Public health management of cases and contacts associated with novel coronavirus disease 2019 (COVID-19)
March 13, 2020
This page is continually under review and will be updated as this situation evolves. Please visit the provincial and territorial resources for COVID-19 page for updated guidance specific to your province or territory.
On this page
- Case management - confirmed cases, probable cases and Persons Under Investigation (PUI)
- Contact management (of probable and confirmed cases)
- Appendix 1: Instructions for isolating in the home or co-living setting
The Public Health Agency of Canada (PHAC), in collaboration with Canadian public health experts has developed this guidance for federal/provincial/territorial (F/P/T) public health authorities (PHA) in the event that a case of novel coronavirus disease (COVID-19) is suspected or confirmed within their jurisdictions.
The strategy outlined in this guidance is containment (i.e. to reduce opportunities for transmission to contacts in the community) and is based on the Canadian context and public health assumptions that reflect the currently available scientific evidence and expert opinion. It is subject to change as new information on transmissibility and epidemiology becomes available. It should be read in conjunction with relevant P/T and local legislation, regulations and policies. For information regarding COVID-19, visit the Canada.ca and WHO web site.
In the context of the COVID-19 response, there will be incoming travellers whose management will fall under the Quarantine Act and who will be managed in quarantine facilities. The considerations for these individuals is beyond the scope of this guidance document.
Case management - confirmed cases, probable cases and Persons Under Investigation (PUI)
Reporting and Notification
An interim national case definitionReference 1 for COVID-19 has been developed, specifically for confirmed cases, probable cases and Persons Under Investigation (PUI), as well as associated surveillance reporting requirements. P/T public health authorities (PHA) should report confirmed and probable cases of COVID-19 nationally to the PHAC within 24 hours of receipt of their own notification.
It is important for front line health care providers to notify PHAs of any cases (i.e. confirmed or probable), PUI and individuals who do not fulfill the case definition, in accordance with jurisdictional reporting requirements. PHAs will need to provide overall coordination with health care providers and provincial laboratories for the management of cases/PUI and to establish communication links with all involved health care providers for the full duration of illness.
Facilitate appropriate laboratory testing by the health care provider in consultation with the provincial Public Health Laboratory (PHL). As per relevant laboratory guidance and identified protocols, ensure that appropriate specimens from a case are forwarded to the respective PHL. The PHL will then coordinate the submission of specimens to the National Microbiology Laboratory for further testing, as necessary. Include exposure/travel history with specimens being sent. Refer to Protocol for Microbiological Investigations of Severe Acute Respiratory Infections (SARI)Reference 2 for details on specimen collection and handling, and consultation with the PHL microbiologist on-call. Refer also to additional laboratory guidance provided by PHLs
The treating health care provider (whether in the home or in an acute care setting) will provide individual clinical management of the case/PUI based on their condition and at the discretion of the health care provider. At this time, there is no specific treatment (e.g. antivirals) for cases of COVID-19. Guidance on the clinical management of severe acute respiratory infection (i.e. in a hospital) when a case of COVID-19 is suspected is available from the WHO.Reference 3
Health care workers providing care for a case/PUI should follow relevant guidance developed for infection prevention and control including Routine Practices and Additional PrecautionsReference 4, and COVID-19-specific infection prevention and control (IPC) guidanceReference 5. Any aerosol-generating medical procedures should be avoided in the home environment. If an AGMP is required, consideration should be given to transferring the case/PUI to hospital due to the need for Additional Precautions.
Case Management in the Home and Co-Living Settings (isolation)
Early epidemiologic evidence suggests that the majority of people who develop COVID-19 will have mild illness and may not require care in a hospital. It is important that people who do not require hospital-level care convalesce at home as long as effective isolation and appropriate monitoring (i.e. for worsening of illness) can be provided.
Cases/PUIs should be isolated in the home setting while symptomatic (i.e. not go out unless directed to do so to seek medical care) until symptoms have resolved and the person is feeling well enough to resume normal activities, and has met the clinical and laboratory criteria set by the PHA for discontinuing isolation.Footnote a Refer to Appendix 1: Instructions for isolating in the home or co-living situation.
The location where a person will be isolated will be determined by their healthcare provider and the PHA. When determining the location, several factors to determine the suitability of the home setting are described below.
