COVID-19 Symptoms and Management

Last update: April 25, 2022

Signs and symptoms

COVID-19 can cause illness ranging from a very mild, cold-like illness to a severe lung infection, including atypical presentations especially in older persons, children and people living with a developmental disability. It is important to note that people with COVID-19 can be asymptomatic while infected and transmission can still occur during their infectious period.

Please refer to the Ministry of Heath’s COVID-19 Reference Document for Symptoms (PDF) for the most up to date COVID-19 symptoms.

With ongoing community spread in Ottawa, please consider COVID-19 as a potential diagnosis for all patients presenting with symptoms of acute respiratory infection, regardless of their travel or contact history.

Requests for medical notes

OPH recommends that healthcare providers do not provide notes or statements attesting to a clinical assessment that COVID-19 has been “ruled out” as a cause of symptoms. OPH recommends instead that healthcare providers support the patient/parent/guardian to make appropriate declarations when completing their school or workplace screening self-assessment questionnaire (see screening tools below).

Case and contact management in highest risk settings

Please refer to current guidance on the management of cases and contacts in highest risk settings as it may differ from the public health advice for community settings provided below. Additional sector specific guidance, such as for long term care facilities are available.

COVID-19 testing and Assessment Centres

These centres will perform COVID-19 testing for those who are eligible. Some of these centres also offer in-person clinical assessment of acute symptoms by a nurse or physician and treatment when indicated. Details on how to access a COVID-19 testing and assessment centre are available on our public facing testing page as well as on the website of the Ottawa Testing Taskforce.

Isolation requirements for COVID-19 cases in Ottawa

Isolation of cases is the mainstay of case management to break chains of transmission in our community and prevent more people from becoming ill.

Physicians and NPs can help decrease COVID-19 transmission in our community by reinforcing messaging around isolation requirements and appropriate testing. Please see the OPH Information for those who have symptoms, test positive for COVID-19 and high-risk contacts webpage for detailed information.

Symptomatic individuals who have not completed testing (RAT or PCR)

Any person (regardless of vaccination status) presenting with at least one sign or symptom (PDF) must self-isolate according to current testing guidance (PDF).
The following screening tools are available to help the public identify when they need to self-isolate:

Individuals testing positive (RAT or PCR)

Any individual with a positive COVID-19 test (RAT or PCR) should isolate immediately, regardless of symptoms.
The isolation period starts on the day of specimen collection or symptom onset, whichever is earlier.
The isolation period depends on relevant clinical factors. In all cases, individuals must be afebrile and have 24 hours of improving symptoms (or 48 for gastrointestinal symptoms) prior to ending self-isolation.
Durations of self-isolation are provided in current provincial guidance (PDF) and summarized on the OPH Information for those who have symptoms, test positive for COVID-19 and high-risk contacts webpage.

Symptomatic individuals who test negative

If the individual is symptomatic and tests negative on RAT:
- A single negative RAT does not rule out COVID-19
  - Two consecutive negative RATs, separated by 24-48 hours, means COVID-19 infection is less likely. The individual should still self-isolate until they are afebrile and symptoms have improved for 24 hours (or 48 hours for gastrointestinal symptoms). Asymptomatic family members can discontinue self-isolation.
If the individual is symptomatic and tests negative on PCR:

The individual may discontinue isolation once they are afebrile and symptoms have improved for 24 hours (or 48 hours for gastrointestinal symptoms). Asymptomatic family members can discontinue self-isolation.

Any individual isolating because they are a high-risk contact of COVID-19 must finish their isolation period, regardless of a negative RAT or PCR test result

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Notification and management of high-risk contacts

Please note that the information in this section may continue to evolve with changes in epidemiology of COVID-19 and potential updates to provincial guidance for case and contact management.

Household contacts of COVID-19 positive / symptomatic individuals have different isolation requirements according to their age and vaccination status. Household members who satisfy one of the following three criteria are not required to self-isolate:

Those who are aged 18 years or older and have received a booster dose are not required to self-isolate
Those who are under 18 years and are fully vaccinated are not required to self-isolate
Those who have previously tested positive for COVID-19 in the past 90 days are not required to self-isolate

Household contacts who do not satisfy one of the above criteria are required to self-isolate according to current guidance (PDF) which is summarized on the OPH Information for those who have symptoms, test positive for COVID-19 and high-risk contacts webpage.

