Frequently Asked Questions on Novel Coronavirus (COVID-19)

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.

General Information

Testing

  • Who can be tested for COVID-19?

    Anyone concerned that they may have been exposed to COVID-19 can now get tested, whether or not they have symptoms.

    For more information on who should be tested, refer to the COVID-19 Provincial Testing Guidance Update. You can also refer to the most recent Niagara Region Public Health Memo on COVID-19 testing with regard to our advice on testing asymptomatic individuals, to help with that decision.

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

  • Are family members and close contacts of cases to be sent for testing?

    Public health nurses are working directly with the close contacts of all laboratory confirmed COVID-19 cases in Niagara. They're providing close contacts with medical direction and instruction for testing and self-isolation.

  • Do all patients tested for COVID-19 need to be self-isolated for 14 days?

    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 need to self-monitor for symptoms but 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 re-tested 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.

    If patient is positive for COVID-19:

    • They must self-isolate for a minimum of 14 days or until they are asymptomatic, whichever is longer
    • See specific instructions for health care workers under scenarios below

    If patient is negative for COVID-19:

    • If symptoms have resolved and they're not a contact of a confirmed case, nor recently travelled outside of the country, then they can resume normal activities
    • If the patient is a close contact of a confirmed case, they should continue to self-isolate for 14 days from the date of last exposure to this case. If they have recently travelled outside of the country, they must complete quarantine for 14 days from their date of return from travel.
    • We continue to encourage physical distancing, frequent hand-hygiene, avoidance public places and self-monitoring for symptoms
  • What is the test for COVID-19 and how can I access swabs?

    A single upper respiratory tract specimen will be accepted for COVID-19 testing. Upper respiratory tract specimens include a nasopharyngeal swab (NP) OR viral throat swab collected in universal transport medium (UTM). NP is the preferred specimen and is not aerosol generating.

    To order swabs from Public Health Ontario, use the requisition for specimen containers and supplies.

    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.

  • 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
  • Do I need to notify Niagara Region Public Health and Emergency Services when I test someone for COVID-19?

    Yes. In addition to COVID-19 being a new infectious disease it is also classified as a disease of public health significance and must be reported to Public Health. If you are testing patients for COVID-19, notify Public Health immediately by calling 905-688-8248 and follow the prompts.

    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.

    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.

  • Is Niagara Region Public Health testing for COVID-19?

    No. Niagara Region Public Health offices don't provide COVID-19 testing. Anyone who requires testing is referred for an appointment at one of the testing locations in Niagara.

  • What is the process for sending patients for testing?

    Niagara Health has three assessment centres located in St. Catharines, Niagara Falls and Welland. All centres allow for patient self-referrals and walk-in appointments for COVID-19 testing.

    • St. Catharines and Niagara Falls assessment centres are open Monday to Sunday, 9 a.m. - 5 p.m.
    • Welland assessment centre is open Monday, Wednesday and Friday, 9 a.m. - 5 p.m.

    A temporary drive-thru testing centre (separate from the Niagara Health assessment centres) is located in Fort Erie. This testing centre is by physician referral and appointment only.

    We recognize that patients talking to their trusted health care provider is the optimal approach. You have relationships with your patients, know their medical history and can best assess their symptoms. Primary care providers can screen their own patients over the phone and directly refer those who are symptomatic to a COVID-19 testing location. A toolkit is available to support your office in setting up your clinic and notifying your patients, should you choose to offer this to your patient roster. Contact the primary care and stakeholder engagement advisor for a copy of the toolkit and referral form.

    Public Health’s COVID-19 Info-Line is still available for physicians, health care providers and patients. Call 905-688-8248, and follow the prompts.

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

    It can take up to approximately seven days to receive lab test results for COVID-19. With the large number of swabs that labs are processing, results are taking longer than usual to be posted. Public Health doesn't have earlier access to the results than health care providers do. It's important that your patient remains in self-isolation while they wait for their lab test result.

    If your patient receives an indeterminate result from their online search for results, this may mean that results are not completed by the lab. Advise the patient to continue to check back in a day or two for their results if they have not 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?

    Physicians can access patient test results on Clinical Connect. Public Health doesn't have earlier access to patient test results.

    Patients in Niagara are encouraged to check their results by signing up for My Chart. Ontario has also launched a new online portal for the public to access their COVID-19 test results online. However, this portal only contains lab test information submitted to the Ministry by participating laboratories across Ontario.

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

    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.

  • Do I need to collect a separate swab for COVID-19 and influenza?

    Influenza testing is reserved for sentinel physicians, hospitals and long-term care homes.

Scenarios

  • I am a health care worker and tested positive for COVID-19. When can I return to work?

    While awaiting test results, you must normally self-isolate. However, if you have no symptoms, even mild symptoms, no known close contact with a positive case of COVID-19, and no travel history, but you decided to get a COVID-19 test, you can return to work but self-monitor.

    If you received a positive test result:
    Based on the latest science and new guidance from the Ministry of Health on May 2, 2020, most individuals who work in the health care field can return to work unless otherwise directed by their employer / occupational health and safety if they have:

    • Recovered from mild to moderate illness
    • Don't have shortness of breath or a fever (seek medical attention if you still have shortness of breath or a fever)
    • Were never hospitalized for their illness
    • Completed 14 days in self-isolation (starting on the day they were tested)

    Health care workers who tested positive and experienced severe illness and required hospitalization need to receive two negative results, 24 hours apart to discontinue self-isolation and return to work. The public health infectious disease nurse assigned to the case will arrange for follow up testing.

