COVID-19 Rehab Resources - Updated: April 8, 2020
Rehabilitation will play an important role in supporting better outcomes for patients with COVID-19. The following resources are provided to support rehab professionals, other clinicians and administrators as they provide and plan for care in this challenging and unprecedented time.
For Physical Medicine & Rehabilitation
- Special Collection - Coronavirus (COVID-19): evidence relevant to clinical rehabilitation | Cochrane Library
- Perfect Storm: COVID-19 Associated Cardiac Injury and Implications for Neurological Disorders - Catherine Ruth Jutzeler, Thomas Edward Nightingale, Andrei Vasilievich Krassioukov, and Matthias Walter
- Changes to Rehabilitation Service Delivery and the Associated Physician Perspectives During the COVID-19 Pandemic A Mixed-Methods Needs Assessment Study - Jaime C. Yu, MD, MEd, FRCPC, McKyla McIntyre, MD, MSc, Heather Dow, CAE, CPhT, Lawrence Robinson, MD, FABPMR, and Paul Winston, MD, FRCPC
- Post-Stroke Tele-Rehabilitation “Start-Up” For Bruyère Health Care Professionals - Very Basic Tips
- Canadian COVID-19 Resources (compiled by Allergan)
- Choosing Wisely Canada Recommendations
- Practical Considerations for Implementing Virtual Care in Physical Medicine and Rehabilitation: For the Pandemic and Beyond
McKyla McIntyre, MD1, Lawrence R. Robinson, MD, FABPMR2, Amanda Mayo, MD, FRCPC2 - http://foundationforpmr.org/home-exercises-for-people-with-disabilities/
- International Rehabilitation Forum
- http://www.capmr.ca/images/Covid_19_rehabilitation_strategy.pdf
- http://www.capmr.ca/images/Covid-19_Rehabilitation-introduction.pdf
- GTA Rehab Network - covid-19
- Handbook of COVID-19 Prevention and Treatment
- Post Acute Care Preparedness for COVID-19 Thinking Ahead (JAMA editorial, March 25, 2020)
- Joint statement on the role of respiratory rehabilitation in the COVID-19 crisis: the Italian position paper (March 30, 2020)
- Post Acute Care Preparedness for COVID-19 Thinking Ahead (JAMA editorial, March 25, 2020)
- COVID-19 Response and Chronic Disease Management (March 23, 2020)
- Physiotherapy management for COVID-19 in the acute hospital setting. Recommendations to guide clinical practice (March 23, 2020)
- Handbook of COVID-19 Prevention and Treatment - The First Affiliated Hospital, Zhejiang University School of Medicine (March 18, 2020)
- 2019 New Corona Virus Pneumonia Respiratory Rehabilitation Guidance (Second Edition) (February 28, 2020) Note: The English version of this document can be accessed using Google Chrome. Hover your cursor on the far right of URL address bar to access the translate function.
- COVID-19 resources provided by the Regional Geriatric Program of Toronto and the RGPs of Ontario
- Pulmonary Rehabilitation Resources in a Complex and Changing World
- The role of speech and language therapists in the intensive care unit (Sept 2019)
- Occupational Therapy in the ICU: A Scoping Review of 221 Documents (2019)
- Early Mobility in the ICU: Translating the Rehab Approach to Acute Care (2017)
- Physical rehabilitation interventions for adult patients during critical illness: An overview of systematic reviews (2016)
- Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomized controlled trial (2009)
- CPA Position Statement on Physiotherapy in the ICU
- Recovery and outcomes after the acute respiratory distress syndrome (ARDS) in patients and their family caregivers (2016)
- Long-Term Outcomes and Health Care Utilization after Prolonged Mechanical Ventilation (2016)
- Long-term cognitive impairment after critical illness (2013)
- Safety and Feasibility of an Exercise Prescription Approach to Rehabilitation Across the Continuum of Care for Survivors of Critical Illness (2012)
Below is an update including resources from the Public Health Agency of Canada: Information on Coronavirus disease (COVID-19)
There are a number of updated resources available on the CMA website including their NEW Outbreak Update: Coronavirus disease (COVID-19) and the COVID-19 Virtual Assistant.
