Frequently asked questions

Last revised on August 24, 2020

Questions and answers about COVID-19 can be found on the Government of Canada's COVID-19 webpage. Questions about:

Learn more about Long-Term Care Homes (LTCH) and Retirement Homes (RH)

Questions from the Ottawa community

1. How is the 2019 Novel Coronavirus (COVID-19) diagnosed? 

It is diagnosed by a healthcare provider based on travel history, symptoms, and laboratory tests. If you would like to be diagnosed, please visit our COVID-19 testing criteria page.

In order to decrease transmission of COVID-19 in Ottawa,  it is IMPERATIVE that all residents of Ottawa practice physical distancing

If you think you have COVID-19 symptoms or have been in close contact with someone who has it, use the Ontario Government self-assessment tool to help determine how to seek further care.

2. If I was tested, how long does it take to get results?

It usually takes approximately 24 hours to a few days to receive test results for COVID-19. Please continue to self-isolate while awaiting test results.

On April 3, 2020, the Ontario Government launched a new online portal to access COVID-19 test results. This portal will offer fast and secure access to test results on your computer and mobile device. You can find the tool by visiting Government of Ontario’s new user-friendly online portal.

Please continue to self-isolate while awaiting test results. 

3. What can members of the public (including schools and workplaces) do to protect themselves?
The best way to prevent infection is to avoid being exposed to this virus. In general, everyday preventive actions can help prevent the spread of respiratory viruses, including:
  • Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Avoid close contact with people who are sick.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces.
  • If you have fever, cough and difficulty breathing, seek medical care early and share your recent travel history with your health care provider
  • Practice physical distancing to protect yourself and to limit transmission in the community
4. Are there any confirmed cases in Ontario? 

Yes. Public Health Units are reaching out to known contacts to inform them that they may have been exposed to a potential health risk, what signs and symptoms they should look out for, and when and what type of medical treatment should be sought out if that becomes necessary. 

Every day at 10:30 a.m. and 5:30 p.m.  ET the Province of Ontario's novel coronavirus (COVID-19) web page will be updated with the most up-to-date information including the status of cases in Ontario.

5. What is Ottawa Public Health doing in response to this situation?

Ottawa Public Health continues to actively monitor this situation in collaboration with our provincial and national health colleagues, and stakeholders that include local hospitals and community agencies.

Cases and potential suspect cases of the 2019 Novel Coronavirus (COVID-19) are now reportable to local health authorities under the Health Protection and Promotion Act.

If there were potential cases of which we have been notified, we would immediately follow up directly with these individuals to let them know.

We would inform these people that they may have been exposed to a potential health risk, what signs and symptoms they should look out for, and when and what type of medical treatment should be sought out, if that becomes necessary. This work is part of routine public health follow-up of a case of an infectious disease.

6. What are Canadian public health officials doing in response to this situation?

The Public Health Agency of Canada (PHAC) is actively monitoring the 2019 novel coronavirus situation. They are in close contact with the World Health Organization to assess any potential risk to Canadians.

The Government of Canada, provinces and territories have multiple systems in place to identify, prevent and control the spread of serious infectious diseases into and within Canada.

7. When will I need to self-isolate/stay at home?

You must self-isolate if you:

For ALL Ottawa residents who are not currently self-isolating:

  • Practice physical distancing
    • Stay home as much as possible. Only leave your property for essential travel such as grocery shopping or visiting a pharmacy
    • Stay at least 2 metres (6 feet) away from people outside of your household
  • Wash your hands with soap and water thoroughly and often
  • Do not touch your face with unwashed hands
  • Clean phones, other devices and frequently touched surfaces regularly
8. How can I care for myself or my family members with Covid-19?

Currently, there is no specific antiviral treatment for mild cases of Coronavirus Disease 2019, Novel Coronavirus (COVID-19). However, many of the symptoms can be treated, and therefore treatment is based on the patient’s clinical condition.  If symptoms feel worse than a standard cold, seasonal allergies, or are lasting longer than usual, follow the guidelines provided by Ottawa Public Health. However, most people with COVID-19 will recover on their own. 

You or your family member will want to:

  • Drink plenty of fluids.
  • Get rest and sleep as much as possible.
  • Use fever reducing medications according to the label and in consultation with your health-care provider or pharmacist.
  • Try a humidifier or hot shower to help with a sore throat or cough.
  • Have all family members practice good hand hygiene and maintain at least two metre distancing where possible.
  • Use a solution of 20 mL of bleach with 1 litre of water (or 4 tsp of bleach with 4 cups of water) to disinfect surfaces that are touched often including but not limited to counters and doorknobs.

It is important to get the best information for your family. If you, or your family members test positive for COVID-19, you will be asked to self-monitor, or self-isolate. You can find more information on self-isolation for caregivers and household members in this handout from Public Health Ontario.  

If you need immediate medical attention, call 9-1-1, and mention your symptoms, whether you have been tested, and any travel history.

9. Is there a possibility that a person who gets the virus once can get it again?

People who have recovered from COVID-19 infection have antibodies to fight future COVID-19 infections but it is not yet known how long this immunity will last. There is no evidence of people being re-infected with COVID-19 at this time. But the coronavirus that causes COVID-19 illness (the virus itself is called SARS-CoV-2) has only been known for a short period of time and more evidence will come to light in the coming weeks and months. 

