Okay. Kelly will share your comments with clinical team at AC Will await name who is picking up swabs at AC @noon. w: . . m5: a?m Dav1d Musy] Pre51dent& CEO Eat?343%; Of?ce: 5 Email: david.musyj@wrh.on.ca . mm ?5 Mobile/Home: 519?995?2966 it WebApr 10, 2020, at 10:20 AM, Waiid Ahmed wrote: I will let you know who will pick up the swabs. Yes, if we are directing the HCW for swabbing, please swab them. Some of the criteria that we use to give that direction include high risk exposure, 4-5 days since the exposure (to prevent any transmission) etc. Of course on top of all that would be a clinical judgement that your team at the center can use to make a calf themselves. Wajid Ahmed MBBS, MAS, MSG, Medical Officer of Health Administration Windsor?Essex County Health Unit 1005 Oueilette Avenue, Windsor, NQA 4J8 Ph. 519258-2146 ext. 1436 Fx. 519-258-6003 On Apr. 10, 2020 10:14 am, David Musyj wrote: The message below originated from a user OUTSIDE of The 200 swabs will be at Assessment Centre at Oueliette. Who is picking them up to make sure we give to right person Alsoijust so we are perfectly clear if a LTC/retirement home HCW worker attends AC with NO Not even any atypical You are agreeing they should NOT be swabbed. We just need our clinical team to know exactly what directions PH is giving them when they are calling you. We wiil swab them if you are telling them to be swabbed. Because that is what they are teliing us. - I am copying Kelly so she. can share answer with clinical team in AC [photo] David Musyj President CEO Office: 519-254-5577, ext. Email: On Apr 10, 2020, at 10:02 AM, Wajid Ahmed wrote: David, our staff will pick up the 200 swabs from the assessment center at noon when they come to pick up the paper work. As far as the HCW showing up at the assessment center yesterday, we were told that they had mild and that is why we supported them getting tested. Claudia, you are right there is no distinction between and workers based on the direction we received. As a physician I do have significant concerns with this approach. i do not support a blanket approach to test ALL workers because it will be more problematic and will not provide any benefit either from an operation perspective or from a risk reduction perspective. I support universal masking of all staff and appropriate PPE use by staff at the facilities. support anyone even with mild or with atypical should be tested. We already had this discussion with the homes and explained it to them and they were fine with it. Thanks, We] id Wajid Ahmed MBBS, MAS, Medical Officer of Health Administration Windsor-Essex County Health Unit 1005 Ouellette Avenue, Windsor, NQA 4J8 Ph. 519-258-2146 ext. 1436 Fx. 519-258-6003 From: den Boer, Claudia Sent: Friday. April 10, 2020 9:53 AM To: David Musyj Wajid Ahmed Cc: Bruce Krauter Wassim Saad MD Subject: RE: What do you think? The message below originated from a user OUTSIDE of DavidIWaiid - can you just clarify for me regarding the testing criteria for in what I read, there was no distinction between or workers - all were to be tested. Is this correct? Thanks. Claudia From: David Musyj [ma?a?avid?usmmodna] Sent: April 10 2020 9: 36 AM To: Wajid Ahmed Cc: Bruce Krauter den Boer, Ciaudia Wassim Saad MD >; Claudia Den Boer Email: On Apr 9, 2020, at 12:18 PM, Wajid Ahmed wrote: This email originated from outside of the organization. Do not click links or open attachments unless you know the content is safe. If necessary, please contact the sender for confirmation. Hi David, We are working closeiy every long term care homes and retirement homes for all their infection prevention and control need. With the new lab model they will be getting swabs from public health to test their residents and staff. We have ordered swabs to send out to and retirement homes and they shouid have it today I am not sure if any of the and Retirements homes have expressed any concerns about swabbing their own clients or their staff. They have done swabs already on all their residents and some staff without any concerns. They do the swabbing for influenza all the time and they know how to do it. Please let public health know if you hear any concerns about that. Thank you, Wajid Wajid Ahmed MBBS, MAS, MSG, Medical Officerof Health Administration Windsor-Essex County Health Unit . 1005 Ouellette Avenue, Windsor, NBA 4J8 Ph. 519-258-2146 ext. 1436 Fx. 519?2563430013 logo] [Connect with us online] {Connect with us on Facebook] Our vision is a healthy community. D-19 - What you need to know to help you and your family stay healthy. 1. Wash your hands with soap and water thoroughly and often. 2. Cough and sneeze into your sleeve or a tissue. Dispose of tissue immediately and wash your hands. 3. Keep surfaces clean and disinfected. 4. Stay home when you are sick. This e-mail and attached material is intended for the use of the individual or institution to which it is addressed and may not be distributed, copied or disclosed to other unauthorized persons. This material may contain confidential or personal information that may be subject to the provisions of the Freedom of information and Protection of Privacy Act, the Municipal Freedom of information and Protection of Privacy Act or the Personal Health Information Protection Act. If you receive this transmission in error, please notify me immediately by telephone at the number listed above and do not print, copy, distribute or disclose it further. From: David Musyj Sent: Thursday, April 9,2020 10: 13 AM To: Claudia Den Boer Cc: Wajid Ahmed Bruce krauter Paul Bradford MD Subject: Re: What do you think? The message below originated from a user OUTSIDE of Aiso EMS I suggest talk to them and possibly divide up. When this started in January EMS and WRH pressed for the model mentioned on call today. We finaliy got it. I know EMS aiready has pian in place for swabbing in community through medical directives of Dr Ahmed. 1 do not know what CHC would require to do this as well. Possibly same or similar. However imagine EMS ready to go now. Bruce - this is to go into homes and swab residents and staff etc. [photo] David Musyj President CEO Office: 519-254-5577, ext. Email: On Apr 9, 2020, at 10:08 AM, den Boer, Ciaudia Subject: Re: Swabs and Swabbing LTC/Re?rement Home residents Date: April 11, 2020 at 6:39:18 PM EDT To: Iustin Lammers Cc: Wajid Ahmed , Bruce Krauter Claudia Den Boer Theresa Marentette Great work Justin. Wei! done gj?x David Musyj President CEO 35:3 mags wwtm?k Of?ce: 519?254?5577. ext. 56013 at: Email: david.musyj@wrh.on.ca Mobile/Home: 519?995-2966 Web: a On Apr 11, 2020, at 6:34 PM, Justin Lammers wrote: Hi all, I attended Country with our VPN team and we coliected 26 samples. We wili return at Mam tomorrow to finish the remaining 30. Thanks, Justin Lammers Deputy Chief Professional Standards Essex Windsor EMS Sent From My iPhone Justin Lammers Deputy Chief, Professional Standards Division ext. 2600 On Apr 11, 2020, at 15:45, David Musyj wrote: Thanks for this email. Thanks for getting EMS engaged. I know Claudia has shared with you the other LTC homeisH that need support in swabs and/or swabbing. i would imagine not many wouid turn down EMS to attend and do the swabbing for their team to focus on other resident issues. To your other point. All of us report to a Board. However are paid by our community and Province through taxes and as a result they are our eventual employers. They wouid expect nothing iess of us but to be working together and pooling resources and expertise to help them out during times like this. I am sorry you?feit it took time to respond to emaiis. However everyone else on this string was saying the same thing on