COVID-19 Related FAQs
We will continue to add/amend to these questions and answers as matters change.
Who and what defines Essential / Emergency care?
Defining essential / emergency care is a challenge being faced not only by our members but by other Health Regulatory Colleges and health professionals at this time. As with other Regulators, COCOO trusts that Members will use their own individual professional clinical judgement to determine what is essential /emergency care that reflects the needs of their patients. Defining need should be made in a fair, principled, and transparent manner. We cannot provide an exhaustive list because it would risk being too restrictive or not able to deal with all exceptions.
- Essential /emergency care could include: Care for wounds, infections, and post-operative appointments, trauma, and sudden onset of symptoms such as unexplained pain or swelling and redness in known neuropathic patients
What about those of us that work in Family Health Teams or Hospitals?
COCOO can only instruct members of the College not employers such as FHTs. It is VERY wise to provide the College guidance to the employer in order that they can make decisions based on COCOO advice.
We have lots of wound patients. They are, in my opinion, emergency patients as well and not just post-op patients!
Members must individually use professional clinical judgement to determine what THEY conclude as essential/ emergency care. You must consider if you have the correct PPE, as defined by the most current PHO guidelines, to deal with anyone who may present with possible COVID 19 including N95 masks, gowns etc. If not you should have a plan on where to direct those patients.
Are there any consequences for not following your strong recommendation? I work for a Member and I am in direct contact with patients that do not require immediate attention. I am being forced to continue to work. I am very concerned for my health and any potential retribution from the Member.
At this point in time we do not know if there will be any consequences. However, this question is really an employment question that needs legal input. The College cannot provide legal advice. There is employment information on some law firm websites which you could search for as general guidance. However, I would suggest that you consult with an employment lawyer for advice– information on websites is not meant to be legal advice.
Can an employee refuse to work because of the coronavirus?
Yes, if the employee has reason to believe that the circumstances are a health and safety risk. Under the OHSA, an employee may refuse to work or do particular work where he or she has reason to believe that “the physical condition of the workplace or the part thereof in which he or she works or is to work is likely to endanger himself or herself.
- Be proactive; identify and address the potential risks to employee health and safety (this would also be part of an employer’s duty to maintain a safe workplace for employees under occupational health and safety legislation).
- Clearly communicate the steps the company has implemented for the protection of employees; provide regular updates based on developments in circumstances and the guidance from public health officials.”
Are members entitled to provide professional services to their patients via telephone and other electronic media.
The answer is YES with the caveat that you must ensure that the standards of practice of the profession are maintained including that you ensure that you are maintaining confidentiality about the communication of personal health information. Emails are not considered confidential unless appropriate measures have been taken to ensure that only the patient is able to retrieve/review the email.
Can I mail, courier or have my patients pick up their Prescription Custom Made Foot Orthotics (PCFOs) during COVID-19 Pandemic?
NO you must maintain all the Standards of Practice of the College of Chiropodists of Ontario. If your professional clinical judgement is that the provision and dispensing of PCFO is an essential emergency care for a patient you must provide the service in a manner that meets the College Standard, having screened for COVID-19 and using the most current protocols specified by Public Health Ontario. You should visit these sites regularly to keep current on information and guidance that is being provided:
I am self-isolated due to COVID-19 following advice given by the Ontario and Federal Government What are my professional responsibilities?Your Title Goes Here
The College understands that this was a difficult decision to make, but if you meet the criteria for self-isolation set out by Public Health, the hospital system and the Ministry of Health, this is the right decision to make. Given the fact that you are unavailable to your patients, take reasonable steps to help make coverage arrangements for their ongoing care needs, where you can, (recognizing the stresses on the system) and help patients navigate the system and find the right care for them.
To the extent that you can, take advantage of virtual care options to provide care remotely even while in self-isolation where it would be appropriate in the circumstances to do so.
I am a practitioner in a private community based office and have run out of PPE and therefore have effectively closed my office. What are my responsibilities to my patients who may need emergency assistance?
First: try implementing virtual care to provide that care directly and ensure they get the care they need.
Second: try coordinating with colleagues to provide coverage. This may include colleagues whose scope of practice is different than yours, but who are able to provide assistance.
Third: while pharmacists are also currently experiencing the pressure of delivering care during the pandemic, they may be able to assist in some instances, like extending of renewing prescriptions.
Finally: avoid as much as possible simply redirecting patients to the Emergency Department of your local hospital. Hospitals are also being overwhelmed and finding means for providing care in the community as much as possible helps the entire system respond to this public health emergency. Instead, do your best to help patients navigate the system to find the care they need while you’re unavailable to them.
Can you give me a brief refresher on privacy issues regarding email and Skype or FaceTime conferencing with our patients? I’ve heard of some communicating with their patients in this manner and just want to make sure I am compliant and secure.
The College has taken legal advice but much of what you have asked is not legal in nature.
- Legally/professionally members must ensure that all communications involving personal health information is confidential and limited to the patient and those with whom the patient has consented to share the information. If the means of communication is done over a secure internet connection and the software uses encrypted connections, the communication should be private. It is our understanding that FaceTime and Skype are encrypted and therefore should be private. We would suggest that emails not be used for communications involving personal health information as they are not private and there is no way to absolutely ensure that the information is only seen by the intended recipient
Suggested Signage for Members
The Chief Medical Office of Health of Ontario has directed ALL Regulated Health Professionals that ALL non-essential and elective services should be ceased or reduced to minimal levels, subject to allowable exceptions, until further notice.
We want to assure patients who attend our office during this period that we are maintaining appropriate infection prevention and control procedures according to Public Health Ontario protocols. We are also strongly advising our staff to follow the directions of the Government of Ontario regarding how to minimize the spread of the virus. It must be understood, however, that these are unprecedented times and despite screening all of our patients before they attend the office, it is impossible to give any assurances that the persons who do attend have not been exposed to the virus which could potentially put others at risk.
Important Note from the Ministry
The Ministry is looking for additional experienced health care providers to help provincial efforts to prevent and control the spread of COVID-19.
Specifically, they are looking for health care providers who may be working part-time and want to help and are prepared to increase their work hours or former healthcare providers who are retired, or on inactive status with their regulatory college; and are prepared to return to employment. The government is looking for health care providers (including those registered with health regulatory Colleges) who may be working part-time and are prepared to increase their work hours, or former healthcare providers who are retired, or on inactive status with their regulatory college and are prepared to return to employment.
For more information please visit the following sites:
In English:: http://www.healthforceontario.ca/en/M4/COVID19
For your information a link can also be found in the following locations on the Ministry Website
Link on the Ontario.ca/coronavirus
And on the COVID-19 page for providers on health.gov.on.ca