Niagara Region Public Health and Emergency Services is closely monitoring the COVID-19 pandemic. This is an evolving situation and we'll continue to update information as it becomes available.
If you have questions, call our COVID-19 Primary Care Info-Line Monday to Friday, 9:15 a.m. - 7:30 p.m. Call 905-688-8248, press 7, then press 1 for physicians.
On Thursday, July 23, Niagara Regional Council passed a temporary face covering by-law (By-law 2020-46) to require residents to wear mandatory face coverings in enclosed public places, and on Regional and municipal transit during the COVID-19 pandemic.
The by-law remains in effect until Oct. 1, 2020, unless extended by Regional Council. Learn more about the face covering by-law.
Yes, view the most up-to-date COVID-19 statistics in Niagara.
Review the self-monitoring sheet for individuals who are asymptomatic.
This would need to be addressed on an individual basis.
For any workplace, if you're concerned about an employee's risk due to their medical status, all employees should connect with their occupational health, and have their occupational health connect with you.
Ontario is looking for people with experience in providing health care to help provincial efforts to prevent and control the spread of COVID-19.
If you're a health care provider working part-time, a former health care provider who is retired or on inactive status, or a health care provider in training, and you would like to be matched to positions and opportunities where services are needed most, sign up on the Workforce Matching Portal.
Public Health is committed to identifying and working collaboratively with Niagara's school boards and the community on reopening concerns as well as advising on communication and outbreak guidance for schools. We're sharing best evidence with school boards around:
Resources are being shared with the schools directly. If you or your practice are advising teachers or parents, or providing resources, let us know what's being shared so that we can ensure consistent communication. Email the primary care and stakeholder engagement advisor.
For information, visit the Government of Canada’s website on how to quarantine at home.
The province released their Operational Guidance: COVID-19 Management in Schools. The guidance includes details around case and contact management, cohorts and outbreak management, and school closures.
If a student or adult tests positive and is part of a school setting, Public Health investigates to determine any potential risk to others. If an outbreak is declared in a school setting, Public Health closely supports schools to help minimize the transmission of infection and provide case-specific recommendations.
Public Health recommends that any child with symptoms of COVID-19 who fails screening remain at home or return home as soon as possible if symptoms develop at school or child care.
Learn about symptoms and next steps.
After assessing someone with COVID-19 symptoms:
If a COVID-19 test is indicated, you can do the swab if desired, or complete a referral to the assessment centre. For a copy of the documentation referral form, email the primary care and stakeholder engagement advisor.
If swab / referral cannot be completed by your office, the parent / guardian can self-refer to the Niagara Health assessment centre at 905-378-4647 ext. 42819.
If they have any remaining questions, they can call the Public Health COVID-19 Info-Line for referral at 905-688-8248, press 7, then press 2.
Once it's determined that a COVID-19 test is indicated, the symptomatic child AND all household members must self-isolate while awaiting test results.
If the child receives a positive result, the child and household members should remain in isolation. Public Health will contact the family to provide further direction and support.
If the test is negative, household members may leave self-isolation, but the child cannot until they have not had any symptoms for 24 hours or it's been 10 days since their symptoms started (whichever is shorter). They also must not have a fever, be using fever reducing medications, and have symptom improvement.
If the symptom or symptoms are related to a chronic or pre-existing condition, such as allergies, post-nasal drip, migraines, asthma, and a test is NOT recommended, they can return to the school / child care once they feel well enough, without waiting for symptoms to resolve.
If you provide advice that COVID-19 is unlikely and a test is NOT recommended, but the symptoms are not attributed to a non-infectious condition, the child should stay out of school / child care until they have not had any symptoms for 24 hours or it's been 10 days since their symptoms started (whichever is shorter). They also must not have a fever, be using fever reducing medications, and have symptom improvement.
If a recommended COVID-19 test is declined or families have refused to call a health care provider, the child and all household members must complete a 10 day self-isolation period from the onset of symptoms.
In addition to a failed screen, exclusion from school / child care also applies to those individuals who:
When the screening tool asks if a child has "a runny or congested nose (not due to allergies)" a parent may answer "No" if the child has a runny / congested nose AND is known to have allergies (or other chronic condition) such that a runny / congested nose is usual for the child, and the current symptoms are not at all different.
Public Health doesn't recommend that a school / child care facility ask for a doctor's note for previously diagnosed conditions, including allergies. Parent attestation is adequate.
If the child has received a negative test result, the child should stay out of school / child care until 24 hours after their symptoms have resolved OR, 10 days after the onset of their symptoms, whichever is shorter, as long as the child does not have a fever (without use of fever-reducing medications) and symptoms are improving.
If the child receives a positive result, the child and household members should remain in isolation. Public Health will contact the family to provide further direction and support.
If a recommended COVID-19 test is declined or families have refused to see a health care provider, the child and all household members must complete a 10 day self-isolation period from the onset of symptoms.
Niagara Region Public Health offices don't provide COVID-19 testing. Anyone who requires testing is referred for an appointment at one of the testing locations in Niagara.
