Important COVID-19 Update:
Middlesex London COVID-19
Remote Patient Monitoring Care Pathway

Provincially there has been a significant increase in the number of COVID -19 positive patients over the last 2 weeks. ICU admissions provincially are rapidly increasing and many hospital admissions are related to the Variants of Concern. As primary care providers, we may start seeing more positive test results in our patients.

Below is a summary of the COVID-19 Care Pathway that has be designed for those patients who are found to be COVID-19 positive in London Middlesex.
Click here for a PDF document of this information.
Why Remote Patient Monitoring? 

  • To systematically monitor people with COVID-19 in the community and subsequently optimize care (e.g., detect pneumonia or asymptomatic hypoxia, escalate medical assessment, and intensify medical care early)
  • To reduce the risk of infection among health care workers, by leveraging remote monitoring, as appropriate

Who can access Middlesex-London Remote Patient Monitoring?

  • Anyone who is COVID-19-positive living in Middlesex London 

What is the Middlesex London Remote Patient Monitoring Process?
  1. The Middlesex London Health Unit (MLHU) offers everyone access to Remote Patient Monitoring (RPM).
  2. If patient agrees, the MLHU refers the patient to the Middlesex London RPM program.
  3. Central Intake for the Middlesex London RPM program stratifies patients, based on risk:

  • B)    Patients considered Medium to High-Risk: age > 40 years, or age < 40 years with respiratory disease (e.g., asthma, COPD), obesity, diabetes, ESRD or immunosuppression, to be supported by LHSC Urgent COVID-19 Care Clinic (LUC3).
What is the role of Primary Care?

  •  Patients can decompensate 7-12 days after initial diagnosis. Follow-up with all COVID positive patients within one week of diagnosis by the Primary Care Provider (PCP) is therefore encouraged.  If they initially declined RPM and remain well, they can follow up with the PCP.  Alternatively, with their permission, they can be referred to RPM at any time and stratified for RPM based on their risk as defined above. 

  • Referral Form downloads below:

  •  For patients who are monitored/managed by their PCP, the following recommendations may be implemented:
  • Tylenol and Ibuprofen for treating headaches, fever and body pain
  • Saline nasal rinses for headaches and sinus congestion
  • Vitamin D3 4000 IU daily 

  • Referral is suggested to LUC3 if a patient develops any of the following symptoms:
  • Dyspnea at rest or with exercise
  • Continuous fever despite antipyretics 
  • Palpitations
  • Intractable vomiting or diarrhea
  • Weight loss
  • Dizziness or confusion

  • Alert LUC3 for prompt virtual follow up by calling the clinic number at 519-663-3331 if the patient continues to have any of the following symptoms 2-3 weeks post-diagnosis:
  • New or worsening dyspnea or cough
  • New paresthesia 
  • Worsening headaches
  • New or worsening palpitations

  • Instruct patient to call 911 if experiencing any of the following symptoms:
  • Loss-of-consciousness
  • New weakness
  • New, severe dyspnea
  • New chest pain

  • Reinforce that all patients must continue social isolation until they are cleared by the MLHU.
If there are non-hospital COVID-19 related issues/solutions in your region, please escalate them to your
Regional Pandemic Clinical Lead
(tasked by Ontario Health West to facilitate, coordinate, and engage with stakeholders for the pandemic response within the SW LHIN area RE: primary care/vulnerable populations)...structure HERE.
Dr. Gordon Schacter
Co-Chair, SW Prim Care/Vulnerable Pop'n Response
London Middlesex Pandemic Clinical Lead