Confused about COVID? Family doctors answer your questions (University of Toronto & College of Family Physicians of Ontario)
I’m not feeling well. How do I know if I have COVID? What should I do? (Confused about COVID?)
Want or need to get a COVID-19 test?
How and When to Use a Rapid Antigen Test
A positive rapid antigen test (RAT) is now considered diagnostic of COVID in the current situation where case numbers in the community are high. A PCR swab is not needed to confirm. Note that this accuracy will change as the community prevalence reduces. At low community case numbers (low “pre test probability”) the proportion of positive RATs that are false positives increases, reducing the usefulness.
RATs are less sensitive for the Omicron variant compared to the Delta variant using a nasal sample only, particularly in the first 2 days after infection. The ability to detect Omicron is improved by using a new oral-nasal sample collection technique (using the same swab). See instructions for collection below.
A single negative RAT does not reliably rule out infection. Two negative RATs separated by a minimum of 24-48 hours apart are considered to rule out COVID diagnosis. Symptomatic patients should still isolate until improving as per the current isolation recommendations.
How to use RATs for Asymptomatic Screening
RATs are being used in some work or other settings (including primary care clinics) to reduce transmission of cases by regular screening of asymptomatic individuals. Because there is a delay between infection and development of a positive RAT (see the graph on the left), frequent screening is key to effective use. The graph on the right shows the reason for the current recommendation that testing be done between 3 and 5 times per week when using for screening.
Modified from Ontario Science Table: Use of Rapid Antigen Tests During the Omicron Wave
Collection Techniques for adults and children
To improve the ability to detect the Omicron variant, the recommended swab technique for RATs is now an oral-nasal sample collected using the same swab. Individuals can collect these samples by initially swabbing the inside of both cheeks, followed by the back of the tongue or throat, and then both nostrils.
Video instructions from Ontario Science Table: Use of Rapid Antigen Tests During the Omicron Wave
Written instructions from Public Health Ontario: COVID-19 Rapid Antigen Tests: How to Collect a Sample
Read more detail here:
Ontario Science Table: Use of RATs During the Omicron Wave
For Patients with COVID illness / Antiviral eligibility screening tool
Otherwise healthy adults and children can self-isolate, and will not need to seek medical care. If you have symptoms, you can find detailed advice from Hamilton Family Medicine on COVID-19 below.
Connect with your family doctor if you are in a higher-risk group* and have symptoms; your COVID symptoms get worse; or you are experiencing moderate to severe illness.
If you are at a higher risk of more serious illness* you may benefit from closer regular monitoring from your family doctor, which may include check-in calls and in some cases loan of a pulse oximeter to use. (A pulse oximeter is a small clip that measures how much oxygen your blood is carrying.) You may also be eligible for treatments.
COVID-19 antiviral treatment screener
Antiviral treatments are now available in the community (outside of a hospital) for people with symptoms (even if mild) who are at higher risk of severe COVID-19. These treatments must be taken within the first 5 to 7 days of your symptoms starting.
Take this screener to determine if you are at higher risk of severe COVID-19 and may benefit from these treatments.
*Higher risk group: If you have symptoms and are: over 60 OR have any long-term medical conditions OR are unvaccinated OR are pregnant you should contact your usual primary care clinic for an assessment of whether closer monitoring is required and information about managing your illness. Contact your family doctor early in your illness rather than waiting for symptoms to worsen.
COVID-19 Guides for Patients
- COVID GUIDE for ADULTS (including when to seek medical help, how to care for yourself and instructions for using pulse oximeters correctly)
- Translated Patient information documents for people being monitored at home are available in Arabic, Bengali, Chinese (simplified), Dari, French, Hindi, Portuguese, Russian, and Spanish.
- Information for Caregivers of Children with COVID
- Pulse Oximeter Patient Instructions (ProResp)
- Translated Pulse Oximeter Patient Instructions are available in Arabic, Bengali, Chinese (simplified), Dari, French, Hindi, Portuguese, Russian, and Spanish.
- How to Use a Pulse Oximeter YouTube video
- COVID-19 Symptom Timeline: Why Days 5 to 10 Are So Important When You Have Coronavirus (Georgian Bay Family Health Team).
- COVID-19 Timed Position Changes Instructions (Georgian Bay Family Health Team).
This applies to test positive (PCR, rapid molecular, or rapid antigen) or clinical symptom diagnostic algorithm positive.
