Coronavirus disease (COVID-19): For health professionals

What health professionals need to know

Health professionals in Canada have a critical role to play in identifying, reporting and managing potential cases of COVID-19.

COVID-19 is the disease caused by SARS-CoV-2 coronavirus, a new virus that was first recognized in December 2019. Genetic sequencing of the virus suggests that it is a betacoronavirus closely linked to the SARS virus. Coronaviruses are a large family of viruses. Some can infect animals, and some can infect humans.

The World Health Organization (WHO) declared COVID-19 a global pandemic in March 2020.

Those who are infected with COVID-19 may have little to no symptoms. Symptoms of COVID-19 are often similar to other illnesses. They may take up to 14 days to appear after exposure to the virus. Recent studies indicate that transmission of the virus can happen from infected people before they develop symptoms (pre-symptomatic transmission) and from infected people who never develop symptoms (asymptomatic transmission). That is why everyone, even those who feel well, should follow measures to prevent the spread of COVID-19.

In severe cases, infection can lead to death.

The WHO is actively monitoring the situation and has issued updated information on the outbreak, advice on public health measures and infection prevention and control, and enhanced surveillance.

The Public Health Agency of Canada (PHAC) is monitoring the COVID-19 situation closely and providing updates as new information becomes available.

Transmission

Human coronaviruses are most commonly spread from an infected person through: respiratory droplets; close, prolonged personal contact; and touching an infected area, then touching mouth, nose or eyes before washing hands.

Epidemiological information

PHAC is collaborating with provincial and territorial public health partners to collect information on COVID-19 cases in Canada. A detailed epidemiologic summary is available.

Detecting and reporting

Diagnostic testing and medical devices

PHAC's National Microbiology Laboratory (NML) has capacity to identify COVID-19, and is developing and implementing new diagnostic tests, based on the genetic sequence of COVID-19 made available by China on January 10, 2020. Laboratory testing should be initiated in consultation with the respective provincial Public Health Laboratory (PHL). The PHL will then coordinate the submission of specimens to the National Microbiology Laboratory for further testing, as necessary. Refer to Protocol for Microbiological Investigations of Severe Acute Respiratory Infections for details on specimen collection and handling, and regarding consultation with the PHL microbiologist on-call. Refer also to additional laboratory guidance provided by PHLs.

An Interim Order has also been signed to help ensure quicker and more flexible approval of the importation and sale of medical devices that are necessary for Canada's response to COVID-19, including test kits. We have published a list of commercial diagnostic tests authorized for sale in Canada.

An interim order is one of the fastest mechanisms available to the Government of Canada to help make health products available to address larger scale public health emergencies.

If you wish to submit an application for authorization under the Interim Order please contact the Medical Devices Directorate via email hc.devicelicensing-homologationinstruments.sc@canada.ca or call 613-324-7842.

Health care professionals can obtain COVID-19 diagnostic test kits or supportive devices not yet approved for sale through the Medical Devices Special Access Program.

For general inquiries about the licensing or authorization of medical devices in Canada; you can contact the Medical Devices Directorate at 613-957-7285 or hc.meddevices-instrumentsmed.sc@canada.ca.

Reporting

Health care professionals can refer to the Interim National Surveillance Guidelines for Coronavirus Disease (COVID-19), and the Interim National COVID-19 Case Report Form, to aid with the detection and reporting of COVID-19 in Canada.

Note that reporting for COVID-19 cases to the Public Health Agency of Canada is completed by provincial or territorial health authorities. The Public Health Agency of Canada does not accept reports from the public or individual health care providers.