- Severity of illness. The case/PUI is exhibiting mild symptoms that do not require hospitalization, taking into consideration their baseline health status including older age groups, or chronic underlying or immunocompromising conditions that may put them at increased risk of complications from COVID-19. The ill person should be able to monitor their own symptoms and maintain respiratory etiquette and hand hygiene (See Appendix 1).
- Suitable home care environment. In the home, the case should stay in a room of their own so that they can be isolated from other household members. If residing in a dormitory, such as at a post-secondary institution or where there is overcrowded housing, efforts should be made to provide the case/PUI with a single room (e.g. relocate any other roommates to another location) with a private bathroom. If a separate room is not feasible, ensure that shared spaces are well ventilated (e.g. windows open, as weather permits) and that there is sufficient room for other members of the home setting to maintain a two-metre distance from the case/PUI whenever possible. If it is difficult to separate the case/PUI physically in their own room, hanging a sheet from the ceiling to separate the ill person from others may be considered. If the ill person is sleeping in the same room as other persons, it is important to maintain at least 2 meters of separation from others (e.g. separate beds and have people sleep head-to-toe, if possible). If a separate bathroom is not available, the bathroom should be cleaned and disinfected frequently.
- Cohorting cases/PUIs in co-living settings (e.g. those living in university dormitories, shelters, overcrowded housing). Special consideration is needed to support cases/PUIs in these settings when self-isolating. If it is not possible to provide the case/PUI with a single room and a private bathroom, efforts should be made to cohort cases together. If there are two cases/PUIs who reside in a co-living setting and single rooms are not available, they could share a double room.
- Access to supplies and necessities. The case/PUI should have access to food, running water, drinking water, and supplies (see Supplies for the home when self-isolating) for the duration of isolation. Those residing in remote and isolated communities may wish to consider stockpiling the needed supplies, as well as food and medications usually taken, if it is likely that the supply chain may be interrupted or unreliable.
- Risk to others in the home. Household members with conditions that put them at greater risk of complications of COVID-19 (e.g. underlying chronic or immunocompromising conditions, or the elderly) should not provide care for the case/PUI and alternative arrangements may be necessary.
- For breastfeeding mothers: considering the benefits of breastfeeding and the insignificant role of breast milk in transmission of other respiratory viruses, breastfeeding can continue. If the breastfeeding mother is a case, she should wear a medical or procedural mask when near the baby, practice respiratory etiquette, and perform hand hygiene before and after close contact with the baby.Reference 6
- Access to care. While it is expected that the case/PUI convalescing at home will be able to provide self-care and follow the recommended preventative measures, some circumstances may require care from a household member (e.g. the case/PUI is a child). The caregiver should be willing and able to provide the necessary care and monitoring for the case/PUI.
- Psychosocial Considerations: PHAs should encourage individuals, families and communities to create a supportive environment for people who are isolating to minimize stress and hardship associated with isolation as the financial, social, and psychological impact can be substantial. Obtaining and maintaining public trust are key to successful implementation of these measures; clear messages about the criteria and justification for and the role and duration of quarantine and ways in which persons will be supported during the quarantine period will help generate public trust.
Public Health Monitoring of Cases and PUI:
It is recommended that PHAs provide active daily monitoring of cases and PUIs. The parameters of active daily monitoring will vary by PHA, but generally includes having daily contact with the case/PUI for symptom monitoring, to assess for symptom resolution, or to assess for progression of illness.
Case: conduct active daily monitoringFootnote b of the case's health status for duration of illness (and until they have met the criteria set by the PHA for discontinuing isolation).
PUI: conduct active daily monitoring of the PUI's health status until laboratory investigation has confirmed or ruled out COVID-19. If COVID-19 confirmed, follow the advice for a case.
Public Health Advice for Cases/PUI in the home or co-living setting:
Provide public health instructions to the case/PUI and household co-living setting contacts on public health measures including self-monitoring, infection prevention and control, and environmental cleaning of the home setting. See Appendix 1: Instructions for isolating in the home or co-living setting for specific advice.
