Frequently Asked Questions on Novel Coronavirus (COVID-19)

PCR testing in Niagara is only available to eligible individuals. Public Health doesn't recommend that health care providers request a negative PCR test to see patients. Review the Ministry's COVID-19 Guidance: Primary Care Providers in a Community Setting.

Niagara Region Public Health and Emergency Services is closely monitoring the COVID-19 pandemic. This is an evolving situation and we'll continue to update information as it becomes available.

If you have questions, call our COVID-19 Primary Care Info-Line Monday to Friday, 8:30 a.m. - 4:15 p.m. Call 905-688-8248, press 7, then press 1 for physicians.

Updated Jan. 5

General information for Niagara

COVID-19 vaccines

Full vaccination is the greatest protection patients can have against COVID-19.

  • While an mRNA vaccine is preferred as a first and second dose, a mixed schedule will also count as a completed series, according to the Updated National Advisory Committee on Immunization Recommendations on COVID-19 Vaccine Schedules
  • It's not recommended that individuals wait longer than four months to get their second dose. While they will not need to restart the series, Public Health strongly recommends they receive their second dose as soon as possible to ensure maximum protection.
    • As a precaution, the National Advisory Committee on Immunization recommends that individuals who experienced myocarditis and/or pericarditis after a first dose of an mRNA vaccine should wait to get their second dose until more information is available

The Government of Canada is working with provinces and territories to allocate COVID-19 vaccines across Canada. See important updates about COVID-19 vaccine availability in Ontario.

We have also created the Public Health COVID-19 FAQ page dedicated to the COVID-19 vaccines. We'll continue to share updates as we receive more information from the province as it relates to Niagara. Learn about COVID-19 vaccination in Niagara.

The Ministry of Health has created a COVID-19 vaccine-relevant information and planning resources webpage for health care providers.

Testing and self-isolation

To support access to testing for all Niagara residents, Niagara Region Public Health encourages all primary care providers to offer COVID-19 testing to their patients. For more information on testing options, read the COVID-19 testing guidance for primary care.

If it's necessary to refer patients to an external centre for testing, see testing locations in Niagara. Niagara Region Public Health offices don't provide COVID-19 testing. 

If testing your own patients in the office, confirmed PCR tests, probable cases and positive rapid molecular tests are required to be reported to Public Health online. Positive rapid antigen test results are also recommended to be reported to Public Health. For individuals who are known contacts of a positive COVID-19 case (symptomatic or asymptomatic), negative antigen results should be confirmed through a PCR test. See Case Definition - Coronavirus Disease (COVID-19) for full details.

Reporting online is the preferred method for timely follow up from Public Health. However, cases can be reported through our COVID-19 Primary Care Info-Line at 905-688-8248, press 7, then press 1 for physicians. Public Health will notify all patients with positive COVID-19 tests. Patients may access their own results online, or contact their primary health care provider for results.

Get information on:

  • What is the difference between rapid antigen point of care and rapid molecular point of care?

    Rapid antigen point of care tests are most often used in surveillance on asymptomatic individuals - not to be used on high-risk contacts. If the antigen result is positive, it must be confirmed by a molecular point of care test or PCR test.

    Positive antigen test results are recommended to be reported to Public Health.

    Molecular point of care tests are used on symptomatic individuals and high-risk contacts of a case (either symptomatic or asymptomatic). If an individual tests negative on a molecular point of care test but is a high-risk contact, it must be confirmed with a PCR test. Asymptomatic individuals who are not a high-risk contact of a case that test positive on molecular point of care must be confirmed by a PCR test.

  • When is it necessary to do a confirmatory PCR test?

    If you have a patient who tests positive with a Positive Rapid Antigen Test, have them book a confirmatory PCR test within 24 hours. For details, see guidance documents. Scroll down to the Symptoms, Screening, and Testing Resources section for:

    • Point-of-Care Testing Use Case Guidance
    • Considerations for Antigen Point-of-Care Testing
  • If a potential COVID-19 case is referred to testing by my office, but declines a test, are they reported to Public Health?