the emaiis from the start. Thanks again for engaging EMS. Thanks Bruce and team for stepping up again. Thanks Ciaudia for engaging the sector and being a conduit for them to ask for help. Stay safe everyone. David Musyj President CEO Of?ce: 519-254?5577. ext. 56018 Email: david.musyj@wrh.on.ca Mobile/Home: 519395-2966 Web: On Apr 11, 2020, at 2:43 PM, Wajid Ahmed wrote: CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you know the content is safe. If necessary, please contact the sender for con?rmation. Hi All, Even though, i report to my Board and i just want to close the loop on the conversation that led to my time responding to these emails instead of doing actual Public Health work. Heron Terrace - are good with swabbing, the DOC and the nurse are doing the swab and i asked specifically if they need to swab anyone in the facility and any inability to do it. Nancy (DOC) told me that they are good and wili let my team or I know if they need any help with it. i was very clear that if they have any concerns with swabbing and testing to please iet me know and I got no concerns. Country Viilage they are looking to swab additional resident and will give us a number of residents that needs swabbing. Justin will help me get the swabs done. i will personally reach out to other facility to make sure that their needs are met. Wajid WAJID AHMED M335, MAS, MSC, Medical Officer of Health Administration Windsor?Essex County Health Unit 1005 Avenue, Windsor, N9A 418 Ph. 519-258?2146 ext. 1436 Fat. 5153-2586003 From: David Musyj Sent: Saturday, April 11, 2020 2:03 PM To: Wajid Ahmed Cc: Bruce Krauter Claudia Den Boer Justin Lammers Theresa Marentette Subject: Re: Swabs and Swabbing LTC/Retirement Home residents The message below originated from a user OUTSIDE of Dr Ahmed You have been directed to swab high risk residents like LTC and retirement homes. As I type this the additional 200 swabs are still sitting at the door of the assessment centre for PH to pick up. They are doing nothing sitting there. As to who hospital staff are swabbing as in patients has nothing to do with the issue of LTC/Retirement homes. I have no clue what argument you are wanting to make but please just do what we all have been begging you to do. Hospital clinical staff is following provincial guidelines and directions as it relates to hospital patients. Even the West Region today was begging you to do this and not ?drop the swabs off at and expect them to do it. They need our help. It is your medical directive with EMS. Please make it happen today. BTW the assessment centre closes at 4. Please get the swabs before then. David Musyj President CEO Of?ce: 5] 9-254"5577= ext. 56018 Email: david.musyj@wrh.on.ca Mobile/Horne: 519-995-2966 Web: On Apr 11, 2020, at 1:34 PM, Wajid Ahmed wrote: CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you know the content is safe. If necessary, please contact the sender for continuation. Hi David, lust to be clear, I am NOT refusing support from EMS but I don?t even know what and who I am swabbingourjob, we can address the REAL risk in the community instead of hearing. it from multiple channels and repeating the same messages. i am asking again, can you send me what decision making criteria you are using for your staff and staff for testing and swabbing? i think it is important for me to know from a consistency perspective. Thanks, Wajid WAJID AHIVI ED M335, MAS, Medical Officer of Health 1 Administration Windsor?Essex County Heaith Unit 1005 Avenue, Windsor, N9A 438 Ph. 519?258~2146 ext. 1436 Fx. 519-258-6003 From: David Musyj Sent: Saturday, April 11, 2020 1:23 PM To: Wajid Ahmed Cc: Bruce Krauter Claudia Den Boer .iustin Lammers Theresa Merentette Subject: Re: Swabs and Swabbing LTC/Retirement Home residents The message below originated from a user OUTSIDE of Dr Ahmed. While you are debating nothing is happening on the swabbing front. 1 will not continue to email and beg for you to get EMS involved today. This is new on your doorstep 100%. Have them go into a home as stated work with the clinical teams in the building - use their collective clinical judgment and start swabbing. Err on the side of swabbing. I hope for whatever reason you are refusing to accept this support from EMS stops today. Our community, residents and staff of LTC deserve action not medical debate. m? Egg; David Musyj President CEO Of?ce: MW Email: david.musyj@wrh.on.ca Mobile/Home: 519-995-2966 Web: On Apr 11, 2020, at 1:23 PM, Wajid Ahmed wrote: CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you know the content is safe. If necessary, please contact the sender for con?rmation. Hi David, Are you making this decision to swab people in the entire facility? Nowhere in the testing or management document refers to that section. This is what is written on the ministry document about testing. patients: patients transferred from a hospital to a long~term care home or retirement home should be tested prior to transfer. A negative result does not rule out the potential for incubating illness and all patients should remain under a 14-day sel?solation period following transfer. In the event of a resident in a long-term care home or retirement home, residents living in the same room should be tested immediately along with the resident. In the event of an outbreak of in a long-term care home or retirement home contacts of a con?rmed case, determined in consultation with the local public health authority, should be tested including: 0 All residents living in adjacent rooms . All staff working on the unit/care hub All essential visitors that attended at the unit/care hub - Any other contacts deemed appropriate for testing based on a risk assessment by local public health Local public health may also, based on a risk assessment, determine whether any of the abovementioned individuals do not require testing a resident that has been in self-isolation during the period of communicability). Pubiic health is in contact with these homes multiple times a day and is having this conversation multiple times and i am very concerned about what message these homes are getting. if someone else wants to make that decision about testing, i need to see that in writing. While I am fully supportive of having a iow threshold for testing but the real issue is staffing and PPE. Heron terrace is funded by but we are supporting everyone in the community. The issue is not oniy for the funded facility but for everyone. Country Viliage have more COVID cases than anyone else in the region and we just connected with their executive director and they are not looking for any support at this time. lam fully supportive of universally masking everyone and having appropriate PPE because that will save more cases and not testing people. iF someone can find the solution for these homes how to get more staff and PPE, that would be a big help for them. i will follow?up with the homes once again today and ask about this specific issue and wiil reach out to Bruce if capacity is an issue. David, can you send me what decision making criteria you are using for your staff and residents for testing and swabbing? I think it is important for me to know from a consistency perspective. Thank you. Wajid WAJID AHMED MBBS, MAS, MSC, Medical Officer of Health Administration Windsor-Essex County Health Unit 1005 Oueilette Avenue, Windsor, N9A 438 Ph. 519-258?2146 ext. 1436 Fx. 519458?6003 CONFIDENTIALITY NOTICE: This e-mail and attached materiai is intended for the use ofthe individuai or institution to which it is addressed and may not be distributed, copied or disclosed to other unauthorized persons. This material may contain con?dential