COVID-19: Frequently Asked Questions (FAQs)

COVID-19 is a virus, and like most viruses, it constantly changes through mutation. Variants are strains of the same virus that have changed or mutated. New variants of a virus are expected over time. Sometimes new variants disappear and other times they stick around. Variants are common with coronaviruses, the family of viruses that COVID-19 is a part of.

A variant becomes a variant of concern (VOC) when its changes have a clinical or public health significance that affects one or more of the following:

• transmissibility (spread)
• virulence (severity of disease)
• vaccine effectiveness
• diagnostic testing

Variants of concern of COVID-19 are known to spread more easily and can cause more significant illness, although the list of possible symptoms is the same. 

Multiple COVID-19 variants of concern have been identified around the world. VOCs identified globally and in Ontario include:

• B.1.1.7 variant (Alpha variant)
• B.1.351 variant (Beta variant)
• P.1 variant (Gamma variant)
• B.1.617 variant (Delta variant)

Variants of concern have been identified in the TBDHU region and are the primary strain currently circulating. They are reported on the COVID-19 Data Dashboard. Regular public reporting about the status of COVID-19 variants will ensure Ontarians are kept informed.

The best way to protect yourself from all strains of the COVID-19 virus is to follow all current public health measures, including mandatory quarantine for 14 days after international travel.

Current evidence shows all of the COVID-19 vaccines approved for use in Canada are able to prevent mild and moderate cases of COVID-19 and are very effective in preventing hospitalizations and death, including against known variants of concern (VOC). A full vaccine series significantly improves protection against infection and severe cases of COVID-19 compared to only one dose. 

Recent Ontario data also indicates that the Pfizer-BioNTech, Moderna, and AstraZeneca vaccines provide a high degree of protection against the Delta variant, particularly for preventing hospitalization or death (vaccine effectiveness: 78 to 96%) resulting from this VOC.

Research is ongoing and updates will be provided as they are available. For more on real world vaccine effectiveness, see COVID-19 Real-World Vaccine Effectiveness – What We Know So Far from Public Health Ontario.

Point-of-care testing (POCT), also known as rapid testing, is being used in Ontario in various locations, such as long-term care and retirement homes, some larger workplaces and workplaces with congregate living settings, airports, etc. These tests produce quicker results and are a useful surveillance tool, especially to identify new cases and to help prevent outbreaks.

There are two different types: the antigen POCT assay, where a positive result is considered preliminary with some exceptions; and the molecular POCT assay, where a positive result can be considered final. Both are performed via nasal or nasal-pharyngeal swab.

Anyone receiving a positive result from a point-of-care test is required to seek a lab-based PCR test within 24 hours through their nearest assessment centre to confirm the result. They are also required to self-isolate until that result is returned. Most negative POCT results indicate no current COVID-19 infection; however, in some cases further testing is also required. Individuals with a negative POCT should continue to follow all public health measures.

All confirmed positive results are reported by TBDHU as confirmed COVID-19 cases, and are included in the daily COVID-19 status updates as appropriate.

Should individuals who have been vaccinated for COVID-19 receive a rapid antigen test?

Individuals who have received a COVID-19 vaccine, regardless of whether they received one or two doses, are still able to receive an accurate result from a rapid antigen test. Vaccinated individuals should not be excluded from rapid antigen screening initiatives, as it is unknown at this time if they can still transmit COVID-19 despite being vaccinated.

Additional Resources

• Positive COVID-19 Test Reporting Form - TBDHU

Organizations interested in using point-of-care testing can find out more on the Workplaces IPAC page under the Rapid Testing tab.

One of the best ways to reduce your risk is to always maintain at least 2 metres of physical distance from anyone you don't live with. 

High-risk Contacts

High-risk exposure means that the public health investigation of a confirmed case of COVID-19 determined it is more likely that the virus could have been spread to others.

Individuals could be considered high-risk contacts if they:

• were within 2 metres of a person with COVID-19 for 15 minutes or more, even if both people were wearing a mask.
• had multiple close encounters with a person with COVID-19 over a 24-hour period that add up to 15 minutes or more (even if each was less than 15 minutes).
• were within 2 metres of a person with COVID-19 for any amount of time, except transient such as walking past a person on the sidewalk or in a store, if either person was not wearing a mask.
• had close, physical contact with a person with COVID-19, such as a hug.
• live or provide care in the same home as a person with COVID-19.

A public health professional will contact any individual that is found to be a high-risk contact of a person with COVID-19 and will provide further instructions. If you have been told you or your child has been identified as a high-risk contact of a confirmed case of COVID-19, (e.g. they are in a dismissed school or child care cohort), review the Important information for high-risk contacts of COVID-19 page for more details.

Low-risk Contacts

Low-risk exposure means that an individual who had COVID-19 may have come in contact with the public, but due to the nature of the situation, it’s relatively unlikely that the virus was spread. 

