La page de l'ACK sur le COVID-19

COVID-19 ?

The evolution of the COVID-19 situation took us all by surprise. We are currently living in an exceptional situation which is a source of deep uncertainty. In the coming weeks, the CKA is ready to assist you to get through the crisis.

The CKA team continues to be operational remotely. We will strive to maintain the flow of information to Kinesiologists and PKAs. We have the experience and the best tools to communicate and collaborate. In these difficult times, we are available to share tools, information, advise you and help you continue your activities.

Being confined to their homes, Kins may think about how they could change their business model to include Online Services; some of you may have time to take on online continuing education seminars or to advance projects which are constantly postponed for lack of time.

Finally, the CKA invites you to stay informed on this crisis and its management as daily news could bring solutions or ideas for you. The CKA team is committed to assist you in difficult time.

LATEST INFORMATION


Return-to-work COVID-19 Framework

Many provinces will release their return to work framework gradually in the next few weeks, and we invite Kinesiologists to stay informed of the prevention measures recommended by their provincial government. The CKA has gathered information made available at present time and will strive to update this document as soon as more information is made available. Refer to the COVID-19 website page. (Link)

Thus far, we know that:

  • The College of Kinesiology of Ontario (CKO) is waiting for the Ontario authorities to release their framework for reopening the province sometime this week. CKO will then provide new guidance to registrants.
  • The British Columbia Association of Kinesiologists (BCAK) is working on publishing an infection control guide that will be available later.
  • The Fédération des kinésiologues du Québec (FKQ) has released a policy for resuming activities providing recommendations adapted from those of the Professional Order of Physiotherapy of Quebec.

The CKA would like to share some elements to be considered as Kinesiologists think of returning to work and reminds Kins to also review their provincial government guidelines as they come available. The CKA would like to remind Kins that it is mandatory to follow all government recommendations in order to prevent the spread of COVID-19. We ask Kins to exercise judgment in assessing the possible risks of spread.

The current situation

Since kinesiology is not deemed a priority health care service during the pandemic, it is recommended that Kinesiologists who work in private clinics or who do individual consultations postpone all nonessential face-to-face interventions and instead offer online services (some provincial guidelines recommend online services to be provided on an essential basis as well).  The CKA has guidelines for online services on CKA website. (link)

This may change as government announces confirming the gradual return to work. The CKA continues to encourage the use of online services even after this return to work notice by government for some cases.

Recommended Instructions:

Some kinesiologists will have clear return-to-work guidelines provided by their employers.  Kinesiologists working independently will need to consider adaptations to their work.  Here are elements to consider:

  1. Before considering a consultation
  2. Face-to-face consultations
  3. Greeting the client
  4. During the consultation
  5. After the consultation
  6. Other important recommendations
  7. Instructions for personal protective equipment (PPE)

Details

  1. Before considering a consultation

Kins and clients showing the following conditions and symptoms should not come to the clinic:

  • Anyone showing the following signs: fever, cough, breathing difficulties, diarrhea, loss taste or smell(for up to date symptoms www.canada.ca);
  • Anyone who has recently travelled outside the country (they should be in quarantine for 14 days);
  • Anyone who has had a positive COVID-19 test less than a month ago or if anyone is awaiting the result of a test;
  • Anyone that has been in close contact with a confirmed or probable case of COVID-19 for less than 14 days;
  • If necessary, keep record of this information in your client's file.

 

  1. Face-to-face consultations

If a face-to-face consultation is required e.g. assessment, reassessment, care requiring intervention in person or physical contact with the client, emergency or care immediately required, special techniques, etc., please respect the following instructions:

  • Limit to the strict minimum anyone accompanying, attending or helping the client;
  • Adopt rules of physical distance between customers and staff (excluding you): 2 meters (6 feet) apart e.g. space appointments accordingly limiting people together in the waiting area;
  • Post reminders of measures to reduce the spread of COVID-19;
  • Follow the steps detailed below and communicate these to the client before he/she shows up for his/her appointment:

 

  1. Greeting the client

The receptionist in addition to wearing proper masks, gloves, gown or lab coat, must:

  • Ensure that arrival time of the clients does not cause people to gather. The appointment time should be spaced accordingly;
  • Ask clients, upon arrival, to wash their hands for at least 20 seconds with water and soap or use an alcohol-based disinfectant or;
  • Direct the client immediately to the treatment area to prevent the client from moving from one place to another.