Contact management (of probable and confirmed cases)
Considering the context for this guidance is containment of the virus, close contacts of confirmed and probable casesFootnote c occurring in Canada should be identified and managed as per the recommendations in this document until the containment objective is achieved or a new objective becomes necessary (e.g., if sustained person to person transmission is occurring in the community). An individual risk assessment conducted by the PHA will identify the contact's exposure risk level and to determine the required level and parameters of isolation, and PHA actions for the 14-day monitoring period.
The purpose of contact management is twofold:
- to facilitate rapid identification of new cases and to support containment by:
- identifying and isolating any symptomatic contacts as quickly as possible; and
- reducing the opportunity for transmission to others in the community from those with mild symptoms that may go unnoticed, and by providing contacts with information regarding infection prevention and control measures they should follow, as well as what to do if they develop symptoms
- to gain a better understanding of the epidemiology of this novel coronavirus.
Depending on exposure risk level, there are three categories of contacts (high, medium or low). Table 1 Categories of contacts by exposure risk level describes the risk level, provides isolation and contact management advice as well as associated PHA actionsFootnote d:
|Risk Level||Description of Risk LevelFootnote e||Isolation Level/ Contact actions||Public health authority (PHA) actions|
1) Close contact(s) of a case:
1) Non-close contact:
Self-monitor for symptoms for 14 days following their last contact.
Only transient interactions (e.g., walking by the case or being briefly in the same room)
Persons possibly exposed through travel
Decisions regarding the management of travellers who may have been unknowingly exposed to the virus that causes COVID-19 while travelling should take into consideration:
- The location(s) of travel – The location of travel serves as indicator of likelihood of having come in contact with a case during travel and therefore risk of having had an exposure to the virus. Whether a PHAC Level 3 Travel Health Notice (i.e., "avoid all non-essential travel") is in effect for any the travel locations is a key consideration.
- Note: The level of travel health notice is based on a risk assessment that takes into consideration several variables including but not limited to the epidemiology of the disease in the country, trends, control measures and surveillance systems in place.
- The setting the traveller will be returning to in Canada – The setting the traveller will be returning to in Canada helps assessment of the potential impact/consequences of the traveller introducing or spreading the virus in their work or school setting. Depending on the type of work, for example caring for elderly patients in a health care setting, or maintaining critical infrastructure, transmission of the virus in these settings could increase the risk of severe cases, health care delivery disruption and/or societal disruption.
- Local situation – The current epidemiology, response goal (i.e. containment or mitigation), demographics, health care delivery and critical infrastructure resources and surge capacity are also important considerations.
All of these considerations together with analysis of the potential positive and negative impacts of a recommendation should inform the measures implemented for returning travellers.
Table 2 describes recommendations for travellers who have travelled outside of Canada in the previous 14 days. All measures should start upon arrival in Canada and continue for a period of 14 days.
- Any traveller who develops symptoms compatible with COVID-19 within the 14 day monitoring period should be considered a PUI and from an IPC perspective should be managed as a case. If laboratory testing is negative for the virus that causes COVID-19, the individual is no longer a PUI, but should self-isolate/self-monitor for the remainder of the 14 day monitoring period. If transferring the symptomatic person from the community to an acute care facility, notify the receiving facility prior to arrival to ensure appropriate IPC measures are in place.
|Travel location||Traveller type||Traveller actions||PHA actions|
|Any country/area for which a Level 3 Travel Health Notice is in effect||All travellers||
|Any country/area outside of Canada (i.e., excluding those for which a level 3 THN is in effect)||Health care providers and those working in health care settings||
|Critical infrastructure workers||
|Primary and secondary school students and staff||
|All other travellers||
Contact tracing for airplane passengers and flight crew
Decisions related to contact tracing individual air travellers/crew who may have been exposed to a confirmed case of COVID-19 on a flight should be made based on a risk assessment conducted by the PHA to which the case is notified, considering the:
- type and severity of symptoms during the flight,
- current messaging to all international travellers (e.g., to self-isolate, avoid crowds and public places, etc.),
- timing of notification and likelihood of getting sufficient passenger contact information (i.e., within 14 days of flight),
- incremental benefit of individual communication to those seated within 2 metres of the case versus public communication of the flight number (with or without identification of the section of the plane where the case was seated).
There is no direct evidence at present that contacting individual air travellers has facilitated early case finding. Nor is there in evidence regarding transmission risk in relation to flight duration.
