COVID-19 resources for health care providers

Return to work for staff in highest-risk settings

Highest risk settings include:

• Hospitals and health care settings, including complex continuing care facilities and acute care facilities

• Congregate living settings (e.g., long-term care homes, retirement homes, First Nation elder care lodges, group homes, shelters, hospices, temporary foreign worker settings), and correctional institutions

• First Nations, Inuit, Métis communities

Work self-isolation and workplace exposure recommendations in highest-risk settings

• Employers may permit Essential Healthcare Workers that have been identified as close contacts to work self-isolate. Check with your occupational health staff or human resources for further guidance on returning to work.

• In exceptional circumstances where work would be severely compromised without additional staffing, an earlier return to work under work self-isolation may be considered for an asymptomatic health care worker who is self-isolating due to a high-risk exposure. Employers are to perform a risk assessment to determine the risk of having a worker work self-isolate and if a worker is critical to operations. Health care workers living with someone who is positive have the highest risk of acquiring COVID-19 and are not recommended to work-isolate.

The following measures must be followed for workers on work self-isolation. They must:

• Continuously test negative according to Testing Requirements for Work Self-Isolation
• Actively screen before each shift
• Be fully vaccinated
• Adhere to strict masking at all times
• Frequently wash hands
• Do not use breakrooms
• Not attend work if symptomatic
• Self-isolate when outside of the workplace

Framework for critical staffing prioritization

Return to work testing requirements for cases and contacts outlines the levels of risk options for contingency staffing with early return for close contacts and cases. For close contacts, use of rapid antigen testing options is preferred to options when testing is not available.

It is the organization's responsibility to implement this guidance to determine which staffing option to use during staffing shortages.

Return to work testing requirements for cases and contacts

The following workplace measures should be implemented for 10 days after last exposure for early return to work:

• Continuously test negative according to Testing Requirements for Work Self-Isolation
• Actively screen before each shift
• Ensuring well-fitting source control masking
• Frequently wash hands
• Avoid the use of breakrooms and shared spaces with other staff
• Not attend work if symptomatic
• Working in only one facility, where possible
• Self-isolate if criteria is not met for exemption from isolation

In health care settings where there is IPAC and occupational health oversight of return-to-work decision-making, COVID-19 positive staff meeting the criteria above may return to work and care for all patients, but every attempt should be made to avoid working with immunocompromised, elderly patients or patients who are unvaccinated.

 Resources

• Management of Cases and Contacts of COVID-19 in Ontario (version 15.2), March 27, 2023 (PDF) - Ontario Ministry of Health 

 Vaccination

• Toolkit for Health Care Providers - Public Health Agency of Canada

• Vaccines for COVID-19 - Public Health Agency of Canada

• COVID-19 Resources - canVAX

• COVID-19 Vaccines - Centre for Effective Practice (CEP) 

• Common questions about COVID-19 - Immunize Canada

• Reported side effects following COVID-19 vaccination in Canada - Public Health Agency of Canada

• Adverse event following immunization reporting for health care providers in Ontario - Public Health Ontario

• COVID-19 Vaccine-Relevant Information and Planning Resources - Ontario Ministry of Health 

• COVID-19 Vaccines - Public Health Ontario 

• Moderna COVID-19 Vaccine monograph

• Pfizer-BioNTech COVID-19 Vaccine monograph

Local epidemiology 

• Updates about the status of cases in KFL&A.

• Updates about the status of cases in Ontario is available on the Ministry of Health.

Screening, testing, and case management for patients

• Authorized medical devices for uses related to COVID-19 - Government of Canada

• COVID-19 Provincial Testing Guidance - Ontario Ministry of Health 

• COVID-19 Patient Screening Guidance Document - Ontario Ministry of Health

• National Case Definition: Coronavirus disease (COVID-19) - Government of Canada

• COVID-19 Reference Document for Symptoms - Ontario Ministry of Health

• Public Health Management of Cases and Contacts of COVID-19 in Ontario - Ontario Ministry of Health

• Testing Guidelines for COVID-19- Public Health Ontario

• COVID-19 Virus Test Requisition - Public Health Ontario

Guidance documents

• Coronavirus disease (COVID-19): guidance documents - Public Health Agency of Canada

• COVID-19 Guidance for the Health Sector - Ontario Ministry of Health

Screening and self-isolation for health care providers

• Health care workers self-isolation while at work - Public Health Ontario

Environmental Cleaning – Clinical setting

The Public Health Agency of Canada has developed the following guidance related to environmental cleaning of clinical settings during the ongoing COVID-19 outbreak. 