Recommendations to public health care professionals

Familiarize yourself with the interim national case definition for COVID-19 to consider the possibility of COVID-19 in persons with relevant clinical and exposure history.
Familiarize yourself with the Interim National COVID-19 Case Report Form, to facilitate case reporting of confirmed and probable COVID-19 cases.
- Provincial/territorial public health authorities should report confirmed and probable COVID-19 cases to PHAC within 24 hours of their own notification.
- PHAC must report events that meet the requirements for International Health Regulations Articles 6 and 7 to the WHO within 24 hours of assessment of public health information.
- The Protocol for Microbiological Investigations of Severe Acute Respiratory Infections (SARI) will help to facilitate the diagnosis of severe respiratory infections due to both unknown and known respiratory pathogens that have the potential for large-scale epidemics.
Familiarize yourself with the guidance on the public health management of cases and contacts associated with COVID-19.

Infection prevention and control

Find out more about personal protective equipment for use against COVID-19.

Reprocessing of N-95 Respirators

Healthcare professionals providing direct care to patients across the country above all need access to the personal protective equipment (PPE) they need for each and every shift.

The COVID-19 pandemic has created unprecedented demand for certain supplies, including PPE. The Government of Canada is using a range of strategies to respond to this increased demand by

purchasing as many additional supplies as possible,
increasing domestic production, and
extending the use of N95 respirators through reprocessing, as required.

Reprocessing of devices intended for single use only is not a new concept. It has been done successfully with other devices used in Canada and similar technology can be applied to N95 respirators.

A list of all authorized N95 respirators and all authorized equipment used in the reprocessing of N95 respirators is available on Health Canada's website. A notice to Health Care Professionals is posted on Health Canada's website that provides further information about Health Canada's evidence requirements and basis for the approach. You can also find guidance we have provided to industry on the minimum requirements that must be met to receive an authorization for equipment used in the reprocessing of N95 respirators originally intended for single use only.

Treatment

Health Canada is closely tracking all potential drugs and vaccines in development in Canada and abroad. We are working with companies, academic research centres and investigators to help expedite the development and availability of treatments to prevent and treat COVID-19.

On July 27, 2020, we granted authorization with conditions for the use of Veklury (remdesivir) to treat COVID-19 in adults and youth (12 years and older weighing at least 40 kg) with pneumonia requiring supplemental oxygen. Remdesivir is the first drug authorized to treat patients with severe symptoms of COVID-19 who have been hospitalized. There are currently no vaccines authorized for COVID-19 in Canada.

Products that may ease symptoms such as fever and cough may be used to treat patients with COVID-19. Among hospitalized patients who have COVID-19 and require supplemental oxygen or mechanical ventilation, clinicians should strongly consider:

dexamethasone 6 mg IV for 10 days (or until discharge if earlier) or equivalent glucocorticoid dose

This guidance is not meant to replace clinical judgment or specialist consultation.

Refer to the interim guidance on clinical management of patients with moderate to severe COVID-19.

Drugs and Vaccines

Clinical trials are the most appropriate way for Canadians to access experimental drugs or vaccines that could help treat or prevent COVID-19. Clinical trials are used to gather information on the safety and efficacy of a product while allowing access under controlled circumstances. Health Canada is prioritizing the review of all COVID-19-related clinical trial applications. We have already authorized several trials.

Before a drug or vaccine can be sold in Canada, we look at the scientific evidence, including clinical trial results. We ensure there is enough evidence to support a product's safety, efficacy and quality.

Health Canada will prioritize the review of market authorization applications to facilitate earlier access to COVID-19 drugs or vaccines. We may also authorize access to the Canadian market with certain restrictions (Notice of Compliance with Conditions).

To support and expedite the authorization of drugs and vaccines for COVID-19 in Canada, we are also:

collaborating with international counterparts and
leveraging all available knowledge

In Canada, we are working with industry associations and specific drug sponsors. Our goal is to learn as much as possible about potential vaccines and therapies, and facilitate their availability in Canada.

Special access to non-marketed drugs and medical devices

Through our Special Access Program (SAP), health care professionals may access non-marketed drugs or medical devices to treat or diagnose COVID-19 in patients.

COVID-19 health product advisories

Guidance

Refer to our guidance for health professionals for technical guidance on COVID-19, including infection prevention and control.

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