Should the PHA determine that contact tracing individual air travellers is warranted, the Public Health Agency of Canada's Office of Border and Travel Health can assist PHA in obtaining a flight manifest; however, it should be noted that flight manifests are not kept indefinitely and do not contain contact information on all travellers. PHA may be required to provide a letter citing their authorities under their Public Health Acts in order to obtain the manifest. If contact tracing is not feasible, a public advisory to notify the public of the potential exposure may be considered.
Contact tracing efforts should focus on those seated within a 2 metre radius of the case, as this is the accepted exposure risk area for droplet transmission.
Contact tracing efforts oriented towards individual air travellers/crew should, at a minimum, focus on:
- passengers seated within two metres of the index case AND
- crew members serving the section of the aircraft where the index case was seated AND
- persons who had close contact with the index case, e.g. travel companions or persons providing care.
PHAs may wish to request the aircraft seat map from airlines to best target the contact tracing efforts. If the seat map is not available, PHAs may wish to trace economy class passengers seated in the 5 seats surrounding the case in all directions, up to and including 3 rows in front and 3 rows behind the case. In business class, due to seat spacing this may only involve tracing passengers in the 2 surrounding rows due to the space between seats. PHAs may also wish to confirm that the case sat in the assigned seat for the duration of the flight, and ask about the case's movements during the flight.
PHAs could consider expanding the scope of their contact tracing for individual travellers if the case had severe symptoms, such as persistent coughing and sneezing, or had diarrhea or vomiting, during the flight. Alternatively, the PHA could consider publicly communicating the flight number and possibly the section of the plane where the case was seated, as long as it does not reveal the identity of the case. In the event that a crew member is a confirmed case of COVID-19 and was symptomatic during the flight, passengers seated in the area served by that crew member, as well as the other crew members, should be included in any individually-oriented contact tracing efforts.
Appendix 1: Instructions for isolating in the home or co-living setting
- Isolating in the home setting
- Personal Protective Measures for infection prevention and control
- Self-care while convalescing
- Precautions for household members (e.g. caregivers, roommates) to prevent transmission to others in the home
- Supplies for the home when isolating
Isolating in the home setting
Stay at home
The case/PUI should isolate themselves in the home setting until advised by the Public Health Authority (PHA) that isolation can be discontinued. Staying at home means:
- Not go out unless directed to do so (i.e. to seek medical care)
- Not go to school, work, or other public areas
- Not use public transportation (e.g. buses, subways, taxis)
Personal Protective Measures for infection prevention and control
The case/PUI should follow good respiratory etiquette and hand hygiene practices.
Respiratory etiquette describes a combination of measures intended to minimize the dispersion of respiratory droplets when coughing, sneezing and talking.
- Cover coughs and sneezes with a medical or procedural mask or tissue. Dispose of tissues in a lined waste container and perform hand hygiene immediately after a cough or sneeze OR
- Cough/sneeze into the bend of your arm, not your hand
Hand hygiene refers to hand washing or hand sanitizing and actions taken to maintain healthy hands and fingernails. It should be performed frequently with soap and water for at least 15-20 seconds:
- Before and after preparing food;
- Before and after eating;
- After using the toilet;
- Before and after using a medical or procedural mask
- After disposing of waste or handling contaminated laundry;
- Whenever hands look dirty.
Handwashing with plain soap and water is the preferred method of hand hygiene, since the mechanical action is effective at removing visible soil and microbes.
If soap and water are not available, hands can be cleaned with an alcohol-based hand sanitizer (ABHS) that contains at least 60% alcohol, ensuring that all surfaces of the hands are covered (e.g. front and back of hands as well as between fingers) and rub them together until they feel dry. For visibly soiled hands, remove soiling with a wipe first, followed by use of ABHS.
When drying hands, disposable paper towels are preferred, but a dedicated reusable towel may be used and replaced when it becomes wet.
Avoid touching their eyes, nose, and mouth with unwashed hands.
