COVID-19 UPDATES

Self-Assess for COVID-19 and download the app here: https://covid19.thrive.health/

All updates on this page have been sent as clinic-wide emails to clients of the clinic. If you have not received an email, please check your spam folder or your featured tab menu in your email account as often these automatically get sorted by your email provider.

Hello SCBP Clients,

A quick update for you! As we try many ways to reach you with most of our appointments being by phone, we suggest you kindly help us out by:

-Watching for regular email updates from South Community Birth
-Watching your spam folder for a message from a care-provider with a “no-return” email address. (their name should be recognizable)
-Listening to phone messages from a blocked phone number. It might be one of our providers telling you they are going to call you again soon or want to give you a time for your next telephone or in clinic appointment.

Thanks so much

COVID-19: Update #6 - March 28, 2020

NOTHING IS MORE IMPORTANT THAN THE SAFETY OF ALL OUR PATIENTS -

PLEASE HELP US TO ACHIEVE A ZERO CONTACT INFECTION RATE AT OUR CLINIC

To keep us all safe we continue to update how we are booking our appointments - by phone, video or in-person clinic visits.

Update #6 Contents page

  1. Covid-19 self assessment 1
  2. Vaccine clinics
  3. Virtual appointments - how to book
  4. All visits - have pharmacy information ready
  5. SCBP - prenatal and postpartum visits
  6. Update on pregnancy and COVID-19
  7. Virtual support group - for pregnancy people and their partners
  8. Virtual support group - Fear and uncertainty during a pandemic
  9. Government financial support programs - Emergency Response Benefit
  10. Helpful links for grownups
  11. Helpful links for kids

Our phone lines are very busy, all day. Before you call us with Covid-19 questions, please do this self assessment. This is updated as recommendations from the BC Centre for Disease Control evolve.

COVID-19 Self-Assessment

https://www.thrive.health/covid19

South Hill Health Centre

Vaccine Clinics for children age 2 months to 18 months

Thank you for your patience while we took the time to find a way to give your child their routine immunizations in the safest way. To minimize your interaction with other families and staff at the clinic we will be opening the clinic on Saturdays for spaced out, booked, vaccine only appointments. Starting Saturday April 4th, 2020. These appointments will be for babies aged 2 months to ~ 18 months only. For children 4-6 years old requiring vaccines, these will be delayed for now. After reviewing with the BC Children’s Hospital Immunization program, our in-house Pediatrician and the Canadian Pediatric Society recommendations, this is how we can help you get your vaccines during this challenging time.

Click here for details about booking a Vaccine Clinic Appointment (vax link here)

Reminder: The vaccine visit will be limited to vaccines only

Virtual Appointments - how to book

Click to get started with Doxy.me video appointments. It is very simple for you to use and only requires your consent to use and then sign in. We encourage you to book a video appointment, face-to-face with your care provider.

For all phone/video appointments and prescription renewals: please have your preferred pharmacy information available at the time of your phone or virtual visit including; Name of your pharmacy, address, phone and fax numbers.

You will still NOT be able to book an in-person/clinic appointment online - you must call the clinic at 604-428-8878, to REQUEST a face-to-face appointment. Your request will be reviewed by a care provider and if they feel a clinic visit is needed, we will call you to come in.

As per our last update, ALL EXISTING / PREVIOUSLY BOOKED APPOINTMENTS ARE HELD EITHER BY PHONE OR VIDEO APPOINTMENT. This includes appointments you have previously booked, either online or by phone with our medical office assistants. You will be called by your care provider (doc or NP) close to the time you have booked for your existing appointment. Please stay close to your phone at this time and accept a call even if it is from a blocked number. If your care provider feels an in-clinic visit is needed, we will let you know and call you to come in.

BOOKING NEW APPOINTMENTS. We have made some changes to our South Hill website online booking page at: https://southhillhealth.com. Now at the time of booking you can choose between a phone or video appointment online.

South Community Birth Program - Starting Monday March 30

We are continuing to follow BC Women’s Hospital (and the World Health Organization’s) suggested schedule of visits for check-ups, for low-risk pregnant people. If your South Hill doctor works at the Family Practice Maternity Service at BC Women’s, please be advised that they will also be following this schedule:

For Prenatal Care, First visit - up to 12 wks -this will be done by phone or video. All relevant testing will be ordered. We will see you for in person visits at: 16 wks; 22 wks; 28 wks; 32 wks; 35 wks; 37 wks; 39 wks; and 40 wks (then weekly or more frequent as needed).

For visits in person, in the clinic, please arrive at your appointment time and stay in your car. Your care provider will call you and conduct the majority of your appointment on the phone/video and then ask you to come in for the physical exam portion of your visit. This is being done to minimize the amount of time you are in the clinic. When you arrive in the clinic we are practicing Physical Distancing.

We will continue to do most of our information sharing on the phone/video. While we are in this critical phase of Physical Distancing, we will be doing quick medical check-ups in the clinic but all necessary lab requisitions and relevant educational materials will be emailed. Your care provider will be booking your follow-up details after every appointment. Some pregnant people may need fewer in-person visits, while others with complications will need more.

