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Vancouver Island Allergy

Vigilance for COVID-19: Keeping Up the Fight Now is More Important Than Ever

April 14, 2021

As we all continue to do our best to reduce the risk of COVID-19 transmission to patients and our community, we wanted to provide some information to help prepare you beforehand for your appointment. Hopefully you have received instructions already; if not, please read on!

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For all new appointments, we would ask all patients to avoid antihistamines for at least four days, and to avoid tricyclic antidepressants for at least one week before your appointment. If you do not know what type of antidepressant you might be taking, please check with your pharmacist to review your medications before your appointment. If you are unable to stop your antihistamines or tricyclic antidepressants, please let us know as this will limit our ability to complete your testing and your assessment.

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We will be screening all patients for COVID-19 before entry into the clinic, and would ask that all patients stay in your vehicle once you arrive. A medical 3-ply mask or N95 mask will be necessary and need to be worn at all times for everyone in the office; cloth masks are not acceptable. Hand sanitizer is available, but there is no public bathroom.

For the protection of all patients and staff, once your arrive in our parking lot and safely park your vehicle, please call our office at (250) 595-8111 to review some initial questions by phone. Before entry, we will then complete the screening process for COVID-19 at the door with each patient.

We would ask all adult patients come alone, but if the patient were a minor, one adult parent or guardian would be allowed to join the patient. If a translator were necessary or if there are other extenuating circumstances, please call us at (250) 595-8111 to speak with our staff about your appointment.

The New Normal, may be

May 18, 2020

I have been working on our office policy after the announcement from BC Premier Horgan and our Public Health Officer Dr. Bonnie Henry to open up the BC economy in the wake of the COVID-19 pandemic. I thought this should be relatively straightforward, but it is not as I had foreseen. Perhaps I am over-thinking this. With working through the publications by the BC government, the Public Health Office and BCCDC, the recommendations from the BC College of Physicians and Surgeons, and what WorkSafe BC would also require, I am finding more information I have to consider with the daunting task of trying to keep everyone safe while providing medical care in my subspecialty.

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Opening back our office will need to be gradual, coordinated, and calculated.  We will need to keep everyone safe, workers and patients. With these considerations, I will delay our office reopening. There has yet to be guidance provided by the College of Physicians and Surgeons of British Columbia; their publication Guidelines for COVID-19: Infection Prevention and Control for Private Surgical Facilities was not available before the weekend. Once published and after we review the suggestions and assure we can safely implement the recommendations and minimize the risk of infection to those in the office, we will begin allowing patients gradually back into the office for allergy treatments and assessments.

For now, we will continue with the virtual appointments online and, when technology fails us, rely on telemedicine and a phone call to provide some basic management and care until we can safely resume patient visits in the clinic. There will be temporary and permanent changes that will be developed from our experiences with COVID-19, but we will be here to help. Stay safe, everyone.

Flattening the Curve: Temporary Office Procedure Changes

March 17, 2020

After the discovery of the first patients in December 2019, COVID-19 has spread rapidly across the globe. In its wake, more cases and fatalities continue to appear in an international crisis that is unprecedented in the modern era, an emerging pathogen that so far has no cure. While we race to find the solution to this pandemic, we, the local and international community, will need to rally together to stop the spread and the impact of COVID-19.

Our office will also need to change its policy temporarily. The members of our subspecialty in British Columbia have been in discussions on the impact of COVID-19 on our patient population and communities, and nationally, the national Clinical Immunology and Allergy societies in North America have also published a joint contingency plan as a guide. The BCCDC and Canada have been very active in providing updates and suggestions as the outbreak has been developing. These sources will be the guide for us as physicians to help in the future care of our patients for the foreseeable future.

Until the pandemic is over, all symptomatic patients will be asked not to come in to limit the spread of infection; if there is a suspicion of COVID-19, call 811 for the Nurses’ Line for assessment and further instructions. Here is an online self-assessment tool to help review your symptoms. 

For those in our community self-isolating after contact with a possible patient with COVID-19 or have returned from international travel, here are some tips for self-isolation. Please practice social distancing; this will help to minimize the spread of the infection.

For the safety of all in our community, I will be limiting all face-to-face patient meetings to only emergent/urgent cases. All other upcoming scheduled new referral and follow-up appointments will be kept but will become online and virtual. We will be sending out a link through email for your virtual meeting shortly. All testing (skin testing, patch testing, pulmonary function testing, food and drug testing, venom testing) will be completed after the pandemic is over, and social distancing is no longer a necessity. 

When we return next week, we will be increasing the frequency of cleaning of our office throughout the day to help reduce the chance of spread through surface and item contact. Handwashing soap will be readily available, and handwashing will be encouraged for at least 20 seconds for all those who come into the clinic.

All patients on prescription medications should continue with their medications. Patients on immunoglobulin replacement (intravenous (IV) or subcutaneous (SC)), C1 esterase inhibitor (IV or SC), or biologic agents should continue with treatment. These will not change with COVID-19. Those patients on intravenous treatment in hospital might consider transitioning to home SCIG or SC-C1INH therapy; this could be arranged if patients were wishing to limit their need to go to hospital for their intravenous treatments. Patients on oral immunotherapy will continue with their treatment schedule.

Almost all immunotherapy injections will be put on hold or stopped. In some instances, the time between maintenance doses for patients receiving will be extended to reduce the number of visits. There will be only one injection an hour to limit the number of patients in the office and to minimize group sizes while we observe social distancing. Large groups in the office will not be allowed.

All food and drug challenges will be cancelled and rescheduled, and OIT patients will stay on their current dosages at home. Eating in the office will be forbidden.

For those in our community at most significant risk, the immunodeficiency patients, the exacerbating asthmatic, and any other extraordinary patient requiring help, please call our office to see what we can arrange if you are feeling unwell. For patients receiving immunotherapy injections, please call in and we will discuss what can be done with your injections considering these trying circumstances.

If we can stop the spread in our community, hopefully, life will return to a new normal state as soon as possible. We will take the lessons learned from this pandemic and move forward, realizing this community we have is global, and that we are a small world, after all. Thank you for your time reading this.