or personai information that may be subject to the provisions of the Freedom of Information and Protection of Privacy Act, the Municipal Freedom of Information and Protection of Privacy Act or the Personal Health information Protection Act. If you receive this transmission in error. please notify me immediately by telephone at the number listed above and do not print, copy, distribute or disclose it further. From: David Musyj Sent: Saturday, April 11, 2020 1:01 PM To: Wajid Ahmed Cc: Bruce Krauter Claudia Den Boer Justin Lammers Subject: Re: Swabs and Swa bbing LTC/Retirement Home residents Dr Ahmed While we are debating the and issue (it will never be resolved until research is completed 2 years from now) can we just look at the list of Outbreak homes. Start with the ?outbreak? homes. We know Huron Terrace needs help and support for swabbing and also staf?ng. Have 1. EMS get some of the 400 swabs from PH 2. PH contact one of the homes on the list (PH pick the one with the most residents and staff with COVID- 19) positive; and 3. PH tell EMS which home to go into and EMS start swabbing the rest of residents in the home talking to the clinical staff and ?nding out from their point of View who is higher risk which has typical/atypcial Err on side of swabbing. 4 If EMS has swabs left ever go to next home PH decides start this TODAY David Musyj President 8: CEO Of?ce: 519-254-5577, ext. 58018 Email: Mobiieil?lome: 519-995~2966 ?r 3 Web: WW On Apr 11, 2020, at 12:14 PM, Wajid Ahmed wrote: This email originated from outside of the organization. Do not click links or open attachments unless you know the content is safe. If necessary, please contact the sender for con?rmation. Bruce, some homes want to swab everyone (even and I am reluctant on doing that but let me give it a thought before we go there. David can recall Tom Stewart comment this morning as well when he was not supportive of swabbing people. i agree to have a low threshold for swabbing. We haven?t heard any concerns about swabbing other than swab shortage. if you are aware, please let me know and we can connect and discuss the logistics. Wajid WAJID AHMED MBBS, MAS, MSC, I Medical Officer of Health Administration Windsor~Essex County Health Unit. 1005 Ouellette Avenue, Windsor, NQA 418 Ph. 519-258-2146 ext. 1436 Fx. 519-258-6003 From: Bruce Krauter Sent: Saturday, April 11, 2020 11:28 AM To: David Musyj Wajid Ahmed Cc: Claudia Den Boer Justin Lammers Subject: RE: Swabs and Swabbing Lit/Retirement Home residents The message below originated from a user OUTSIDE of?EQH?m Good day, i have copied Deputy Chief Lammers on this and we are able to assist when requested. For everyone?s information, we swabbed at Leamington Hospice yesterday and it went quite weli. i see Waterloo is doing it, but we will standby Bruce Bruce Krauter Chief Essex-Windsor EMS 360 Fairview Ave. W. Suite 218 I Essex, ON I NSM 1Y6 P: SIS-7766441 ext. 2654 F: 519-776-1254 TTY: 1-877-624-4832 From: David Musyj Sent: Saturday, April 11, 2020 10:58 AM To: Wajid Ahmed Cc: Bruce Krauter Claudia Den Boer Subject: Swabs and Swabbing LTC/Retirement Home residents Dr Ahmed have just been informed that Public Health?s original 200 swabs are arriving. instead of ?paying back? the original 250 WRH lent i am leaving another 200 at the Assessment Centre for your team to pick up today before 4PM. They are there NOW. Again, like yesterday's 200, I am willing to personally deliver anywhere today myself. i strongly ask again to use EMS to help swab LTC/retirement homes starting TODAY. Dropping them off and expecting an already stretched LTC/retirement home staff to swab and burn through PPE doing so is in my opinion not appropriate, timely, efficient or resident focused. i beg you personaliy to use resources that are available right now - EMS. I know you are taking personal responsibility for getting LTC homes swabbed. However, when and if our ESC numbers come out for resident swabbing and they are very low BUT we have homes on ?outbreak? and some pleading for support from Claudia?s team we are ALL to blame. That is why I am being direct on this issue. On a side note Claudia?s team is addressing LTC staffing BUT she aiso needs your Public Health support on clear and consistent messaging on when staff can return to work following a negative swab result on staff. i know WRH had that exact issue with PH with WRH's own employees and physicians and pleaded for PH to direct that staff back to the hospital. WRH follows directives and guidelines. As to any LTC homes in ?outbreak? and their staff coming to the Assessment Centre we are swabbing all of them whether have typical or atypical This is as a result of now the clearest direction from anyone on this issue. The numbers are NOT that large and should hopefully allow LTC homes to operate subject to PH not taking a "14 day cannot work post even a negative test result approach." You now have 400 swabs for this work. Please access this help from EMS that is being offered again for the residents. David Musyj 1 President CEO Of?ce: 519-254-5577, ext. 56018 Email: david.musyj@wrn.on.ca MobiiefHome: 519?995-2966 Web: From: David Musyj Subject: Re: Tweet Twitter Date: April 13, 2020 at 2:29:43 PM EDT To: Wajid Ahmed Cc: Claudia Den Boer Bruce krauter I do not know if you will get 1000 all at once. However I would expect you can start with the ones you have and work your way through as much as you can do. When you run out you run out. On Apr 13, 2020, at 2:28 PM, Wajid Ahmed wrote: CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you know the content is safe. If necessary, please contact the sender for con?rmation. Thanks David for sharing. i still have reservation on that approach but letbalance the risk of getting the false negatives. I am heping that we get the direction from the ministry to sort the issue out. If London lab can send us thousands of swabs, we can develop a plan to systematically swab each of the homes in the region with EMS support. WAJID AHMED mess, MAS, MSG, Medical Officer of Health Administration Windsor-Essex County Health Unit 1005 Ouellette Avenue, Windsor, N9A 4J8 Ph. 519-258-2146 ext. 1436 Fx. 519-258-6003 Our vision is a healthy community. - What you need to know to help you and your family stay healthy. 1. Wash your hands with soap and water thoroughly and often. 2. Cough and sneeze into your sleeve or a tissue. Dispose of tissue immediately and wash your hands. 3. Keep surfaces clean and disinfected. 4. Stay home when you are sick. CONFIDENTIALITY This e-maii and attached materiai is intended for the use of the individual or institution to which it is addressed and may not be distributed, copied or disclosed to other unauthorized persons. This material may contain con?dential or personal information that may be subject to the provisions of the Freedom of information and Protection of Privacy Act, the Municipal Freedom of information and Protection of Privacy Act or the Personal Health information Protection Act. if you receive this transmission in error, please notify me immediately by telephone at the number listed above and do not print, copy. distribute or disclose it further. From: David Musyj Sent: Monday, April 13, 2020 2:18 PM To: Claudia Den Boer Wajid Ahmed Bruce krauter Subject: Tweet Twitter The message below originated from a user OUTSIDE of Just fyi As stated we can debate etc. Bottom line is the Premier wants LTC residents tested. 