    The province has provided the definition of a probable case with footnotes.

    For patients who meet the definition of a probable case: If your patient meets the definition of a probable case they should be reported to Public Health. Someone identified as a probable case should be tested, but if they refuse, they and their unvaccinated household members must self-isolate, and will receive further direction from Public Health. If a probable case refuses to isolate, this should also be reported to Public Health.

  • My patient declined a COVID-19 test. What are the next steps?

    If you recommend a COVID-19 test for a patient, and it is declined for any reason, we must assume they have COVID-19. They are to self-isolate for 10 days from the day of their symptom onset (away from household members, when possible). If self-isolation away from household members isn't possible, household members are to remain in self-isolation for the duration of the individual's illness AND then an additional 10 days from the last exposure to the symptomatic individual.

    Household members that are fully vaccinated do not need to self-isolate, unless they develop symptoms. Household members that were previously positive for COVID-19 within the last 90 days and have since been cleared also do not need to self-isolate, unless they develop symptoms. If household members become symptomatic, they should consult their health care provider and / or go for testing, even if they are fully vaccinated or previously positive for COVID-19.

  • What do I need to know about asymptomatic testing?

    Asymptomatic testing is not recommended by Public Health, unless under the direction of Public Health on a case-by-case basis. Anyone with respiratory symptoms, other mild symptoms, or fever that you suspect may have COVID-19 or anyone concerned that they may have been exposed to COVID-19 should be referred to the Niagara Health COVID-19 Assessment Centre for testing, if you're not testing in your office.

  • What is the turnaround time on receiving results after testing?

    The turnaround time on receiving test results depends on the current volume of tests being processed. It can take up to seven days for patients to receive their COVID-19 lab test results, but typically it's within 48 hours. It's important that symptomatic patients or asymptomatic high-risk contacts that are not fully vaccinated remain in self-isolation while they wait for their test results.

    Public Health doesn't have earlier access to your patients' COVID-19 test results and is unable to respond to callers on our COVID-19 Info-Line that are asking for laboratory results. If patients are having difficulty accessing results or need a paper copy, have them call 905-378-4647 and ask for the Release of Information Office.

    If your patient receives an indeterminate result from their online search for results, this may mean that results are not completed by the lab. Tell the patient to continue to check back in a day or two for their results if they haven't been contacted by the testing site / provider.

    If the result is a true indeterminate result for COVID-19 from the laboratory, the testing site / provider will contact the patient regarding repeating the test.

  • How are test results accessed?

    Public Health will follow-up with anyone who tests positive.

    Review our August 17, 2020 memo on how to access test results. For more information, visit testing and lab results for COVID-19.

    Some patients who are tested may not have access to their test results through the online portal, specifically those without OHIP, with a red-white OHIP card, without internet access or language barriers. If you're testing your patient, confirm before, or at the time of testing, that they're able to access the online portal. Any individual without access to the online portal must be informed by telephone of their result as soon as reasonably possible.

  • Who can be tested for COVID-19?

    Anyone concerned that they may have been exposed to COVID-19 or anyone with respiratory symptoms, other mild symptoms, or fever that you suspect may have COVID-19 can be referred for testing. For more information on who should be tested, visit the COVID-19 Provincial Testing Guidance Update.

    Get more information on Public Health Ontario's ongoing viral detection and repeat positives review.

  • Are family members and high-risk contacts of cases to be sent for testing?

    Yes. Public Health recommends that high-risk contacts (regardless of vaccination status or if they were previously positive for COVID-19) get tested on day seven from the last exposure to the positive case. If testing was completed on day zero to six, repeat testing is recommended.

