COVID-19 FAQ

Last updated April 24, 2020

Can I still see my doctor if I have a medical concern?

Ontario’s doctors are open for business during the COVID-19 pandemic and are doing everything they can to continue to care for patients. Doctors are able to deliver care through virtual means – by phone or video. If you need health care – including non-COVID care, please call your doctor’s office. Virtual care helps to keep patients out of waiting rooms where they could be at risk of infecting others or becoming infected themselves. Patients can access virtual care two main ways: By calling their primary care doctor Contacting a virtual care clinic directly, including the province’s new Ontario Virtual Care Clinic, for patients with non-COVID health concerns, at seethedoctor.ca. Virtual care visits by phone or video are covered by OHIP.

I think (or I know) I had COVID-19 but I’m feeling better now. When can I leave the house?

Generally, people who have tested positive for COVID-19 or who are presumed to have had COVID-19 based on their symptoms should stay home and isolate from all household contacts for 14 days after the onset of symptoms or for at least 72 hours after symptoms have resolved if symptoms have been ongoing for longer than 14 days. If possible, this means a different bedroom and washroom, with no sharing of food or towels. Leaving the house should be minimized by ALL household members, including those with no symptoms, to limit the risk of infecting others. We still do not know for sure how long a person is contagious for after they have had COVID-19. There are cases of people testing positive for the virus two or three weeks following symptom resolution. It is also possible that people who have tested negative for COVID-19 after symptom resolution might still be carrying the virus in small quantities. The safest practice is to avoid close contact, keep hands clean, don’t touch your face, and assume that you may still be contagious for 2 weeks or more after you’ve had COVID-19 and are feeling better. More details on self-isolation can be found here: https://www.publichealthontario.ca/-/media/documents/ncov/factsheet-covid-19-guide-isolation-caregivers.pdf?la=en

I don’t have any masks but you recommend we wear a mask in stores. What to do?

The Centre for Disease Control (CDC) in the USA is recommending that the public wear a face-mask of cloth covering their mouth and nose to help prevent transmission of COVID-19 infection to others and to help prevent people from contracting the virus. It is extremely important to AVOID TOUCHING YOUR FACE if you choose to wear a mask or face-covering cloth. If wearing a home-made face cover, it must be washed frequently. For more details, see the CDC website: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html

Public Health Ontario (PHO) is has stopped short of recommending to the public that they wear masks, in part because there is concern that personal protection equipment be reserved for workers in health care. A detailed explanation of the PHO approach is available here: https://www.publichealthontario.ca/-/media/documents/ncov/covid-wwksf/what-we-know-public-masks-apr-7-2020.pdf?la=en

We’re starting to argue in my house about what is an essential outing. Can you give some guidance on this?

Essential outings include obtaining food and other important groceries, medical visits and pharmacies. These outings should be minimized as much as possible. For example, go to the grocery store no more than once per week and obtain all essentials in one visit to the store. Also, make your outings as short as possible. Avoid spending unnecessary time in stores. People should continue to seek emergency care if they have concerns rather than “waiting it out” at home in the hopes that symptoms improve over time. More information on physical distancing can be found here: https://www.publichealthontario.ca/-/media/documents/ncov/factsheet/factsheet-covid-19-guide-physical-distancing.pdf?la=en

I’ve had a bad headache for days. Could I have COVID-19?

Typical symptoms of COVID-19 include sore throat, fever, cough and shortness of breath. However, we now know that some people experience combinations of body aches, headache, abdominal pain, vomiting and diarrhea. There are some with mild symptoms of loss of smell and/or taste. Other individuals may experience no symptoms at all. Symptoms can last for days or weeks, and can start out mild but progress to severe over days to weeks. In short, yes you could have a mild form of COVID-19 or your headache might not be related to COVID at all. Do not hesitate to seek medical attention for guidance and advice.

Someone in my house has COVID-19 (either tested positive or presumed to be positive based on symptoms). Can I go grocery shopping?

