Category: Uncategorized

Healthcare Resources – COVID-19/Respiratory Illness Update

Gregory Crunican

Respiratory Illness – Where Are We Now? 

Over the past few weeks as we have entered the respiratory illness season, instances of COVID-19, Flu, Colds and RSV have increased exponentially in most regions. While this is a predictable occurrence each year, it continues to be a health and safety concern not only for the people we support but for employees as well. There is limited reporting specific to COVID-19 at this time, with most of the reporting that had been in place for the past three years finishing in the summer of 2023. What we do have is the waste water data, which is an indicator of how wide spread the COVID-19 virus is in a community. This data is only available in Ontario, and updated weekly.

We are currently at the highest rate of COVID-19 circulating within Ontario that we have seen in the past year. Some districts are experiencing a decrease in cases, or a leveling off, but continue to be at 12 month highs for case counts. More information about how to interpret the graph above and specific graphs for different regions in Ontario can be found here.

What Can We Do? 

The key focus for our teams to help limit the risk of respiratory infections in our homes is to break the chain of infection. Proper infection prevention and control measures such as hand hygiene practices, appropriate use of PPE, and remaining home when sick are strategies to help prevent any respiratory infection from spreading.

Additionally the proper use of a well fitted medical mask as a universal precaution continues to show a reduction in the spread and risk of contracting respiratory infections such as Influenza and COVID-19.

Vaccines for both COVID-19 and Influenza, targeted towards the dominant circulating strain, remain available for everyone.

COVID-19 Vaccines – Updated Recommendations

The Moderna, Pfizer and Novavax vaccines targeted to XBB-1.5 COVID-19 strain have all been approved for use in Canada at this time. These vaccines are approved for people 6 months of age and older. Of note with this approval is a slight deviation from previous guidance related to COVID-19 vaccines. With previous vaccines targeting specific strains of the COVID-19 virus, it was still required to complete the original 2 dose regimen to receive the targeted booster. Now, the recommendation is for one dose regardless of past vaccination history in individuals 5 years of age and older. For children between the age of 6 months and 5 years, two doses remains the recommendation unless they have received a previous COVID-19 vaccine.

Similar to recommendations and guidance for the Flu vaccine, the COVID-19 vaccine is recommended to everyone who is eligible to receive it, if it has been greater than 6 months since their last COVID-19 vaccine or greater than 6 months since being infected with COVID-19.

Ontario continues to track and publish data on adverse events following immunizations. Below is a table specific to the COVID-19 vaccine. We continue to see low reported risk associated with the COVID-19 vaccines when compared to the risk associated with acquiring COVID-19 infection. The full report can be found here.

Conclusion 

As we navigate the respiratory illness season, it is important that we all continue to self monitor for symptoms of respiratory illness and not report to work when we are ill. Doing so will help us to mitigate the risk of infection for the people we support and the teams we work with. The people we support remain some of the most vulnerable to negative outcomes from respiratory illness, such as COVID-19, the flu and RSV. Immunizations to not only COVID-19 but also the Flu, and the proper use of medical masks,  are some of the best ways we can protect ourselves, while also decreasing the overall risk of passing an illness on to someone else.

Healthcare Resources – Pulmonary Disease and Developmental Disability

Gregory Crunican

Introduction

As we enter the cold and flu season in Canada, this article will outline why additional precautions for people with developmental disabilities have been so prevalent over the past 3 years as we have navigated not only COVID-19 but all Pulmonary Diseases.

If you have any questions, concerns or would like to add something to the discussion you can reach out to the Healthcare Strategies Manager at gcruncian@christian-horizons.org.

What is Pulmonary Disease?

Pulmonary Disease encompasses a variety of different infections or structural issues specific to the respiratory system. The respiratory system is not only the lungs but also includes the oral/naval cavity, trachea, right/left bronchus, right/left bronchioles and the alveolus. The diagram below from the Lung Association identifies all of the important landmarks.

Source found here. 

As we discuss pulmonary disease, a variety of resources will be utilized from different jurisdictions. While research on health outcomes for people with developmental disabilities continues to be a growing area in Canada, most of our guidelines are based on research done in other countries.

How Common is Pulmonary Disease in people with Developmental Disabilities? 

People with developmental disabilities are at an increased risk for developing chronic pulmonary diseases throughout their lives. Chronic illnesses include asthma or chronic obstructive pulmonary disease (COPD). At the same time people with developmental disabilities are at an increased risk of negative health outcomes from acute pulmonary diseases such as colds, flu and COVID-19 (Source)

Due to the increased risk of not only chronic pulmonary disease but negative health outcomes, advocacy during medical appointments and more broadly with public health agencies continues to be an important component of supporting people with developmental disabilities.

