The Dalglish Family Hearts & Minds Clinic for 22q11.2 Deletion Syndrome

COVID-19 is a respiratory disease caused by a new coronavirus called SARS-CoV-2.

Definition of "Symptomatic" for COVID-19

• fever - temperature of 37.8°C (100.04°F) or greater

OR

• any new/worsening:
  • cough
  • shortness of breath
  • sore throat
  • runny nose or sneezing (see note below)
  • nasal congestion (see note below)
  • hoarse voice
  • difficulty swallowing
  • new smell or taste disorder(s)
  • nausea/vomiting
  • diarrhea
  • abdominal pain

OR

• clinical or radiological evidence of pneumonia

Note: In patients presenting with ONLY runny nose/sneezing or congestion, consideration should be given to other underlying reasons for these symptoms such as seasonal allergies and post-nasal drip

Atypical Symptoms/Signs of COVID-19

Atypical presentations of COVID-19 should be considered, particularly in children, older persons, and people living with a developmental disability.

Atypical Symptoms

• Unexplained fatigue/malaise
• Delirium (acutely altered mental status and inattention)
• Unexplained or increased number of falls
• Acute functional decline
• Exacerbation of chronic conditions
• Chills
• Headaches
• Croup
• Conjunctivitis

Atypical Signs

• Unexplained tachycardia (very fast heart beats), including age specific tachycardia for children
• Decrease in blood pressure
• Unexplained hypoxia (low oxygen level), even if mild i.e. O₂ saturation <90%
• Lethargy, difficulty feeding in infants (if no other diagnosis)

Although this disease has been spreading quickly around the world, there are a few things you can do to avoid catching it.

• Stay at home as much as possible
• Avoid being very near another person
  • "Social distance" means keeping about 6 feet apart (2 metres, or 3 big steps)
• Wash your hands with soap and water properly and frequently
  • If soap and water are not available, use an alcohol-based hand sanitizer. Rub the sanitizer all over your hands and let your hands dry in the air.
• Wear masks as an added layer of protection
• Avoid touching your eyes, nose, and mouth with your hands
• Sneeze or cough into your sleeve or a tissue and wash your clothes often
• Disinfect spaces regularly,especially phones, door handles, etc.
• If you have returned from anywhere outside Canada, including the United States, you must self-isolate (i.e. stay at home and avoid close contact with others, including those in their home) for a total of 14 days.

See also

• Tip Sheets from our Clinic and the International 22q Foundation
• CBC article: Masks: Everything you need to know but might be too afraid to ask
• CNN article: Dear Grandma, read this before you visit the little ones
  • The tips from this article are also applicable for visits that involve our patients and people with chronic health conditions
• Video: Why does staying at home help?
• Video: How viruses attack the body and how it fights back
• Nutrition and advice on buying/storing food items from the Dietitians of Canada
  • Please scroll down on the website

If you are concerned that you may have been exposed to, or are experiencing symptoms of COVID-19, please see:

Toronto’s COVID-19 Assessment Centres – Who should visit and who should not.

• The COVID-19 Assessment Centres closest to our Clinic are located at Women's College Hospital and Mount Sinai Hospital.

Alternatively, please contact one of the following:

• For those in Toronto - Toronto Public Health hotline
• Information is available in multiple languages
• Phone: 416-338-7600
• Telehealth at 1-866-797-0000
• You can try calling your primary care provider (such as family doctor) but note that many will be on reduced hours.
• Your local public health unit

See also:

• UHN's Your Guide to Managing COVID-19 at home

Ontario Ministry of Health: COVID-19 Provincial Testing Guidance Update - May 28, 2020

COVID-19 Quick Reference Public Health Guidance on Testing and Clearance - May 28, 2020

COVID-19 Information for individuals with 22q

• From our Clinic
  • COVID-19 - What it is and how you can help
• International 22q Foundation - COVID-19 Resources
  • What is COVID-19?
  • Why should we stay home?
  • Staying calm during COVID-19
  • False information and scams
  • Immunodeficiencies and COVID-19
  • Heart conditions and COVID-19 [Italian version]
  • When can we return to work/school?
  • PCR vs. Antibody testing

COVID-19 Information for individuals with immunodeficiencies

The Immune Deficiency Foundation generated a series of COVID-19 Videos.

