Note: This information is current and a change from Kevin Smith’s weekly update which was set up to automatically Send this morning.

Yesterday we were informed by the Province of Ontario that the Pfizer announcement about delays in shipment has meant that there are now restrictions on vaccination.

All Pfizer vaccine available for first doses are directed by the Province to go to long-term care homes (LTCs) and high risk-residents in residential homes (RHs), staff and Essential Care Givers (ECGs).  Second doses for LTC homes and high-risk RH residents are to be given on the recommended schedule which is 21 days after the first dose.  The second doses for health care workers (HCWs) who have received a first dose will be given as closely as possible to recommended schedule (21 days) but flexibility has been given by the Chief Medical Officer of Health to go up to a 42-day interval.  

All vaccines are under the jurisdiction of the Province for reallocation to ensure coverage of all LTCH and high-risk RH residents, staff and ECGs around the province. 

Any vaccine received this week will used for LTC homes, high risk residents of RHs, and second doses for those who had received first dose and work in LTC homes.  The plans to give first doses to staff from UHN, SickKids, Toronto Grace, Women’s College and Mount Sinai are on hold until the supply of vaccine for acute care is confirmed.  If you have a booking for a second dose and there is a need to extend the period between doses because of supply, you will be contacted directly and informed of the change in date and time.

We know that receiving this message is very hard.  The vaccination of everyone at UHN is what needs to happen in the order laid out last week.  As soon as additional information becomes available we will send it along.  We know that this is a difficult waiting game with many changes and uncertainties and we ask for your patience as we work through this time.


Good morning, TeamUHN!

It is a pleasure to connect with you across care, research, and education through this weekly CEO update – all in service of A Healthier World. 

Key reminders and updates

  • Tomorrow on Jan. 19 – Virtual Open Forum on COVID-19: Read answers to FAQs here – updated regularly. (Corporate Intranet > COVID-19 Preparedness > Virtual Open Forum (top right box) > Open Forum FAQ). Submit questions here or enter #UHNCOVID-19x36 on Slido.com. Livestream here (Chrome/Firefox).
  • Good news: All of Toronto's long-term care homes have been given their first doses of COVID-19 vaccine. COVID-19 vaccine supply remains extremely limited, though, and Pfizer recently announced temporary delays in shipment to Canada. There is a lot of hard work ahead. Read more about the vaccine rollout in the "Overview of last week" below.
  • New COVID-19 vaccine information page available: Visit the page on UHN.ca which includes total number of vaccines administered, information about vaccine clinics, eligibility and beyond.
  • If you receive multiple invitations to book your COVID-19 vaccine appointment (e.g. because you are cross-appointed at different hospitals), please do not book at multiple clinics. If you book at multiple clinics, you are disadvantaging other people by making it seem like there are less available slots in the booking system. If you've already booked somewhere else, please cancel your UHN appointment using the link within your confirmation email.

 

Overview of last week

1. Activated UHN's Executive COVID-19 IMS Table

  • Background: We are trending towards an overwhelmed health system with 12,000 projected cases per day by February, based on the most recent government data. This has necessitated the activation of UHN's Executive COVID-19 IMS (Incident Management System). Membership includes our Executive Leadership Forum and other members of COVID-19 work streams: Susy Hota (Medical Director, Infection Prevention & Control), John Granton (Interim Medical Director, Health Services) and Niall Ferguson (Head of Critical Care). The group meets on Tuesdays and Thursdays.
  • What happened last week? The group discussed the current state of COVID-19, staff bandwidth, clinical pressures, provincial stay-at-home orders, redeployment, long-term care, and vaccines.
  • What do I need to know? Information sharing, maximizing our limited resources and taking a team-based approach are more important than ever. We need to maintain a big picture overview of the pressures on UHN and cannot afford an ad hoc approach.  

 