For Postpartum Care, our hospital or in-clinic visits will be held on approximately days 1 and 2. Clinic visits will be booked in 2 parts- a 15 minute clinic visit for the exam and then a follow up phone or video appointment to review the baby’s feeding plan, etc. We will see you again in the first week; then at 2, 4 and 6 weeks. There will be as many phone/video appointments as needed, in between these postpartum visits.

Connecting Pregnancy

By mid-April, CP will soon be back-up and running, on video, using Zoom. Stay tuned for more details.

If there are any concerns about you or your baby’s well-being, at any time, you will be instructed to call the urgent on-call line at 604-875-2161 (ask for SCBP provider on-call)


Update on Pregnancy and COVID-19

On Thursday Mar 26, BC Women’s Hospital, Obstetricians/Infectious Disease specialists (Dr Deb Money and Dr. Julie Van Schalkwyk) carefully reviewed the currently available studies and presented the following information at web-based Rounds:

  • Pregnant people are not at more risk of acquiring SARS CoV2, nor at more risk of getting severe disease than comparable aged adults.
  • Pregnant people who are not working in essential services or health care should socially isolate like all members of the community.
  • Those who are in essential services including health care workers can continue to work if asymptomatic and not a recent COVID-19 contact.
  • Any pregnant person who develops an influenza like illness should be evaluated, by phone consult if needed, and consideration of oseltamivir treatment if symptoms consistent with influenza and less than 72 hours since symptom onset as influenza in pregnancy can be complicated and influenza is still circulating in BC.
  • If a pregnant person develops symptoms consistent with COVID-19 and is in the third trimester (after 28 weeks) they should be tested and then managed according to the severity of the illness.

The SOGC highlights the fact that each person’s circumstances may involve a different level of risk: pregnancy risk, health status and risk of exposure. They recommend consulting the occupational health and safety department in your workplace to determine how best to protect yourself. PPE and good hygiene practice are recommended, along with additional measures on a case-by-case basis. [March 13th 2020]

We are offering the two virtual support groups via Zoom with our fantastic Counselor, Danielle Schroeder. This one is specifically for pregnant people/couples:

Prenatal virtual support group (facilitated by Registered Clinical Counsellor, Danielle Schroeder, MA, RCC):

We are all dealing with a tremendous amount of uncertainty, confusion and changes to our daily lives, which can cause increased anxiety, depression and fear. If you are feeling unsettled or worse, please know that we are here to help. We are offering a Virtual Prenatal Support Group for expecting parents. Social support is an important part of self-care during this time of physical distancing.

This Virtual Prenatal Support Group is a safe space to discuss anxiety, fear, your relationship, pregnancy, and care of self, during this time of social distancing and uncertainty.

The group will take place using the Zoom platform which is safe and easy to use.

This is a pre-registered group and will be limited to 8 people (or couples) per session which will run over 3 weeks.

Group session dates:

Session 1: Thursdays April 16th, 23rd, & 30th from 2-330pm

Session 2: Thursdays May 7th, 14th, & 21st 2-330pm

Cost : $75 for the session (includes all three groups in that session). Same price if you are one person or a couple attending.

Subsidies are available!

For more information or to register please email Danielle at: yellaschroeder@gmail.com

This one is specifically for dealing with anxiety, fear and uncertainty during COVID-19:

Living with fear and uncertainty during a pandemic

Thursday April 2nd, 2020,

2-3pm

with Danielle Schroeder (registered clinical counsellor)

Nothing could have prepared you for navigating the joys and fears of pregnancy and/or caring for a new baby during a pandemic. It is proving to be a jarring experience for most and brings with it overwhelming feelings of fear, panic, and stress. In this free one-hour workshop we will explore what it means to live with fear and uncertainty in your life right now, offer strategies to feel more safe and in control, and ultimately trust in your capacity to get through this.

If you’re interested to attend please email Danielle at:

yellaschroeder@gmail.com






Government Financial Support

This is a detailed list of financial support including; the Emergency Response Benefit (available in April); Support for students and seniors; mortgage assistance; increasing the child tax benefit

https://www.canada.ca/en/department-finance/economic-response-plan/covid19-individuals.html

COVID-19 Provincial Emergency Support

BC is implementing a number of emergency measures:

https://www2.gov.bc.ca/gov/content/safety/emergency-preparedness-response-recovery/covid-19-provincial-support

Supporting Renters, Landlords during COVID-19

Additional measures to keep people housed and protect their health:

https://news.gov.bc.ca/releases/2020MAH0048-000561

Support for Canadians and Businesses during COVID-19

These measures were delivered as part of the Government of Canada’s COVID-19 Economic Response Plan and will provide up to $27 billion in direct support to Canadian workers and businesses.

https://www.canada.ca/en/department-finance/news/2020/03/canadas-covid-19-economic-response-plan-support-for-canadians-and-businesses.html

Work-sharing Program

Your company may qualify for the work-sharing program. Work-Sharing (WS) is an adjustment program designed to help employers and employees avoid layoffs when there is a temporary reduction in the normal level of business activity that is beyond the control of the employer.

https://www.canada.ca/en/employment-social-development/services/work-sharing.html

Here is specific information on Ei benefits and new policies for COVID-19 related cases.

