Physician Town Hall Hosted by: Dr. Susan Shaw - April 22, 2021 - Saskatchewan Health ...
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Qu’Appelle Valley
Physician Town Hall
Hosted by: Dr. Susan Shaw
Dr. John Froh
April 22, 2021
www.saskatchewan.ca/COVID19
Town Hall Reminders
• This event is being recorded and will be available to view on
the Physician Town Hall webpage (Names, Polling Results,
and Q&A are not posted unless a question is asked verbally).
• Please sign in using your full name!
• Watch for this icon during the event and respond to our live
polls.
• Submit your questions using the Q&A function at anytime!
www.saskatchewan.ca/COVID19
Truth and Reconciliation
We would like to acknowledge that we are
gathering on Treaty 2, 4, 5, 6, 8 and 10
territory and the Homeland of the Métis.
Recognizing this history is important to our
future and our efforts to close the gap in
health outcomes between Indigenous and
non-Indigenous peoples. I pay my respects to
the traditional caretakers of this land.
www.saskatchewan.ca/COVID19
Panelists joining us this evening...
• Beyond the list of presenters on the agenda, we also have a
number of colleagues joining us to support the Q&A.
• Panelists – please introduce yourselves in the chat.
• Ask your questions during the event and panelists will try to
answer!
www.saskatchewan.ca/COVID19
Variants of Concern: Impacts on System Flow and Capacity
COVID-19 Surveillance and Epidemiological Trends Dr. Johnmark Opondo
Offensive Strategy Highlights Dr. Johnmark Opondo
Dr. Kevin Wasko
Vaccine Strategy Highlights Dr. Tania Diener
Dr. Julie Stakiw
Defensive Strategy Highlights Dr. John Froh
VOC: Impacts on System Flow and Capacity John Ash
Safety Update Dr. Mark Fenton
Physician Wellness Dr. Alana Holt
Q&A Opportunity to ask your questions live!
www.saskatchewan.ca/COVID19
COVID-19 Surveillance and
Epidemiological Trends
Dr. Johnmark Opondo
Medical Health Officer
COVID-19
Health System Update
www.saskatchewan.ca/COVID19
COVID-19 cases, rate per 100,000 (last 7-days), by province/territory, Apr 22, 2021
SK now has the 3rd
highest new case
rate in Canada
after AB and ON
www.saskatchewan.ca/COVID19
Source: Public Health Agency of Canada https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html
COVID-19 cases (rate per 100,000), by province/territory, Apr 22, 2021
SK ranks 3rd in rate
of total cases in
Canada after QC
and AB
www.saskatchewan.ca/COVID19
Source: Public Health Agency of Canada https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html
COVID-19 vaccine, population coverage (1 dose), by province/territory, April 22, 2021
Almost 21% of
Saskatchewan’s
population has received
at least one dose of a
COVID-19 vaccine
www.saskatchewan.ca/COVID19
Source: Public Health Agency of Canada: https://health-infobase.canada.ca/covid-19/vaccination-coverage/
Epidemic curve, SK-COVID-19 pandemic, by zone, Feb 1 2020 – Apr 21 2021 (n = 38,883)
450 45000
400 Central East Central West Far North East 40000
350 35000
Far North West North Central North East
300 30000
Number of Cases
North West Regina Saskatoon
Cumulative
250 25000
200 20000
150
South Central South East South West 15000
100 10000
Unknown Region Far North Central
50 5000
0 0
3/2/2020
10/26/2020
1/20/2020
2/3/2020
2/17/2020
3/16/2020
3/30/2020
4/13/2020
4/27/2020
5/11/2020
5/25/2020
6/8/2020
6/22/2020
7/6/2020
7/20/2020
8/3/2020
8/17/2020
8/31/2020
9/14/2020
9/28/2020
10/12/2020
11/9/2020
11/23/2020
12/7/2020
12/21/2020
1/4/2021
1/18/2021
2/1/2021
2/15/2021
3/1/2021
3/15/2021
3/29/2021
4/12/2021
www.saskatchewan.ca/COVID19
Source: Panorama, IOMNew cases and
test rates, 7-
day rolling
average, per
100,000, by
subzone,
April 18, 2021
www.saskatchewan.ca/COVID197-Day Rolling Average
0.0
50.0
100.0
150.0
200.0
250.0
300.0
350.0
11/1/2020
11/4/2020
11/7/2020
11/10/2020
11/13/2020
11/16/2020
11/19/2020
11/22/2020
11/25/2020
11/28/2020
12/1/2020
12/4/2020