We encourage all residents to continue following public health recommendations to limit the spread of transmission: practice physical distancing, wash hands frequently, never touch eyes, nose or mouth with unwashed hands, and wear a mask when physical distancing is not possible.  We need to continue to consider that any individual we encounter may be at risk for infection

Past evidence about the duration of immunity to the four other human coronaviruses (excluding SARS-CoV-1—the virus which caused SARS in 2003—and SARS-CoV-2) has recently been reviewed by researchers. It is possible that immunity to these viruses may not last that long (reinfection may be possible after a year, perhaps as early as within 6 to 12 months). This information is not about SARS-CoV-2, which may behave differently. We are continually monitoring updated evidence and guidance and how it applies to COVID-19. 

The new serology tests that look for antibodies against the COVID-19 virus target a variety of antibodies in people who have been infected with COVID-19. Some antibodies are “neutralizing antibodies” which are effective in killing the virus while others are less effective but are still good indicators for showing that the person has been infected. Serologic testing therefore does not necessarily identify that the person would be immune to future infections.

People who recovered from SARS infection acquired in the 2003 epidemic (an infection caused by SARS-CoV-1, a similar virus to the COVID-19 virus) had protective antibodies reported in studies that took place as long as 2 years after their infection.  

10. Should I get re-tested once I have recovered from COVID-19?

Ottawa Public Health and the Province of Ontario do not recommend using a negative test to show recovery from COVID-19. Research on COVID-19 and local experience has found that many individuals who have had COVID-19 continue to shed dead non-infectious virus or virus pieces for weeks to months following infection. This viral shedding can result in a positive test. Instead, it is recommended to use a non-test based approach where an individual’s COVID-19 infection is considered “cleared” when all of the following criteria are met:

  1. The individual has completed 14 days of isolation from when their symptoms began OR when they received a positive test result (if they never had symptoms of COVID-19)
  2. The individual has not had a fever for 72 hours
  3. The individual’s symptoms have been improving for at least 72 hours

Provincial Guidance is available to provide individuals with further details regarding the required amount of self-isolation and recovery time based on COVID-19 test results.

Once an individual has been cleared from isolation, they are safe to return to regular activities, such as going to work, grocery shopping, or going to other public spaces. Being re-tested after finishing isolation is not required or recommended because a positive result at that time is just a sign that you had previously been sick. Although not routinely recommended, re-testing may be used in health care settings in specific circumstances related to return to work of infected health care workers or in patients admitted to hospital.

11. Am I at risk for contracting COVID-19 if I receive a package or products by mail?

While COVID-19 can survive on some surfaces for varying lengths of time, transmission through contact with contaminated surfaces (for example where individuals touch a contaminated surface and then touch their own nose, eyes or mouth without first washing their hands) is not thought to be a major contributor to the spread of COVID-19, particularly in comparison to spread through inhalation of respiratory droplets from an infected person. People delivering and receiving packages should perform proper hand hygiene (washing hands with soap and water for at least 15 seconds or using alcohol-based hand sanitizer) regularly and always before touching their own faces (particularly mouth, nose or eyes, or face mask). Consistently performing proper hand hygiene after handling any items means that no waiting period is required for handling donated food items, mail or packages. 

12. As an employer, what do I need to do to prevent the novel coronavirus (COVID-19)?

Visit our webpage about COVID-19 information for workplaces which provides many recommendations.

13. Should healthcare workers who have travelled outside of Canada go back to work upon their return? 

The Federal Quarantine Act requires any person entering Canada by air, sea or land to self-isolate for 14 days whether or not they have symptoms of COVID-19. Leaving your property to go for a walk is not permitted under the Quarantine Order, issued on March 25, 2020.

Employers/healthcare institutions may implement requirements for their staff beyond what is being recommended for returning travellers.  

14. How do I pick up a returning traveller from an affected area from the airport? Are there precautions I should take? 

If a returned traveller has no symptoms and is well, it is best they use a private car. If a private car is not available, the person can take public transportation, but must not make any unnecessary stops on their way home, and must practice physical distancing at all times. The person can take a ride-share, but must not make any unnecessary stops on their way home. The person should sit in the back-seat passenger side, keep the windows open, and practice physical distancing at all times.

All returning travelers should wear a mask (if available) when they are picked up from the airport.

All returning travellers with symptoms or who appear ill should report these while going through customs in the airport. They must go to their place of isolation using private transportation only, such as a personal vehicle. Please refer to the Government of Canada website for more information.

15. Am I at risk for contracting COVID-19 by walking past someone? 

Make an effort to step-aside, or pass others quickly and courteously on sidewalks. Passing someone on the sidewalk is not considered close contact or a significant risk for exposure to COVID-19.

16. Which businesses are allowed to open? 

As of June 12, 2020 the Government of Ontario has enabled certain regions (including Ottawa) to enter Phase 2 of the Framework for Re-opening our Province. It is important to remember that those businesses and services that are permitted to reopen must do so with proper health and safety measures in place. For more information on which businesses are allowed to open during this phase, please visit the Government of Ontario website. 

17. How do I handle waste products at home? 

During COVID-19, Ottawa’s Green Bin program is accepting plastic bags as a bagging option for organic waste. Used paper facial tissues should be placed in plastic bags and can go in the green bin as per regular waste disposal practices.

Residents should continue to practice proper hygiene when handling any waste by thoroughly cleaning their hands with soap and water for at least 20 seconds or using hand sanitizer if soap and water are unavailable. Clean any surfaces that may have come in contact with waste products with a household disinfectant. You can use 20 mL of bleach with 1 litre of water (or 4 tsp of bleach with 4 cups of water) as an easy disinfectant.