Monitor your symptoms
The case/PUI should monitor their symptoms and immediately report worsening of symptoms to a health care provider or PHA for further assessment. If it is determined that transfer to an acute care facility is required, instructions will be provided regarding transportation (e.g. by ambulance or private vehicle). If calling an ambulance, the dispatcher should be notified that the case/PUI may have COVID-19. If the person is transferred by private vehicle, the receiving facility should be notified to ensure that appropriate infection prevention and control measures are in place. During travel, the ill person should wear a medical or procedural mask if tolerable or cover their nose and mouth with a tissue. Those transporting the ill person should use appropriate personal protective equipment when within 2 metres of the ill person (details below).
Limit contact with other people
The case/PUI should avoid being in close proximity (within 2 metres) of other people, including household members and visitors who do not have an essential need to be in the home, with the exception of individuals providing care or delivering supplies or food.
When interactions within 2 metres are unavoidable, these should be as brief as possible, and the case/PUI should wear a medical or procedural mask. If possible, the ill person or caregiver should arrange to have supplies dropped off at their front door to minimize direct contact. If the case/PUI must leave the home setting, a medical or procedural mask should be worn.
Medical or procedural Masks
Face masks (medical or procedural) provide a physical barrier that may help prevent the transmission of the virus from an ill person to a well person by blocking large particle respiratory droplets propelled by coughing, sneezing and talking. However, using a mask alone is not guaranteed to stop infections and should be combined with other prevention measures including respiratory etiquette and hand hygiene.
Applying a consistent approach to putting on and taking off a mask are key in providing overall protective benefits. The following steps will help to ensure masks are used effectively:
- Before putting on a mask, wash hands with soap and water or ABHS. The mask should be worn with the coloured side facing out.
- Cover mouth and nose with mask and make sure there are no gaps between your face and the mask, press the mask tight to your face using your fingers to secure along the perimeter of the mask, pressing firmly over the bridge of your nose. Wash hands again with soap and water or ABHS.
- Avoid touching the mask while using it; if you do, clean your hands with soap and water or alcohol-based hand sanitizer.
- Replace the mask with a new one as soon as it is damp or dirty with secretions. Do not re-use single-use masks.
- To remove the mask, remove both straps from behind the ears. Do not touch the front of mask, and ensure that the front of the mask does not touch your skin or any surfaces before you discard it immediately in a closed waste container. Wash hands with alcohol-based hand rub or soap and water.
Limit contact with pets
Due to the theoretical possibility that animals in the home could be infected by COVID-19, it is recommended that cases also refrain with contact with pets, if possible.
Avoid Sharing Personal Household Items
The Case/PUI should not share personal items with others, such as toothbrushes, towels, washcloths, bed linen, cigarettes, unwashed eating utensils, drinks, phones, computers, or other electronic devices.
Clean all high-touch surfaces
High-touch areas such as toilets, bedside tables and door handles should be disinfected daily using a store bought disinfectant, or if not available, a diluted bleach solution (one part bleach to 9 parts water to make a 0.5% sodium hypochlorite solution). If they can withstand the use of liquids for disinfection, high-touch electronics such as phones, computers and other devices may be disinfected with 70% alcohol (e.g. alcohol prep wipes).Reference 7
Disinfectants can kill the virus making it no longer possible to infect people. Disposable gloves should be used when cleaning or handling surfaces, clothing, or linen soiled with body fluids. Dormitories and co-living settings where ill persons are convalescing should be cleaned and disinfected daily.
All used disposable contaminated items should be placed in a lined container before disposing of them with other household waste.
Self-care while convalescing
At this time, there is no specific treatment for COVID-19. The case/PUI should rest, eat nutritious food, stay hydrated with fluids like water, and manage their symptoms. Over the counter medication can be used to reduce fever and aches. Vitamins and complementary and alternative medicines are not recommended unless they are being used in consultation with a licensed healthcare provider.
Monitor temperature regularly
The case/PUI should monitor their temperature daily, or more frequently if they have a fever (e.g., sweating, chills), or if their symptoms are changing. Temperatures should be recorded and reported to the PHA as per its instructions. If the case/PUI is taking acetaminophen (e.g. Tylenol) or ibuprofen (e.g. Advil), the temperature should be recorded at least 4 hours after the last dose of these fever-reducing medicines.Footnote h
Maintain a suitable environment for recovery
The environment should be well ventilated and free of tobacco or other smoke. Airflow can be improved by opening windows and doors, as weather permits.
