If you are a patient of HealthCare 365 please call our office and we’ll go through the assessment with you and discuss which steps you should take. You can also take the Self Assessment.

If you took the self assessment before March 27, 2020, please take it again.

If you are not a patient of HealthCare 365 please contact Public Health or your family physician.

• Telehealth Ontario
• Telephone: 1-866-797-0000

• Toronto Public Health Hotline
• Monday to Friday: 8:30 a.m. – 8 p.m.
• Saturday and Sunday: 10 a.m. – 6 p.m.
• Telephone: 416-338-7600
• TTY: 416-392-0658
• Email: PublicHealth@toronto.ca

• 311 Toronto
• Outside City limits: 416-392-2489
• Call if you have questions about City services.
• Telephone: 311
• TTY: 416-338-0889
• Email: 311@toronto.ca

Testing at the Public health lab in Ontario is done 7 days/week. Site to check on COVID19 test results: https://covid19results.ehealthontario.ca:4443/agree

Those particularly vulnerable to COVID infection include patients who are older and /or have:

• Diabetes
• Heart disease
• Lung problems

Mechanisms behind increased susceptibility are being explored, including genetic differences that may explain why certain individuals are more likely to become infected.

According to Philip Murphy (Principal investigator from the National Institute of Allergy and Infectious Diseases), the difference may lie in a gene that codes for a cell surface protein (receptor) that the coronavirus uses to enter your airway's cells. Variations in this gene may alter the receptor, making entry easier or harder for the coronavirus.

Increased susceptibility based on blood group has been suggested through recent publications, however the methodology and interpretation of data collected is preliminary, and highly questionable.

COVID-19 is an RNA virus.

A virus contains three parts:

1. Capsule (Outer shell)
2. Capsid (Shell around the genetic material)
3. RNA (The genetic material it carries)

COVID-19 virus affects the cells of the upper and lower respiratory tract, and is spread by droplets from coughing or sneezing.

COVID-19 attaches to a cell in the respiratory tract by recognizing and attaching to a specific protein on the outer membrane of the host cell.

It is then drawn into the cell, where the virus particle separates into its components. These components manipulate the cell's transportation mechanisms to reach the nucleus of the cell.

The genetic material of the virus then penetrates the nucleus and tricks the cell's DNA into making copies of viral RNA. Other viral messengers signal the development of the remaining viral components (envelope and capsid).

The virus then reassembles and exits the cell to infect other cells.

Viruses cannot reproduce without a host. The virus needs US. If we are not close enough to be affected by droplet transmission, the virus cannot be passed on.

Droplet transmission is 2 metres/6 feet, thus we need to maintain this distance from one another. This distance can be thought of as 2 people standing next to each other with their arms outstretched until practically touching.

COVID-19 is thought to be transmitted before the development of symptoms and throughout the course of illness.

This has been proven through studies testing for the presence of viral RNA in respiratory secretions and other sources (i.e. stool). Detection of viral RNA does not necessarily indicate the presence of infectious virus.

To stop the spread and ensure the safety of you and those around you, please consult the following resource:

https://www.ontariofamilyphysicians.ca/tools-resources/timely-trending/novel-coronavirus-2019-ncov/ocfp-coronavirus-infographic-4-final.pdf

The most effective measures you can take to prevent the spread of COVID-19 is to STAY HOME and AVOID contact with other people.

If you must go out:

• Practice Physical Distancing (AT LEAST 6 feet/2 metres)
• Clean your hands OFTEN (Using Soap and water or alcohol-based hand sanitizer, for AT LEAST 20 seconds)

GLOVES:

Regularly washing your bare hands offers more protection against COVID-19 than wearing gloves. You can still pick up COVID-19 contamination on gloves, which can then be transferred to your face and potentially result in infection or be spread from your gloves to other surfaces.

Regularly and thoroughly clean your hands with an alcohol-based hand rub or wash them with soap and water for at least 20 seconds. Avoid touching your eyes, nose, and mouth.

Disinfect spaces regularly at home, and pay attention to high-touch surfaces (ex. Printers, desks, phones, kitchen appliances, door handles, etc.). If you must leave the house, avoid touching surfaces where possible.

MASKS:

The Canadian Medical Association has stated that health providers are running out of personal protective equipment. Surgical and N95 masks should be saved for medical professionals so that they can stay healthy and care for ill patients.