2:13 4 as LTE 1 Messages Tweet Robert Ben zie @robertbenzie NEW: Premier Doug Ford says Ontario Health CEO Matt Anderson assured him everyone in long?term care homes would be tested, but province's own guidelines do not say that. Premier admits he ?is frustrated." . ?Get these damned tests done," he says. #onpoli 1:41 PM Apr ?13, 2020 . Twitter Web App From: Subject: Tweet Twitter Date: April 13, 2020 at 2:18:25 PM EDT To: Claudia den Boer Wajid Ahmed Bruce krauter Just fyi As stated we can debate etc. Bottom line is the Premier wants LTC residents tested. Messages Robert Benzie @robertbenzie NEW: Premier Doug Ford says Ontario Health CEO Matt Anderson assured him everyone in long-term care homes would be tested, but province's own guidelines do not say that. Premier admits he "is frustrated." ?Get these damned tests done," he says. #onpoli 1:41 PM Apr ?13, 2020 - Twitter Web App On Mar 5, 2020, at 11:48 PM, Wajid Ahmed wrote: What time is the meeting Bruce? 1 have some reservation about the in home assessment model especiaily at this stage of the pandemic pian. Happy to discuss that Wajid WAJID AHM ED MBBS, MAS, MSG, Medicai Officer of Health 1 Administration Windsor?Essex County Health Unit 1005 Avenue, Windsor, NBA 418 Ph. 519?258-2146 ext. 1436 Fx. 519-258-6003 Begin forwarded message: From: David Musyj Subject: ?ow chart and Clinical guideline FOR PUBLIC HEALTH AND EMS Date: March 5, 2020 at 7:21 :14 AM EST To: Wajid Ahmed Cc: Janice Dawson Justin Lammers Bruce Krauter Erika Vitale Karen Fiiddell Dr Ahmed Has your team reviewed these documents. Can we look to implement locally This would fiil the gap ii cases start to increase. Would reduce the demand on a testing centre, support self quarantine and reducing possible spread. . David Musyj President a CEO Of?ce: 519-254-55?7, ext. 56018 .. Emaii: devid.mosvi@wrh.on.ca MobileiHome: 519-995?2966 Web: wrh.m.oa .23- f'v-Iva 25.0 On Mar 2, 2020, at 10:55 AM, Bruce Krauter wrote: FYI, what Renfrew County has done with community Paramedics (VPN) for screening in home. I have not reviewed fully. Bruce Bruce Krauter Chief ext. 2654 From: Justin Lammers Sent: Monday, March 2, 2020 10:48 AM To: Bruce Krauter Subject: FW: COVlD?19flow chart and Clinical guideline Renfrew County Community Paramedicine Response Guideline Justin Lammers Deputy Chief, Professional Standards Division ext. 2600 Justin Lammers Michael Vanhartingsyeldt Subject: flow chart and Clinical guideline Hello, Thank you for your patience. Please see our clinical guideline and flow chart. Take what you need to make it work with your local Public Health. Thank you, The information in this emaii and any accompanying document(s) are intended solely for the addressee(s) named, and is confidential. Any other distribution, disclosure or copying is strictly prohibited. if you have received this communication in error, piease reply by email to the sender and delete or destroy ali copies of this message with all attached document(s). Ce courriel peut faire ?tat d?information privil?gi?e ou confidentielle destin?e a une personne on a une entit? nomm?e dans ce message. Dans l??ventualit? ou le lecteur de ce message n?est pas Ie r?cipiendaire vis? ou i?agent responsible de ie faire suivre au recipiendair Vise, yous ?tes par la pr?sente ayis? que toute revue, diffusion, distribution ou reproduction de cette communication est interditte. Si cette communication a recu par erreur, veuiilez nous en aviser par r?ponse de courriei et supprimer le message originai et touts documents ci?joints. Begin forwarded message: From: Wajid Ahmed Subject: RE: Swabs required to Complete weekend testing Date: Ma 1, 2020 at 5:32:17 PM EDT . Bruce krauter er@countyofessex.on.ca> This emaii originated from outside of the organization. Do not click links or open attachments unless you know the content is safe. If necessary, please contact the sender for confirmation. Thanks- Swabbing at homes will be complete before May 15th as per CMOH direction. Monday is cancelled and we will continue on with our plan and keep at least 2?3 days of swabs on hand before we confirm each homes. I won't respond further on this topic. Have a nice weekend. Wajid Ahmed MBBS, MAS, i Medical Officer of Health Administration Windsor?Essex County Health Unit 1005 Oueilette Avenue, Windsor, N9A 4J8 Ph. 519-258-2146 ext. 1436 Fx. 519-258-6003 On May 1, 2020 5:28 _wrote= The message below originated from a user OUTSIDE of CEO for Erie St. Clair, Hamiiton Niagara Haldimand Brant, South West and Waterloo Wellington LHINs and Regional Lead, West Region From: David Musyj Sent: Friday, May 1, 2020 5:23 PM To: Wajid Ahmed Cc: Lauckner, Bruce Thomas Stewart Bruce krauter Subject: Re: Swabs required to Complete weekend testing CAUTION - EXTERNAL - This email originated from outside of the organization. Do not follow instructions, click links, or open attachments unless you recognize the sender and know the content is safe. Confirmed more swabs coming tonight or Sunday night We are good for weekend and Monday Great work all We continue with plans as previously set. No need to cancel anything. [photo] David Musyj 1 President CEO Office: 519-254-5577, ext. 56018 Email: Mobiie/Home: On May 1, 2020, at 5:00 PM, David Musyj wrote: Hi Hold tight on cancelling Monday i have a line on more swabs Again, i strongly suggest we talk on Sunday. No need to cancel yet. I will not comment about the rest of the email. We need to move forward not go backwards on swabbing issue etc. [photo] David Musyj 1 President CEO Office: 519?254-5577, ext. 56018 Email: Mobile/Home: 51 9-995-2966> Web: On May 1, 2020, at 4:06 PM, Wajid Ahmed wrote: Wow, only you care about the health and safety of your community and province and no one else. Maintaining a good practice at the facility and having enough staffing SAVES life and PROTECT the community not swabbing. Focus on reducing the transmission especially in the green homes. Someday, I can give you lessons in epidemiology, public health, and ciinicat science. And I can learn political lessons from you Monday is CANCELLED doesn't matter what happens now. Since we are moving forward with the swabbing as per OH direction, we do not have swabs for any homes if they request on the weekend. And if something happens, i am not responsible and will not hesitate to say what kind of direction and pressure came from everyone involved instead of letting me make a decision based on the locai circumstances. WAJID AHMED MBBS, MAS, Medical Officer of Health Administration Windsor?Essex County Health Unit 1005 Oueilette Avenue, Windsor, NQA 4J8 Ph. 5192562146 ext. 1436 Fx. 519-258?6003 .git> Email: david. rnusyj@wrh. on. ca On May 1, 2020, at 3:41 PM, Wajid Ahmed wrote: CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you know the content is safe. if necessary, please contact the sender for confirmation. i sent my staff to the assessment center and they were denied the swabs and were told that EMS will pick up. i am not sure about any partnership/collaboration we have. I also didn't hear anything back from you about Monday and Tuesday swab availability. Attached please find the email from Transform (our supplier for swabs) saying that they do not have any idea about swabbing. I am CANOELLING Monday swabbing. if I don't receive the swabs over the weekend or early morning Monday, i may end up Tuesday swabbing as well. I have received direction from the Chief Medical Officer of Health (CMOH) to complete all the Fied, Green Yellow by May 15th. If we get the swabs, we can still complete the work by May 15th. Wajid WAJID AHMED MBBS, MAS, MSG, Medical Officer of Health Administration Windsor-Essex County Health Unit 1005 Ouellette Avenue, Windsor, N9A 4J8 Ph. 519?258?2146 ext. 1436 Fx. 519-258-6003 Begin forwarded message: From: Waiid Ahmed Subject: RE: Swabs required to Complete weekend testing Date: Ma 1, 2020 at 5:32:17 PM EDT Bruce krauter