Updated COVID-19 guidance for contact identification and management relating to a health care worker

Advisory Alert

December 16, 2020

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Dear Facility Administrator:

FOR IMMEDIATE ATTENTION

I am writing to highlight for you a recent change to the Public Health Management of Cases and Contacts of COVID-19 in Ontario (http://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/contact_mngmt/management_cases_contacts.pdf [531 KB, PDF]). This document provides provincial guidance on the management of cases and contacts of COVID-19. The December 1, 2020 change has important implications for your practice.

Within all health care settings, when a health care worker (HCW) has been identified as a case of COVID-19, all patients for whom the HCW has provided direct care, or who had other similar close physical contact (i.e. the patient was ˂ 2 meters away from the HCW for any duration of time) are considered high risk contacts UNLESS BOTH THE HCW and the patient were wearing a mask (medical or non-medical). High risk contacts must be isolated for 14 days and tested in the recommended timeframe from last exposure. Direct care is defined as: Providing hands-on care, such as bathing, washing, turning the resident, changing clothing, continence care, dressing changes, care of open wounds/lesions or toileting.

The same applies for co-workers who had close contact with the COVID-19 positive HCW. Unless BOTH case and co-worker were masked (medical or non-medical) OR the co-worker was wearing a medical mask and eye-protection, co-workers will be deemed as high-risk contacts and require self-isolation for 14 days from last exposure.

Contacts wearing appropriate mask or PPE as described above would be deemed low risk contacts and advised to self-monitor for 14 days.

This change applies also to the identification of close contacts when a staff presents with new symptoms compatible with COVID-19 and an outbreak assessment is triggered under Directive #3 of the Chief Medical Officer of Health. This change in guidance understandably will have significant impact in the management of COVID-19 cases and contacts in your facilities.

Clarification of this direction is anticipated from the province and will be shared with you as it is received, however for the time being, for HCW and client/patient encounters, please consider providing residents/patients/clients with masks and HCW with eye protection, in addition to medical masks to lower the risk of exposure to asymptomatic/pre-symptomatic HCWs.

Furthermore, as per Federal and Provincial direction, Long-Term Care Home staff are a priority population for early COVID-19 vaccination. In anticipation of vaccine becoming available in our area, Public Health Sudbury & Districts will reach out to you soon for required information related to staffing, including staffing numbers and categories, full/part time status, and contact names. Please be prepared for this request as your rapid responses will be appreciated.

Thank you for your attention to these very important matters and for your ongoing commitment to preventing the spread of COVID-19 infection in our community.

Sincerely,

Original Signed By

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

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This item was last modified on December 16, 2020