Centro Healthcare

Periodic Health Visits

Mon, 03 Jan 2022 18:42:00 GMT

Periodic Health Visits: An Alternative Approach to the “Annual Physical”

For years, Canadians have been accustomed to a yearly “check-up” with their family

physician in order to maintain a good bill of health. It was thought that this yearly visit

and “once over” would reliably screen for illnesses that could potentially already be

present or effectively prevent future illnesses from occurring. Typically, patients would

have a full physical exam as well as have a full panel of bloodwork ordered.

Unfortunately, a systematic review of multiple randomized trials has clearly

demonstrated that this methodology and approach is not effective at decreasing the risk

of death due to major illnesses such as heart disease and cancer.

The Canadian Taskforce on Preventive Healthcare (CTPH) has recently stated:

“The traditional annual physical exam of asymptomatic adults is not supported by

evidence of effectiveness and may result in harm. It should not be a regular activity”

Choosing Wisely Canada now has the following recommendations:

1. Don’t do annual screening blood tests unless directly indicated by the risk profile

of your patient

2. Don’t do annual physical exams on asymptomatic adults with no significant risk

factors

Thankfully, a more effective approach has been recommended by the Canadian Task

Force called the “Periodic Health Visit” or the “Periodic Preventive Health Check”. This

visit is more specifically tailored to the individual needs of each patient and has shown

the greatest usefulness in patients who are 65 or older. If you have questions or would

like to learn more about this type of visit, feel free to schedule a call with one of our

doctors or visit the links below.

1. https://choosingwiselycanada.org/health-check-ups/

2. https://choosingwiselycanada.org/family-medicine/

3. https://www.cfp.ca/content/63/11/824

4. https://www.cfpc.ca/en/resources/patient-education/patient-education

COVID Vaccine Exemption

Wed, 29 Sep 2021 19:12:00 GMT

The Ontario Medical Association has identified criteria that qualify for exemption from the COVID-19 vaccination. Based on these guidelines, Centro healthcare will be able to provide COVID-19 vaccination exemption letters for the following conditions listed below.

1. Patients who have had an allergy to any of the vaccine ingredients (including polyethylene glycol, tromethamine, and polysorbate) or to those patients who have experienced a severe allergic reaction or anaphylaxis to the 1st dose.

These patients will be referred to an allergist/immunologist for evaluation to determine if and how they may safely receive the vaccine. In the interim, your family physician will be able to provide you a medical exemption pending evaluation.

2. AstraZeneca is also contraindicated in patients who have had a previous episode of capillary leak syndrome or if they’ve experienced venous and/or arterial thrombosis and thrombocytopenia following vaccination with AstraZeneca COVID-19 vaccine.

3. Individuals with a history of myocarditis (12 to 17 years of age) should consult with a specialist to discuss their options for vaccination. As a precautionary measure, individuals who were diagnosed with myocarditis/pericarditis after dose 1 of Pfizer or Moderna should wait to receive their 2nd vaccine until more information is available.

4. Individuals who are actively receiving monoclonal antibody therapy or convalescent plasma therapy for the treatment or prevention of Covid 19 qualify for a time-limited medical exemption while they are actively receiving therapy.

If you do not fall into one of the categories listed above, unfortunately, we are unable to provide a Covid vaccine exemption letter.

As always, if you have any questions/concerns please book an appointment with your family physician.

Centro Healthcare Family Health Organization

COVID Vaccine FAQs

Thu, 29 Apr 2021 20:11:00 GMT

Dear Patients, With Ontario facing the most devastating wave of COVID-19 yet, and more contagious variant strains circulating, it is so important that you protect yourself and that includes through vaccination. We are encouraging you to get vaccinated as soon as you can. If you still have questions after reading this information, please call our office.

Take the first vaccine offered to you – Waiting for your ‘preferred’ vaccine risks potentially getting COVID-19 and associated illness. To best protect yourself and others, We agree that the best COVID19 vaccine is the one that reaches your arm first. Only COVID-19 vaccines that Health Canada determines to be safe and effective are approved for use, and all are highly effective in preventing severe illness, hospitalization, and death from COVID-19, including AstraZeneca. This is the same advice we as family doctors give to our own family members and loved ones.

Below you find some credible resources for some of the FAQs that we encounter from our patients.

