Over the last two days there have been a number of requests regarding outbreaks and point prevalence testing. Instead of sending separate emails, we decided to collect the requests and send them in one email for your convenience.
I ask that you please review each request independent of each other and respond to ALL requests that apply to your travels/presence in these areas. This matter is rather urgent and we ask that you please submit all that apply ASAP.
Thanks in advance.
St Joseph’s Healthcare Hamilton- Charlton Site, Mary Grace Unit
Please provide the following information if you have been present at St. Joseph’s Healthcare Hamilton , Charlton Site, 5 Mary Grace Unit, between January 13th – January 20th . Your information will be provided to Occupational Health Services for follow up.
St Joseph’s Healthcare Hamilton- Charlton Site, 6GI
Please provide the following information if you have been present at St. Joseph’s Healthcare Hamilton , Charlton Site, 6GI Unit, between January 12th – January 20th . Your information will be provided to Occupational Health Services for follow up.
McMaster Children’s Hospital: Please fill out the following form if you had exposure to a patient at McMaster Children’s Hospital on Ward 3C, Bed 21-B between January 11th – 20th (Note: Patient was also in MRI on January 17th): https://forms.gle/ChPZt84zs5rDuYjr5
Hamilton General Hospital: Please fill out the following form if you have spent more than 6 hours in the Emergency Department at the Hamilton General Hospital between January 6th – 20th (Note: this includes time spent in the ED Consult Room): https://forms.gle/yh77Eq57MHBQ9XJc8
West Lincoln Memorial Hospital: Please fill out the following form if you have spent time on Ward C at the West Lincoln Memorial Hospital between January 11th – 20th : https://forms.gle/MxiEdHd3DyKGE5KC9
Juravinski Hospital: Please fill out the following form if you have spent more than 6 hours on Ward E4 at the Juravinski Hospital between January 13th – 20th : https://forms.gle/N4D7kA63ubckubRR7
I just received messages from SJH and HHS that due to the slowdown in supply by Pfizer, hospitals have been directed by the provincial government to stop administering first doses to anyone other than staff and residents of Long-term Care homes. Second doses will continue to be given as scheduled.
The new timeline is to restart delivering vaccines to healthcare workers in the hospital by the end of February or early March.
I know how disappointing this is for all of you who have not yet had the chance to be vaccinated, especially as our numbers are continuing to spike in the community and the hospitals. And we had hoped that everyone would be vaccinated by March.
I am sorry to have to let you know about this development.
Parveen Wasi MD FRCPC
Associate Dean Postgraduate Medical Education
Michael G. DeGroote Centre for Learning
Faculty of Health Sciences, McMaster University
905-525-9140 x 22116 firstname.lastname@example.org
There has been considerable back and forth regarding the block change, especially due to the HGH-ED outbreak declared Friday. If you have not already been contacted about your plan for Block 8, this will occur shortly. I apologise for the short notice and if you have received different messages over the weekend. The processes continue to be refined with updated directions from Infection Protection and Control and our occupational health offices. These guidelines specifically refer to block changes that involve moving to another site.
Thank you for your patience.
Current outbreak units
An algorithm for an Outbreak Process has been developed by hospital leadership to manage exposure responses for postgraduate learners. This memo addresses the action to be taken when a resident/fellow who has worked in an outbreak unit is facing a block change resulting in movement to a new site or rotation. Risk stratification to inform action is stratified into the following categories based on the amount of time spend on an outbreak unit.
Minimal Exposure – less than 1 cumulative hour/24 hours
Lesser Exposure – greater than or equal to 1 hour but less than 6 cumulative hours/24 hours
Prolonged Exposure – greater than or equal to 6 cumulative hours/24 hours
Process for Block Change following Outbreak Exposure
There have been lists generated for each of the outbreak units for PG learners, according to the dates sent to us by the hospitals. These lists are sent on to Employee Health Services (EHS) to assign risk categories and to determine actions. It is important that residents are prompt in providing relevant data to EHS, if requested.
