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Rolling with and adapting to the waves of a global pandemic: Nova Scotia Health’s COVID-19 response


Nova Scotians proudly celebrating their first COVID-19 vaccination in New Minas, Nova Scotia.

By Erin Gray

Surges of COVID-19 cases are often referred to as waves – fitting for a province like Nova Scotia that is so deeply connected to the ocean. The 2021-22 year provided its share of waves. But through the ebbs and flows of the virus, Nova Scotia’s health system has continually adapted – following the best scientific evidence, leveraging innovation and integration, and doing everything possible to keep Nova Scotians safe.

The arrival of COVID-19 in 2020 flipped life upside-down and necessitated a province-wide response.

The 2021-22 year lent the opportunity to find new solutions to challenges that COVID-19 brought with it. Through the year, as the response to COVID-19 changed, Nova Scotia Health was able to refine tools, partnerships, and ways of reaching communities. The province reached a new level of collaboration, reinforcing existing partnerships and creating opportunities for new ones.

Efforts in the first half of 2021 were heavily focused on COVID-19 vaccination and a mass immunization program implemented unlike anything we had ever seen in this province.

With the approval of Moderna, Pfizer and Astra-Zeneca, the provincial government took a phased approach to vaccine distribution, placing priority on health care workers, followed by an age-based rollout starting with those 80 or older.

Working against time, Nova Scotia Health formed a massive team of experts to lead the distribution of the much-anticipated vaccine. Tasked with distributing vaccines that required specific storage equipment meant new methods of distribution and inventory management, which were led by Public Health’s Biodepot team. Online COVID-19 vaccine ordering was implemented in August 2021 to improve vaccine distribution and improve transparency and communication with providers.

Teams led by Public Health quickly assessed and set up clinic locations based on population distribution across the province and a focus on reaching priority populations. Mass community clinics, health care worker clinics, long-term care clinics and community outreach clinics were all part of the enormous effort Nova Scotia Health made to ensure every Nova Scotian who wanted their vaccine had access to it.

Public Health worked in partnership with partners in African Nova Scotian, First Nations and newcomer communities to help ensure access to the vaccine, as well as to support testing and manage outbreaks as needed. Public Health also worked closely with shelters and transition houses to support their robust COVID-19 response.

In the fall of 2021, when most of the population had been vaccinated, there was a shift in public health measures for isolation.

The testing strategy also shifted from regular asymptomatic testing to only those with symptoms, close contacts and populations at risk for severe illness. This was when the introduction to wide-spread use and availability of rapid antigen tests took on new importance.

With a glimmer of hope for a “normal” holiday season, nothing had prepared the system and Nova Scotians for what was to come in December 2021 – Omicron. When the Omicron variant entered the province, the approach to COVID-19 response had to change simply because of the overwhelming case numbers.

The public health system had to focus its attention on those most at risk for severe illness from COVID-19 and the management of cases changed dramatically:

  • * Public Health had to focus contact tracing efforts on high-risk congregate (group) settings rather than on all positive cases, due to the volume of cases.
  • * PCR testing was limited to those at higher risk of serious illness, and confirmatory PCR testing had to be paused. Therefore, anyone who tested positive on a rapid antigen test was considered infected and advised to follow Public Health guidelines for isolation.
  • * Public Health also stopped issuing exposure notifications, as locations couldn’t be verified without contact tracing in place. The public was advised to consider every public location a potential exposure location and follow public health measures accordingly.

Throughout the year, innovation continued to play an important role in the key advancements made in relation to COVID-19:

  • * Nova Scotia Health launched the COVID-19 Recovery website (MyCOVIDRecovery.ca) to help Nova Scotians understand and manage their long-term health and wellness after having COVID-19. This program includes screening, assessment and navigation supports for patients and health care providers, referrals to specialty services, rehabilitation and community resources as needed and ongoing support for symptom management and self-management.
  • * In response to the need for Nova Scotians to easily find answers to their COVID-related questions, Nova Scotia Health set up a centralized COVID questions email. A dedicated team of public health team members responded to thousands of inquiries, and providing the most accurate, up-to-date information available.
  • * Public Health and Information Management and Technology worked together to create easier access to COVID-19 test results for Nova Scotians. The technology began with auto-calls and emails to notify people of their negative test result. Negative, positive and indeterminant results can now be accessed by an online portal, as well as by email. Auto calls remain in place for those who do not access their results online or by email.
  • * Nova Scotia Health created internal digital tools for Nova Scotia Health employees and physicians, such as HealthQ, to support health care workers do their daily monitoring for COVID-19 symptoms and report their COVID-19 status to Occupational Health, Safety and Wellness.
  • * Nova Scotians who tested positive for COVID-19 were provided access to a Digital Daily Health Check-in, so that Public Health could monitor for concerns. During the third wave of COVID-19 when cases began to exceed Public Health’s capacity to follow up quickly with each case, text notification was introduced for positive cases. By communicating via text, cases were able to isolate immediately and follow the necessary requirements until someone was able to follow-up with them directly.
  • * With dramatically increased case numbers and stricter criteria for PCR testing, Nova Scotia Health teams, in partnership with the provincial government, established the Report and Support tool for anyone who tested positive on a rapid antigen test, or who booked a PCR test. This tool allows Nova Scotia Health to collect information to help quickly identify people who are eligible for and may benefit from COVID-19 medications and treatments to reduce the risk of severe disease and hospitalization.

While the pandemic is not over yet, and there have been many challenges, there have also been remarkable achievements, innovation, partnerships and a strong showing of resiliency. No one could have expected this virus to continue to restrict life as much as it has for more than two years.

Nova Scotians have faced constant change and limitations due to the virus – gathering limits, border restrictions, travel requirements, isolation and testing. As challenging as it has been, the COVID-19 pandemic has shown the benefits of being an integrated province-wide health system. The tools and knowledge from this experience will reshape the health system’s approach moving forward.