City staff and contractors continue to use the precautions that are already in place to protect workers from the hazards of handling municipal waste. In addition, the City is taking steps to ensure a steady supply of personal protective equipment for front-line staff. Ottawa Public Health manages the disposal of hazardous waste and has protocols in place to ensure its safe handling. 

18. Who can returning travellers call if they need mental health supports in Ottawa?

Returning home can be stressful and it may take time before you feel better and life returns to normal. Give yourself time to heal. It's OK to NOT be Ok. Please know that help is available and we encourage you to reach out to Distress Centre of Ottawa to connect with someone at 613-238-3311.

19. What can I do about religious celebrations and invitations? 

Learn more on the Province of Ontario's Framework for Reopening our Province: Stage 2 

Ottawa Public Health continues to advise that limiting activities to members of your own household remains important to limit the spread of COVID-19 and save lives. Physical distancing of at least two (2) metres from non-household members should be maintained.

We MUST all practice physical distancing and keep 2 metres or 6 feet away from others when we are out. This is very important so we can stop the spread of COVID-19.  

During times of the year when celebrations are happening: 

  • limit gatherings with others in person to celebrate 
  • use technology to connect with others 
  • spend more time with your own family who live with you 
  • create new traditions at home, cook your favourite food together, decorate together, play games together for example.  

Being apart from family and friends can be very difficult for all of us. It's normal for situations like COVID-19 to affect your mental health. Everyone experiences these events in their own way. It is completely normal to feel stress and concern during these times and so it is important to practice positive coping strategies. 

Below is a listing of Mental Health Resources available to you. 

If you are in crisis, please contact the Mental Health Crisis Line (24 hours a day/7 day a week) at 613-722-6914 or if outside Ottawa toll-free at 1-866-996-0991. 

If you (or your child) are experiencing thoughts of suicide or harming yourself, please call 9-1-1. 

For more support and help, visit our mental health webpage

20. What precautions should I take when handling my groceries to limit the possible transmission of germs/viruses?

COVID-19 is a type of coronavirus. Although there are still things we are learning about COVID-19, we do know that other coronaviruses do not survive very long on surfaces like cereal boxes or canned foods. Coronaviruses are usually spread through respiratory droplets (for example when someone coughs or sneezes). There is currently no evidence that people have become infected with COVID-19 through items bought at a grocery store. Still, it might be possible that the item you handled or bought was recently touched by someone who had COVID-19 on their unwashed hands. The best way to protect yourself is by washing your hands often with soap and water, including after handling your groceries. Use alcohol-based hand sanitizer if soap and water are not available. Washing fruits and vegetables thoroughly under running tap water is recommended as per normal when preparing foods. Always wash your hands with soap and water before washing fruits and veggies and between handling different kinds of foods. Visit Ottawa Public Health’s Keeping foods safe (clean, cook, chill, separate) for more information.

21. Alcohol and COVID 19: Know the Facts

According to a new Nanos poll commissioned by the Canadian Centre on Substance Use and Addiction (CCSA), Canadians under 54 are drinking more while at home due to COVID 19. The main reasons for the increase among those who report drinking more are a lack of regular schedule (51%), boredom (49%) and stress (44%).

General myths about alcohol and COVID 19

Myth: Drinking alcohol kills the virus that causes COVID 19.

Fact: Drinking alcohol will not disinfect your mouth and throat and will not protect you from COVID 19 or prevent you from being infected by it.

 

Myth: Alcohol (beer, wine, distilled spirits or herbal alcohol) makes the immune system stronger and makes you more resistant to COVID 19.

Fact: Alcohol can in fact weaken your immune system and make you more susceptible to COVID 19 and other illnesses.

 

Myth: Drinking alcohol helps you to cope with stress.

Fact: Alcohol is known to increase the symptoms of panic and anxiety disorders, depression and other mental disorders, and the risk of family and domestic violence.

Remember drinking alcohol will not protect you from COVID 19. For more information visit the PAHO/WHO website

If you choose to drink, drink responsibly and follow Canada's Low Risk Alcohol Drinking Guidelines to reduce short and long-term risks. 

For more information on alcohol and local resources visit the OPH web site.

22. Should I be wearing gloves in public?

  • Wearing gloves for everyday activities in public is not recommended.
  • Wearing gloves can make you feel more protected from the virus than you are. Wearing gloves increase the risk of getting COVID-19 if you touch other things with your gloves and then touch your face. 
23. Ottawa Public Health recommends against wearing gloves. How do I use them correctly if I decide not to follow this advice?
  1. Wash your hands properly with soap and water or use an alcohol-based hand sanitizer before you put on gloves.
  2. When you are wearing gloves, do not touch your face or use any personal items (e.g. cell phone, bag) that you might touch again when you do not have gloves on.
  3. Throw the gloves out in a closed garbage bin right away and wash your hands with soap and water or use an alcohol-based hand sanitizer.
    • Remember:
      • Do not touch your face with your gloves.
      • Do not touch your mask with your gloves (if you are wearing one).
      • Do not touch your personal items (like your phone) with your gloves so you don’t bring the virus home with you!
      • Do not re-use gloves that are made for one use.

24. Is there a vaccine being developed for COVID-19?

Yes. Currently, there is no vaccine available for the prevention of COVID-19. Health Canada is closely tracking all potential treatments and vaccines in development in Canada and abroad.