Guidance to be published
IPC for COVID-19 – Interim Guidance for Long-Term Care Settings
IPC for COVID-19 – Interim Guidance for Home Healthcare Settings
Coronavirus disease (COVID-19): Optimizing the use of masks and respirators during the COVID-19 outbreak; This includes
- Guidance on the use of expired N95 respirators and masks; and
- Guidance on the use of commercial-grade respirators for medical purposes.
https://www.canada.ca/en/health-canada/services/drugs-health-products/medical-devices/masks-respirators-covid19.html
Coronavirus disease (COVID-19): Guidance documents
Coronavirus disease (COVID-19): Considerations in the use of homemade masks to protect against COVID-19 https://www.canada.ca/en/health-canada/services/drugs-health-products/medical-devices/activities/announcements/covid19-notice-home-made-masks.html
Coronavirus disease (COVID-19): List of diagnostic devices for use against coronavirus (COVID-19)
https://www.canada.ca/en/health-canada/services/drugs-health-products/medical-devices/covid-19.html
Coronavirus disease (COVID-19): Canada’s Response
https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/canadas-reponse.html
Coronavirus disease (COVID-19): For health professionals
https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/health-professionals.html
For health professionals
- Interim national case definition: Coronavirus Disease (COVID-19)
- Infection prevention and control for coronavirus disease (COVID-19): Interim guidance for acute healthcare settingsRoutine practices and additional precautions for preventing the transmission of infection in healthcare settings
- Interim national surveillance guidelines for human infection with Coronavirus Disease (COVID-19)
- Coronavirus disease (COVID-19): Summary of Assumptions
- Public health management of cases and contacts associated with coronavirus disease (COVID-19)
For businesses
- Coronavirus disease (COVID-19): Resources for Canadian businesses
- Risk-informed decision-making guidelines for workplaces and businesses during the COVID-19 pandemic [Updated - Risk Mitigation (including personal protective equipment)]
- Bank of Canada asks retailers to continue accepting cash
For communities Community-based measures to mitigate the spread of coronavirus disease (COVID-19) in Canada
For schools and daycares
Coronavirus disease (COVID-19): Awareness resources – resources are available in PDF Format in multiple languages
- https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/awareness-resources.html
- Coronavirus (COVID-19): radio public service announcement – Audio
- COVID-19: Public Education – Hand washing – Video
- COVID-19 Public Education – Distancing – Video
- Preventing COVID-19 in the workplace: employers, employees and essential service workers – Factsheet
- How to self-isolate at home when you may have been exposed and have no symptoms – Infographic
- People who are at high risk for severe illness from COVID-19 – Infographic
- Cleaning and disinfecting public spaces (COVID-19) – Infographic
- Social Distancing – Infographic
- A Pan-Canadian response to COVID-19 – Information Sheet
- For travellers without symptoms returning to Canada – Information sheet
- Know the difference : Self-monitoring, self-isolation, and isolation for COVID-19 – Infographic
- Keeping you safe at work: Marine sector health and COVID-19 – Information Sheet
- Reduce the spread of COVID-19: Wash your hands - Infographic
- How to care for a person with COVID-19 at home: Advice for caregivers – Factsheet
- Vulnerable populations and COVID-19 – Factsheet
- How to isolate at home when you have COVID-19 – Factsheet
- About coronavirus disease (COVID-19) – Infographic
- Be prepared (COVID-19) – Infographic
- For travellers with symptoms returning to Canada – Information Sheet (includes contact information for public health authorities in each province and territory)
- Be prepared – Factsheet
- Know the facts about coronavirus disease (COVID-19) - Factsheet
The latest information and the status of measures in Canada are posted on Canada.ca/coronavirus or available to the public through the Coronavirus Information Line (1-833-784-4397). The website is available in English, French and simplified Chinese
- Facebook: Healthy Canadians
- Facebook: Travel Advice from the Government of Canada
- Twitter: @TravelGoC
- Twitter: @GovCanHealth
- Twitter: @CPHO_Canada
- LinkedIn: Public Health Agency of Canada
Below are details on the various government programs for Businesses and Individuals during COVID-19 as of April 7, 2020. There are two sections: Government assistance and Insurance.
GOVERNMENT ASSISTANCE
Canada Emergency Wage Subsidy (CEWS)
The objective of this plan is to help employers keep employees working.
- 75% of salary on the first $58,700 per employee, to a maximum of $847 per week per employee. There is no limit per employer.
