COVID-19 Updates

What exactly is COVID-19?

COVID-19 is the name given by the World Health Organization (WHO) on February 11, 2020  for the disease caused by the novel coronavirus SARS-CoV-2. It started in Wuhan, China in late 2019 and has since spread worldwide. 

Viruses and the diseases they cause have different names: COVID-19 is an acronym, which stands for coronavirus disease of 2019.

It was later renamed “severe acute respiratory syndrome coronavirus 2,” or SARS-CoV-2 by the International Committee on Taxonomy of Viruses on February 11, 2020. It was named SARS-CoV-2 because the virus is a genetic cousin of the coronavirus which caused the SARS outbreak in 2002 (SARS-CoV). 

The unofficial name for the virus is “the COVID-19 virus.”

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(Source: GoodRX)

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How Ontario is responding to COVID-19

Learn about coronavirus (COVID-19) cases in Ontario and how the province is keeping people safe via The Government of Ontario’s official website.

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Need Guidance?

Ontario’s Ministry of Health and Ministry of Long Term Care webpage lists Guidance for the Health Care Sector which advises what protocols to follow when dealing with each sector.

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For Ministry of Health COVID-19 Guidance: Home and Community Care Providers:

Screening

1. The latest case definition for screening is available on the MOH COVID-19 website. 

2. All clients should be screened by the appropriate staff member by phone before

appointments are scheduled (e.g., by personal support workers, schedulers,

managers, etc.) using the latest case definition for COVID-19.

3. Staff should also ask about any other person who will be in the home during the

appointment (e.g., visitor or family member) and where appropriate, screen this

person too. 

Positive Screening: What to do

4. If either the patient or other person in the home screens positive, staff should call

the local public health unit to discuss the most appropriate setting for clinical

assessment. 

“If the care provider is not a practitioner with a duty to report diseases of

public health significance to local public health, they should follow their

organization’s relevant policies and procedures, or contact their supervisor

or Medical Director for guidance.”

5. If individuals are referred to hospital (e.g. emergency department) for testing, the

staff member and/or agency should coordinate with the hospital, local public

health unit, paramedic services, and the patient, to make safe arrangements for

travel to the hospital that maintains isolation of the patient. All referrals to

hospital should be made to a triage nurse.

6. If a patient is very ill and requires acute care, the staff person should call an

ambulance and let the paramedic call-takers know that the client is symptomatic

for COVID-19 virus (It is standard that all PSWs can take this action, but it still requires communication to your immediate supervisor/manager to advise it is, or has been, done. As an example: when you arrive to find your client is unresponsive, incapacitated, incoherent or has fallen, you would call paramedics).

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For Ministry of Health COVID-19 Guidance: Long-Term Care Homes:

Passive Screening

• Signage should be visible and remind all persons in the LTCH to perform hand hygiene and follow respiratory etiquette.

• Signage should indicate signs and symptoms of COVID-19 and steps that must

be taken if COVID-19 is suspected or confirmed in a staff member or a resident. A

list of COVID-19 symptoms, including atypical symptoms, can be found in the

COVID-19 Provincial Testing Guidance Update document.

Active Screening for Staff, Visitors, and those Entering the LTCH

• LTCHs should instruct all staff to self-monitor for COVID-19 at home. All persons

should be made aware of signs and symptoms of COVID-19 infection, as listed in

the COVID-19 Provincial Testing Guidance Update document.

• LTCHs must conduct active screening for COVID-19 symptoms of all staff,

essential visitors, and anyone else entering the home. Screening must include

twice daily (at the beginning and end of the day or shift) symptom screening,

including temperature checks. This excludes emergency first responders who

should, in emergency situations, be permitted entry without screening.

• Essential visitors include a person performing essential support services (e.g.,

food delivery, maintenance, family providing care services, and other health

care) or a person visiting a very ill or palliative resident. If an essential visitor is

admitted to the home, precautions must be taken as outlined in Directive #3 for

Long-Term Care Homes under the Long-Term Care Homes Act, 2007.

• LTCHs should have a screener at the entrance who is able to conduct screening

during business hours and change of shift. Outside of these times, the home’s

charge nurse/administrator should develop processes and procedures to ensure

that all persons entering the home are screened and visits are logged. These

procedures are to be applied seven days a week and 24 hours a day. A detailed

sample of the COVID-19 screening checklist is available on the MOH COVID-19 website.