Prolonged Exposure: for residents/fellows who have had 6 or greater cumulative hours in a 24- hour period on the outbreak unit at any time in the preceding 7 days prior to the block change will require 7 days isolation and retesting to demonstrate a negative Day 7 swab prior moving to a new site. Dr. Fox-Robichaud (HHS) will be working through this process with EHS and notifying you. The 7- day isolation can start to be counted the day after the last prolonged exposure, even if you are still in the clinical environment. e.g. Last prolonged exposure occurred January 7th ( call in the HGH ER) – self-isolation period can be counted as of January 8th even if you have continued to work on your daytime rotation. Please confirm the start date with EHS and/or Dr. Fox-Robichaud when you are called regarding the self-isolation.
Lesser Exposure: for residents who have had greater than or equal to 1 hour but less than 6 cumulative hours/day. Residents in this category may move to their next rotation at a new site and must self-monitor for symptoms for 14 days. Results of any recent COVID swabs must be known prior to move. Exception: A resident whose next block rotation is an area deemed by Infection Control and Employee Health to have a significant proportion of vulnerable patients requiring care may be asked to isolate for 7 days with retesting to demonstrate a negative Day 7 swab prior to moving to a new site. The sites deemed by Infection Control and Employee Health that fall within this vulnerable category are: medical oncology/ malignant hematology/ stem cell transplantation and NICU. (Under this circumstance, the residency office may be able to reassign the resident to alternate rotation.)
Minimal Exposure: for residents who have had less than 1 cumulative hour per day. Residents in this category may move to the next rotation and must self-monitor for symptoms for 14 days.
Residents whose most recent exposure to an outbreak unit exceeds 7 days will be able to move to the next block and must monitor for symptoms for 14 days after their latest exposure.
Residents moving to a community site who have been on an outbreak unit during the last block must contact the EHS/ Occ health office at that institution, regardless of exposure time. While the hospitals have tried to standardise the process as much as possible at the sites within SJH and HHS, other institutions have their own guidelines.
Residents who are coming to SJH and HHS from a community must contact EHS at their destination hospital site if they have been on an outbreak unit at their community site- prior to starting the rotation at either SJH/HHS.
If you did not complete the google forms sent out by Dr. Fox-Robichaud or PGME, and have been on the outbreak units this block- please email EHS (email@example.com) and copy Dr. Fox-Robichaud with details
Name. contact information
dates of exposure, specify the last date of exposure
Hours of exposure each 24-hour day
6 or greater hours per day
Less than 1 hour
If you have questions or have not been contacted by Dr. Fox-Robichaud tomorrow. please use email firstname.lastname@example.org
For any questions you are not sure who to ask, please let me know and I will forward to the appropriate hospital folks.
Any points of clarification re this email, please contact me directly.
Point prevalence testing is occurring in the JHCC overflow unit of staff/physicians/learners for the core team and anyone who has had a cumulative time in the area of about 6 hours in any given day from Dec. 21 to now. We’re exploring if there’s something happening in this area with Covid-19.
If this applies to you can you complete the following Google doc for Dr. Fox-Robichaud who will provide the list to EHS to arrange for testing.
This will be a brief message for you before the holiday blocks. Thanks everyone for your patience over the last two weeks- a flurry of activity and emails regarding block change and now about redeployment. All of you have responded with so much understanding and kindness- it has been so appreciated. And thanks to all of you emailing about issues- it really helps us to know what you’re concerned about so we can help to address it in a timely manner. So please as always, email me anytime over the holidays if things are coming up at email@example.com.
I want to wish you a safe, peaceful and restful holiday. As you undoubtedly are, I am looking forward to 2021 and a year where we can slowly get back to the lives we knew before the pandemic.
A few updates:
If there is something that I have not addressed below or you need more information, please email me.
All of you on the redeployment list have received an email today regarding your redeployment schedule over the holidays. Please let us know as soon as you can if there are any conflicts with your holiday block request.
Information about redeployment, including a powerpoint presentation by Internal Medicine, is available on our PGME Redeployment Orientation webpage. I would also advise you to review the PPE donning and doffing videos, if necessary.