    If you received a negative test result:
    It's important to remember that a COVID-19 test is only a snapshot of your health on the specific date and time the swab was taken. No testing is perfect and a negative result doesn't mean you haven't been exposed to COVID-19. You can still develop symptoms days after your test was taken.

    If your test comes back negative, but you begin to develop COVID-19 symptoms, even if they're mild, you need to be re-tested.

    • Once you have received a negative result, you can return to work once you're asymptomatic (no longer have symptoms) as long as you have not had a known exposure (such as returning to Canada or contact with a confirmed case) to someone with COVID-19. If after 14 days, you still have symptoms, as long as your symptoms are mostly resolved and you have no fever, you can return to work.
    • If you have received a negative test result, but it has not been 14 days since your last exposure (such as returning to Canada or contact with a confirmed case), you need to stay in self-isolation for 14 days from the date of your last exposure

    Refer to the Ontario Ministry of Health guidance document (page 9) under Health and Human Resources for more information for health care workers who are critical to operations.

    Workers in the health care field include regulated health professionals, workers from retirement homes, hospitals, clinics, long-term care, independent health facilities, mental health and addictions counselling.

  • I have a patient who is asymptomatic, no travel history, but they had contact with someone who is having acute respiratory symptoms and is awaiting test results.

    The province provided guidance on asymptomatic, risk-based testing. People who are concerned that they've been exposed to COVID-19 can be referred for testing. This includes people who are contacts of, or may have been exposed, to a confirmed or suspected case.

    Advise them to:

    • Self-isolate for 14 days from the last exposure to the symptomatic person. If they live in the same household as the symptomatic person, everyone in the household should self-isolate for 14 days.
    • Call Niagara Region Public Health COVID-19 Info-Line at 905-688-8248, press 7 then press 2, or call your office
    • If symptoms develop, they will need to remain in self-isolation for 14 days from symptom onset
    • If they remain asymptomatic for 14 days they can discontinue self-isolation after that period, and practice physical distancing, avoiding public places and self-monitoring for symptoms
  • My patient received a negative COVID-19 result after having history of travel but is still symptomatic.

    Advise your patient to:

    • Continue self-isolating if they have respiratory symptoms until those symptoms resolve, or up to a full 14 days since the beginning of symptoms, whichever is longer. After 14 days, if symptoms have improved, and only residual cough remains, they may return to daily activities while being mindful of physical distancing, avoiding public places and self-monitoring for symptoms.
    • If symptoms haven't changed or have worsened, then patients must continue to self-isolate and follow up with you, their health care provider, to be reassessed
  • I have a patient who is asymptomatic, no travel history, but they had contact with someone who travelled but doesn't have symptoms.

    Tell them to:

    • Avoid crowded public spaces and places where they can't easily separate themselves from others if they become ill
    • Call Niagara Region Public Health COVID-19 Info-Line at 905-688-8248 ext. 7019 or call your office if they experience symptoms of COVID-19, such as fever, new cough or difficulty breathing
    • Call ahead before visiting any health care provider and let them know about their exposure to someone with travel history and symptoms so the provider can ensure that they use proper infection control measures
    • Monitor for symptoms for 14 days after exposure
    • Common signs of infection include fever, new cough, shortness of breath and difficulty breathing

Infection Prevention and Control

To prevent the spread of COVID-19, follow environmental cleaning and disinfecting recommendations for COVID-19 for health care settings and follow Public Health Ontario's guidance on cleaning and disinfection for public settings.

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.

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. This document outlines measures that must be in place in order to meet public health guidelines and promote a safe environment for the provision of in-person health services by health care providers.

  • 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 and can be told what to expect when they come into the office for their appointment.

    If they screen positive over the phone, the appointment should be deferred if possible and the individual referred for testing.

    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.

  • What is the guidance around well child visits and immunizations?

    Read our interim guidance memo on which well child visits should be conducted in-person during the pandemic, and recommendations for providing routine immunizations.

Vaccine Storage and Handling

  • What do I do with vaccine wastage?

    During this time, maintain vaccine wastage, including expired vaccine, at your premises. Keep it separate from usable vaccine by removing from the fridge. Clearly indicate that these vaccines are wasted.

    Don't return vaccine wastage to Public Health until further notice.

  • How do I monitor the vaccine fridge temperature?
    • Continue to record minimum, maximum and current temperatures twice daily of the refrigerator used for vaccine storage during all days the office is open
    • If your office is closed, arrange for a staff member to record fridge temperatures at least weekly, but preferably every 72 hours
    • Consider purchasing a data logger as a back up to your digital thermometer in the event of a thermometer malfunction or power outage. The digital min/max thermometer is your main temperature monitoring device even with a data logger in place. Continue to document the temperature readings from the digital min/max thermometer in the temperature logbook.
    • Set the data logger to record temperatures every 5 to 10 minutes, but no longer than every 30 minutes provided it doesn't overwrite readings prior to download. This recording frequency is most beneficial when determining vaccine stability after a temperature excursion.
    • Go to the office weekly to download the data logger. Record the temperature readings from the digital min/max thermometer at this time in the temperature logbook.
    • Indicate any closure dates in the temperature logbook
    • Promptly report any out of range temperatures to Public Health so that vaccine stability can be determined
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