Frequently Asked Questions on Novel Coronavirus (COVID-19)
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.
If you don't see a response to your question here or on COVID-19 Information for Health Care Professionals, email HCP Engagement or call our COVID-19 Health Care Professionals information line Monday to Friday, 8:30 a.m. - 4:15 p.m. at 905-688-8248, press 7, then press 1. You can also review our Medical Advisories and Memos for the latest health alerts and advisories (COVID and non-COVID related).
Updated June 17
Testing
- What do I need to test patients in my office and where can I get it?
Testing in office can be performed if the health care professional is able to follow the recommendations outlined by the Province, has the appropriate tools and knowledge of how to test, and can ensure coordination of sample delivery to a laboratory providing COVID-19 testing.
You will also need:
- A room to isolate patient (doesn't need to be a negative pressure room)
- Fit tested seal-checked N95 respirator (or equivalent), gloves, isolation gown and eye protection (goggles, face shield or safety glasses with side protection).
- Health care workers who are not yet fit-tested for an N95 respirator (or equivalent) must wear a non fit-tested N95 respirator (or equivalent), KN95 respirator, or well-fitted surgical/procedure mask based on a risk assessment
- Nasopharyngeal (NP) swabs
- COVID-19 Virus Test Requisition
- Hand hygiene facilities available
- Cleaning and disinfectant supplies, such as wipes
Order COVID-19 testing swabs using the online West Region Swab Order Form.
Access additional PCR testing forms and instructions through Public Health Ontario.
What do I need to know about making testing referrals?
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.
Ensure that your patient is aware of the need for safe arrangements for travel to the testing location that maintains isolation of the patient (i.e. patient should wear a medical mask or N95/KN95 respirator if they have one, otherwise they should wear a high quality three layer cloth mask and should avoid public transit if possible).
- What do I need to know about making testing referrals?
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.
Ensure that your patient is aware of the need for safe arrangements for travel to the testing location that maintains isolation of the patient (i.e. patient should wear a medical mask or N95/KN95 respirator if they have one, otherwise they should wear a high quality three layer cloth mask and should avoid public transit if possible).
COVID-19 treatment
We encourage all family physicians to communicate proactively with patients at higher risk for severe disease on how to seek treatment should they become infected with COVID-19.
Patients who are mildly to moderately ill and who have had symptoms for less than five to seven days should be assessed by a health care provider.
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What treatment is available?
See the recommended drugs in adult patients with COVID-19 guide for how to properly assess disease progress and recommend treatment.
There are two antiviral treatments available:
- Paxlovid
- Remdesevir
For COVID-19 antivirals to be effective, they must be administered early in the course of illness. Out patients are currently eligible for Paxlovid within five days of symptom onset, and Remdesivir within seven days of symptom onset.
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Who is eligible for treatment?
The province has outlined the following as persons who should reach out to you in primary care for assessment and testing as possible candidates for Paxlovid:
- Individuals aged 70 and over;
- Individuals aged 60 and over with fewer than three vaccine doses; and
- Individuals aged 18 and over who are immunocompromised (have an immune system that is weakened by a health condition or medications);
- Individuals aged 18 and over with fewer than three vaccine doses and at least one risk condition (e.g., a chronic medical condition)
- Individuals who are unvaccinated and pregnant
Children and adolescents under the age of 18 with risk factors for severe disease should contact their pediatrician to determine if treatments are available.
If you are unable to prescribe COVID-19 treatment, refer to the Clinical Assessment Centre within five to seven days of symptom onset.
Refer to the Ontario Science Table recommended drugs in adult patients with COVID-19 guide or the Clinical Assessment Centre referral form for complete eligibility criteria.
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How can my patients access treatment?
Paxlovid is now available for patients much more easily with a prescription from primary care, with the medication then being dispensed in pharmacies. This improves access, and allows you to treat your patients with COVID-19 the same way you would treat other illnesses.
Referrals can also be made to the Clinical Assessment Centre through Niagara Health. Check their page for up-to-date information on access to treatment.
If you are prescribing Paxlovid:
- Use the Paxlovid prescription form
- Review the Ontario Science Table's guidelines which outline who will best benefit from Paxlovid
- Review Ontario Health's Access to COVID-19 antiviral treatment (Paxlovid)
- Paxlovid: What Prescribers and Pharmacists Need to Know (for a list of drug interactions and contraindications, as well as guidance on what to do for each of those interactions)
- Check for possible drug interactions and contraindications before prescribing Paxlovid for your patients. Note that some medications will be able to be paused during Paxlovid treatment, and others will not (therefore, Paxlovid cannot be prescribed, and referral to a Clinical Assessment Centre should be considered).
