December 8

Dear Program Directors and Program Administrators:

We received the following guidance from LHSC regarding movement of faculty/residents and students between Victoria and University Hospital yesterday.

“Based on this direction the LHSC has developed the following approach to hospital appointed physicians, residents, fellows and Schulich students rotation in and out of University Hospital:

  • Hospital appointed physicians, residents, fellows and Schulich students will not be allowed to rotate between LHSC hospital sites until further notice.

  • Hospital appointed physicians, residents, fellows and Schulich students who have been clinically working in a health care facility currently declared in outbreak can commence work/learning at any LHSC site following 14 days of self-isolation/quarantine. The duration of time spent working clinically in a health care facility in outbreak does not impact this requirement.

Exceptions to either of the above rules may occur in scenarios for providers that are part of a group of individuals that provide specialized services AND the group is too small to cohort AND their services are required at more than one health care facility/site. When these conditions are met the individuals moving from one site to another must use all applicable infection control practices and PPE to minimize the likelihood of transmission of disease.

The above rules will be evaluated on an ongoing basis and at least weekly.”

So to try to answer some of the many questions – this is an attempt to clarify the message we received; I may not have thought of all the questions you have but these are questions that I have and have had responses from LHSC for.

  • Ideally movement between hospitals and sites will be limited as much as feasible, however there is recognition that movement between sites will be required for a variety of reasons and scenarios.

  • This applies to LHSC only. Movement between Victoria Hospital (which is not on outbreak status) and St. Joseph’s Hospital is not addressed, and at this point there is no official guidance from St. Joseph’s restricting physician movement between St. Joseph’s and Victoria Hospital and the vice versa.

  • Residents may move between rotations within a site unless they are on work quarantine. For example, a resident on neurology at UH may rotate to medicine at UH.

  • Residents may come on to rotations at UH from other sites as required for clinical work and call requirements.

  • Residents at Victoria Hospital (not on outbreak) may move to other sites – for example family medicine in the community, or to University Hospital, for clinical work and call requirements.

  • Residents currently at University Hospital (outbreak site) will require a 14-day period of self-isolation before going to a rotation at another site. Residents at University on ‘work quarantine’ will require a 14-day period of self-isolation prior to changing to another rotation, including a University Hospital non ‘work quarantine’ rotation.

  • When will the ‘outbreak’ at UH be over? - MLHU and LHSC want to identify stability and then add 14 days. ‘Stability’ is not quantified.

I am sure there are a number of other questions that I haven’t thought of or addressed, but please let me know if you have questions, and I will try to answer them or find the answers for you.

I truly appreciate how difficult and stressful this is for you and our residents. For some programs the logistics of call schedules are overwhelming. Please know you have my support, and appreciation for your work, and I will try to keep everyone updated as things change.