- Eligible employers include individuals, corporations and partnerships.
- Any business with at least a 30% decrease in revenue compared to current month of the previous year.
- CEWS would be claimed against wages in three periods March 15-April 11, April 12-May 9 and May 10-June 6. > I.E If there is a 30% revenue decrease for each of these periods you would be eligible to apply. Employers have to apply 3 times, once for each period.
- Employers are to pay employee wages first then apply for the CEWS through the CRAs business account portal. Payment will be received through direct deposit. Employers must keep detailed records.
- Employers must do “everything they can” to pay the other 25% of employee wages.
- The CEWS subsidy will be taxable to the employer as government assistance.
- Non-arms length's employees are limited to pre-crisis earnings.
- You will need to attest to the decrease in revenue and keep detailed records. If it is determined that you are ineligible, you will need to repay the loan and anti-abuse rules will apply.
- If your corporation does not qualify for the CEWS program, you can apply through the 10% Temporary wage subsidy program (TWS) listed below
- ACTION: Apply through CRAs my business account portal.
- For complete information on the Canada Emergency Wage subsidy click here
INSURANCE
Below is a review on coverage for COVID-19 (claims on your disability, office overhead, critical illness and life insurance), premium deferral options and how to update your insurance.
Claims:
- Disability insurance
If you are quarantined and diagnosed with COVID-19, you are considered disabled and your policy will cover you. Self isolation without a diagnosis of COVID-19 is not considered a disability. - Office overhead insurance
Office overhead insurance is designed to cover your business expenses in the event that you are disabled or injured; closing your clinic as a safety precaution is not covered under office overhead insurance. - Critical illness insurance
Critical illness insurance has defined definitions at the time a policy was purchased. COVID-19 is not a defined critical illness. - Life insurance
If you pass away due to COVID-19, your policy will pay to your beneficiaries.
Can you defer your insurance premium?
YES. Most tier one individual insurers (including RBC Insurance) are offering up to 3 months interest free premium deferral if you are unable to make premium payments on your insurance due to COVID-19.
- Sun Life, Canada Life, Manulife, RBC Insurance. Details here
- As of April 7, 2020, the OMA has not advised of premium deferrals. OMA Covid-19 response
Do you need more insurance?
Physicians have been reflecting on their insurance needs and some have asked how they can increase their insurance. Due to COVID-19, you can apply with reduced medical requirements as listed below:
Life insurance - apply for new insurance with no medical (no blood, urine or vitals)
- Up to age 50 can apply for $1,000,000
- Age 51-60 can apply for up to $300,000
- Age 61-70 can apply for up to $99,000
- Rapid underwriting
Critical illness insurance – no medical (blood, urine, vitals).
- Up to age 40 can get $250,000 – no fluids required
- Age 41-50 can get $100,000.
- Age 51-55 can get $50,000
- Discount – up to 10% discount for physicians through our office
Disability insurance – no medical (blood, urine, vitals).
- Up to age 50 can apply for up to $6,000/month.
- Age 51+ can apply for up to $2,500/month
- Discount – up to 25% discount for physicians through our office
10% Temporary Wage Subsidy (TWS)
The objective of this plan is to help employers keep employees working irrespective of revenue decrease.
- 10% of remuneration paid from March 18, 2020 to June 19, 2020
- Capped at $1,375 per employee to a max of $25,000 per employer
- Benefit capped by reducing payroll remittance
- Not a subsidy but a reduction in tax remittance.
- ACTION: Reduce your income tax remittance
Canada Emergency Business Account (CEBA) - Loan for up to $40,000
The objective of this plan is to help businesses with an interest free loan
- Up to $40,000 interest-free loan for small businesses and not-for-profit organizations.
- If repaid by Dec 31, 2022, up to 25% is forgivable (up to $10,000).
- Organizations that paid between $50,000 and $1 million in payroll for 2019.
- Organizations that have had their revenues temporarily reduced.
- Financial evidence is required.
- ACTION: Apply through your online banking. We expect this to be up online by April 15, 2020
Employment insurance (EI)
The one-week waiting period is waived for new claimants who are quarantined and a medical certificate is not required to apply. Qualification for EI will still be on a case-by-case basis, taking into account regional rates of employment and the number of hours worked in the past 52 weeks. Apply here.