Staying at home and not being able to do normal everyday activities outside of the home can be socially isolating. PHA can encourage people who are isolating themselves at home to connect with family and friends by phone or computer.
Precautions for household members (e.g. caregivers, roommates) to prevent transmission to others in the home
For caregivers of a case/PUI, it is important to take appropriate steps to protect yourself and others in the home environment from contracting COVID-19.
- Perform regular hand hygiene. The ill person and the household members should perform hand hygiene regularly.
- Practice good respiratory etiquette followed by hand hygiene.
- Limit the number of caregivers. Ideally, the ill person should be able to care for themselves. Caregiving within 2 meters of the ill person should be limited to one person.
- Prevent exposure to contaminated items and surfaces. Do not use personal items that belong to the case/PUI such as toothbrushes, towels, washcloths, bed linen, cigarettes, unwashed eating utensils, drinks, phones, computers, or other electronic devices. The lid of the toilet should be down before flushing to prevent contamination of the environment.
- Frequent cleaning and disinfecting. High-touch areas such as toilets, bedside tables and door handles should be disinfected daily using a store bought disinfectant, or if not available, a diluted bleach solution (0.5% sodium hypochlorite).
- Disposing of waste. All used disposable contaminated items should be placed in a lined container before disposing of them with other household waste.
- Use precautions when doing laundry. Contaminated laundry should be placed into a laundry bag or basket with a plastic liner and should not be shaken. Gloves and a medical or procedural mask should be worn when in direct contact with contaminated laundry. Clothing and linens belonging to the ill person can be washed together with other laundry, using regular laundry soap and hot water (60-90°C). Laundry should be thoroughly dried. Hand hygiene should be performed after handling contaminated laundry and after removing gloves. If the laundry container comes in contact with contaminated laundry, it can be disinfected using a store bought disinfectant, or if not available, a diluted bleach solution (0.5% sodium hypochlorite).
- Use of personal protective equipment. If household members have direct contact with the case/PUI, they should wear a medical or procedural mask and eye protection when within two meters and should perform hand hygiene after contact. Caregivers should wear disposable gloves when in direct contact with the ill person, or when in direct contact with the ill person's environment as well as soiled materials and surfaces. Hand hygiene should be performed before putting gloves on and after removing them.
Eye protection is recommended to protect the mucous membranes of the eyes during case/PUI care or activities likely to generate splashes or sprays of body fluids including respiratory secretions.
- Eye protection should be worn over prescription eyeglasses. Prescription eyeglasses alone are not adequate protection against respiratory droplets.
- Protective eye wear should be put on after putting on a mask.
- After applying eye protection, gloves should be donned (see above).
- To remove eye protection, first remove gloves and perform hand hygiene. Then remove the eye protection by handling the arms of goggles or sides or back of face shield. The front of the goggles or face shield is considered contaminated.
- Discard the eye protection into a plastic lined waste container. If the eye protection is not intended for single use, clean it with soap and water and then disinfect it with a store bought disinfectant , or if not available, a diluted bleach solution (0.5% sodium hypochlorite), being mindful not to contaminate the environment with the eye protection.
- Perform hand hygiene.
Disposable single use gloves should be worn when in direct contact with the ill person, cleaning contaminated surfaces, and handling items soiled with body fluids, including dishes, cutlery, clothing, laundry, and waste for disposal. Gloves are not a substitute for hand hygiene; caregivers must perform hand hygiene before and after putting on and taking off gloves.
- Gloves should be removed, hand hygiene performed, and new gloves applied when they become soiled during care.
- To remove gloves safely, with one of your gloved hands pull off your glove for the opposite hand from the fingertips, as you are pulling, form your glove into a ball within the palm of your gloved hand. To remove your other glove, slide your ungloved hand in under the glove at the wrist and gently roll inside out, and away from your body. Avoid touching the outside of the gloves with your bare hands.
- Gloves must be changed and hand hygiene performed when they are torn.
- Discard the gloves in a plastic-lined waste container.
- Perform hand hygiene.
- Double-gloving is not necessary.
Reusable utility gloves may be used; however, they must be cleaned with soap and water and decontaminated after each use with a store bought disinfectant, or if not available, a diluted bleach solution (0.5% sodium hypochlorite).
