November is a BIG month for the Calendar of health promotion in Canada and we want to let you know all about it, and give you some ideas on ways to participate! 

One of the most well-known movements during November is Movember! 

When you think of movember you think ‘a lot of men growing some crazy beards for a good cause!’ But what is this cause? Movember is about Men’s health, including things like prostate cancer, testicular cancer and mental health. ‘Movember’ is a Canadian registered charity with a goal to bring awareness to premature death in men.  But Movember isn’t just about growing a beard for a cause, there are plenty of other ways to participate in Movember month if you don’t have a beard to grow! The Movember movement talks about four ways to “do your part” and this includes, ‘Grow a stache’, which is all about growing a beard to raise awareness and raising funds to support the charity. ‘Move for Movember’, explains the 60km walk to raise awareness for the 60 men lost to suicide each hour, globally, and raising funds in the process. ‘Host a mo-ment’ and ‘Mo your own way’ encourages you to get creative and raise awareness for Movember month your own way! 

Head over to their website for more information on what this charity is all about and how you can help out! https://ca.movember.com/ 

Another big one for the month of November is Crohn’s and Colitis awareness! What is crohn’s and colitis? Crohn’s and Colitis Canada explains these diseases like this “Inflammatory bowel disease (IBD) describes a group of conditions, the two main forms of which are Crohn’s disease and ulcerative colitis. IBD also includes indeterminate colitis. 

Crohn’s disease and ulcerative colitis are diseases that inflame the lining of the GI (gastrointestinal) tract and disrupt your body’s ability to digest food, absorb nutrition, and eliminate waste in a healthy manner. These are lifelong diseases and people can experience acute periods of active symptoms (active disease or flare), and other times when their symptoms are absent (remission).” 

There are a few ways to get involved in Crohn’s and Colitis awareness this month, including a “Gutsy Walk” organized by Crohn’s and Colitis Canada where you can raise money and awareness to support the cause. Their website explains the cause and ways to get involved in much more detail, clink on the link to go see! https://crohnsandcolitis.ca/About-Crohn-s-Colitis 

The month of November has so many more health promotion days that are all listed under the Calendar of health promotion on the Government of Canada website. Be sure to check it out and find out ways you can participate and help out around your community! https://www.canada.ca/en/health-canada/services/calendar-health-promotion-days.html#m11 

As always, call us to book your annual prostate exam or your annual check up! You can reach us at (250) 782 1103 or you can send us a message on Facebook. Our website also has an email button if that works best for you! We look forward to seeing your smile in our office!

As you will be aware, British Columbia is beginning a phased plan to slowly open up again, with businesses and services working in new ways compared to how they worked before the arrival of COVID.

This is only possible because we have all followed the instructions of Dr. Bonnie Henry, in particular physical distancing, hand washing and staying at home as much as possible.

COVID has not gone away, but the risk of one of us catching COVID and of COVID overwhelming healthcare has reduced.

It is very important that we go through these next steps cautiously and safely, so that the risk of overwhelming healthcare and the risk of you catching COVID do not both increase dramatically. It is important that you continue to follow the measures that Dr. Henry advises; it is through all of our behaviour that we will prevent COVID cases rising again.

Over the coming weeks and months, we will start provision of a slowly increasing amount of in- person healthcare in our offices, and provide some of the routine healthcare that could be safely suspended at the beginning of this pandemic, such as screening, through a stepwise plan. This plan will only progress as long as the risk of COVID to all of us remains low.

In the first instance, we will continue to see patients virtually, via video or on the telephone. Where we deem it necessary, not just for urgent conditions or conditions we couldn’t diagnose without doing a physical examination, but for some examinations needed for chronic diseases or some screening for example—face to face care will now occur in our own offices.

The reasons we will not see everyone in-person are as follows:

• ●  We have to continue to reduce COVID risk in our offices through physical distancing, which will reduce the amount of people we can have in our office at any one time.
• ●  The risk of COVID has not gone away—consequently, the regional Health Authoritiesrequire us to wear PPE (masks and eye protection) during all in-person encounters. PPEremains in short supply worldwide—therefore we have to be economical with its usage.
• ●  We have to clean our exam rooms frequently and thoroughly to ensure you are not atrisk of catching COVID from your visit- this will reduce the number of people we can seein our office each day.
• ●  We know that virtual care is safe and effective in a number of conditions and welcomedby a number of our patients as more convenient.

We want to reassure you that safe care will continue to occur, and that you will be seen in- person if it is clinically necessary. This does not mean that everyone can be seen back in the office, but over time we anticipate seeing more of you in the office as long as COVID cases do not rise.