Many universities have cancelled all incoming and outgoing electives. The list is located on our Electives Status webpage. If you do have an elective booked, please check the site. As well, if electives are cancelled at the university, the PGME office at that site will email you to let you know. We are following the situation closely with our PDs and for now, McMaster PGME has NOT cancelled incoming and outgoing electives. However, this may change quickly, and we will let you know of any changes immediately. Cancellation of electives may not entirely be due to safety concerns but also preservation of equity for learners.
Many of you have asked about the adequacy of current PPE recommendations. This has been discussed at the hospital meetings and a recommendation will be coming soon. However, our PGME recommendation is that you use eye protection ( face shield or goggles) and the surgical mask for all patient contact. I have been assured that face shields are plentiful and available on most units and offices. I would also recommend that you consider buying goggles – please keep any receipts and we will reimburse you.
Please review the guidelines about proper cleaning and disposal for face shields and googles.
Vaccination roll-out discussions are in place for potential start date in early January. Residents and fellows will be considered in the same schedule as other front-line workers. We will continue to get updates and inform you as soon as we get more information.
I ask that you please monitor your Medportal email addresses over the holiday break. Should there be an urgent information that needs to be communicated we will send you an email to your Medportal email address through MedSIS.
PGME will be closed from December 23, 2020 until January 1, 2021 inclusive and will resume business hours on Monday, January 4th, 2021. For urgent issues, you are welcome to email me at firstname.lastname@example.org or call 905- 920-6282.
Sophia Boljanic at 905-541-6061 or Stuart McAslan at 289-400-7818.
PGME has been informed that Hamilton Health Sciences (HHS) has initiated tracing for possible exposure to a patient who tested positive for Covid-19 at St. Peter’s Hospital on 2 West. This has not been declared an outbreak, however, HHS will be swabbing broadly & adding precautionary measures given the risk presented.
Any learner who has been on 2 West at St. Peter’s Hospital between December 2 2020 – present are asked to contact Erika Unelli (email@example.com) with the following information:
Details of time spent on the unit (i.e. date(s) on the unit, length of time, PPE usage, etc.)
If PGME learners could please send their information to Erika as soon as possible, it will be collected and provided to Employee Health Services as one list. Once the list is collated, Erika will send the list to EHS, who will be in touch with the PGME learner directly regarding next steps.
ONLY PGME learners who have been on the unit & are symptomatic should contact Employee Health Services directly at ext. 42200 or firstname.lastname@example.org – all others are to send the requested information to Erika to avoid a surge of requests to EHS.
I am so sorry for all of the emails today- it has been crazy with news of wards on out breaks every few hours.
There is a priority system for testing according to exposure time
6 hours or greater- priority
1- 4 hours – next , likely after the weekend
Anyone with symptoms- priority ( please do not come to work/leave work if you are experiencing any symptoms)
OUTBREAK WARDS (from latest to earlier this week)
M2- from December 2nd
E4- from November 27th (NOTE DATE CHANGE from first email)
B3/ E3: from November 24th
Please email Erika as soon as possible ( i understand she is away today but will be collecting the information over the weekend to pass on to EHS)
date of exposure to what unit(s)
if possible, duration of exposure as above
As you are probably all aware of, this is a rapidly changing process and I will keep in contact with all of you over the weekend in need be. And please email me directly at email@example.com with any questions/concerns.
Seriously hoping that this will be the last mass email for the day!!
E4 at the JH has been declared in outbreak as of this morning
EHS has the list of learners who are scheduled on the floor who they will contact for testing.
If you have been on E4 in the last week ( from December 4th) doing a consult from another service or while on call- please email Erika at firstname.lastname@example.org as soon as possible and she will let EHS know
EHS will triage testing according to risk and duration of exposure.