er@countyofessex.on.ca> CAUTION: This emaii originated from outside of the organization. Do not click links or open attachments uniess you know the content is safe. If necessary, please contact the sender for confirmation. Thanks- Swabbing at homes will be complete before May 15th as per CMOH direction. Monday is cancelied and we will continue on with our plan and keep at ieast 2-3 days of swabs on hand before we confirm each homes. I won?t respond further on this topic. Have a nice weekend. Wajid Ahmed MBBS, MAS, MSG, i Medicai Officer of Health Administration Windsor-Essex County Heaith Unit 1005 Ouellette Avenue, Windsor, N9A 4J8 Ph. 519-258-2146 ext. 1436 Fx. 519-258-6003 On May 1, 2020 5:28 pm? ?wrote: The message below originated from a user OUTSIDE of CEO for Erie St. Clair, Hamilton Niagara Haldirnand Brant, South West and Waterloo Wellington LHle and Regional Lead, West Region From: David Musyj Sent: Friday, May 1, 2020 5:23 PM To: Wajid Ahmed Cc: Lauckner, Bruce Thomas Stewart Bruce krauter Subject: Re: Swabs required to Complete weekend testing CAUTION EXTERNAL E-MAIL - This email originated from outside of the organization. Do not follow instructions, click links, or open attachments unless you recognize the sender and know the content is safe. Confirmed more swabs coming tonight or Sunday night We are good for weekend and Monday Great work all We continue with plans as previously set. No need to cancel anything. [photo] David Musyi President CEO Office: 519254-5577, ext. 56018 Email: Mobile/Home: On May 1, 2020, at 5:00 PM, David Musyj wrote: Hi Hold'tight on cancelling Monday I have a line on more swabs Again, I strongly suggest we talk on Sunday. No need to cancel yet. I will not comment about the rest of the email. We need to move forward not go backwards on swabbing issue etc. [photo] David Musyj President CEO Office: 519-254?5577, ext. 56018 Email: Mobiie/Home: Web: On May 1, 2020, at 4:06 PM, Wajid Ahmed wrote: Wow, only you care about the health and safety of your community and province and no one else. Maintaining a good IPAC practice at the facility and having enough staffing SAVES iite and PROTECT the community not swabbing. Focus on reducing the transmission especially in the green homes. Someday, i can give you lessons in epidemiology, pubiic health, and clinical science. And I can learn political lessons from you 6) Monday is CANCELLED doesn?t matter what happens now. Since we are moving forward with the swabbing as per OH direction, we do not have swabs for any homes if they request on the weekend. And it something happens, I am not responsibie and will not hesitate to say what kind of direction and pressure came from everyone involved instead of letting me make a decision based on the local circumstances. WAJID AHMED. MBBS, MAS, MSG, Medical Officer of Heaith Administration Windsor?Essex County Health Unit 1005 Oueilette Avenue, Windsor, NQA 4J8 Ph. 519-258-2146 ext. 1436 Fx. 519-258-6003 .gif> Subject: RE: Swabs Date: May 1, 2020 at 2:01 :01 PM EDT To: Justin Lammers David Musyj Cc: Bruce Krauter Kelly Heron Karen Riddeli Erika Vitale Wassim Saad MD Karen McCullough Katelyn Dryden Claudia Den Boer , Nicole Robinson Hi Justin, The swabs are ready for you! Thank; Jenn From: Justin Lammers Sent: Friday, May 1, 2020 1:59 PM To: David Musyj Cc: Bruce Krauter Kelly Heron Karen Riddell Erika Vitaie Wassim Saad MD Karen McCullough Jennifer Cameron Katelyn Dryden Claudia Den Boer Nicole Robinson Subject: Re: Swabs This email originated from outside of the organization. Do not click links or open attachments unless you know the content is safe. If necessary, please contact the sender for con?rmation. Strike teams are currently engaged and I can?t get an ETA. If it gets close, I?ll have a district Chief pick them up from AC at 330. Justin Lammers Deputy Chief Professional Standards Essex Windsor EMS Sent From My iPhone Justin Lammers Deputy Chie? Professional Standards Division Essex?Windsor EMS 360 Fairview Ave. W. Suite 2181Essex, ON N8M 1Y6 P: 519776-6441 ext. 2600 F: 519-776?1254 W: 1-877?624-4832 This e-maii and any attachments may contain personal information or Information that is otherwise confidential. If you are not the intended recipient, any use, disciosure or copying of any part of it is prohibited. If this e-mail is received in error, please immediately reply and delete or destroy any copies of it. On May 1, 2020, at 13:46, David Musyj wrote: Hi Can we get 800 swabs for Justin Lamrners/EMS to pick up at Assessment Centre before end of day today. Justin - what will be ETA I assume when your team drops off today?s swabbing. Katelyn- the remainder should last WRH to close of Monday. We will need more Tuesday. Public Health will not disclose how many swabs they have ?on hand?. We are giving EMS/hospital teams all we can give to make it through the weekend. Justin - needless to say any staff that are not working will need to go to AC as always to get swabbed. Any questions ask. :9 David Musyj President CEO .. imm- Of?ce: 519?254?5577. ext. 56018 Email: david.musvi@wrh.on.ca Mobile/Home: 519?995-2966 Web: From: Wajid Ahmed Sent: Friday, May 1, 2020 1:55 PM To: David Musyj Cc: Lauckner, Bruce Tom Stewart Subject: RE: Swabs required to Complete weekend testing :c'li'rikflinks-Esme'njia if you can give me an answer by 3pm that would be great because we already calied the homes and put them back on the list for mass swabbing. Just a reminder we need 1269+50=1319 swabs to proceed as planned. Transform didn?t give us any indication that they are delivery. i told you yesterday that we need roughly 1200 swabs and today I gave you a breakdown of everything as well. I went ahead and ?uncancel? everything and right now everything hinges on the swabs (even if iabs can process the specimen). it will significantly damage our relationship with the because i went ahead with your assurance that you wiil get me the swabs. Thanks, Wajid WAJID AHMED MBBS, MAS, Medical Officer of Health Administration Windsor?Essex County Health Unit 1005 Ouellette Avenue, Windsor, N9A 438 Ph. 519?258~2146 ext. 1436 Fx. 5194586003 Our vision is a healthy community. - What you need to know to help you and your family stay healthy. 1. Wash your hands with soap and water thoroughly and often. 2. Cough and sneeze into your sleeve or a tissue. Dispose of tissue immediately and wash your hands. 3. Keep surfaces clean and disinfected. 4. Stay home when you are sick. NOTICE: This e-mail and attached materia! is intended for the use of the individual or institution to which it is addressed and may not be distributed, copied or disclosed to other unauthorized persons. This material may contain con?dential or personal information that may be subject to the provisions of the Freedom of Information and Protection of Privacy Act, the Municipal Freedom of information and Protection of Privacy Act or the Personal Health information Protection Act. If you receive this transmission in error, please notify me immediately by telephone at the number listed above and do not print, copy, distribute or disclose it further. From: Wajid Ahmed Sent: Friday, May 1, 2020 1:50 PM To: ?David Musyj' Cc: 'Lauckner, Bruce? ?Tom Stewartl Subject: RE: Swabs required to Complete weekend testing We need to deliver swabs to homes today by 4:30pm. Please let me know the status of the swabs. We have used all the swabs to test and also delivered the swabs that are requested by the facility to test residents and staff. Really appreciate the follow~up and update. Wajid From: Wajid Ahmed Sent: Friday, May 1, 2020 11:49 AM To: 'David Musyj? Cc: Lauckner, Bruce Subject: RE: Swabs required to Complete