GPs left in dark about their role in next stage of campaign
Family doctors say province has offered no details on plan to administer shots to seniors
With weeks to go until people over 80 outside of nursing homes start getting COVID-19 vaccines, many of Ontario’s family doctors say they’re still in the dark about how the rollout will work.
After reports on Friday that family doctors would soon be contacting their patients in that age group with more details, they’ve been flooded with calls from seniors wondering where to go and when.
Dr. Anna Holland, an Etobicoke family doctor and addiction medicine specialist, is wondering these same things.
“We completely understand as family physicians the confusion, because we are part of that confusion,” she said. “We are frustrated.”
Retired general Rick Hillier said at a Friday press conference that seniors over 80 will be contacted in “the next week or two” with more details, and they will receive a card “to let them know what to do.”
Shots will start for this age group by mid-March, said Hillier, who heads the province’s vaccine task force. Following a technical briefing with provincial officials, The Canadian Press reported it will be family doctors who will do the contacting.
But this was news to them. “There are more questions than answers right now,” said Burlington family physician Dr. Jennifer Kwan.
“We would love to help but we just need to know when, how, where? Is it going to be in our office? Is it going to be in a clinic? How do we sign people up?”
Hillier said Friday the province has been in a “drought” of vaccines, but about 180,000 doses of the Pfizer shot are expected this week, along with 47,000 doses of the Moderna vaccine.
The province is working with the 34 public health units, which have put together their own vaccine plans, with the goal of at least 10,000 jabs a day. Hospitals, family doctors and pharmacies will all play a role, he said.
“Perhaps using those family doctors and primary caregivers to come together in one setting, and to put in a mini mass-vaccination site,” he added.
Asked for more details, Ministry of Health spokesperson Alexandra Hilkene said in an emailed statement that “planning is currently underway to determine how to best contact” those over 80, an age group public health units aim to reach in early March.
“As vaccination clinics become available to the public, we will communicate when and how you can sign up to be vaccinated,” she said. “We recognize that not everyone is comfortable with or has easy access to the internet. To address this, we will establish a provincial customer service desk to register or book appointments, and neighbourhood mobile clinics are being planned by public health units.”
The province is developing an online web portal for booking vaccine appointments.
In Toronto, there will be nine mass vaccination sites, as well as mobile vaccine clinics for high-risk neighbourhoods. Toronto Public Health did not respond to a request for more information on the role of family doctors in time for publication.
“The message that I’m trying to get out is that patients should not be calling our office about the COVID-19 vaccine,” said Holland.
If phone lines are tied up, people with medical concerns may not be able to get through, she fears.
“Family doctors are eager and we are perfectly positioned to deliver the COVID-19 vaccine. We know our patients; we have the knowledge, skills and infrastructure, but we haven’t been given any information on it, and we need this information so that we can plan. And also we need support,” Holland added.
That support would include being paid for the work, and funds for supplies like personal protective equipment and extra staff if needed.
Kwan said doctors want to be involved, noting they do “millions of flu shots a year” and can identify patients who would be eligible, but need more information and notice.
Concerns over how adults over 80 who don’t live in nursing or retirement homes will be contacted for vaccinations flared Monday at Queen’s Park.
Opposition parties said confusion over the involvement of family doctors left many “blindsided,” and suggests Premier Doug Ford’s government is not ready despite having had months to nail down its plans.
Solicitor General Sylvia Jones, whose ministry oversees the vaccination task force, said the approach will vary from public health unit to public health unit, and they will get shipments of either Moderna or Pfizer, to keep things simple, based on population.
Liberal MPP John Fraser (Ottawa South) questioned how adults over 80 without family doctors, or in hospital, would be contacted for vaccination appointments and said details like this, along with an online booking system for all Ontarians, should be in place by now.
“The government is doing all of this work on the fly,” said New Democratric Party Leader Andrea Horwath.
Health Minister Christine Elliott said the rollout team has been in “frequent communication with all 34 of the local medical officers of health” who are responsible for their own plans for their areas.
Reports that family doctors are going to start calling patients over 80 have caused “confusion and frustration,” said Dr. Liz Muggah, president of the Ontario College of Family Physicians, in an email.
The college, along with other primary care organizations, is meeting with Hillier on Tuesday for more clarification.
“We know our patients want to hear from their family doctor but, the reality is, we do not have answers for many of their questions right now and are waiting for more information about the rollout of the vaccines,” she added.
Dr. Jim Wright, chief of the Ontario Medical Association’s health policy, research and economics department, said many family doctors have been “inundated with calls from their patients over 80.”
The roughly 15,000 of them across the province want to help. But they need to know what their role will be.
“Phase 1 is just the beginning,” said Wright, whose organization represents doctors.
“We should be planning right now for what’s going to be a huge logistical effort.”
Principals say ensuring physical distancing has been their top challenge during the pandemic, a new survey by People for Education has found.
The report by the research and advocacy group, to be released Tuesday, asked administrators to rank concerns — and for leaders in elementary and secondary schools offering inperson classes, almost threequarters named that as one of their top two issues, followed by co-ordinating and scheduling staff.
“Smaller class sizes. It is impossible to keep students socially distanced. I am constantly the COVID police,” said one principal in an elementary school in northern Ontario.
Blaine MacDougall, president of the Catholic Principals’ Council of Ontario, said administrators are exhausted. “They understand it’s a pandemic and they are there for their students, and for their staff and for their families — they just wish that a couple of things could be taken off their plates” during a time of “unprecedented pivoting and changes.”
The report notes principals’ extra duties, such as implementing COVID changes, screening, reporting and contact tracing, plus timetabling — and re-timetabling — as well as co-ordinating efforts with local public health units. As the province ramps up its asymptomatic testing program, principals will also be responsible for weekly reporting.
“This isn’t principals saying ‘our issues are worse or more important than anybody else’s,’ ” said People for Education executive director Annie Kidder. “These are people who are saying this because they are responsible for people in their schools” and are asking for smaller classes or more education assistants to help their staff.
When asked about stress levels, about half of principals in schools offering in-person classes said their stress is unmanageable, and almost 60 per cent of virtual principals felt that way.
“It’s been the most challenging year as an administrator — but at the other end, it has also been the most rewarding” to see everyone pulling together, said Toronto Catholic principal Robert D’Addario.
D’Addario, of Our Lady of Lourdes elementary in downtown Toronto, said the board has been good at providing administrators with guidance and supports.
He agrees physical distancing has been “the number one concern” but said it helped that the board mandated masks from kindergarten up at the start of the school year. His students are provided with masks— and a visor if they want one.
The People for Education report notes that principals would like to delay any curriculum changes and do away with “all non-essential paperwork” and a shorter school day to allow time for planning during the pandemic.
The report, part of People for Education’s annual school survey, heard from 1,173 schools across Ontario, most of them offering in-person learning.