Risk Mitigation in the Context of Dual Public Health Emergencies: Interim Clinical Guidance

On March 11, the World Health Organization declared COVID-19, caused by a novel coronavirus, a pandemic, citing concern over alarming levels of spread and severity across the globe. In British Columbia, a public health emergency due to COVID-19 was declared on March 17, 2020. British Columbia is in a unique situation, with the current crisis compounding an existing public health emergency declared in April 2016, due to escalating opioid overdoses and related deaths. At the intersection of these dual public health emergencies are a number of risks, including the risk for overdose and other harms related to an increasingly toxic illicit drug supply, the risk of infection and spread of infection among those with underlying health conditions and who face social marginalization, and risks due to withdrawal for those who must self-isolate or quarantine to prevent the onward spread of COVID-19. Extraordinary measures are needed to support people who use drugs (PWUD) (including alcohol) and prevent ongoing community spread of COVID-19 among a vulnerable, often immune-compromised population.

This protocol is intended to provide clinical guidance to health care providers to support patients to mitigate these competing priorities and compounded risks and enable social distancing and self-isolation measures, where possible, to reduce and prevent the spread of COVID-19. These guidelines are not intended for treatment of substance use disorders but rather to support individuals with substance use disorders to self-isolate or social distance and avoid risk to themselves or others.

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