12/7/2020
12/10/2020
12/13/2020
12/16/2020
12/19/2020
12/22/2020
12/25/2020
Cases
12/28/2020
12/31/2020
1/3/2021
1/6/2021
1/9/2021
1/12/2021
1/15/2021
1/18/2021
1/21/2021
Source: Interactive epi file-Updated April 14
1/24/2021
1/27/2021
1/30/2021
2/2/2021
2/5/2021
2/8/2021
2/11/2021
2/14/2021
2/17/2021
2/20/2021
2/23/2021
2/26/2021
3/1/2021
Test Positivity
3/4/2021
3/7/2021
3/10/2021
3/13/2021
3/16/2021
3/19/2021
3/22/2021
Current Test Positivity: 7.7%
3/25/2021
3/28/2021
3/31/2021
4/3/2021
4/6/2021
4/9/2021
4/12/2021
COVID-19 cases and test positivity, 7-day rolling average, Nov 1, 2020 – April 18, 2021
4/15/2021
4/18/2021
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
5%
www.saskatchewan.ca/COVID19
Test PositivitySK COVID-19 outbreaks (N = 224) by settings, Jan 25 – April 21, 2021
250
200 Confirmed outbreaks are another “tip of the iceberg”
Approximately 2/3 outbreaks are in workplaces (n = 143;
Number of Outbreak
150
63.8%)
100
*Includes: group home, LTC facility, PCH, communal living setting, correctional
50 centre, assisted living facility, shelter
0
Post-secondary
Correctional Centre
Restaurant/Bar
Community
Health Facility
Event
Sport
Workplace
LTC Facility
Business
Place of Worship
Overall
Assisted Living Facility
Group Home
Gym
Personal Care Home
Communal Living Setting
www.saskatchewan.ca/COVID19
Source: COVID response unit, Ministry of HealthWhere are people catching COVID-19 in Saskatchewan?
2%
1% Contact/household
4% Congregate living
7%
Health care setting
5% Social/entertainment
6%
Labour
2% 66% Educ facil/daycares
1%
Retail/other business
Recreation/fitness
Travel
www.saskatchewan.ca/COVID19
Source: Panorama IOM, last 30-days, Most Likely Source (n = 1,087)Assessed Risk of Epidemic
Transmission, by Zone
Apr 14 – 20, 2021
Previous week
Current week
Colour Threshold level for
* Epidemic Spread
“The New Normal”
COVID transmission is
controlled, but there is a risk
of community transmission.
High risk that COVID
transmission is not
controlled.
High likelihood that COVID
transmission is not
controlled.
Week Apr 7 – 13, 2021 Week Apr 14 – 20, 2021Current situation
• SK average daily new cases increased from last week and rising
• Seeing the effects of communicable individuals travelling into and out of
communities during the Easter long weekend
• Increased hospitalizations and deaths will occur next 2-4 weeks
• Younger age group with more severe illness
• Recently: deaths ageUpdate from local Public Health
• Feeling the impacts of travel in and out of communities, gatherings
over the holiday long-weekend and speed of variant transmission
• Large outbreaks: provincial corrections, mining site, gatherings
• Workplace outbreaks nearly all linked to inconsistent mask use and
distancing or attending work while symptomatic
• Need: quick collaboration with contact tracers
• Low testing in pockets of the province remain a concern
• Gatherings of youth without adherence to public health measures
• Facing vaccine selection anger at immunization clinics
www.saskatchewan.ca/COVID19Public Health Orders: Update New Public Health Order announced April 13th – in effect to May 10 New restrictions • Private indoor gatherings limited to immediate household members only in all of Saskatchewan • Places of worship capacity limits reduced to
Cases with VoC, as of April 22
www.saskatchewan.ca/COVID19Emergence of B1.617 Variant of Interest - India
•BCBC and
and QBQB havehave
reported
reported
importation importation
of this VOI of
this VOI
• Ban on direct flights from India or
Pakistan
Ban on for the next
direct 30 days
flights
•from
We stillIndia
need toor bePakistan
vigilant with
landthe
for border
nextscreening
30 daysand intra-
provincial travel
We still need to be
vigilant with land
border screening and
intra-provincial travel
