By Dr. Tom Hannam MD FRCSC REI
Today our doctors had full (virtual) clinics with patients and our lab team was onsite to check embryos as part of our daily essential services. Every Thursday I’ll let you know if there are any planned changes to this routine.
In the GTA various levels of government are doing an excellent job of trying to keep the population safe. Today we know of stories of $700 fines to people in transit who don’t have a valid reason to be going to a worksite. In any other time or place, “yikes”, but I continue to believe everyone is just doing their best in unprecedented times.
Hospital systems anticipate being startlingly busy in the next few days and weeks. What can we do? We already donated PPE. The next best thing we can do as an organization is to continue to support social distancing.
Which leads to the next question of course: for how long?
Until it is safe, for our patients and each other.
There are external bodies providing guidance too. Two days ago, Pauline Ryan, Director of Independent Health Facilities with the Ministry, wrote:
To all IHF Licensees and staff:
I want to take this opportunity to thank you for your ongoing efforts in response to the current COVID-19 outbreak. I recognize that everyone is playing an important role: delivering essential services to patients; coordinating with other community providers; mobilizing resources; or otherwise. This situation is unprecedented in our time and the efforts of Independent Health Facilities (IHFs) will continue to be important moving forward.
They go on to make sure that IHFs are working with updated guidelines from public health
The CFAS has been working on their guidelines. From 30 March:
Given that the number of total cases of COVID-19 (confirmed and probable) continues to rise in Canada, our directives remain to:
- Conduct consultations by telemedicine or phone
- Complete current IVF cycles utilizing freeze-all only
- Suspend all diagnostic and elective procedures and surgeries
- Postpone any new cycle starts (IUI, IVF, FET), aside from urgent cryopreservation for oncology, until further notice
We won’t want to re-open for egg and embryo freezing until we can satisfy both IHF directives and CFAS principles, along with Provincial and OMA guidelines. When might that be? Last week I had said April 14, but events keep building.
The entire world is going to need to consider how to get started again, not just the fertility world.
Already there are some important developments. Today we can use thermal imaging to screen staff and patients, but even better will be effective point of care viral swabs with results in minutes, and lab-on-a-stick solutions that can tell you if you’ve started to build immunity from a single pinprick of blood.
Solutions like these are limited by distribution, do not always have sensitivity & specificity parameters confirmed, and aren’t yet to us for trial. When they do come to Canada, they are going to need to go to cancer clinics, first responders, and geriatric care homes. And pregnant patients.
Rather than committing to a calendar date, I’m committing to safety. Things are moving quickly. If you need a number, six weeks, but don’t listen to me just yet, we need to watch events unfold together. More updates every Thursday, with real guidance as to how we are preparing to open to onsite care. I recognize how important time is to the fertility community; it is inextricable from the condition itself. I’m sorry for how difficult this is for everyone.
I want our team to be free to care for you in person as soon as we can.
About the Author
Dr. Tom Hannam
The founder of the Hannam Fertility Centre, Dr. Hannam has sat on the board of the Canadian Fertility and Andrology Society, and is a member of the American Society for Reproductive Medicine, the Society of Obstetrics and Gynaecology of Canada, and the European Society for Human Reproduction and Endocrinology.