COVID vaccine fact sheet from the Ministry of Health
https://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/vaccine/COVID-19_vaccine_info_sheet.pdf

I have some medical conditions. Is it safe for me to get the COVID19 vaccine?
As per the Centre for Disease Control and Prevention: “People with underlying medical conditions can receive a COVID-19 vaccine as long as they have not had an immediate or severe allergic reaction to a COVID-19 vaccine or to any of the ingredients in the vaccine.” Learn more here: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/faq.html .

I had reactions to vaccines before. Can I still get the COVID19 vaccine?
Look at the ingredient lists and see if you have severe allergies to any of the COVID-19 vaccine ingredients:
https://www.canada.ca/en/health-canada/services/drugs-health-products/covid19-industry/drugs-vaccines-treatments/vaccines.html )
Learn more here: https://immunizebc.ca/covid-19-vaccine-frequently-asked-questions

I am pregnant or breastfeeding. Should I get the COVID-19 vaccine? Will it affect my future fertility? Will it affect my periods ?
I am pregnant or breastfeeding. Should I get the COVID-19 vaccine?
COVID-19 Vaccine myths and facts
https://sogc.org/common/Uploaded%20files/Covid%20Information/FAQ_Myth-Fact_17Sept2021.pdf
S t atement from the Society of Obstetricians and Gynecology of Canada
https://sogc.org/en/content/featured-news/SOGC_Statement_on_the_COVID-19_vaccines_and_rare_adverse_outcomes_of_%20thrombosis.aspx
Ministry of Health released this decision-making tool for pregnant and breastfeeding individuals
https://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/vaccine/COVID-19_vaccination_pregnancy_decision_making_support_tool.pdf There is no evidence that the COVID19 vaccine will affect fertility.
Information from Johns Hopkins on COVID vaccines and pregnancy
https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/the-covid19-vaccine-and-pregnancy-what-you-need-to-know
Statement from the Society of Obstetricians & Gynecologists of Canada regarding COVID vaccines and fertility
https://www.sogc.org/common/Uploaded%20files/Latest%20News/EN_SOGCStatement_COVID-19Vaccination-Fertility.pdf A 30min in-depth scientific Q&A video with a reproduction and fertility specialist doctor
https://www.youtube.com/watch?v=fFudXb8l7H8

If I already had COVID19 and recovered, do I still need to get vaccinated with a COVID19 vaccine?
As per the Public Health Association of British Columbia and the Centre for Disease Control: If you had COVID-19 you should still get the vaccine once you have recovered. This is because you may not be immune to the virus that causes COVID-19 and you could get infected again. However, as vaccine quantities are currently limited, those who tested positive for COVID-19 within the last three months are expected to have protection for the short term and can have their COVID-19 vaccination deferred. Read more here:
https://immunizebc.ca/covid-19-vaccine-frequently-asked-questions
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/faq.html

Do I need a note from my doctor if I have one of the health conditions listed under the Phase 2 vaccine roll-out?
Notes are NOT required to prove eligibility for vaccination based on the list of Phase 2 health conditions.
What should I expect after I get the COVID19 vaccine?
Please review this Vaccine After-Care sheet: https://tools.cep.health/wp-content/uploads/2021/03/Vaccine_After-Care_Sheet_gsUPDATED.pdf

Message regarding the AstraZeneca Vaccine
On May 21, Ontario’s Chief Medical Officer of Health announced that people who received their first dose of the AstraZeneca (AZ) vaccine between March 10 and March 19 may choose to get their second doses of the vaccine starting Monday, May 24 and up until May 31, 2021.
There is still a pause on the AZ vaccine as a first dose, announced on May 11.
Here is more information, including options right now, for those of you who received a first dose of the AZ vaccine.

What are my options for my second dose if I received one dose of AZ?

If you received your first dose of AZ between March 10 and 19, you may choose to get vaccinated during the week of May 24 through 31 with a shortened 10-week interval between doses. If you do not wish a shortened dose interval, you can wait to receive a second AZ dose at the 12-week interval. For those wishing the earlier second dose at the 10-week interval, please contact the location where you received your first dose to book an appointment for your second dose.

If proven to be safe and effective, you may choose to wait to have a second dose with one of the mRNA vaccines (Pfizer or Moderna) at a 16-week interval (see more information below on what we know about the evidence for mixing and matching vaccines).

For anyone vaccinated from March 20 onwards, or those vaccinated between March 10-19 who wish to have a 12-week interval between AZ doses, please stay tuned. Further details will be provided soon by the Ministry of Health on booking second doses.

Please review this consent form in the meantime for more information on options for a second dose. You can also call us to discuss the benefits and risks if you have additional questions.

What is the best interval between getting my AZ shots?