COVID-19 is a new infectious disease and is classified as a disease of public health significance and must be reported to Public Health. If you're testing patients for COVID-19, notify Public Health immediately by calling 905-688-8248 and follow the prompts. Make sure the patient is sent home with instructions to self-isolate and manage prescription(s) or other needs in a way that assumes the patient has COVID-19.
Niagara Health has three assessment centres located in St. Catharines, Niagara Falls and Welland. All centres allow for patient self-referrals and require appointments for COVID-19 testing.
A temporary drive-thru testing centre (separate from Niagara Health assessment centres) is located in Fort Erie. This testing centre is by physician referral and appointment only. For questions on the referral process, email the primary care and stakeholder engagement advisor.
The Ontario government is partnering with pharmacies to expand access to asymptomatic COVID-19 testing. As of Friday, Sept. 25, a select number of pharmacies in Ontario will begin offering testing by appointment only to those without COVID-19 symptoms. Those with symptoms should go to an assessment centre for a test.
Those looking to be tested at a pharmacy need to be asymptomatic and meet specific criteria. They will also need to call a participating pharmacy to make an appointment.
Asymptomatic testing is not recommended by Public Health, unless under the direction of Public Health on a case-by-case basis. Anyone with respiratory symptoms, other mild symptoms, or fever that you suspect may have COVID-19 or anyone concerned that they may have been exposed to COVID-19 should be referred to the assessment centre for testing, if you are not testing in your office.
It can take up to approximately seven days to receive lab test results for COVID-19. With the large number of swabs that labs are processing, results are taking longer than usual to be posted. It's important that your patient remains in self-isolation while they wait for their lab test result.
Public Health doesn't have earlier access to your patients COVID-19 test results and is unable to respond to callers on our COVID-19 Info-Line that are asking for laboratory results. If patients are having difficulty accessing results or need a paper copy, have them call 905-378-4647 and ask for the Release of Information Office.
If your patient receives an indeterminate result from their online search for results, this may mean that results are not completed by the lab. Tell the patient to continue to check back in a day or two for their results if they haven't been contacted by the testing site / provider.
If the result is a true indeterminate result for COVID-19 from the laboratory, the testing site / provider will contact the patient regarding repeating the test.
Public Health will follow-up with anyone who tests positive.
Some patients who are tested may not have access to their test results through the online portal, specifically those without OHIP, with a red-white OHIP card, without internet access or language barriers. If you're testing your patient, confirm before, or at the time of testing, that they're able to access the online portal. Any individual without access to the online portal must be informed by telephone of their result as soon as reasonably possible.
Anyone concerned that they may have been exposed to COVID-19 or anyone with respiratory symptoms, other mild symptoms, or fever that you suspect may have COVID-19 can be referred for testing. For more information on who should be tested, visit the COVID-19 Provincial Testing Guidance Update.
Dr. Brian Kerley from the Niagara North Family Health Team has created a video to inform Niagara residents about the rational use of testing for COVID-19 using the nasopharyngeal swab and how to interpret the results.
Get more information on Public Health Ontario's ongoing viral detection and repeat positives review.
Public health nurses are working directly with the close contacts of all laboratory confirmed COVID-19 cases in Niagara. They're providing close contacts with medical direction and instruction for testing and self-isolation.
If your patient has no symptoms, has not had known close contact with a positive case of COVID-19 and no travel history but decided to get a COVID-19 test, they need to self-monitor for symptoms but are not required to self-isolate.
A COVID-19 test is only a snapshot of your patient's health on the specific date and time the swab was taken. No testing is perfect and a negative result doesn't mean that they haven't been exposed to COVID-19. Individuals can still develop symptoms days after a test was taken.
If patient is positive for COVID-19:
If patient is negative for COVID-19:
A single upper respiratory tract specimen will be accepted for COVID-19 testing. To order swabs from Public Health Ontario, use the requisition for specimen containers and supplies. You can also call Public Health's COVID-19 Health Care Professionals Info-Line or email email@example.com.
Testing for COVID-19 is done by real-time PCR using protocols validated by PHO Laboratory and the NML. Public Health Ontario has provided information on testing for COVID-19 and to support the interpretation of lab results. View their information on test methods.
One serological test for antibodies to the virus has been approved by Health Canada but is not yet available for widespread use. Review the Ministry’s COVID-19 Provincial Testing Guidance Update for more information on serology testing (page 2).
IMPORTANT: If you're testing for COVID-19, refer to the Public Health Ontario Updated IPAC Recommendations for Use of Personal Protective Equipment for Care of Individuals with Suspect or Confirmed COVID-19.
You will also need:
Niagara Region Public Health cannot provide specimen pick-up and transport at this time. Work with your local lab to coordinate specimen pick-up based on the transportation of dangerous goods criteria.
While awaiting test results, you must normally self-isolate. However, if you have no symptoms, even mild symptoms, no known close contact with a positive case of COVID-19, and no travel history, but you decided to get a COVID-19 test, you can return to work but self-monitor.