weekend testing And BACK if you cant provide the swabs ?teii this to Bruce and Tom, Copying in Bruce Lauckner. From: David Musyj Sent: Friday, May 1, 2020 11:42 AM To: Wajid Ahmed Cc: Bruce Krauter Subject: Re: Swabs required to Complete weekend testing The message below originated from a user OUTSIDE of So you have ZERO swabs at PH available for Saturday and Sunday You handed out your last one today If so what was your plan even for Monday if this weekend was cancelled like you wanted You expecting a delivery this weekend Again please tell me how many swabs you have available for this weekend. David Musyj President CEO Of?ce: 5192546577, ext. 56018 Email: Mobile/Home: 519?995?2966 Wwb:w.wrh.on.oa - . #53 On May 1, 2020, at 11:35 AM, Wajid Ahmed wrote: CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you know the content is safe. Ifnecessary, please contact the sender for con?rmation. THIS IS NOT A GAME AND PLEASE DO NOT ME THAT PEOPLE LIVES ARE AT RISK. I told you what we have. All the swabs we received is sent to the homes, we have 44 homes in the region and every home is doing enhanced swabbing at their facility and request 20?30 swabs every few days. All the swab distribution is happening through Public Health and we are sending it out to all the homes that are requesting it. i am not getting any benefit to keep the swabs for myself or for the health unit. WAJID AHMED MBBS, MAS, Medical Officer of Health Administration Windsor?Essex County Health Unit 1005 Ouellette Avenue, Windsor, NBA 418 Ph. 519?258?2146 ext. 1436 Fx. 519-258-6003 Our vision is a healthy community. - What you need to know to help you and your family stay healthy. 1. Wash your hands with soap and water thoroughly and often. 2. Cough and sneeze into your sieeve or a tissue. Dispose of tissue immediately and wash your hands. 3. Keep surfaces clean and disinfected. 4. Stay home when you are sick. CONFIDENTJALITY NOTICE: This email and attached material is intended for the use of the individual or institution to which it is addressed and may not be distributed, copied or disclosed to other unauthorized persons. This material may contain confidentiai or personal information that may be subject to the provisions of the Freedom of information and Protection of Privacy Act, the Municipal Freedom of Information and Protection of Privacy Act or the Personai Health information Protection Act. if you receive this transmission in error, please notify me immediately by teiephone at the number iisted above and do not print, copy. distribute or disclose it further. From: David Musyj Sent: Friday, May 1, 2020 11:17 AM To: Wajid Ahmed Cc: Bruce Krauter Subject: Re: Swabs'required to Complete weekend testing The message below originated from a user of Great thanks This all assumes you started with zero swabs ljust con?rmed with EMS Again, I know you took possession of 1200 swabs yesterday You gave 311 to Berkshire that leaves 800 You gave 382 Villages at St Clair plus 74 at Cardinal Place That totals 767 That leaves AT LEAST 433 after today I assume then you just need the net Please disclose the exact total you have in possession for the weekend please. I trulv do Not want to play this game. People?s lives are at risk. David Musyj President 8. CEO Office: 519-254-5577. ext. 56018 Email: devid.musvi@wrh.on.ca MobiieKE-Iome: 519-995-2966 Web: On May 1, 2020, at 11:01 AM, Wajid Ahmed wrote: CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you know the content is safe. If necessary, please contact the sender for con?rmation. Please see the attached sheet for our swab needs to do the mass testing as planned. Thanks Wajid WAJID AHM ED MBBS, MAS, MSG, Medical Officer of Health I Administration Windsor-Essex County Health Unit 1005 Oueilette Avenue, Windsor, NBA 418 Ph. 519-258?2146 ext. 1436 Fx. Sent: Friday, May 1, 2020 10:58 AM To: Wajid Ahmed Subject: FW: Swabs required to Complete weekend testing We need 1269 swabs this weekend. Please see attached. THERESA MARENTETTE Chief Executive Officer, Chief Nursing Officer 1 Administration Windsor-Essex County Health Unit 1005 Ouellette Avenue, Windsor, NQA 418 Ph. 519?258-2146 ext. 1475 FX. 519-258-6003 Cc: Kristy McBeth Victoria Peczulis Subject: Swabs required to Complete weekend testing Good Morning, have done a quick calculation of the number of swabs required for Mass Testing completion. LORI ADAMS Clerk Environmental Health Windsor-Essex County Health Unit 1005 Ouellette Avenue, Windsor, NBA 418 Ph. 519-258-2146 ext. 1450 Fx. 519-258?8672 <5ig~icon~ website Begin forwarded message: From: David Musyj Subject: Re: Leamington Mennonite Home and other LTCH Date: May 5, 2020 at 10:01 :29 AM EDT To: Waiid Ahmed Cc: Claudia Den Boer Thanks. Please tell me the exact homes and person that said we "took over?. We cailed 4 homes for Monday as directed by i did exptain to them WRH was askedidirected to handle the Monday swabbing. They needed to know why I was even calling them. As we discussed Sunday afternoon 1 asked based on this direction whether PH was continuing or stopping. You said continuing and as a result even the Monday requisitions were switched back to PH. We talked to no other home rezswabbing other than during SWAT and their claim for more swabs from PH. Wilt await exact homes and names that told you this so we can correct that. David Musyj President CEO Of?ce: 519-254-5577. ext. 56018 Email: david.musyi@wrh.on.ca Mobile/Home: 519-995-2966 Web: On May 5. 2020, at 9:44 AM, Waiid Ahmed wrote: CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you know the content is safe. If necessary, please contact the sender for con?rmation. Hi David and Claudia, The Leamington Mennonite Home which was previously contacted as a part of our efforts and said they would do their own swabbing at the home when they received swabs (which are pending from us) called and said they were contacted by the ?Ministry of Health? and provided a mass swabbing date of May 11. i am not sure who is doing the swabbing for them. Other LTCH have also indicated they have been contacted by WRH and told that they have ?ta ken over? long term care homes and that direction would come from them. Can you please confirm ifthat?s the direction being given to the LTCH and by whom? Thanks, Wajid WAJID AHMED MBBS, MAS, MSC, Medical Officer of Health Administration Windsor~Essex County Health Unit 1005 Ouellette Avenue, Windsor, NBA 4J8 Ph. 519?258?2146 ext. 1436 Fx. 519?258-6003 Our vision is a healthy community. COWS-19 - What you need to know to help you and your family stay healthy. 1. Wash your hands with soap and water thoroughly and often. 2. Cough and sneeze into your sleeve or a tissue. Dispose of tissue immediately and wash your hands. 3. Keep surfaces clean and disinfected. 