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Algoma Public Health

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Health Professionals Q&A for COVID-19

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  1. What special precautions should be taken when assessing a patient who may have COVID-19 in the primary care setting?

  2. When should a patient get tested for COVID-19?

  3. If local capacity to conduct testing becomes challenged by high volumes and/or limited resources, how should testing be prioritized?

  4. Can I test a patient for COVID-19 in my clinic?

  5. How can I order specimen collection kits in order to do COVID-19 testing?

  6. Where can patients get tested for COVID-19 in Algoma?

  7. What is the role of Algoma Public Health when there is a person under investigation for COVID-19?

  8. What is the turnaround time for COVID-19 testing?

  9. How should the patient be managed following COVID-19 testing?

  10. Are there any special actions to take for environmental cleaning?

  11. What is the current guidance for health care workers returning from international travel?

  12. If I assess a patient and determine that they should be tested for COVID-19 based on both symptoms and exposure risk being present, does everyone who has been in contact with the patient need to self-isolate for 14 days?

  13. How should I manage a symptomatic patient who is not tested for COVID-19?

  14. How should I manage asymptomatic individuals who have not been tested for COVID-19?

  15. How are health providers and patients notified about COVID-19 testing results?



 

1. What special precautions should be taken when assessing a patient who may have COVID-19 in the primary care setting?

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2. When should a patient get tested for COVID-19?

  • Testing for COVID-19 should be based on clinical assessment to determine the presence of symptoms compatible with COVID-19, and the presence of exposure risk.
    • Asymptomatic, risk-based testing has been made available at assessment centres for
      • People who are concerned that they may have been exposed to COVID-19.  This includes people who are contacts of or may have been exposed to a person with suspected or confirmed COVID-19.
      • People who are at risk of exposure to COVID-19 through their employment, including essential workers (e.g. health care workers, grocery store employees, food processing plants)

  • The Ministry of Health provides a COVID-19 Quick Reference Public Health Guidance on Testing and Clearance
  • The Ministry of Health has also issued a COVID-19 Provincial Testing Guidance Update. 

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3. How should testing be prioritized, if local capacity to conduct testing becomes challenged by high volumes and/or limited resources?

  • If local capacity to conduct testing becomes very limited, testing should be prioritized  to inform public health and clinical management for individuals who are more acutely ill, who are at higher risk of spreading the illness to many individuals or to vulnerable individuals, or who are health care workers.  These groups include:

    • Symptomatic health care workers (regardless of care delivery setting) and staff who work in health care facilities
    • Symptomatic residents and staff in long term care facilities and retirement homes and other institutional settings (e.g. homeless shelters, prisons, correctional facilities, day care for essential workers, group homes, community supported living, disability-specific communities/congregate settings)
    • Hospitalized patients admitted with respiratory symptoms (new or exacerbated)
    • Symptomatic members of remote, isolated, rural and/or Indigenous communities
    • Symptomatic travellers identified at a point of entry to Canada
    • Symptomatic first responders (i.e. firefighters, police)
    • Individuals referred for testing by local public health

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4. Can I test a patient for COVID-19 in my clinic?

 

  • COVID-19 testing may be conducted in a primary care office setting, with appropriate contact and droplet precautions. 
  • Additional guidance for COVID-19 testing is available in the Ministry of Health’s COVID-19 Guidance for Primary Care Providers in a Community Setting.
  • Instructions for testing from the Public Health Ontario laboratory are available here.

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5. How can I order specimen collection kits in order to do COVID-19 testing?

 

  • Due to global shortages, Public Health Ontario’s webpage on specimen collection and handling provides information on alternative collection kits that are acceptable for COVID-19 testing.
  • Public Health Ontario’s COVID-19 test requisition and requisition for specimen containers and supplies can be found here.

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6. Where can patients get tested for COVID-19 in Algoma?