Clinical trials showed that AZ works best when the two doses are spread out by at least 12 weeks – estimated at over 80% protection against symptomatic disease versus an estimated 69% when given between nine and 12 weeks. Your personal circumstances, including COVID-19 prevalence in your community and your risk of being infected by the people around you, should be a consideration in your decision.

Is it safe to get the AZ vaccine as a second dose?

The AZ vaccine is approved by Health Canada.
We know that a second dose provides greater and significant protection than one dose alone against serious illness, hospitalization, and death from COVID-19.
The risk of a serious blood clot (VITT) associated with the second dose of the AZ vaccine is currently estimated at approximately 1 in 600,000, based on data from the United Kingdom. If/when you receive the AZ vaccine, know the signs of the associated rare blood clots because it can be best treated if addressed early. Please reach out to our office or seek emergency care if you have the warning symptoms. [For a quick summary of symptoms, see graphics here: https://drive.google.com/drive/folders/1Zvt1ui-FAQ2UrJZp5ABu3rST8tlEaWsF

Is it safe to get a different brand of vaccine as my second dose?

There is no published data so far on effectiveness of mixing and matching different vaccine brands, but a large clinical trial is underway with results anticipated in June 2021. The early data looking at side effects in the first few days show that mixing doses results in more significant side effects but not severe enough to land people in hospital.

Canada’s National Advisory Committee on Immunization is expected to make recommendations based on these findings in the upcoming weeks.

When can I get the COVID19 vaccine if I just had another vaccine or if I need to get another vaccine soon after?

Per NACI guidance, there should be a minimum 14-day waiting period to get the COVID-19 vaccine after any previous vaccine (e.g., shingrix/pneumovax) and additional vaccines should not be given for 28 days after the COVID-19 vaccine.

I take several prescription medications. Do I need to stop them before I get the vaccine?

No. We do not know of any medications you have to stop in order to get the vaccine.

I received the first dose of the AstraZeneca vaccine. What do I do about my second dose?

Ontario announced that it will follow the new National Advisory Committee on Immunization (NACI) recommendations on vaccine interchangeability . Individuals who received a first dose of the AstraZeneca vaccine may receive a second dose of either AstraZeneca, Moderna or Pfizer with a dose interval of 12 weeks. The rate of vaccine-induced thrombotic thrombocytopenia in individuals who receive a second dose of AstraZeneca is approximately one in 600,000. Individuals who received a first dose of an mRNA vaccine (Pfizer or Moderna) should receive the same vaccine for their second dose. If the same one is unavailable for the second dose, the vaccines may be used interchangeably. Read the province’s news release .

Where can I get updates?

We will update you as soon as we have information. You can also check the provincial and our local public health unit website.

Please book your vaccination appointment as soon as you are eligible.

https://www.york.ca/wps/portal/yorkhome/health/yr/covid-19/covid19vaccinationclinics/04covid19vaccinationclinics/!ut/p/z1/jY_PCsIwDIefxQeQpLVu3bHOP21VJog6e5FSUQuzE5UdfHrH2MWD05wS8iU_PjCQgwm28mf79GWwRT3vTXRQYqaknKPOGE9RYCY0jTlOEgK7BsAvJRDMP_cdgOl-r38F1Ab0vkyXZzA3-7z0fTiVkLuy8sc-SdqOJJV1zodG2xU-ePeAHNn35Q7MZ_JszRmqrY7FlmTI1KAFKGWRJClqlBlHNY1XwzGXBOe0BTrkbtdN_lqMEuVF7w08xRCU/dz/d5/L2dBISEvZ0FBIS9nQSEh/#.YIMepJNKj5Y

Please remember – our office is open to you, by phone or in person to answer any vaccination questions. We are here to help keep you safe and get through this pandemic together.

Centro Healthcare Family Health Organization

COVID-19 Vaccine Status

Mon, 22 Mar 2021 15:31:00 GMT

Dear patients

We know you are hoping to get your COVID-19 vaccine as soon as possible and are seeking the latest information. Here is what we know now.

AstraZeneca Vaccine

We have not received the AstraZeneca COVID vaccine in our clinic. The AstraZeneca vaccine is being offered only to people ages 60-64 (if you are 60-64 as of the day of vaccination, or if you will be or have been 60-64 in 2021). We will let you know as soon as possible when the vaccine becomes available to us. Please do not call us to try to book an appointment. We need to keep our phone lines free for patients with immediate medical needs.

Vaccines for patients over 80 (born in 1941 or earlier):
If you are 80 or older and do not live in a care home, the York region site will have details about vaccinations in your area.