2. COVID-19 vaccine update 

  • Background: General Rick Hillier's direction for Ontario's vaccine rollout has been speed over precision. That said, we continue to prioritize high-risk groups and will continue to evolve the approach as needed. We recently shared our definition of high-risk and priority groups at UHN so that everyone has a better understanding of the order in which they will be vaccinated.  If the description of the group applies to you as you read it, that is your group.
  • Group A includes:
    • I am a clinician/learner/researcher/leader doing direct face-to-face care with known COVID patients, high risk Persons Under Investigation (PUI) or live COVID samples, or carry out Aerosol Generating Medical Procedures (AGMP)
    • I am a non-clinician working in patient care areas with known COVID patients (e.g. clinical administration, environmental services)
    • My role requires me to respond and be directly involved in Code Whites or Code Blues or screen at entry points.
    See the full list of Group A to F here (Corporate Intranet > COVID-19 Preparedness > Latest News > "UHN Vaccine Clinics – Week of January 18…").
  • What happened last week? We were notified that we will be receiving a small allotment of doses at UHN this week. We are dedicating this allotment entirely to Group A – but do not have enough to offer vaccines to everyone in that group. The areas we are targeting in Group A are: ICUs (Intensive Care Units), Emergency Department, General Internal Medicine, Transplant COVID-19 team, Dialysis, Allied Health working in the aforementioned units, Joint Department of Medical Imaging staff working in the aforementioned units or Interventional Radiology, Pharmacy, Environmental Services, Nutrition, Security, Phlebotomy, Pathology, Princess Margaret COVID Assessment and Urgent Care, Aphoresis. With the small supply we are expecting this week, we will not be able to vaccinate everyone in Group A.
  • What do I need to know? Our biggest limiting factor in the vaccine rollout is variability in supply from the Federal and Provincial Government. This week's allotment is very small as you've likely heard through the media, due to a decision to ensure that all in long-term care are vaccinated, and resulting from a slow down in production of Pfizer vaccine. We do not have clear information as to the provision of exact numbers of vaccine and must ensure second doses are made available. We will be reaching out with further information later today or Tuesday. Thank you for your patience as we work hard to secure and share clear information about the future vaccine plans. 

 

3. Working with partner hospitals to preserve our health system – GTA IMS Table – and getting ready for redeployment in the near future

  • Background: On Nov. 17, 2020, the Toronto Region created a GTA Hospital IMS table in response to the rising number of COVID-19 cases. The table reports to Ontario Health. If a hospital needs help managing its volumes, the GTA Hospital IMS table is available to assist with transfers between hospitals. The purpose is to help equalize pressure across the health system and create a single hospital network during this time.
  • What happened last week? 521 patients have been transferred from hospitals under pressure to those within the GTA which could accommodate patients (between Nov. 17, 2020 and Jan. 12, 2021). UHN received 53 of those patients (mostly for acute care and a few for rehab).
  • What do I need to know? The latest provincial data is very concerning and projects that more than 2,500 patients will be hospitalized because of COVID-19 by Feb. 24. In response, GTA hospitals must ensure they have staff available to support critical areas within their own sites by adjusting service levels and redeploying staff as needed. UHN has three redeployment centres: Staff, Physicians, and Residents and Fellows. These centres are aligned, and all upcoming redeployment requests will be coordinated through these centres to ensure we are addressing our most pressing needs. UHN is a provincial and national resource for many specialized services, including transplant, cancer and cardiac, and our goal is to preserve these services as long as possible. The GTA Hospital IMS table recognizes that UHN has this unique responsibility. Every service is important, but the numbers are daunting and we need to ensure we are taking a safe, ethically supported approach. 

 

4. Announced a new era for people, culture and community at UHN 

  • Background: UHN is Canada's top research hospital and we have the opportunity to be known as one of Canada's top employers. To develop the best work experience possible, we need to further invest in Human Resources and bring in a new era for a truly empowered TeamUHN. We have appointed Sheila O'Brien to help drive this change as our new Executive Vice President of People, Culture and Community. Sheila comes with more than 30 years of human resources experience and is widely recognized for her work in human rights, women's issues, education, health and welfare. She has served as a Commissioner with the Canadian Human Rights Commission and was invested in the Order of Canada in 1999. Emma Pavlov, our previous Executive Vice President of Human Resources, retired last year and Diana Elder stepped in as Interim Vice President – Human Resources. Diana's leadership throughout the pandemic is recognized in her appointment as UHN's Vice President, Human Resources.
  • What happened last week? Sheila started her new role and is working with Diana to unleash the full potential of every member of TeamUHN. Thanks to our Human Resources and Organizational Development colleagues who will help them usher in a new era for UHN.
  • What do I need to know? The pillars of the new people, culture and community strategy will be formed around culture and effectiveness, recruiting and development, succession planning, labour relations and rewards and recognition. 

Closing notes

  • For anonymous and confidential emotional support, call UHN's peer-to-peer support line at 416-340-5443. The hours were extended and you can now reach a professional peer counsellor during the evening and on weekends (Monday to Friday 11:00 a.m. to 10:00 p.m.; Weekends 10:00 a.m. to 4:00 p.m.). For additional mental health support, please consider using the UHN Cares program (Corporate Intranet > COVID-19 Preparedness > Mental Health Supports).

 

Feedback?

Your feedback is welcome and valued. Please reply directly to me or leave anonymous feedback here.

Have a good holiday season,

Kevin


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