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.

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.

• November 26, 2020 - Services, Resources, Guidance Bulletin
• November 20, 2020 - Ontario Government Announces Further COVID-19 Restrictions
• November 19, 2020 - Services, Resources, Guidance Bulletin
• November 13, 2020 - Changes to COVID-19 Framework; 2020 Budget Funding Rollout
• November 12, 2020 - Services, Resources, Guidance Bulletin
• November 11, 2020 - COVID-19 Updates (members only)
• November 6, 2020 - Province Tables 2020 Ontario Budget
• November 4, 2020 - 2020 Ontario Budget and New Details re: OHA Member Call
• November 3, 2020 - OHA Seeking Feedback on Ontario's COVID-19 Response Framework
• November 2, 2020 - COVID-19 Updates: Memo on Reimbursement of Hospital COVID-19 Expenses (members only)
• October 30, 2020 - Media Coverage of Financial Pressure on Hospitals
• October 29, 2020 - Services, Resources, Guidance Bulletin
• October 26, 2020 - Ontario Government Invests $116.5 Million to Add 766 More Beds this Winter
• October 23, 2020 - COVID-19 Updates - Long-Term Care Commission Interim Recommendations 
• October 22, 2020 - Services, Resources, Guidance Bulletin
• October 22, 2020 - COVID-19 Updates
• October 19, 2020 - COVID-19 Updates - Transcript of OHA Presentation to LTC COVID-19
• October 15, 2020 - Services, Resources, Guidance Bulletin
• October 9, 2020 - COVID-19 Updates
• October 8, 2020 - Government Releases FAQs re: Amendments to Directive #5 (members-only)
• October 8, 2020 - Services, Resources, Guidance Bulletin
• October 7, 2020 - COVID-19 Updates
• October 6, 2020 - Government Announces Amendments to Directive #5 (members only)
• October 1, 2020 - Services, Resources, Guidance Bulletin
• September 25, 2020 - COVID-19 Update Bulletin (Including New Investments for Surgical Backlog)
• September 24, 2020 - Services, Resources, Guidance Bulletin
• September 17, 2020 - Services, Resources, Guidance Bulletin
• September 14, 2020 - HIRF Announcement & OHA Statement on Increase in COVID-19 Cases
• September 10, 2020 - Services, Resources, Guidance
• September 3, 2020 -  COVID-19 Updates & Member Call on Hospital Finances (member only)

To access earlier bulletins from January - August 2020, please click here.

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 (updated regularly)
• OHA Submission re: Government's COVID-19 Provincial Framework (November 13)
• Hospital Redeployment to Long-Term Care Homes (members only)
• Management Orders for Long-Term Care Homes - Backgrounder
• Ontario Announces Support for Workers, Municipalities and Retailers in Response to COVID-19 - Backgrounder
• Emergency Management and Civil Protection Act and COVID-19 - Backgrounder
• The Latest Research and Information on COVID-19 (Resource Page)
• Strengthening Mental Health and Wellness During COVID-19 (Resource Page)
• 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.

Bioethics Resources

• Resources from the Joint Centre for Bioethics at the University of Toronto are available here. Those pertaining to COVID-19 are listed below.
• Ontario Bioethics Table (2020 - UPDATED): Ontario COVID-19 Health System Response – Bioethics Table Charter & Terms of Reference
• Bean S, Denburg A, Greenberg R, Anderson J. (2020): Ethical Framework for Drug Shortages that Occur during the COVID-19 Pandemic in Ontario
• Ontario Bioethics Table (2020): Ethics Framework for Ramping Down Elective Surgeries and Other Non-Emergent Activities During the COVID-19 Pandemic
• Ontario Bioethics Table (2020): Priority Setting of Personal Protective Equipment – Provincial/Regional Distribution
• Ontario Bioethics Table (2020): Priority Setting of Personal Protective Equipment – Within Health Care Institutions and Community Support Services
• Health Ethics Alliance (2020): Ethical Framework for the Allocation of Personal Protective Equipment (during COVID-19)
• The Hastings Center (2020): Ethical Framework for Health Care Institutions Responding to Novel Coronavirus SARS-CoV-2 (COVID-19)
• UNESCO IBC & COMEST (2020): Statement on COVID-19: Ethical Considerations From a Global Perspective
• Canadian Medical Association: Framework for Ethical Decision Making During the Coronavirus Pandemic
• New England Journal of Medicine:
  
  Emanuel, E. J., Persad, G., Upshur, R., Thome, B., Parker, M., Glickman, A., Zhang, C., Boyle, C., Smith, M., & Phillips, J. P. (2020). Fair Allocation of Scarce Medical Resources in the Time of Covid-19. The New England Journal of Medicine, 382(21), 2049–2055. https://doi.org/10.1056/NEJMsb2005114
  • This article outlines ethical values and guiding principles, which determine six specific recommendations for allocating medical resources in the Covid-19 pandemic: maximize benefits; prioritize health workers; do not allocate on a first-come, first-served basis; be responsive to evidence; recognize research participation; and apply the same principles to all Covid-19 and non–Covid-19 patients.
• The Hastings Center (2020): Responding to Covid-19 as a Regional Public Health Challenge: Preliminary Guidelines for Regional Collaboration Involving Hospitals

