As per the Ontario Ministry of Health Website update November 2023

COVID-19 General Management Recommendations

 

 Click here to determine if you are at HIGHER RISK of SEVERE COVID-19

 

Click here for COVID-19 TESTING LOCATIONS

 

If you have symptoms of COVID-19      

Stay home and self-isolate, EVEN IF YOU HAVE A NEGATIVE RAPID COVID-19 TEST, until all of the following apply:

  • your symptoms have been improving for at least 24 hours (or 48 hours if you had nausea, vomiting and/or diarrhea)
  • you do not have a fever
  • you have not developed additional symptoms

Learn how to properly self-isolate when you have COVID-19

Do not leave your home except to get tested, seek medical care or for a medical emergency. If you have severe symptoms like chest pain or difficulty breathing, go to the nearest emergency department.

You should then continue to take additional precautions for up to 10 days after your symptoms started as extra protection against the spread of COVID-19 and other respiratory viruses circulating in the community.

If you are immunocompromised or considered high-risk for severe COVID-19 infection and test positive for COVID-19, you should stay home for 10 days and follow the guidance below for Treatment of Higher Risk Individuals.

 

If you work in a high-risk setting

If you have symptoms of COVID-19 or have tested positive for COVID-19 and work in a high-risk setting (such as a hospital, a long-term care home, or a retirement home), you should speak with your employer and follow your workplace guidance for return to work.

 

Inform others of their exposure

Tell your household members and similar close contacts that you are sick and refer them to the additional precautions section below.

A close contact is anyone you were less than two metres away from for at least 15 minutes, or multiple shorter lengths of time, without measures such as masking, distancing, and/or the use of personal protective equipment in the 48 hours before your symptoms began or your positive test result, whichever came first.

 

Additional precautions

Taking additional precautions can add another layer of prevention against the spread of COVID-19 and other respiratory viruses circulating in the community.

If any of the following apply to you, you should take the additional precautions listed below:

  • your COVID-19 symptoms have been improving and you are no longer isolating at home
  • you were exposed to someone with COVID-19 but have no symptoms
  • you tested positive for COVID-19 but have no symptoms

For 10 days after your symptoms started, last day of exposure, or positive test result:

  • self-monitor for new or worsening symptoms
  • seek testing (if eligible) if you develop any new or different symptoms
  • wear a tight-fitting, well-constructed mask as much as possible in all public settings, unless:
    • you are temporarily removing it for essential activities (such as when eating in shared space at school/work) while still maintaining as much distancing from others as possible
    • you are unable to mask (such as children under two years of age)
  • avoid non-essential activities where you need to take off your mask (for example, playing a wind instrument, sports that require removing your mask, dining out)
  • avoid non-essential visits to anyone who is immunocompromised or may be at higher risk of illness (for example, seniors)
  • avoid non-essential visits to highest risk settings, such as hospitals and long-term care homes
    • where visits cannot be avoided, wear a mask and recommend the individual being visited also wear a mask
If you have been exposed to COVID-19 and work in a high-risk setting (such as a hospital, a long-term care home, or a retirement home), you should speak with your employer and follow your workplace guidance for return to work.

Get more information for caregivers, household members and close contacts

 

COVID-19 Treatment for Higher Risk Individuals


Patients at higher risk include any of the following individuals:

  • 60 years of age or older
  • 18 years of age or older and immunocompromised
  • adults who have 1 or more comorbidity that puts them at high risk of severe COVID-19 disease
  • adults with inadequate immunity (if you are unvaccinated or not up to date with COVID-19 vaccines)

If you have symptoms (even if mild) of COVID-19 infection and are at higher risk of severe COVID‑19, seek testing and care immediately by either:

  • contacting your local pharmacy to find out if there is a pharmacist available that can prescribe Paxlovid 
  • contacting your family doctor if you are unsure about pharmacist availability

If you develop severe symptoms requiring medical attention, such as shortness of breath or chest pain, call 911 or go to the emergency department.

If you are having difficulty accessing care, contact Health811 by phone at 811 or visit the Health811 website to chat online with a nurse who will assess your eligibility to obtain an antiviral prescription from a virtual clinic.

In order to be eligible for anti-viral treatment, you must have a positive COVID-19 test. 

First of all, perform a rapid antigen test if you have one, but it’s important to understand that these tests may be negative in the early stage of infection.  YOU MAY STILL HAVE COVID-19 IF YOUR RAPID TEST IS NEGATIVE!  Seek PCR/Molecular testing and care immediately if the test is negative or if you don’t have a rapid antigen test.

If you test positive for COVID-19, you may be eligible for one of the following options:

 

Paxlovid

Paxlovid is an antiviral medication taken by mouth at home. Treatment must begin within five days of the start of symptoms.

Paxlovid can be prescribed by any physician, nurse practitioner and participating pharmacists, and prescriptions can be filled at most pharmacies.

Paxlovid consists of nirmatrelvir, which inhibits a SARS-CoV-2 protein to stop the virus from replicating, and ritonavir, which slows down nirmatrelvir’s breakdown to help it remain in the body for a longer period at higher concentrations. Paxlovid is administered as three tablets (two tablets of nirmatrelvir and one tablet of ritonavir) taken together orally twice daily for five days, for a total of 30 tablets.

Paxlovid has the potential for numerous significant and serious drug interactions when taken with some medications and may not be appropriate for all people. You must give your health care provider a list of any medications (including any natural health products or vitamins) and tell them about any important medical conditions or allergies you have.  For more information, visit the Health Canada Consumer Information Summary.

Your health care provider will decide if any changes to your medications are necessary before safely taking Paxlovid or another treatment.

Read the Paxlovid handout (information in 29 languages). 

 

Remdesivir

Remdesivir is an antiviral medication that must be taken intravenously (IV) via designated clinics. Remdesivir treatment must begin within seven days of the start of symptoms and requires a referral from a physician (doctor) or nurse practitioner.  Remdesivir is only prescribed to people who cannot take Paxlovid because they are on certain medications or have certain medical conditions.

 

 

Remember:  Antiviral treatments are not a replacement for vaccination or taking other recommended precautions. Learn where to get vaccinated and book an appointment today.

 

Evusheld

Evusheld is a monoclonal antibody therapy has been used for the prevention of COVID-19 in select immunocompromised patients since April 2022.

Evidence has indicated Evusheld is likely ineffective against multiple variants currently circulating in the province. As a result, Evusheld is no longer routinely recommended in Ontario for either the prevention or treatment of COVID-19.  

If you have received Evusheld in the past, you cannot rely on it for protection against COVID-19. If you begin to develop symptoms of COVID-19, take a COVID-19 test and seek medical attention immediately.

To learn more:

 

CanTreatCOVID Study

The CanTreatCOVID Study is open to adults in Ontario aged 18 – 49 years with one or more chronic condition(s), or adults aged 50 years and over who have tested positive for COVID-19 with symptoms starting within the last five days. Participants in the study may be eligible to receive COVID-19 medications (including Paxlovid).

Visit the CanTreatCOVID website or call 1-888-888-3308 for more information. The CanTreatCOVID study is supported by the Canadian Institutes of Health Research, Health Canada and Public Health Agency of Canada.