Management of Cases and Contacts of COVID-19 in Ontario (April 11, 2022)
- for 10 days from the onset of symptoms, or from the date of their test (whichever came sooner).
- 12 years of age or older AND either partially vaccinated (1 dose), or unvaccinated they must self-isolate
- Immunocompromised (regardless of age and vaccination status)
- Hospitalized for COVID-19 related illness
- For at least 5 days from symptom onset and until symptoms have been improving for 24 hours (or 48 hours if gastrointestinal symptoms) whichever is longer in duration
- 12 years of age or older AND fully vaccinated (2 or more doses)
- <12 years of age (regardless of their vaccination status)
- Severely immunocompromised and those who have been in ICU should isolate for 20 days. See full guidance on page 13 for examples of severe immunocompromise.
- All test confirmed cases (i.e. people who test positive on PCR, rapid molecular, or rapid antigen) should notify high risk contacts of their exposure. High risk contacts include:
- 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).
Isolation guidelines for these contacts are below:
NOTE: It has been clarified that primary care is NOT considered a “highest risk” setting and are expected to follow the guidance for normal contacts (unless also working in a “highest risk” setting). It makes sense that after the 5 days of self isolation to take greater precautions on return to work (i.e. as close to workplace isolation precautions as is possible / avoiding immunocompromised patient contact as much as possible)
“Fully Vaccinated” at present means they have received at least 2 doses of COVID vaccine. People who have tested positive for COVID within 90 days (and after Dec 20) follow the same guidance as fully vaccinated.
Household contacts: Asymptomatic household contacts should extend their isolation period if new household members subsequently become cases. Household contacts only have to isolate until the last symptom or test positive person in their household member has finished their isolation period, regardless of ongoing exposure.
Close contacts who have previously tested positive for COVID-19 in the last 90 days (based on positive test results), are not required to self-isolate, as long as they are currently asymptomatic. These individuals are advised to self-monitor for symptoms for 10 days from last exposure and can attend work, including in the highest-risk settings
Questions about COVID-19 Vaccines
- All you need to know and frequently asked COVID vaccine questions go to City of Hamilton Public Health
- AstraZeneca COVIShield Clotting Risk and Effectiveness Information (McMaster Family Health Team, updated May 12, 2021)
- Lay summary of the Canadian Science Table report on clotting risk following AstraZeneca COVID-19 vaccination.
- AstraZeneca and Johnson & Johnson patient info sheets (Centre for Effective Practice)
- COVID-19 Vaccine: Is It the Right Choice for Me? (EBSCO Clinical Decisions)
- Translated Vaccine Resources (Toronto Public Health)
Scroll down on page for Amharic, Arabic, Bengali, Simplified Chinese, Traditional Chinese, Dari, Farsi, French, Germa, Greek, Gujarat, Hindi, Hungarian, Italian, Karen, Korean, Nepali, Polish, Portuguese, Punjabi, Russia, Serbian, Somali, Spanish, Tagalog, Tamil, Tigrinya, Turkish, Ukrainian, Urdu, and Vietnamese.
- A Safe and Effective Second Dose (English); Une seconde dose sécuritaire et efficace (French) – Fact sheet on vaccine interchangeability (Ontario Ministry of Health, June 21, 2021).
- COVID-19 Vaccine Information Sheet (age 12+) (Ontario Ministry of Health, December 14, 2021)
- Patients can also call the hotline: 905-974-9848, option 7 or email: firstname.lastname@example.org with general vaccine questions
- Patients should discuss any personal medical questions related to the vaccine with their health care provider (i.e., If they are unsure about their allergies, if they have autoimmune or immunosuppressed conditions, if they are pregnant, or who need to discuss getting the vaccine)
- COVID-19 Vaccine Medical Exemptions (Focused Communications, September 26, 2021)
- The current list of immunosuppressant medications from the Ontario Ministry of Health can be found starting on Page 5 of this living document – COVID-19 Third Dose Recommendations.
- Do I really need a third dose? (Confused about COVID?)
- To share with parents about vaccinating children
- Factsheet on Youth and Children Vaccination from the MOH.
- COVID-19 Vaccine Consult Service (VSC) from SickKids and VaxFacts – for patients who might benefit from a dedicated, confidential phone appointment to answer their vaccine questions.
- Max the Vax, a compilation of credible information and resources about vaccines and vaccination for kids.