• World Health Organization: Ethics and COVID-19

Government Resources

• General Ministry of Health Resources
• Website: www.ontario.ca/coronavirus (COVID-19 Dashboard)
• Directives: All current Directives issued by the MOH are posted here
• Guidance documents: Visit the MOH website for health sector guidance
• Communications: For all government communications related to COVID-19, including Command Table summaries, memos, and advisories, visit the Ministry's website.
• HHR Resources: Health Workforce Matching Portal
• Ontario Health Workforce Matching Portal One-Pager for Health Care Providers
• Training Guide for Health Care Providers
• FAQ for Health Care Providers
• Online workplace PPE supplier directory
• Lab Testing: Testing Guidance Update (September 24, 2020)
• Testing and Clearance: Quick Reference document  (July 29)
• Patient screening: COVID-19 Patient Screening Guidance Document (June 11)

• Case and contact management:

• Updated guidance document for Management of Cases and Contacts of COVID-19 in Ontario (October 9)

• Appendix 3: Daily Clinical Update Form – Acute Care Setting (June 23)

• Case Definition: Updated Case Definition for Novel Coronavirus (August 6) - French
• COVID-19 Reference Document for Symptoms (August 6)
• COVID-19 Patient Screening Guidance Document (June 11)
• Acute care guidance (other MOH guidance documents are available here)
• Guidance for Acute Care (June 15) 
• Directive 5 for public hospitals - Updated as of October 8 (FAQs)
•  Directive 1 to Health Care Providers (March 30)
• The CMOH Directive #2 (May 25): Amended to reflect the gradual restart of all deferred and non-essential and elective services carried out by health care providers.
• COVID-19 Operational Requirements: Health Sector Restart: Outlines measures that must be in place for the provision of in-person health services by health care providers. (June 15)
• Also see below, OH guidance framework: A Measured Approach to Planning for Surgeries and Procedures During the COVID-19 Pandemic
• Related guidance:
• Guidance document (Information on the use of N95 filtering face respirators beyond the manufacturer-designated shelf life)
• Div. Ct. Decision on Hospital Visitor Restrictions
• Divisional Court of Ontario Decision in Sprague v. Her Majesty the Queen in Right of Ontario - Backgrounder
• Long-Term Care:
• Updated Directive #3 to Long-Term Care Homes (June 11) - Reflects new testing guidance and strengthened screening, testing and outbreak management
• Resuming Visits in Long-Term Care Homes - September 2
• MLTC Policy on New Admissions and Re-admissions to Long-Term Care Homes - June 11
• Control of Respiratory Infection Outbreaks in Long-Term Care Homes, 2018
• Minister's Directive: COVID-19: Supporting Long-Term Care Homes (April 24)
• COVID-19 Screening Tool for Long-Term Care Homes and Retirement Homes (May 6)
• Emergency Orders Issued on April 15 re. LTC: here, here and here.
• LTC Guidance Document (April 15)
• Guidance on long-term care outbreaks (April 15) 
• Guidance document for LTCHs and RHs on Mask Use
• Ontario Health Guidance (other resources are posted on the OH website, along with Health System Response Table Updates):
• Infection Prevention and Control (IPAC) for Scheduled Surgeries and Procedures During the COVID-19 Pandemic (June 8)
• Updated: Recommendations for Regional Health Care Delivery During the COVID-19 Pandemic: Outpatient Care, Primary Care, and Home and Community Care (June 15) - Note: These recommendations should be applied together with the Operational Requirements for Health Sector Restart provided by the Ministry of Health (MOH) on May 26, along with MOH sector-specific guidance.
• Optimizing the Supply of Personal Protective Equipment During the COVID-19 Pandemic (August 11)
• Personal Protective Equipment (PPE) Use During the COVID-19 Pandemic (August 11)
• A Measured Approach to Planning for Surgeries and Procedures During the COVID-19 Pandemic (June 15)

• Public Health Ontario (PHO) resources:
• Public Health Ontario (PHO) has updated their site related to COVID-19 testing including an updated list of accepted swab types, including specimen collection and handling.  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:
• Latest travel advice
• Information for health professionals (e.g., details on transmission, detection and reporting, infection prevention and control, and treatment)
• 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.
• Public Resources (View PHO's Public Resources):
• COVID-19 - What you need to know (French)
• COVID-19 Self-Monitor Fact Sheet (French)
• Self-Isolation Fact Sheet (French)
• Guidance for Caregivers (French)
• PHO Fact sheets on Physical Distancing (French) and Taking Care of Yourself and Each Other (French)
• When and How to Wear a Mask (French)
• Patient and Visitor signage is available on the Ministry's website (scroll to the bottom of the page)
• Resources for Ontarians Experiencing Mental Health and Addictions Issues During the Pandemic
• COVID-19 Health Literacy Project: This initiative was started by a first-year medical student at Harvard Medical School, and quickly expanded into a national coalition of over 150 medical students representing over 35 institutions and 34 languages. In an effort to help patients from vulnerable communities know when and how to seek care, they created and translated accessible COVID-19 information into different languages. All their materials are reviewed and vetted by faculty members at Harvard Medical School, and are created in collaboration with Harvard Health Publishing.