Recognizing Pulmonary Disease

Pulmonary diseases affect the respiratory system. This results in changes to an individual’s ability to breath. Any of the following symptoms could be expected:

  • Increasing Breathlessness
  • Persistent “chesty” Cough with Phlegm.
  • Wheezing (a high-pitched whistling sound made while breathing)

Prolonged and unimproved symptoms could be a sign of a chronic pulmonary disease.

Sudden onset of these symptoms could be the result of a cold, the flu or COVID-19. This is likely to be an issue during cough/cold season which typically lasts from October – April each year. To help differentiate between them, consider the below graphic.

Common symptoms of a cold, the flu, and COVID-19 infographic. Open PDF for full description

Source

Treatment

Treatment for pulmonary disease relies on determining what the underlying cause of the issue is and whether it is an acute or chronic issue. In the case of bacterial pneumonia, the treatment may require antibiotics. For Cold and Flu, treatment will typically focus on managing the symptoms and allowing the body’s own immune system to fight the infection. For COVID-19 there is the option of anti-viral medications specific to COVID-19 that can help lesson the severity of the illness.

More chronic illness, such as COPD, will focus on improving the overall quality of life for the person supported. This may include daily inhalers or supplemental oxygen. For those with asthma, the focus is often on avoiding triggers for asthma attacks and having “rescue inhalers” available in case of an asthma attack. Rescue inhalers are prescribed by a primary health care provider, to be used in situations when a person supported is having difficulty breathing.

Emergency Situations

Even with the best planning and unlimited supports, emergencies can occur with little or no warning.

When someone is in respiratory distress, the signs tend to be clear. The individual will be straining for breath, likely using accessory muscles to breath. When someone is using accessory muscles to breath it will appear as though they are breathing in an exaggerated way with their full chest expanding, shoulders lifting, and the abdomen expanding. The heart rate is likely to be increased and oxygen levels will decrease. People with a light complexion may show signs of cyanosis or “blue tinged skin” around the fingers and lips.

When emergencies occur the team should ensure the persons immediate safety and follow the care plan for next steps. The next steps may include:

  • Administering any PRNs such as inhalers
  • Calling emergency services (911).

Closing Thoughts

Pulmonary Disease is not only a seasonal issue, with many illnesses that affect an individual’s ability to breath, it is important that we are prepared to support them.  With the increased risk of negative health outcomes for people with developmental disabilities, when they have pulmonary diseases it is necessary for teams to know how to identify pulmonary disease and how to support people when they are ill.

Breathe – The Lung Association. Respiratory System. (Source)

Surrey Place, Primary Care Guidelines, Respiratory Disorders (Source)

Healthcare Resources – Respiratory Illness

Gregory Crunican

What is Respiratory Season? 

With the weather changing and gatherings occurring more and more indoors the risk of respiratory illness transmission increases. What is normally seen in the Norther Hemisphere is an increase of respiratory illness’ between the months of September – April. Typically there is a peak of community transmission but this occurs at different times depending on many variables including the type of infections in circulation that year. This year it is predicted that our respiratory illness season will see an increase in the number of Respiratory Syncytial Virus (RSV), Cold, Flu and COVID-19 cases. Important to note is that the strain of COVID-19 circulating this season has a high likelihood of avoiding previous immunity due to the mutations it has undergone.

Minimizing the Risk of Illness 

These illnesses include Respiratory Syncytial Virus (RSV), Colds, Flu, and COVID-19.

When considering how best to prevent or minimize the risk of illness to ourselves and those close to us the chain of infection can help us identify areas where we prevent infections from occurring. By breaking the chain at any point, we can prevent either ourselves from becoming ill, or prevent getting those closest to us sick.

 

Starting in the top right corner of the diagram the “Agent” (Germs) and “Where Germs Live” (Reservoir) are difficult factors for us to control. It is true that some illness has been eradicated, such as Small Pox, but this strategy does not help us stay healthy over the next few months. We also can not remove the reservoir for respiratory infections as they replicate within us. At the same time how “Germs Get Around” (Mode of Transmission) is beyond our control. Instead we focus on what we can control:

“How Germs Get Out” (Portal of Exit)

Focusing on respiratory illness, the primary way in which they spread is through droplets. Whether saliva or mucus that are expelled when we cough, sneeze, have a runny nose or through simply talking, the germs hitch a ride out of our bodies looking for the next person to infect. How can we best minimize spreading the illness then?