URGENT PLEASE READ: Juravinksi E3 and B3 Outbreak - Update
Dear Residents and Fellows,
An outbreak has been declared on the E3 and B3 ward at the Juravinski Hospital with one patient and two staff testing positive. The hospital will be reaching out to all learners who are currently on the medicine CTU for COVID testing. Postgraduate learners can continue to work on the unit and will only be asked to isolate if they are either test positive or have symptoms. Please ensure that you follow our current guidelines and call EHS ( x 42200) if you are concerned about any symptoms. Those of you who are currently on the Juravinksi CTU rotation have already heard from Dr. Raza, CTU Director.
There will be residents and fellows on other services who have done consults on patients on E3 and B3. If you have been on these wards at any time since November 24th , please contact Erika Unelli at email@example.com with your full name & cell phone/preferred phone number. Erika will collate a list to provide to EHS.for further instructions regarding requirement for testing.
As a reminder, it is extremely important that all of us follow the public health and IPAC guidelines. Please ensure you are always masked when interacting with patients and the health care team and practice appropriate hand hygiene.
Please respect physical distancing when you are removing your mask when eating/ drinking. I realise that residents have identified lack of spaces when eating with limited access to lounges etc. that can allow appropriate distancing. We are continuing to work with the hospitals in the identification of spaces that can be used. But always maintaining vigilance, especially at those times when we are not directly interacting with patients is crucial in helping protect ourselves, our colleagues, and our patients.
It has been brought to our attention that limitations have been set regarding where employees can eat and drink in each respective hospital. In order to assist and accommodate you we have created a list of locations accessible to learners to eat and drink. Please note that this list is not inclusive and we anticipate the addition of locations in the coming days. We recommend checking this list often for updates.
You CAN eat in the following hospital locations
Lounge H 234- Code 4 3 2 . For Medical Learners only – fits 4 people.
Lounge H 209-1 – Code 9691# For Medical Learners only – 3 people.
Eating area in Cafeteria on the second floor.
In their call rooms if they have one for that night.
Library tables – 6 people.
Study rooms in the library – 3 people.
If learners cannot find a space in any of the above, contact Nelly Javanrouh and she will assist.
Courtyard Garden near C3 (outdoor space) available between 08:00 hrs. – 20:00 hrs., seven days a week.
Atrium seating open from 0700 hrs. – 1700 hrs., seven days a week. Maximum capacity – 45 people.
Nora’s Café open 24 hours a day, seven days a week for staff and physicians only. Maximum capacity 70 people.
Courtyard Café open 24/7 for staff and physicians only. Maximum capacity – 33 people.
McMaster University Medical Centre
Farncombe Atrium (3rd floor Blue), open 7 days/week, 8 a.m. – 7 p.m. Closed for cleaning daily between 1:30 p.m. to 2:10 p.m.
HSC 4H1 (4th floor Purple), open 7 days/week, 8 a.m. – 7 p.m. Closed for cleaning daily between 11:30 a.m. – 12 p.m.
The EHS/OHS COVID-19 Screening workflow has been recently updated. The workflow document, along with EHS/OHS and equivalent contacts can be found on our website. As updates occur or contacts change, this website will reflect the most up-to-date information.
HHS has released an updated Parent/Caregiver document with scenarios that are meant to help staff determine if they are able to attend work when they have a child who has been sent home from school or childcare due to COVID-19.
As of July 9th there will no longer be screening booths at any of the staff/physician/Learner entrances of the HHS sites. All will be expected to use the HHS on-line screening tool and self-screen. Please be advised that Learners may be asked to provide their screening results while in the hospital as it is expected that there will be spot checks to confirm that the screening process was followed and they were cleared to enter the building. Another important piece of information for all Learners on placement, physicians and staff entering HHS sites as of July 9th – masks will not be provided at the staff/physician/Learner entrances of any of the HHS sites. It will be the responsibility of the Learners, physicians and staff to have a mask upon entry if they are to use these entrances. It is advised that Learners a) take home a clean mask from the unit in prep for the next day b) the Learners be provided with a stock of masks for their rotations c) if they forgot a mask they can enter via the visitor entrance where masks will be available.