System Partner/Hospital Resources & Other Resources

• Canadian Institute for Health Information:
• ICD-10-CA coding direction COVID-19 (French)
• CorHealth: COVID-19 Resource Centre
• Covid Care Learning: Educational resources have been developed and posted on www.covidcarelearning.ca to assist organizations that are continuing to plan for redeployment to the meet the needs for COVID-19 care. This website was created with the support of the Ontario healthcare and education communities to provide key resources to prepare healthcare professionals who will be treating Ontarians impacted by COVID-19. These resources are intended for anyone in the hospital or long-term care sector, including those involved in the care of COVID-19 and other critically ill patients or residents. Read a previous OHA bulletin for instructions on loggin in.
• COVID-19 Visit Risk tool: This 10-minute quiz was developed by researchers at the National Institute of Ageing, a public policy research centre at Ryerson University in Toronto, and walks you through exactly how risky your planned interactions with friends or loved ones are when it comes to COVID-19.  
• Innovative Medicines Canada COVID-19 Resource Centre
• The website will feature the many contributions from members who are testing for COVID-19, discovering new treatments and vaccines, and will also contain a section on drug shortages. It  will be updated daily with new and relevant information.
• Intubation Boxes: Klick is offering free intubation boxes, delivered at no cost to hospitals. Click here for more information.
• Long-Term Care COVID-19 Commission: The dedicated resource site features a list of briefings and meetings (with transcripts) and updates to date.
• Michael Garron Hospital: Checklist (sample) for supporting LTC homes (prevention workstreams)
• Ontario College of Family Physicians: Resource Page
• Ontario College of Physicians and Surgeons of Ontario
• Physician Resource page
• FAQ: Updated regularly to provide advice/guidance on key issues CPSO is hearing about and where joint messaging could be helpful.
• Ontario Community Support Association: New Community Support Program Provides Help for Vulnerable Seniors in Isolation
• Ontario Medical Association:
• Summary of Guidance for Primary Care Providers in Community-Based Settings (OMA)
• BookJane - OMA's technology solution to help manage physician demand in hospitals and other healthcare facilities (Registration and User Guide)
• Research- related resources: Two recently launched websites allow users to submit their COVID-19 questions to be examined through a network of researchers.
• Rapid Evidence Access Link (REAL), created by an interdisciplinary team of health systems students and professionals, scans credible evidence sources and produces concise notes on a variety of COVID-19 queries. It focuses on operational and tactical questions from individual health service providers and clinicians.
• The COVID-19 Evidence Synthesis Network is comprised of organizations in Ontario's evidence synthesis and knowledge translation community. It provides high-quality, relevant, and timely synthesized research evidence about COVID-19 to inform decision makers as the pandemic continues, with a focus on strategic policy and program questions.
• Sunnybrook Health Sciences Centre:
• Diagnosis and Management of First Case of COVID-19 in Canada: Lessons applied from SARS
• What can early Canadian experience screening for COVID-19 teach us about how to prepare for a pandemic?
• University Health Network: Click here to access a set of resources developed by UHN featuring tips to ensure inclusion and equity for marginalized community members during COVID-19.
• University of Toronto: University of Toronto Engineering researchers have developed Redeploy, a tool that optimizes and automates the matching of available staff to jobs that need to be filled throughout the hospital.

Global Resources

• Health Maps
• https://www.healthmap.org/ncov2019/
• John's Hopkins Heat Map

• 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)

• NEJM Article: Fair Allocation of Scarce Medical Resources in the Time of Covid-19

• 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 guidance support for mental and psychological well-being during COVID-19
• Case Report Form for suspected cases of multisystem inflammatory syndrome (MIS) in children and adolescents temporally related to COVID-19
• WHO Online Education

• NEW - Long-term care facilities in the context of COVID-19: The COVID-19 pandemic affects older people disproportionately, especially those living in long-term care facilities (LTCF) with significant impact on mortality and morbidity. Concerted action is needed to mitigate the impact of COVID-19 by enhancing infection prevention and control (IPC) measures within LTCF. The COVID-19 IPC course for LTCF consists of 4 training modules to be used in conjunction with the LTCF communication toolkit and preparedness checklist. This package is tailored for LTCF and based on WHO's in-depth technical guidance on IPC.

• 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.