25. Pool/Hot Tub Sharing

If you are planning to allow people outside of your household to use your pool and/or hot tub when it is not in use by you and your household members, keep the following in mind: 
  • Pools/hot tubs that are properly operated, maintained, and disinfected should remove or inactivate the virus that causes COVID-19
  • Risk of transmission of COVID-19 still exists if you are in close proximity with members outside of your household. Learn more on the Province of Ontario's Framework for Reopening our Province: Stage 2  
  • Commonly touched surfaces and items such as chairs, outdoor tables, play equipment, inflatable water toys, and pool/hot tub cleaning equipment may become contaminated when used by others

 Resource: COVID-19 and Water

26. Why am I still testing positive for COVID-19 after 14 days of isolation? Am I still contagious?

Even after a person has recovered from infection with COVID-19, they can still test positive for the virus. In these cases, the test is detecting viral remnants that are no longer living and unable to cause infection. Continuing to test positive after recovery from COVID-19 infection is actually quite common with some studies showing that half of people who have had COVID-19 will still test positive at 2 to 4 weeks after their initial test. Some people have continued to receive positive tests for 2 months after recovery, and some people have received a negative test only to be followed by another positive test. For these reasons, Ottawa Public Health and the Province of Ontario do not recommend the routine use of a negative test to show recovery from COVID-19. Instead, if the person has not had a fever for 72 hours and symptoms are improving, then 14 days after symptoms started the person is considered recovered and no longer contagious to others.  For the same reasons, repeat testing for COVID-19 is not recommended in the 3 months following initial COVID-19 infection in people without symptoms (e.g. as part of surveillance testing).

27. After testing positive for COVID-19, do I need a negative test to be able to resume regular activities, such as work and going out in public?

Provincial Guidance is available to inform individuals of the required amount of self-isolation and recovery time based on COVID-19 test results. An individual’s COVID-19 infection is considered “cleared” after 14 days of isolation provided that for at least 72 hours the individual no longer has a fever and symptoms are improving. Once an individual has been cleared from isolation, they are safe to return to work and regular activities, such as grocery shopping. A test after finishing isolation is not required or recommended because a positive result at that time is just a sign that they had previously been sick.
28. What is new with stage 3 reopening?

While maintaining physical distancing, you can now:

  • eat in at restaurants
  • use playgrounds
  • play non-contact team sports
  • gather in groups (up to 50 people indoors and up to 100 people outdoors)
  • go to a movie  

These activities are considered to be higher risk for the spread of COVID-19.  

You should consider your risk when choosing your activities. You should also think about the health of every person in your social circle. If anyone in your circle is at higher risk from COVID-19, everyone in the circle should choose lower risk activities to keep them safe. Everyone needs to consider their own risk factors when making decisions. Let’s all be COVIDWise!  

29. What precautions should I take with an indoor wedding or reception?

The number of people that can gather in groups has increased to 50 people indoors and up to 100 people outdoors. These activities are considered to be higher risk for the spread of COVID-19.  You should consider your risk and the health of those in your social circle when choosing your activities. 

Here are some precautions to take:

  • Masks must be worn by patrons except when eating or drinking.  
  • If necessary, masks can be removed for such thing as:
    • making a speech
    • saying vows
    • performing a first dance (if on a stage that is not accessed by the public)
    • walking down the aisle while physical distancing is maintained.  
  • Masks may also be taken off for pictures as long as the pictures are not being taken in an indoor public space. Physical distancing needs to be kept between any individuals who are not part of the same social circle. 
  • OPH recommends against singing and loud speeches in indoor settings.  If you choose to sing or have loud speeches, you need to make sure you are meeting provincial regulations. In this situation, OPH also recommends taking an additional precaution. The extra measure is to increase the distance between officiant or speaker and audience to 5 metres. You also need to follow the provincial minimum distances and other requirements such as shielding between officiants, singers, or any performers. 
  • Other measures to reduce the risk of COVID-19 transmission during officiation/speeches include:
    • masking 
    • using a microphone to avoid projecting the voice 
    • limiting contamination of objects (e.g. microphone, podium) 
    • frequent environmental cleaning
    • improving ventilation  
  • If the bride and groom wish to ‘perform’ a first dance, they should do so at least 2 metres from attendants. Group dancing at a reception is not permitted. 
30. What do I need to know about going to a movie theatre or play?

It is important to remember that these activities are considered to be higher risk for the spread of COVID-19.  

If you are planning on going out to a movie or play*, here are some things you need to know:

  • You need to wear a mask at all times in the cinema or theatre space (e.g.in their seats, hallways, washrooms, concession stands) except when eating and drinking  
  • Individuals from the same social circle can sit next to each other in a theatre  
  • Physical distancing remains imperative. A minimum of 2 metres should be maintained between seats that hold individuals from different social circles  
  • Singing and shouting while seated should be avoided by audience members 

* This is specific to entertainment where there is no singing. 

31. How can I reduce the risks of COVID-19 transmission in indoor spaces? 

COVID-19 is primarily transmitted through direct contact to the respiratory droplets of an infected person.While ventilation of indoor environments with fresh air is important, the basis of reducing the risk of transmission while indoors continues to be following COVIDWise principles:

W – Wear a mask or face covering where required, or when you cannot maintain a physical distance of two metres (six feet).

I – Isolate yourself when you have any symptoms and get tested.  Learn about testing: OttawaPublicHealth.ca/COVIDcentre

S – Stay two metres (six feet) apart from those outside your household.