Generally speaking, if you are a close contact of someone with COVID-19, you should avoid public outings for a quarantine period of at least 14 days. You could be incubating the illness yourself and run the risk of spreading it to others if you go out. Best to have others do shopping; several community organizations have been established for this reason. If you must go out, you should wear a mask, keep your hands clean, and maintain a strict 2 meter distance from others. In particular, avoid public gathering places (especially closed spaces) where the risk of transmission is highest. More detailed information can be found here: https://www.publichealthontario.ca/-/media/documents/ncov/factsheet-covid-19-guide-isolation-caregivers.pdf?la=en

 

Someone in my house was diagnosed with COVID-19. I am a household contact. Can I go shopping or to minyan?

No.

if you are a close or household contact of someone with COVID-19, you may not leave your home for the quarantine period of at 14 days. This is a legal requirement as you could be incubating the illness yourself and run the risk of spreading it to others if

you go out. You will need to arrange for others to do your shopping. Several community organizations have been established for this reason. More detailed information can be found here: https://www.publichealthontario.ca/-/media/documents/ncov/factsheet-covid-19-guide-isolation-caregivers.pdf?la=en

 

Someone in my house is under a 14-day travel quarantine. Can I go grocery shopping or to minyan?

If somebody you live with is under a travel quarantine they must strictly self-isolate. If they are meticulously

following isolation precautions, are not symptomatic and have not tested positive for COVID-19, you may go out shopping or to other public places while adhering to masking, physical distancing, hand hygiene guidelines. If the person is not strictly self-isolating

in your home, you are considered a potential exposed contact (even if the person has not been tested or is negative) and may not go to minyan. It is best if someone else do your groceries.

Someone in my house has COVID-19 (either tested postive or presumed to be positive based on symptoms). How do I protect the rest of the family?

If someone in your house has COVID-19-19 (confirmed or presumed), you should avoid close contact with that person. This includes using separate bedrooms and bathrooms, if possible. So not share any objects, dishes, utensils, or phones. Wash the surfaces of your home regularly with sanitizer or warm soapy water and wash your hands regularly throughout the day. Be careful not to touch your face or wear a mask when you are in close proximity to the person who is ill. More information can be found here: https://www.publichealthontario.ca/-/media/documents/ncov/factsheet-COVID-19-19-how-to-self-isolate.pdf?la=en

I do not own gloves or masks. How should I be going out and shopping in a safe manner?

According to local guidelines, it is not necessary to wear gloves and a mask when you go grocery shopping, as long as you maintain appropriate distance from other individuals while you are out, keep your hands clean, and don’t touch your case. Try to maintain 2 meters of distance from other people at all times. If possible, wipe down surfaces like grocery carts before and after using them. Carry hand sanitizer or Lysol wipes with you. Or wear lightweight gloves if you have them (keeping in mind that your gloves could be a source for contamination if you’re not careful not to touch your face with the gloved hand or if you touch surfaces with a dirty glove that are then not wiped down). Should you opt to wear a mask or scarf, it is important to refrain from touching your face. But please remember that, with or without gloves and mask, you should only be going out for essential activities–shopping for food, visiting the pharmacy, etc.

What is the proper way to wear gloves and wash hands?

If you choose to wear latex gloves when you leave the house, they should not be reused. You may wash your gloves the same way you wash your hands to keep them clean while you are wearing them. You should remove the gloves carefully, making sure you don’t contaminate your hands by touching the outside, dirty part of the glove and then wash your hands with soap and warm water for approximately 20 seconds after removing and disposing of the gloves.

Are there any treatment regimens that have shown meaningful therapeutic effects for COVID19 patients (ie chloroquine, antiretrovirals etc, experimental therapies)?

There are no specific medical therapies that have been proven to be effective in treating COVID-19. Currently, treatment for patients with severe COVID-19 symptoms is supportive. This basically means your doctors will try to make you comfortable and help your body ride out the virus using oxygen, IV fluids, and potentially mechanical ventilation. There have been a number of therapies that have received significant media attention, such as hydroxychloroquine, azithromycin and remdesivir. These are currently being evaluated through clinical trials that are ongoing in Canada and other countries. However, none of these treatments have yet been proven to be effective. It is important to recognize that some of these therapies have potentially serious side effects and risks, and should not be used without supervision and prescription from a licensed physician. Other trial that are ongoing involve taking antibodies from patient who have had COVID-19 and recovered completely, and injecting them into very sick patients. These studies are also ongoing.