If a person finds out that they are at low-risk of exposure, they should carefully monitor their health for symptoms for the next 10 days. If any symptoms do develop, even if mild, they must self-isolate immediately and arrange for testing. In most circumstances, low-risk contacts can continue to attend child care or school in person as long as they remain without symptoms. 

Review this infographic on Who is a Close Contact for more details.

A probable case is a person who:

• has symptoms of COVID-19 AND
• had an exposure* AND 
• has not been tested OR is waiting for test results.

*An exposure includes international travel, contact with a confirmed case of COVID-19, or worked or attended a facility that is under an outbreak of COVID-19 in the past 14 days.

Individuals who test positive for COVID-19 are monitored closely by a Public Health Nurse (PHN). The person's symptoms are continuously assessed during their isolation period. The length of isolation and recovery can vary depending on the course of their illness.

Cases are classified as resolved when their PHN has determined they are no longer infectious based on guidance from the most recent Case and Contact Management Guide, from the Ontario Ministry of Health. 

Public health does not normally recommend testing, nor is it required, to classify a case as resolved. However, in some circumstances, a test-based approach may be used to discharge someone from isolation. 

Please note: Hospitalized patients and health care workers have different criteria for coming out of self-isolation and will follow the directions provided by the hospital or their employer (e.g. Occupational Health and Safety).

Quarantine refers to the 14 days that a person must:

• Stay at home.
• Monitor for symptoms.
• Avoid contact with other people.

You will have to quarantine if you:

• Are returning from outside Canada.
• Have been in contact with a possible COVID-19 case.
• Have been told to by your local public health unit.

Isolation is when you stay at home and limit contact with others because you have symptoms of COVID-19 and may have been exposed.

COVID-19 mainly causes infections of the nose, throat and lungs. Infected individuals are most contagious when they are sick, as well as the 48 hours before they show symptoms. COVID-19 is most commonly spread from an infected person through:

• respiratory droplets generated when coughing, sneezing or talking.
• close, prolonged personal contact, such as touching or shaking hands, that is within 2 metres and for at least 15 minutes.

Evidence indicates that the virus can be transmitted to others from someone who is infected but not showing symptoms. This includes people who have not yet developed symptoms (pre-symptomatic) or who never develop symptoms (asymptomatic).

The virus can land on surfaces and survive for hours, but it does not spread easily this way. However, touching something with the virus on it, then touching your mouth, nose or eyes before washing your hands can spread the virus.

There is no evidence at this time that the virus can transmit over long distance through the air, such as through air ducts, so building residents are not at increased risk from shared vents. Quickly passing by another person is not a high risk either.

TBDHU has worked with Long Term Care Homes (LTCH) and Retirement Homes around preparedness for COVID-19 so that facilities are prepared before a potential outbreak.

TBDHU works with the LTCH to implement twice a day screening of residents and staff to monitor for COVID-19 symptoms, and to identify new infections as early as possible.

TBDHU works with homes to implement enhanced cleaning, particularly for frequently touched surfaces.  

When a resident in a Long Term Care Home develops symptoms that may be attributed to COVID-19, as per the Ministry of Health and Long Term Care directives, the LTCH is required to report the symptomatic resident to TBDHU. Then the resident and their roommate require testing and the home has to immediately implement respiratory/droplet precautions for that resident and their roommate. Reporting can happen daily.

When a Long Term Care Home (LTCH) has one reported positive case of COVID-19 (could be a staff member or a resident), an outbreak is declared. The TBDHU infectious disease team manager, nurses and public health inspectors work with the facility to ensure outbreak control measures are put in place, in accordance with provincial guidelines.

Then TBDHU investigates positive cases of COVID-19 and their contacts. They provide recommendations for testing of residents and staff according to the current Ministry of Health guidelines (all residents and staff on floors with a COVID-19 outbreak are to be tested, whether or not they have symptoms).

During any infectious disease outbreak in a LTCH, it is important to institute measures to prevent and control the spread of the infection in the facility, while balancing the daily life of the residents in the home. Usually, when an outbreak is declared in a particular unit or floor, infection prevention and control (IPAC) measures are implemented in that area to prevent the spread to other areas of the building.

For the remainder of the outbreak, TBDHU continues to support LTCHs to provide infection control recommendations and to ensure all prevention and control measures are in place.

It is the LTCHs responsibility to implement all of the infection and prevention control measures.

Concerned families and friends should communicate directly with the Long Term Care Home about their loved ones at the facility. They can also call the Ministry of Long Term Care's COVID-19 telephone line, which is available seven days a week, at 1-866-434-0144.

Ontario’s Ministry of Health is responsible for and regularly updates their Directive #3 for Long Term Care/Retirement Homes (LTCH/RH) under the Long Term Care Homes Act, 2007. The Ministry of Health and Long Term Care is also the lead for mandating laboratory testing for COVID-19 in these settings and is also the lead alongside Ontario Health for arranging PPE.