  • Staying home if we are feeling unwell
  • Limiting the number of people we are visiting with
    • The less people we are in close contact with the less likely we are to spread an illness
  • Wearing a mask

“How Germs Get In” (Portal of Entry)

If we prevent germs from entering our body, we can prevent illness. The most common ways in which germs enter our body is through the mucous membranes (eyes, mouth and nose). Some of the best ways to stop germs from entering our body are:

  • Hand Hygiene – by removing the germs on our hands we won’t accidently touch our eyes, nose or mouth.
  • Wearing a mask
  • Eye Protection
  • Environmental Cleaning – cleaning high touch areas in communal settings will ensure germs aren’t living on the surfaces and passing to our hands and then from our hands to our eyes, mouth or nose.

“Next Sick Person” (Susceptible Host)

If none of the links in the chain of infection are broken and a virus or bacteria (germ) enters our body we are not guaranteed to get sick. A number of factors can help our immune system to be prepared to fight off an infection:

  • Immunity to the germ (virus) because of vaccinations
  • Immunity from prior infection with the same/similar germ (virus or bacteria)
  • Sufficient Rest
  • Proper nutrition
  • Reduced Stress

There are also a number of factors that make someone more likely to become ill:

  • Infants and Children
    • Less developed immune system
  • Elderly
  • People with a weakened immune system (immune compromised)
  • Lack of immunizations
  • Anyone
    • It is important to be aware that even if you have no risk factors you can still become sick. Our immune systems are amazing, but they are not perfect.

Keep these tips and tricks to prevent illness in mind over the coming weeks as we all look to gather with our loved ones.

COVID-19 Updates August 9th, 2023

Gregory Crunican

Our values, vision, and mission together with your well-being and the well-being of people who use our services continue to be our top priority during the current pandemic.

This week, look for the following updates:

UPDATES

This update will affect our Rapid Antigen Testing guidance for Ontario locations.

As of July 28th homes began to have their biohazard bins collected for the final time. With the change in approach to COVID-19 by the province the biohazard bins are no longer required. Our guidance related to COVID-19 has been updated to reflect these changes.

COVID-19 Rapid Antigen Testing (Ontario)

  • Employees who wish to complete rapid antigen testing when they fail passive screening will be provided with the materials needed and complete the test at home.
    • Employees will report their test result to their supervisor and follow the return to work flowchart to determine next steps.
    • When completing the rapid tests at home employees can dispose of the test kits in their own garbage.
  • The people we support can complete rapid tests in their homes either assisted or independently if they are symptomatic.
    • Employees will assist as needed
    • If result is positive follow the established next steps to support someone who has COVID-19
    • Biohazardous materials can be disposed of in the garbage.

SUPPORT PEOPLE TAB

COVID-19 Preparedness Checklist

  • The COVID-19 Preparedness Checklist was last updated on August 9th, 2023.
  • The Hand Sanitizer Recall List (on the U:\\ drive) was updated March 2022. Please confirm the removal of recalled sanitizers from all locations

 

Thank you for your continued work and dedication, your commitment and tenacity to provide the best service and supports is exceptional!

◊

Questions or suggestions about any of the resources listed on the site?
Send us an email to let us know: covid-19@christian-horizons.org

COVID-19 Updates April 20th, 2023

Gregory Crunican

Our values, vision, and mission together with your well-being and the well-being of people who use our services continue to be our top priority during the current pandemic.

This week, look for the following updates:

UPDATES

Over the past weeks, significant changes to our COVID-19 guidelines have occurred. This resource gives a quick synopsis of past guidance and current guidance.  Refer to our guidance documents for more in-depth information.

Simple Overview of COVID-19 Guidance – then and now

SUPPORT PEOPLE TAB

A number of resources have been updated this week to reflect the recent changes to Rapid Antigen Screening.

COVID-19 Preparedness Checklist

  • The COVID-19 Preparedness Checklist was last updated on April 20th, 2023.
  • The Hand Sanitizer Recall List (on the U:\\ drive) was updated March 2022. Please confirm the removal of recalled sanitizers from all locations

COVID-19 Screening Protocol 

  • Updated to reflect changes to Rapid Antigen Testing

COVID-19 Symptom Self-Check Poster

  • Updated to reflect changes to Rapid Antigen Testing

Employee COVID-19 Exposure Flowchart

  • Updated to reflect most recent guidance for employees after a COVID-19 exposure or symptom development.

Rapid Antigen Screening Instructions Ontario 

  • Updated to reflect changes to Rapid Antigen Testing

COVID-19 Visiting Guide for Locations

  • Updated to reflect current visiting guidance for direct support locations.

 

Thank you for your continued work and dedication, your commitment and tenacity to provide the best service and supports is exceptional!

