Recommendation and Guidance Updates
Case Definitions: Case definitions were updated and released March 30, 2020. Changes reflect additional testing capacity and guidance to consider a symptomatic case with indeterminate COVID-19 result a probable case. Locally, any travel outside of Canada within 14 days of symptom onset is considered to meet the exposure component (impacted area) of the current case definition.
Communicable Period: period of communicability has been updated based on emerging information to include 48 hours prior to symptom onset to 14 days after symptom onset.
COVID-19 Testing: With evidence of community transmission, HPEPH is encouraging health care providers to use their clinical judgment and test persons suspected of having COVID-19 as resources allow. As per the updated Ministry of Health Quick Reference March 27, 2020, testing for COVID-19 should be based on clinical assessment, and not based on the case definition. Priority for testing should be given to individuals as per this Ministry of Health Reference Guide. Current turnaround time for test results is dependant on patient status and capacity, at present this varies from 24 hours to 1 week.
Assessment Centre: Plans are nearing final stages for COVID-19 assessment centres located within our local area. Details on locations and operational hours will be announced to our colleagues and community members as soon as finalized.
Criteria for Discharging from Isolation and Considering Case Resolved:
As per the March 27 updated Ministry of Health Quick Reference, individuals should be in isolation for the duration specified and released provided the individual is afebrile and symptoms improving. Absence of cough is not required for those known to have a chronic cough or who are experiencing reactive airways post-infection.
For individuals at home
- 14 days following symptom onset and patient is afebrile with symptoms improving
- This applies to individuals whether they were confirmed by testing, and individuals who were not tested but have symptoms compatible with COVID-19
For hospitalized patients
- Isolate in hospital until 2 negative tests, obtained at least 24 hours apart
- If discharged home within 14 days of symptom onset, follow advice of individuals at home
Health Care Worker (HCW) Self Isolation and Return to Work Recommendations:
- HPEPH supports health care organizations to make their own assessment and decisions regarding critical staffing needs.
- We are not able to advise on critical staffing needs for other health care settings and recommend HCW’s report to their Occupational Health for direction.
- If a staff person is deemed critical to operations by the organization, the MOHLTC Quick Reference HCW specific recommendations for self isolation requirements and return to work criteria should be followed.
- Detailed criteria is included in our new Health Care Worker Self-isolation and Return to Work Guidelines posted on HPEPH COVID webpage.
Ontario Ministry of Health NEW Guidance and Directives:
Reporting of COVID-19:
- COVID-19 is a designated disease of public health significance and is thus reportable under the Health Protection and Promotion Act. Regulated health professionals must report all confirmed and probable cases of COVID-19 to HPEPH, including any patients being tested for COVID-19.
- Reports can be made via fax or email using the new COVID-19 Primary Care Reporting Form available on our COVID-19 HCP webpage or by telephone to our Communicable and Infectious Disease intake line 613-966-5500 x 349. Please ensure report form is completed in full and all requested information is included.
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