Please remember our office is open and providing care, though please do not turn up in-person unless it is pre-arranged. We can be contacted by phone/email/online in the usual way.

We look forward to seeing more of you in my/our office in the future. Yours Sincerely,

Dr’s Du Plessis, Venter and NP Demeter

Prioritization of patient care services

When services resume, HEALTH CARE PROVIDERS may face difficult decisions regarding which patients to see and the prioritization of service provision. HCP must prioritize access to in-person services based on their own clinical judgement and with consideration given to the patient perspective and the referral source. 

When determining priority for in-person care, HCP should reflect upon the following considerations: 

• What is the acuity of the patient’s condition?
• What is the functional impairment or impact of the condition on health-related quality of life? 
• What is the impact of not receiving services (i.e. will further delay result in a worse outcome for the patient)? 
• Is it appropriate to provide the service via virtual care?
• Is the service one which can only be provided in person (e.g. assessment of chronic disease, breast or pelvic examination)?
• How long has a patient waited for care?

SOCIAL DISTANCING AND COVID-19

Together, we can slow the spread of COVID-19 by consciously keeping a physical distance between each other. Social distancing is the most effective way to reduce the spread of COVID-19.

What does social distancing mean?

It means making changes in your behaviour to minimize close contact with others, including:

•   Avoiding crowded places and non-essential gatherings
•   Avoiding common greetings, such as handshakes
•   Staying home and self-isolating if you are sick
•   Avoiding anyone who is sick
•   Limiting contact with people at higher risk (e.g., older adults and those in poor health)
•   Keeping a distance of at least 2 arms’ lengths (2 metres or 6 feet) from othersHere’s how you can practice social distancing:

•   Greet with a wave instead of a handshake, a kiss, or a hug
•   Stay home, including for meals and entertainment
•   Enjoy the outdoors, but only in small groups and maintain socialdistance
•   Do not play any team sports
•   Shop or take public transportation during off-peak hours
•   Conduct virtual meetings
•   Host virtual playdates for your kids
•   Use technology to keep in touch with friends and family
•   Use food delivery services or online shopping
•   Work from homeRemember to practice hand hygiene and respiratory etiquette:

•   Wash your hands often with soap and water for at least 20 seconds and avoid touching your face
•   Cough or sneeze into a tissue or your elbow
•   Avoid touching surfaces that other people touch oftenIf you think you might have COVID-19:

•   Self-isolate from others as soon as you have any symptoms (e.g., fever, cough, sneezing, sore throat, or difficulty breathing)
•   If you’re not at home when a symptom develops, go home immediately and self-isolate
•   Call the Northern Health COVID-19 Online Clinic & Information Line: 1-844-645-7811
•   Use the BCCDC self-assessment tool: covid19.thrive.healthNH COVID-19 ONLINE CLINIC & INFORMATION LINE: 1-844-645-7811BC GOVT. COVID-19 HELPLINE: 1-888-COVID19 OR 1-888-268-4319

Suspension of the Driver Medical Examination Reports 

RoadSafetyBC is temporarily suspending the issuance of Driver Medical Examination Reports (DMER), along with any outstanding DMERs and other medical requirements, in response to the pressure on the medical community during the COVID-19 pandemic. RoadSafetyBC will not be seeking additional medical information from physicians at this time.

Physicians are still asked to report the highest-risk medically compromised drivers to RoadSafetyBC through Section 230 of the Motor Vehicle Act, and are asked to do so with as much information as possible to enable swift action by the Superintendent.

https://bc.thrive.health

Please follow the above link for self assessment tool.

MARCH 18, 2020  NEWS SICK NOTESCOVID-19

BC’s doctors are asking employers to not require sick notes during the COVID-19 outbreak, building on statements from both the Provincial Health Officer Dr Bonnie Henry and Health Minister Adrian Dix that there is “no need – none – for sick notes at this time.” 

“Sick notes place an unnecessary burden on the health care system, at a time when our priority is to use existing resources to help patients in need,” said Doctors of BC President Dr Kathleen Ross. “When patients come into the office to get sick notes, they are putting physicians, their staff and other patients at risk.”

Doctors of BC started advocating in 2014 for a policy to end the use of sick notes in human resources practices. Although a long-term solution is needed, employers can do their part now by taking this step to immediately ease pressure on the health care system.

Doctors of BC reminds everyone to take necessary steps to limit the spread of COVID-19, including social distancing, self-isolating as necessary, and practicing good hygiene. If you are worried that you may have COVID-19, you are encouraged to use the new self-assessment tool developed by the BC Center for Disease Control.

Lopinavir/Ritonavir (Kaletra®)
Recommendation: Recommend against the routine use of lopinavir/ritonavir outside a randomized- controlled trial.

