08 April 2020 – Active screening and surveillance of all people in long-term care homes

Type of Intervention: Regulation
Sectors Involved: Health
Level of Jurisdiction: Ontario
Lead People/Agency: Ministry of Health and Long-Term Care; Ontario’s Chief Medical Officer of Health Dr. David Williams

Overview: This directive was issued for Long-Term Care Homes (under the Long-Term Care Homes Ac, 2007) under Section 77.7 of the Health Protection and Promotion Act (HPPA). The directive is regarding the necessary and urgent requirement to implement additional protection for staff and residents of long-term care homes. These precautions include active screening for all staff, essential visitors, and residents, surveillance of all residents, screening for new admissions, management of essential visitors, changes to home policies and procedures during outbreaks, and specimen collection and testing for outbreak management.
Full details here: http://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/directives/LTCH_HPPA.pdf

Other links: 1 2
Type of Justification: Advice of INTERNAL government advisory committee or group, Advice of EXTERNAL expert advisor or advisory committee
Source of Evidence or Justification: World Health Organisation, Sub-national government (provincial), sub-national governmental agency (Public Health Ontario)
Evidence/Justification: Cites WHO’s declaration of COVID-19 as a pandemic virus (March 11, 2020) and potential severity of the illness. Also cites the spread of COVID-19 to Ontario, technical advice provided by Public Health Ontario on scientific recommendations regarding infection prevention and control measures for COVID-19 by the WHO, and the declaration of emergency by the province of Ontario (March 17, 2020) under the Emergency Management and Civil Protection Act as justification for the development of this directive and the required steps that must be implemented. Additionally, the fact that residents of long-term care homes and retirement homes are older and more medically complex than the general population, thus more susceptible to infection from COVID-19, is used as justification for this directive. Cites Ontario’s recommendations for control of respiratory infection outbreaks in long-term care settings and the Provincial Infectious Diseases Advisory Committee on Infection Prevention and Control best practice guidelines for infection prevention and control in all health care settings as evidence to support the implementation of some of the required precautions/procedures.