4. Stay home when you are sick. CONFIDENTIALITY NOTICE: This email and attached materiat is intended for the use of the individuai or institution to which It is addressed and may not be distributed, copied or disciosed to other unauthorized persons. This materia! may contain confidential or personal information that may be subject to the provisions of the Freedom of Information and Protection of Privacy Act, the Municipal Freedom of Information and Protection of Privacy Act or the Persona! Heaith Information Protection Act. If you receive this transmission in error, please notify me immediatety by telephone at the number listed above and do not print, copy, distribute or disclose it further. Adam Paglione From: David Musyj Sent: Friday, May 22, 2020 2:58 PM To: Adam Paglione Subject: Fwd: Heron Terrace Fyi below W?i?ii?i?i David Musyj President CEO - an": arm Of?ce: 519-254?5577, ext. 56018 Email: david.musyj@wrh.on.ca Mobile/Horne: 519995-2966 Web? Begin forwarded message: From: David Musyj Date: May 22, 2020 at 1:31:17 PM EDT To: Wajid Ahmed Cc: Karen Riddell Claudia Den Boer Subject: Re: Heron Terrace Dr Ahmed We are talking to Heron Terrace to see how this can be coordinated to avoid any EMS and/or hospital teams andfor staff from entering the home proper. In any event we will look at a trailer OR an external entrance into a ?xed room that the swabbing team will be able to enter and also the staff (social distancing and provided a mask while waiting). We have to appreciate not everyone has a vehicle. In the meantime, since you referenced the South Korean research on a patient that tests positive again to be infectious this research article might be helpful to justify what we are suggesting and also the way the province is heading as to swabbing of 1 1 .htrn?s e1 e&delivervNam 921-DM28991 Swab and reswab until all negative (serial swabbing) . smart - David Musyj President CEO Office: 519?254-5577, ext. 56018 Email: david.musyj@wrh.on.ca Mobile/Home: 519-995-2966 Web? On May 22, 2020, at 12:48 PM, Wajid Ahmed wrote: CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you kn content is safe. If necessary, please contact the sender for con?rmation. Hi David, This is what i recommend. 0 Go ahead and support Heron terrace with the ?staff? testing the ones who were never positive a i want to restrict all the number of people going you are considering EMS to support with the staff testing, I would recommend that you setup a trailer or a drive?thru setup instead of EMS or any other staff going inside the facility to test staff 0 If Heron terrace is doing their own testing then they can do it inside the facility 0 At this point, i see that as one off testing (for all staff) until we hear more on the testing guidelines i understand your concerns and agree that we are ali trying to help Heron Terrace come out of the outbreak. Thank you, Wajid WAJID AHM ED MBBS, MAS, MSC, I Medical Officer of Health I Administration Windsor-Essex County Health Unit 1005 Ouellette Avenue, Windsor, N9A 4J8 Ph. 519~258-2146 ext. 1435 Fx. 519?258-6003 Sent: Friday, May 22, 2020 10:54 AM To: Wajid Ahmed Cc: Karen Riddell Claudia Den Boer Subject: Re: Heron Terrace The message below originated from a user OUTSIDE of Hi Just followup to our call Here is history of resident just declared positive. Will await your 11 am call with HT to recon?rm Tuesday swabbing of staff at HT is still happening. The plan is to swab all actively working staff not those that are NOT working or not planning on returning to work. 3 Specimen taken April 12?? (not sure of this date, but received by PHO on the NEG Specimen ta ken April NEG Specimen taken May 11th: NEG Specimen taken May P05 gz?m David Musyj President CEO Of?ce: 51 9-254-"5577, ext. 5601 8 $411.2 Email: david.musyj@wrh.on.ea gt, .5 Mobile/Home: sis?9952966 On May 21, 2020, at 6:34 PM, David Musyj wrote: Okay. We will keep Tuesday as planned until told otherwise. If you can con?rm on Friday May 22 or Saturday May 23 that you agree to proceed with swabbing the HT staff on Tuesday May 26 that would be great. Thanks Wigwam g. .e 3- Re. (mm, em? metre; David Musyj President CEO Of?ce: 519-254-5577, ext. 56018 Email: david.rnusyj@wrh.on.ca Mobile/Home: 519-995?2966 Web: On May 21, 2020, at 3:04 PM, Wajid Ahmed wrote: CAUTION: This email originated ??om outside of the organization. Do not click links or open attachrm content is safe. If necessary, please contact the sender for conf?mnation. Hi David, Thank you for your email. As you are aware, issued an order yesterday for Heron Terrace and i want to give it a thought before we can move forward with it. i will get back to you after following up with Heron Terrace to see how they are doing. Thanks Wajid WAJID AHMED MBBS, MAS, MSC, I Medical Officer of Health Administration Windsor-Essex County Health Unit 1005 Ouellette Avenue, Windsor, N9A 4J8 Ph. 519?258-2146 ext. 1436 FX. 519-258?6003 <_sig_i Sent: Thursday, May 21, 2020 2:31 PM To: Wajid Ahmed Cc: Karen Riddell Claudia Den Boer .ca> Subject: Re: Heron Terrace The message below originated from a user OUTSIDE of This is a portion of one of the Premier's responses to this issue ng??f??tg? David Musyj President CEO W"?r Of?ce: 519-254-5577. ext. 56018 gr Ernarl: davrd.musyj@wrh.on.ca by}; . Mobile/Home: 519995-2966 Web: On May 21, 2020, at 1:18 PM, David Musyj wrote: Dr Ahmed I know we are trying to work collaboratively with Public Health with Heron Terrace. The goal is to get them out of outbreak and as a result be in a position to move residents back from the ?eld hospital, HDGH and community to Heron Terrace. With respect to employees at Heron Terrace can you agree to swabbing them weekly This will be done by EMS and hospital staff. We will do all the work involved. Swabbing and paperwork. As we all agree the way residents are currently being infected is as a result of staff being positive. This coupled with intensive IPAC support will allow us to collaboratively eliminate from that LTC residence. It is not just one side of the equation. Once we get to total negative we can re evaluate. I am just listening to Premier Ford. He just reiterated that ?one time? testing of LTC and RH is not the goal. We will be going back in to test again and possibly more frequently. See NYC approach to nursing homes 2MOMJ Thanks for your consideration. ?it; ?reman David Musyj President CEO -. ?E-Gi??icu kim?f?? Of?ce: 519?254?5577, ext. 56018 Emaii: devid.musyj@wrh.on.ca MobiielHome: 519-995~2966 Web: Adam Paglione From: Adam Paglione Sent: Monday, May 25, 2020 11:23 AM To: Adam Pagiione Subject: FW: Heron Terrace Swabbing Begin forwarded message: From: David Musyj Date: May 20, 2020 at 4:35:28 PM EDT To: Karen Riddell Cc: Karen McCullough Subject: Re: Heron Terrace Swabbing p/s/mobile.reuters.com/a rticle/a mp/ld QBEWW David Musyj I President 8: CEO Office: 519?254-5577, ext. 56018 Email: david.musyj@mh.0n.ca meg} Mobile/Home: 519-995-2966 Web: a On May 20, 2020, at 4:32 PM, Karen Riddell wrote: So looks like testing next week not supported by public health. Please advise as will need to cancel EMS scheduled for Tuesday. Karen Riddell VP Critical Support Office: 519-254-5577 ext. 52839 1? Mobile: 519-995-0413 I Email: Web: Begin forwarded message: From: Wajid Ahmed Date: May 20, 2020 at 4:20:39 PM EDT To: Karen Riddell Subject: RE: Heron Terrace Swabbing CAUTKJN: This email originated ?om outside of the organization. Do not click links or open attachments unle: content is safe. If necessary, please contact the sender for con?rmation. Hi Karen, Based on the testing guidance document (Dated May 14, 2020), there is no recommendation to do serial testing to assess ongoing transmission in the home. i think they should test their staff even with mild and isolating them until tested/cleared instead of relying on a 'diagnostic test? to be used as a 'screening test?. I am copying the recommendations for your reference (page 3 4). Residents Living in Long?Term Care and Retirement Homes Definition: Residents living in either long?term care/nursing homes or retirement homes. Any persons with the following, should be tested as soon as possible: patients/residents in line with the provincial case definition, who are experiencing any or sign compatible with Hospitals may discharge patients to Long?Term care homes where: 1. It is a readmission to long-term care (the resident is returning to their home) 2. The receiving home is NOT in a outbreak 3. The resident has been tested for at point of discharge, has a negative result and is transferred to the home within 24 hours of receiving