    If a contact of a case becomes symptomatic, testing is recommended earlier. Public Health works directly with the close contacts of all laboratory confirmed COVID-19 cases in Niagara to provide close contacts with medical direction and instruction for testing and self-isolation.

  • Do all patients tested for COVID-19 need to self-isolate?

    Symptomatic patients that are sent for testing need to self-isolate until they get their results, regardless of their vaccination status or if they were previously positive for COVID-19.

    Asymptomatic patients sent for testing because they are a high-risk contact also need to self-isolate for the full 10 days from their last exposure to the positive case. Asymptomatic high-risk contacts that are fully vaccinated or previously positive for COVID-19 within the past 90 days and have since been cleared do not need to self-isolate, unless they develop symptoms.

    Learn more about self-isolation. Health care providers can also provide Public Health's self-isolation fact sheet to patients.

    If your patient has no symptoms, has not had known close contact with a positive case of COVID-19 and no travel history but decided to get a COVID-19 test, they are not required to self-isolate.

    A COVID-19 test is only a snapshot of your patient's health on the specific date and time the swab was taken. No testing is perfect and a negative result doesn't mean that they haven't been exposed to COVID-19. Individuals can still develop symptoms days after a test was taken.

    • If your patient's test comes back negative, but they begin to develop COVID-19 symptoms, even if they're mild, they need to be retested and self-isolate while they await their test result. This is important so we can all protect the health and safety of our loved ones and our community from whatever infection they may have.
  • What do I need to test patients in my office?

    Important: If you're testing for COVID-19, refer to the Public Health Ontario Updated IPAC Recommendations for Use of Personal Protective Equipment for Care of Individuals with Suspect or Confirmed COVID-19.

    Make sure the patient is sent home with instructions to self-isolate and manage prescription(s) or other needs in a way that assumes the patient has COVID-19.

    You will also need:

    • A room to isolate patient (doesn't need to be a negative pressure room)
    • Personal protective equipment - gloves, gowns, surgical mask and eye protection (face shield or goggles are acceptable as eye protection)
    • NP swabs
    • COVID-19 Virus Test Requisition
    • Coronavirus Labstract
    • Hand hygiene facilities available
    • Cleaning and disinfectant supplies (such as wipes)
  • How can I access swabs to test for COVID-19?

    A single upper respiratory tract specimen will be accepted for COVID-19 testing.

    Testing for COVID-19 is done by real-time PCR using protocols validated by PHO Laboratory and the NML. Public Health Ontario has provided information on testing for COVID-19 and to support the interpretation of lab results. View their information on test methods.

    One serological test for antibodies to the virus has been approved by Health Canada but is not yet available for widespread use. Review the Ministry’s COVID-19 Provincial Testing Guidance Update for more information on serology testing (page 2).

  • Does Public Health have any direction on COVID-19 specimen transport?

    Niagara Region Public Health cannot provide specimen pick-up and transport at this time. Work with your local lab to coordinate specimen pick-up based on the transportation of dangerous goods criteria.

    • Ensure process for specimen transport is in place before specimen collection
    • Before preparing for transport of the specimen, ensure that at least two unique identifiers are located on the specimen containers and the lab test requisition is placed in the exterior pocket of the plastic biohazard bag
    • The specimen must be placed in a sealed biohazard bag
    • The closed container is then placed inside the specimen transport bag with an absorbent pad in the bottom of the bag
    • Specimens are to be stored at two to eight degrees Celsius following collection
    • Specimen must reach the laboratory within 72 hours of collection
  • What information is Public Health sharing on COVID-19 variants of concern?

    With the increased transmissibility of variants of concern, more intensive efforts are important to prevent further spread, including the need to provide immediate testing for those individuals who have even mild COVID-19 symptoms.

    See Niagara's daily case count for more on these variants.

    More information at:

Providing care during COVID-19

Follow the Ministry of Health's COVID-19 Guidance: Primary Care Providers in a Community Setting for in-person care and essential visits.

