Holiday Greetings and Advisement that Rapid Changes to COVID-19 Case and Contact Management are Underway

Advisory Alert

December 24, 2021

*Cette information est seulement disponible en anglais.

To: Local Health System Partners

FOR IMMEDIATE ATTENTION

Dear Colleagues,

Please let me extend my very warmest wishes to you and your loved ones this holiday season. There are no words to adequately to express my gratitude to you for your sacrifices and dedication over this last year and beyond. Your patients and our communities are healthier and safer thanks to you – notwithstanding the personal toll. Thank you from me personally and on behalf of our entire team at Public Health Sudbury & Districts. May you find some moments of peace and replenishment this holiday season.

Penny

COVID-19 Case and Contact Management in the Context of the Omicron Variant

Please be advised that the Ministry of Health guidance on COVID case and contact management is rapidly changing in the face of the Omicron surge.

While details are still evolving, we are shifting to a new “paradigm” of how we manage COVID-19 with the goal of protecting vulnerable people at highest risk of severe outcomes, protecting public health and health system capacity, and ensuring maintenance of critical infrastructure. As we transition to learning how to live more “normally” with COVID-19, I hope that the key directions summarized below are helpful to you. We will do our best to share more information as it is available.

Rapid Antigen Testing (RAT)

• As access to PCR testing is increasingly limited, anyone who tests positive on a rapid antigen test should be considered to have COVID-19 and must self-isolate for 10 days from symptom onset or positive test date (if asymptomatic) regardless of their vaccination status.
• A confirmatory PCR test is not required while access to PCR testing remains limited.
• With widespread community circulation of COVID-19, a positive rapid antigen test is almost certainly a true positive.

Self Isolation

• Those who are self-isolating should not leave home for any reason such as to go to work, school, shopping, indoor or group exercise, except to get tested for COVID-19 or for medical emergencies.

Isolation requirements (household)

If timely access to PCR testing is not available, Public Health Sudbury & Districts advises the following individuals and their household contacts to self-isolate immediately and continue to self-isolate for 10 days from the end of their exposure, after symptoms start, or after positive test, regardless of COVID-19 vaccination status:

• The individual or anyone in their household has tested positive on a COVID-19 rapid antigen test or a PCR test.
• The individual or anyone in their household is experiencing any of the most common symptoms of COVID- 19:
  • Any one of: fever, cough (new or worsening), shortness of breath, decrease or loss of taste or smell
  • Any two of: runny nose/nasal congestion, headache, extreme fatigue (not related to receiving a COVID-19 vaccine in the past 48 hours), sore throat, myalgia (not related to receiving a COVID-19 vaccine in the past 48 hours), GI symptoms of nausea, vomiting and/or diarrhea
• Symptomatic individuals must still self-isolate even if testing negative on a rapid antigen test as these tests can produce false negative results.

Isolation requirements for high-risk contacts (non-household exposure)

• All high-risk contacts who are not fully immunized must self-isolate immediately and continue to isolate for 10 days after the end of their exposure.
• All high-risk contacts who develop symptoms of COVID-19, regardless of vaccination status, must be treated as if they have COVID-19 and self-isolate (see above).

Isolation requirements for high-risk contacts (non-household exposure, fully immunized)

• Fully immunized, asymptomatic high-risk contacts are not required to self-isolate but must self-monitor for symptoms for 10 days and not visit high risk settings (e.g. long-term care homes, retirement homes, group homes, shelters, etc.) or individuals who may be at higher risk of illness (e.g. seniors) for 10 days from the last exposure.
• Fully immunized, asymptomatic high-risk contacts who work in a high risk setting must not attend work for 10 days from the last exposure, but may be eligible for review if there are critical staff shortage as aligned with COVID-19 Provincial Testing and Clearance Guidance.
• The current volume of cases means that high-risk contacts will not typically be informed by Public Health, but will be advised by the case or another contact.

Reporting to Public Health Sudbury & Districts:

• Please do not report Rapid Antigen test results or patients you suspect to have COVID-19 based on symptoms / exposure history to Public Health.
• Currently these patients should follow Public Health instructions as if they had lab confirmed COVID-19, however they are not reported to Public Health.

Please remind patients that COVID-19, in particular Omicron, often presents with minor symptoms (congestion or runny nose) or may cause no symptoms at all. Decreasing the number of people we associate with is important to control spread.

Sincerely,

Original Signed By

Dr. Penny Sutcliffe
Medical Officer of Health and Chief Executive Officer

NOTE: All Advisory Alerts are found on our website.

This item was last modified on December 24, 2021