https://www.canada.ca/en/employment-social-development/corporate/notices/coronavirus.html

Work Absence

If your employer has requested a sick note in order for you to be off work related to COVID19 illness, or risk of illness, please provide them with the following letter. You do not need a medical certificate from your doctor, NP or midwife:

https://bcfamilydocs.ca/wp-content/uploads/2020/03/COVID-19-Employer-Sick-Note-BC-Family-Doctors-25032020.pdf

Taking steps to keep kids learning during school suspension

https://news.gov.bc.ca/releases/2020EDUC0026-000580



HELPFUL LINKS FOR GROWNUPS

Insight Timer App for sleep, anxiety and stress:

https://insighttimer.com/

That discomfort your feeling is grief

https://hbr.org/2020/03/that-discomfort-youre-feeling-is-grief?

Readers’ Ideas for finding community at home

https://www.nytimes.com/2020/03/24/travel/coronavirus-quarantine-what-to-do.html?

How to work from home

https://qz.com/se/work-from-home

National emergency library - download over 1.5 millions titles for free until June 30:

https://archive.org/details/nationalemergencylibrary



HELPFUL LINKS FOR KIDS

Pluto the Dog’s latest message to kids

https://www.youtube.com/watch?v=Q5ATJTtIkPQ

A kids guide to cornonavirus - podcast

https://www.nytimes.com/2020/03/27/podcasts/the-daily/kids-coronavirus.html

A big list of podcasts for kids:

https://www.nytimes.com/2020/03/17/parenting/podcasts-for-kids.html

National emergency library - download over 1.5 millions titles for free until June 30:

https://archive.org/details/nationalemergencylibrary



Stay healthy and safe,

Lee Saxell (she/her), RM, MA

(Co-Director) on behalf of the South Community Birth Program Team

Rita McCracken (she/her), MD, PhD

(Interim Medical Director) on behalf of the South Hill Health Centre Team

We acknowledge that our clinics operate on the traditional, unceded territory of the Coast Salish peoples, including the Səl̓ílwətaʔ/Selilwitulh (Tsleil-Waututh), the xʷməθkwəy̓əm (Musqueam), and the Skwxwú7mesh (Squamish) Nations.

If you are experiencing an emergency, such as problems breathing, please call 911.

If you have health concerns, call HealthLink BC at 8-1-1.

Your one-stop-shop for all our patient updates: https://southhillhealth.com

COVID-19: Update #5 - March 20, 2020

NOTHING IS MORE IMPORTANT THAN THE SAFETY OF ALL OUR PATIENTS -

PLEASE HELP US TO ACHIEVE A ZERO CONTACT INFECTION RATE AT OUR CLINIC

Covid-19 information is still changing hour to hour. We are trying to keep our patients updated on what is happening at our clinic, plus provide a synopsis of trustworthy information.

UPDATES ABOUT BOOKING APPOINTMENTS

South Hill Health Centre - Starting Monday March 23

As per our last update, ALL EXISTING / PREVIOUSLY BOOKED APPOINTMENTS ARE HELD EITHER BY PHONE OR VIDEO APPOINTMENT. This includes appointments you have previously booked, either online or by phone with our medical office assistants. You will be called by your care provider (doc or NP) close to the time you have booked for your existing appointment. Please stay close to your phone at this time and accept a call even if it is from a blocked number. If your care provider feels an in-clinic visit is needed, we will let you know and call you to come in.

***IMPORTANT: WE NEED YOUR CURRENT CONTACT INFORMATION***

PLEASE LET US KNOW THE PREFERRED PHONE NUMBER FOR REACHING YOU. PLEASE TYPE THIS NUMBER INTO YOUR APPOINTMENT REQUEST WHEN BOOKING ONLINE.

BOOKING NEW APPOINTMENTS. We have made some changes to our South Hill website online booking page at: https://southhillhealth.com. Now at the time of booking you can choose between a phone or video appointment online.

Our new online video network provider is called Doxy.me. You will receive an email with details - it is very simple for you to use and only requires you to sign a consent and then sign in. Stay tuned for more information about Doxy.me.

You will NOT be able to book an in-person/clinic appointment online - you must call the clinic at 604-428-8878, to REQUEST a face-to-face appointment. Your request will be reviewed by a care provider and if they feel a clinic visit is needed, we will call you to come in.

Our phone lines are very busy all day. Before you call us with Covid-19, please do this self assessment and check the recent Covid-19 updates, which may answer your questions:

https://www.thrive.health/covid19

South Community Birth Program - Starting Monday March 23

We will also be doing more phone visits (either Skype/Zoom) starting Monday. However, pregnant people and newborn babies will still need to be seen for physical check-ups. We will follow BC Women’s Hospital (and the World Health Organization’s) suggested schedule of visits for check-ups, for low-risk pregnant people. If your South Hill doctor works at the Family Practice Maternity Service at BC Women’s, please be advised that they will also be following this schedule:

Visit #1 - up to 12 wks. This will be done by phone or video. All relevant testing will be ordered.

