Hastings Prince Edward Public Health
Online Bulletin for Health Care Providers

January 10, 2022

From:
Dr. Ethan Toumishey
Acting Medical Officer of Health
Hastings Prince Edward Public Health

COVID-19 vaccine news & updates

Changes to COVID-19 testing eligibility

Effective December 30, publicly-funded PCR testing will only be available for high-risk individuals who are symptomatic and/or are at risk of severe illness from COVID-19, including for the purposes of confirming a COVID-19 diagnosis to begin medical treatment, and workers and residents in the highest risk settings, as well as vulnerable populations. A full list of eligible individuals can be found here.

Individuals with symptoms consistent with COVID-19 are presumed positive and if not eligible for testing, they should follow isolation and/or self-monitoring guidelines.

Testing for asymptomatic contacts of cases is generally no longer recommended, except for high-risk contacts/individuals that are part of confirmed or suspected outbreaks in high-risk settings, as recommended by public health. Most positive rapid antigen tests will no longer require PCR confirmation.

Changes to COVID-19 isolation requirements

Based on the latest scientific evidence, individuals who are fully vaccinated, as well as children under 12, are required to isolate for five days following their onset of symptoms. Household members are also required to isolate while the symptomatic individual is isolating,

Individuals who are unvaccinated, partially vaccinated or immunocompromised are required to isolate for 10 days. Individuals who work in high-risk health care settings can return to work after 10 days from their last exposure or symptom onset, or from their date of diagnosis.

Work self-isolation for essential health care workers

Regardless of COVID-19 vaccination status, high-risk contacts should not be working in the highest risk settings, unless required for critical work shortages.

To ensure sufficient staffing levels, staff who are critical to operations in these settings who are household contacts of cases, or have been otherwise advised to self-isolate, may return to work on work self-isolation if they:

  • remain asymptomatic; AND
  • are actively screened ahead of each shift; AND
  • are fully vaccinated; AND
  • continuously test negative on required testing (see table 1)

Alternatively, two negative RATs on days 6 and 7 collected 24 hours apart is sufficient to allow early return to work on day 7.

Table 1: Testing Requirements for Work Self-Isolation

Nature of exposure Work self-isolation Testing Requirements
No ongoing exposure to case 10 days since last exposure

RAT on day 6 and 7 for return on day 7
OR
Initial PCR test and daily RAT

Ongoing household exposure Work self-isolation for 10 days from last exposure to the case in their period of contagiousness (up to 15 days from the date on which the household case became symptomatic or from the date of the positive test of the household case).

RAT on day 9 and 10 for return on day 11
OR
Initial PCR test and daily RAT

Ongoing outbreak exposure Work self-isolation until 10 days after exposure to the last case (presuming ongoing exposure during the outbreak).

Follow PHU guidelines for RAT and PCR/rapid molecular testing as part of recommended outbreak management testing.

Staff who are cases (i.e. have tested positive) should not be considered for work self-isolation. Any critical situations where this is being considered must be discussed with the public health unit.

Reminder: mild symptoms in fully vaccinated individuals may be due to COVID-19 infection

Recent COVID-19 case investigations have identified that fully vaccinated people can have very mild symptoms which are often attributed to alternative diagnoses such as a cold or allergies. These cases can unknowingly transmit COVID-19 to others.

HPEPH recommendations:

  • All individuals should continue to self-screen or follow their school or workplaces' COVID-19 screening checklist.
  • Individuals with symptoms compatible with COVID-19 should not work or attend school while ill and should be tested for COVID-19 if eligible even if fully vaccinated. If not eligible for testing, stay home as directed (5 days for fully vaccinated individuals) AND symptoms are improving for at least 24 hours (48 hours for gastrointestinal symptoms).

Revised COVID-19 directives

The following Chief Medical Officer of Health (CMOH) Directives have been revised with interim recommendations for additional requirements regarding personal protective equipment in light of the emerging evidence on the Omicron variant.

Required precautions for all health care workers providing direct care to OR interacting with a suspected, probable (i.e. placed in precautions as high-risk contact, in an outbreak zone of the facility or recently transferred from a facility in outbreak) or confirmed cases of COVID-19 are a fit-tested, seal-checked N95 respirator (or approved equivalent), eye protection (goggles or face shield), gown and gloves.

REMINDER: Ontario is enhancing proof of vaccination requirements and strengthening the verification of medical exemptions

Effective January 4, 2022, Ontario will begin requiring the use of the enhanced vaccine certificate with QR code and the Verify Ontario app in settings where proof of vaccination is required. The QR code can be used digitally or by printing a paper copy. Individuals can visit their local library or can call the Provincial Vaccine Contact Centre at 1-833-943-3900 to have their vaccine certificate mailed to them. They can also visit a Service Ontario centre to receive a printed copy.

To obtain an enhanced vaccine certificate with QR code, individuals who have an eligible medical exemption must ask an Ontario physician or registered nurse in the extended class to submit their exemption directly to the public health unit where the issuer’s practice is located. Once an individual’s exemption is reviewed and entered into COVaxON by the public health unit, they will be able to access their enhanced vaccine certificate with QR code through the COVID-19 vaccination portal.

Organizations and businesses that are required to take part in Ontario’s proof-of-vaccination system will be advised to no longer accept physician notes beginning January 10, 2022.

Ontario temporarily moving to modified Step Two of the Roadmap to Reopen

As of January 5, 2022, for at least 21 days Ontario is temporarily moving into Step Two of the Roadmap to Reopen with modifications. Please refer to O. Reg. 263/20 Rules for Areas in Step 2 for the complete list of measures and conditions that apply to certain businesses, organizations, places and individuals.

  • indoor gatherings limited to five people or fewer
  • outdoor gatherings limited to 10 people or fewer
  • restaurants, bars and other food or drink establishments indoor service closed
  • indoor areas of facilities used for sports and recreational fitness activities, including gyms, sporting events and personal training are closed
  • businesses and organizations must make sure that all work is conducted remotely, unless the nature of the work requires workers to be on-site at the workplace.

New and updated COVID-19 resources


Current information on COVID-19 specifically for health care providers can be found at hpePublicHealth.ca, Ontario Ministry of Health and at publichealthontario.ca.

Contact Information: 

To give us your comments: hart.sara@hpeph.ca

To report communicable diseases:613-966-5500 x349

To report AEFI or DOPHS: Online / Fax: 613-966-1813 or CDCFAX1@hpeph.ca

You have received this email at from Hastings Prince Edward Public Health as a result of a request you have made or due to a service/subscription that you are registered for. While you may discontinue your subscription to this mailing at any time by pressing the unsubscribe button below, please note that this bulletin will be used to provide important updates about infectious and communicable disease.