◊

Questions or suggestions about any of the resources listed on the site?
Send us an email to let us know: covid-19@christian-horizons.org

Healthcare Resources – COVID-19 Vaccines

Gregory Crunican

Introduction

On December 14th 2020, the first COVID -19 vaccines were administered in Canada (source). This would be the beginning of an extensive vaccination campaign that would see nearly 80% of the population in Canada complete the initial recommended series of vaccinations. (source)

Since December 2020, guidance around the spacing between the first and second dose of the COVID-19 vaccine and information related to booster doses has come out in media releases that can be difficult to follow. The goal of this article is to outline the current guidance so that you can make the best choice for yourself in regards to vaccinations and help the people we support attain accurate information. The information outlined below is exclusively from the governments of Canada, Ontario, and Saskatchewan unless otherwise specified. Links to the sources will be provided.

Primary Series

Most COVID-19 vaccinations begin with 2 doses. These initial doses are called a primary series. The doses do not need to be from the same manufacturer (Moderna/Pfizer) however they have and will most often be the same type of vaccine, typically mRNA. There was an approved Health Canada exception to this rule for those who had received the Astra-Zeneca vaccine when there was a supply shortage of mRNA vaccines.

At this time, anyone choosing to start their immunizations now would most likely receive an initial mRNA vaccine (Pfizer/Moderna) or a Norvax vaccine followed by a second dose 8 weeks later.

Receiving a complete primary series is very important for better, longer-lasting protection (source).

Booster Doses

As the COVID-19 virus has naturally mutated and the initially acquired immunity from vaccination decreases, booster doses have become available initially to high risk populations, followed by everyone else.

The current recommendation for booster doses of the COVID-19 vaccine are:

  • six months, following your last dose/booster or last COVID-19 infection if you are aged five and older and not at high-risk of severe COVID-19 illness
  • three months, following your last dose/booster or last COVID-19 infection if you are at high risk of severe COVID-19 illness or if you are immunocompromised and have spoken to your health care provider (source)

Bivalent Vaccine/Booster

Booster doses of the original mRNA vaccines continue to provide good protection against severe COVID-19 outcomes, including those caused by Omicron variant infection; however,  evidence to date shows that both the Moderna and Pfizer bivalent booster doses induce a stronger immune response and provide improved protection against the Omicron variant. This is achieved by targeting two strains of the COVID-19 virus, the original strain and the Omicron strain.  (source, source)

Safety

As per Health Canada:

Source for the above information

Closing Thoughts

Just over three years ago on March 12th 2020, the initial lockdown in Ontario began, 8 days later Saskatchewan was in a similar situation. Since that time, our collective understanding and available tools to fight COVID-19 has drastically improved. It has been more than two years since the first vaccines were available to help combat COVID-19 and they remain our best tool to prevent negative outcomes resulting from a COVID-19 infection.

COVID-19 Updates January 26th – February 2nd, 2023

Gregory Crunican

Our values, vision, and mission together with your well-being and the well-being of people who use our services continue to be our top priority during the current pandemic.

This will be the final weekly COVID-19 Update.  Updates will now be published in On the Horizon only when there are resource changes. Please continue to check each week.

In the coming weeks a new article will begin to be published titled Healthcare Resources. This article will be an introductory look at a number of different health topics that are relevant to our sector.

SUPPORT PEOPLE TAB

COVID-19 Preparedness Checklist

  • The preparedness checklist will no longer be a weekly requirement in the ODB. Instead, when updates to COVID-19 resources are completed based on ministry guidance an email will be sent to all Managers from the Healthcare Strategies Manager. The Preparedness Checklist will then be updated in the ODB and teams will need to complete the checklist in the ODB within 7 days.
  • The COVID-19 Preparedness Checklist was last updated on January 12th, 2023.
  • The Hand Sanitizer Recall List (on the U:\\ drive) was updated March 2022. Please confirm the removal of recalled sanitizers from all locations

COVID-19 Screening Protocol

  • Sign in for employees and visitors attesting to the completion of COVID-19 screening is no longer required
    • Visitors to homes will be recorded through the support notes, in the same way they were prior to COVID-19
  • Sign in to office location may still be required
  • The completion of Rapid Antigen Screening every 3 days remains in place for employees, visitors and contractors.
  • A reminder that self monitoring for symptoms of a respiratory illness remains a crucial step in our infection control procedures.

 

Thank you for your continued work and dedication, your commitment and tenacity to provide the best service and supports is exceptional!