The CDC has recently recommended that people wear face cloth coverings if they must leave the house (i.e. going to the grocery store or to pick up other necessities). The Public Health Agency of Canada notes that wearing a homemade mask has not been proven to protect the person wearing it. This is ONLY to help prevent asymptomatic transmission of the virus (i.e. passing it on to others before you have symptoms). Children younger than 2 years should not wear a cloth face covering because of concerns they might suffocate.

For more information on homemade masks, such as how to make them, please visit the following resource: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html.

Please note that homemade masks are not perfect and must be used safely.

Watch the following video to learn safe practices you can use when wearing a MASK or GLOVES.

NO! The CDC does not encourage the production and use of homemade hand sanitizer and the need to work under sterile conditions to make the product.

• To be effective against killing some types of germs, hand sanitizers need to have a strength of at least 60% alcohol and be used when hands are not visibly dirty or greasy.
• Do not rely on “Do It Yourself” or “DIY” recipes based solely on essential oils or formulated without correct compounding practices.
• Do not use hand sanitizer to disinfect frequently touched surfaces and objects. See CDC’s information for cleaning and sanitizing your home

Hand washing step by step using the WHO Technique:

When to wash your hands:

https://www.canada.ca/en/public-health/services/healthy-living/hand-hygiene.html

Do not enter elevators if you cannot maintain a 2 m distance from others. Ensure that you wash your hands properly after touching elevator buttons. You should assume that buttons are contaminated and anything you touch them with is then contaminated. To this end, using your hand and washing it immediately after is better than using your sleeve. Using a disposable tissue may be best.

It is NOT recommended to be in close proximity (under 2m) with anyone that does not live in your home!

Everyone MUST CONTINUE to practice physical distancing: staying home, washing your hands frequently, and staying six-feet apart. The virus is easy to pickup and this is the best way to end the spread.

Find new physical distancing-friendly routines for social interaction to help you stay healthy. It’s important to remember that physical distancing does not mean social isolation. Stay in touch with friends and family through phone, instant messaging or video chat.

Public Health Ontario does not discourage going on walks outdoors with your pets or with those you live with (i.e. spouse, child), while maintaining distance from other people.

All communal or shared, public or private outdoor recreational amenities in Ontario are closed until further notice. This includes playgrounds, sports fields and courts, off-leash dog parks, beaches, picnic areas, outdoor community gardens, park shelters, and condo parks.

Green spaces such as parks, trails, and ravines will remain open for “walkthrough access” according to the province.

Always clean hands with alcohol-based hand sanitizer, or soap and water when you return home.

Remain at home unless you must go out for essentials and have no other means of getting them. The best thing we can do to end the spread of the virus is to limit being in public places.

If you have the virus, or think you might have it, because you travelled or have symptoms you must STAY HOME. Use delivery services or click-and-collect options (where groceries are ordered and brought to your car) for essential supplies.

If you must leave your home to travel to the grocery store be sure to limit the frequency and go during off peak hours as much as possible. If you see lines, leave and come back.

The new virus can survive on some surfaces, so experts say to keep your hands to yourself as much as possible and avoid touching your face when shopping. After unpacking your groceries at home, the CDC suggests washing your hands & washing your produce.

There is currently no evidence to suggest that food is a likely source or route of transmission for the virus and there are currently no reported cases of COVID-19 transmission through food.

When picking up food, call ahead so it is ready when you arrive. Use tap to pay if possible.

Similar to unpacking your groceries at home, wash your hands prior to unpacking your takeout.

Care providers for any of your upcoming appointments and tests will contact you directly to let you know if any appointments have been rescheduled. If you cannot remember if you have been contacted already, feel free to give us a call and we can help you find out!

If your appointment has not been rescheduled, please contact your care provider directly before going in. Please keep a few tips in mind:

• Discuss with your care provider if virtual appointments are available to you. Where possible care can be delivered by phone, video, or other virtual means.
• Discuss with your care provider if different processes are in place before going to your appointment. Some doctor’s offices are asking patients to wait in their cars to avoid being in the waiting room.
• Care may be prioritized to ensure that the sickest patients have access to treatment. That does not mean that patients won’t be treated. This will mean, for example, that if you have a periodic health visit scheduled with no time sensitive concerns, it may need to be rescheduled.

There is no clinical evidence regarding non-steroidal anti-inflammatory drug use with increased risk of COVID-19.

• DO NOT stop BP medication unless directed by your MD
• DO NOT stop LOW DOSE ASA (81 mg) (Aspirin - 81 mg) if taken for heart disease or if infected with COVID-19
• Patients with hypertension (elevated BP) or heart failure should use only Tylenol for pain relief (due to potential negative effects of these drugs on elevated BP, heart disease, and heart failure)