• To find out how individuals with immunodeficiencies have been doing when they contract COVID-19, please see the April 10 video (7 min 55 sec) and the May 8 video (9 min 11 sec)

Date of video	Topics
March 3, 2020	COVID-19 update Preventing infection Logistical plans What to do if you get sick
March 10, 2020	Update and nomenclature Testing Life long immunity Risks to patients with immunodeficiencies Are immunoglobulins protective How not to touch your face
March 18, 2020	Updates on treatment How does the immune system respond to a virus? Specific concerns for different immunodeficiencies Vaccine development Links
April 10, 2020	Course of typical infection Therapies How well people with immunodeficiencies do when they have COVID-19
May 8, 2020	Treatment Statistics Immune modulators How well people with immunodeficiencies do when they have COVID-19 Vaccine development Are immunoglobulins protective?
May 29, 2020	PCR vs. Antibody testing Immunoglobulin replacement Going back to school or work Multisystem inflammatory syndrome in children

COVID-19 Information for everyone

There are a lot of information on the Internet about the current pandemic, but not everything is accurate.

Please visit the following websites for the most up-to-date and reliable information:

• University Health Network (UHN) - COVID-19 Info/Policies – UHN is the organization that runs the Toronto General Hospital.
• UHN's COVID-19 Resources
  • This site offers pamphlets in other languages
• COVID-19 - What you need to know from the Ontario Medical Association
• City of Toronto
• Public Health Ontario
• Government of Canada - includes outbreak updates, symptoms, prevention, travel, preparation
• A COVID-19 Glossary from the CBC

Please do not come to the Clinic if you have any of the symptoms listed above.

Please see our section on Clinic operations and hospital restrictions during COVID-19.

Please note that Toronto General Hospital has a Universal Masking Policy.

While there are support services and financial assistance available, we urge you to be very careful about possible scams. Please visit the Government of Canada's Slam the scam website to learn how to protect yourself.

Support

• The Center for Disease Control's page on Stress and Coping

• Connectability Resources for people with Intellectual Disabilities

• Ontario 211 - Community and Social Services Help Line (more info)

• West Neighbourhood House (more info)

  • Get help with your finances: filing taxes, finding and getting emergency benefits, and help with budgeting.

• Planning Network

  • Supports for People with Disabilities and Their families

• Toronto Drop-In Network

• Pooran Law's COVID-19 Resource Centre

• How to talk to your kids about COVID-19: Considerations for health care providers

  • Note: This article is also suitable for workers who are providing essential services during the COVID-19 pandemic.

Financial assistance

• Possible additional funding for Ontario Works (OW) and Ontario Disability Support Program (ODSP) recipients

  • Please contact your caseworkers to apply.

• Passport funding

  • temporary changes to eligible expenses during COVID-19
  • Update on May 19, 2020

• Canada Emergency Response Benefit (CERB) with CRA

• Support for Families

  • Financial support to parents to assist with the costs of educational resources

See also

• Interactive guide for Financial help for Canadians affected by COVID-19

Watch videos on handling COVID-19 and self-isolation

• Broadcast from Queen Elizabeth II
• Advice from former astronaut Chris Hadfield on coping with self isolation
• Message from the 22q11.2 Society
  • Some of us are in this video!

Be a tourist in your own home

• Visit zoos and aquariums virtually

  • You can take part in the International 22q Foundation's 10^th annual 22q at the Zoo Virtual Worldwide Awareness Day on May 17^th, 2020.

• Tour famous landmarks around the world using Google Streetview

Things to do with children

• List from the Globe and Mail - for adults taking care of children during isolation
• Booklet from rarechromo.org - for children with rare genetic disorders