Infection prevention and control guidelines

Long-term care homes (LTCH) and retirement homes (RH)

Outbreak management

Early recognition of cases signals suspected outbreaks. Swift action is essential for effective management of outbreaks in long-term care, and retirement homes and has the potential to make a significant impact during the outbreak that will benefit both residents and staff. Please refer to the Ministry of Health and Long-Term Care’s guidance document Recommendations for the Control of Respiratory Infection Outbreaks in Long-Term Care Homes and Recommendations for the Control of Gastroenteritis Outbreaks in Long-Term Care Homes for advice on how to manage outbreaks.

Outbreak definitions

Definitions for respiratory outbreaks and gastroenteritis outbreaks from the Ontario Ministry of Health and Long-Term Care. Whenever there are two cases of acute respiratory tract illness within 48 hours on one unit, an outbreak should be suspected, and tests should be done to determine the causative organism. Specimens submitted under an outbreak number are given testing priority and undergo an expanded testing algorithm. 

COVID-19 outbreaks

For outbreaks and advice related to COVID-19 for LTCHs and RHs please refer to the Ministry of Health’s (MOH) Guidance Document for Long-Term Care Homes, Retirement Homes, and Other Congregate Living Settings for Public Health Units. To learn more about the requirements for long-term care homes specific to COVID-19 please review the Guidance Document for Long-Term Care Homes and Minster’s Directive. Ministry for Seniors and Accessibility Guidance Document for Retirement Homes also provides complementary information to assist in the implementation of the MOH guidance document. 

Outbreak reporting

As per the MOH’s Infectious Diseases Protocol, and in alignment with the Health Protection and Promotion Act, suspected and confirmed outbreaks are reportable to KFL&A Public Health. If you suspect an outbreak in your facility during business hours, call 613-549-1232, ext. 4722 or email ipac@kflaph.ca. After hours, please call 613-549-1232 and follow the prompts to page the on-call manager.

Infection prevention and control (IPAC) in LTCH and RHs

Preventing the spread of COVID-19 in LTCHs and RHs is critical for the health of residents, health care workers, and other staff. Public Health Ontario (PHO) has developed a fundamentals document and a checklist to help staff conduct an IPAC assessments related to COVID-19 in long-term care and retirement homes.

National long-term care standards 

Health Standards Organization (HSO) standards focus on the delivery of high-quality long-term care services. The Canadian Standards Association standards focus on creating safer physical environments.  The standards complement each other to have a collective impact on long-term care as part of a quality environment. Resources are available on the PHO website providing more information on construction, renovation, maintenance, and design in health care.

Congregate living and shelter settings

Outbreak management

Individuals living in congregate living settings (CLSs) may have an increased risk for severe disease (e.g., older adults, immunocompromised individuals, individuals with multiple chronic medical conditions, or individuals who are pregnant). Ontario’s COVID-19 response in higher-risk CLSs provides a balanced approach that aims to protect clients and residents from severe outcomes of COVID-19, while minimizing the impact on the resident’s overall health and well-being. The Ministry of Health’s guidance document for CLSs outlines how to manage cases, contacts, and outbreaks of COVID-19.

Other resources CLSs and shelters that may be helpful include:

• Public Health Ontario’s Cohorting in outbreaks in congregate living settings
• COVID-19 "Isolate in Place" - tips for shelter service settings.
• Managing COVID-19 Outbreaks in Congregate Living Settings - Checklist

Childcare settings

KFL&A Public Health supports licensed childcare centres to promote a safe and healthy environment. All licensed childcare centers, within the KFL&A region, are inspected.

Requirements and guidelines are found within the Ontario Health Protection and Promotion Act, as well as the Childcare and Early Years Act.

Health and safety measures

Screening should occur at home prior to arriving at the facility to avoid sick children or staff entering the Childcare Centre.

Staff at the childcare facility should also conduct screening on everyone entering the facility and those who are symptomatic be sent home.

Please see the Ministry of Health Covid-19 school and childcare screening tool.

Parents should screen children and staff should  every day before going to childcare centres.

Outbreak management

When an outbreak occurs KFL&A Public Health works with childcare settings to implement appropriate infection control measures. Early identification, and implementation of control measures will minimize the duration of an outbreak. To report a confirmed or suspected outbreak please contact KFL&A Public Health’s IPAC team at 613-549-1232, ext. 4722 or email ipac@kflaph.ca.