Canada Emergency Response Benefit
Passing of emergency legislation Bill C-13 on March 25 created the Canada Emergency Response Benefit, combining the two previously announced Emergency Care Benefit and Emergency Support Benefit. The benefit provides a taxable benefit of $2,000 a month for up to 4 months to:
- workers who must stop working due to COVID-19 and do not have access to paid leave or other income support.
- workers who are sick, quarantined, or taking care of someone who is sick with COVID-19.
- working parents who must stay home without pay to care for children that are sick or need additional care because of school and daycare closures.
- workers who still have their employment but are not being paid because there is currently not sufficient work and their employer has asked them not to come to work.
- wage earners and self-employed individuals, including contract workers, who would not otherwise be eligible for Employment Insurance.
- ACTION Apply here.
Canada Child Benefit (CCB)
The Government is proposing to increase the maximum annual Canada Child Benefit (CCB) payment amounts, for the 2019-20 benefit year, by $300 per child. No action is required.
Goods and Services Tax Credit – Available in May 2020
The Government is proposing to provide a one-time special payment through the Goods and Services Tax credit (GSTC). The average boost to income for those benefiting from this measure will be close to $400 for single individuals and close to $600 for couples. No action is required.
Filing your tax returns
The Canada Revenue Agency will defer the filing deadline for the 2019 tax returns of individuals, including certain trusts, and corporations.
- Individuals, the filing deadline has been extended until June 1, 2020. The payment date for 2019 tax year has been extended to September 1, 2020.
- Self-employed, the filing deadline has not changed of June 15, 2020. The payment date for 2019 tax year has been extended to September 1, 2020.
- Corporations, for corporations that have a filing date after March 18 and before June 1, 2020, the filing date has been extended to June 1, 2020.The payment date for 2019 tax year has been extended to September 1, 2020 for balanced and installments due under Part 1 of the income tax act.
- For complete detail see CRA filing payment dates
- No action is required
Mortgage Default Management Tools
The Canada Mortgage and Housing Corporation (CMHC) and other mortgage insurers offer tools to lenders that can assist homeowners who may be experiencing financial difficulty. The Government, through CMHC, is providing increased flexibility for homeowners facing financial difficulties to defer mortgage payments on homeowner CMHC-insured mortgage loans. CMHC will permit lenders to allow payment deferral beginning immediately. See the CMHC website for COVID-19 updates.
INSURANCE
Below is a review on coverage for COVID-19 (claims on your disability, office overhead, critical illness and life insurance), premium deferral options and how to update your insurance.
Claims:
- Disability insurance
If you are quarantined and diagnosed with COVID-19, you are considered disabled and your policy will cover you. Self isolation without a diagnosis of COVID-19 is not considered a disability. - Office overhead insurance
Office overhead insurance is designed to cover your business expenses in the event that you are disabled or injured; closing your clinic as a safety precaution is not covered under office overhead insurance. - Critical illness insurance
Critical illness insurance has defined definitions at the time a policy was purchased. COVID-19 is not a defined critical illness. - Life insurance
If you pass away due to COVID-19, your policy will pay to your beneficiaries.
Can you defer your insurance premium?
YES. Most tier one individual insurers (including RBC Insurance) are offering up to 3 months interest free premium deferral if you are unable to make premium payments on your insurance due to COVID-19.
- Sun Life, Canada Life, Manulife, RBC Insurance. Details here
- As of April 7, 2020, the OMA has not advised of premium deferrals. OMA Covid-19 response
Do you need more insurance?
Physicians have been reflecting on their insurance needs and some have asked how they can increase their insurance. Due to COVID-19, you can apply with reduced medical requirements as listed below:
Life insurance - apply for new insurance with no medical (no blood, urine or vitals)
- Up to age 50 can apply for $1,000,000
- Age 51-60 can apply for up to $300,000
- Age 61-70 can apply for up to $99,000
- Rapid underwriting
Critical illness insurance – no medical (blood, urine, vitals).
- Up to age 40 can get $250,000 – no fluids required
- Age 41-50 can get $100,000.
- Age 51-55 can get $50,000
- Discount – up to 10% discount for physicians through our office
Disability insurance – no medical (blood, urine, vitals).
- Up to age 50 can apply for up to $6,000/month.
- Age 51+ can apply for up to $2,500/month
- Discount – up to 25% discount for physicians through our office