The Ministry of Health Management of Cases and Contacts of COVID-19 in Ontario

NOTE: It has been clarified that primary care is NOT considered a “highest risk” setting and are expected to follow the guidance for normal cases and contacts (unless also working in a “highest risk” setting).

Primary care providers who contract COVID-19 should follow the standard community guidelines, unless they are also working in a “highest risk” setting

Changes to ministry guidance (August 31, 2022) include elimination of minimum isolation periods for most cases. Here’s a summary of current guidance:

  • Individuals who have symptoms of ANY respiratory illness should stay home until symptoms have been improving for at least 24 hours (48 hours if nausea, vomiting or diarrhea)
  • If they have a fever, they should stay home until the fever is completely gone.
  • Avoid non-essential visits to vulnerable people for a full 10 days starting the day after symptoms appear.
  • Symptomatic and test-positive individuals should wear a mask when in public spaces for 10 days from the start of symptoms/positive test result
  • For those who are hospitalized, immunocompromised or reside in a highest-risk setting (i.e., acute care, long-term care and retirement homes, group homes, shelters, etc.), 10-day isolation remains and symptoms must be improving as noted above. Note: does not include primary care (see points above which apply to Primary Care, and page 7 of Guidance).

For healthcare workers in highest-risk settings referenced above:

  • Close contacts of someone with a positive COVID test or symptoms may work in their highest-risk work setting if asymptomatic.
  • No change to isolation requirements for symptomatic or test positive individuals who work in highest-risk settings – may return to work 10 days after onset of symptoms or positive test result. Testing for clearance is generally not recommended. See Appendix A of Guidance for more, including options for critical staffing shortages and workplace measures for reducing risk.

Primary care providers who are a high risk contact of a person with COVID-19 is defined as:

  • Anyone with whom the COVID-19 positive person came into close contact within the 48 hours prior to symptom onset if symptomatic or 48 hours prior to the test date if asymptomatic, and until the positive person started self-isolating.
  • Close contact means you were in close proximity to them for at least 15 minutes or for multiple short periods of time without appropriate personal protective equipment (as per Management of Cases and Contacts of COVID-19 in Ontario).
  • Other high risk contacts as advised by public health

Primary care providers who are high risk contacts and who are:

  • Asymptomatic AND
  • Fully vaccinated AND
  • Have been identified critical to operations in their organization AND
  • Are actively screened ahead of each shift AND
  • Are negative on any required tests (e.g., initial PCR and any other required RATs and PCRs)

May continue to work under self-isolation if they are critical to workforce needs. Important note: if also working in a high-risk setting, must follow guidelines for that setting.

Health Care Workers should wear fit tested N95 respirators at all times during work as should staff working alongside the HCW.  Non-HCW should wear a well fitted KN95 or surgical mask.

In addition they should refer to and follow the How to Self-isolate while Working fact sheet as well as the guidance on Management and Critical Staffing Shortages for other guidance including testing requirements for workplace isolation and return to work after isolation according to context.

Note: This does not change the requirements for clearance and discharge from isolation outside this setting.

Primary care providers who are a household member of a high risk contact of a person with Omicron variant COVID-19 do not need extra precautions and can work with usual PPE.

“Fully Vaccinated” at present means they have received at least 2 doses of COVID vaccine