MEDICAL ADVISORY: Novel Coronavirus (COVID-19) Update #8

Issued by: Gayane Hovhannisyan, MD, MPH, PhD, FRCPC, Associate Medical Officer of Health (Acting)

First Positive Case of COVID-19 in Niagara

Niagara Region Public Health & Emergency Services (NRPH&ES) has received laboratory confirmation of the first case of COVID-19 in Niagara region
The confirmed case is an 84 year old male
There is no community transmission in Niagara at this time and the risk to local residents remains low
The Government of Canada recommends avoiding all non-essential travel outside of Canada
All returning travellers outside of Canada are being asked to self-isolate for 14 days and monitor for signs and symptoms of respiratory infection

Interim Testing Recommendations

There is a global shortage of viral nasophayngeal swabs due to COVID-19, and locally we have a limited supply. The following approach is recommended to prioritize testing for COVID-19 for the following groups with acute respiratory symptoms and relevant exposure*:

Hospitalized patients
Older adults and those with underlying medical conditions
Health care workers and Paramedics (includes minor respiratory symptoms or sore throat)
First responders (Fire and Police)
Residents and staff of long-term care homes, retirement homes and supportive housing

*As of Friday March 13, 2020, relevant exposure includes any of the following: travel outside of Canada in the last 14 days or had a closed contact with a person who travelled outside of Canada in the last 14 days; close contact with a person with confirmed COVID-19 infection.

Please note: Testing of asymptomatic individuals is not recommended.

As an interim measure, and until more supply is available:

Anyone who travelled outside of Canada and has mild respiratory symptoms that DO NOT require hospitalization;

AND

DO NOT meet the above priority groups, should be sent home on self-isolation until symptom free;

AND

For 24 hours after symptoms resolved. These individuals must remain in self-isolation for the full 14 days, even if symptoms resolve and they are feeling better.

Please check NRPH website for up-to-date information on the availability of swabs.

You do not need approval for testing from Public Health Ontario or Ministry of Health; the health care provider can offer testing based on their discretion and availability of supplies.

All cases, where testing is performed, are reportable to Public Health. The patients can be directed to the NRPH&ES website for up-to-date information on the availability of testing.

For additional information on specimen collection and turn around time please consult the Coronavirus Disease 2019 (COVID-19).

PPE requirement for assessment and specimen collection

Droplet/Contact precautions:

Use of gloves, gowns, surgical mask and eye protection (face shield or goggles are acceptable as eye protection)
Hand hygiene

Niagara Region Website for Health Care Professionals

A list of frequently asked questions to support primary care professionals is now on our website. We will be updating the FAQ section as new questions arise throughout this evolving pandemic.

Health Care Professional COVID-19 Phone Extension into Public Health

A phone extension specifically for health care professionals has been activated:

905-688-8248 Ext. 7554