 

  1. During the consultation

The Kinesiologists must:

  • Wash hands for at least 20 seconds with soap and water or with an alcohol-based disinfectant before each consultation (wearing gloves is also an option).
  • Follow instructions for personal protective equipment (PPE):
    • Always wear a mask when carrying out interventions.
    • It is recommended to use gloves, glasses (visor), a smock or a long-sleeved lab coat in addition to the mask if there is a risk of exposure to biological liquids during the intervention or for clients having a weaker immune system.
    • Apply the rules to properly put on PPE.

 

  1. After the consultation

The kinesiologists must:

  • Invite clients to wash their hands for at least 20 seconds with soap and water or with an alcohol-based disinfectant before leaving;
  • Wash hands for at least 20 seconds with soap and water or an alcohol-based disinfectant. If you have chosen to wear gloves, change them after each consultation and then wash your hands;
  • If soiled, change gloves, mask, gown or lab coat after each consultation. Clean glasses if required.
  • Apply PPE withdrawal rules.
  • Ensure that instruments, tools and other materials used in the previous consultation room are cleaned with a disinfectant before and after each consultation.

 

  1. Other important recommendations

  • If clients have flu symptoms, take appropriate measures to isolate and prevent the possible spread of pathogens.
    • Ask clients to refrain from any encounter or treatment until their symptoms go away.
    • Consider waiving cancellation fees to reduce the risk of an infectious client infecting you and others.
  • Ensure that other staff members wear a mask, gloves, isolation gown or lab coat and that they properly.
  • If possible, make protective glasses or visors available to members of your staff who wish to take advantage of them.
  • During opening hours and at the end of the day. This may include wall surfaces subject to hand or body contact, exercise mats, equipment, machinery, toilets, door handles, etc., and will vary depending on the work environment.
  • Make disinfectant pumps available, especially at reception and in all places that require coming into contact with objects (signing forms or other).
  • Promote contactless payment.
  • Ensure that employees receive training on hygiene measures to be applied during a pandemic
  • Do not shake hands with customers.
  • Be prepared to use additional infection control mechanisms to protect the health and safety of your client if governmental standards are not respected.
  • Avoid sharing pens, pencils, clipboards, etc. without applying the appropriate sterilization procedures.
  • When assessing or working with clients, do not touch clients unless necessary and use protective gloves when appropriate.
  • If you are performing assisted stretching or other activities where skin-to-skin contact is necessary to perform the activity properly, make sure that all skin areas are properly cleaned immediately afterward. This usually includes washing the hands and forearms up to the elbow and possibly above unless a long-sleeved garment is worn.
  1. Instructions for personal protective equipment (PPE)

Wearing a procedure mask in healthcare settings

How to put on and take off a procedure mask

Protective goggles, gowns and gloves (section "Measures to be applied as a preventive measure")

Dressing procedure and undressing

Infection prevention and control

Hand hygiene and respiratory etiquette

Cleaning and disinfection of care equipment Home

INSPQ instructions for home care provision healthcare

Source: OPPQ

Without prejudice

Disclosure: Currently the practice of kinesiology varies from one province to another. The information in this document may differ and not correspond with the provincial legislation. The main purpose of this document is to present the current portrait of kinesiology (definitions, fields of practice, acts, etc.) across Canada, with information regarding resources in the various fields of kinesiology, practical tools, the extent of its scope of practice and other potentially useful documents. This document is in perpetual revision as per the evolution of the practice of kinesiology in Canada. The CKA / ACK will not be held responsible for any consequences or damages that may occur as a result of the use, misuse, misinterpretation or abuse of the information found on its website. We emphasize that the aim of this document is to help guide you. Should anyone require guidance in interpreting any of the provided information, they should seek the advice of their provincial kinesiology association

This document is based on a similar guideline from the Fédération des kinésiologues du Québec which was based on the Ordre professionnel de la physiothérapie du Québec (OPPQ) Statement. The CKA thanks and acknowledges the FKQ for sharing information as a resource for the development of this guideline.


Are You Re-deployed to Work on the Frontlines of COVID-19 ?

