Dear Patients (updated 21SEP21)

COVID-19 is the term used to describe the respiratory illness caused by the SARS-CoV-2 virus (2019 coronavirus).  Many measures remain in place in order to slow the spread of this virus in Canada. Fortunately most cases of infection are mild or moderate in severity and require no treatment at all, just rest and staying at home.  However, COVID-19 can be a serious illness for some.  Here is video to understand more about the virus.

We continue to follow the directives of the Ontario Ministry of Health, and the following modified clinic operations continue:

1. The office staff availability varies by doctor and floor. Please contact your doctors office to book a telephone appointment.

2. For the foreseeable future, all appointments will be booked as telephone assessments (and we do not have a date when regular in-person visits might resume). If you have a telephone appointment booked, you will receive a phone call from a blocked or unknown number so please answer the phone and be sure your phone can accept these types of calls. If you do not answer, a new appointment will have to be scheduled.
   
   If a physical (in-person) examination is deemed essential, you will be provided very specific instructions from your physician on how and when that will occur.
   
   Please note "annual physical examinations" are never deemed essential and these are not being booked at this time.  You should still perform age-appropriate health screening tests.  To book a telephone appointment, email reception or call to arrange a time.

3. If you have any respiratory-related or other COVID symptoms (e.g. cough, fever, sore throat, loss of taste or smell) or other secondary symptoms and you are concerned about COVID-19 you can use this COVID-19 self-assessment tool and follow its advice. Select for Self-Isolation Instructions, Ontario Public Health has a Self-Isolation document as well.

4. If you are HIV-positive and are on antiretrovirals we recommend that you receive the COVID-19 vaccine as soon as it is available to you. Currently the four licensed products are deemed safe for HIV-positive patients who are on anti-retroviral medications and have undetectable viral loads. The International Aids Society website has excellent answers to most questions. related to COVID-19 and HIV infection.

5. We do not have any COVID-19 vaccines onsite.  To book a COVID-19 vaccine use this link- have somebody help you if you are having difficulty with the booking process or call 1-833-943-3900. To learn more about go to Ontario's COVID-19 vaccine program.
   
   
6. The Province of Ontario now requires proof of vaccine in certain settings.  Use this link to get your official proof of vaccination.
   
   
7. COVID-19 Vaccine Exemption Requests - Guidance regarding the provision of exemption letters for COVID-19 vaccination has now been provided to physicians by the College of Physicians and Surgeons of Ontario.  Medical conditions that qualify for exemption are:
   1. Allergist/immunologist confirmed severe allergy or anaphylactic shock to a previous dose of the vaccine product (one of its ingredients) that cannot be mitigated, or
   2. Pericarditis or myocarditis (heart inflammation) after receiving an mRNA vaccine product.

   At this time, no other medical conditions (e.g. history of other allergies, fear of needles, etc.) qualify for an exemption, as per the Ontario Chief Medical Officer.

8. If you are HIV-positive or on PrEP and you are now due or overdue to complete blood work, please contact your physician to receive emailed requisitions that you can print (check each physicians specific policy on email correspondance), or they also be faxed directly to Lifelabs (needs to be done at least 24H before your appointment, or you can arrange to pickup the requisition from your physician (please follow each physicians specific policies). For prescription refills, please have your pharmacy fax a request for medication renewals as per the usual protocol. If you have stopped your PrEP, please arrange for a telephone appointment for instructions on how to resume your medication properly when you decide to do so.

9. COVID-19 PCR tests can only be done at designated assessment centres in Toronto, and some pharmacies.
   Select to find one near you. Please read through the instructions on the website because assessment centres may have slightly different protocols to be seen, and rules frequently change about who can be tested. Patients report the best service at the centres located at St. Michael’s Hospital and Michael Garron (formerly Toronto East General) Hospital.

10. A blood test for COVID-19 antibodies is available through Dynacare labs; it costs $70 and you need a requisition from a physician to have the test done.

11. If you have severe respiratory symptoms like shortness of breath or fever that is not responding to Tylenol then you should go to an emergency department. Advise the staff there that you have severe respiratory symptoms.

12. Prevention is critical – practice both physical distancing of at least 2 meters, wear a mask when indoors in public places and ANYWHERE you cannot maintain a 2 meter space. Wash your hands properly or using hand sanitizer frequently. Select for more information about face masks.

13. Currently, community virus spread is common. Because this coronavirus is mainly spread by respiratory droplets/aerosols, and infection can occur 1-3 days before you might have any symptoms, a mask will help protect you and protect others. Even if you feel fine you still might be contagious. A variety of masks are easily and widely available.
    Wear a mask accordingly to local by- laws, this is usually when you cannot ensure physical distancing or are indoors.  Currently masking is the best known measure of protection.

14. Mental health maintenance is important during these times when we all have been asked to stay home and limit our social contacts. Our clinic website has information about online resources to help look after your mental health.

15. If you are caring for a person who has been diagnosed with COVID-19, follow this advice to protect yourself and others in the home, as well as those in your community.

Thank you for your patience and cooperation during this pandemic.