Updates on the novel coronavirus

The OHA developed this webpage to keep members apprised of recent Ministry of Health updates regarding the novel coronavirus, and to highlight relevant resources for members. It is important to note that the health system is well-prepared to respond to this type of issue. As the situation unfolds, officials from the Ministry and public health, including the Chief Medical Officer of Health, remain in close contact with health care providers and partners across the system, including the OHA. This includes daily stakehholder calls to share information, guidance, and address any challenges, should they arise.

For any questions or concerns, Health sector partners can contact the Health System Emergency Management Branch at 1-866-212-2272 (24/7) or eocoperations.moh@ontario.ca (business hours).

Daily Update - March 29, 2020

Situation Report #64 COVID-19
Ministry of Health | Health System Emergency Management Branch

Situation: Case count as of March 29, 2020

Area	Case count	Change from yesterday	Deaths	Change from yesterday
Worldwide total	709,644	+81,753	33,518	+4,620
Europe	381,614	+41,394	23,933	+3,714
China	81,439	+45	3,300	+5
Middle East	57,188	+7,549	2,864	+175
Asia & Oceania	28,763	+1,903	523	+50
Africa	4,174	+285	129	+14
Latin America and Caribbean	14,138	+1,751	306	+63
North America	142,328	+28,826	2,463	+599
United States	136,492	+27,747	2,400	+591
Canada	5,836	+1,079	65	+10

211 new cases were reported today in Ontario, bringing the cumulative total to 1326 (this includes eight resolved cases and 23 deaths).
In Ontario, there are 7,203 persons under investigation with lab results pending.

Actions Taken:

The guidance document for Community Labs and Specimen Collection Centres has been updated and uploaded on the ministry website.
New guidance documents for Emergency Child Care Services and Industry Operators have been developed and uploaded on the ministry website.
The Ontario government is implementing a new emergency order to ensure that staffing and resources are available to help care for and protect long-term care residents during the COVID-19 crisis. These temporary measures provide further flexibility for long-term care homes and allow homes to redirect their staffing and financial resources to essential tasks.
The Ontario government is issuing a new emergency order under the Emergency Management and Civil Protection Act to prohibit organized public events and social gatherings of more than five people, effective immediately. This order would not apply to private households with five people or more. It would also not apply to operating child care centres supporting frontline health care workers and first responders provided the number of persons at each centre does not exceed 50 people. Funerals would be permitted to proceed with up to 10 people at one time.
Ontario's Chief Prevention Officer announced updated guidance to help employers better understand their responsibilities and what is needed to prevent the spread of COVID-19 on the construction sites.

Related OHA Communications

Please note that some of the bulletins below are members only. Please sign in to OHA.com/news to view all bulletins.

Contains links to documents from the March 18 MEOC Situation Report, including Canadian Blood Services, the Provincial Transfer Authorization Centre, Cyber precautions).

OHA members can direct their questions to Melissa Prokopy, Director, Legal, Policy and Professional Issues, at mprokopy@oha.com or 416-205-1565.

OHA Resources

Summary of Legislative Changes Related to COVID-19
Ontario Announces Support for Workers, Municipalities and Retailers in Response to COVID-19 - Backgrounder
Emergency Management and Civil Protection Act and COVID-19 - Backgrounder
Emergency Management Toolkit: Each level of government (federal, provincial, municipal and local) has an important role to play in the preparedness and response to emergencies. A detailed overview of those responsibilities can be found on page 5 of the OHA's Toolkit.

Government Resources

Ministry of Health website: www.ontario.ca/coronavirus (Provides detailed information on how individuals can protect themselves, what to do if you’re sick after travel, and how to recognize possible symptoms)

Updated Case Definition for Novel Coronavirus (March 13)

Screening checklist (March 13)

Health Care Provider Website
Public Health Management Guidance document and Quick Reference document on Testing and Clearance

Orders in Council: Doc 1, Doc 2, Doc 3 (March 17)

Guidance documents for providers:

Guidance for Acute Care (March 19)

For the recent CMOH Directive on PPE, please see "Ministry Communications to Date" section below
Government of Canada: IPC for (COVID-19): Interim guidance for acute healthcare settings (Click here for section on PPE)
Also, see below under "Global Resources", the WHO interim guidance on the use of PPE for COVID-19

For a complete list of guidance documents, please visit the ministry's website.
NEW: Guidance document with information on the use of N95 filtering face respirators beyond the manufacturer-designated shelf life
Public Health Ontario (PHO) has updated their site related to COVID-19 testing including an updated list of accepted swab types.
Health Canada has released an FAQ document regarding Subsection 56(1) Class Exemption for Patients, Practitioners and Pharmacists Prescribing and Providing Controlled Substances in Canada during the Coronavirus Pandemic.

COVID-19 Bioethics Resources

Ontario Bioethics Table (2020): Ethics Framework for Ramping Down Elective Surgeries and Other Non-Emergent Activities During the COVID-19 Pandemic
Health Ethics Alliance (2020): Ethical Framework for the Allocation of Personal Protective Equipment (during COVID-19)

More resources

Government of Canada:

Community-based measures to mitigate the spread of coronavirus disease (COVID-19) in Canada
Risk-informed decision-making for mass gatherings during COVID-19 global outbreak
Government of Canada: IPC for (COVID-19): Interim guidance for acute healthcare settings (Click here for section on PPE) - Note: also cited in guidance for acute care settings above

Public Health Ontario (PHO) resources: Additional resources from PHO are available to assist hospitals in the triage, screening, patient management, and testing in acute care settings
Public Health Agency of Canada (PHAC) resources: PHAC resources include the latest travel advice and information for health professionals, such as details on transmission, detection and reporting, infection prevention and control, and treatment.
Public Resources:
- Visitor Signage for LTC Homes (French)
- COVID-19 - What you need to know (French)
- COVID-19 Self-Monitor Fact Sheet (French), (Other languages)
- Self-Isolation Fact Sheet (French), (Other languages)
- Guidance for Caregivers (French), (Other languages)
- Public information sheet (multiple languages)
- Patient and Visitor signage is available on the ministry's website.