Visit #2 - 16 wks

Visit #3 - 22 wks

Visit #4 - 28 wks

Visit #5 - 32 wks

Visit #6 - 35 wks

Visit #7 - 37 wks

Visit #8 - 39 wks

Visit #9 - 40 wks (then weekly or more frequent as needed)

While we are in this critical phase of Social or “Physical” Distancing, we will be doing quick medical check-ups in the clinic but information sharing will be on the phone/video. All necessary lab requisitions and relevant educational materials will be emailed in advance. Your care provider will be booking your follow-up details after every appointment. Some pregnant people may need fewer in-person visits, while others with complications will need more.

If there are any concerns about you or your baby’s well-being, at any time, you will be instructed to call the urgent on-call line at 604-875-2161 (ask for SCBP provider on-call)

For postpartum care, our hospital or clinic visits will be held at approximately:

Visit #1 & #2 - in Week 1

Visit #3 - in Week 2

Visit #4 - Week 4

Visit #5 - Week 6

This will be adjusted if more are needed. There will be as many phone/video appointments as needed, inbetween these postpartum visits. However, we will be minimizing visits to the clinic in order to protect everyone. As always, for any concerns you have 24 hours access to our careproviders at 604-875-2161 (ask for the SCBP provider on call).

Covid-19 - Symptoms

  • Incubation of Covid-19 is 1-14 days but mostly 3-7 days (average 5 days)
  • Most will get a mild respiratory illness: 89% fever; 68% cough; 38% fatigue; 34% sputum production (thick mucous when coughing); 19% shortness of breath; 14% sore throat; 14% headache
  • Uncommonly, there will be diarrhea and vomiting
  • Sore throat, runny nose, and muscle aches are uncommon, so it is not typical of the flu or a cold

If you have been asked to self-isolate due to contact with someone with COVID-19, or have the illness, contact your care provider immediately.

New Provincial Covid-19 Symptoms Self-Assessment Website Launched

This site is updated as recommendations from the BC Centre for Disease Control evolve.

https://www.thrive.health/covid19

UPDATE ON PREGNANCY AND AFTER THE BABY COMES

The increased risk for older people and those with chronic health issues has received a lot of coverage, but there has been less information for people who are pregnant or just had a baby. On Thursday Mar 19, BC Women’s Hospital experts updated care providers at a web-based rounds. That same day the BC Centre for Disease Control also released guidelines for pregnancy. Below are some highlights:

Pregnancy

  • Pregnant patients are NOT more susceptible to contracting Covid-19
  • It is expected the large majority of pregnant people will experience only mild or moderate cold/flu like symptoms.
  • Less than 20% will develop severe symptoms
  • Pregnant patients with mild COVID 19+ symptoms should be kept at home in self-isolation when possible. Most will only experience mild or moderate cold/flu like symptoms. Visitors should be kept to a minimum
  • Care should be done by phone or other Virtual health options
  • Pregnant people should be advised NOT to come to hospital unless they are in need of urgent obstetric or medical care
  • While pregnant people with symptoms should self-isolate at home, if these symptoms are in the 3rd trimester, swab for Covid-19 and influenza.

Labour

  • At BC Women’s, Anesthetists (expert doctors who place epidurals, etc) are encouraging early epidural for labour pain relief in order to reduce the risk of giving a general anesthetic (GA) for an emergency cesarean section. GA allows for the highest risk of transmission of the virus. Of course, the decision to have an epidural, or not, rests with the labouring person.
  • Only one support person may accompany you in labour (a doula may also attend).

Postpartum

  • There are no visitors allowed in the hospital during your stay
  • If the new parent is Covid-19 positive, keeping parent and baby together is recommended
  • New parent is to wear mask and utilize strict hand washing protocol for breastfeeding and skin to skin
  • Breastfeeding is encouraged because the protective effect of breastfeeding is particularly strong against infectious diseases through directly transferring antibodies and other important immune factors to the baby
  • Test infant for COVID-19 No isolation of infant from parent unless clinically indicated by disease severity
  • Where appropriate, early discharge of the baby with a parent or caregiver, should be facilitated

WORK ABSENCE & EMPLOYMENT INSURANCE

Thanks to Dr Jennifer‌ ‌Robson, at ‌Carleton‌ ‌University for putting together this comprehensive document regarding Employment Insurance.

As per instructions from the Minister of Health and the Provincial Medical Officer of Health, you will not need a note to miss work if you have symptoms: https://news.gov.bc.ca/releases/2020HLTH0077-000484

People in quarantine (including those who are not sick and those whose workplace is closed to enforce social distancing), can apply for Employment Insurance Medical Leave. You do not need a medical certificate from your doctor, NP or midwife:

https://www.canada.ca/en/employment-social-development/corporate/notices/coronavirus.html

COVID-19 - HELPFUL LINKS FOR GROWNUPS

Anxiety Canada

https://www.anxietycanada.com/articles/what-to-do-if-you-are-anxious-or-worried-about-coronavirus-covid-19/

Calm - Take a deep breath. Train your mind to sleep more, stress less and live better https://www.instagram.com/calm/?hl=en

Talking to your kids about coronavirus and social distancing

https://www.forbes.com/sites/tarahaelle/2020/03/18/talking-to-your-kids-about-coronavirus-and-social-distancing/#45a594d32c15

I visited 18 countries today - how about you?

https://www.messynessychic.com/2020/03/19/i-visited-18-countries-today-how-about-you/?