  • The following hospitals have capacity to conduct COVID-19 testing in the Algoma region:

    • Sault Ste. Marie

      • By appointment only. Not everyone who attends the clinic will be tested.
      • Individuals meeting the criteria may call the COVID-19 Assessment Centre at 705-759-3434 ext. 7152 between the hours of 8 a.m. – 8 p.m., 7 days per week, instead of presenting to SAH’s Emergency Department.
      • The patient must give basic information and will be assessed based on the COVID-19 Assessment Centre’s guidelines established by Ontario Health. 

    • Wawa 

       

      • By appointment only; walk-in appointments are strictly prohibited. Not everyone who attends the clinic will be tested
      • In order to receive an appointment, please call: 705-856-2244 ext. 244 or 705-856-2244 ext. 246 the patient will be screened and a telephone interview will be conducted to determine if testing is required.
      • Hours of operation: Monday - Friday (8:30 a.m. - 4:30 p.m.), closed for lunch from 12 p.m. - 1 p.m.
      • Closed April 10th, 13th and all statutory holidays

       

      Services: Dubreuilville, Hawk Junction, Michipicoten First Nation, Missanabie, Wawa, and White River


    • Elliot Lake 

       

      • Call the Family Health Team at 705-461-8882
      • Patient inquires will be screened and telephone interviews will be conducted to determine if a patient should be tested
      • Hours of operation: 9:30 am - 2:00 pm  

    • Blind River

       

      • Open 7 days a week, (10 a.m. - 6 p.m.)
      • By appointment only; walk-in appointments are strictly prohibited. Not everyone who attends the clinic will be tested
      • In order to receive an appointment please call: 705-356-2265 ext. 2661 or toll free 1-888-425-0321
      • Community members who feel they need to be assessed for COVID-19 should fill out this online form*

      *Once you submit the form, you can expect to be contacted by the assessment centre through a telephone conversation within 48 hours

 

  • Certain Algoma health providers may also have some limited capacity to conduct COVID-19 testing for their patients. 

  • All patients being tested for COVID-19 must be reported to public health.  Public health follow-up to assess exposures, support self-isolation, and conduct any necessary contact tracing is vital to identifying and disrupting any local chains of transmission.  Please notify Algoma Public Health as follows:

Phone

705-759-5404 or 1-866-892-0172, ext. 5404 (Mon-Fri, 8:30am to 4:30pm)

705-254-6611 (after hours line for physicians reporting a disease of public health significance)


Fax

A fully completed COVID-19 reporting form may be faxed to 705-541-7309.

 

For hospitals and other facilities that are conducting a larger volume of COVID-19 testing, reporting may be batched.

 

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7. What is the role of Algoma Public Health when there is a person under investigation for COVID-19?

  • Public health management includes
    • Guidance on testing decisions based on assessment of exposure risk and knowledge of local testing capacity
    • Assistance in liaising with the assessment centre or hospital that is conducting the testing
    • Advising the patient on how to appropriately self-isolate at home until results are available
    • Identifying potential sources of exposure from which the patient may have become infected
    • Identifying any close contacts and providing instructions on how to self-monitor for symptoms and take any additional precautions, depending on the level of risk

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8. What is the turnaround time for COVID-19 testing?

 

  • At this time, COVID-19 turnaround time is about 24-72 hours for positive results in priority groups (see above).  Turnaround times may increase as volumes rise and may be longer for notification of negative results.

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9. How should the patient be managed following COVID-19 testing?

  • Treatment for COVID-19 is supportive.  There are no specific therapies at this time.
  • If clinically well enough to be discharged, people who have been tested for COVID-19 should be instructed to self-isolate at home while results are pending. Fact sheets and resources for the public are available from Public Health Ontario here.
  • Once notified, Algoma Public Health will call the patient to provide self-isolation instructions and complete additional public health follow-up, including any necessary contact tracing.

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10. Are there any special actions to take for environmental cleaning?

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11. What is the current guidance for health care workers returning from international travel?