Provincial online system
Eligible residents can now register for appointments starting on March 17.

For more information about COVID vaccines visit the Ministry of Health website: https://covid-19.ontario.ca/covid-19-vacci nes-onta rio

Please be assured that we will let you know if we have any vaccine and if you are eligible to receive it from us. Please take the first vaccine offered to you.

COVID-19 Vaccine – Patient Update

Tue, 05 Jan 2021 17:32:00 GMT

With the recent approval of the Pfizer and Moderna COVID vaccines by Health Canada, Canadians have something to look forward to in 2021. After discussing how the vaccine will be distributed in Ontario, this article will explore and answer the most commonly asked questions we have received from patients.

Vaccine Distribution

The COVID vaccines will be distributed in three phases, to the residents of Ontario:

Phase 1: Priority population in the GREY-lockdown and RED-control area
Phase 2: Expanded access to priority populations (more vaccination sites)
Phase 3: All eligible Ontarians – vaccines widely available across the province

Priority Populations to receive vaccinations between Dec 2020 to Jan 2021:

Residents, employees, staff and essential caregivers of living settings that provide care for seniors
Healthcare workers
Adults in First Nations, Métis and Inuit populations
Adult recipients of chronic home health care

Question 1: How has the COVID vaccine been developed so quickly?

mRNA (messenger ribonucleic acid) is a way of transferring information of the building blocks of our genetic makeup or DNA (deoxyribonucleic acid) to the cells which make the protein. The strategy of using mRNA in the development of vaccines and other therapies has been around for some time and is one of the reasons why these vaccines could be developed so quickly. mRNA vaccines have been used in animals for influenza, Zika, Rabies and in humans for cancer treatment and cancer vaccine trials. mRNA vaccines are like ‘CD players’ that can play any kind of ‘CD’. Using this antiquated analogy, one can think of it as scientists having had the CD player before COVID-19 pandemic came to be. Once they figured out the ‘Coronavirus CD’, they could place it into the CD player and make the vaccine a lot faster than before, by building on what information was already known.

Question 2: Do I really need to take this vaccine? I’m not in a high-risk group for COVID-19.

COVID-19 is much more serious than the flu. In Canada, the flu kills roughly 3,500 patients per year. In less than a year, COVID-19 has killed 4 times as many patients.
More than 14,000 Canadians have died of COVID-19. Even if a young and healthy person does not die, they may have long term complications affecting multiple organ systems. Long-term effects include memory loss, fatigue, body aches, unexplained breathing difficulties, and damage to the lungs and heart. Even if a young and healthy person does not develop severe COVID-19 infection, you may still pass on the virus to someone who will. If you are vaccinated, you’re helping protect the people around you in what is known as herd immunity — that is once a critical mass of patients are immunized, the number of cases diminishes significantly. Vaccination is a key step in helping control and eventually stopping the pandemic.

Question 3: Did scientists skip any steps in the vaccine production and approval?

No steps were skipped in the process of developing, testing, approving, and producing the vaccines. Health Canada’s independent scientists have thoroughly reviewed all of the data before approving the vaccines as safe and effective for Canadians. The vaccines were produced faster than before not because of skipped steps but because of unprecedented international collaboration and funding. Normally, vaccine clinical trials need ~8000 people for the approval process. The Pfizer-BioNTech trial had over 45,000 people and the Moderna trial over 30,000. Unlike with other vaccines that go one step at a time and then plan the next step, for the COVID-19 vaccines, governments invested in having companies plan all the steps at the beginning and build up their manufacturing capacity.

Question 4: How do mRNA vaccines work? How are they different from the vaccines we received when we were children or that our children have received prior?

The purpose of any vaccine is to mimic the infection, thereby allowing the body’s natural defense mechanisms to build immunity to the virus but not cause the full-blown illness. The vaccine will train the immune system to recognize COVID-19 and respond quickly if you are ever exposed to the actual COVID-19 virus. mRNA is something we already rely on in our bodies. On a regular basis, mRNA carries genetic messages from the DNA (genetic makeup) to the ribosomes – the “kitchen” of each cell, where the proteins we need for everyday life are made. mRNA is the recipe that carries information for protein production. Our immune system “reads” our proteins to develop antibodies, tools that fight off the infection. A COVID-19 mRNA vaccine contains the genetic material to make the ‘spike protein’ that instructs the immune system to develop antibodies against COVID-19. This spike protein does not cause disease; rather, when our immune system sees the spike protein made, it builds antibodies to it. The vaccine does not stay in your body and does not change your genetic make up. After the protein is made, the cell breaks down the recipe instructions (mRNA).