E – Exercise proper hand hygiene; wash your hands regularly or use sanitizer especially before touching your face.

Poor ventilation in indoor spaces is linked with increased transmission of respiratory infections, particularly if the space is small. Transmission of COVID-19 has been associated with closed spaces, including by people who are pre-symptomatic. It is therefore important that, along with COVIDWise measures, proper ventilation – preferably with fresh air (e.g., by opening windows and doors) – is practiced, whenever possible.

32. How do heating, ventilation and air-conditioning (HVAC) systems affect the transmission of COVID-19?

There is no evidence that COVID-19 can be transmitted to people in other rooms using the same HVAC system. In fact, a well-maintained HVAC system may help reduce transmission of COVID-19 by bringing fresh outdoor air to indoor spaces while at the same time, removing the inside air that people have exhaled.

Within a single room, however, air conditioners and fans may increase the distance in which a virus can be transmitted. To help prevent the flow of air from infected areas into other areas and reduce the concentration of virus particles in these areas:

  • Minimize the use of air conditioners and fans (e.g., by using the lowest setting)
  • Direct airflow away from surfaces and people
  • Increase natural ventilation by opening a window if weather permits.

Note that air conditioners and fans also require regular maintenance, such as:

  • Surface cleaning, including the blades
  • Removal of any moisture or water that has collected in portable air conditioners
  • Filter changes
  • Other maintenance activities found in manufacturers’ instructions.

That being said, COVIDWise behavior remains the best way to reduce the risk of transmitting the virus indoors.

For further reference on HVAC systems, the following web-based resources are available:

33. How are other congregate care setting being supported?

Ottawa Public Health (OPH) is supporting other congregate care settings such as shelters, rooming homes, group homes, correctional institutions, and isolation and physical distancing centres.

Staff and residents at congregate care settings are being provided with information to prevent new cases. Guidance includes personal protective equipment use and access, screening, enhanced Infection Prevention and Control measures, and physical distancing. To support physical distancing in congregate care settings, OPH and community partners have worked together to relocate residents out of shelters and into other accommodations.

Within congregate care settings, health care workers are provided with guidance and support to quickly identify and isolate individuals with symptoms of COVID-19. Screening and mobile testing is being made available in congregate care in order to reduce barriers (i.e. Ottawa Inner-City Health’s Mobile Assessment Van). Collaborative responses are also in place to assist with the self-isolation of residents/families who have tested positive for the virus at designated isolation centres, when possible.

OPH staff declare and monitor outbreaks in congregate care settings. OPH works with congregate care operators to review control measures, conduct site visits and monitor for new cases for the duration of the outbreak.

OPH is working with community partners to identify and address the unmet needs of people living in rooming houses in Ottawa during the COVID-19 pandemic.

Partners of this initiative include OPH, Ottawa Inner City Health, Community and Social Services Department, Somerset West Community Health Centre, and Centertown Community Health Centre.

In addition, the Champlain COVID-19 Response Committee (CCRC) has created the Champlain Health Region Congregate Care & Living Operations Task Force
which includes representation from Ottawa Community Paramedics and OPH. These partners are actively supporting congregate settings with surveillance testing for COVID-19 in order to reduce transmission.

Information about Long-Term Care Homes (LTCH) and Retirement Homes (RH)

Supporting LTCHs and RHs during COVID-19

Background

All Long-Term Care Homes (LTCH) in Ontario are part of the provincial health care system, and are licensed, regulated, and inspected by the Ministry of Long-Term Care. The majority of LTCHs in Ottawa are operated privately, some are non-profit, and a small portion (4) are City-run, not-for-profit facilities.

Managing Infectious Disease Outbreaks in LTCHs

During any infectious disease outbreak in a LTCH, it is important to institute measures to prevent and control the spread of the infection in the facility, while balancing the daily life of the residents in the LTCH. Usually, when an outbreak is declared in a particular unit or floor, Infection Prevention and Control (IPAC) measures are implemented in that area to prevent the spread to other areas of the building

Ottawa Public Health’s Role
As per Ministry of Health guidance, if one person in a LTCH or RH tests positive for the COVID-19 virus it results in the declaration of an institutional outbreak. Once an outbreak is declared in an institution, members of OPH’s IPAC team serve as a direct liaison to that institution, and provide support by:
  • Investigates people who test positive for COVID-19 virus and their contacts.
  • Conducting initial and ongoing on-site visit, as required.
  • Providing recommendations for testing of residents and staff according to the current Ministry of Health guidelines (all residents and staff on floors with a COVID-19 outbreak are to be tested, whether or not they have symptoms).
  • Provides COVID-19 test swabs, and linking facilities to sources of provincial Personal Protective Equipment (PPE) supplies, if needed.
  • Conducting on-going surveillance for the duration of the outbreak.
  • Supporting the LTCH/RH throughout the outbreak to ensure all infection prevention and control requirements have been implemented to control the outbreak.

Outbreak management activities also include providing guidance on institutional policies, supporting the implementation of physical distancing/isolation measures and ensuring protocols are in place for enhanced cleaning and disinfecting, particularly of high touch surfaces within the institution.

Province of Ontario’s Role

LTCHs are part of the provincial health care system and the Ministry of Long-Term Care is responsible to regulating, licensing, and inspecting all LTCHs. The Long-Term Care Home Quality Inspection Program (LQIP) safeguards residents’ well-being by investigating complaints and critical incidents, and by ensuring that all LTCHs are inspected at least once per year. Inspection reports for homes are available here.