www.saskatchewan.ca/COVID19Key Public Health messages this week • We are in the most critical point of the pandemic, yet • Influenced by community transmission • Spread of variants is preventable - everything we do now, matters • AVOID NON-ESSENTIAL TRAVEL • Socialize in groups
Key Public Health messages this week
What we do matters, today and into the future
• Continue the stronger Public Health measures came into effect
last Friday
• Need targeted immunization approach to at-risk populations NOW
• Jurisdictions with: 1) faster, stringent restrictions & 2) High social
cohesion/trust in the message experience better health outcomes
• We have not yet seen the peak of this surge
• We need to strengthen/use every layer of protection
www.saskatchewan.ca/COVID19Offensive Strategy Highlights
Dr. Johnmark Opondo
Medical Health Officer – Offensive Strategy
COVID-19
Health System Update
www.saskatchewan.ca/COVID19Offensive Strategy
Key goal: prevent, contain and mitigate viral spread and promote population health
Key work of Public Health:
1. Emergency preparedness and response, including cross-sector business and service continuity
2. Epidemiology and surveillance: understand patterns of transmission to adjust response measures
3. Case, contact and outbreak investigation and management
• Population-based measure that aims to interrupt networks of transmission and control
epidemic
• Notification Isolation/Quarantine Investigation Reporting Monitoring Evaluation
• Assisted Self-Isolation Sites (ASIS), ASIS Medical and Secure isolation sites (SIS)
• Risk assessment: case communicability period, acquisition, exposure setting(s), contacts
4. Testing strategy: symptomatic, active case finding (investigations), public health surveillance
5. Enforcement: Public Health Orders, Public Health inspection, compliance/education
6. Risk communication: public awareness, behavior change, population health promotion
7. COVID-19 Immunization planning and delivery
www.saskatchewan.ca/COVID19Test to Protect COVID TESTING CONCEPT OPERATIONS (02-25-2021)
Test to Protect 3 Objectives: 1. Test to Protect for Health Care Workers: Implement voluntary regular and timely POC self-testing for HCWs and their households to identify and proactively contain the spread of SARS-CoV-2 in healthcare facilities. 2. Test to Protect in Vulnerable Populations: Implement regular and timely POC testing for targeted populations toward informing and proactively allocating resources and containing the spread of SARS-CoV-2 in at-risk populations. 3. Test to Protect in Communities: Work with third party partners to implement POC testing for the public toward mass screening and reporting to contain the spread of SARS-CoV-2.
EOC
CONCEPTUAL Chief: Carrie Dornstauder/Dr. Opondo Testing Strategy
PM: Em Morin Provincial Lab Services
DRAFT SI: Karen Worobec
Test-Trace-Isolate
Lenore, Dr. Magee
Updated: April 16, 2021 Lab Clinical Expert: Nicole Cox
MOH: Melissa Kimens Test Oversight Committee Dr. Babyn, Tami Denomie
Admin: Nolan Paul Clinical
Document Aide: TBD
Test Advisory Committee Dr. Minion, Sherri Buhler Content
Liaison:
Kathy Rossler
Leader Forum Carrie Dornstauder, Dr. Opondo
Sherri Buhler
Supply, Data, Comms
Manager: Camille Audette
Surveillance & Admin: Heather McQuarrie
Screening Jennifer Tenant
Outbreak
IHICC (Test to Protect)
Management
Community Intake
HCW Stream*
School Stream
Business Stream
Target: April
Test Acute TBD: 30 – 100% Sustainable
Centers LTC Institutional HCW have Community
Leads: Debbie Sinnett, Karen Care based
/Community access
Leads: Kathy Rossler, Sherri Buhler, Worobec Leads: IHICCs,
PCR Centers program
Karen Worobec Karen Worobec
Target: 90%
Target: Included in 4,500 staff/residents Target: Included in Leads: Lead:
Carrie, App &
weekly testing 4,500 Carrie
Priority
Maureen, Distribution
Pop Up / TBD: Lead: MHO Target: tiers1, 2 Centres
Mobile Volunteers Camille team
Target: TBD Outbreak Management TBD Target: TBD External to
Outreach
SHA
Target:
Lead: Family/Visitors/Supports Lead: Em and
