COVID-19 Response Update

April 5, 2020

In this issue:

· Latest actions out of the Emergency Operations Centre

· Updated COVID-19 Clinical Guidelines: Expansion of Testing Criteria and Discontinuing Self-Isolation

· Long-term care visitor restrictions

· COVID-19 Healthcare Cybersecurity Training

· Childcare spaces for pandemic workers

· Reminders

Latest actions out of the Emergency Operations Centre (EOC)

Efforts are ongoing to finalize a matrix that outlines the relationships between the different levels of incident command, as well as a decision-making process for the SHA EOC.

Updated COVID-19 Clinical Guidelines – Expansion of Testing Criteria and Discontinuing Self-Isolation

The following updated guidance is provided to inform clinical decisions about testing, management of test results and persons required to self-isolate due to the presence of COVID-19 symptoms.

Note: Clinical Guidelines are statements that include recommendations intended to optimize care. They are designed to enhance, not replace, clinical judgement and expertise of health care providers.

The information currently posted at Clinical Guidelines for Testing, Management and Reporting (Updated April 4, 2020) has been updated as follows:

What is new?

· Expanded testing recommendations to include all persons with symptoms (of any severity) compatible with COVID-19.

· Guidelines for management of persons with COVID-19 symptoms who are not tested or with negative test results, including health care workers (HCW).

· Case Definitions and Contact Definitions are now included in the Saskatchewan Communicable Disease Manual chapter on COVID-19.

· Information and clarification of requirements for mandatory Self-Isolation is available at Saskatchewan.ca/COVID-19.

What has changed?

· Cases admitted to hospital or health care facility or residents of long term care or personal care homes no longer require 2 negative tests, a minimum of 24 hours apart, before lifting infection prevention and control (IPAC) precautions.

· All persons with COVID-19 symptoms (of any severity) should self-isolate immediately and until at least 48 hours after symptoms significantly resolve, regardless of test results.

Þ If self-isolating prior to testing (mandatory self-isolation) – continue until 14 days after last exposure.

Þ If self-monitoring prior to testing – continue at least until 14 days after last exposure.

· Guidelines for management of Health Care Workers (HCW) and Infection and Prevention and Control (IPAC) measures.

What is the same?

· MHO consultation not required to discontinue self-isolation.

Rationale

· Updated guidance is provided:

Þ To promote strategic use of laboratory resources and supplies

Þ To support identification of triggers for key public health actions

Þ To provide a justifiable strategy that can be used to manage expectations regarding who is to be tested

· Expanded testing guidelines will increase access to testing for people with COVID-19 symptoms and inform surveillance to identify community transmission.

· Understanding that all persons with COVID-19 symptoms may not be tested, requiring self-isolation immediately and until 48 hours after symptoms significantly resolved reduces risk for community transmission.

· Requirements for discontinuing self-isolation based on consideration of likelihood of persons being infected despite a negative test result (false negative) and potential to transmit the virus once symptoms are significantly resolved.

These recommendations are developed and reviewed by the Senior Medical Health Officer with Provincial Clinical Departments of Public Health and Preventive Medicine, Family Medicine, Laboratory Medicine, and Infectious Disease, and provided with the support of the provincial Chief Medical Health Officer.

Please note that provincial and national* guidance will continue to be updated as situation evolves within Saskatchewan and across Canada, and based on evidence and best practice.

Long-term care visitor restrictions

Currently, visitors are NOT permitted in any Saskatchewan Health Authority (SHA) operated hospitals, clinics, community and continuing care facilities, except for compassionate care reasons. Compassionate care includes the support of a family member prior to a major surgery, end-of-life care, or for someone who is aiding in clinical care at a physician’s discretion.

We recognize that support for residents in long-term care is important to their well-being. As such, residents may now designate two visitors for compassionate care reasons. Designated visitors would usually be an immediate family member such as a spouse or child or an individual with an equivalent relationship.

Only one designated visitor may visit at a time. A daily log will be maintained to record visitors to the facility, and the individual will be required to pass a preliminary screening test before being admitted. Hand hygiene procedures both prior to and after visiting the resident are mandatory.

For more information on compassionate care visitation for residents in long-term care, please see:

· Long Term Care Visitation

· Work Standard – Visitor Restrictions in Continuing Care

· Visitor Screening Tool for Continuing Care Units and Special Care Homes

· Visitor Screening Log (Form)

· COVID-19 Environmental Cleaning and Disinfection – Information for Public Facilities (April, 2020)

Childcare spaces for pandemic workers

On March 20, the Government of Saskatchewan announced that it would be re-purposing childcare facilities co-located in schools to provide childcare services exclusively to health care workers and other employees providing services related to the COVID-19 pandemic response.

As of April 2, the Ministry of Education has received 295 applications from pandemic workers for 480 childcare spaces. 

As the total of available child-care spaces to pandemic workers is approximately 2,200, there are still many spaces available for pandemic workers who require child-care services.

To apply for a childcare space(s), complete this application form. Send your completed form to [email protected]. The Ministry of Education will forward your form to a childcare centre in your community for consideration.

To view a list of childcare centres that are offering child-care services to pandemic workers, click here.

COVID-19 Healthcare Cybersecurity Training

As the COVID-19 situation unfolds and the need for virtual care increases, we are seeing a surge in cyberattacks against hospitals, organizations and healthcare professionals. Healthcare professionals may inadvertently trigger breaches that lead to locked down institutions, health systems and encrypted electronic patient records.

To help support health professionals manage this increased risk, Saegis, a subsidiary of the CMPA, is offering free COVID-19 Healthcare Cybersecurity,  a bilingual eLearning course for those working in the Canadian healthcare space. The course is comprised of two modules which will each take approximately seven minutes to complete.

English link: saegis.solutions/en/saegis-programs/practice-management-services
French link: saegis.solutions/fr/solutions-saegis/services-gestion-pratique

Reminders:

Map of provincial COVID-19 cases now available

Data on the number of cases of COVID-19 in Saskatchewan, including a provincial map indicating positive cases by zone, is available on the COVID-19 site. (Please note that Central is both east and west; the cases are the totals for both sides.)