Insurance for work outside scope of kinesiology

Some Kinesiologists are asked to "work on the frontlines of COVID-19".  Here is how a Kin may relate to your professional insurance coverage in this situation.

The CKA is thankful that there are so many dedicated healthcare professionals that will do everything possible to help us get through the COVID-19 crisis.

The CKA National Insurance Program is only intended to cover Kinesiology services falling under the scope of practice.  That being said, Trisura extended the liability coverage to other healthcare modalities if the Kin has the credentials and experience.  The other healthcare modalities that Trisura will consider covering include Osteopathic Manual Practitioner; Massage Therapist or Reflexologist.

Any Kins who are re-deployed to work on the frontlines of COVID-19 will need to obtain separate liability insurance or receive coverage from their employer.  PROLINK/Trisura has the experience insuring Respiratory Therapists and Nurses.  PROLINK/Trisura is looking into covering Kins outside of the CKA program because the exposure related to assisting patients suffering from COVID-19 is much different than the typical risk of exposure that is expected for a Kinesiologist.  In the case of frontline services provided during COVID-19, there may be dozens of tasks that Kins are asked to do. This brings uncertainty surrounding their functions in the hospitals. 

The most cost-effective solution for Kins being recruited to work with COVID-19 patients maybe to have their employer (i.e., hospital or clinic) confirm they will cover the Kin. If not, Kins are invited to call PROLINK for more coverage.


Clarification : Definition of Essential Services, Essential Businesses and Online Services

Definition of Essential Service

We know that Kinesiologists are looking for a clear definition of what is considered an essential service within kinesiology. It is difficult to provide a clear definition because this largely depends on each individual patient/client. Kinesiologists, as highly-trained, competent and qualified health professionals, are best positioned to determine what is essential for their patients/clients. 

A service is considered essential if the patient's/client's health or function would considerably decline if service is not provided. If this decline could lead to hospitalization, for example, then the service is considered essential. The idea behind recent directives is to minimize strain on the healthcare system so that other care is prioritized (i.e. for those showing symptoms or suffering from COVID-19). 

Kinesiologists are asked to use their professional knowledge and judgement to determine if a service is essential, if that service should be provided in-person, or if it is appropriate to move to virtual service.

It is strongly encouraging social or physical distancing, meaning that you must make every possible effort to limit in-person contact. If you must be in contact with others, you should be maintaining at least two metres from them. 

Essential and Non-essential Businesses

While a business may be deemed essential, it may not be appropriate to continue performing some services. Kinesiologists who work in or provide service to an essential business should ensure that they are implementing protocols that protect their health and the health of others in the course of their work. Kinesiologists should discuss with their employer their role and whether it fits with the definition of essential service.

Providing Services Virtually

Although this information relates to Kinesiologists practicing in Ontario, this may apply to your province. Kinesiologists may want to verify with their provincial authorities.

Many Kinesiologists are asking if they are allowed to conduct services virtually during the COVID-19 pandemic. Normally, it is permitted for Kinesiologists to provide services virtually. 

However, the College of Kinesiology of Ontario has received clarification from the Ministry of Health that virtual service should be limited to essential service only. 


Latest New Government Funding

Most recently the Government of Canada has launched two new financial support programs for which Kinesiologists may be eligible: CERB & CEWS. Since these programs have not yet been legislated, not all details are yet available. The CKA has gathered the following information to help you understand the different programs.

  • If you have NO REVENUE, the CERB is eligible to self-employed. We recommend that you sign up as soon as possible: (link)
  • If you have REVENUE FOR UP TO 10 HOURS OR LESS PER WEEK, the CERB is eligible to self-employed. We recommend that you sign us as soon as possible.

If you have a corporation and you have less than 15% of your normal revenue, the CEWS is available for employees but may also be available for self-employed.