Questions 5: Do the Pfizer and Moderna vaccines contain mercury, formaldehyde, aluminum or fetal cells?

No, both vaccines do not have any of the ingredients mentioned above. For a full list of ingredients for both vaccines, please see reference 2 at the end of this article.

Questions 6: If I get the vaccine, does that mean I cannot become infected with COVID?

No. Vaccinated individuals can still be infected, but vaccination greatly reduces the risk of infection, developing a severe version of disease and death due to the disease.

Question 7: There have been unsafe vaccines created in the past. How can the government and healthcare providers be so sure these vaccines are safe?

It is true that some vaccines in the past were associated with adverse events and then removed from the market. Those vaccines were not tested in nearly as many people as the COVID-19 vaccines. Normally, vaccine clinical trials need ~8000 people for the approval process. The Pfizer-BioNTech trial had over 45,000 people and the Moderna trial over 30,000.

Question 8: Can this vaccine cause COVID-19 in me?

The vaccine cannot give you COVID-19. None of the licensed vaccines so far use the live virus that causes COVID-19. It is still possible to contract COVID-19 after you have been vaccinated. Like other vaccinations, it takes a few weeks for the body to build immunity after vaccination. Someone could be infected with the virus just before or just after vaccination and get sick, because the vaccine didn’t have enough time to provide protection.

Question 9: What are the side effects of the Pfizer and Moderna vaccines?

Most people can expect to feel a sore arm, a bit of tiredness and a mild headache as the vaccine starts to work. Some people will feel muscle aches, joint pain, chills or a mild fever. Reactions at the injection site will improve by 48-72 hours. Rare side effects include anaphylaxis.

Question 10: Is there anyone who should not get this vaccine?

The vaccines are currently not approved for pregnant and breastfeeding women, patients younger than 16-18 years old, cancer patients and those whose immune system may be weak. If you need any further guidance or are unsure about these categories, you must speak to your family doctor before you consider getting the COVID vaccine.

Question 11: I would like to delay getting the vaccine once it is offered to me to see what delayed side effects or other issues may show up in others before getting it myself. Will this cause any issues?

The pandemic – and the lockdowns and public health measures – will not end until the majority of Canadians are vaccinated. To ensure we can vaccinate everyone as quickly as possible, it is important that people access the vaccine the first time it is offered to them. Canada has purchased more shots per person than any other country in the world and will be getting those vaccines delivered over time. If you wait to get vaccinated and get infected in the meantime, you may end up in hospital – which would vaccine, the pandemic will keep going – and that includes the restrictions, inability to put more strain on the system than getting the vaccine. If Canadians wait to get the see family and friends, send your kids to school, travel etc.

References

https://www.ontariofamilyphysicians.ca/tools-resources/covid-19-resources/covid-19-vaccines/fp-covid-vax-questions.pdf
ht t ps://tools.cep.health/tool/covid-19-vaccines/#addressing-patient-questions-about-vaccines
https://www.dfcm.utoronto.ca/covid-19-community-practice

Flu and You: Influenza Fact Sheet 2020/2021

Tue, 06 Oct 2020 17:35:00 GMT

Influenza and pneumonia are among the top 10 leading causes of death in Canada. While most people can recover from the flu in 1-2 weeks, some cases can cause severe illness. Public Health estimates that each year, there are 12,200 Canadians hospitalized with flu, and approximately 3,500 deaths.

The best way to prevent infection is to get vaccinated.
Flu vaccine is recommended for anyone age 6 months and older.
Flu vaccination is more important than ever with the current COVID-19 pandemic.

Although the flu vaccine won’t protect you from the COVID-19 virus, it can help to keep people out of hospitals, reduce exposure risk, decrease unnecessary testing, and free up healthcare resources for severely ill patients.

Transmission and symptoms
Influenza transmission is by droplets and is spread through coughing or sneezing. Mucus and respiratory secretions can also cause the spread of the virus. Incubation period usually lasts 1-4 days, but influenza can be contagious before symptoms even start.
Symptoms can include a sudden onset of high fever, cough, and/or muscle aches and pains. Other common symptoms include headache, fatigue, loss of appetite, sore throat, cough, and/or runny nose.

Who is at high risk for influenza?