What to do:

Increase frequency of cleaning of high-touch surfaces to control the spread of microorganisms during a respiratory infection outbreak, such as COVID-19.

What to use:

Environmental cleaning products registered in Canada with a Drug Identification Number (DIN) and labelled as a ‘broad-spectrum virucide’ are sufficient to destroy SARS-CoV-2, the virus that causes COVID-19.

What to clean and when:

All surfaces, especially those that are horizontal and frequently touched, should be cleaned at least twice daily and when soiled.

Other considerations:

Follow your ‘terminal cleaning’ protocol for cleaning of a patient's room after discharge, transfer or discontinuation of contact and droplet precautions. See Appendix 6 in the Best Practices for Environmental Cleaning for Prevention and Control of Infections in All Health Care Settings, 3rd Edition for a sample ‘terminal cleaning’ procedure.

Ensure rooms have minimal equipment or supplies to help facilitate the environmental cleaning process.

Infection Prevention and Control (IPAC) measures for COVID-19

The Ontario Ministry of Health recommends Droplet and Contact Precautions in addition to Routine Practices for the routine care of any patient with suspected or confirmed COVID-19. All staff that are required to wear personal protective equipment need to be properly trained in donning and doffing. 

The Ontario Ministry of Health recommends that all patients be screened over the phone for symptoms of COVID-19 prior to their appointment. If in-person, a plexiglass barrier can protect staff from droplet and contact spread. It also recommends that signage is displayed requesting patients with symptoms wear a mask, perform hand hygiene upon entering the office, and practice cough etiquette. 

Specific IPAC measures include:

• Performing hand hygiene (i.e., using alcohol-based hand rub or washing hands with soap and water) before entering and after exiting the patient’s room, and after taking off and disposing of personal protective equipment.
• Instruct the patient that if they need to cough or sneeze, to do so into a tissue and clean their hands or cough into their sleeve.
• Instruct the patient to wear a surgical or procedure mask if tolerated.
• In the community office setting, patients with suspected or confirmed COVID-19 should be placed immediately in a separate room with the door closed.
• Conducting examination procedures that minimize contact with droplets or aerosols (i.e., sitting next to rather than in front of a coughing patient).
• Wearing appropriate Personal Protective Equipment (PPE) when caring for a patient with suspected or confirmed COVID-19:
• Wear eye protection (goggles or face shield).
• Wear gloves and gown.
• Wear a surgical or procedure mask.
• COVID-19 Guidance for the Health Sector - Ontario Ministry of Health and Long-Term Care - provides specific health care setting guidance for mask use. 
• Use Airborne Precautions when aerosol generating medical procedures (AGMPs) are planned or anticipated to be performed on patients with suspected or confirmed COVID-19.
• Universal Mask Use is recommended for all Long-Term Care Facilities in Ontario.
• View a instructional video on reusing masks. 
• More information on Aerosol Generating Medical Procedures (AGMPs) and specific Guidance for Acute Care - Ontario Ministry of Health
• Cleaning and disinfecting communal or shared equipment after use; pay attention to contact time on the label.
• KFL&A Public Health recommends that health care providers become familiar with PIDAC’s "PIDAC Best Practices for Prevention, Surveillance and Infection Control Management of Novel Respiratory Infections in All Health Care Settings".
  
  • Section 3.2 “Personal Protection Equipment and Practices” describes specific infection prevention and control (IPAC) measures for health care providers at risk of direct exposure to patients with suspect or confirmed infection with a novel respiratory agent.
• Testing for COVID-19 must be conducted in accordance with provincial guidelines. - Ontario Ministry of Health

General resources and information for health care providers

• Interim Infection Prevention and Control Measures Based on Respiratory Virus Transmission Risk in Health Care Settings - Public Health Ontario
• Online IPAC courses - Public Health Ontario
• Orders, Directives, Memorandums, and other resources - Ontario Ministry of Health
• Coronavirus COVID-19 Global Cases Map -Johns Hopkins
• Post-acute COVID-19 syndrome in adults - Public Health Ontario

 Signage for health care settings

• Patient Signage - Ontario Health (English)
• Visitor Signage - Ontario Health (English)

Patient information sheets

• Infographic on Managing Stress, Anxiety and Substance Use during COVID-19 - Canadian Centre on Substance Abuse
• COVID-19 awareness factsheets - Government of Canada
• Multilingual information sheets (e.g., How to self-monitor, how to self-isolate, and self-isolation: guide for caregivers, household members, and close contacts) - Public Health Ontario
• COVID-19 Information for the public - Ministry of Health