Snapshots of these programs:

  1. CERB – Canada Emergency Response Benefit
    For workers & Self-employed -  $2000/month for up to 4 months
    • Eligible are self-employed that have no revenue OR have 10 hours or less*;
    • Eligible workers cannot receive both EI and CERB at the same time.
    • If you are receiving EI, you will continue receiving EI.
    • If you have applied for EI yet it has not been process, it appears that it will be automatically rolled into CERB first.
    • It appears that eligible workers are entitled to the CERB first, then EI once the CERB runs out.
    • The delay to receive payment for CERB is fairly quick – 3 to 5 days.
    • Apparently website is not up to date, so it is proposed to proceed anyway as you would like for EI.
    • You need to answer questions regarding your income status every 2 weeks,
    • When to apply: https://www.canada.ca/en/revenue-agency/services/benefits/apply-for-cerb-with-cra.html
      • If you are born in the months of Jan., Feb, March, you can apply on Mondays
      • If you are born in the months of April, May, June, you can apply on Tuesdays
      • If you are born in the months of July, Aug., Sept,, you can apply on Wednesdays
      • If you are born in the months of Oct., Nov., Dec., you can apply on Thursdays
      • Any birth dates, you can apply on Fridays, Saturdays and Sundays
    • How to apply

      There are two ways to apply:

    • Online with CRA My Account
    • Over the phone with an automated phone service
    • Get ready

      To ensure your application will be as easy and quick as possible, here is how to get started:https://www.canada.ca/en/revenue-agency/services/benefits/apply-for-cerb-with-cra.html

  2. CEWS – Canada Emergency Wage Subsidy
    For corporations -  if revenue decline of 15%, 75% reg. wage for 3 months
    • Must re-apply each month separately
    • Must show decline of revenue of 15% or more over the same time period in 2019 – for each month applied;
    • Subsidy will cover up to 75% of first 58.700$ of eligible remuneration per employee, representing a benefit of up to 847$ per employee per week of the program.
    • When to claim for each month separately:
      • For March 2020, you can claim between March 15- April 11
      • For April 2020, you can claim between April 12- May 9
      • For May 2020, you can claim between May 10 – June 6

*Emergency services: the eligibility criteria will be extended - Announced April 6th 2020.

The expansion of this new social safety net will give a financial boost to workers who have had their work hours reduced to 10 hours a week or less, Prime Minister Justin Trudeau gave as an example during his daily press conference before the Rideau Cottage.

Workers who still have their jobs and who earn less money now than they get the benefit will also get some form of compensation. Mr. Trudeau notably appointed home care professionals or those caring for the elderly.

source: https://www.lapresse.ca/covid-19/202004/06/01-5268197-prestation-durgence-les-criteres-dadmissibilite-seront-elargis.php


A Guide to Understand the Financial Programs


Carleton prof creates plain-language guide for getting government aid

 Blair Crawford, Ottawa Citizen, published March 28, 2020

 

A Carleton University professor, former a staff member to MPs on Parliament Hill, has created a plain language guide to help those trying to access government programs in the time of coronavirus. Although she doesn't answer our question on "no revenue" vs "a decline of revenue", she answers the questions: "I'm self-employed. What benefits can I get?"

Here is the link to article
Link to guide


Call for the Mobilization of Volunteers to Support Health Workers

The Trudeau government wants to mobilize volunteers who have some expertise in the health field across the country in order to lend a hand to hospital workers who are on the front lines during this crisis of the pandemic of COVID-19.

The Federal Ministry of Health is in the process of establishing an inventory of these specialized volunteers. This inventory will be provided to the provinces and territories to support doctors and nurses, Prime Minister Justin Trudeau announced during his daily press conference outside the Rideau Cottage.

Those interested can register with the Federal Ministry until April 24 at the following address 

 


Zoom Teleconferencing System

Precautions to take

Important information about using Zoom

This application seems to know some weaknesses in terms of confidentiality regardless of whether it is a paid or free version. ZOOM has since then upgraded security levels by an upgrade of its program and requiring that all meetings have password and enable waiting room from now on. Watch this video:

 

Here are some parameters to configure to better protect yourself:

  1. Deactivate the " Enable join before host" function
  2. Select "Other possible animators" and dedicate this function to another person in case your line is interrupted.
  3. Replace "Screen sharing" with "Host only"
  4. Deactivate "File transfer"
  5. Deactivate "Allow deleted participants to re-join"

The CKA recommends using the paid version of this application to ensure encrypted communications. Since Zoom has reacted well and fast to remedy the situation, the CKA will continue using this videoconference with the enhanced security features.