20 things to do at home instead of banging your head against a wall

https://www.messynessychic.com/2020/03/12/hobbies-at-home/

COVID-19 - HELPFUL LINKS FOR KIDS

Pluto the Dog’s Message to Kids - we are following Pluto!

https://www.youtube.com/watch?v=eiBYw3bDFro

Cats teach kids how the virus spreads https://twitter.com/ziyatong/status/1240303392188248070

Children Stuck at Home Can Still Explore the Zoo or Aquarium. Some Penguins Could, Too.

https://www.nytimes.com/2020/03/18/us/coronavirus-zoos-webcams.html



Stay healthy and safe,

Lee Saxell (she/her), RM, MA

(Co-Director) on behalf of the South Community Birth Program Team

Rita McCracken (she/her), MD, PhD

(Interim Medical Director) on behalf of the South Hill Health Centre Team

We acknowledge that our clinics operate on the traditional, unceded territory of the Coast Salish peoples, including the Səl̓ílwətaʔ/Selilwitulh (Tsleil-Waututh), the xʷməθkwəy̓əm (Musqueam), and the Skwxwú7mesh (Squamish) Nations.

If you are experiencing an emergency, such as problems breathing, please call 911.

If you have health concerns, call HealthLink BC at 8-1-1.

Your one-stop-shop for all our patient updates: https://southhillhealth.com




COVID-19: Update #4 - March 17, 2020

NOTHING IS MORE IMPORTANT THAN THE SAFETY OF OUR PATIENTS - PLEASE HELP US TO ACHIEVE A ZERO CONTACT INFECTION RATE AT OUR CLINIC! STAY HOME UNLESS YOU ARE SPECIFICALLY INSTRUCTED TO COME IN


South Hill Health Centre - starting tomorrow, Wednesday March 18

ALL EXISTING APPOINTMENTS ARE NOW BOOKED AS PHONE APPOINTMENTS. This includes appointments you previously booked online or on the phone. You will be called by your care provider at approximately the time you are booked for your existing appointment. Please stay close to your phone at your appointment time. If your care provider feels you MUST be seen in person, they will call or email you personally.

STAY SAFE AND DO NOT COME INTO THE CLINIC UNLESS ABSOLUTELY NECESSARY.

FOR NEW APPOINTMENTS: As of tomorrow, March 18, all appointments will be by phone. If you believe you must see a care provider for acute medical illness or an emergency, YOU MUST PHONE THE CLINIC to book an in-person appointment (604-428-8878). (NOTE: You will be asked some health questions so we can determine whether you should speak to a care provider and/or where we should see you: either in the clinic or in our back parking lot in our mobile clinic (pictured below).


Monday, March 23 - We Will Launch our New Telehealth Video Platform - Doxy.me

This will enhance your virtual visits as your care provider will be able to see your health problem using a simple smartphone or computer-based video conferencing tool. Ten minutes before your scheduled appointment time you will “click on the link” that has already been texted or emailed to you and sign in to Doxy.me. You will be placed in a “virtual waiting room”, where you will be asked to complete a consent form to participate. Your care provider will “pick you up” in the virtual waiting room and your video chat will begin. Please make sure you are in a location with strong wifi and where you can speak confidentially and freely.

You will receive an email about our Doxy.me Telehealth platform.


South Community Birth Program - starting tomorrow, Wednesday March 18

We will continue to conduct many of our appointments by phone this week. You have or will receive a call from an administrator or a care provider to arrange this. Pregnancy questions and answers will be conducted on the phone, while quick belly checks and baby weights will be done in the clinic.

We will soon have information about Telehealth/video conferencing for SCBP as well.

Rest assured: we will be attending you during labour and birth - in person! We already have plans in place in case any of us should get sick. We will not miss your special day!


Changes at BC Women’s Hospital to birth attendants during labour and birth: We were concerned (and we understand) why BC Women’s Hospital (BCWH) limited and allowed only one person to support patients in labour. However, after lots of discussion,in addition to your chosen birth partner, BCWH is also allowing the attendance of professional doulas, recognizing how much value they bring to the labour and birth. Our hats are off to BCWH for acknowledging the importance of the doula for not only labour support but also for being cultural brokers and providing valuable language translation during labour.

Registered Clinical Counselor: Has Covid-19 caused you to feel more anxious? Our registered counselor, Danielle Schroeder, is now booking on-line appointments. Contact her to inquire about her sliding scale fees. Extended health covers her services.

https://oab.owlpractice.ca/danielleschroeder/booking

Remember: You do not need a Doctor/NP/Midwife note for sick leave if you are ill or required to self-isolate.

New Provincial Covid-19 Website Launched Mar 16

Wondering if you need to be swabbed for COVID19? Use this link:

https://www.thrive.health/covid19

We have been working with a fantastic company called Thrive Health (www.thrive.health). They have been developing our soon-to-be-launched South Community Birth Program APP (now in patient testing mode). They very quickly developed and launched a Covid-19 website for the Ministry of Health and the BC Centre of Disease Control. Currently, this is THE site for up-to-the-minute information on Covid-19, in BC. Save this link in your bookmarks and pass it on.


