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COVID-19: Advice for Health Care Providers

Novel Coronavirus (COVID-19) Key Points

On December 31, 2019, a cluster of cases of pneumonia in Wuhan, China was reported to the World Health Organization. The cause has been confirmed as a new coronavirus that has not previously been identified in humans (novel coronavirus or COVID-19).

The current situation around COVID-19 is evolving. New information is becoming available daily and a clearer picture is being formed as this information is analyzed by provincial, national and international health agencies.

Updates about the status of cases in Ontario is available on the Ministry of Health Coronavirus webpage.

Currently, persons considered most at risk for novel coronavirus infection are those older than 70 years of age, those who are immunocompromised, and those with underlying medical conditions.

Coronaviruses are spread through contacts and droplets. The Ontario Ministry of Health is recommending a precautionary approach that combines Airborne Precautions and Droplet/Contact Precautions in addition to Routine Practices for any patient with suspected COVID-19. Airborne precautions (including the use of N95 respirators) were initially put into place to protect health care workers; however, in light of new evidence, the precautions for the COVID-19 virus have been downgraded to droplet.

Note: Airborne precautions should be used when aerosol generating medical procedures (AGMPs) are planned or anticipated to be performed on patients with suspected or confirmed COVID-19.

Guidance Documents

The Ministry of Health has developed guidance documents for health care providers to assist in potentially identifying and managing individuals who may be exposed to COVID-19. The most up-to-date versions can be located on the Ministry of Health’s Sector Specific Guidance website.

Signs and Symptoms

COVID-19 can cause illness ranging from very mild, cold-like discomfort to a severe lung infection. Symptoms can include:

  • fever
  • new or worsening cough
  • shortness of breath
  • sore throat/hoarse voice
  • difficulty swallowing
  • loss of sense of smell or taste
  • nausea
  • vomiting
  • diarrhea
  • abdominal pain
  • runny nose or nasal congestion

Atypical symptoms commonly found in children, seniors, and individuals living with a developmental disability can include:

  • unexplained fatigue or malaise
  • muscle aches
  • delirium
  • unexplained or increased number of falls
  • acute functional decline
  • exacerbation of current chronic conditions
  • chills
  • headaches
  • croup
  • conjunctivitis
  • multisystem inflammatory vasculitis (in children)

Other signs can include:

  • clinical or radiological evidence of pneumonia

Atypical signs can include:

  • unexplained tachycardia
  • decrease in blood pressure
  • unexplained hypoxia
  • lethargy or difficulty feeding in infants

View the Ministry of Health's COVID-19 Reference Document for Symptoms. Complications of COVID-19 include pneumonia, kidney failure and, in the most severe cases, death.

The incubation period for COVID-19 ranges from 1-14 days. It is possible that the virus may spread to another individual before someone shows symptoms.

Some people, such as the elderly and those who are immunocompromised, may not develop a fever. For these individuals, the presence of new or worse cough, or difficulty breathing, may be enough to trigger further precautions.

Prevention Measures

There are everyday actions that can help prevent the spread of germs that cause respiratory illnesses. Take these simple steps to reduce exposure to the virus and protect your health, your family's and your patients:

  • wash your hands often with soap and water or alcohol-based hand sanitizer
  • sneeze and cough into your sleeve
  • avoid touching your eyes, nose or mouth
  • avoid contact with people who are sick
  • stay home if you are sick
  • wear a non-medical mask or face-covering when in indoor public spaces or when outdoors if distancing is difficult
  • follow your workplaces COVID-19 guidelines and protocols for a safe environment

Travel Recommendations

Anyone who has travelled outside of Canada is required to self-isolate for 14 days upon their arrival back in Canada. Please visit our travel page for more details on isolation.

Visit the Government of Canada travel page for more details.

Testing Information

The Ministry of Health provides guidelines for testing of individuals for COVID-19. Testing is prioritized for groups who are at risk of more severe disease or those who live or work in settings that are higher risk. 

The focus remains on:

  • Individuals who have travelled outside of Canada and have symptoms
  • Close contact with a confirmed or probable case of COVID-19
  • School personnel and students

Other considerations for assessment and testing include:

  • Hospital inpatients
  • Residents of long-term care and retirement homes
  • Health care workers, caregivers, care providers, paramedics, and first responders, including police and firefighters
  • Remote, isolated, rural and Indigenous communities
  • Other congregate living centres, including homeless shelters, prisons and group homes
  • Specific vulnerable populations, including patients undergoing chemotherapy or hemodialysis and requiring transplants, as well as pregnant women, newborns and cross-border workers
  • And other essential workers, as defined by provincial orders.

Testing for COVID-19 is based on a clinical assessment of each person. Please visit our testing page for more details.

If you suspect an individual may be infected with COVID-19, report the suspected case to the Porcupine Health Unit by calling 705-267-1181 ext. 2919 or 1-800-461-1818 to speak to the Intake Nurse. For after-hours or weekend reporting, call 705-267-1181 or 1-800-461-1818 and press “4” for COVID-19 symptoms/travel, "5" for COVID-19 business-related calls, or "6" for general inquiries. Messages will be returned within 24 hours.

Details on how to test, specimen collection, and the specific test requisition for COVID-19 are available on the Public Health Ontario (PHO) website.

NOTE: the following mandatory information must be included on the PHO COVID-19 Test Requisition

  1. Whether the individual meets criteria for a person under investigation (yes/ no)
  2. Travel history (country and dates)
  3. Contact of case or probable case (yes/no); if no, other sick contacts (yes/no; if yes, describe)
  4. Symptom onset date
  5. Patient symptoms (fever, cough, runny nose, pneumonia)
  6. Patient setting (ICU, hospitalized, ER or outpatient)

Reporting to Porcupine Health Unit (PHU)

Novel coronavirus is now a reportable under Ontario's public health legislation. If you suspect an individual may be infected with COVID-19, report the suspected case to the Porcupine Health Unit at 705-267-1181 ext. 2919 or 1-800-461-1818. The Porcupine Health Unit is available after-hours and on weekends by calling 705-267-1181 or 1-800-461-1818 and press “4” for COVID-19 symptoms/travel, "5" for COVID-19 business-related calls, or "6" for general inquiries. Messages will be returned within 24 hours. 

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