Santé et sécurité bannière


Please find attached a Directive from the Chief Medical Officer of Health to Long-Term Care Homes.

The ministry would also like to remind all organizations in the health system, per the attached memo from March 19th that:

  • All employees who have travelled outside of Canada should self-isolate for a period of 14 days starting from their arrival in Ontario 
  • Health care workers should not attend work if they are sick
  • If there are particular workerswho are deemed critical, by all parties, to the continued operations of an organization, these groups should undergo regular screening, use of appropriate PPE and active self-monitoring


Directive #3 for Long-Term Care Homes under the Long-Term Care Homes Act, 2007 

Issued under Section 77.7 of the Health Protection and Promotion Act (HPPA), R.S.O. 1990, c. H.7 

WHEREAS under section 77.7(1) of the HPPA, if the Chief Medical Officer of Health (CMOH) is of the opinion that there exists or there may exist an immediate risk to the health of persons anywhere in Ontario, he or she may issue a directive to any health care provider or health care entity respecting precautions and procedures to be followed to protect the health of persons anywhere in Ontario; 

AND WHEREAS pursuant to O. Reg 68/20 made under the Retirement Homes Act, as part of the prescribed infection prevention and control program, all reasonable steps are required to be taken in a retirement home, to follow any directive pertaining to COVID-19 that is issued to long-term care homes under section 77.7 of the HPPA; 

AND HAVING REGARD TO the emerging evidence about the ways this virus transmits between people as well as the potential severity of illness it causes in addition to the declaration by the World Health Organization (WHO) on March 11, 2020 that COVID-19 is a pandemic virus and the spread of COVID-19 in Ontario, and the technical guidance provided on March 12, 2020 by Public Health Ontario on scientific recommendations by the WHO regarding infection prevention and control measures for COVID-19; 

AND HAVING REGARD TO the declaration by the Premier of Ontario and Cabinet of an emergency in Ontario under the Emergency Management and Civil Protection Act on March 17th, 2020 due to the outbreak of COVID-19 in Ontario; 

AND HAVING REGARD TO residents in long-term care homes and retirement homes being older, more frail, and more medically complex than the general population, and therefore being more susceptible to infection from COVID-19; 

I AM THEREFORE OF THE OPINION that there exists or may exist an immediate risk to the health of persons anywhere in Ontario from COVID-19; 

AND DIRECT pursuant to the provisions of section 77.7 of the HPPA that: 

COVID-19#3 for Long-Term Care Homes under the Long-Term Care Homes Act

Date of Issuance: March 22, 2020 

Effective Date of Implementation: March 22, 2020 

Issued To: Long-Term Care Homes under the Long-Term Care Homes Act, 2007 referenced in section 77.7(6), paragraph 10 of the Health Protection and Promotion Act. 


Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV), Severe Acute Respiratory Syndrome (SARS-CoV), and COVID-19. A novel coronavirus is a new strain that has not been previously identified in humans. 

On December 31, 2019, the World Health Organization (WHO) was informed of cases of pneumonia of unknown etiology in Wuhan City, Hubei Province in China. A novel coronavirus (COVID-19) was identified as the causative agent by Chinese authorities on January 7, 2020. 

On March 11, 2020 the WHO announced that COVID-19 is classified as a pandemic virus. This is the first pandemic caused by a coronavirus. 

On March 17, 2020 the Premier and Cabinet declared an emergency in Ontario under the Emergency Management and Civil Protection Act due to the outbreak of COVID-19 in Ontario and Cabinet made emergency orders to implement my recommendations of March 16, 2020. 

Symptoms of COVID-19

Symptoms range from mild – like the flu and other common respiratory infections – to severe, and can include: 

  • fever 
  • cough 
  • difficulty breathing 

Complications from COVID-19 can include serious conditions, like pneumonia or kidney failure, and in some cases, death. 

There are no specific treatments for coronaviruses, and there is no vaccine that protects against coronaviruses. Most people with common human coronavirus illnesses will recover on their own. 

Required Precautions and Procedures 

Long-term care homes should immediately implement the following precautions and procedures for residents: 

  • Residents of long-term care homes should not be permitted to leave the home for short-stay absences to visit family and friends. Instead, residents who wish to go outside of 
  • the home should remain on the home’s property and maintain safe social distancing from any family and friends who visit them. 
  • Wherever possible, employers should work with employees to limit the number of different work locations that employees are working at, to minimize risk to patients of exposure to COVID-19. 

In accordance with O. Reg 68/20 made under the Retirement Homes Act, retirement homes must take all reasonable steps to follow the required precautions and procedures outlined in this Directive. 

Note: As this outbreak evolves, there will be continual review of emerging evidence to understand the most appropriate measures to take. This will continue to be done in collaboration with health system partners and technical experts from Public Health Ontario and with the health system. 


Long-term care homes, retirement homes and HCWs may contact the ministry’s Health Care Provider Hotline at 1-866-212-2272 or by email at with questions or concerns about this Directive. 

Long-Term Care homes and HCWs are also required to comply with applicable provisions of the Occupational Health and Safety Act and its Regulations. 

David C. Williams, MD, MHSc, FRCPC 

Chief Medical Officer of Health