Felecia TBD Nicole C
Watson
Auditing Target: June 30, 2021
Lab PCR Testing Antigen Testing POC PCR Testing Antigen Testing
Operational Standards Pathways – screening, LTC, Appropriateness of
Safety Task Force CD Teams/PH 8-1-1 OHS Family Presence Expert Panel Acute, Community Care/Clinical Standards
(Influence or Impacted Kath Stevenson, Erica
Petrina/Dr. Kelly Pam/Sherri Buhler Vanessa Verkerk Petrina McGrath Felecia Watson Gaylene Molnar
by Strategy) Pederson, Gaylene MolnarTest – Trace – Isolate “TEST TO PROTECT”
“The right test, for the right time for the right situation”
Please continue to encourage your patients to know the symptoms of COVID-19
www.saskatchewan.ca/COVID19HCW Home Antigen Testing
Two potential processes for physicians interested in rapid antigen testing:
• Physicians, who are interested in providing antigen testing for their patients and/or
staff through their practice, please contact us at
Antigentestingintake@saskhealthauthority.ca.
• Physicians who work on-site at SHA or Affiliate Healthcare facilities may be eligible to
participate in the at home testing program for Saskatchewan Health Authority and
Affiliates Healthcare Workers.
We are working on making it easy for physicians to access the training.
More information coming soon!
www.saskatchewan.ca/COVID19Vaccine Strategy
Dr. Tania Diener
COVID Vaccine Strategy Chief
Dr. Kevin Wasko
Physician Executive – Integrated Rural Health
Dr. Julie Stakiw
Physician Lead, Vulnerable Populations
COVID-19
Health System Update
www.saskatchewan.ca/COVID19Immunization Campaign Goals
• Protect those most vulnerable
• Minimize serious illness & death
• Protect health care capacity
• Minimize spread of COVID-19
• Immunize as many people, as
quickly as possible; safely.
www.saskatchewan.ca/COVID19Vaccine Administration per 100,000 Population
Canada
29309.39
Doses Administered
Per 100,000 population
As at April 22, 2021
https://covid19tracker.ca/vaccinationtracker.html
109787.55
99050.45
67639.04
28313.02 27069.96
27843.13
30987.85 26934.56
26412.96
30197.62
28960.61
25258.72
28021.86Vaccine Summary 1st and 2nd dose by Region
Region 1st Doses Given 2nd Doses Given Total Doses Given
Far North West 5,570 1,530 7,100
Far North Central 460 330 790
Far North East 5,141 1,225 6,366
North West 21,650 3,069 24,719
North Central 23,075 4,546 27,621
North East 11,536 1,505 13,041
Saskatoon 80,767 7,456 88,223
Central West 10,492 1,073 11,565
Central East 30,429 4,393 34,822
Regina 78,226 9,379 87,605
South West 9,402 761 10,163
South Central 19,395 1,790 21,185
South East 23,760 4,048 27,808
329,192 43,142www.saskatchewan.ca/COVID19
372,334
https://dashboard.saskatchewan.ca/health-wellness/covid-19-vaccines/vaccines#cumulative-doses-tabWho has been immunized? April 22, 2021
Age 80+ Age 50-59
1st doses = 44,151 (86%) 1st doses = 43,888 (30%)
2nd doses = 12,137 (24%) 2nd doses = 6,026 (4%)
Age 70-79 Age 40-49
1st doses = 66,066 (83%) 1st doses = 26,175 (17%)
2nd doses = 5,248 (7%) 2nd doses = 5,359 (4%)
Age 60-69 Remote Northern Residents 50+
1st doses = 97,220 (70%) 1st doses = 7,642 (55%)
2nd doses = 4,923 (4%) 2nd doses = 2,254 (16%)
Source: https://www.saskatchewan.ca/government/news-and-media
www.saskatchewan.ca/COVID19Expanding Vaccination COVID-19 Eligibility
Additional Health Care Workers Eligible for Vaccination (April 16)
• Vaccine eligibility for non-SHA healthcare workers on the frontline in clinical care
areas is being expanded to include:
• Frontline staff in private physician offices who provide patient care
• Frontline staff in private digital imaging clinics
• Frontline staff in community labs
• Frontline staff at the Saskatchewan Cancer Agency
• These healthcare workers will receive a letter of eligibility over the coming days,
which will be required to register for COVID-19 vaccination. Appointments for this
group must be made through the telephone booking system only.
