Updated Eligibility for PCR Testing and Case and Contact Management Guidance in Ontario
In response to the rapidly spreading and highly transmissible Omicron variant, the Grey Bruce Health Unit echoes the provincial direction of the Ontario government, in consultation with the Chief Medical Officer of Health, and is updating its COVID-19 testing and isolation guidelines. Key changes include the following:
- Symptomatic testing will be available for high-risk individuals, and individuals who work in high-risk settings.
- Individuals with symptoms consistent with COVID-19 are presumed positive and they should follow isolation and/or self-monitoring guidelines.
- Testing for asymptomatic contacts of cases is generally no longer recommended, except for high-risk contacts/individuals that are part of confirmed or suspected outbreaks in high-risk settings, as recommended by public health.
- Positive rapid antigen tests will no longer require PCR confirmation.
- Based on the latest scientific evidence, individuals with COVID-19 should isolate for five days if they are fully vaccinated or under the age of 12, and if their symptoms are improving for at least 24 hours.
Eligible Groups for PCR Testing
Effective December 31, 2021, PCR testing will only be recommended for individuals if they belong to the following groups:
- Symptomatic people who fall into one of the following groups:
- Hospitalized patients
- Patients in Emergency Departments, at the discretion of the treating clinician
- Patient-facing health care workers
- Staff, residents, essential care providers, and visitors in hospitals and congregate living settings, including long-term care, retirement homes, First Nation elder care lodges, group homes, shelters, hospices, temporary foreign worker settings, and correctional institutions
- Outpatients for whom COVID-19 treatment is being considered
- Underhoused or homeless
- People who are from First Nation, Inuit, and Métis communities and individuals travelling into these communities for work
- Symptomatic elementary and secondary students and education staff who have received a PCR self-collection kit through their school
- People on admission/transfer to or from hospital or congregate living setting
- High-risk contacts and asymptomatic/symptomatic people in the context of confirmed or suspected outbreaks in high-risk settings, including hospitals, long-term care, retirement homes, other congregate living settings and institutions, and other settings as directed by the local public health unit
- Individuals, and one accompanying caregiver, with written prior approval for out-of-country medical services from the General Manager, OHIP
- Asymptomatic testing in hospital, long-term care, retirement homes and other congregate living settings and Institutions as per provincial guidance and/or Directives
If you have symptoms of COVID-19
Individuals who are vaccinated, as well as children under 12 who have symptoms of COVID-19 will be required to isolate for five days following the onset of symptoms. These individuals can end isolation after five days if their symptoms are improving for at least 24 hours, and all public health and safety measures, such as masking and physical distancing, are followed
Individuals who are unvaccinated, partially vaccinated or immunocompromised will be required to isolate for 10 days.
If you are someone who works or lives in a high risk-health care setting (i.e., hospitals, long-term care, retirement homes, congregate living settings) you must notify your employer. Individuals who work or live in these settings should not attend work for 10 days from their symptom onset, or from their date of diagnosis. To ensure sufficient staffing levels, workers in these settings may have the opportunity to return to work early on day seven of their isolation, with a negative PCR test, or two negative rapid antigen tests on day six and seven. Speak with your employer or occupational health and safety department for more information.
All household contacts must also isolate for the same duration as the person with symptoms, regardless of their vaccination status. If you have symptoms of COVID-19, you should also consider informing close contacts beyond your household contacts by providing them with the link to Ontario.ca/exposed. Individuals who are eligible for a lab-based PCR test are encouraged to get tested.
If you have concerns about your symptoms, contact your doctor, health care provider or Telehealth for more information and guidance. If you develop severe symptoms requiring medical attention, such as shortness of breath or chest pain, call 911.
If you do not have symptoms of COVID-19 but are feeling unwell, isolate until symptoms have improved for at least 24 hours.
If you’ve been exposed to someone who has tested positive for COVID-19
If you are fully vaccinated and you have no symptoms, and do not live with the positive case, you are advised to:
- Self-monitor for symptoms for 10 days since you last interacted with the positive case
- Maintain masking, physical distancing and adherence to all other public health measures if leaving home
- Do not visit any high-risk settings or individuals who may be at higher risk of illness (e.g., seniors) for 10 days from your last exposure.
If you are not fully vaccinated, or are immunocompromised, you must isolate immediately for 10 days following your last contact. If you live with the positive case, you must isolate for the length of their isolation period.
Individuals who are eligible for testing are encouraged to get tested.
If you live, work, attend, volunteer, or have been admitted in a high-risk health care setting, you must notify your employer and should not visit the high-risk setting for 10 days since your last exposure or symptom onset, or from your date of diagnosis. To ensure sufficient staffing levels, workers in these settings will have the opportunity to return to work early on day seven of their isolation with a negative PCR test, or two negative rapid antigen tests on day six and seven. If you live in a high-risk setting, you should isolate regardless of vaccination status.
If you have COVID-19 based on a positive test result
If you test positive from a PCR, rapid molecular or a rapid antigen test and you are fully vaccinated or under 12 years of age, you must isolate for five days from the positive test result if you have no symptoms or from symptom onset and until their symptoms are improving for 24 hours (or 48 hours if gastrointestinal symptoms).
If you are partially vaccinated, unvaccinated or immunocompromised, you should self-isolate for 10 days from the onset of symptoms, or from the date of your test (whichever came sooner).
In addition, household contacts of individuals who have tested positive must also self-isolate during this time. Individuals must isolate regardless of their vaccination status.
You should also notify your close contacts. 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 personal protective equipment in the 48 hours before your symptoms began or your positive test result, whichever came first.
Appropriate Use of Rapid Antigen Testing
Ontario currently has a limited supply of rapid antigen tests that are being prioritized for health care and highest risk settings. This includes rapid antigen test use for “test-to-work” in which asymptomatic staff in these sectors can return to work when they would otherwise be on isolation at home.
Focusing the use of rapid antigen tests for these sectors will help keep hospitals, long-term care and retirement homes and congregate settings operating as safely as possible. As of December 20, a total of 50 million rapid antigen tests have been deployed across more than 49,000 sites since the beginning of the pandemic, with the vast majority (approximately 41 million) deployed to these priority sectors.
Rapid antigen testing may be used to confirm if a symptomatic individual has COVID-19, with no requirement for a confirmatory PCR or rapid molecular test.
In addition to Ontario directly procuring additional rapid tests where possible, the province is continuing to urge the federal government to make more rapid tests available to provinces as quickly as possible.
How to Access Supports While Isolating
If you require assistance while isolating, visit COVID-19: Support for people. People can also contact their public health unit for many isolation supports including:
- Use of isolation facilities;
- Referral to community supports and agencies;
- Mental health supports;
- Courier and delivery supports for food and necessities;
- Additional resources available to support isolation through the High Priority Communities strategy.
Employers cannot threaten, fire, or penalize an employee in any other way because the employee took or plans on taking job-protected leave due to COVID-19, and doctors notes are not required for employees to use the leave. You can learn more about job-protected leave here.
For More Information:
Dr. Ian Arra, MD MSc FRCPC ACPM ABPM
Medical Officer of Health and Chief Executive Officer
To arrange to speak with Dr. Arra, please contact: firstname.lastname@example.org
519-376-9420 or 1-800-263-3456 ext. 3940