It is strongly recommended that flu vaccine be given to the following groups:

Children younger than 5 years old
Adults age 65 years and older
Pregnant women at any gestational age
Residents of nursing homes and other chronic care facilities
Adults and children with the following chronic health conditions:
Heart disease (Heart attack, congenital heart disease, congestive heart failure)
Respiratory disease (Asthma, COPD, cystic fibrosis)
Neurologic and neurodevelopment conditions
Stroke
Endocrine and metabolic disease (Diabetes, inherited metabolic disorders)
Kidney disease
Liver disease
Blood disorders (Hemoglobinopathy, anemia, sickle cell)
Morbid obesity (BMI greater than or equal to 40)
Younger than 19 years old on long-term aspirin or salicylate medications
American Indians and Alaska Natives
Cancer and other immune compromising conditions (HIV or AIDS, current chemotherapy/radiation treatment, chronic corticosteroid treatment, other medications that suppress the immune system)

Please talk to your doctor if you might have had an allergic reaction to the flu vaccine in the past.

Herd immunity

Even if you are low risk, getting flu vaccination may also protect the people around you. When a sufficient portion of the population has become immune to an infection, it reduces the likelihood of infection for people who lack immunity or who are unable to get the flu shot. This could protect vulnerable people, such as babies, frail elderly, and people with chronic health conditions.

Preventing bacterial pneumonia

The flu vaccine does not have any protection against bacterial pneumococcal disease. Pneumococcal bacteria can cause lung infection (pneumonia), bloodstream infection (bacteremia) and infection of the spinal cord or lining of the bran (meningitis). There are 2 vaccines available to help prevent pneumococcal infection:

Pneumovax23
Prevnar13

These are recommended for all adults age 65 or older, and can potentially be given sooner if a patient has high risk conditions (such as chronic respiratory disease or immunocompromise). Talk to your doctor to see if these vaccines are right for you.

Universal precautions – Protect yourself and others from infectious diseases

It is important to remember that each of us can do our part by following public health guidelines to prevent the spread of contagious diseases.

Hand washing – with soap and water for at least 20 seconds or use an alcohol based hand sanitizer if hand washing is not available
Universal mask wearing – to cover your nose and mouth in public places
Physical distancing – keeping 6 feet or 2 meters distance from others
Disinfecting commonly touched surfaces regularly
Staying home if you are sick, except to get medical care

2020 Flu Clinic Days
Saturday, October 31
Saturday, November 7

Please call 905-605-4744 to book a flu vaccination appointment.

References

Centers for Disease Control and Prevention
Government of Canada Influenza: For Health professionals
Public Health Ontario
Canadian Immunization Guide Chapter on Influenza and Statement on Seasonal Influenza Vaccine

All About Your Mental Health and Well-being

Thu, 07 May 2020 17:49:00 GMT

As family doctors, we see and treat a wide array of conditions for our patients. Mental health makes up a significant portion of the conditions that we see and treat regularly. We understand the pivotal role that counselling can play in building the skills that we need to manage our day to day.

Below, we have put together a list of mental health resources that offer counselling services including by virtual means, as well as other resources such as apps and books that we feel will benefit our patients. Please check them out!

Mental Health Resources Offering Online Care
Wellness Together Canada – This is a free, online platform for youth and adults that offers access to mental health tools and resources, self-assessment, and an opportunity to connect directly with mental health professionals by video, phone or text.
https://ca.portal.gs
Big White Wall – Online peer support community. Anonymous and 24/7. BWW includes an online community, resources and self-help courses covering topics such as anxiety, sleep, weight management, depression and many more. Available for anyone 16+.
www.bigwhitewall.com
BounceBack Ontario – Free skill-building course offered by the Canadian Mental Health Association that helps adults and youth (15+) address areas of low mood, mild to moderate depression and anxiety, stress or worry. It is delivered over the phone and through online videos.
https://bouncebackontario.ca
Greenspace Mental Health – Greenspace’s Matching Program connects individuals to direct one-on-one counselling / therapy with a therapist in private practice (by phone and video during COVID). These services are generally covered by third-party insurance companies. For all ages.
https://www.greenspacehealth.ca/patients/

Counseling services in York Region
https://www.centralhealthline.ca/listServices.aspx?id=10232&region=YorkRegion

National Mental Health Organizations
CAMH: https://www.camh.ca/en/health-info/mental-health-and-covid-19
CMHA: https://cmha-yr.on.ca/learn/covid-19/
Anxiety Canada: https://www.anxietycanada.com/
Centre for Clinical Intervention: https://www.cci.health.wa.gov.au/Resources/Overview