Supplies for the home when isolating
- Medical or procedural masks for case and others in the home
- Disposable Gloves
- Eye protection
- Fever-reducing medications
- Running water
- Hand soap
- Alcohol based hand sanitizer (ABHS) containing at least 60% alcohol.
- Waste container with plastic liner
- Regular household cleaning products
- Store bought disinfectant, or if not available, bleach and a separate container for dilution.
- Alcohol (70%) prep wipes
- Regular laundry soap
- Dish soap
- Disposable paper towels
- Reference 1
PHAC. Interim National Case Definition: Novel Coronavirus (2019-nCoV). [Online] 6 February 2020. [Accessed on 7 February 2020] https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/health-professionals/national-case-definition.html
- Reference 2
Canadian Public Health Laboratory Network. Protocol For Microbiological Investigations Of Severe Acute Respiratory Infections (SARI). [Online] 2013. [Accessed: 16 January 2020] https://www.canada.ca/en/public-health/services/emerging-respiratory-pathogens/protocol-microbiological-investigations-severe-acute-respiratory-infections-sari.html
- Reference 3
WHO. Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected. [Online] 11 January 2020. [Accessed on 17 January 2020] https://www.who.int/internal-publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected
- Reference 4
Routine Practices and Additional Precautions for Preventing the Transmission of Infection in Healthcare Settings [online] September 2017[Accessed on Feb 22, 2020] https://www.canada.ca/en/public-health/services/publications/diseases-conditions/routine-practices-precautions-healthcare-associated-infections.html
- Reference 5
PHAC. Infection prevention and control for novel coronavirus (2019-nCoV): Interim guidance for acute healthcare settings. [online] February 4, 2020. [Accessed February 7, 2020] https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/health-professionals/interim-guidance-acute-healthcare-settings.html
- Reference 6
WHO. Home care for patients with suspected novel coronavirus (nCoV) infection presenting with mild symptoms and management of contacts. [Online] 4 February 2020. [Accessed on 7 February 2020] https://www.who.int/publications-detail/home-care-for-patients-with-suspected-novel-coronavirus-(ncov)-infection-presenting-with-mild-symptoms-and-management-of-contacts
- Reference 7
Kampf G, Todt D, Pfaender S, Steinmann E. Persistence of coronaviruses on inanimate surfaces and its inactivation with biocidal agents, Journal of Hospital Infection https://doi.org/10.1016/j.jhin.2020.01.022
- Footnote a
Decisions on discontinuing isolation should be made by the PHA in conjunction with the case's health care providers, considering both the clinical and laboratory findings. The Canadian Public Health Laboratory Network recommends two consecutive negative tests for the virus that causes COVID-19, at least 24 hours apart be considered as laboratory evidence that the case is no longer communicable; at a minimum collect NP swabs, with consideration for both NP and throat swabs at all sampling times to maximize sensitivity for detecting the virus.
- Footnote b
Where applicable and where the PHA is aware of persons being tested
- Footnote c
The recommendations for contact management may also be applied to contacts of PUI if warranted, based on an individual risk assessment.
- Footnote d
Adapted from Public Health Ontario. At-a-Glance Risk Levels and Precautions for COVID-19. February 2020.
- Footnote e
Adapted from Public Health Ontario. Public health management of cases and contacts of novel coronavirus (COVID-19) in Ontario February 12, 2020 (version 4.0).
- Footnote f
As part of the individual risk assessment, consider the duration of the contact's exposure (e.g., a longer exposure time likely increases the risk), the case's symptoms (coughing or severe illness likely increases exposure risk) and whether exposure occurred in a health care setting.
- Footnote g
In general, self-isolation means that a contact stays in their home and does not go out, and avoids being within the same room with others within the home setting. If this cannot be avoided, a distance of at least 2 metres should be maintained from others.
- Footnote h
The peak effect of temperature reduction was found to be 2.5-3.0 hours after ingestion for both acetaminophen and ibuprofen treatments in a systematic review of antipyretic effect of ibuprofen and acetaminophen in children. Wahba H. The antipyretic effect of ibuprofen and acetaminophen in children. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy. 2004 Feb;24 (2):280-4.
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