- UWaterloo School of Pharmacy Focused COVID Communication team, including FAQs on the mRNA vaccine for children and decision tool on whether to vaccinate a child now or wait.
- Translated Vaccine Fact Sheets (Ages 5-11) (City of Hamilton)
How do I get the vaccine in Ontario?
- Information on where to get vaccinated in Hamilton and answers to frequently asked COVID-19 vaccines questions is available on City of Hamilton website
Self-isolation and Physical Distancing
Return to School
- Back to School with McMaster Children’s Hospital
- OMA COVID Clearance Attestation Form
- Helping your family prepare for return to school (Dana Abenstein, Darren Abenstein, Farah Alli-Shaw)
- Safe Return to School Toolkit (Windsor-Essex County Health Unit)
- Navigating Patient Concerns and Requests in the COVID-19 Context (Centre for Effective Practice)
Mobility and Fitness
- Physical Activity at Home with Online Programs (prepared by Laura Doyle and Colleen McPhee)
- Staying Active at Home ( recorded webinar provided by the Hamilton Family Health Team)
- Staying Heart Healthy at Home During COVID-19 (recorded webinar provided by the Hamilton Family Health Team)
- List of Publicly Funded Physiotherapy Clinics (prepared by Stonechurch Family Health Centre)
- City of Hamilton Recreation Assistance Program
- Back Pain with Extension (prepared by the Interprofessional Spine Assessment and Education Clinic)
- Back Pain with Flexion (prepared by the Interprofessional Spine Assessment and Education Clinic)
- Online wellness workshops for all patients in Hamilton (provided by the Hamilton Family Health Team)
- Resources for Canadians living with pain during COVID-19 (Health Canada)
- Take Control Take Charge resources and webinars (Province of Ontario)
Community Services, Food and Financial Resources
- Hamilton Directory of Community Services, COVID-19 Update, (prepared by Canadian Mental Health Association, Hamilton)
- Food and Financial Resources (Prepared by Dan Edwards and Sundee Himberg)
- Planning your Pandemic Pantry (Primary Care Dietitians Association)
- COVID-19, Food and Supplements: Facts and Myths (Primary Care Dietitians Association)
- How to Grocery Shop Safely During COVID-19 (Primary Care Dietitians Association)
- Food and Mood: Diet and Depression (recorded webinar provided by the Hamilton Family Health Team)
Working from Home
- Working from Home — Tips and Tricks (prepared by Martha Bauer)
Maternal Newborn Care
- Looking After Your New Baby During COVID-19 (prepared by Tejal Patel, Rebecca Steen, and Angela Reitsma)
- Health Nexus – COVID-19 patient resources
- ACOG – COVID-19 patient resources
- PCMCH COVID -19 Vaccine Information Page
- I am pregnant or breastfeeding. Should I get the COVID-19 vaccine?
- I’m pregnant. How can I keep safe? What should I do if I get COVID? (Confused about COVID?)
- Resources prepared by Health Nexus
- What to do During COVID-19 if You Have Diabetes (recorded webinar provided by the Hamilton Family Health Team)
Mental Wellness & Stress Management
- Online Resource for Social Connection and Mental Wellness an Social Connection (prepared by Canadian Mental Health Association, Hamilton)
- 50 Ways to Stay Mentally Healthy While Social Distancing (prepared by Canadian Mental Health Association, Hamilton)
- Online wellness workshops for all patients in Hamilton (recorded webinar provided by the Hamilton Family Health Team)
- Mental Health Resources for Parents and Children (provided by the Toronto Sick Kids Hospital)
- 50 Activities For The Elderly In Lockdown and Isolation (Golden Careers)
- Supporting child and youth mental health during COVID-19 (City of Hamilton)
- COVID-19 mental health (City of Hamilton)
- Resources for Low Mood and Anxiety
- Stress Symptoms (prepared by K. Lynn Dykeman, Colleen O’Neill and Dee Mangin)
- Stressbusting During COVID-19 (prepared by K. Lynn Dykeman and Colleen O’Neill)
- Stressbusting During COVID-19 Part 2: More Ways To Help You Deal With Stress (prepared by K. Lynn Dykeman and Colleen O’Neill)
- Tolerance for Uncertainty: A COVID-19 Workbook: a guide to accept your feelings, tolerate the distress, and thrive (prepared by Dr. Sachiko Nagasawa)
- Sleep Well (prepared by Martha Bauer, Colleen O’Neill, Kiska Colwill and Naomi Dore)