Are there any medical therapies that will protect me from getting COVID-19?

Currently, there are no medical therapies such as vitamins, minerals, vaccines or pharmaceuticals that have been shown to protect against COVID-19. Sleep, regular exercise, stress-relieving activities and eating healthy are helpful at preventing any illness. Unfortunately, the only intervention that have been shown to prevent COVID-19 infection is physical distancing. Together with good hand hygiene, not touching your face, and avoiding all nonessential interactions with others (including friends and family) outside of one’s immediate household, this is what we know can protect you and others from COVID-19.

If you have the virus but do not become severely ill, what can you do at home to treat it?

If you have been diagnosed with COVID-19, or believe you have the virus, even if you are not critically ill there are a number of important steps to take. You can relieve your symptoms by staying hydrated (i.e. drinking fluids) even if your appetite is poor, taking acetaminophen (aka Tylenol) for fever or pain, lozenges or hot drinks for sore throat, honey for cough, and most importantly, letting your body rest. It is important to stay home unless you require medical assistance, in which case you should either call your doctor, go to your nearest emergency department, or call 9-1-1 (or Hatzoloh). Be in touch with your doctor, and continue to monitor your symptoms for signs you are getting worse. Around 1 out of every 6 people who gets COVID-19 becomes seriously ill and develops difficulty breathing. Older people, and those with underlying medical problems like high blood pressure, heart problems or diabetes, are more likely to develop serious illness. People with fever, cough and difficulty breathing should seek medical attention. If you’re not sure whether you need medical care, call your doctor, 9-1-1 or Hatzoloh and ask. More information on self-isolation can be found here: https://www.publichealthontario.ca/-/media/documents/ncov/factsheet-covid-19-guide-isolation-caregivers.pdf?la=en

Does COVID-19 pose any unique risks to infants and young children?

From what we have learned so far about COVID-19, serious illness is rare in young children. In teenagers and those with medical conditions (neurological, kidney, heart, lung), the risk is likely higher. However, most of the time, children seem to act as carriers of the virus with relatively mild symptoms and because of this, they still pose a risk to others by spreading it to those who could become critically ill.

What is the timeline for the spread and resolution of this pandemic? When will we hit the peak number of infections? How long will public health measures be in place, and when will things return to normal?

The peak of cases in Canada, and Ontario specifically, is expected to be in mid- to late-April. But this can change as we learn more about the prevalence of disease. Nobody knows how long the public health measures will be in place. We look to the experience of other countries, such as China, South Korea and others to see how well their measures work. That said, we can expect current public health measures to continue for at least another 4 weeks, if not for several months. (Written April 13, 2020.)

What is the natural course of the virus in someone who is infected? What symptoms do they experience, and for how long?

On average, symptoms take 5-7 days to appear after exposure to COVID-19. For the majority of people, symptoms will present within 14 days of exposure. Rarely (in approximately 1 in 50 cases), symptoms can take even longer (3-4 weeks) to present. Those who are infected with COVID-19 may have little to no symptoms. Some experience chills, fever, cough or sore throat, or chest pain or shortness of breath, while others have none of these symptoms but experience vomiting or diarrhea. Loss of sense of taste and/or smell has been reported by many COVID-19 patients. It is thought that people can transmit the virus to others before they begin to feel unwell, making social distancing and public health measure critical for ALL.

If one has had the virus, can they get it again?

We do not know yet if people can become reinfected with the COVID-19 virus. Likely there is some protective immunity after infection. Studies show that infected individuals form antibodies, but we do not know yet how long this immune response is sustained. Some viruses, such as influenza, mutate each season and therefore people can become re-infected. There are some concerning reports from South Korea that individuals who had the virus and then tested negative have now tested positive again. It is unknown if this represent reinfection or possibly a “reactivation” of the virus.

How long does the virus remain alive on surfaces?

The COVID-19 viruses has been to shown to be viable (alive) on paper/cardboard for approximately 24 hours. Other materials like plastic and metal may allow the virus to survive up to 72 hours. For safest practice, surfaces should be cleaned with usual household cleaning materials or even warm water with soap if there is concern for contamination with virus.

