Case and Contact Tracing

Anti-viral treatments are now available by prescription for free to people with COVID-19 who are at higher risk of progressing to severe disease requiring hospitalization. It’s important to begin these treatments within 5 days of symptom onset, even if symptoms are mild, so prompt testing is needed. Public Health Units are not involved in assessing eligibility for or dispensing these treatments. See this resource to learn who should get Paxlovid – people at higher-risk for severe COVID-19. See if you are eligible to be tested with a PCR test which is more sensitive and will give you results sooner. Paxlovid (anti-virals) should be administered within 5 days of symptoms starting, even if symptoms are mild so do not wait to see if symptoms get worse. To find a test centre that can also assess you for antiviral treatment at the same time use the screening tool.

In general, these are the groups that are eligible for antiviral treatment:

• Anyone 70+
• Anyone 18+ who is immune-compromised
• Anyone 60+ who has NOT had 3 doses of vaccine
• Anyone 18+ who has NOT had 3 doses of vaccine AND has at least one risk factor (the screening tool lists the risk factors for you)

See this handout about Paxlovid, who is eligible and how to access it in Ontario.

Check the updated COVID-19 assessment tool – click here for the latest version.

Symptoms include:

• One of:
  • fever or chills
  • cough
  • shortness of breath
  • decreased or loss of taste or smell
• Two or more of:
  • runny nose or nasal congestion
  • headache
  • extreme fatigue
  • sore throat
  • muscle aches or joint pain
  • gastrointestinal symptoms (such as vomiting or diarrhea)

If you have symptoms of COVID-19 then assume you may have the virus, and may be contagious.

• Monitor your symptoms, and seek medical attention or call 911 if needed (e.g. chest pain, shortness of breath, or difficulty breathing). Ontario’s online self-assessment tool can be used to monitor symptoms
• If you do a Rapid Antigen Test (RAT) then:
  • A positive RAT indicates COVID-19 infection, confirmatory PCR testing is not needed.
  • Two negative RATs 24–48 hours apart indicate COVID-19 is unlikely, stay home until symptoms are improving and use a mask when out and follow other precautions.
  • If negative – re-test if symptoms persist, worsen, or new ones arise.
• If you qualify for a PCR test then:
  • A positive PCR test indicates COVID-19 infection
  • A negative test indicates COVID-19 unlikely, stay home until symptoms are improving and use a mask when out and follow other precautions. If you develop new or worsening symptoms, get re-tested.
• Seek medical attention or call 911 if needed (e.g., chest pain, shortness of breath, or difficulty breathing). Ontario’s online self-assessment tool can be used to monitor symptoms.
• Individuals in the general public who are experiencing symptoms or test positive:
  • Stay home and isolate from others in the home if you are sick. This means:
    • Isolate until you have no fever and your symptoms are improving for at least 24 hours (or 48 hours if you have gastro-intestinal symptoms) as advised by current provincial guidance.
    • After isolating, wear a high quality, well-fitted mask when out in public for 10 days from when your symptoms started.
    • Avoid non-essential visits to vulnerable individuals at risk of severe infection and highest risk settings (e.g., hospitals, long-term care) for 10 days from when your symptoms started.
    • Avoid activities that require mask removal in public (e.g., dining out, high contact sports).
    • Follow this advice whether you have tested for COVID or not.
  • Household members do not need to isolate unless they start to experience any symptoms. Refer to the What Does a Close Contact (High Risk) Contact Mean? and What Do You Do If You Are a Close (High) Risk Contact? menus for more information.
  • Notify high risk contacts (anyone you had close contact with starting from 2 days before your symptoms started) and advise them to follow the guidance for High Risk Contacts in the tabs below.
• Individuals with severe COVID-19 illness (requiring ICU level of care):
  • Isolate at least 20 days (or at discretion of hospital IPAC) after the date of COVID-19 testing or symptom onset (whichever is earlier/applicable) and until symptoms have been improving for 24 hours (or 48 hours if gastrointestinal symptoms) and no fever present.
• Individuals who live in a highest risk setting (e.g., hospitals, congregate living settings, living settings for International Agricultural Workers), are hospitalized for COVID-19 related illness (not requiring ICU level of care), or are immunocompromised:
  • Isolate at least 10 days after the date of COVID-19 testing or symptom onset (whichever is earlier/applicable) and until symptoms have been improving for 24 hours (or 48 hours if gastrointestinal symptoms) and no fever present. Duration of isolation may be modified based on hospital IPAC direction (for inpatients) or health care provider direction (for individuals with immune compromise). Setting-specific guidance prevails for case isolation in highest risk settings.
• Individuals who work in highest risk settings (e.g., hospitals, congregate living settings, living settings for International Agricultural Workers):
  • Speak with the employer and follow their workplace guidance for return to work.
  • Arrange a PCR test.
  • Self-isolate while waiting for results.
  • For routine operations (e.g., in the absence of staff shortages), COVID-19 positive cases that work in highest risk settings may return to work:
    • 10 days after symptom onset or date of COVID-19 testing (whichever is earlier); and
    • They have no fever and other symptoms have been improving for 24 hours (or 48 hours if gastrointestinal symptoms).
  • Household members do not need to isolate unless they start to experience any symptoms. Refer to the What Does a Close Contact (High Risk) Contact Mean? and What Do You Do If You Are a Close (High) Risk Contact? menus for more information.
  • Notify close contacts (anyone you had close contact with starting from 2 days before your symptoms started) and advise them to follow the guidance for High Risk Contacts in the tabs below.