Active Screening for Current Residents

• LTCHs should conduct active screening of all residents, at least twice daily (at

the beginning and end of the day) to identify if any resident has symptoms of

COVID-19, including temperature checks. Residents with symptoms (including

mild respiratory symptoms or atypical symptoms) must be isolated and tested

for COVID-19. For a list of typical and atypical symptoms, please refer to the

COVID-19 Provincial testing Guidance Update.

Positive Screening: What to do 

• Anyone showing symptoms of COVID-19 should not be allowed to enter the LTCH and should go home immediately to self-isolate. 

• Residents with symptoms of COVID-19 must be isolated in droplet and contact precautions and tested. 

• Staff should provide care to residents with suspect or confirmed COVID-19 using the precautions outlined in Directive #1 for Health Care Providers and Health Care Entities, as well as Public Health Ontario’s Technical Brief on IPAC Recommendations for Use of Personal Protective Equipment for Care of Individuals with Suspect or Confirmed COVID-19.

Reporting of Positive Screening

• COVID-19 is a designated disease of public health significance (O. Reg. 135/18)

and thus reportable under the Health Protection and Promotion Act.

• The LTCH should contact their local public health unit to report a staff member

or resident suspected to have COVID-19. The local public health unit will provide

specific advice on what control measures should be implemented to prevent

further spread and how to monitor for other possible infected residents and staff

members. LTCHs must also follow the critical incident reporting requirements in

section 107 of O. Reg 79/10 under the Long-Term Care Homes Act. 

• All referrals to hospital should be made through emergency department triage. If

a resident is referred to a hospital, the LTCH should coordinate with the hospital,

local public health unit, paramedic services, and the resident to ensure safe

travel that maintains the resident in appropriate isolation precautions. Patient

transfer services should not be used to transfer a resident with suspect or

confirmed COVID-19.

PLEASE NOTE:

*Please understand if you are a PSW, this means:

• You are to ensure you do the appropriate screening as laid out by your employer's policy if asked, and when needed

• Check the care plan before you go to a new/unfamiliar client wherever possible

• If you are unable to check the care plan before you visit a new/unfamiliar client, communicate with your immediate supervisor/scheduler before visiting with your client to see if there has been a screening done prior to your visit

• DO NOT DIAGNOSE and DO NOT ASSUME

• Most importantly: if you suspect a client has the active virus, DO NOT take it upon yourself to call public health. This could be deemed a breach of privacy under PHIPA (Personal Health Information Protection Act) 

• Instead, speak to your immediate supervisor/manager in a live call and have them take appropriate action, as sharing personal health information to anyone outside of the immediate care team without consent can have consequences.There is Provincial legislation specifically regarding the privacy of Personal Health Information (PHI): consent requirements are highly specific in Ontario. 

• Make sure to read communications from your employer as it may contain the latest information you might need to know immediately.

• When in doubt, always speak to your direct supervisor or management team as they will often have the most recent and up to date information first.

Personal Health Information (PHI) in Ontario

In Ontario, personal information includes any and all information related to the provision of health care for an individual's physical or mental health. This includes:

• family history

• personal identification information

• plans of service

• payment information

• eligibility for health care

• information regarding body parts or substances

• health numbers

PHI also includes any other information not specifically listed that can identify the individual or a substitute decision maker who acts on the individual’s behalf.

PHIPA has been deemed “Substantially Similar” to federal privacy law (Personal Information Protection and Electronic Document Act (PIPEDA)) 

PHIPA Ontario, therefore, can in most cases, be used in place of Canada’s federal law where health records are concerned. The law applies to all “health information custodians,” including allied health clinics delivering health care services and practitioners who provide healthcare for payment, regardless of whether the services are publicly funded or not.

While we do our best to bring you the most current and accurate information, it can be challenging as the information changes quickly. If you  notice an irregularity, please bring it to our attention so we can correct it as quickly as possible.

Sources:

Good RX - https://www.goodrx.com/blog/what-does-covid-19-mean-who-named-it/

World Health Organization (WHO) - https://www.who.int/

International Committee on Taxonomy of Viruses - https://talk.ictvonline.org/

Government of Ontario - https://www.ontario.ca/page/how-ontario-is-responding-covid-19

Ministry of Health - http://www.health.gov.on.ca/

Ministry of Long Term Care - http://www.health.gov.on.ca/

Public Health - https://www.publichealthontario.ca/en/diseases-and-conditions/infectious-diseases/respiratory-diseases/novel-coronavirus/public-resources