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Updated: October 5, 2020

What type of exposure to COVID-19 requires self-isolation in Ontario?

Summary

The following is a summary of evidence sources that provide provincial and national public health guidance on what type of exposure to COVID-19 requires self-isolation in Ontario. For additional information about each of the sources, see the Table below.

The Government of Canada states that one must quarantine for 14 days if they: 1) are returning from travel outside of Canada, even if they don’t have symptoms; 2) had close contact with someone who has or is suspected to have COVID-19; or 3) have been told by public health that they may have been exposed and need to quarantine [1,2]. If an individual  starts to feel symptoms of COVID-19, the Government of Ontario states in its COVID-19: Stop the spread guidance to: 1) go to an assessment centre; 2) avoid leaving home for other reasons; 3) inform all close contacts (defined as persons less than two metres away or living in the same household) within the 48 hours prior to the start of symptoms; and 4)  monitor symptoms and self-isolate [6]. While waiting for laboratory results, the Eastern Ontario Health Unit advises  in their Self-Monitoring, Self-Isolation and Isolation Instructions for COVID-19 report that one should remain in self-isolation [7]. An emergency order under the Quarantine Act requires any travellers entering Canada to either quarantine for 14 days from the day they enter Canada, even if they do not have symptoms or isolate if they do have symptoms [1,3].  

In its Coronavirus disease (COVID-19): Travel restrictions, exemptions and advice, the Government of Canada notes that a suitable place to quarantine is one that: 1) does not have any people who are 65 years or older, have underlying medical conditions or compromised immune systems, 2) is not a group living environment, 3) a person can stay for at least 14 days, and 4) has access to basic necessities such as water, food, medication and heat in the colder months [2]. Public Health Ontario states in its How to Self-Isolate guidance that one should self-isolate for 14 days from the start of symptoms, which means: 1) avoiding going to work, school, public places or public transportation, 2) avoiding visitors unless essential care providers, 3) making sure any shared rooms have good airflow such as open windows and practice adequate hand hygiene, and 4) wearing a mask over their nose and mouth when leaving the house to see a health care provider or to get tested [5]
 
Within the COVID Alert: Canada’s COVID-19 exposure notification app report, the COVID Alert app by the Government of Canada defines exposure as being less than 2 metres apart for more than 15 minutes over the past 14 days with someone who is COVID-19 positive [4]. If someone tests positive for COVID-19 and an app user meets these criteria for exposure with the positive individual, the app will notify the user about potential exposure and the user should contact local public health authority for further instruction [4].  
 

Evidence

What‘s Trending on Social Media and Media

The Government of Canada has released a short video to explain how the COVID Alert app works.  
 
NBC News released an article to create awareness about the risk level of being exposed during various activities. Dr Ezekiel Emanuel, a bioethicist, said coronavirus infection risk is related to four factors: indoors or outdoors, crowd size, exposure time, and whether heavy breathing (e.g., shouting, singing, etc.) is involved. 

Organizational Scan

Both the Government of Canada and the province of Ontario created a COVID-19 self-assessment tool to take for anyone who is concerned they were exposed to COVID-19 or have symptoms. Based on the results of the assessment tool, recommendations on what to do next will be provided. 
 
Public Health Ontario released a guide for caregivers, household members and close contacts for someone with COVID-19. Although the local public health unit will give more specific instructions about how to monitor an individual’s health and what to do if someone starts to feel sick, this guide suggests to wash hands frequently, wear and dispose of PPE properly, limit the number of home visitors, and tips of cleaning home, laundry and household items. 

Public Health Ontario created a resource about self-isolation for those with COVID-19 symptoms or who may have been exposed to COVID-19. Guidelines include staying home and avoiding contact with others, keep a distance of at least two metres and wear a face covering, wash hands, and cover coughs and sneezes. 

