PHO defines IPAC as evidence-based practices and procedures that, when applied consistently in health care settings, can prevent or reduce the risk of transmission of microorganisms to health care providers, clients, patients, residents and visitors.

Most mask mandates in Ontario have been revoked. Masks are still required to be worn in long-term care and retirement homes. Masking is recommended in higher-risk congregate living settings. Organizations may also have their own masking policies in place. Individuals should continue to wear a mask if they feel it is right for them, are at high risk for severe illness, recovering from COVID-19, have symptoms of the virus or are a close contact of someone with COVID-19

Please refer to this resource from the Government of Canada with information on the different types of masks and their uses.

Extended use is wearing a respirator continuously and it is preferable to re-use (i.e., taking off and putting on repeatedly) because repeatedly doffing and donning a used respirator increases the risk of self-contamination and may affect the integrity and function of the mask. Extended use of N95 respirators should only be considered during supply shortages and in consultation with your IPAC professional.

Additional information can be found here.

N95 fit testing is required in order to ensure that staff are wearing a respirator that has an appropriate seal and provides them with the necessary protection.

Please refer to the PPE section of the MOH COVID-19 Guidance: Long-Term Care Homes, Retirement Homes, and Other Congregate Living Settings for Public Health Units document for more information about N95 requirements for each sector.

The CIC® examination is the standardized measure of the basic knowledge, skills and abilities expected of professionals working in the field of infection prevention and control. The CIC exam is offered by the Certification Board of Infection Control and Epidemiology, Inc (CBIC).

For more information about the CIC exam, including eligibility requirements, cost, etc. please refer to the CBIC website here.

Considerations include, but are not limited to: efficacy of the disinfectant, ease of use, compatibility with items and surfaces, safe for use, cost, and environmental impact.

Additional information can be found here (Page 28: 1.3.2.1 Choosing a Disinfectant).

Facilities should have a plan in place for estimating the number of days of supplies and for maintaining an adequate supply of PPE for client/resident care for both usual care requirements and outbreak scenarios, with connections to suppliers for PPE needs.

Additionally, facilities may use the Regional COVID-19 Portal PPE Order Forms.

From PHO’s FAQ: “A risk assessment must be done before each interaction with patient/resident/client or the environment in order to determine which personal protective equipment (PPE) is required to prevent transmission during the interaction. PPE should be donned (put on) just prior to the interaction typically just outside the patient room and the PPE should be doffed (removed) and disposed of in the appropriate receptacle following the interaction. Ideally, PPE should be removed immediately at the exit of the patient/resident/client space. However if there is a lack of space (e.g., less than 2 metre distance from the client/patient/resident), staff may remove gown and gloves within the room at the exit and then exit the room and remove facial protection which includes mask/respirator and eye protection just outside the room. Some considerations regarding the donning and doffing area would be a) alcohol based hand rub is easily accessible b) appropriate receptacles i.e., garbage for disposable PPE, bin for linen if cloth gowns are used and c) waste receptacles are not adjacent to clean supplies to avoid contamination.”

Grey Bruce Public Health IPAC does not offer N95 fit testing services. We cannot endorse specific organizations, but Ontario Health West HMMS Portal provides a non-exhaustive list of fit testing organizations.

MCCSS organizations can connect with their local IPAC Champion for additional information on fit testing.

The Ministry of Health screening tool for Long-Term Care and Retirement Homes, which can also be used by Congregate Settings, can be found here.

Any questions related to outbreak management should be directed to the Grey Bruce Health Unit’s Infectious Diseases team member responsible for your zone.

If you have a question specifically related to Infection Prevention and Control, please connect with the IPAC Hub for assistance.

IPAC Function in IPAC Hub:

• Services provided directly to congregate settings

• A variety of services are provided

• Services provided are required for congregate catchment areas based on acuity of needs identified

IPAC Function in Public Health:

• Outbreak response and IPAC inspections/audits

• Auditing a service or practice in response to a complaint or suspected IPAC lapse

• Enforcement

Please refer to this document for more information.

Long-Term Care Home

Retirement Home

Assisted Living Settings

Supportive Housing

Shelters

Adult Developmental/Intervenor Services and Congregate Residential Programs

Violence Against Women Shelters/Residential Programs

Anti-Human Trafficking Residential Programs

Children's Residences

Youth Justice Facilities and Open and Secure Custody Settings

Indigenous Healing and Wellness Strategy Residential Programs

PCR (also known as polymerase chain reaction) tests show if someone currently has COVID-19. Swabs have to be shipped to one of more than 40 laboratories across Ontario in order to be analyzed. In a lab, technicians can process and analyze about 96 of these tests per machine in 4 to 6 hours. Shown to be highly accurate, the PCR lab test is the gold-standard of COVID-19 testing.

Rapid antigen tests (or RATs) look for proteins from the COVID-19 virus. Results are available in about 15 to 20 minutes, at the same site the sample is taken. This test may be useful for repeated screening of asymptomatic people in high-risk settings, such as staff, volunteers, residents or visitors in long-term care homes. Antigen tests are not as accurate at PCR tests, however.

For LTCHs, RHs, and CLOs, RATs should be completed in tandem with a PCR test.

Resource

Please refer to the Long-Term Care Home / Retirement Homes Resources section of the Ontario Ministry of Health and Ministry of Long-Term Care webpage.