www.saskatchewan.ca/COVID19AstraZeneca Eligibility Across Canada
AstraZeneca now approved for use in immunizing adults 40 years and older in SK (April 20)
• Cross-Canada picture:
• Saskatchewan/Manitoba – People aged 40 and older
• BC/Ontario/Alberta – People turning age 40 and older in 2021
• Quebec - People aged 45 and over
• NS/Nfld – People aged 55 to 64
• NB/PEI – People aged 55 and up
• Yukon/NWT/Nunavut - Northern residents will be vaccinated with Moderna
• To date, residents ages 40 and over who have contracted COVID-19 have seen the most
severe outcomes, accounting for 84 per cent of total hospitalizations and 96 per cent of total
deaths.
www.saskatchewan.ca/COVID19Expanding Vaccination COVID-19 Eligibility
44 and older province wide (April 22) & 40 and older (April 28)
• Once COVID-19 vaccine eligibility has been opened to all residents ages 40 and over,
Saskatchewan will prioritize access to the COVID-19 vaccine to remaining prioritized
first-responders, along with additional front-line workers ages 16+, depending on
vaccine product, including:
• Police officers
• Firefighters
• Volunteer firefighters
• Front-line healthcare workers with direct patient contact employed by the SHA or private
employers (including dentists, optometrists, chiropractors)
• Teachers and educational staff working directly with students
• Correctional staff
• Border security officers
www.saskatchewan.ca/COVID19Hematology 101, Blood Clots and Astra Zeneca
VIPIT (Vaccine induced prothrombotic Immune thrombocytopenia) also known as
VITT (Vaccine Induced thrombosis and thrombocytopenia) is caused by a specific
antibody that activates platelets and causes blood clots.
a) Mechanism of action mimics HITT (Heparin Induced Thrombocytopenia and
Thrombosis)
www.saskatchewan.ca/COVID19Hematology 101
…with respect to Astra Zeneca Vaccine Risk of Rare Blood Clots
2 “Hematologic” Contraindications
a) Previous history of HIT (HIT antibody lingering might interfere with lab assay to
detect VIPIT/VITT antibody and complicate management)
b) Previous history of Thrombotic Antiphospholipid Antibody Syndrome (APS)
i. This requires APS antibodies (Anti-cardiolipin, Anti-Beta 2 glycoprotein 1, or
Lupus anticoagulant) AND a history of thrombosis.
ii. *This is a “soft” contraindication as APS can interfere with the testing for
VITT and therefore a risk/benefit analysis.
iii. Individuals with either of these conditions should receive an mRNA vaccine
(Pfizer, Moderna)
www.saskatchewan.ca/COVID19Hematology 101
…with respect to Astra Zeneca Vaccine Risk of Rare Blood Clots
The following are NOT associated with a risk of VIPIT/VITT with Astra Zeneca Vaccination
a) Any Inherited or acquired thrombophilia (Protein C/S deficiency, Factor V Leiden, Prothrombin
Gene mutation, hypo/dysfibrogenemias etc)
b) Mechanical Risk Factors: recent surgery, immobilization, long airplane rides
c) Hypercoaguable states: active cancer, oral contraceptive use
d) Autoimmune disorders including Lupus
e) Previous history of thrombosis including arterial (MI, stroke) and venous (DVT, PE) **There has
been no reported VIPITT/VITT in patients with previous history of CVST
f) Family history of blood clots or clotting disorders
g) History of platelet disorders including too many platelets ( essential thrombocytosis,
Polycythemia) or too few platelets (ITP) or Von Willebrand’s Disease
h) Any Medications
www.saskatchewan.ca/COVID19Astra Zeneca and Johnson and Johnson Vaccine Exemption Letters
• Template letter will be made available to all physicians and nurse practitioners and
will be the ONLY exemption letter allowed for preferred vaccine selection
• Template Letter will indicate the only 2 Exemptions (with the exception of severe