Review of Evidence

Resource Type/Source of Evidence Last Updated
How to quarantine at home when you may have been exposed to COVID-19 and have no symptoms
— Government of Canada
National Guidance

This guidance states that a person needs to quarantine for 14 days if they: 1) are returning from travel outside of Canada; 2) had close contact with someone who has or is suspected to have COVID-19; 3) have been told by public health that they may have been exposed and need to quarantine. The Government of Canada has implemented an Emergency Order under the Quarantine Act that requires any person entering Canada to quarantine themselves for 14 days if they do not have symptoms or to isolate for 14 days if they do have symptoms in order to limit the introduction and spread of COVID-19. The 14-day period begins on the day the person enters Canada.    A quarantine means that, for 14 days you need to: 1) stay at home and monitor symptoms; 2) avoid contact with other people; 3) practice physical distancing in your home with other members of your household. 

Last Updated: May 27, 2020
Coronavirus disease (COVID-19): Travel restrictions, exemptions and advice
— Government of Canada
National Guidance

This guidance notes that even if a person does not have COVID-19 symptoms they must still isolate for 14 days. A suitable place to quarantine is one that: 1) does not have any people who are 65 years or older, have underlying medical conditions or compromised immune systems; 2) isn’t a group living environment; 3) a person can stay for at least 14 days; and 4) has access to basic necessities such as water, food, medication and heat in the colder months. 

Last Updated: September 9, 2020
Quarantine Act
— Government of Canada
National Guidance

This guidance states that the purpose of the Quarantine Act is to protect the health of a population by taking comprehensive measures to prevent the introduction and spread of communicable diseases within a population. 

Last Updated: August 24, 2020
COVID Alert: Canada’s COVID-19 exposure notification app
— Government of Canada
National Guidance

This guidance describes the new COVID Alert app produced to let Canadians know if they have been exposed to COVID-19. If someone tests positive for COVID-19, any person who has spent more than 15 minutes with them, with less than 2 metres apart and over the last 14 days will be notified that they may have been exposed through the app. If the app sends a notification about a potential exposure, the individual should get in touch with the local public health authority for further instruction. 

Last Updated: July 30, 2020
How to Self-Isolate
— Public Health Ontario
Provincial Guidance

This guidance describes that to self-isolate one should: 1) avoid going to work, school, public places or public transportation; 2) avoid visitors unless essential care providers; 3) make sure any shared rooms have good airflow such as open windows; practice adequate hand hygiene; and 4) wear a mask over your nose and mouth when leaving the house to see a health care provider or to get tested. If an individual develops symptoms, it is advised to contact Telehealth (1-866-797-0000) or a health care provider and to isolate for 14 days from when the symptoms started. 

Last Updated: July 30, 2020
COVID-19: Stop the spread
— Government of Ontario
Provincial Guidance

This guidance recommends that an individual who should start to feel symptoms of COVID-19 should go to an assessment centre to get tested, stay at home unless they are going to the assessment centre and tell people in close contact with the individual in the 48 hours before symptoms began to monitor symptoms and self-isolate. Close contact in the context of COVID-19 is defined as being less than two metres away from or living in the same household as someone with COVID-19. 

Last Updated: August 18, 2020
Self-Monitoring, Self-Isolation and Isolation Instructions for COVID-19
— EOHU: Eastern Ontario Health Unit
Municipal Guidance

This guidance notes that if an individual is waiting for laboratory test results, they should remain in self-isolation. If there are others in the home  the self-isolating individual should: 1) stay in a separate room and use a separate bathroom, if possible; 2) keep as much distance among members of the household; 3) keep interactions brief and wear a mask; 4) clean and disinfect surfaces at least once daily (e.g., toilets, doorknobs, television remotes, phones; and 5) avoid contact with pets if you live with other people that may also be touching them. 

Last Updated: October 5, 2020
COVID-19 Self-Assessment Tool
— Government of Canada
Organizational Scan Last Updated: October 5, 2020
COVID-19 Self-Assessment
— Government of Ontario
Organizational Scan Last Updated: September 13, 2020
Self-isolation: Guide for caregivers, household members and close contacts
— Public Health Ontario
Organizational Scan Last Updated: July 30, 2020
How to Self-Isolate
— Public Health Ontario
Organizational Scan Last Updated: July 30, 2020
Disclaimer: The summaries provided are distillations of reviews that have synthesized many individual studies. As such, summarized information may not always be applicable to every context. Each piece of evidence is hyperlinked to the original source.

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