Recommendation and Guidance Updates
Case Definitions: Case definitions remain current as of last update March 13, 2020 (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.
COVID-19 Testing: As per Ministry of Health Quick Reference March 25, 2020, testing for COVID-19 should be based on clinical assessment, and not based on the case definition. Due to the shortage of supplies and testing capacities, the following should be prioritized for testing:
- Symptomatic health care workers (HCW) and staff who work in health care facilities
- Symptomatic residents and staff in Long Term Care facilities and retirement homes
- Hospitalized patients admitted with respiratory symptoms (new or exacerbated)
- Symptomatic members of remote, isolated, rural and/or indigenous communities
- Symptomatic travellers at point of entry to Canada
Ontario Public Health Laboratory Testing:
Complete summary of current testing practice is available at COVID-19 Test Info or on Public Health Ontario website. Current turnaround time is dependant on patient status and capacity, at present this varies from 24 hours to 1 week.
Local Specimen Collection Capacity: Currently HPEPH has arrangements with local EMS to provide in-home testing of select persons on a case by case basis. Additional specimen collection is being completed at HPEPH as deemed appropriate through case management.
Assessment Centre: Plans are nearing final stages for a local COVID-19 assessment centre in Belleville. A call for clinicians went out yesterday on behalf of HPEPH and Quinte Health Care for patient follow-up requirements. Details can be found in our March 25 HCP Memo.
Health Care Worker (HCW) Illness and Self-Isolation:
As per March 19th CMOH direction, HCW’s who have travelled outside of Canada are to self-isolate for a period of 14 days starting from their arrival in Ontario
- HCW should not attend work at all if they are sick
- HCW who are deemed critical by all parties may be permitted to work during the 14 days if they are well, undergo regular screening, use appropriate PPE for the 14 days and undertake active self monitoring including twice daily temperature checks
- HCW must immediately self identify to their occupational health and safety department if symptoms develop
HPEPH supports healthcare organizations to make their own assessment and decisions regarding critical staffing needs. HPEPH will not advise on critical staffing needs for other healthcare settings. HCWs in these categories need to report to their Occupational Health for direction. Although it is required to report probable and confirmed cases of COVID-19 to Public Health, it is not necessary to contact HPEPH for staffing decisions.
Criteria for Discharging from Isolation and Considering Case Resolved:
As per the Ministry of Health Quick Reference, March 25th, individuals should be in isolation for the duration specified and released provided the individual is afebrile and symptoms are 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
- This applies to individuals whether thy 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
For health care workers
- For return to work, 2 negative tests are required, obtained at least 24 hours apart
- If critical for operations, health care workers may return to work 14 days after symptom onset while wearing appropriate PPE, and continuing use of appropriate PPE until 2 negative specimens at least 24 hours apart.
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.
Ontario Ministry of Health NEW Guidance and Directives:
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