allergy to a vaccine component include:
• Previous history of HIT (HIT antibody lingering might interfere with lab assay to detect
VIPIT/VITT antibody and complicate management)
• Previous history of Thrombotic Antiphospholipid Antibody Syndrome (APS)
Physician questions regarding vulnerable patient populations or processes
can be sent to vaccinereview@saskhealthauthority.ca
www.saskatchewan.ca/COVID19AEFI (adverse event following immunization) Reporting
Reminder
• Apart from the usual AEFI (adverse event following immunization) reporting PHAC requires reporting
of specific Adverse Events of Special Interest (AESI) following immunization with any COVID-19
vaccine using the national Adverse Event Following Immunization (AEFI) reporting form
• To be reported immediately to local public health as AEFIs:
www.saskatchewan.ca/COVID19Visit the Vaccine Uptake Support Webpage
www.saskatchewan.ca/COVID19Defensive Strategy Highlights
Dr. John Froh
Deputy Chief Medical Officer - Pandemic
John Ash
Executive Director of Acute Care Regina
COVID-19
Health System Update
www.saskatchewan.ca/COVID19Defensive Strategy
Key Goal: Adapt/expand to meet projected COVID-19 demand
in hospitals.
Key Strategies: Key Factors Going Forward
• Surge acute capacity through use of surge spaces/processes.
• Utilize and balance capacity across the SHA to manage the Acuity of patients is Patients presenting to
care needs of COVID and non-COVID patients. higher than what was Acute Care are
• Convert hospitals to Alternate Level of Care where required. experienced in the decompensating
fall/winter quicker
• Enhanced outbreak management mitigation and response
capacity. B.1.1.7 variant is 50% more infectious, 60%
more severe and is impacting a younger
• Field hospitals for contingency scenario only. demographic
Performing well across all strategies despite extremely high
hospitalization rates over the last 2-3 months.
www.saskatchewan.ca/COVID191st Pandemic: March 2020-Feb 2021 2nd Pandemic: March 2021-TBD
Original COVID Strain Variants of Concern (VOC)
Original COVID strain less transmissible, less severe and less deadly 64% increased risk of hospitalization
than VOCs Up to 100% increase risk of requiring ICU
Up to 61% increase risk of death
Ratio of acute bed to ICU: 4-to-1 Ratio of acute bed to ICU bed in Regina:
1.5-to-1
Lower severity of illness compared to patients in 2nd pandemic Puts burden on most highly trained, least available & hardest to recruit staff
ICU admissions lag high case counts ICU admissions occurring earlier/faster/longer
ICU patients primarily elderly with comorbidities Disproportionately young, otherwise healthy people
Deteriorate faster
System was shut down in initial phase Capacity challenges magnified:
Targeted slow downs only, most services available + vaccine rollout
Vaccines were not available Vaccines have mitigated impact on older populations.
Not vaccinating all congregate living facilities creates risk for increased
acute demand
www.saskatchewan.ca/COVID19Variants of Concern Related Demand More Aggressive
www.saskatchewan.ca/COVID19Current State: Regina ICU Census by Age Group (Mar 1-Apr 14)
www.saskatchewan.ca/COVID19Current State ICU Surge
VOCs in Regina:
If Regina situation
unfolds province-
wide, ICUs will be
overwhelmed
www.saskatchewan.ca/COVID19Current State ICU Comparison
Provincial April 20 COVID+ Rate of COVID+ ICU Per 1 Million Active Case Rates per 100,000
ICU Census Population
Saskatchewan 51 43.4/million 152
Saskatoon 10 36.6/million 84
Regina 35 153/million 198
BC 121 24.7/million 140
ON 334 Intubated 23.8/million intubated 207
AB 88 19.8/million 230
* If entire province reaches Regina levels, approx.