Somethings To Do While Confined

Continuing Education – with CKA Partners

Kinesiologists that are not working are encouraged to file their continuing education experiences into your profile in your PKA's website. For MKA, NBKA, KANS, KPEI, and NLKA: https://www.cka.ca/en/stay-current

Furthermore, it might also be time to take on new continuing education opportunities. The CKA, through its partners RockTape, First Line Education and Human Kinetics, provide you with different interesting webinars, books and video.

Visit the CKA Boutique

Continuing Education - Webinars from PKAs

BCAK andFKQ: Both PKAs have webinars available on their respective websites. Most of these are available on their YouTube channel. In addition, they are in the final stages of development of their own hub. They will also be developing free educational webinars in the coming months. Once ready, they wish to share with everyone.


How to Communicate With Clients

Three practical tips for communicating in this troubled period:

  1. Don't say there is a lot of "uncertainty and anxiety". We know it. Go further: ask yourself what this uncertainty actually means for your audiences. Be empathetic. Be helpful. But be convincing.
  1. Ask yourself why you are communicating right now. What is the essential message you wish to spread, in this period where attention is scarce and messages numerous?
  1. If you can't find one, maybe it's better to wait. Not communicating is also a strategy. Take the opportunity to rethink your positioning!

Recently the CKA has issued two eAnnouncements to Affiliated Kinesiologists on the Coronavirus. If you have missed them, consult the following:

Special COVID-19 Information and more - published on March 23rd 2020

This eAnnouncement included subjects such as:

  1. Insurance coverage confirmed
  2. Online Services vs. Insurance & Scope
  3. Guidelines for Online Services
  4. Governments Financial Support
  5. Website links to Provincial & Federal Resources

Read more

Suggestions to Prevent the Spread of COVID-19, published on March 17th 2020

This eAnnouncement included subjects such as:

  1. Providing urgent Kinesiology services
  2. Clients of 70 years and over
  3. Suggestions to Prevent the Spread of COVID-19
  4. Infection Control Reminder
  5. Novel coronavirus web page of ministry of health in your province for more information.
  6. What health professionals need to know
  7. From the College of Kinesiology of Ontario: Practice Standard- Infection Control.

Read more


A message from

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COVID-19 RISK MANAGEMENT 
GUIDE FOR CKA AFFILIATES

We are living through an unpredictable time across the country, and the world, as we try to reconcile the new reality imposed by the COVID-19 pandemic. In the last week alone, governments have asked businesses, and entire societies, to shut down—and unfortunately, no one is certain how long these measures will be enforced.

We all know that we must do whatever we can to #flattenthecurve and protect the most vulnerable in our society.

Still, no matter if you are a business owner, independently employed, or an employee, it is understandable that you may be concerned about the future of your practice and your finances. And, as a healthcare professional, you also have to consider an added complexity: the continuity of care for your patients or clients.

To help you navigate the current landscape, we've put together this risk management guide to address the following topics:

1. Providing Continuity of Care (Virtual Care Services);
2. Ensuring Your Financial Resilience (Navigating Government Programs);
3. Understanding the Role of Your CKA Insurance. 

CLICK HERE FOR YOUR RISK MANAGEMENT GUIDE

This is a challenging time for all of us. If you have questions or concerns about your business, your continuity planning, or your health or travel insurance, please connect with us. We are only a call or an email away.

Take care,

The PROLINK Team


GUIDELINES FOR ONLINE SERVICES

Should you wish to begin offering your services online, here are guidelines, concent forms and a video from BCAK and a webinar from Hexfit/FKQ. We greatly appreciate that PKAs are sharing these with the Kinesiology community across Canada.

From BCAK
Guideline for Telehealth Services
Telehealth Consent Form
Video

http://newsletters.yapla.com/ckfinder/core/connector/php/connectoimage/company/CPYqCPtn1Wxyx4LOeS2QlIc/images/BCAK%20video.JPG

Note: In BC, online services are called Telehealth services; not to be confused with the same term used differently in Ontario.

From FKQ
Guideline for Télésanté or Téléreadaptation
Video
Webinar

  http://newsletters.yapla.com/ckfinder/core/connector/php/connectoimage/company/CPYqCPtn1Wxyx4LOeS2QlIc/images/FKAQ%20webinar.JPG

 Note: In QC, online services are called Télésanté relating to remote health services or Téléreadaptation relating to rehabilitation.