If you received a positive test result:
Anyone with a positive test result will be contacted by Public Health to determine the period of self-isolation. In general, there is a minimum 10 day self-isolation period after symptom onset.
If you received a negative test result:
It's important to remember that a COVID-19 test is only a snapshot of your health on the specific date and time the swab was taken. No testing is perfect and a negative result doesn't mean you haven't been exposed to COVID-19. You can still develop symptoms days after your test was taken.
If you tested negative, but have had a high risk exposure, such as returning from travel outside of Canada or contact with a confirmed case:
If you have tested negative and have not had a high risk exposure:
If you begin to develop COVID-19 symptoms after a negative test, even if they're mild, you need to be retested.
Refer to the Ontario Ministry of Health guidance document (page 9) under Health and Human Resources for more information for health care workers who are critical to operations.
Workers in the health care field include regulated health professionals, workers from retirement homes, hospitals, clinics, long-term care, independent health facilities, mental health and addictions counselling.
In general, asymptomatic individuals without exposure to a confirmed case should not be referred for testing.
People with a household member who has been referred for testing or is awaiting test results should self-isolate until the result is received. If the result is negative, they can discontinue isolation. If the test is positive, they should remain in self-isolation and will be advised further by Public Health.
If an asymptomatic individual has had close contact with someone with symptoms of COVID-19 who is awaiting test results, but is not in their household, they should self-monitor.
Anyone who travels outside of Canada should self-isolate for at least 14 days after their return, regardless of symptoms and test results.
To prevent the spread of COVID-19, follow environmental cleaning and disinfecting recommendations for COVID-19 for health care settings and follow Public Health Ontario's guidance on cleaning and disinfection for public settings.
You can order the Novel Coronavirus (COVID-19) screening poster for health care professionals under "Infection Prevention and Control".
Additional signage is available to support proper cough and hand hygiene practices for staff and patients on the resource order page.
The proper use of personal protective equipment is critical to keeping both clinicians and patients safe. At a minimum, all health care providers are to wear a surgical / procedural mask for interactions with and within two metres of patients who screen negative. Contact / droplet precautions are to be used for interactions with and within two metres of patients who screen positive.
Follow the Ministry of Health's COVID-19 Guidance for Primary Care Providers in a Community Setting (page 8) for a summary of required precautions.
Given community spread of COVID-19 in Ontario and evidence that transmission may occur from those who have few or no symptoms, masking (surgical / procedure mask) for the full duration of shifts for health care providers and other staff working in direct patient care areas is recommended.
Ontario Health West is implementing an easy-to-use process to provide an allocation of personal protective equipment through our regional supply chain lead organization, Healthcare Materials Management Services. This initial allocation of personal protective equipment is intended to help you ramp up in-person care in a timely and safe manner, while continuing to provide virtual care as appropriate.
For more detailed information on cleansing and disinfection, refer to the:
Follow the Ministry of Health's COVID-19 Guidance: Primary Care Providers in a Community Setting for in-person care and essential visits.
The Chief Medical Officer of Health's Directive #2, limiting the provision of non-essential in-person care, has been amended to support the gradual resumption of non-essential health care. The direction isn't to have you return to normal practice, but rather move towards a 'new normal'. To support this, the Ontario Ministry of Health has made available COVID-19 Operational Requirements for Health Sector Restart.
As the gradual restart of services continues, you're in the best position to determine which services can continue to be offered virtually, such as phone consultations, virtual assessments, and which services can safely resume in-person. As a reminder, Ontario approved new physician billing codes for telephone assessments, enabling doctors to conduct more assessments over the phone rather than in their clinic.
You will also need to be cautious and resume practice in a controlled and gradual manner while taking steps to protect yourself, your staff, the patient and the public. This document outlines measures that must be in place in order to meet public health guidelines and promote a safe environment for the provision of in-person health services by health care providers.
No. The National Advisory Committee on Immunization states that if post-exposure prophylaxis (PEP) is required (for example measles, hepatitis A, hepatitis B, rabies, meningococcus and varicella), it should be given without delay to all patients who need it.
It's important that your patients are informed in advance about your new office practices, the safety precautions you're taking, and how you're keeping each other safe.
Active and passive screening of patients is extremely important during this time. Patients and essential visitors should be screened over the phone for symptoms of COVID-19 before their appointments and can be told what to expect when they come into the office for their appointment.
If they screen positive over the phone, the appointment should be deferred if possible and the individual referred for testing.
As an additional precautionary measure, on the day of the appointments, patients and essential visitors should be screened again on site, with staff taking proper precautionary measures to protect against the possible spread of COVID-19.
Your office may consider posting signage to inform patients of the specific measures being taken to ensure the safety of patients and clinical staff during this time, such as screening of patients and essential visitors, cleaning and disinfecting frequency of examination rooms and high-touch surfaces, and use of personal protective equipment.
You can order the Novel Coronavirus (COVID-19) Screening Poster for Primary Care Providers and other Infection Prevention and Control print material on Public Health's resources order page.