180 people in ICUs (227% normal capacity)
www.saskatchewan.ca/COVID190
5
10
20
30
35
15
25
1-Mar
2-Mar
3-Mar
4-Mar
5-Mar
6-Mar
7-Mar
8-Mar
9-Mar
10-Mar
11-Mar
12-Mar
13-Mar
14-Mar
15-Mar
16-Mar
17-Mar
18-Mar
19-Mar
20-Mar
21-Mar
22-Mar
23-Mar
24-Mar
25-Mar
26-Mar
27-Mar
28-Mar
29-Mar
ICU COVID Census
30-Mar
31-Mar
1-Apr
2-Apr
3-Apr
4-Apr
5-Apr
6-Apr
7-Apr
8-Apr
9-Apr
10-Apr
11-Apr
12-Apr
13-Apr
14-Apr
15-Apr
16-Apr
17-Apr
18-Apr
Current State & Trends: Regina vs Saskatoon
19-Apr
the PHO
www.saskatchewan.ca/COVID19
Growth AFTERICU Capacity and Potential Demand
Daily Total (COVID + Non-COVID) ICU Census
180
150+ Patients
ICURN:Patients Ratio Severely Altered
Majority of Care Provided by Non-Traditional ICU Staff
160
Disaster Triage Required
116-150 Patients
140 ICURN:Patients Ratio Significantly Altered
Utilizing Significant Non-Traditional ICU Staff
Significant Service Slowdowns/Cancellations
120 Traige Widely Applied, Commensurate to Occupancy
79-116 Patients
100 94 ICU April 22 ICURN:Patients Ratio Altered
Utilizing Non-Traditional ICU Staff
Service Slowdowns Required
80 Some Triage RequiredICU Surge Planning
Facility Name Baseline Bed Capacity Base ICU Surge Plan as Red Contingency ICU Surge
(79 adult beds) of April 14, 2021 Black (150+)
(up to 116 beds) * (up to 150 beds)
adding 3 PICU beds to
79)
Battleford Union 3 0% Increase 33% Increase 33% increase
Victoria Hospital PA 8 13% Increase 38% Increase 50% increase
St Pauls Hospital Saskatoon 12 92% Increase 133% Increase 150% Increase
Royal University Hospital 15 53% Increase 87% Increase 100% Increase
Saskatoon
JPCH 0 3* 6* 6 beds total
Regina General Hospital 20 110% Increase 170% Increase 200% Increase
Pasqua Hospital Regina 7 86% Increase Unable to increase more Unable to increase more
Yorkton Regional Health Center 6 50% Increase 83% Increase 100% Increase
Dr FH Wigmore Hospital 4 50% Increase 125% Increase 150% Increase
Cypress Regional Health Center 4 100% Increase 200% Increase 350% Increase
– Swift Current
www.saskatchewan.ca/COVID19Provincial Programs: Critical Care
Action Plan to safely Increase Critical Care Capacity:
• Ongoing work on virtual support between tertiary and regional ICU teams including the development of
electronic charting and access to eViewer/SCM etc and other modalities to help with strong consultation
processes in place.
• Discussions with colleagues in SAA, STARS and EMS to better understand the capacity and plans for
transport of critically ill patients.
• Final work to support more physician coverage in regional sites that are planning on increasing ICU
capacity.
• Ongoing conversations in regards to the critical care resource allocation framework and decision making
processes for triage of patients. We have NOT yet stood this up in the province.
• Teams are very tired
• Began tracking HCW:patient ratio's of care, acuity of patients in the ICU (intubated/ventilated, proned,
ECMO etc) to better understand care burden and load levelling capacity which will be used to inform EOC
and the ministry specifically on critical care acuity.
• Continue to have critical care OR cancellations due to capacity which creates significant challenges for ICU
and surgical teams.