Remdesivir
Recommendation: Recommend against the routine use of Remdesivir outside a randomized-controlled trial.

Chloroquine/Hydroxychloroquine
Recommendation: We recommend against the use of chloroquine and hydroxychloroquine for treatment or prophylaxis outside of a clinical trial

Oseltamivir Recommendation: Recommend against use of oseltamivir unless suspected or confirmed influenza infection.

Ribavirin and interferon
Recommendation: Strongly recommend against use of ribavirin and/or interferon for risk of harm.

Tocilizumab
Recommendation:Recommend against the routine use of Tocilizumab outside a randomized-controlled trial.

Steroids
Recommendation: Recommend against the use of steroids. However, steroids may be used if anothercompelling indication is present (e.g. asthma exacerbation, refractory septic shock).

Antibiotic Therapies Recommendation: If bacterial infection is suspected antibiotics should be initiated based on institutional antibiograms and sensitivities.

NSAIDs
Recommendation: Recommend acetaminophen use preferentially for symptomatic management of COVID-19 but do not recommend against the use of NSAIDs such as ibuprofen.

ACE inhibitors and ARBs
Recommendation: Recommend that patients on ACE inhibitors and ARBs continue these agents as indicated and not cease therapy solely on the basis of COVID-19.

Other investigational therapies
Recommendation: Recommend against any other investigational agent, including ASC09, azvudine, baloxavir marboxil/favipiravir, camostat mesylate, darunavir/cobicistat, camrelizumab, thymosin, natural health products, and traditional Chinese medicines due to lack of data, lack of availability, or both.

Reference:

http://www.bccdc.ca/Health-Professionals-Site/Dcouments/Guidelines

To our Dawson Creek patients and community We are taking this unusual step to write to you personally regarding the COVID-19 virus. You will have heard the directive from our Provincial Health Officer, Dr Bonnie Henry, to self-isolate and practice social distancing.  The time to act is now. Our province is in a state of emergency. What we do today will impact the health of British Columbians in the weeks to come. • Stay home unless absolutely necessary. No dinner parties. No shopping for anything but essentials. No group or team sports, not even outside. No playdates. Instead have coffee with a friend online or do that online exercise or yoga class you have been meaning to do. • Keep six feet or two metres away from everyone at all times.• Wash your hands thoroughly.• Call your loved ones and friends to check in on them regularly.• Remind young people in your life that they too can get sick from this virus. More importantly, they can be asymptomatic carriers and unknowingly cause a lot of harm to parents, grandparents, and other loved ones.  If you are concerned that you may have COVID-19 symptoms, including a sore throat, dry cough, fever or breathing difficulties, please call 1-844-645-7811, the Northern Health Covid-19 Online Clinic and Information line. They will conduct a telephonic assessment, and will provide you with directions on what to do next. Many of our medical staff are booking routine care appointments at their community clinics. The appointments will be conducted telephonically or via online video streaming, and you will only be asked to come in to the office if your healthcare provider deems it necessary for you to do so. We are doing this for patient and health care provider safety, to limit potential exposure to the virus. Please phone your healthcare clinic if you need more information. Northern Health facilities, including Dawson Creek hospital, have initiated new rules which will affect visitors to the hospital. Please check the website to obtain the most up to date information on this and other COVID-19 related developments at http://www.northernhealth.ca If we as a community can work together to follow all the recommendations for social isolation and hygiene, this will be one of our most effective strategies in keeping this pandemic in check. We want to reassure you that we are responding as quickly as we can to a rapidly changing environment, and will do our best to provide the best and safest care to our community. From the Dawson Creek Medical StaffDr. Tari Aganaba, Dr. Howard Chang, Dr. Margaret Clark, Dr. Matt Fletcher, Dr. Andre Goetze, Dr. Jim Hargreaves, Dr. Dirk Kotze, Dr. Sally Garbett, Dr. George Okafor, Dr. Rais Russel, Dr. Charles Larsen, Dr. Ulrike Meyer, Dr. Michael Pilgrim, Dr. Anton Venter, Dr. Magda du Plessis, Dr. Remi Oyedeji, Dr. Nidaa Al-Alous, Dr. Daniel Obaseki, Dr. Lourens Human, Dr. Marius Meyer, Dr. Louw Burger, Dr. Cornelia Popa, Dr. Aous Al-Shehabi, Dr. Wanda Marlatt, Dr. Paul Alberts, Dr. Daniel Botha Sr, Dr. Jacques Brussow, Dr. Ettienne Roux, Dr. Johan Faasen, Midwife Sonje Juul, Midwife Haley Hayner and Nurse Practitioner Christy Demeter.