During COVID-19, the Ministry of Health provides directives to LTCHs with respect to managing cases and outbreaks and is the lead for providing PPE.

Contact Information for Families with Loved Ones in LTCH
Concerned families and friends should communicate directly with the LTCH about their loved ones at the facility. Concerns with the operation of a LTCH should be directed to the Ministry of Long-Term Care through their complaint process
Frequently Asked Questions
1. What is being done to support long-term care/retirement homes? 

All long-term care homes (LTCHs) and retirement homes (RHs) in Ottawa receive regular communications and guidance from Ottawa Public Health’s Infection Prevention and Control team. These homes are familiar with required infection prevention and control measures, COVID-19 testing guidelines and outbreak management protocols.

Ottawa Public Health (OPH) is working closely with the Ministry of Long-Term Care and the Champlain COVID-19 Response Committee (CCRC) to address issues (e.g., human resources, PPE, education, etc.) in LTCH/RH. During prevention efforts and outbreak management, OPH in collaboration with the facility, will report any concerns directly to CCRC and MLTC to determine what supports can be provided immediately to the facility. OPH is in weekly contact with the Ministry of Long-Term Care which is responsible for the regulation, licensing and inspections of LTCHs.

OPH is providing LTCHs with infection prevention and control education and support and community paramedics are supporting testing and non-urgent medical care. These measures are making a difference and more partnerships are being established as assessments continue.

2. When is a COVID-19 outbreak declared and what support is provided to the long-term care/retirement home? 
Ministry of Health guidelines state that one single person with a COVID-19 positive test in a long-term care home (LTCH) or retirement home (RH) results in the declaration of an outbreak. Once an outbreak is declared, Ottawa Public Health (OPH)’s Infection Prevention and Control team is assigned to assist the home and provide support by:
  • conducting an on-site visit  
  • providing advice and guidance on infection prevention and control measures
  • conducting on-going surveillance for the duration of the outbreak 
  • supporting the home by recommending that all infection prevention and control requirements are implemented to control the outbreak
  • offering other resources to the home

Infection prevention and control measures such as wearing proper surgical/procedural masks at all times while at work, active screening, and separating people who may have the COVID-19 virus and people who have tested positive for the COVID-19 virus, continue to be the most effective way to decrease the transmission of COVID-19 in these homes.

3. Who is tested when a long-term care/retirement home has a COVID-19 outbreak? 

Ottawa Public Health (OPH) provides guidance on which residents, staff, and close contacts require testing in a long-term care home (LTCH) or retirement home (RH) and helps with completing these tests.

In the event that a resident living in a long-term care or retirement home develops symptoms compatible with COVID-19, residents who do not exhibit symptoms but who are living in the same room are tested immediately along with the person with symptoms. OPH may also, based on a risk assessment, identify other staff, visitors or residents who should be tested for COVID-19.

In the event that a person tests positive for the COVID-19 virus, all staff in the entire home AND all residents in the home will be tested.

4. Are residents separated when a long-term care/retirement home has an outbreak? 

Homes with an outbreak actively work on separating (cohorting) residents with and without symptoms. Residents with symptoms (including mild respiratory and/or atypical symptoms) are isolated and tested for COVID-19. Residents who test positive for COVID-19 must remain in isolation under Droplet and Contact Precautions. Where possible, these residents should be isolated in a single room, or alternative accommodations within the home (e.g, to respite or palliative care beds/rooms or other rooms as appropriate) and grouped according to their status.

5a. Should I consider removing my loved one/family member from their long-term care/retirement home? (See FAQ 5b for retirement home)

 

Ottawa Public Health (OPH) understands that some families may contemplate removing their loved one from their long-term care homes (LTCH) or retirement homes (RH) to protect them from COVID-19. While OPH is unable to provide individual advice, OPH's recommendation to anyone thinking of removing their loved one from their LTCH is to assess the situation and identify the various risks in bringing the person home. Is someone available and able to manage their care at home? Is there movement in and out of the home that could introduce risks? Is there anyone else in the home who may be at risk for more serious outcomes from a COVID-19 infection? 

Absences: At this time, Ministry of Long-Term Care guidance (Directive #3) classifies absences from LTCHs as short stay or temporary as follows:

  1. Short stay absences:
    • Residents may leave the home’s property for a short stay absence for health care related, social, or other reasons. A short stay absence does not include an overnight stay, with the exception of single-night emergency room visits. Upon return to the home, residents will be actively screened by the LTCH but will not require testing or self-isolation.
    • Residents must be provided with a medical mask to be worn at all times when outside the home (if tolerated) and reminded about the importance of public health measures, including maintaining physical distancing (2 metres /6 feet).
    • Outpatient medical visits are considered a short stay absence, and residents do not require testing or self-isolation upon their return.
    • Emergency room visits that take place over a single night (e.g., assessment and discharge from the emergency department spans one overnight period) should also be considered equivalent to an outpatient medical visit that does not require testing or self-isolation upon return. If the resident is admitted to the hospital at any point, or the emergency room visit takes place over two or more nights, homes should follow the steps for Re-Admissions to LTCH.
  2. Temporary absences:
    • Residents may leave the home’s property for a temporary absence (one or more nights) for personal reasons. Upon return to the home, the resident will be required to self-isolate for 14 days. Residents who are discharged from a hospital will have to follow re-admissions criteria.
    • Homes must review and approve all temporary absences based on a case-by-case risk assessment that includes, but is not limited to, the following:
      • The home’s ability to support self-isolation for 14 days upon the resident’s return.
      • Local disease transmission and activity.
      • The risk associated with the planned activities that will be undertaken by the resident while out of the home.
      • The resident’s ability to comply with local and provincial polices/ bylaws.
      • Any further direction provided by the Ministry of Long-Term Care.

