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General Information
Long-Term Care Homes (LTCH), Retirement Homes, Hospice, and Residential Care

To protect the health of residents in these types of facilities, staff are ONLY to allow entry to essential visitors (to residents who are very ill or require end-of-life care) and conduct active screening on these visitors for symptoms and travel history until further notice. Entry should be denied if visitors fail the screening.  Please refer to the COVID-19 Guidance document for Long-Term Care (Version 3 – March 17, 2020) that has been developed by the Ministry of Health.

LTCHs should also conduct active screening (when possible, over-the-phone screening) for ALL resident admissions, returning residents, readmissions, and health care workers for symptoms of COVID-19, any travel history in the past 14 days, or exposure to COVID-19.  If an incoming or returning resident has symptoms compatible with COVID-19, travel history outside of Canada, or potential exposures to COVID-19, the LTCH must consult with the Windsor-Essex County Health Unit (519-258-2146 ext.1420).

Please note that this information can be adapted for use in other settings as appropriate (i.e. retirement homes, hospice, residential care).

General Information
for Shelters

Persons experiencing homelessness may be at risk for infection during the COVID-19 crisis. This information is intended to support response planning for the prevention and management of COVID-19 in shelters. Shelters include facilities that provide temporary, or longer-term residence, for homeless individuals and families.

Frequently Asked Questions
for Long-Term Care Homes

Why is it important to only allow essential visitors into LTCHs and perform active screening on anyone coming into the facility for symptoms, potential exposure and travel history?

Residents in LTCHs are likely to be older individuals with complex chronic health conditions such as lung and neurological diseases that make it difficult to maintain clear respiratory pathways.  Respiratory infections, such as COVID-19 are easily transmitted in institutional environments. Information about COVID-19 suggests that elderly individuals and those with underlying health conditions are at an increased risk for severe outcomes.

How can LTCHs conduct active screening?

Active screening involves stationing a staff member(s) at the main entrance to the facility to ensure all incoming individuals are screened before being allowed entry. The screening station should be in operation during regular business hours and at the change of shift. Outside of these times, there should be a process and procedure in place to ensure all individuals arriving at the facility are screened and visits are logged.  

On arrival, ask all visitors:

  1. Do you have a fever, new or existing cough, or difficulty breathing?
    If visitors answer yes to any symptoms, ask them to leave and only return when their symptoms have resolved.
    If they have no symptoms, ask the following questions:
  2. Have you travelled outside Canada in the last 14 days? 
  3. Have you been in close contact with someone who has been tested positive or awaiting results for COVID-19?
  4. Have you been in close contact with a person with acute respiratory illness who has travelled outside Canada in the last 14 days?

If visitors answer yes to any of the questions, ask them to leave and only return after 14 days from their exposure. Advise them to contact their health care provider, Telehealth Ontario, or visit for more information.

Consider the following when implementing an active screening process:

  • Determine the entrance where a table and a staff member(s) will set up a screening station for all incoming individuals
  • Provide a script for screening that includes a process for handling visitors or staff who fail the screening
  • Post up signage to alert all patients, staff, residents, and visitors of the active screening process
  • Ensure that alcohol-based hand rub (ABHR) with 70 – 90% alcohol, facial tissues, and procedure masks are available at the active screening desk
  • State clear rules at the entrance to allow or prohibit entry
  • Provide a handout to visitors explaining the changes

All LTCHs should instruct staff to continuously self-monitor for symptoms of COVID-19. All LTCH staff should be aware of the early signs and symptoms of acute respiratory infection (such as fever, cough, shortness of breath). If a staff member is required to self-isolate they must NOT come to work and must report their symptoms to the LTCH.

How should a LTCH facility provide care for a resident who develops a cough, difficulty breathing, or fever?

Instruct the resident to wear a procedure mask (if tolerated) and isolate them in a room to wait for further assessment. Health care workers (HCWs) should initiate Droplet and Contact Precautions.

HCWs can safely collect nasopharyngeal and throat swabs using Droplet and Contact Precautions. All respiratory specimens collected for acute respiratory illness or outbreaks will automatically be tested for COVID-19 at the laboratory.

If the resident is a suspect or confirmed case of COVID-19, please refer to PHO’s Updated IPAC Recommendations for Use of PPE for Care of Individuals With Suspect or Confirmed COVID-19 (Technical Brief – March 12, 2020).

What are the best practices for environmental cleaning in an LTCH or Health Care Setting?

Refer to the Best Practices for Environmental Cleaning for Prevention and Control of Infections in All Health Care Settings, 3rd Edition for detailed instructions on how to conduct proper cleaning in an LTCH or Health Care Setting.

How should LTCH staff monitor new and current residents for symptoms of respiratory illness and respond to new and current residents with potential exposure to COVID-19?

New Residents

Screen all newly admitted residents by asking them the following questions:

  1. Do you have a fever, new or existing cough, or difficulty breathing?
  2. Have you travelled outside Canada in the last 14 days?
  3. Have you been in close contact with someone who has been tested positive or awaiting results for COVID-19?
  4. Have you been in close contact with a person with acute respiratory illness who has travelled outside Canada in the last 14 days?

