• All primary care setting should follow Routine Practices (routine precautions) plus droplet and contact precautions
• Follow Cleaning the Environment section in PIDAC's Infection Prevention and Control for Clinical Office Practice Document
• Approved hospital cleaning and disinfecting agents must be used for environmental cleaning
• Clinic/examination areas and high tough surfaces are cleaned and disinfected at least daily and when visibly soiled
• Areas in direct contact with the patient are cleaned and disinfected between patients

• All primary care settings should undertake passive screening (signage) and active screening (asking questions) of patients for COVID-19 (See case definition).
• Patients who screen positive over the phone:
• Please ask them to self-isolate
• Primary care offices that have PPE for droplet/contact precautions and testing supplies we ask that they offer the patient clinical assessment, examination and possibly testing (as indicated, see Testing below) in their clinics
• The primary care provider should contact BCHU to report if they meet the case definition
• Where primary care offices DO NOT have PPE or testing supplies, the primary care provider should take a clinical history and travel/exposure assessment by phone to determine if the patient is a probable case (see case definition)
• If the patient is a probable case:
• The primary care provider should contact BCHU to report the probable case, and if the patient is unwell enough to require physical assessment or meets priority testing, criteria should be referred to the nearest emergency department or assessment centre
• The primary care provider should coordinate with the hospital, BCHU and the patient to make safe arrangements for travel to the hospital that maintains isolation of the patient
• Patients who screen positive in-person:
• Patients should be instructed to wear a surgical mask (if tolerated) and be placed in a single room with the door closed on arrival to wait for further assessment
• Where primary care offices DO NOT have PPE and/or testing supplies, the primary care provider should take a clinical history and travel/exposure assessment  to determine if the patient is a probable case (see case definition)
• If the patient is a probable case:
• The primary care provider should contact BCHU to report the probable case and if well enough the patient may be given instruction to self-isolateand be sent home
• If the patient is unwell enough to require physical assessment or meets priority testing criteria should be referred to the nearest emergency department or assessment centre
• The primary care provider should coordinate with the hospital, BCHU and the patient to make safe arrangements for travel to the hospital that maintains isolation of the patient

BCHU does not perform swabbing or testing.

The Ontario Ministry of Health updates COVID-19 provincial testing guidance. You can access this guidance on the Ministry of Health website.

A new appendix document centred on Serology Testing and MIS-C has also been shared to support the public health management of serology testing and MIS-C.

• Clinicians who suspect COVID-19 are required to report the individual to their local public health unit.
  

The Government of Canada has put in place an Emergency Order under the Quarantine Act that applies to all travellers arriving in Canada in order to slow the introduction and spread of COVID-19 in Canada.

TRAVELLERS WITH SYMPTOMS - Mandatory Isolation

If you have recently returned to Canada and have symptoms, you must isolate. This is mandatory. If required, immediate medical attention will be provided upon arrival in Canada.

Mandatory isolation means you MUST:

• Go directly to the place where you will isolate, without delay, and stay there for 14 days
• Go to your place of isolation using private transportation only, such as your personal vehicle
• Stay inside your home
• Not leave your place of isolation unless it's to see medical attention
• Do not go to school, work, other public areas or use public transportation (e.g., buses, taxis)
• Stay in a separate room and use a separate bathroom from others in your home, if possible
• Not have visitors and limit contact with others in the place of isolation , including children
• Not isolate in a place where you will have contact with vulnerable people such as older adults and individuals with underlying medical conditions
• If your symptoms get worse, immediately contact your health care provider or public health authority and follow their instructions.

If you have symptoms but do not have a place to isolate, you will be required to isolate for 14 days in a facility designated by the Chief Public Health Officer of Canada.

Violating any instructions provided to you when you entered Canada could lead up to six months in prison and/or $750,000 in fines.

TRAVELLERS WITHOUT SYMPTOMS - Mandatory Quarantine (mandatory self-isolation)

If you have recently returned to Canada and have no symptoms, you must quarantine (self-isolate) yourself. This is mandatory. You are at risk of developing symptoms and infecting others.

This means you MUST:

• Go directly to your place of quarantine, without delay, and stay there for 14 days
• Do not go to school, work, other public areas and community settings
• Monitor your health for symptoms of COVID-19
• Arrange to have someone pick up essentials like groceries or medication for you
• Do not have visitors
• Stay in a private place like your yard or balcony if you go outside for fresh air
• Keep a distance of at least two arms lengths (approximately two metres) from others

You can take public transportation to get to your place of self-isolation after you arrive in Canada, but you must not stop on the way home and practice physical (social) distancing at all times.

Violating any instructions provided to your when you entered Canada could lead up to six months in prison and/or $750,000 in fines.

If you develop symptoms within 14 days:

• isolate yourself from others
• immediately call a health care professional or BCHU and:
• describe your symptoms and travel history
• follow instructions carefully
  

• Novel Coronavirus- Public Health Ontario
  
• Novel Coronavirus Guidance for Primary Care Providers in a Community Setting - Ministry of Health
  
• COVID-19 Reference Document for Symptoms - Ministry of Health
• COVID-19 Quick Reference Public Health Guidance on Testing and Clearance - Ministry of Health
• Operational Guidance: COVID-19 Management in Schools - Ministry of Education
• COVID-19 Guidance School Management Outbreak - Ministry of Health
  
• How to Self-Isolate - Public Health Ontario
  
• Guidance for Immunization Service Providers During COVID-19
• COVID-19 Vaccine-Relevant Information and Planning Resources
  
• Patient Signage (English)
  
• Visitor Signage (English)
  
• Patient Signage (French)
  
• Visitor Signage (French)