How accurate is the current test for the virus? Are there any plans to do other forms of testing?

Currently, we test for the virus by swabbing the back of the nose. The test identifies the genetic material (RNA) of the virus. Sensitivity of the test ranges from 60-95%, meaning that between 1 in 3 and 1 in 20 people who test negative for COVID-19 will actually have the virus. Result accuracy may be influenced by how early in the disease someone is tested. As such, a negative test does not rule out COVID-19, and those with suspicious symptoms should assume that they have it, and MUST still self-isolate from others. Current tests typically take 12-72 hours to be processed, depending on where the testing facility is located. New tests are under development that will hopefully be more accurate and rapid.

Is it safe to order prepared food? What if someone at the catering company is known to have tested positive? Is there a risk of getting COVID from the person delivering your food?

Currently there is no evidence of COVID-19 infection caused by eating prepared food or handling food packaging, but here are some general things you can do to protect yourself and your family: hot foods will be less risky since coronavirus is deactivated by heat. Ask if there is an option to pay online or by phone to minimize contact. If choosing delivery, ask the delivery person to leave the food at your door. If you go to the store or restaurant in person and curbside pickup is not available, maintain appropriate distance from the store worker and try not to touch common surfaces with your hands. Wash your hands after handling delivery packaging and containers. Dispose of all packaging and wash your hands before eating.

If I am quarantined or self-isolating, am I allowed to go for a walk?

The best and safest answer is no. If you absolutely need to get fresh air and get outside for the sake of your sanity, and you are not actively coughing or vomiting or sneezing, it is reasonable to go outside with your face covered and your hands properly cleaned. You should avoid touching your face and avoid touching any common surfaces (even with gloved hands) such as door handles with your hands. You must also be extra cautious to keep maximal distance from everyone, so best to be outside in places where nobody else will be near you. These outings, if necessary, should be limited to short outings and short distances (e.g. not more than 100m from your home).

Could this virus mutate and become transmittable by other means, not just by droplets?

There is currently no evidence that COVID-19 has mutated to be able to spread by other means. This said, there is emerging evidence that small droplets which are very light and have the ability to float in air, can be expelled from people sneezing, coughing or even talking loudly, can linger in the air for several hours, and can travel distances farther than 6 ft. Keeping good airflow in closed spaces (e.g. open windows and doors) and face covers (to prevent these droplets from getting out into the air in the first places) can help to prevent exposure to these small droplet particles while we are all maintaining 6-foot distances from others.

What is the process for getting tested if you are worried you may have COVID-19?

If you are worried you have COVID-19, please contact public health to seek advice about testing. Local public health units are listed at http://www.health.gov.on.ca/en/common/system/services/phu/locations.aspx. Alternatively, you can call Telehealth at 1-866-797-0000. You can also access the following link to a self-assessment tool that can also help you determine how to seek further advice and care. https://covid-19.ontario.ca/self-assessment/#q0. If you are feeling sick or unwell, and you may need urgent medical attention, please call 9-1-1 or go to the nearest emergency department.

Can I reuse PPE if they are disinfected with rubbing alcohol or wipes?

Single-use masks can be re-used assuming they are not soiled or broken. Masks should be removed with care not to touch your face or the inside of the mask with uncleaned hands. Masks should be left lying face down on a clean surface for 3-5 days before re-use. Single-use masks should not be cleaned with sanitizers of any kind. Some hospitals and healthcare providers are using careful decontamination techniques for their single-use N95 masks that do not damage the protective filter and structural integrity of the mask. We do not recommend that people undertake these projects at home, and we do not recommend the use of N-95 masks for non-healthcare providers. Single use gloves and gowns should not be re-used.

How are funerals being conducted (or how should they be conducted) during this pandemic?