If residents answer yes to any of the above questions, isolate immediately and use droplet precautions.

All residents:

  • Monitor all residents daily for symptoms of respiratory illness and keep a central record or results.
  • Immediately isolate any residents with respiratory illness or fever.
  • Ensure that staff Personal Protective Equipment (PPE) is available near the point of care for all residents and that staff do not have to walk far to access it.
    • PPE includes disposable gowns, gloves, procedural masks and eye protection.
    • Garbage bins and ABHR should be available immediately outside the room.

If needed, signage for additional precautions should be posted immediately outside the room.

How should staff self-monitor for signs and symptoms of COVID-19?

  • All LTCH staff should be continually self-monitoring for signs and symptoms of COVID-19 using the self-monitoring document from Public Health Ontario.
  • Staff should be regularly reminded to stay home if they are feeling ill.
  • Staff should report any travel outside of Canada or contact with a suspect or confirmed cases of COVID-19 to the LTCH Health and Safety Department, their health care provider or the WECHU. All instructions must be followed.

Frequently Asked Questions
for Shelters

What are the recommended measures for screening clients at the shelter?

  • Post screening signs at all entrances of the building and screen all clients coming in
  • All clients – including those who are staying in longer-term accommodations – should be asked the following questions upon arrival at the shelter or at daily check ins:
    • Do you have any of the following symptoms: fever, a new or existing cough, or difficulty breathing?
    • Have you travelled outside of Canada in the past 14 days?
  • Anyone who answers “YES” to one or both of these questions should be given a mask and placed in a private room away from other clients, or a separate part of the building.
    • Ensure that this person remains isolated from other clients and staff as much as possible (e.g., designating a separate washroom to clients exhibiting symptoms of COVID-19, placing them in a private room, advising them to avoid the common area, etc.).
    • Advise this person to contact the Windsor-Essex County Health Unit at 519-258-2146 ext. 1420 immediately for further direction.

Those who answer “NO” to both questions can be assigned to the general area.

What can the shelter do to prevent the spread of COVID-19 among staff and clients?

  • Clients and staff should be advised to practise good hand hygiene (e.g., frequent handwashing, alcohol-based hand sanitizer) and respiratory etiquette (e.g., sneezing into a bent elbow or disposable tissue).
  • Clients and staff should be advised to maintain a distance of 2 metres from other clients and staff, and consider using plastic or glass separators.
  • Clients and staff should be advised not to share food, drinks, or personal hygienic items, such as combs, brushes, toothbrushes, shaving equipment, and nail cutters.
  • Encourage sick employees to stay home.
  • Monitor hygienic supplies regularly to ensure that inventories are sufficient. Order more supplies as required. Hygienic supplies include liquid hand soaps, paper towels, trash baskets, alcohol-based hand sanitizers, and disposal masks. Single-use disposable products are recommended, such as paper towels and disposable tissues. If using refillable hand-sanitizing dispensers, ensure that they are cleaned first followed by disinfection between refills.
  • Post signs in visible locations around the building to educate clients and staff about how to prevent the spread of infection. Below are a few resources that shelters can print, share, and post around the building to help reduce the risk of spreading COVID-19: 

How can shelters prepare for staff shortages during the COVID-19 crisis?

  • Expect that the homelessness service sector will be affected by the COVID-19 crisis and anticipate modified service delivery based on staff capacity.
  • Plan for staff and volunteer absences. Staff may need to stay home from work if they are sick, caring for a sick household member, or caring for children in the event of school dismissals. Identify critical job functions and positions at the shelter and plan for alternative coverage by cross-training current employees or hiring temporary employees/volunteers as required.

What are the recommended measures for cleaning and disinfecting the shelter?

  • Routine cleaning followed by disinfection is a best practice to prevent the spread of COVID-19. Facilities should follow their protocols for regular cleaning and disinfection.
  • Commonly used cleaners and disinfectants are effective against COVID-19. Check the expiry date before using cleaners and disinfectants, and always follow the manufacturer’s directions for use to ensure their effectiveness.
  • Consider increasing routine cleaning and disinfecting in the part of the building where clients with respiratory symptoms are residing.
  • In addition to routine cleaning, high-touch surfaces should be cleaned and disinfected twice per day, and when visibly dirty. Examples of high-touch surfaces include doorknobs, handrails, light switches, toilet handles, and faucet handles.
  • High-touch electronic devices (e.g., tablets, computer keyboards, telephones) can be disinfected with 70% alcohol-based sanitizers (e.g., disposable alcohol wipes).
  • Gloves should be worn when handling cleaning and disinfecting products.

When should PPE be worn at the shelter?

  • All clients with respiratory symptoms should wear a mask.
  • PPE is not required for administrative staff who do not have direct contact with clients.

for Long-Term Care Homes

COVID-19 Preparedness and Long-Term Care Homes presentation

The following is a FREE presentation offered for long-term care homes pertaining to outbreak management and infection control practices, in light of COVID-19.

You can also watch this video on Youtube.

for Shelters

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Last modified: 
Friday, March 27, 2020 - 3:15pm