Podcasts
Happiness lab: https://www.happinesslab.fm/

Mindfulness and Meditation
Headspace app: https://www.headspace.com/headspace-meditation-app
Calm app: https://www.calm.com/
Breathr app: https://keltymentalhealth.ca/breathr

I nsomnia
CBT for insomnia: https://www.cbtforinsomnia.com/

Online Cognitive-Behavior Therapy
TruReach app: quick CBT app – http://www.trureachhealth.com/index.html
CBT-i Coach: https://apps.apple.com/ca/app/cbt-i-coach/id655918660
Moodgym: https://moodgym.com.au/
E-couch: https://ecouch.anu.edu.au/welcome

Marriage Counseling
The Gottman Method: https://www.gottman.com/
Emotionally focused therapy: https://www.drsuejohnson.com/books/

Workbooks (Google These)
Anxiety and phobia workbook
Mind over mood workbook

Children’s Mental Health Books
What to Do When You Worry Too Much by Dawn Huebner (kids book)
What to Do When You Dread Your Bed by Huebner (kids book)
What to do When Your Brain Gets Stuck by Dawn Huebner (kids book)
Parent Effectiveness Training (Gordon Model): Dr. Thomas Gordon (for parents)
Parenting your Anxious Child by K Manassis (for parents)
The Shyness & Social Anxiety Workbook by Jennifer Shannon & Christine Padesky (teens)
The Anxiety Workbook for Teens by Lisa Schab (teens)
My Anxious Mind: A Teens Guide for Managing Anxiety and Panic by Tompkins (teens)
Talking Back to OCD by John S. March (kids & teens)
When my Worries Get Too Big by Kari Dunn Buron (kids)
What to do When Mistakes Make You Quake by Claire Freeland (kids)

COVID-19 Factsheet

Mon, 23 Mar 2020 20:53:00 GMT

What is the novel coronavirus (COVID-19)?

Coronaviruses are a large family of viruses that originate in animals but are known to cause respiratory illness in humans, particularly during the fall and winter months.

What are the symptoms of COVID-19?

The symptoms of COVID-19 are similar to other respiratory infections, such as influenza, and include things like:
Fever
Cough
Difficulty breathing
Your risk of experiencing severe symptoms is higher if you have a weakened immune system. This may be the case for:
Older people
People with chronic disease (for example, diabetes, cancer, heart, renal or chronic lung disease)

What should I do if I am feeling sick or concerned I may have exposed myself to COVID-19?

If you have flu-like symptoms and/or have travelled outside of Canada in the last 14 days (or had close contact with someone who is sick), you should FIRST CALL your doctor at Centro Health ( 905-605-9509 ), Telehealth Ontario (1-866-797-0000), or contact your local public health unit (1-800-361-5653).

What is the treatment for COVID-19?

Currently, there is no specific treatment for COVID-19. Most people will recover on their own by drinking plenty of fluids, resting as much as possible, and using a humidifier or hot shower to help with a sore throat or cough.

What can I do to protect myself from contracting COVID-19 and help prevent its spread to others?

Wash your hands with soap frequently and thoroughly for at least 20 seconds.
Instructional video: https://youtu.be/IisgnbMfKvI
Clean and disinfect common surfaces that a lot of people touch.
Avoid touching your eyes, nose and mouth with your hands.
Cough and sneeze into your upper sleeve or the bend of your arm, not into your hand.
Avoid contact with people who are sick and stay home from work or social engagements when you are ill.
Don’t wear a mask unless you are sick.
As of March 13, 2020, Canada’s Chief Public Health Officer and Ontario’s Chief Medical Officer of Health have advised against all non-essential travel.

Sources:

1) OMA. “COVID-19. What you need to know”. https://www.virusfacts.ca/

2) Public Health Ontario. https://www.publichealthontario.ca/en/diseases-and-conditions/infectious-diseases/respiratory-diseases/novel-coronavirus?amp%3Bqid=96637021

3) York Region Public Health. https://www.york.ca/wps/portal/yorkhome/health/yr/infectiousdiseasesandprevention/covid19/covid19/!ut/p/z1/jZDfT4MwEMf_Fh94lB6Mjc63ijrKtmBi3LAvpoMOMKwlLYPEv95Ol5glit7D5e7yuR_fQwxliEne1yXvaiV5Y_MXNnulZEHjeAlJGuAICKQk8UMM93MPbT8B-MUIIPaf_hGAjY9P_lpgFfh6Ha1LxFreVde13CuUWS9yq_FoitoIboThsmi16IU8KUdZrvq68ObfwRaxy1WLJxwA3SQh2XgpBHRyBnw_mMVeBAnEKQb6ED5O73DswdI_A-Nqykbtvh5P5G6C7dla7IUW2j1qW666rjU3DjgwDINbKlU2ws3VwYGfWiplOpRdkqg9PGfvq9s5fZs2_YpcfQDml0gV/dz/d5/L2dBISEvZ0FBIS9nQSEh/#.Xm0xZahKjIV