If the home denies a temporary absence request, the home must communicate this to the resident/substitute decision maker in writing, including the rationale for this decision.

In the event a resident has been removed from a LTCH and the LTCH or RH has a COVID-19 outbreak, the resident cannot return to the home until after the outbreak is declared over. Individuals should speak with their specific home regarding moving a resident to confirm that the space in the home will still be available if they have left for an extended period of time. The individual will need to remain in self-isolation within the family home, given the potential exposure to COVID-19 and risk to others. There are guidelines for self-isolation on the OPH website

5b. Should I consider removing my loved one/family member from their retirement home?

Retirement home residents who wish to go outside the home (e.g., absences with friends or family, shopping, medical appointments, etc.) are permitted to do so if the following requirements are met:

  • The retirement home must NOT be currently in a COVID-19 outbreak.
    • In the event that a home allows absences but enters into an outbreak, all new absences must end. Homes must establish compliance with all Chief Medical Officer of Health (CMOH) Directives for homes in outbreak and follow directions from the local public health unit.
  • The resident must pass active screening every time they reenter the home. If a resident does not pass screening, the home will follow existing isolation policies.
  • The resident must wear a face covering/mask while outside the home and respect physical distancing.
    • The resident is responsible for supplying a face covering/mask while they are on absences. The home may, at its discretion, opt to supply face covering/masks for absences.
  • Education on all required protocols for short absences will be provided by the home.
  • For 14 days following their return to the home from an absence that includes an overnight stay, a resident must:
    • Pass active screening upon return to the home;
    • Not receive indoor visitors;
    • Be monitored for symptoms;
    • Avoid using common areas; however, if a common area cannot be avoided, the resident must use a face covering/mask;
    • Limit contact with other residents;
    • Not participate in group activities;
    • Wash their hands often (using soap and water or an alcohol-based hand sanitizer);
    • Adhere to respiratory etiquette; and
    • Follow appropriate physical distancing guidelines.
  • Residents who are following the 14-day period of enhanced precautions may leave the home for non-overnight absences (e.g., to buy groceries or other essentials). Doing so will NOT reset the 14-day time period. However, an overnight stay during the 14-day period will reset the 14-day time period.
There are guidelines for self-isolation on the OPH website.
6. When is an outbreak declared over in a long-term care/retirement home and what type of guidance is provided to those institutions going forward?

In collaboration with the local public health unit, the outbreak may be declared over when no additional residents or staff test positive for the COVID-19 virus after 14 days (maximum incubation period) from the latest of:

  • Date of isolation of the last resident case; OR
  • Date of illness onset of the last resident case; OR
  • Date of last shift at work for last staff case.

After an outbreak, a long-term care home (LTCH)/retirement home (RH) is recommended to continue infection prevention and control measures as advised by OPH. Such measures might include:

  • Screening of all staff, visitors and residents in accordance with the Ministry of Health Screening Tool
  • Physical distancing
  • Universal masking of all staff at all times
  • Increased cleaning and disinfection of high touch areas
  • Modifying or cancelling communal activities
  • Biweekly Covid-19 testing of staff
7. What precautions are being taken to protect residents of long-term care homes?

The following precautions and procedures are currently in place during the COVID-19 Pandemic.

Active Screening

  • Active screening of all staff and visitors twice daily
  • Active screening of all residents at least twice daily

Staff Masking

  • In all long-term care homes, regardless of whether the home is in an outbreak or not, all staff are required to wear surgical/procedure masks while at work.
  • When staff are on breaks, and not in contact with residents, they may remove their masks.
  • Staff not wearing masks must maintain physical distancing, of at least 2 metres (6 feet) away from colleagues to prevent the transmission of the COVID-19 virus.

Managing Visitors

The aim of managing visitors is to balance the need to mitigate risks to residents, staff and visitors with the mental, physical and spiritual needs of residents for their quality of life. At minimum, visitor policies must:

  • Be informed by the ongoing COVID-19 situation in the community and the home and be flexible to be reassessed as circumstances change.
  • Include education about physical distancing, respiratory etiquette, hand hygiene, infection prevention and control practices (IPAC) and proper use of personal protective equipment, including masks.
  • Include a process for communicating with residents, families and visitors about policies and procedures including those related to the gradual resumption of visits.
  • Include a process for gradual resumption of general visitors that stipulates that:
    • Visits should be pre-arranged
    • Residents are permitted up to a maximum of two visitors at a time
    • Visitors must only visit the resident they are intending to visit, and no other residents
    • Visitors should use a cloth mask or face covering only if the visit is outdoors. If the visit is indoors, a surgical/procedure mask must be worn at all times
    • Visits are not permitted when:
      • A resident is self-isolating or symptomatic, or
      • A home is in an outbreak

For more information, you can read the Ontario Ministry of Health’s Directive #3 for Long-Term Care Homes.