- Liverpool Drug Interaction Checker
Below are links to electronic medical record forms that automate the prescription form and faxing processes. These resources will help with Paxlovid prescriptions and referrals.
If you are referring to the Clinical Assessment Centre:
The Niagara Health COVID-19 Assessment Centre will take referrals for patients with:
- Complex medication regimens so that they can adjust dosing appropriately
- Referrals to receive remdesivir infusions where Paxlovid is contraindicated
- Without a primary care provider
Complete the Clinical Assessment Centre referral form to refer the patient to the assessment centre at Niagara Health where the patient will be assessed, tested, and prescribed treatment if eligible.
- Patients will still be accepted without recent bloodwork. Do not delay referral, as bloodwork can be completed at the clinical assessment centre.
- Patients who are eligible for treatment are always eligible for PCR testing. They do not need referral to seek PCR testing. Appointments are necessary for PCR testing.
- A positive rapid antigen test, PCR or rapid molecular test is required as part of the assessment for antiviral treatment
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Additional treatment resources
- COVID-19 antiviral treatment screener
- Ontario Health Paxlovid Patient Fact Sheet
- Confused About COVID Medication Information Sheet
- Hamilton Family Medicine Antiviral / Paxlovid Access
- COVID-19 Antiviral Treatment
- Participating Pharmacies in Dispensing Paxlovid
- COVID-19 Health System Response Materials | Ontario Health
COVID-19 vaccination
- What if I have a patient who is requesting a Johnson and Johnson (Janssen), Novavax (Nuvaxovid) or Medicago (Covifenz) vaccine?
Every effort should be made to immunize with an mRNA vaccine. Other vaccines should only be used when an mRNA vaccine is declined and after informed consent.
- Health Canada has authorized Novavax's Nuvaxovid COVID-19 vaccine for adults aged 18 and older. Ontario is expecting to receive its first shipment this spring. For more information on this vaccine see our Medical Advisory from April 5, 2022.
- Health Canada has also authorized Medicago's Covifenz, a made-in-Canada plant-based option for adults aged 18-64. We will share more details once we have received guidance from National Advisory Committee On Immunization and supply details from the federal and provincial governments.
If you have clients / patients asking for either of these vaccine options, have them call the COVID-19 Info-Line to indicate their interest.
- Where can I find advice for COVID-19 vaccine allergy-related questions?
To support the rollout of COVID-19 vaccinations across the province, the Ontario eConsult of Excellence, Public Health Ontario, OMA, Ontario MD, Ontario Health, and the Ministry of Health have created a COVID-19 - Allergy / Immunology BASETM Managed Specialty Group. This new eConsult service offers allergy advice related to the COVID-19 vaccine.
Physicians and nurse practitioners will be able to submit electronically both patient-specific and general questions about COVID-19 vaccine allergies. Within a few days, allergy and clinical immunology specialists will provide a response.
To learn more or to register, visit the Ontario eConsult service.
Infection prevention and control and screening
For guidance and recommendations on personal protective equipment and infection prevention and control refer to
- COVID-19 Guidance: Personal Protective Equipment for Health Care Workers and Health Care Entities - Ministry of Health
- Technical Brief - Updated IPAC Recommendations for Use of Personal Protective Equipment for Care of Individuals with Suspected or Confirmed COVID-19 - Public Health Ontario
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How can I order personal protective equipment?
To order personal protective equipment go to Ontario Together: Help fight COVID-19 or review the Niagara PPE Provider Directory to find a provider.
You can also order personal protective equipment from Healthcare Materials Management Services.
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What do I need to know about screening for COVID-19?
Passive screening of staff continues to be recommended. Staff and healthcare providers should self-monitor for COVID-19 symptoms and not come to work if they are experiencing symptoms. Learn about Provincial COVID-19 screening guidance for employers.
Follow COVID-19 patient screening guidance for active screening of patients entering healthcare settings.
Variants of concern
- What do I need to know about COVID-19 variants of concern?
The Public Health Agency of Canada expects the SARS-CoV-2 virus to continuously evolve, and is closely monitoring the domestic and international situation and preparing for new variants.
Niagara Region Public Health does not breakdown local cases by COVID-19 variant.
For additional information, visit:
- Public Health Ontario, COVID-19 Variants of Concern
- World Health Organization, Tracking SARS-CoV-2 variants
More information
Ministry of Health
- Living with and Managing COVID-19 Technical Briefing
- COVID-19 Guidance for the Health Sector
- COVID-19 Vaccine Relevant Information and Planning Resources
National Advisory Community on Immunization
Centre for Effective Practice
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