the result; and 4. The receiving home has a plan to ensure that the resident being readmitted can complete 14~days of self?isolation In the event of a resident in an institutional setting, residents living in the same room should be tested immediately along with the resident. In the event of an outbreak in a long?term care home or retirement home contacts of a confirmed case, determined in consultation with the local public health unit, should be tested including: . All residents living in adjacent rooms - All staff working on the unit/care hub 0 All essential visitors that attended at the unit/carehub - Any other contacts deemed appropriate for testing based on a risk assessment by local public health Local public health may also, based on a risk assessment, determine whether any of the above- mentioned individuals do not require testing a resident that has been in self? isolation during the period of communicability). i hope this helps. Thanks, Wajid WAJID AHMED MBBS, MAS, MSC, I Medical Officer of Health I Administration Windsor?Essex County Health Unit 1005 Ouellette Avenue, Windsor, N9A 418 Ph. 519-258?2146 ext. 1436 Fx. 51925843003 l?i Ii wacau 1. Our vision is a healthy community. What you need to know to help you and your family stay healthy. 1. Wash your hands with soap and water thoroughly and often. 2. Cough and sneeze into your sleeve or a tissue. Dispose of tissue immediately and wash your hands. 3. Keep surfaces clean and disinfected. 4. Stay home when you are sick. CONFIDENTIALITY NOTICE: This e-maii and attached material is intended for the use of the individual or institution to which it is addressed and may not be distributed, copied or unauthorized persons. This material may contain confidential or personal information that may be subject to the provisions 0? the Freedom of Inform; Privacy Act, the Municipal Freedom of information and Protection of Privacy Act or the Personal Health Information Protection Act. if you receive this msimmsdisisirkr. at. the newest liaise disclose it furtheri From: Karen Riddell Sent: Wednesday, May 20, 2020 3:15 PM To: Wajid Ahmed Subject: Heron Terrace Swabbing The message below originated from a user OUTSIDE of Hi Dr Ahmed. just wanted to clarify my understanding i thought that we had recommended swabbing Heron Terrace again next week due to ongoing transmission occurring in the home and had set up with EMS to assist. I understand from Kelly Batson at Heron Terrace that you have advised that they will not be swabbed again. is that accurate? ljust want to ensure that i understand the plan moving forward. Karen Riddell Vice President Critical Care, Cardiology, Stroke, Trauma and Clinical Support Services Office: (519) 254?5577 ext. 52839 Mobile: (519) 995?0413 Email: karen.riddell@wrh.on.ca Web: \?ii gentlemen \e ?imi? Adam Paglione From: Adam Paglione Sent: Monday, May 25, 2020 11:23 AM To: Adam Paglione Subject: FW: Heron Terrace Swabbing Begin forwarded message: From: David Musyj Date: May 20, 2020 at 4:35:28 PM EDT To: Karen Riddell Cc: Karen McCullough Subject: Re: Heron Terrace Swabbing .reuters.com/a David Musyj President CEO 519?2251516577, ext. 56018 Email: david.musyj@wrh.0n.ca Mobile/Home: 519-995~2966 Web: On May 20, 2020, at 4:32 PM, Karen Riddell wrote: So looks like testing next week not supported by public health. Please advise as i will need to cancel EMS scheduled for Tuesday. 483*; Karen Riddell I VP Critical Support Office: 519454-5577 ext. 52339 - Mobile: 519-995m0413 Email: karen.riddell@wrh.0n.ca Web: Begin forwarded message: From: Wajid Ahmed Date: May 20, 2020 at 4:20:39 PM EDT To: Karen Riddell Subject: RE: Heron Terrace Swabbing This email originated ??om outside of the organization. Do not click links or open attachments nnle: content is safe. If necessary, please contact the sender for confnmation. Hi Karen, Based on the testing guidance document (Dated May 14, 2020), there is no recommendation to do serial testing to assess ongoing transmission in the home. i think they should test their staff even with mild and isolating them until tested/Clea red instead of relying on a ?diagnostic test? to be used as a ?screening test?. 1 am copying the recommendations for your reference (page 3 4). Residents Living in Long?Term Care and Retirement Homes Definition: Residents living in either long?term care/nursing homes or retirement homes. Any persons with the following, should be tested as soon as possible: patients/residents in line with the provincial case definition, who are experiencing any or sign compatible with Hospitals may discharge patients to Long?Term care homes where: 1. it is a readmission to long?term care (the resident is returning to their home) 2. The receiving home is NOT in a outbreak 3. The resident has been tested for at point of discharge, has a negative result and is transferred to the home within 24 hours of receiving the resuit; and 4. The receiving home has a plan to ensure that the resident being readmitted can complete 14?days of self?isolation In the event of a resident in an institutional setting, residents living in the same room should be tested immediately along with the resident. in the event of an outbreak of in a long-term care home or retirement home contacts of a confirmed case, determined in consultation with the local public health unit, should be tested including: 0 All residents living in adjacent rooms 0 All staff working on'the unit/care hub - Ali essential visitors that attended at the unit/carehub 0 Any other contacts deemed appropriate for testing based on a risk assessment by local public health Local public health may also, based on a risk assessment, determine whether any of the above? mentioned individuals do not require testing a resident that has been in self- isolation during the period of communicability). I hope this helps. Thanks, Wajid WAJ I AH MBBS, MAS, Medical Officer of Health Administration Windsor?Essex County Health Unit 1005 Ouellette Avenue, Windsor, NBA 418 Ph. 519?258-2146 ext. 1436 Fx. 519?258?5003 Our vision is a healthy community. What you need to know to help you and your family stay healthy. 1. Wash your hands with soap and water thoroughly and often. 2. Cough and sneeze into your sleeve or a tissue. Dispose of tissue immediately and wash your hands. 3. Keep surfaces clean and disinfected. 4. Stay home when you are sick. CONFIDENTIALITY This email and attached materiai is intended for the use of the individual or institution to which it is addressed and may not be distributed, copied or unauthorized persons. This material may contain confidential or personai information that may be subject to the provisions of the Freedom of Inform: Privacy Act, the Municipal Freedom of Information and Protection of Privacy Act or the Petsonai Health Information Protection Act. if you receive this attest: notifmsimmediate?! attire number. .Iiststiebers and tie. diameteer disease it further? From: Karen Riddell Sent: Wednesday, May 20, 2020 3:15 PM To: Wajid Ahmed Subject: Heron Terrace Swabbing The message below originated from a user OUTSIDE of Hi Dr Ahmed. i just wanted to clarify my understanding i thought that we had recommended swabbing Heron Terrace again next week due to ongoing transmission occurring in the home and had set up with EMS to assist. I understand from Kelly Batson at Heron Terrace that you have advised that they will not be swabbed again. is that accurate? I just want to ensure that I understand the plan moving forward. Karen Riddell Vice President Critical Care, Cardiology, Stroke, Trauma and Clinical Support Services Office: (519) 254?5577 ext. 52839 Mobile: (519) 995-0413 Wt; Web: ?aerate? zigzag ..