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.

Daily Update - July 2, 2020

Situation Report #159 COVID-19
Ministry of Health | Health System Emergency Management Branch

***CLICK HERE TO VIEW THE FULL VERSION OF TODAY'S SITUATION REPORT.***

Area / Région	Case count / Nombre de cas	Change from yesterday / Changement par rapport à hier	Deaths / Décès	Change from yesterday / Changement par rapport à hier
Worldwide total / Total mondial	10 918 836	+229 191	521 372	+4 989
Canada	104 643	+372	8 637	+22
Ontario	35 370	+153	2 680	+04

Ontario:

Confirmed Cases	Cas confirmés	Data Source / Source des données	Yesterday / Hier	7-day % change / % de changement sur 7 jours
Cumulative Cases	Nombre cumulatif de cas	iPHIS / SIISP	35 370	3%
Health Sector Worker Cases	Nombre de cas chez les travailleurs du secteur de la santé	iPHIS / SIISP	6 006	2%
Cumulative Resolved	Nombre cumulatif de cas résolus	iPHIS / SIISP	30 730	4%
Cumulative Deaths	Nombre cumulatif de décès	iPHIS / SIISP	2 680	1%
Long-Term Care Home Residents	Nombre de décès de résidents des CSLD	iPHIS / SIISP	1 712	1%
Retirement Home Residents	Nombre de décès de résidents des maisons de retraite	iPHIS / SIISP	186	2%
Health Sector Workers	Nombre de décès de travailleurs du secteur de la santé	iPHIS / SIISP	11	0%
Mode of Acquisition*	Mode d'acquisition*			Percent of Total / % du total
Outbreak-associated or close contact of a confirmed case	Associés à l'éclosion ou contact étroit avec un cas confirmé	iPHIS / SIISP	21 215	60%
Travel	Voyage	iPHIS / SIISP	1 611	5%
No known epidemiological link	Aucun lien épidémiologique connu	iPHIS / SIISP	6 731	19%
Information missing or pending	Renseignement manquant ou en attente	iPHIS / SIISP	2 997	8%

Acute Care:

Acute Care	Soins aigus	Data Source / Source des données	Yesterday / Hier	7-day % change / % de changement sur 7 jours
Confirmed patients hospitalized***	Cas confirmés hospitalisés***	dBCS / RqL	119	-56%
Cumulative hospitalized health sector workers	Nombre cumulatif de travailleurs du secteur de la santé hospitalisés	iPHIS / SIISP	231	2%
Cumulative health sector workers in ICU	Nombre cumulatifs de travailleurs du secteur de la santé aux soins intensifs	iPHIS / SIISP	56	2%
				7-day average / Moyenne de 7 jours
Current vented patients (includes COVID+)	Patients actuellement branchés à un respirateur (incluent les COVID+)	CCSO / SOSMPC	445	481
CRCI Vented	COVID+ sur respirateur	CCSO / SOSMPC	45	52

For more information about cases and deaths in Ontario over the course of this pandemic, and for breakdowns by region, age, and sex, please view the Ontario COVID-19 Data Tool by Public Health Ontario.
Please visit the ministry website for sector-specific guidance and directives, memorandums and other resources.

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.

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
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.

Government Resources

General Ministry of Health Resources

Website: www.ontario.ca/coronavirus (new version)
Childcare: Website for emergency childcare for health care and frontline staff
Directives: All current Directives issued by the MOH are posted here
HHR Resources: Health Workforce Matching Portal

Online workplace PPE supplier directory
Lab Testing: Testing Guidance Update (June 2)
Testing and Clearance: Quick Reference document (June 25)
Patient screening: COVID-19 Patient Screening Guidance Document (June 11)
Case and contact management: Appendix 3: Daily Clinical Update Form – Acute Care Setting (June 23)

Case Definition: Updated Case Definition for Novel Coronavirus (May 11) - French

COVID-19 Reference Document for Symptoms (May 25)
COVID-19 Patient Screening Guidance Document (May 17)
Guidance for Occupational Health and Safety (March 20)

Acute care guidance (other MOH guidance documents are available here)

Guidance for Acute Care (June 15)
Directive 5 for public hospitals (See Ontario Health Guidance below for supportive documents)

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

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 in partnership 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 (May 10)
Personal Protective Equipment (PPE) Use During the COVID-19 Pandemic (May 10)
A Measured Approach to Planning for Surgeries and Procedures During the COVID-19 Pandemic (May 7)
Frequently Asked Questions for CMOH COVID-19 Directive #5 (March 30)
COVID-19 Health Care Worker Multi-Employer Recommendations (March 30)
Retirees re-joining the workforce to support the COVID-19 Pandemic response (March 27)
Workplace Accommodation for At-Risk Front-Line Health Care Providers (March 27)

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.
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

COVID-19 Bioethics Resources: Latest resources can be found here.
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.
Talking to Children About the Pandemic
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.