Travel Advisory Notice

Nothing has changed about travelling out of Canada: no non-essential travel outside of Canada, including to the United States. Anyone choosing to travel will be required to self-isolate for 14 days upon return.

The big change is who can come into Canada: Our borders are now closed, except for those from the United States. We are staying up-to-date on whether this controversial exception will stay in place. This has been a big disappointment for many of our pregnant patients, who were planning for the arrival of their family, South of the US border or from overseas, to celebrate the birth of their new family member (and help out!).

https://pm.gc.ca/en/news/news-releases/2020/03/16/prime-minister-announces-new-actions-under-canadas-covid-19-response

Schools Closing in BC

The big news today is that all BC K - 12 Schools Suspended Indefinitely. Our last update had a question mark at the end of the above heading. The question mark is gone. But we suspect all you parents out there already know this:

https://www.cbc.ca/news/canada/british-columbia/coronavirus-covid-19-bc-schools-1.5500453

On the last update we sent you a link on : How to prepare for extended school closings – and not lose your mind. https://www.upworthy.com/tips-for-parents-coronavirus

Here are a few more ideas to keep your kids occupied and preserve your sanity:

Stuck at home? These 12 famous museums offer virtual tours you can take on your couch:

https://vt.co/lifestyle/if-youre-stuck-at-home-these-12-museums-offer-virtual-tours-you-can-take-from-your-couch

Budding music producers in your progeny? Here is a kitchen at-home training video:

https://www.youtube.com/watch?v=Wk5sVLgAsVw

Show your kids how Social Distancing Works:

https://www.youtube.com/watch?v=8Hi9-5F2zW4



Stay healthy and safe,

Lee Saxell (she/her), RM, MA

(Co-Director) on behalf of the South Community Birth Program Team

Rita McCracken (she/her), MD, PhD

(Interim Medical Director) on behalf of the South Hill Health Centre Team


If you are experiencing an emergency, such as problems breathing, please call 911.

If you have health concerns, call HealthLink BC at 8-1-1.

Your one-stop-shop for all our patient updates. https://southhillhealth.com

We acknowledge that our clinics operate on the traditional, unceded territory of the Coast Salish peoples, including the Səl̓ílwətaʔ/Selilwitulh (Tsleil-Waututh), the xʷməθkwəy̓əm (Musqueam), and the Skwxwú7mesh (Squamish) Nations.

Take the COVID-19 Self-Assessment






COVID-19: Information for Pregnancy & Birth – Update #3 - March 15, 2020

At South Community Birth Program and South Hill Health Centre, we are collapsing our news updates into one because we have so much overlap of our patients & as care providers – we are one family! We are working hard to keep you well informed with the latest updates and breaking news. This update is specifically directed at our pregnant patients who will be giving birth at BC Women’s Hospital.

The 3 leading organizations for Obstetrics and Gynecology published Covid-19 practice advisories this week. You can read them here:

These are the key highlights from all 3 of these key organizations:

PREGNANCY

  • Pregnant people should be considered an at-risk population due to physiologic and immunologic changes in pregnancy
  • Covid-19 transmission to the baby in pregnancy seems unlikely. There has been a single case report of possible transmission in pregnancy. Again, there is very limited data.
  • As there is no evidence your baby can get infected while in the uterus it is currently considered unlikely that there will be congenital effects of the virus on your baby’s development.
  • To date, there is currently no conclusive data suggesting an increased risk of miscarriage or early pregnancy loss in relation to COVID-19. Case reports from early pregnancy studies with SARS and MERS reported pregnancy losses but did not demonstrate a convincing relationship between infection and increased risk of miscarriage or second trimester loss.
  • As with SARS and MERS and drawing upon our knowledge of other respiratory illnesses in pregnancy, adverse outcomes are likely to be strongly correlated with degree of illness – most pregnant people who contract Covid-19 will experience only mild or moderate cold/flu like symptoms.
  • If you are immunocompromised, have asthma or lung disease, diabetes, renal disease, or chronic illness, be extra vigilant in pregnancy with hand hygiene and Social Distancing.
  • If you do have the Covid-19 virus in pregnancy it is recommended you have an ultrasound 14 days following the resolution of acute illness.

There might be a greater risk of the baby’s growth being restricted in the uterus and being born smaller than usual - based on data from other coronaviruses (e.g. two-thirds of pregnancies with SARS were affected by small intrauterine growth). Therefore, pregnant people with Covid-19 should be have an ultrasound to monitor for growth restriction in the baby.

LABOUR

  • In two case series in China, including a total of 18 pregnant persons infected with COVID-19 and 19 babies (one set of twins), there were 8 reported cases of fetal compromise. Given this relatively high rate of fetal compromise, continuous electronic fetal monitoring in labour is currently recommended for all persons with COVID-19.
  • Beyond this we don’t have enough data to make further recommendations. For labour.