8. Where can I find outbreak information on specific long-term care/retirement home? 
The detailed summary of confirmed COVID-19 outbreaks in Ottawa, long-term care homes (LTCHs) and retirement homes (RHs), is available on the Daily COVID-19 Dashboard webpage. This detailed summary is updated daily.
9. Will residents in long-term care/retirement homes be moved to other facilities such as hotels, recreation complexes and schools?

Ottawa Public Health (OPH) and our partners continue to work together to review strategies to protect the health of residents in the City, including those in long-term care homes (LTCHs) and retirement homes (RHs). The current strategy is to provide support to the facilities directly, as opposed to moving residents to other buildings. Support to these homes is being provided through several coordinated teams and includes infection prevention and control support and education, support with separating (cohorting) residents and staff with and without symptoms, and providing additional staff, specifically health care workers.

10. What is surveillance testing, and will it be expanded to include retirement homes and other congregate care settings?

Surveillance testing is the proactive COVID-19 testing of all residents and staff (those with and without symptoms) at a long-term care home (LTCH) or retirement home (RH). Surveillance testing helps Ottawa Public Health (OPH) better understand the current state of COVID-19 infections in Ottawa. The test results provide a snapshot of current infections and are used to track where the virus has spread. OPH follows up immediately with homes and individuals (staff) if there is a positive test result. 

Testing and site-visits have been completed in all 28 Ottawa LTCHs.   Retirement homes (RHs)  are also undergoing site-visits. ​OPH is working with partners to provide surveillance testing in RHs that are in a declared outbreak and require additional supports. The most important way to stop the transmission of COVID-19 and deaths due to COVID-19 in LTCHs is strict adherence to Infection Prevention and Control measures, which includes ensuring all healthcare workers are wearing masks at all times, physical distancing, and continuous active screening.

Other congregate settings that have undergone surveillance testing include Ottawa’s emergency child care centres. In total to date 76 staff have been tested for Covid-19 to date.

It is important to note that a negative test does not mean that an individual is not infected, since the person could be incubating the infection. Tests completed early in an infection may produce a false negative result.

11. When can I go visit my loved one living in a long-term care home?

The province has gradually reopened long-term care homes (LTCH) to visitors. Baseline requirements must be met prior to being able to accept any visitors. Below is an outline of the requirements for LTCH and visitors during Phase 1 from the Ministry of Long-Term Care – Resuming Visits in Long-Term Care Homes guidance.

  • The long-term care home must NOT be currently in outbreak.
  • In the event that a home has relaxed visitor restrictions and enters into an outbreak, all non-essential visitations must end. Homes must establish compliance with all Ontario Ministry of Health directives for homes in outbreak and follow directions from the local public health unit.
  • The home has developed procedures for the resumption of visits and a process for communicating these procedures with residents, families, visitors and staff, including but not limited to infection prevention and control (IPAC), scheduling and any setting-specific policies.
    • The process must include sharing an information package with visitors on IPAC, masks and other operational procedures such as limiting movement around the home, if applicable, and ensuring visitors’ agreement to comply. Home materials must include an approach to dealing with non-adherence to home policies and procedures, including the discontinuation of visits.
    • Protocols must be in place to maintain the highest of IPAC standards prior to, during and after visits.
    • Each home should create and maintain a list of visitors with the time and date of each visit as well as contact information. The list will be available for relevant/appropriate staff members to access.

Visitor Requirements

Prior to each visit, the visitor must:

  • Pass an active screening questionnaire administered by home staff
  • Attest to home staff that they have tested negative for COVID-19 within the previous 2 weeks and subsequently not tested positive. The home is not responsible for providing the testing.
  • Comply with long-term care home infection, prevention and control (IPAC) protocols, including proper use of face or surgical/procedural masks.
    • Visitors should use a mask/face covering if the visit is outdoors. If the visit is indoors, a surgical/procedure mask must be worn at all times.
    • Visitors are responsible for bringing their own mask/face covering for outdoor visits. The home is responsible for supplying surgical/procedure masks to indoor visitors and to outdoor visitors who do not have a face covering.
      • Homes should avoid accessing the provincial pandemic stockpile for this purpose.
    • Any non-adherence to these rules will be the basis for discontinuation of visits.

Outdoor and Indoor Visit

  • Up to 2 visitors a time are allowed. A visitor is defined as any family member, close friend or neighbor.
  • Scheduling of visits is required.
  • Homes should establish practices that:
    1. Provide meaningful and equitable access to visits for all residents; and
    2. Consider the staffing and space capacity available to the home to maintain safety of residents, staff and visitors.
  • Homes will have discretion in scheduling and must take into account the directives in place at the time and whether the visitor is an essential caregiver (e.g. supports with feeding etc.)
  • Homes may regulate the number of visitors to the home at any one time.

12. When can I go visit my loved one living in a retirement home?

Reopening retirement home guidance currently permits outdoor visiting and indoor visiting in designated areas or resident suites (if appropriate physical distancing can be maintained).

The number of visitors per resident, per day, is to be determined by the home, provided that current guidance on physical distancing (2 metres /6 feet or more) can be accommodated.

For outdoor visits, the visitor may bring an outdoor/lawn chair, or one may be provided by the retirement home. Staff will clean and disinfect the visiting area after each visit.

Scheduling of visits is required. This will allow for appropriate physical distancing and staffing coverage.

Visits can be time limited to allow the home to accommodate all residents. Homes should consider the needs of residents in prioritizing visits. A sufficient block of time should be made available by homes to allow for at least one meaningful weekly visit per resident at a minimum.

 

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