Reduce the Spread of Respiratory Viruses

How Respiratory Viruses Spread

• Respiratory droplets that come out of your nose and mouth when you breathe, talk, cough or sneeze;
• Aerosols, which are tiny respiratory droplets that can stay in the air longer;
• Touching something with the virus on it, then touching your mouth, nose or eyes.

Close contact with people in crowded indoor spaces is a common way that viruses spread.

People at Higher Risk of Serious Illness

Knowing if you are at higher risk of getting sick from a respiratory virus can help you make informed decisions about your health and when to use layers of protection.

Some people at higher risk of getting very sick or being hospitalized with a respiratory virus include:

• Seniors
• People with weakened immune systems
• Pregnant individuals
• Infants and young children

Some settings and situations can put you at higher risk of getting and spreading respiratory viruses, including:

• Congregate living settings such as long-term care homes or shelters
• Crowded indoor public settings with poor ventilation

During respiratory virus season, which is usually during the fall and winter months:

• • Stay up to date on respiratory virus activity in Toronto by visiting Toronto Public Health’s Integrated Respiratory Diseases Dashboard.
  • Find out when there is higher respiratory virus activity in Ontario by visiting the Ontario Respiratory Virus Tool. 

Vaccines

The best way to protect yourself and your loved ones from respiratory viruses each fall is to get vaccinated. This year, vaccines will be available to protect against flu and COVID-19 for everyone, and against RSV for select eligible people. It is safe and convenient to get any of these vaccines at the same time:

• Influenza (Flu) vaccine
• COVID-19 vaccines
• Respiratory Syncytial Virus (RSV) immunization

Stay Home If You Are Sick

Staying home and away from others when you are sick can help prevent viruses from spreading to others. Respiratory viruses can share common symptoms such as fever, cough and runny nose. If you have symptoms of a respiratory virus, you should stay home, whether you have tested or not, and wear a mask if you need to go out.

Learn more about what to do if you think you have COVID-19.

Testing and Treatment

Some high-risk individuals are eligible for COVID-19 and/or flu treatment if they have a confirmed infection. Get tested if you develop symptoms of a respiratory virus and talk to your health care provider. Learn more about who is eligible for publicly funded COVID-19 testing.

Seek medical care if your symptoms feel worse than a common cold by calling your health care provider or 811 (TTY: 1-866-797-0007). If your symptoms are severe, seek immediate medical attention.

Physical Distancing

Respiratory viruses are spread mainly from person-to-person through respiratory droplets that can travel up to two metres. Keeping a physical distance from others, where possible, is a layer of protection that can be used to reduce virus spread, especially for those at higher risk of serious illness.

Here are some ways to practice physical distancing:

• Greet others from a distance with a smile, nod or wave.
• Avoid trips during peak times, to limit contact with large crowds.
• Avoid crowded stores and return when it is less busy.
• Consider curbside pick-up, if available.
• Connect with others online, by phone or outdoors.

Face Masks

Consider wearing a well-fitting, high-quality mask in crowded indoor public settings with poor ventilation, especially if you or people around you are at higher risk of getting very sick from a respiratory virus. Masking continues to be an important layer of protection to reduce virus spread and keep you, your loved ones, and those most vulnerable in our community safe.

Masks are recommended for anyone who:

• Has tested positive for or has symptoms of a respiratory virus. Wear a mask for 10 days after symptoms start or from the positive test result.
• Is caring for someone, is a close contact of, or lives with someone who has tested positive for, or has symptoms of a respiratory virus.

Masks should not be worn by:

• Children under the age of two.
• People who have trouble breathing or who cannot remove the mask without help.

Masks may also still be expected or required in certain scenarios, including:

• In healthcare settings such as long-term care homes, retirement homes, hospitals and clinics.
• In congregate care settings, such as shelters, group homes, 24-hour respite and drop-in sites.
• At businesses and organizations that have their own masking policies in place.
• As personal protective equipment.
• On some public transportation.

Check with individual organizations to learn more about their specific policies.

Choosing a Mask

A high-quality, well-fitted and comfortable mask is recommended for the best protection.

• High-quality:
  • A medical mask or respirator (such as an N95 mask) can provide better protection.
  • Cloth masks should be made of at least three layers of tightly woven fabric (such as cotton or linen), or two layers with a filter layer for extra protection.
• Well-fitted:
  • A mask should fit your face, covering your nose, mouth and chin without gaping.
  • Ties/ear loops should fit securely to avoid having to adjust during use.
• Comfortable:
  • Your mask should be comfortable, easy to breathe through, and not limit your vision.

Tips for Wearing a Mask

• Wash or sanitize your hands before putting on and after taking off your mask.
• Place the mask over your nose, mouth and chin.
• Change your mask if it becomes wet or dirty.
• Avoid touching your face or mask when wearing it.
• Remove your mask by the ear loops without touching the front of the mask.
• Throw away disposable medical masks or respirators after each use.
• Wash cloth masks after each use.
• Put your used mask in a plastic bag or directly in the garbage or laundry bin.

Communicating with People who are Deaf, Deafened or Hard of Hearing While Wearing a Mask

Some people who are deaf, deafened or hard of hearing may remove their mask, or may ask others to remove their mask, because they rely on facial movements and/or lip-reading to communicate.