Ministry Communications To Date

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

CMOH Memo: Visitors to Acute Care Settings (June 15)
Memo Re-introductions of Visits & Transfer of Hospital Patients and Community Clients to Long-Term Care Homes (June 11)
Important Update on the Minister’s Order and Direction on PPE Data Collection/ CSE Survey (June 9)

Changes to the Survey Portal

Command Table Summary (May 29)
Command Table Summary (May 25)
Memo: Testing Strategy (May 24)
Command Table Summary (May 22)
Command Table Summary (May 19)
Ontario Health: Health System Response Table Update #4 (May 16)
Command Table Summary (May 15)
Command Table Summary (May 13)
Command Table Summary (May 11)
Command Table Summary (May 8)
OH Memo: A Measured Approach to Planning for Surgeries and Procedures During the COVID-19 Pandemic (May 7) - View government release
Command Table Summary (May 6)
Command Table Summary (May 4)
Command Table Summary (May 1)
News Release: New temporary emergency orders under the EMCPA to support the immediate needs of the province's hospitals and health care worker (May 1)
Command Table Summary (April 29)
Ontario Health: Health System Response Table Upate #3 (April 29)
Memo: Transfer of Hospital Patients and Community Clients to Long-Term Care Homes (April 29)
Command Table Summary (April 27)
Emergency Order to support Hospitals in Assisting Long Term Care Response (April 25)
Command Table Summary (April 24)
Memo: Transfer of Hospital Patients to Retirement Homes (April 23)
Command Table Summary (April 23)
Ontario Health: Health System Response Table Upate #2 (April 22)
Memo re: Testing in Long-Term Care Homes (April 20)
Command Table Summary (April 20)
Command Table Summary (April 17)
Memo: Hospital Supports to Long-term Care (April 17)
Memo: Ontario Regulation 257/00 Amendments under the Ambulance Act: Reducing Barriers to Ensure Sufficient Ambulance Service Personnel During Provincial Declarations of Emergency (April 17)
Command Table Summary (April 15)
Memo: Temporarily stop all transfers from hospitals to LTCHs and RHs (April 15)
Memo: Additional support for Long Term Care Homes (LTCHs) and Retirement Homes (RH) (April 15)
Command Tably Summary (April 13)
Memo: Temporary Physician Funding for Hospitals During COVID-19 Outbreak (April 10) - Appendix
Command Table Summary (April 10)
Ontario Health: Health System Response Table Upate #1 (April 8)
Command Table Summary (April 6)
Memo (French): Deputy Minister of Health to the Collaboration and Command Tables re: PPE (April 6)
Memo: Use of Alternate Health Facilities and Temporary Structures such as Field Hospitals and Conference Centres (April 6)
Command Table Summary (April 3)
Stakeholder Collaboration Table Summary (April 2)
Memo: Use of Hotels and Retirement Homes (April 2) - Guidance Document
Command Table Summary (April 1)
Command Table Summary (March 30)
Joint statement (Government and the Ontario Nurses' Association re: health and safety measures in hospitals)
Memo: Guidance by Sector – Hospitals (March 30)

Roll-up of all guidance/directives/memos issued to date for hospitals

Memo: Tracking and payment for hospital and physician services provided to uninsured patients during COVID-19 (March 30) - OMA FAQ
Memo: Hospital Classifications under s. 32.1(1) of the Public Hospitals Act during the COVID-19 emergency (March 28)
Memo: Update on COVID-19 Preparations: Supplies and Equipment (March 28)
Minister's Order directing health system providers to report PPE inventories (March 27)
Command Table Summary (March 27)
Letter: General approval under subsection 4(2) of the Public Hospitals Act for COVID-19 capacity expansion (March 26)
Command Table Summary (March 25)
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) (March 24)
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)
Command Table Summary (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 Enhanced Public Measures for COVID-19 (March 12)
CMOH Directive on PPE (March 12 - Note that this has been updated - see Acute Care guidance documents above)

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 & 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.
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.
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:

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

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 Info Video
FAQ about the virus
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

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.