Why You Should Avoid Walk-In Clinics

Tue, 17 Mar 2020 17:29:00 GMT

Continuity of care means having comprehensive medical care provided to you in a coordinated manner by your family physician. Over a long period of time, we develop a physician – patient relationship with you, and this combined with in-depth knowledge of your health allows us to make medical decisions that that are in your best interest.

When our patients go to walk in clinics, continuity of care becomes disrupted:

Most walk-in clinic doctors do not have your complete medical history. They do not have an established relationship with you to guide medical decision-making.
Your family physician will not know what happened at the walk–in clinic, what tests were ordered, or what treatment/referrals were done
Any results or reports generated from the visit will return to the walk-in clinic and not to your family physician
Walk-in clinics will not arrange for follow up of ongoing issues

At Centro Healthcare, we work together as a team to provide after hours coverage so our

patients do not need to go to walk-in clinics. We provide an after hours Clinic Monday to Thursday from 5 – 8pm, and on Saturdays from 10am – 1pm, for urgent issues.

We do not operate as a walk-in clinic; we ask our patients to make appointments to avoid unnecessary wait times and crowded waiting rooms.

When you attend the After Hours Clinic:

You will be seen by your family physician or one of the doctors in our team
The doctor you see will have access to all of your medical records and be able to communicate directly with your family physician
Be assured that your family physician will have the full story from your after hours clinic visit including any results/reports generated from the visit

Our team of physicians at Centro Healthcare is dedicated to providing the best medical care for our patients. Instead of going to a walk in clinic, please give us a call at 905-605-4744 to schedule a same day urgent appointment or an appointment in our After Hours Clinic.

IT’S THAT TIME OF THE YEAR AGAIN – WHAT YOU NEED TO KNOW ABOUT THE INFLUENZA VACCINE

Tue, 16 Oct 2018 07:39:00 GMT

WHAT IS INFLUENZA OR THE FLU?

Credit: thetowerlight.com

In Canada, approximately 12,200 people are hospitalized each year and about 3,500 people die each year due to complications from influenza. Infants, older adults and those with certain chronic health conditions are most vulnerable.

Many often confuse the common cold with the flu but the two are caused by different viruses.

While both illnesses have similar symptoms, the flu is much more severe and can result in serious complications requiring hospitalization.

The following can help differentiate between the two:

Nausea, vomiting and diarrhea may occur especially in children.

WHO CAN GET THE INFLUENZA VACCINE?

Anyone over the age of 6 months old can get the influenza vaccine including pregnant women.

The vaccine is especially recommended for:

WHO SHOULD NOT GET THE INFLUENZA VACCINE?

Those who have had a severe allergic reaction to the influenza vaccine – this does not include those who report having the cold or “flu” or side effects (mild redness, tenderness and swelling at the injection site) after the vaccine.

There is a small amount of egg protein in the vaccine. Having an egg allergy does not mean you cannot get the vaccine, with the exception of those who get an anaphylactic reaction from exposure to eggs or egg products. Anaphylactic reaction means those who get swelling of the lips, tongue or eyelids with or without difficulty breathing with or without vomiting.

CAN I GET THE FLU FROM THE FLU VACCINE?

No, the flu vaccine cannot cause influenza ¹ . This is because the vaccine either consists of viruses that have been killed (and therefore cannot cause infection) or simply proteins from the virus. The Flu Mist vaccine, which is sprayed into the nostrils, consists of a live-attenuated or weakened virus that is not capable of causing infection where temperatures are warm such as in the lungs.

WHY DID I GET SICK WITH FLU-LIKE SYMPTOMS AFTER I GOT THE VACCINE? 1

Some will say the flu vaccine makes them sick. Here are some possible explanations as to why some get flu-like symptoms despite getting the vaccine:

WHEN CAN I GET THE FLU SHOT?

Flu season starts in the late fall and winds down in the Spring. You can get the flu shot at anytime however we recommend getting vaccinated early in the season so you are protected through to the spring.

REFERENCES

Credit: Avalonlibrary.org