The latest release from the W.P.S.H.C.F. – Answers to commonly asked questions and more
You Asked…
How much PPE do we have?
Provincial guidelines for the Health Centre recommend a two-week supply. This has been very difficult to maintain. With a shipment from the Ministry this past Wednesday, our current supply of Personal Protective Equipment (PPE) is sufficient for eight days. This is monitored closely and the utilization of PPE is directly related to the type and volume of patient care being provided in all departments of the health centre.
Donald Sanderson, Chief Executive Officer
When will elective surgeries begin again?
Ontario Health has notified all hospitals not to begin ramping up elective surgeries and procedures if their hospitals have capacity because of the impact long-term care needs could have on acute care and the very high risks. [Ontario Health is] working on recommendations for taking a measured approach to ramping up at the appropriate time.
April 22 Response – Matthew Anderson, President and CEO, Ontario Health
How did our Laboratory secure the ‘rare’ BioFire COVID-19 analyzer?
We started searching in early March when we realized provincially, we didn’t have the ability to do a significant amount of testing. We know how critical testing can be for a pandemic and wanted to do everything in our power to put us in a good position locally. It is really important that we do testing to understand the scale of what we are facing with the pandemic. The ability to have rapid results is critical to guide clinical decision making, avoiding risk while treating patients, and preserving the constrained supply of PPE by using it only when necessary and appropriate.
Can you do testing while you wait for Health Canada?
We have the analyzer, we simply don’t have the BioFire test kits to perform the COVID-19 testing. The test kits are made in Salt Lake City, Utah. We cannot obtain test kits until the Health Canada approval comes through. Rest assured that we are doing everything possible to expedite test results and working with many organizations and government bodies to improve this process.
There are other useful applications for this testing equipment that will be beneficial in the future.
Once approved will testing replace the Assessment Centre?
At a 45-minute turnaround time for results, our BioFire will only be able to complete 30 tests per 24-hour period. The target is in-hospital use. We will use this in-house testing system in parallel with the provincial lab testing/results process.
Laura Laaksonen, MLT 
Manager of Laboratory Services and Medical Imaging
Why is the Mobile x-Ray System key to COVID-19 Response Planning
The importance of a portable x-ray machine during the COVID-19 pandemic cannot be stressed enough. Most importantly, it allows imaging to be done directly at the point of care, without transporting an at-risk patient throughout the hospital. These portable machines are used throughout the hospital, including in the Emergency Department, the Intensive Care Unit, the Operating Room, and in Acute Care.
Our current portable x-ray device requires two Medical Imaging Technologists to be involved during COVID cases, because it requires that for every image taken, a potentially-contaminated image plate must be removed from the patient’s bed, then cleaned off, and handed off to a second technologist for developing in the clean part of the Medical Imaging Department, before it can finally be processed for viewing. The new device will actually allow for the immediate viewing of the image without having to move a potentially-contaminated plate into the department for processing.
These portable machines use a significantly lower dose of radiation, which reduces the risks to the patients and staff. As you may imagine, updating the technology from our 15-year-old machine will also allow for clearer images and increased efficiency. The new machine is also capable of serving several patients in succession. Imaging multiple cases will no longer pose a delay in processing between patients.
In short, we can serve more patients, in a shorter amount of time, with better results, and in a much safer way which poses less risk to patients!
Wil Smith, M.D., President of Medical Staff
What’s the difference between BiPaP breathing devices and Ventilators? 
BiPaP machines can be life saving in numerous clinical situations and are less invasive than traditional ventilators. The BiPaP can avoid invasive procedures, allow for removal of invasive instruments earlier, and they can be used in various areas of the health centre.
All ventilators in the Health Centre were previously bought by Donors to the Foundation.
There are three existing ‘main’ ventilators in the Health Centre. These dual Bi-PAP / ventilators ($28,000) were bought by a Seasonal donor in 2016 and the other two by participants, pledgers and sponsors in our annual cardiac care Georgian Bay Walk Run, Pole. While serving as our “main” ventilators, they are also capable of providing BiPAP service if needed (they are sophisticated multi-purpose machines). When functioning as ventilators, they would be used only in critical care areas (Intensive Care Unit, Operating Room, and Emergency Department).
Our Health Centre was built during the time of SARS, so six negative pressure rooms were constructed in the building. These rooms are essential to protecting doctors and technicians when placing breathing tubes that connect a patient to the ventilator during this virus.
Doctors and nurses can control the concentration of oxygen, the volume of the breath, how many breaths per minute, and even adjust pressure similar to a CPAP machine. In ordinary circumstances, the health centre would care for a maximum of two ventilated patients in the intensive care unit.
As part of our pandemic planning, and with Donor support, we have made contingency plans to care for as many as six to eight patients in an extreme emergency. The four additional BiPAP devices ($8,000 ea) that we are awaiting are “standard” BiPAP devices, which can provide non-invasive care (used with a mask rather than a breathing tube). They can be used outside of a critical care setting and could serve as a means for patients to potentially avoid having to go onto a ventilator. (Pictured below.)
As we wait for our 4 new BiPAP devices to arrive mid-May, we have three types of ventilators (below): standard ICU ventilators (also BiPAP), compact transport ventilators, and anesthesia machine ventilators. All three models are pictured here, and all three models can be utilized if the situation requires.
Terence Fargher, M.D., Chief of Staff
Standard ICU Ventilators (also BiPAP)
Compact Transport Ventilators
Anesthesia Machine Ventilators
What is RISK AVOIDANCE and why is it so important?
With so much that is ‘odd’ being asked of us — to ‘stay in place’ as much as possible, physical distance from our friends and wear a mask when grocery shopping – there is now a new term being shot at us: Risk Avoidance.
What does it really mean? With the ‘odd’ directives above in mind, everything has become a ‘risk’ that could potentially land you in our Emergency Department or even a prolonged stay in the Health Centre. Driving is an example. We’ve been urged to drive the speed limit. Others have said, try 10 k an hour under. It makes sense when you realize, being stopped by the police has a potential contact risk. Then driving slower means you are less likely to be in an accident or, on our local roads, hit a deer. As reported in the local newspaper, the North Star, the first identified positive COVID person in the North Bay / Parry Sound District was an OPP Officer. With that in mind, add the notion of ‘contact tracing’ and you realize how even driving has added ‘risks’ that we never before could imagine.
For many of us, it’s hard to wrap our minds around this new world of risk. But when you combine it with the ‘stay-in-place’ directive or how an action might have an associated visit to our Emergency Department it becomes clearer.
By avoiding risky behaviour and avoiding visits to the Emergency Department, we help the Health Centre conserve resources — people, equipment and PPE. This ensures they are available to respond to COVID-19.
Following these measures helps you avoid risk:
  • Avoid unnecessary travel outside the community
  • Continue to practise physical distancing by keeping 6 feet apart
  • Socialize only with those people you live with in your home
  • Do NOT run on trails shared by others, asymptomatic people will spread the virus further as breathe is expelled
  • Only 1 family member shop at the grocery store, pharmacy and LCBO, only once per week
  • Do not gather in groups
  • Wear a mask when in a store – there have been so many mixed messages on this… your takeaway? Mask ON