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Coronavirus Update
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Issued under Section 77.7 of the Health Protection and Promotion Act

(HPPA), R.S.0.1990, 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, under section 77.7(2) of the HPPA, for the purposes of section 77.7(1), the CMOH must consider the precautionary principle where in the opinion of the CMOH there exists or there may exist an outbreak of an infectious or communicable disease and the proposed directive relates to worker health and safety in the use of any protective clothing, equipment or device;

AND HAVING REGARD TO the emerging evidence about the ways this virus transmits between people as well as the 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 10, 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 recommendations provided by Public Health Ontario and the

WHO as to the droplet and contact spread of COVID-19, the demonstrated need to ensure the adequate supply of personal protective equipment (PPE) for medical procedures where

COVID-19 may become airborne to ensure worker health and safety, and ensuring adequate supply of personal protective equipment during the duration ofCOVID-19;

AND HAVING REGARD TO the precautionary principle, which in my opinion has been met, in that this directive will protect health care workers’ health and safety in the use of any protective clothing, equipment and device and the failure to adhere to this directive may put worker health and safety at risk;

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 #1 for Health Care Providers and Health Care Entities

Date of Issuance: March 12, 2020

Effective Date of Implementation: March 12, 2020

Issued To: Health Care Providers, Health Care Entities

* Health Care Organizations must provide a copy of this directive to the co-chairs of the Joint

Health & Safety Committee or the Health & Safety Representative (if any).

Introduction:

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 thatCOVID-19 is classified as a pandemic virus.

This is the first pandemic caused by a coronavirus.

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 the 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

 • Droplet and Contact precautions for the routine care of patients with suspected or confirmed COVID-19, and

• Airborne precautions when aerosol generating medical procedures (AGMPs) are planned or anticipated to be performed on patients with suspected or confirmed COVID-19.  Health Providers and Health Care Entities must review and adopt the Technical Brief “Updated IPAC Recommendations for Use of Personal Protective Equipment for Care of Individuals with Suspect or Confirmed COVID-19” dated March 10, 2020 prepared by Public Health Ontario.

This comprehensive document reviews foundational Infection Prevention and Control & Occupational Health and Safety strategies; including the role of Personal Protective Equipment (PPE) within the Hierarchy of Hazard Controls and a description of what PPE should be used in different settings and for different activities.

Note: The guidance outlined in this directive is a change in current practices respecting

COVID-19 based on a better understanding of the epidemiology of the virus and the spectrum of illness that it causes, three months into this COVID-19 outbreak, it has been made in close consultation with Public Health Ontario and I have considered the Precautionary Principle in issuing this directive.

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.

Questions

Hospitals and HCWs may contact the ministry’s Health Care Provider Hotline at 1-866-212-2272 or by email at emerciencvmanagement.moh@ontario.ca with questions or concernsabout this Directive.

Hospitals and HCWs are also required to comply with applicable provisions of theOccupational Health and Safety Act and its Regulations.

David C. Williams, MD. MHSc, FRCPC

Chief Medical Officer of Health

Ministry of Health | Health System Emergency Management Branch  

Visit https://sefpo.org/2019-novel-coronavirus-covid-19/ for more information on the The 2019 Novel Coronavirus (COVID-19), including situation reports and related news,