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COVID-19 (2019-nCoV)

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Reporting Obligations

Persons under investigation or probable cases who meet the case definition below must be reported by phone or fax. During business hours 8:30am–4:30pm Monday to Friday and ask for the Infectious Diseases Team at extension 2222. After hours and weekends ask for on call.

Phone: 613-345-5685 or 1-800-660-5853
Fax: 613-345-5777

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The Public Health Agency of Canada COVID-19 case definitions include fever and/or respiratory symptoms along with possible exposure to the virus through travel to an affected area, close contact with a confirmed or probable case, or close contact with a person with acute respiratory disease who had been to an affected area, within 14 days before the onset of the illness.

Epidemiology

Aetiologic Agent

Coronaviruses are large, enveloped ribonucleic acid (RNA) viruses named after their corona- or crown-like surface projections observed on electron microscopy. A novel coronavirus is a new strain that has not been previously identified in humans. Coronaviruses are zoonotic, as they transmit between animals and people. There are at least seven known coronaviruses that infect humans.

On December 31 2019, the World Health Organization (WHO) China Country Office was informed of cases of pneumonia of unknown etiology (unknown cause) detected in Wuhan City, Hubei Province in China. A novel coronavirus (2019-nCoV) was identified as the causative virus by Chinese authorities on January 7, 2020.

On February 11, 2020, the WHO released the official name for the disease caused by the novel coronavirus (2019-nCoV) as COVID-19.

Clinical Presentation

Symptoms of COVID-19 infection include fever and/or respiratory symptoms such as cough, shortness of breath, and breathing difficulties. In more severe cases, infection can cause pneumonia, kidney failure, and even death, particularly in individuals with other chronic health conditions.

Modes of Transmission

Evidence to date suggests that COVID-19 is spread by droplets from an infected person via a cough, sneeze or talking. Droplets typically travel about 2 metres (6 feet) and can live on hard surfaces. While there is evidence of the virus in feces, there is no evidence to date that it can be spread this way. Respiratory etiquette and regular environmental cleaning are important to decrease the risk of spread of infection.

Incubation Period

The mean incubation period appears to be 5 days with a range of 1 to 14 days. The World Health Organization’s COVID-19 case definition includes exposure to a case within the previous 14 days.

Period of Communicability

Not completely understood at this time.

Risk Factors/Susceptibility

Risk Factors:

  • Travel to affected areas in the last 14 days
  • Close contact* with a known case of COVID-19
    * Close contact refers to any person who has provided care for a patient/client (including healthcare workers, family members or other caregivers) or who had similar close physical contact, or who lived with or otherwise had close prolonged contact with a probable or confirmed case while the case was ill.

Complications are more common in immunocompromised people and those with underlying chronic illness.

Diagnosis and Laboratory Testing

Before testing, review the Public Health Ontario direction about testing.

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Swabs should be submitted as soon as logistically and financially feasible to support effective contact tracing if the test is positive, as well decreasing the need for the use of negative pressure rooms in the hospital.

For questions about testing or the results of tests call PHO Laboratory’s Customer Service Centre at 416-235-6556/1-877-604-4567 or the After-Hours Emergency Duty Officer at 416-605-3113.

Treatment and Case Management

Individuals who are positive for COVID-19 and do not require hospitalization for medical reasons can be self-isolated at home under public health follow-up if the home setting is appropriate. Public health is responsible for the contact tracing of all positive cases, and will require that individuals with significant contact self-isolate for a 14 day period.

Guidance Documents

If you are a health care professional, learn how to protect yourself and the individuals you care for by reading the Ministry of Health guidance documents and learn about:

  • Screening
  • Laboratory testing
  • Treatment recommendations
  • Occupational health and safety
  • Infection prevention and control measures

The documents will be updated as necessary.

Requirements for Specific Populations

Travel history outside of Canada in the past 14 days:

  • Asymptomatic travelers should be advised to stay home/self-isolate for 14 days and contact their local public health unit (613-345-5685 or 1-800-660-5853) for further direction on activity restrictions.
  • If patients develop a fever and/or onset of a new cough or have difficulty breathing within 14 days of their travel date, call local public health unit (613-345-5685 or 1-800-660-5853) or telehealth (1-800-797-0000) for advice. Refer to guidance documents above for more information.

Travel history to impacted area,

  • Asymptomatic travelers:
    • With known close contact with a case: self-isolate for 14 days from last known exposure.
    • With known non-close contact with a case: self-monitor for symptoms for 14 days from last known exposure.
  • If patients develop a fever and/or onset of a new cough or have difficulty breathing within 14 days of their travel date, call your local public health unit (1-800-660-5853) or telehealth (1-800-797-0000) for advice. Refer to guidance documents above for more information.

*A close contact is defined as a person who provided care for the patient, including healthcare workers, family members or other caregivers, or who had other similar close physical contact OR who lived with or otherwise had close prolonged contact with a probable or confirmed case while the case was ill.

How to Self-Isolate

Self-isolation: Guide for Caregivers, Household Members and Close Contacts

Additional Resources

Ontario Ministry of Health – Guidance for Health Care Workers and Health Sector Employers on novel coronavirus associated with Wuhan, China (2019-nCoV)

Coronavirus disease (COVID-19): Travel Advice

FAQs on access to PPE for all settings

References

Ministry of Health, Infectious Diseases Protocol, 2019

Ministry of Health, Novel Coronavirus – 2019-nCoV

Ministry of Health, Public Health Management of Cases and Contacts of COVID-19 in Ontario