The Chief Medical Officer of Health's Directive #2, limiting the provision of non-essential in-person care, has been amended to support the gradual resumption of non-essential health care. The direction isn't to have you return to normal practice, but rather move towards a 'new normal'. To support this, the Ontario Ministry of Health has made available COVID-19 Operational Requirements for Health Sector Restart.

As the gradual restart of services continues, you're in the best position to determine which services can continue to be offered virtually, such as phone consultations, virtual assessments, and which services can safely resume in-person. As a reminder, Ontario approved new physician billing codes for telephone assessments, enabling doctors to conduct more assessments over the phone rather than in their clinic.

You will also need to be cautious and resume practice in a controlled and gradual manner while taking steps to protect yourself, your staff, the patient and the public. Review the measures that must be in place to meet public health guidelines and promote a safe environment for the provision of in-person health services by health care providers.

  • Should I delay post-exposure prophylaxis for probable or confirmed cases of COVID-19 or their close contacts?

    No. The National Advisory Committee on Immunization states that if post-exposure prophylaxis (PEP) is required (for example measles, hepatitis A, hepatitis B, rabies, meningococcus and varicella), it should be given without delay to all patients who need it.

  • What do my patients need to know about all these new office practices?

    It's important that your patients are informed in advance about your new office practices, the safety precautions you're taking, and how you're keeping each other safe.

    Active and passive screening of patients is extremely important during this time. Patients and essential visitors should be screened over the phone for symptoms of COVID-19 before their appointments or when patients present to the clinic. If screening over the phone, patients can be told what to expect when they come into the office for their appointment.

    If they screen positive in person, you can direct patients to a different room in the office or ask them to wait in their vehicle until a room becomes available. For more information about IPAC Tips in Primary Care Settings, see Ministry of Health’s COVID-19 Guidance for Primary Care Providers.

    As an additional precautionary measure, on the day of the appointments, patients and essential visitors should be screened again on site, with staff taking proper precautionary measures to protect against the possible spread of COVID-19.

    Your office may consider posting signage to inform patients of the specific measures being taken to ensure the safety of patients and clinical staff during this time, such as screening of patients and essential visitors, cleaning and disinfecting frequency of examination rooms and high-touch surfaces, and use of personal protective equipment.

    You can order the Novel Coronavirus (COVID-19) Screening Poster for Primary Care Providers and other Infection Prevention and Control print material on Public Health's resources order page.

Return to school

Public Health is committed to identifying and working collaboratively with Niagara's school boards and the community on reopening concerns as well as advising on communication and outbreak guidance for schools. We're sharing best evidence with school boards around:

  • Risk mitigation
  • Active and passive screening
  • Support for physical distancing
  • Personal protective equipment
  • Infection prevention control measures

Resources are being shared with the schools directly. If you or your practice are advising teachers or parents, or providing resources, let us know what's being shared so that we can ensure consistent communication. Email the primary care and stakeholder engagement advisor.

For more information around schools and COVID-19, see schools, child care and camps during COVID-19.

For information on the recommendations for symptomatic children who fail the COVID-19 school / child care screening and for self-isolation, see symptoms and frequently asked questions about school / child care.

Workplace inquiries

Employers and employees have a role to play to reduce the community spread of COVID-19. Find recommendations and information that apply to all workplaces and businesses, except health care settings, to help prevent the spread of COVID-19.

Scenarios

Infection prevention and control

Public Health Ontario’s Infection Prevention and Control Assessment for Primary Care, Specialty and Walk-in Clinics during COVID-19 checklist provides guidance, supports and resources for

  • Planning and preparing before restarting or continuing services
  • Screening staff, patients and visitors and how to provide care for patients who screen positive for COVID-19
  • Reprocessing of reusable medical equipment / devices
  • Ensuring physical distancing requirements and more

Review key elements of environmental cleaning in healthcare settings from Public Health Ontario.

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