you are using appropriate precautions!

  • We have connected with UBC regarding redeploying students and residents. But remember there are also many people who are already being laid off in the province who may be willing to do some of this work and we do need to still support the community. We will plan for this as well.

Letter from PHC Medical Staff to BC Residents March 22
Read the Letter from Medical Staff to the people of BC
Update from Emergency Department at SPH March 18, 2020 

We are controlling access to all ED entry points and have closed Comox Entrance.

  • A "pivot" nurse is meeting all patients at the door (before Triage) and screening for COVID-19 with a brief history and temperature, O2 saturation, pulse. The patients will flow as follows from there:
    • If a patient is in acute distress or hemoydnamically stable, he or she would be taken to our first open negative pressure room.
    • If patients looks otherwise well (and is not from LTC or a health care worker) and has no symptoms or mild symptoms, they are informed that NO testing will be done for COVID-19 as per the current BCCDC/MoH testing guidelines, given an information package, and encouraged to leave.
    • If patient appears unwell OR is mildly symptomatic and wants to stay to be assessed by an EP, they will be moved to the Covid screening area in ABSU (where everyone wears PPEs and patient areas are separated by 2 m).
    • If a patient looks too unwell for discharge, they will be swabbed and transferred to our RESP ZONE in the Acute side.
  • We are working on a holding plan for NFA patients.
  • We have turned Acute stretchers 1 to 12 (including negative pressure rooms 3,4,5 and 6) into a RESP ZONE. All respiratory complaints that require an acute bed will be seen here, even if not obviously COVID-19 related.
  • We are following the most up-to-date PPE precautions with droplet precautions (mask, eye cover, gloves, and yellow gown) for all patient contact with PUIs.
  • Advanced PPE (documented earlier) with any aerosolized process, which we are trying to minimize to intubation only (NO CPAP, BiPAP, Nebulizer, high flow nasal O2).
  • Suspect COVID-19 Patients will be admitted respiratory etiquette to the appropriate inpatient unit.
  • Mount Saint Joseph Hospital has similar mirroring process places.

So far the volumes at both EDs have been manageable. We have not had any significant sick calls from staff. And the morale is good. Obviously, this is fluid and could change daily.

Please let me know if you have further questions.

Cheers

Dan

Dan Kalla, MD

Department Head, Emergency Medicine, St. Paul's Hospital and Mount Saint Joseph Hospital

This page last updated Apr 7, 2020 10:05am PDT