◊

Questions or suggestions about any of the resources listed on the site?
Send us an email to let us know: covid-19@christian-horizons.org

COVID-19 Updates January 12th – January 19th, 2023

Gregory Crunican

Our values, vision, and mission together with your well-being and the well-being of people who use our services continue to be our top priority during the current pandemic.

This week, look for the following updates:

SUPPORT PEOPLE TAB

COVID-19 Preparedness Checklist

  • The preparedness checklist will no longer be a weekly requirement in the ODB. Instead, when updates to COVID-19 resources are completed based on ministry guidance an email will be sent to all Managers from the Healthcare Strategies Manager. The Preparedness Checklist will then be updated in the ODB and teams will need to complete the checklist in the ODB within 7 days.
  • The COVID-19 Preparedness Checklist was last updated on January 12th, 2023.
  • The Hand Sanitizer Recall List (on the U:\\ drive) was updated March 2022. Please confirm the removal of recalled sanitizers from all locations

COVID-19 Screening Protocol

  • Sign in for employees and visitors attesting to the completion of COVID-19 screening is no longer required
    • Visitors to homes will be recorded through the support notes, in the same way they were prior to COVID-19
  • Sign in to office location may still be required
  • The completion of Rapid Antigen Screening every 3 days remains in place for employees, visitors and contractors.
  • A reminder that self monitoring for symptoms of a respiratory illness remains a crucial step in our infection control procedures.

 

Thank you for your continued work and dedication, your commitment and tenacity to provide the best service and supports is exceptional!

◊

Questions or suggestions about any of the resources listed on the site?
Send us an email to let us know: covid-19@christian-horizons.org

COVID-19 Updates January 5th – January 12th, 2023

Gregory Crunican

Our values, vision, and mission together with your well-being and the well-being of people who use our services continue to be our top priority during the current pandemic.

This week, look for the following updates:

SUPPORT PEOPLE TAB

There are no additional resource updates this week, last week the following changes were made. 

COVID-19 Weekly Preparedness Checklist

  • The COVID-19 Weekly Preparedness Checklist has been updated for the week of January 5th – January 12th, 2023.
  • The Hand Sanitizer Recall List (on the U:\\ drive) was updated March 2022. Please confirm the removal of recalled sanitizers from all locations

Flowcharts for Guidance on COVID-19 Exposure for Employees

  • Updates to isolation guidance for employees in Ontario
  • The new guidance allows for employees who test positive for COVID-19 to return to work after 10 days, or a negative PCR test or 2 negative RANT tests within 24hours.

COVID-19 Exposure Attendance and Testing Guide

  • Updates to isolation guidance for employees in Ontario.

COVID-19 VACCINE WEBINAR

There is no Webinar scheduled for this week.

To view previously recorded webinars, please click here.

If you are looking for additional webinars with a variety of experts from across Canada, consider the resources available at This is Our Shot and ScienceUpFirst. Additionally, the University of Toronto has provided this resource which they will continue to keep up to date.

Thank you for your continued work and dedication, your commitment and tenacity to provide the best service and supports is exceptional!

◊

Questions or suggestions about any of the resources listed on the site?
Send us an email to let us know: covid-19@christian-horizons.org

COVID-19 Updates December 29th, 2022 – January 5th, 2023

Gregory Crunican

Our values, vision, and mission together with your well-being and the well-being of people who use our services continue to be our top priority during the current pandemic.

This week, look for the following updates:

SUPPORT PEOPLE TAB

There are no additional resource updates this week, last week the following changes were made. 

COVID-19 Weekly Preparedness Checklist

  • The COVID-19 Weekly Preparedness Checklist has been updated for the week of December 29th, 2022 – January 5th, 2023.
  • The Hand Sanitizer Recall List (on the U:\\ drive) was updated March 2022. Please confirm the removal of recalled sanitizers from all locations

Flowcharts for Guidance on COVID-19 Exposure for Employees

  • Updates to isolation guidance for employees in Ontario
  • The new guidance allows for employees who test positive for COVID-19 to return to work after 10 days, or a negative PCR test or 2 negative RANT tests within 24hours.

COVID-19 Exposure Attendance and Testing Guide

  • Updates to isolation guidance for employees in Ontario.

COVID-19 VACCINE WEBINAR

There is no Webinar scheduled for this week.

To view previously recorded webinars, please click here.

If you are looking for additional webinars with a variety of experts from across Canada, consider the resources available at This is Our Shot and ScienceUpFirst. Additionally, the University of Toronto has provided this resource which they will continue to keep up to date.

Thank you for your continued work and dedication, your commitment and tenacity to provide the best service and supports is exceptional!

◊

Questions or suggestions about any of the resources listed on the site?
Send us an email to let us know: covid-19@christian-horizons.org