For any staff, faculty and Learners entering HSC for clinical skills training the FHS screening booth in the red section and MDCL is still open and they can use the FHS app to screen and get a mask from the booth. However, as of July 13, there may be a change and the booth in the FHS red area may be removed and therefore you will require masks to enter and you will need to use the FHS screening app with an expectation that your information may be checked to ensure you have gone through the screening process and were cleared to enter the building. The MDCL booth will remain active. If masks are forgotten the staff, Learners and faculty can a) enter through the MDCL area b) enter through the visitor entrance.
The number of patients at our Hamilton hospitals has remained stable/ slightly decreased over the week and we thankfully going into the weekend a bit further away from our redeployment threshold number than we were last Monday. Although the number of COVID positive patients have stayed the same, there have been fewer admissions of non-COVID patients and major efforts for efficient and safe discharge.
Will continue to update you as frequently as we can.
We did open incoming and outgoing electives July 1. This was a national decision made by the PG Deans. As some of you may have already found out, since that announcement was made, there has been a lot of confusion re changes in this directive at other institutions, primarily affecting the Internal Medicine residents.
University of Toronto has cancelled all incoming and outgoing electives within the Department of Medicine for blocks 1-3; Western has cancelled incoming for blocks 1 and 2 for ALL electives. UBC has cancelled all incoming and outgoing electives within the Dept of Medicine,
There are ongoing discussions today nationally with the IM PD group and the PG Deans.
Will update you as we get up to date and accurate information.
I recognize that there are a lot of inequity issues for allowing incoming electives for IM subspecialties but our own residents cannot go elsewhere. So we will be taking this into consideration depending on what happens in the rest of the country.
Right now- this is primarily affecting the IM residents, but again once I have more information for you, will let you know.
Please let me know if you have any questions; you can email me directly and I will respond as soon as possible.
Hope all of you had some time off this long weekend.
Just updating you on developments over the weekend.
One of our retirement home has had a major outbreak and patients have had to be admitted to our Hamilton hospitals- currently SJH has 39 COVID positive patient and 35-40 patients at HGH ( non-COVID positive patients admitted as well.
We have had faculty from IM and staff who have been redeployed over the weekend to help with discharges and admissions for these patients.
We are still not at the threshold for resident redeployment and the hospitals will continue to utilise faculty for the next few days. However, as the situation can change (and certainly the chance of another outbreak in a LTC facility), thought I would give all of you a heads up. Especially as I sent a message last week saying that it was unlikely redeployment was going to happen.
Will keep you informed as the situation evolves.
Again, there are no immediate plans for resident redeployment at this time.
Just a couple of updates to share with you. Will send a more detailed update on Friday march 20th.
As always, email me your questions and comments.
First, I want to clarify my recent message regarding study leave for the certification examinations for our final year Royal College residents. As mentioned, all postgraduate offices across the country are working with the Royal College to discuss potential alternatives for this year’s exams, aside from deferral until next year. Our recommendation is to coordinate your study leave with your program director and exercise the option of deferring it if you need to. We will leave it to you and your programs to decide what would be best for you. Specialty residents will have received an email from the Royal College March 17th, regarding potential written exam dates; the PG Dean continue to be in discussion with the Royal College.
New self-isolation protocol- approved by SJH, HHS and McMaster University. As of March 13th, we had instituted a 14 day self-isolation after international travel. This is the updated version from HHS/SJH and McMaster University.
Self-monitor your symptoms for 14 days as per EHS instructions.
You must wear a mask upon return to work.
If you develop symptoms, do not come to work. Report to your Public Health Unit and EHS. Follow PH/EHS directions regarding COVID-19 testing, monitoring, and planning your return to work. Notify your program director/ program administrator of your situation.
This protocol is a compromise that tries to balance decreasing al exposure risk to the patients if unneeded and ensuring that we have enough qualified healthcare workers if and when we need it.
Again, a longer message will go out on Friday.
Thanks again for everything you do
Parveen Parveen Wasi, MD, FRCPC Associate Dean
Postgraduate Medical Education
Faculty of Health Sciences