Non-household contacts COVID-19 positive / symptomatic individuals should inform their non-household contacts of their exposure and provide them with the link to Ontario.ca/exposed and the OPH Information for those who have symptoms, test positive for COVID-19 and high-risk contacts webpage. Non-household contacts are not required to self-isolate.

Close contacts (household and non-household) who are not required to self-isolate must follow public health measures including self-monitoring for symptoms and wearing a well fitted mask in all public settings. Additional public health advice is found on the OPH Information for those who have symptoms, test positive for COVID-19 and high-risk contacts webpage.

For the latest information on guidance changes, please see the most recent Public Health Alert.

For more information please see the Ministry of Health’s COVID-19 Case, Contact and Outbreak Management Interim Guidance: Omicron Surge (pdf).

Supports for patients required to isolate

The following supports are available through the City of Ottawa or Ottawa Public Health:

Ottawa Voluntary Isolation centre
- Ottawa has opened a Voluntary Isolation Centre (VIC) for people who do not have access to an adequate shelter or cannot self-isolate safely in their own homes. There are no costs associated to stay at the Centre.
Financial and social support during the pandemic | City of Ottawa
- Includes information and links for supports related to child care, financial assistance, housing services, seniors supports, and other supports such as food banks, grocery / meal services.
Mental Health, Substance Use and COVID-19 - Ottawa Public Health
- Provides information and resources related to mental health and substance use services, mental health resources for diverse communities, mental health resources for workplaces, and how individuals can protect their mental health during the pandemic and during winter months.
Housing services | City of Ottawa
- Contains information on services available in Ottawa such as the isolation centre for single homeless people, physical distancing centres for men and women, and respite centres with showers / washrooms.

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Pharmaceutical Therapies

Please note that OPH does not coordinate access to pharmaceutical treatments for individuals with COVID-19. Provincially, pharmacotherapies are coordinated through Ontario Health. The Ottawa Hospital (TOH) is responsible for local coordination.

COVID-19 antiviral/paxlovid resources and information for both physicians and patients can be accessed through:

- Ministry of Health patient eligibility and where to get treatment: COVID-19 antiviral treatment | COVID-19 (coronavirus) in Ontario
- Ontario Health guidance on Paxlovid for health care providers: Guidance for health care providers : Access to COVID-19 antiviral treatment (Paxlovid)
- Ontario Health factsheet on Paxlovid for patients: Patient handout – Antiviral treatment (Paxlovid)

Questions can be directed to the TOH clinic:

covidtherapeutics@toh.ca
613-737-8899 ext 19507

Role of Ottawa Public Health

Using the Health Protection and Promotion Act, S.O. 2007, Ottawa Public Health (OPH) takes actions to protect the public and prevent the spread of COVID-19 in our community.
We collaborate with provincial and national public health partners, as well as local hospitals and community agencies, to assess the risk level in our community. We lead case investigation and management as well as contact tracing, and as such anyone who tests positive for COVID-19 and their identified high-risk contacts fall under OPH’s jurisdiction. We also work with partners to coordinate the response to outbreaks and make recommendations based on the local situation.
Ottawa Public Health focuses on the health of the population as a whole. As such, all of our work is guided by public health ethics. The Ethical Framework for pandemic response that was developed by the Public Health Ethics working group to support Ottawa Public Health during the COVID-19 pandemic is available for download: The Ethical Framework for pandemic response (PDF - 437 KB).
All people who have tested COVID-19 positive are reportable to local public health under the Health Protection and Promotion Act.
- Note: Given the evolving epidemiology of COVID-19 in our community, physicians and health care professionals are no longer required to notify OPH of symptomatic patients suspected of having COVID-19 at this time. We have removed the Online COVID-19 Reporting Tool from our website.
- All COVID positive PCR lab results are shared with OPH by our lab partners and followed up as appropriate.
- Positive RAT results are not reportable to public health. If you have any questions, please contact the Ottawa Public Health COVID-19 phone line at 613-580-6744.
- All deaths related to COVID-19 and cases of MIS-C are reportable to OPH. Please see the ‘Testing, Results, and Reporting of COVID-19’ for more details

<Back to the Information on COVID-19 for Physician's and Health Care Professionals webpage

o All deaths related to COVID-19 and cases of MIS-C are reportable to OPH. Please see the ‘Testing, Results, and Reporting of COVID-19’ for more details

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COVID-19 Symptoms and Management

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