Here are some tips for better communication:

• Ask the person how they prefer to communicate.
• Use speech-to-text mobile apps or writing paper.
• If the person reads lips, you can remove your mask.
• If you remove your mask, you can consider keeping a distance, wearing a face shield, or standing behind a plexiglass barrier to help reduce your risk.
• Look at and speak directly to the person, not the ASL interpreter (if they are using one).
• Respect the dignity of anyone who requires accommodation.

Hand Hygiene

Hands carry and spread germs such as respiratory viruses. Touching your eyes, nose or mouth without cleaning your hands, or sneezing or coughing into your hands may provide an opportunity for germs to get into your body. Keeping your hands clean through good hygiene is one of the most important layers of protection to reduce virus spread. Learn more about practicing good hand hygiene.

Cover Your Cough or Sneeze

Germs such as respiratory viruses are spread by coughing or sneezing. When you cough or sneeze into your hands, your hands can spread these germs. Covering your cough or sneeze with an elbow or tissue is an important layer of protection to reduce virus spread.

Cleaning & Disinfecting

Respiratory viruses can spread by touching something with the virus on it, then touching your mouth, nose or eyes. Cleaning and disinfecting surfaces, especially those that are touched frequently, is a layer of protection that can be used to reduce virus spread.

General Cleaning Tips

Common cleaners, such as soap and bleach, are effective against respiratory viruses. If using alcohol-based cleaners such as hand sanitizer, make sure it is at least 70 per cent alcohol. Always follow the product instructions.

Clean and Disinfect High-Touch Surfaces

High-touch surfaces may include, but are not limited to:

• Door handles
• Countertops
• Tables
• Light switches
• Sinks and faucets
• Electronic devices (such as cell phones, tablets, keyboards, remote controls)

If surfaces are visibly dirty:

• Use a cleaner, such as soap and water to remove the dirt first
• Apply a disinfectant to kill the germs and viruses
• Leave the disinfecting solution to dry

You can choose a product that cleans and disinfects. Read the label to find a product that does both. Use disinfectant wipes that are appropriate for electronics.

Clean and Disinfect Soft Surfaces

Soft surfaces may include, but are not limited to:

• Clothing
• Drapes
• Bedding (such as sheets and pillowcases)

If soft surfaces are dirty:

• Launder according to the label
• Use regular laundry detergent and the warmest appropriate temperature setting
• Dry items completely in the dryer, if possible

It is safe to wash laundry from a person who is sick with other items.

Establishing a Cleaning Schedule for Public Settings

• Identify high-touch surfaces, objects, and equipment that need routine cleaning as well as disinfection.
• Indoor high-touch surfaces should be cleaned and disinfected at least once per day and when visibly dirty.
• Check for and follow any specific cleaning and disinfection protocols for your setting.

Caution: Always check the expiry date, read the label and follow cleaning product instructions. Use a product approved in Canada (look for a DIN number). Household bleach may not have a DIN but is an effective disinfectant. Do not mix chemicals. Wear protective gloves/eyewear and open windows for good ventilation. Never use products on your skin or food, as this can cause serious harm. Store chemicals out of reach from children and pets.

Ventilation

Respiratory illnesses can spread more easily when people gather indoors together. There are a number of things you can do to improve indoor air quality to help reduce virus spread.

Using Ventilation Systems to Reduce Virus Spread from Respiratory Droplets and Aerosols

• Improve ventilation and filtration:
  • Ventilation means increasing the amount of fresh air that flows into a space. Good ventilation replaces indoor air with fresh outdoor air through air exchanges (like opening windows to air out a stuffy room).
  • Filtration means using a filter to remove viruses, bacteria, and other particles from the air. The filtered air is cleaned and then returned into the room.
  • Good ventilation and filtration help prevent the spread of respiratory illnesses by reducing particles in the air that have the potential to make you sick.
  • The effect of ventilation and filtration will depend on many things such as: room size, number of people, the type of activities taking place and the measures used to improve ventilation.
  • Extra attention may need to be given to ventilation and filtration in settings where aerosol generating activities take place.
• Use and maintain heating, ventilation and air conditioning (HVAC) systems:
  • HVACs can improve ventilation and reduce the amount of viral and bacterial particles in the air.
  • When using HVAC systems:
    • Equipment should be maintained often to make sure it works well.
    • Avoid re-circulating air, for example, adjust vents to let in as much outdoor air and as little recirculated indoor air as possible through air exchange.
    • Keep areas near air vents free and clear from items such as furniture.
• For spaces without HVAC systems or with poor HVAC systems:
  • Use portable air cleaners.
    • Portable air cleaners filter and clean the air.
    • Make sure the air cleaner keeps running and does not blow directly at anyone.
    • Use proper filters that can filter out small particles from the air, such as HEPA filters, and change the filter often.
  • Promote natural, fresh air flow.
    • All indoor spaces can benefit from natural, fresh air flow.
    • Open windows, if safe to do so.
    • Use portable fans, ceiling fans and single unit air conditioners to improve natural air flow.
    • When using a window air conditioning unit or fan, make sure it does not blow directly toward anyone.
      • Place fans near an open window or door to help bring outdoor air into the space.
      • When using ceiling fans, use the setting that moves the air up toward the ceiling.

Additional Resources:

• American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHREA )  
• ASHREA Position Document on Indoor Air Quality 
• ASHREA Position Document on Filtration and Air Cleaning