For the latest updates on COVID-19, please subscribe to the Communiqué e-newsletter.

Symptoms of COVID-19 can be difficult to distinguish from other respiratory illnesses like the flu and RSV.

For more information on clinical signs and symptoms, surveillance, laboratory testing, IPAC, reporting and patient resources, please see Respiratory Viruses Information for Health Professionals.

See the Ontario Ministry of Health’s Current Case Definition for COVID-19.

For more information on the types of testing available and how to get tested:

To obtain free Rapid Antigens Tests in Toronto:

HCPs can order RATs to distribute to their patients free of charge as “eligible persons” under the PASP Agreement. This is in addition to orders placed for RATS for their employees. HCPs not currently enrolled in PASP that would like to distribute RATs to employees and/or patients, can enroll here.

Orders will continue to be through the PPE Supply Portal. For assistance in creating an account or accessing an existing account, or for any questions about orders and shipment, please contact sco.supplies@supplyontario.ca.

Toronto Public Health has restocked rapid antigen test kits with the expiry date of September 2024. The new kits will be made available at City of Toronto Civic Centres and various Toronto Public Health Clinics.

Please see COVID-19 Testing for more information and updates.

For information about expiry extensions for COVID-19 testing products:

For guidance about testing:

For COVID-19 test results:

If you are not providing COVID-19 vaccine in your practice, you can direct your patients to book their vaccine appointment using the Province’s registration system or by calling 1-833-943-3900 (TTY 1-866-797-0007 OR visiting TPH’s COVID-19 Where to Get Vaccinated.

Ordering Vaccine for your Practice

To order Pfizer-BioNTech and Moderna COVID-19 vaccines, complete the TPH COVID-19 Vaccine Program Enrollment Request Form and the onboarding process. Please only complete this form once for each primary care or general pediatric practice. Once complete, access to the ordering portal will be provided.

Email questions about enrolling in the Toronto Primary Care COVID-19 Vaccine Program to COVIDVaccineOrder@toronto.ca.

Billing OHIP for Administration of COVID-19 Vaccine

The Ontario Medical Association (OMA) details of billing (OMA login required to access PDF) for activities related to COVID-19 vaccination. Members should check the OMA portal regularly for updates.

Physicians with questions pertaining to the submission of these billing codes should email the Ministry’s Service Support Contact Centre at SSContactCentre.MOH@ontario.ca.

Homebound Vaccination Referrals

Your patient may be eligible for homebound vaccination if they have medical, cognitive, or psychosocial needs/conditions that inhibit them from visiting you, their primary care provider, or a pharmacist to receive an influenza or COVID-19 vaccine. Transportation and other strategies to remedy the access difficulties should have also been considered but are not available or not appropriate in your patient’s circumstances.

Primary care providers:

  • Identify patients who qualify
  • Get consent for homebound vaccination
  • Refer eligible individuals using the updated template

Note: Primary care providers must register eligible patients this year even if the patient previously received a homebound influenza or COVID-19 vaccination. Registered patients will be screened again by Toronto Paramedic Services during the booking process.

All individuals aged six months and up are eligible to receive a COVID-19 vaccine.

Coadministration of COVID-19 vaccine and influenza vaccine whenever possible is encouraged.

Visit the COVID-19: Vaccinate Eligibility & Doses page to learn more about first doses, second doses, booster doses, including recommendations for immunocompromised individuals and post-transplant re-vaccination.

COVID-19 Vaccine after Previous COVID-19 Infection

Even with a previous COVID-19 infection, people who have not started a vaccine series or those who are previously vaccinated, are still strongly recommended to get the updated COVID-19 vaccine.

Hybrid immunity, having protection from being vaccinated for COVID-19 and a recent past COVID-19 infection, can provide natural immunity but it does not last long. Individuals have a higher risk of getting COVID-19 again if they are not up to date with their vaccinations. Encourage patients to stay up to date with their vaccinations to get the benefit of hybrid immunity.

Individuals six months and older are considered up-to-date with their COVID-19 vaccines when they get the fall 2023 COVID-19 dose(s).

  • Individuals five years and older can receive an updated COVID-19 vaccine six months after their last COVID-19 dose or infection
  • Children six months to four years of age:
    • who have completed their COVID-19 vaccination (primary) series, can get an updated COVID-19 vaccine dose six months after their COVID-19 last dose or infection;
    • who have not completed or started their COVID-19 vaccination (primary) series, can get their doses at eight weeks apart

Every COVID-19 infection increases the risk for long COVID. To maximize the immune response after having COVID‑19, individuals should wait the following intervals after symptoms start or after a positive test (if no symptoms) before receiving their next dose.