POSTPARTUM

  • There is no evidence that the virus has been found in the breast milk of people infected with Covid-19. The primary concern is whether an infected mother can transmit the virus through infective airborne droplets during the period of breastfeeding. A mother with confirmed Covid-19 or who is symptomatic with flu like symptoms should take all possible precautions to avoid spreading the virus to the infant, including washing hands before touching the infant and wearing a face mask, if possible, while breastfeeding. In the light of the current evidence, it is advised that the benefits of breastfeeding outweigh any potential risks of transmission of the virus through breastmilk.
  • All babies born to COVID-19 positive mothers should have appropriate close monitoring and early involvement of neonatal care, where necessary. Babies born to people testing positive for COVID-19 will need follow-up and ongoing check-ups after discharge from the hospital.

This guidance may change as knowledge evolves

AT SCBP: PRENATAL AND POSTPARTUM VISITS IN THE CLINIC

  1. As of Monday, March 16, we will be seeing most of our patients in the clinic for their scheduled appointment. However:
    1. Please do not come to the clinic if you are sick with a cold, cough or flu-like symptoms. Unfortunately, you will be asked to leave. We need to be able to adequately prepare to assess you and keep everyone else safe.
    2. If you are feeling sick, or are worried about COVID19 exposure, we will make a new **PHONE APPOINTMENT** for you and decide what next steps are best. If you meet the criteria we will meet you in the back parking lot (I know, sounds weird) where we will swab you at our new onsite mobile clinic.
    3. If you are sick but need a physical check-up for you or your baby, we will isolate you in a room at the clinic and we will wear protective gear for your check up.
    Our goal is nothing short of ZERO Covid-19 virus infections passed through our clinic! NOTHING IS MORE IMPORTANT THAN THE SAFETY OF ALL OUR PATIENTS - PLEASE HELP US TO ACHIEVE A ZERO CONTACT INFECTION RATE AT OUR CLINIC
  2. YOU DO NOT NEED A SICK NOTE FOR WORK ABSENCE As per instructions from the Minister of Health and the Provincial Medical Officer of Health, you will not need a note to miss work if you have symptoms:
    https://news.gov.bc.ca/releases/2020HLTH0077-000484
  3. Connecting Pregnancy (CP) Group Care, Wednesday Postpartum Drop-in and the Motherlode Groups at South Community Birth Program As of Monday, March 16, we will be cancelling all Groups until further notice. You will have been notified by Monday to reschedule your care.
  4. Travel Advisory Notice The B.C.’s Provincial Health Officer is still advising no non-essential travel outside of Canada, including to the United States. Anyone choosing to travel will be required to self-isolate for 14 days upon return.
    https://travel.gc.ca/travelling/health-safety/travel-health-notices
  5. Schools Closing in BC? This is a great piece for all the parents out there who may be home with their kids and Social Distancing: How to prepare for extended school closings – and not lose your mind.
    https://www.upworthy.com/tips-for-parents-coronavirus

All our patient updates can be found on our home page for easy access. This can now be your one stop shop for all our updates.
https://southhillhealth.com/

To end on a positive note, CBC reports that BC is NOT showing large daily spikes in % of Covid-19 cases. Look at the world report here:

https://www.cbc.ca/news/world/covid-19-coronavirus-march-7-1.5489784

Stay healthy and safe,
Lee Saxell, RM, MA (Co-Director) on behalf of the South Community Birth Program Team
Rita McCracken, MD (Interim Medical Director) on behalf of the South Hill Health Centre Team



COVID-19 Update #2 – March 14, 2020

Welcome to our second Covid-19 update. The news is shifting not only daily but indeed hourly. We are closely tracking news and health implications of COVID-19 (coronavirus).

Due to the provincial calls for social distancing and exceptionally high volume levels, we are making immediate changes to how patients are seen at South Hill. These changes are to reduce risk of COVID-19 transmission at the clinic and to reduce volume of non-essential calls and visits to allow our staff and clinicians to spend time assessing the most urgent cases.

AVOIDING IN PERSON VISITS TO CLINIC and USE OF “TELEHEALTH” PHONE AND VIDEO APPOINTMENTS

1. As of Monday, March 16, we will be switching all currently booked appointments to PHONE appointments.

  • Your MD/NP will call you at the same time your appointment is booked.
  • You do not need to do anything except make sure you are by your phone at that time (please change your phone settings to accept “unidentified callers” as the call may come from a “blocked caller ID”).
  • BUT - If your doctor or NP believes you must be seen in person, you will receive a message from the clinic and you will come in to the clinic at your already booked appointment time. Each currently booked appointment is being reviewed by your doctor/NP this weekend.
  • We will start using a free, easy-to-use video platform for visits this coming week. News about how this will work will be sent you by email and posted on our website and facebook page. Please check these often!!

2. NEW APPOINTMENTS IF YOU ARE FEELING SICK OR HAVE CONCERNS ABOUT COVID-19 EXPOSURE:

  • PLEASE do not come to the clinic sick – you will be asked to leave. We need to be able to adequately prepare to treat you and keep everyone else safe.
  • If you are feeling sick, or are worried about COVID19 exposure, please make a new **PHONE APPOINTMENT**, you will be able to speak to a doctor, NP or a midwife about your symptoms. They will help you decide what next steps are needed.