• As of April 21, there are an additional 38 ICU surge beds open in the province
www.saskatchewan.ca/COVID19ICU Capacity and Potential Demand
Daily Total (COVID + Non-COVID) ICU Census
180
150+ Patients
ICURN:Patients Ratio Severely Altered
Majority of Care Provided by Non-Traditional ICU Staff
160
Disaster Triage Required
116-150 Patients
140 ICURN:Patients Ratio Significantly Altered
Utilizing Significant Non-Traditional ICU Staff
Significant Service Slowdowns/Cancellations
120 Traige Widely Applied, Commensurate to Occupancy
79-116 Patients
100 94 ICU April 22 ICURN:Patients Ratio Altered
Utilizing Non-Traditional ICU Staff
Service Slowdowns Required
80 Some Triage RequiredSafety Update
Dr. Mark Fenton
Saskatoon – Pandemic Area Chief of Staff
COVID-19
Health System Update
www.saskatchewan.ca/COVID19Aerosol Generating Medical Procedures List
• Removal of the Unclear AGMP Potential section of the AGMP List based on
recommendation from the Safety Expert Panel
• Change went into effect on April 21, 2021
• Nebulization and ventilator circuit disconnect without a filter in place have been
added to the AGMP column
• Moved to the Not AGMP column
• Ventilator circuit disconnect (assuming filter in place)
• Gastroscopy
• ERCP
• Transesophageal Echocardiogram (TEE)
• Nasopharyngoscopy
www.saskatchewan.ca/COVID19Safety Bulletin
Scan the QR code below for the
latest Safety Bulletins:
• 16th edition – April 19th
• COVID-19 Vaccine and Benefits for
Healthcare Workers
• More details re: removal of the Unclear
AGMP Potential section of the AGMP List
www.saskatchewan.ca/COVID19The Fundamentals of Civility
Dr. Alana Holt
Co-Lead Pandemic Physician Wellness and Psychiatry
Response Team
Physician Health Program, SMA
Student Wellness Centre, U of S
Dept. of Psychiatry, College of Medicine
COVID-19
Health System Update
www.saskatchewan.ca/COVID19The Five Fundamentals of Civility
1) Respect Others and Yourself.
2) Be Aware.
3) Communicate Effectively.
4) Take Good Care of Yourself.
5) Be Responsible
www.saskatchewan.ca/COVID19Acknowledgement
Dr. Michael Kaufman, Medical Director (Ret.), OMA Physician Health Program.
Articles published in the Ontario Medical Review, 2014 – 2015
or discussed in a webinar at www.afmc.ca
Used with permission.
www.saskatchewan.ca/COVID19Respect Others and Yourself.
Respect for those we know and like.
Respect for those we do not know well.
Respect for those with whom we do not agree.
Civility towards those we aren’t able to respect.
www.saskatchewan.ca/COVID19Respect Others and Yourself
Respect For Those We
Know And Like Be present. Mind space. Share appropriately.
Mind time. Empathy.
Respect For Those We Do
Not Know Well
Engage. Learn role. Invite opinions. Listen actively. Appreciate.
Respect For Those With
Whom We Do Not Agree Assume positive intent. Seek to understand. Engage discussion. Value humanity.
Value the organization. Respect systems.
Civility Towards Those We
Are Not Able To Respect, Civility vs. Incivility. Your behaviour and impact on others and self. Understand
And The Role of Self- procedural steps. Exhibit leadership- courteous, collaborative, assertive
Respect communication. Self respect and compassion.
www.saskatchewan.ca/COVID19The Impact of Civility
• Leads to positive social interactions:
• strong and effective connections
• inspires confidence in the group
• Identifies supportive and helpful resources, and increases efficacy.
• Fosters inclusivity, co-operation, collaboration, team work.
• Is energizing and empowering. Enhances self-respect.
• Improve the health of the care providers.
• Improves the health and culture of the system.
Modified from M. Leiter, New York. 2013
www.saskatchewan.ca/COVID19Your Physician Health Be Civil, Be Kind, Be Respectful
& Wellness Supports
Scan the QR Code to
access Physician Town Hall
Wellness presentations
and more!
Health Care Worker Mental Health Support Hotline:
1-833-233-3314 8am – 4:30pm, Monday-Friday
Saskatoon, NE, NW:
Brenda Senger
Physician
306-657-4553 Thank you for all that
Regina, SE/SW:
Health Jessica Richardson you do!
Program 306- 359-2750Partners
www.saskatchewan.ca/COVID19Q&A Please respond to
Please enter your question in the Q&A section
the live poll!
OR
Raise your hand and we will unmute you so you can comment
or ask your question liveGood News Story! –
Thank you to the over 100 physicians who have completed the Physician Skill
Enhancement program who are ready to support!
Have a good news story to share? Send us an email at news@saskhealthauthority.ca
www.saskatchewan.ca/COVID19Next Town Hall
Thursday April 29, 2021 - 18:00-19:30
Thank you for attending!
www.saskatchewan.ca/COVID19You can also read
