• 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.

Depending on availability of swabs certain groups will be given priority (this list may change and evolve):

• Individuals admitted to hospital with acute respiratory illness
• Symptomatic health-care workers
• Symptomatic residents of long-term care homes and retirement homes and other institutional settings
  
• First Nation community members living on-reserve with acute respiratory illness
• Symptomatic travelers identified at a point of entry to Canada
  

Individuals not falling under these groups, but meeting the above criteria, should be recommended to self-isolate without having testing completed for COVID-19 and should be reported to the Health Unit.

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

For travellers who have been to Italy, Iran or Hubei province (China) in the past 14 days:

• Contact local public health within 24 hours of their return to Canada, to arrange for monitoring, an
• Self-isolate and stay at home for 14 days since last being in Italy, Hubei province (China) or Iran, and
• Self-monitor for fever, cough, or difficulty breathing.

• Notify local public health immediately at 519-753-4937
  
• Notify their healthcare provider prior to visiting any healthcare facility.
  

All other travellers returning to Canada are advised to:

The Government of Canada has warned against all international travel.

All travellers outside of Canada are required to self-isolate for 14 days upon return.  

In Ontario, all children travelling outside of Canada will be REQUIRED to self-isolate for 14 days upon their return.

Should any of these individuals develop symptoms of COVID-19 (fever over 38 degrees Celsius and/or new or worsening chronic cough) within 14 days of their return, they are to:

• Self-isolate immediately, and
• Notify Telehealth 1-866-797-0000 or call BCHU (519-753-4937) immediately for further assessment, and
  
• Notify their healthcare provider prior to visiting any healthcare facility.
  

• Novel Coronavirus - Public Health Ontario 
• Novel Coronavirus Guidance for Primary Care Providers in a Community Setting - Ontario Ministry of Health
• How to Self-Isolate - Public Health Ontario
• Patient Signage (English)
  
• Visitor Signage (English)
• Patient Signage (French)
• Visitor Signage (French)