See Steeles Memorial’s website: https://steelesmemorialchapel.com/ and Benjamin’s Memorial’s website https://www.benjaminsparkmemorialchapel.ca/Home.aspx for details regarding funerals. Funerals are being held at graveside with a maximum of 10 people allowed to attend. Anyone with COVID-19 or suspected COVID-19 symptoms should not attend, even if they are immediate family. People in attendance of these ceremonies should maintain 2 meters separation from all others. Sadly, for people who have died from COVID-19, the number of people allowed to be at the graveside is even less. These constraints and limitations are all incredibly difficult for mourners. At the same time, it is important that we continue to be vigilant to protect the community at large from potential spread. Mourners are encouraged to seek spiritual and emotional support by virtually connecting with their communities and synagogues during this time. Community members are encouraged to participate in virtual shiva visits even more than usual. Shiva is always a difficult time, but this time of isolation and distancing in particular presents unique challenges that we must all be sensitive to.

Will people continue to have access to essential medications?

Yes, we anticipate that people will continue to have access to essential medications. Public health is recommending to not wait to fill essential prescriptions and to fill prescriptions for an extra month if you’re able. To renew your medications, you should call your pharmacy and ask them to fax a renewal request to your physician.

I’m pregnant. Am I more vulnerable to COVID-19?

As of now, data suggest that pregnancy does not pose its own additional vulnerability and your chances of severe illness would be more related to your age and general health status. You should take every recommended precaution at this time but do not need to change your work status if you are an essential worker.

I’m pregnant. Is my baby at risk from COVID-19?

As of now, information based on what is known so far about this virus and other similar past novel corona viruses (SARS, MERS), do not suggest that the virus is harmful to the fetus, regardless of gestational age. Transmission from mother to baby if the mother is sick seems very rare and not of long term consequence to the baby if the baby is born otherwise well.

Is care for pregnancy and labour and delivery changing at this time?

Depending on your risk status, your care provider (doctor/midwife) may well suggest fewer in-person visits at this time to decrease your risk of contracting the virus. This reduction in visits would be based on your gestational age, your risk status and medical history. When you do go for a visit, you will likely be screened for COVID-19 symptoms and may no longer be allowed to have a support person come to an appointment with you. Please inquire with your health provider. Labour and delivery is an emergency service which is not changed in the current crisis and labour wards at all hospitals are functional. Nitrous oxide (laughing gas) for labour pain management is discontinued at this time at most hospitals. Epidurals and spinals for pain management are safe and available. You will be screened for your health and all facilities are limiting visitors at this time. Most facilities still allow one healthy, adult support person while you are admitted to the hospital for labour and delivery, if you yourself are also healthy and without COVID-19 symptoms. However, this can change at any time so please inquire directly with your health provider and facility. Care for early pregnancy emergencies and miscarriages is likewise an emergency service and continues at this time through your healthcare provider, emergency services and early pregnancy clinics.

Can I still access contraception at this time? I do not want to get pregnant at this time.

Please be in touch with your healthcare provider. Depending on your health status and history, contraception can be discussed over the phone or in a virtual visit and prescriptions can be called into a pharmacy for many safe contraceptives. Long-term and permanent contraception that may require a health care visit (such as an IUD or surgical procedure) are mostly being deferred at this time but may be appropriate for high risk patients even now.

How does COVID-19 spread

COVID-19 can be spread by people who have symptoms, or by people who do not know they are infected, before they have symptoms. This is why everyone needs to practice physical distancing, regardless of how they feel. COVID-19 spreads primarily through droplets in the air. These droplets can be present up to 2 meters (6 feet) around any person. They can land on surfaces and contaminate objects that have been within 2 meters of any person.

Is there a vaccine against COVID-19

Currently, there are no vaccines or specific treatment for COVID-19. As such preventing the spread through physical distancing is the most effective way of preventing illness and death.

What is coronavirus ?

Coronaviruses are a large family of viruses. Like all viruses, some people who get them experience mild symptoms, and some more severe symptoms. Some coronaviruses spread easily between people, while others do not.

The symptoms of COVID-19 are similar to other respiratory infections, such as influenza, and include things like:

  • Fever, new cough or difficulty breathing (or a combination of these symptoms)
  • Muscle aches, fatigue, headache, sore throat, or runny nose. Symptoms in young children may also be non-specific (for example, lethargy, poor feeding)

Your risk of experiencing severe symptoms is higher if you have a weakened immune system. This may be the case for:

  • Older people
  • People with chronic disease (for example, diabetes, cancer, heart, renal or chronic lung disease)
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