****If you are having trouble breathing or are extremely unwell, and cannot wait for a phone appointment, you should seek emergency health services at a hospital or urgent care centre****

3. CANCELLING NON-ESSENTIAL APPOINTMENTS:

  • Please consider self-cancelling (on Veribook, our online booking system) any non-essential appointments for at least the next two weeks. Non-essential visits include: well baby checks and vaccines, chronic disease check-ups or non-urgent prescription refills.
  • There will be no charges for cancelled appointments, related to these changes.
  • If you are not sure if your appointment is essential or not, keep your existing appointment as a phone appointment and you can review with your careprovider without making any extra calls to our office.

4. WE CANNOT PROVIDE NOTES REGARDING WORK ABSENCE OR PERFORM UNNECESSARY OR INAPPROPRIATE TESTING:

  • As per instructions from the Minister of Health and the provincial Medical Officer of Health, we will not be providing notes for work absence, nor will we do COVID19 swabs unnecessarily. (https://news.gov.bc.ca/releases/2020HLTH0077-00048… ) If necessary, consider showing your employer this letter.
  • We will be adhering to the screening guidelines provided by the BC CDC and Vancouver Coastal Health.

5. Connecting Pregnancy (CP) Group Care & Wednesday Postpartum Drop-in at South Community Birth Program

As of Monday, March 16, we will be cancelling all CP Groups until further notice.
You will be called to book a short appointment with a care provider, with the goal to be quickly in and out of the clinic. These appointments will be arranged in blocks to coincide with your CP group time.

6. Travel Advisory Notice

As of yesterday afternoon, the B.C.’s Provincial Health Officer is advising no non-essential travel outside of Canada, including to the United States. Anyone choosing to travel will be required to self-isolate for 14 days upon return. This is disappointing news for families planning spring break vacations. You can find the Vancouver Coastal Health current update by clicking on Latest Statement – March 12 here:
http://www.vch.ca/about-us/news/vancouver-coastal-…

In British Columbia, there have been 53 positive COVID-19 cases to date. Of these cases, four in the Vancouver Coastal Health region have now fully recovered. Today, Provincial Health Officer Dr. Bonnie Henry announced seven new cases in the province.
https://travel.gc.ca/travelling/health-safety/trav…

7. Schools Closing in Ontario

Ontario is closing all public schools for two weeks after March break. We are sharing this information with you so you can prepare in case the same thing happens in BC.
https://www.theglobeandmail.com/canada/article-ont…

8. Social Distancing

The most effective way to contain this virus is by limiting our public interactions. See this article from the Globe and Mail yesterday:

Shut it down: It’s time for Canada to get serious about social distancing.
https://www.theglobeandmail.com/canada/article-cor…

Around the world conferences and large gatherings are being cancelled - even Disneyland and Broadway plays in NYC have been shut down. Italy is now banning public gatherings and imposing travel restrictions for 60 million citizens, the first for a modern democracy.

We found this interesting graphic illustrating the power of Social Distancing. In 1918, during the Spanish Flu pandemic, Philadelphia threw a parade that killed thousands. In St. Louis, just 900 miles away, within two days of detecting its first flu cases, the city closed schools, playgrounds, libraries, courtrooms, and even churches. Public gatherings of more than 20 people were banned. This is what deaths due to the outbreak looked like in both cities:

This doesn’t mean mass quarantine or shutting down our borders. But once a virus can no longer be contained, the goal is to slow its spread. Social Distancing has proven to be the most effective method of slowing down the spread and is the best prevention advice we can offer our patients and their families. But don’t forget to also practice good hand hygiene, avoid going to school/work if you feel unwell and stay hydrated and get extra rest as needed.

Remember – in order to continue keeping the clinic safe for all patients, we have implemented the following policies:

  • Bring Your Own Toys (BYOT) and Reading Material – there are none in the clinic.
  • Notify our Administration Staff by Phone – if you are experiencing cough/fever/respiratory symptoms before coming into the clinic. A care provider will call you back.
  • Safety in the Waiting Room – If you are sick, you may be asked to wait in your car, outside or go home. If you are there because a care provider told you to be seen, you will be directed to the sick waiting area. If you have a cough, our front staff will supply you with a face mask if you did not bring one.
  • Use Hand Sanitizer – As you enter the clinic and as you move around the clinic.
  • Pen or Pencil – bring your own pen to record your weight and blood pressure.Again, we know this is a stressful time and if you were planning a trip to Disneyland and have to tell your kids it is cancelled read this great article from The Guardian on talking to your kids about Covid-19:

Stop a worry becoming catastrophic: how to talk to your kids about the coronavirus

https://www.theguardian.com/commentisfree/2020/mar…

We will be sending out regular emails to keep you up to date and well informed. Also, please watch our websites and Facebook pages for updates and advice:

https://southhillhealth.com
https://www.facebook.com/southhillhealth
https://www.facebook.com/SouthCommunityBirthProgra…

The symptoms of COVID-19, are similar to other respiratory illnesses and include a dry cough, fever, tiredness and may involve difficulty breathing.

As always, if you are experiencing an emergency, for example, problems breathing, etc, please call 911. If you have health concerns, call HealthLink BC at 8-1-1.

Stay healthy and safe,

Lee Saxell, RM, MA (Co-Director) on behalf of the South Community Birth Program Team
Rita McCracken, MD, PhD (Interim Medical Director) on behalf of the South Hill Team