Starting or completing the vaccination series:

  • Two months for individuals that are not immunocompromised and have no history of multisystem inflammatory syndrome in children and adults (MIS-C and MIS-A)
  • One to two months (28 to 56 days) for individuals that are immunocompromised and have no history of MIS-C or MIS-A
  • If an individual has a history of MIS-C, until clinical recovery has been achieved or up to 90 days since the onset, whichever is longer, regardless of immunocompromised status

Previously vaccinated:

  • Six months since an individual’s previous COVID-19 infection
  • A shorter interval (three to six months) may be considered based on age and risk.

Referrals for non-mRNA COVID-19 Vaccines

A primary care provider referral is no longer required to receive Novavax COVID-19 vaccines. TPH has updated its appointment booking process to reflect this change.

Reporting Adverse Events Following Immunization (AEFI)

An AEFI is an unwanted or unexpected health effect that happens after someone receives a vaccine, which may or may not be caused by the vaccine. A causal relationship does not need to be proven before reporting. Of particular interest are unusual or unexpected events, or serious reactions requiring urgent care.

Toronto health care providers are required to report all Adverse Events Following Immunization (AEFI) to TPH under the Health Protection and Promotion Act.

Complete the AEFI Reporting Form  and fax it to 416-696-3492 or email it to AEFI@toronto.ca.

To stay up-to-date about AEFIs reported following COVID-19 vaccinations, visit the Public Health Agency of Canada’s weekly report, Reported side effects following COVID-19 vaccination in Canada , regularly.

More information about COVID-19 vaccines can be found at:

The Ministry of Health has published guidance to assist health care providers evaluate contraindications or precautions to COVID-19 vaccination that may warrant a medical exemption. Refer to Table 1 for details.

True medical exemptions are expected to be infrequent and should be supported by expert consultation. Referral and specialist consultation support for physicians and nurse practitioners is available through Ontario’s eConsult Service, OTN Hub , and the Special Immunization Clinic (SIC) Network. In many instances, safe administration of subsequent doses of COVID-19 vaccine is possible under the management of an allergist/immunologist.

Individuals with medical exemptions for COVID-19 vaccinations approved and entered into CovaxON may obtain an enhanced vaccination certificate with a QR code under Ontario’s Proof of Vaccination Policy.

Exemption forms may be submitted by secure fax to 416-338-2487. Submissions must:

  • Be on the Ministry of Health medical exemption template (letters and other submission formats will not be accepted)
  • Be submitted by an Ontario physician (MD) or registered nurse in the extended class (“Registered Nurse (Extended Class)”, “RN(EC)”, “Nurse Practitioner” or “NP”) based in Toronto
  • Comply with Ministry guidance with respect to clinical assessment and exemption types
  • Confirm the patient’s consent to collect, use and disclose their personal health information to TPH
  • If submitting multiple patients’ exemptions, fax each request separately (cover sheet not necessary)

If there is an issue with the submission, TPH will follow up with the medical practitioner.

TPH will provide a confirmation e-mail to the submitting practitioner following entry of the medical exemption into COVaxON. Operational demands related to rising case numbers may result in significantly reduced capacity to enter medical exemptions. Given this, response time estimates are currently unavailable. Once the submission form has been processed by TPH, patients will be able to download an enhanced vaccination certificate with a QR code that indicates their exemption for use in settings requiring vaccine certificates to enter or participate.

Exemptions Due to Participation in a Clinical Trial

Exemptions due to participation in a clinical trial should be sent directly to the Ministry of Health, at covaxverification@ontario.ca, by the Principal Investigator or Study Director of the trial, and not to TPH.

Treatment

In Canada, oral nirmatrelvir/ritonavir (Paxlovid™) and intravenous remdesivir (Veklury®) are Health Canada approved COVID-19 treatments for outpatient use.  Individuals must have a positive COVID-19 test to receive treatment (PCR or rapid antigen test [including self-administered]). COVID-19 medications are recommended for patients who present within 5 days (Paxlovid) or 7 days (Remdesivir) of symptom onset. For recommendations on use:

Individuals who may be eligible for treatment and have an initial negative rapid antigen test result are strongly recommended to seek laboratory-based or rapid molecular testing as soon as possible given the short time frame for receiving therapeutics. For information on testing and treatment, including eligibility and locations:

For information on how primary care providers and other health care providers can access remdesivir treatment for COVID-19 for patients in the community please see Ontario Health’s, Access to remdesivir in the community. This intravenous antiviral therapy for COVID-19 is now provided via the province’s Home and Community Support Services (HCCSS)  organizations.

In Toronto, virtual clinical assessments, prescribing of Remdesivir and referral to HCCSS for remdesivir treatment continues to be supported by the UHN Connected Care Hub .

For more information on antiviral treatments for COVID-19 visit:

Outbreak Forms and Instructions

Testing

Treatment

Follow the Ontario Science Table Guidance: Therapeutic Management of Residents of Long-term Care Homes with COVID-19.

For additional information regarding treatment (refer to the accordian on this page)

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