Ministry Communications To Date

For other government news related to COVID-19, visit the Ministry's website.

Memo: Update on COVID-19 Preparations: Supplies and Equipment (March 28)
Minister's Order directing health system providers to report PPE inventories (March 28)
Command Table Summary (March 27)
Memo: Amendments to Ontario Regulation 79/10 under the LongTerm Care Homes Act, 2007 related to the COVID-19 Pandemic – Admissions and Discharge (See associated FAQs)
Command Table Summary (March 25)
Order under the EMCPA for LTC Homes (March 23)
Command Table Summary (March 23)
CMOH Directive for Long-Term Care (March 23)
Order under the EMCPA for Hospitals (March 21)

Clarification around the Hospital Redeployment order (Regulation 74/20 under the Emergency Management and Civil Protection Act) can be found here.

Notice: ODB Program Changes and Guidance for Dispensers during the COVID-19 Public Health Emergency (March 20)
CMOH Memo: Update on COVID-19 Preparations and Actions (March 20)
Report from Collaboration Table Meeting held Thursday, March 19, 2020
CMOH Directive to Regulated Health Care Providers on Ramping Down Elective Surgeries and Non-emergent Activities (March 19)
CMOH Memo: COVID-19 Updates - Visitors at Acute Care Settings (March 19)
CMOH Memo: ACES/eCTAS COVID-19 surveillance (March 19)

Improving COVID Surveillance within ACES (March 19)

CMOH Memo: Managing Health Worker Illness and Return to Work COVID-19 (March 19)
CMOH Memo: Supporting Expansion of Virtual Home Care Delivery (March 18)
Command Table Summary (March 18)
Ontario Enacts Declaration of Emergency to Protect the Public (News release)
Command Table Summary (March 16)
CMOH Memo: Ramping Down Elective Surgeries and Other Non-Emergent Activities (March 15)
CMOH Memo to Long-Term Care Homes, Retirement Homes, Supportive Housing, Hospices and other congregate care settings (March 13)
CMOH Letter on Enahnced Public Measures for COVID-19 (March 13)
CMOH Directive on PPE (March 12)

Updated IPAC Recommendations for Use of Personal Protective Equipment for Care of Individuals with Suspect or Confirmed COVID-19 (French)

Command Table Summary (March 12)
Memo to the Long-Term Care Homes Sector (March 9)
Command Table Summary (March 9)
Command Table Summary (March 6)
February 12, 2020 memo from CMOH Dr. David Williams
January 23, 2020 letter from CMOH Dr. Barbara Yaffe
January 10, 2020 letter from Chief Medical Officer of Health (CMOH) Dr. Barbara Yaffe

System Partner/Hospital Resources

Health Sciences North: Case Study on the launch of Greater Sudbury's COVID-19 Assessment Centre
Sunnybrook Health Sciences Centre:

Diagnosis and Management of First Case of COVID-19 in Canada: Lessons applied from SARS (In this recently published paper, Sunnybrook documents their experience with diagnostic testing, IPAC management, and post-discharge procedures, also noting the key differences in preparedness and capacities between SARS and COVID-19.

Ontario College of Family Physicians: Resource Page
Ontario Medical Association:

Canadian Institute for Health Information:

ICD-10-CA coding direction COVID-19 (French)

Society of Obstetricians and Gynaecologists of Canada: Committee opinion - COVID-19 during pregnancy

Global Resources

Health Maps

Centre for Disease Control and Prevention:

Strategies for Optimizing the Supply of N95 Respirators
CDC: Mental Health and Coping During COVID-19 (Supporting yourself, children, responders and people released from quarantine)

WHO Resources

To increase access to reliable information, WHO has worked with WhatsApp and Facebook to launch a new WHO Health Alert messaging service. This service will provide the latest news and information on COVID-19, including details on symptoms and how to protect yourself. The Health Alert service is now available in English and will be introduced in other languages next week. To access it, send the word "hi" to the following number on WhatsApp: +41 798 931 892.
Interim Guidance: Rational use of personal protective equipment for coronavirus disease 2019 (COVID-19)
Situation Reports
Technical Guidance
Coronavirus Mythbusters (Including infographics for download)
WHO Info Video
FAQ about the virus
WHO guidance support for mental and psychological well-being during COVID-19
WHO Online Education

Infection Prevention and Control (IPC) for Novel Coronavirus (COVID-19): This course provides information on what facilities should be doing to be prepared to respond to a case of an emerging respiratory virus such as the novel coronavirus, how to identify a case once it occurs, and how to properly implement IPC measures to ensure there is no further transmission to HCW or to other patients and others in the healthcare facility.
This training is intended for healthcare workers and public health professionals, as it is focused on infection prevention and control.
Emerging respiratory viruses, including 2019-nCoV: methods for detection, prevention, response and control: This course provides a general introduction to 2019-nCoV and emerging respiratory viruses and is intended for public health professionals, incident managers and personnel working for the United Nations, international organizations and NGOs. WHO teams are working to translate the resources into all WHO official languages and Portuguese. Many countries have also initiated translation into their own local languages.