• Isolation is the same for all respiratory symptoms regardless of if it is COVID-19 or another virus. This will help reduce the spread of the different viruses that may be circulating. Stay home and isolate from others in the home if you are sick. This means:
  • Isolate until you have no fever and your symptoms are improving for at least 24 hours (or 48 hours if you have gastro-intestinal symptoms).
  • After isolating, wear a high quality, well-fitted mask when out in public for 10 days from when your symptoms started.
  • Avoid non-essential visits to vulnerable individuals at risk of severe infection and highest risk settings (e.g., hospitals, long-term care) for 10 days from when your symptoms started.
  • Avoid activities that require mask removal in public (e.g., dining out, high contact sports).

• A high risk close contact is anyone that a person having symptoms of COVID-19 or that tested positive for COVID-19 had contact with in the 48 hours before their COVID-19 symptoms began or their positive test result, whichever came first when they were:
  • unprotected (both case and contact weren’t wearing a medical or cloth mask),
  • within close distance (less than 2m/6ft apart) and
  • together for several minutes
• Low risk or casual interactions are not considered high-risk contacts. Examples include walking by or briefly being in the same room
• This poster illustrates who is a close contact
• This poster illustrates who is a close contact at work 
• Close contacts are at a higher risk of becoming infected and sharing the virus with others, and are referred to as high-risk contacts.

• If you are a close contact and do NOT have symptoms:
  • Self-monitor for symptoms for 10 days from your exposure.
• If you begin to experience symptoms or test positive, stay home and isolate from others in the home. This means:
  • Isolate until you have no fever and your symptoms are improving for at least 24 hours (or 48 hours if you have gastro-intestinal symptoms).
  • After isolating, wear a high quality, well-fitted mask when out in public for 10 days from when your symptoms started.
  • Avoid non-essential visits to vulnerable individuals at risk of severe infection and highest risk settings (e.g., hospitals, long-term care) for 10 days from when your symptoms started.
  • Avoid activities that require mask removal in public (e.g., dining out, high contact sports).
  • Follow this advice whether you have tested for COVID or not.
• If you are self-isolating – please check out the Mental Wellness and Health Equity pages of our website to see what resources and supports are available. You can also call 1-800-660-5853 for further assistance.

• Your household members should complete screening for symptoms before leaving the home.
• If symptoms develop, follow the guidance above under “What to do if you have symptoms of COVID-19”

• Individuals who decide to travel internationally or domestically must follow all rules and regulations outlined by the Government of Canada.
• Regardless of vaccination status, those who travel should practice personal public health measures while away and upon their return.
  • This includes wearing a mask or face-covering, physical distancing, frequent hand washing, and staying outdoors as much as possible in order to reduce the risk of contracting COVID-19.
  • Travellers should stay informed about the COVID-19 situation at their destination and follow all local COVID-19 restrictions.

Retesting is generally not recommended in order return to work or school after isolation because people can test positive for a little while as the test can detect dead virus. This doesn’t mean you are still contagious. You can return to work when you are feeling better. This means:

• Isolate until you have no fever and your symptoms are improving for at least 24 hours (or 48 hours if you have gastro-intestinal symptoms).
• After isolating, wear a high quality, well-fitted mask when out in public for 10 days from when your symptoms started.
• Avoid non-essential visits to vulnerable individuals at risk of severe infection and highest risk settings (e.g., hospitals, long-term care) for 10 days from when your symptoms started.
• Avoid activities that require mask removal in public (e.g., dining out, high contact sports).
• Follow this advice whether you have tested for COVID or not.

Long-COVID

Some people continue to experience symptoms of COVID-19 for weeks or months after their initial recovery. This can be termed Post COVID-19 Condition or Long-COVID. Post COVID-19 condition is not COVID-19. Symptoms can be quite different from those during the initial infection. It refers to the longer-term effects some people experience after their COVID-19 illness.

While many symptoms have been identified for Long-COVID, the most common include fatigue, shortness of breath, pain, sleep disturbances, anxiety, and depression. For some, the symptoms last for four to five weeks after the initial symptoms. For others the symptoms continue for 12 weeks for more.

Being up-to-date with COVID-19 vaccine decreases the risk of developing Long-COVID.

Here is a short video from the World Health Organization on Long-COVID: WHO’s Science in 5 on COVID-19: Post COVID-19 condition – 30 July 2021 – YouTube

If you feel you are experiencing symptoms of Long-COVID – contact your primary care provider directly. You can use the links below to learn more about how this condition is being assessed, diagnosed and managed.

• Ontario College of Family Physicians Resources for Long-COVID
• Health Canada information on Post COVID-19 Condition
• Public Health Ontario Rapid Review on “Post-Acute COVID-19 Syndrome (PACS) in Adults”

The COVID Alert App is now retired and is no longer being used as a way to alert people to possible exposures. You can delete this app from your phone if you had it downloaded. For more information see this Government of Canada link:

• COVID Alert: Canada’s exposure notification app – Canada.ca