  • Health care workers who have travelled outside of Canada within the last 14 days should self-isolate for a period of 14 days starting from their arrival in Ontario.
  • Health care workers should not attend work if they are sick.
  • If there are particular workers who are deemed critical, by all parties, to continued operations, these workers should undergo regular screening, use appropriate PPE for the 14 days and undertake active self-monitoring, including taking their temperature twice daily to monitor for fever, and immediately self isolate if symptoms develop and self-identify to their occupational health and safety department.
  • Full recommendations from the Ministry of Health are available here.

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12. If I assess a patient and determine that they should be tested for COVID-19 based on both symptoms and exposure risk being present, who else needs to self-isolate, besides the patient getting tested?

 

 The period of communicability for COVID-19 is 48 hours before symptom onset until 14 days after symptom onset.  Close contacts with exposure to the individual being tested during that time period should be advised to self-monitor for symptoms and/or to self-isolate, pending test results.

  • Examples of close contacts include household members, someone who was coughed or sneezed on, someone with prolonged contact with the case, someone who provided care for the case or other similar close physical contacts without consistent and appropriate PPE.

  • Examples of scenarios that would NOT be considered close contact situations include transient interactions such as walking by the case or being briefly in the same room; passengers in the same aircraft, train, bus or other conveyance who were seated more than 2 metres away from the case would also not be considered close contacts. 

When testing a patient for COVID-19, please notify Algoma Public Health, so that we can follow up with the patient to (i) assess who meets criteria as a contact, and (ii) notify contacts and give them specific guidance based on risk level.  APH can also help communicate risk to concerned coworkers in the health care setting.

 

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13. How should I manage a symptomatic patient who is not tested for COVID-19?

  • In some situations, a patient may choose to decline testing, or there may be other barriers to testing, such as transportation.
  • Please notify Algoma Public Health of all probable cases of COVID-19, where you suspect COVID-19 in a patient who is not receiving testing.  APH public health nurses will follow-up with appropriate isolation instructions, contact identification and tracing, and further monitoring as required.
  • These individuals should have ready access to information on worsening signs and symptoms that should prompt urgent medical attention.
  • These individuals should self-isolate for 14 days from symptom onset.  After 14 days, if they are afebrile and their symptoms are improving, they may discontinue self-isolation.
  • If symptoms or fever persist, individuals should follow up with their health provider.
  • The above guidance from the Ministry of Health is based on current evidence regarding viral shedding and viability after symptom onset in outpatients, and will be updated as additional information on the period of infectiousness becomes available.

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14. How should I manage asymptomatic individuals who have not been tested for COVID-19?

 

  • If an individual is asymptomatic and has no exposure risk, provide reassurance and general information on COVID-19.
  • If an individual is asymptomatic but has exposure risk provide information on self-monitoring and self-isolation for 14 days from last exposure.
    • Resources for the public are available from Public Health Ontario here.

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15. How are health providers and patients notified about COVID-19 testing results?

 

  • The ordering clinician and any other health provider indicated on the requisition will receive the laboratory report of results.
  • Algoma Public Health will also receive a copy of positive COVID-19 results for local residents. Results of COVID-19 testing performed at Algoma assessment centres are also typically forwarded to Algoma Public Health.
  • Patients also have the ability to check their results online, using the provincial portal available here.
  • At this time, once testing results are available, APH calls all residents to notify them of results and to provide further instructions.  People with positive results are prioritized.
  • Depending on testing volumes, people with negative results may get their results online or via their health provider before receiving a phone call from APH.  Please note that even when a person tests negative for COVID-19, they should be instructed to complete the 14 days of self-isolation.  Some exceptions apply, depending on presenting symptoms and exposure risk, particularly in the context of essential workers and health care workers.

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16. When can an individual with probable or confirmed COVID-19 be discharged from isolation?

 

  • Please refer to the Ministry’s COVID-19 Quick Reference Public Health Guidance on Testing and Clearance
  • In general, cases can discontinue isolation at 14 days after symptom onset (or 14 days from positive test collection date if never had symptoms), provided that the individual is afebrile and symptoms are improving for at least 72 hours.  Absence of cough is not required for those known to have chronic cough or who are experiencing reactive airways post-infection. 

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