Updated November 14, 2022
Note: This situation is continuously evolving; please subscribe to the Communiqué e-newsletter to receive regular updates.
See the Ontario Ministry of Health’s COVID-19 Reference Document for Symptoms .
See the Ontario Ministry of Health’s Current Case Definition for COVID-19.
Toronto Public Health continues to actively monitor the situation in collaboration with provincial and national health agencies and stakeholders that include local hospitals, airports and community agencies.
Up-to-date information regarding:
Health care settings are being requested to conduct passive and active screening of anyone entering the premises, as detailed by the Ontario Ministry of Health’s COVID-19 Patient Screening Guidance Document.
If this document does not contain information specific to your healthcare setting, please see other documents in the Ontario Ministry of Health’s Health Sector Resources.
For guidance about testing:
The following may be used to obtain COVID-19 test results:
Pharmacists conducting COVID-19 testing can refer to the following documents for information about testing and reporting results:
If you are not providing COVID-19 vaccine in your practice, you can direct your patients to book a COVID-19 vaccine appointment at a City-run clinic using the Province’s registration system or by calling 1-833-943-3900 (TTY 1-866-797-0007). Vaccines are also available at hospital immunization clinics, pop-up clinics, pharmacies and some primary care providers. more information, including supports available such as transportation and/or homebound vaccinations, visit TPH’s COVID-19 Where to Get Vaccinated.
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.
To learn more about providing COVID-19 vaccines in-office, see the Information for Health Professionals Providing COVID-19 Vaccines In-Office fact sheet.
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.
While NACI continues to preferentially recommend the use of mRNA COVID-19 vaccines for most people due to the excellent protection they provide against severe illness and hospitalization, and their well-known safety profiles, the Novavax Nuvaxovid COVID-19 vaccine may be offered as part of a primary series or as a booster dose. Note: the booster dose recommendation is off-label.
The Ontario Ministry of Health guidance is as follows:
*TPH will contact referred patients and arrange their appointment to receive their vaccine.
All children aged 6 months and up are now eligible to receive a COVID-19 vaccine. Children must be at least 6 months of age at the time of vaccination.
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.
The Ontario Ministry of Health, in alignment with NACI, continues to recommend that COVID-19 vaccines should be offered to individuals with previous SARS-CoV-2 infection without contraindications to the vaccine. Below are suggested intervals between previous SARS-CoV-2 infection and COVID-19 vaccination:
NACI recommends that for individuals 5 years and older, COVID-19 vaccines may be given simultaneously with (i.e., same day), or at any time before or after non-COVID-19 vaccines (including live and non-live vaccines). Informed consent should include a discussion of the benefits and risks given the limited data available on administration of COVID-19 vaccines at the same time as, or shortly before or after, other vaccines.
At this time, monovalent Moderna (25 mcg) COVID-19 vaccine, for ages 6 months to 5 years, as well as monovalent Pfizer-BioNTech (3 mcg) for ages 6 months to 4 years should not be given concurrently (i.e., same day) with non-COVID-19 vaccines but rather wait for a period of 14 days before or after administration of non-COVID-19 vaccines. This could prevent erroneous attribution of an adverse event to one of the vaccines.
NACI acknowledges that it may be challenging for both healthcare providers and parents if multiple visits to healthcare providers are required to administer all recommended immunizations. Concurrent administration or a shortened interval between the Moderna Spikevax (25 mcg) COVID-19 vaccine or monovalent Pfizer-BioNTech (3 mcg) and other vaccines may be warranted on an individual basis in some circumstances at the clinical discretion of the healthcare provider.
Studies to assess safety and immunogenicity of concurrent administration of COVID-19 vaccines with other vaccines are ongoing.
For more information visit:
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. Of particular interest are unusual or unexpected events, or serious reactions requiring urgent care.
Toronto health care providers are required to report AEFIs to TPH. 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:
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 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.
The COVID-19 vaccine is the best way to protect your health care setting from the risks of COVID-19. Mangers and clinicians can help encourage vaccination among staff by creating a supportive environment that makes it easier for everyone to get vaccinated.
Please note: the information provided on this webpage does not contain legal advice and should not be relied on or treated as legal advice; those for whom these recommendations are intended may seek their own legal advice for their specific circumstance.
COVID-19 outbreaks in institutional facilities are reportable to their local public health unit. Long-term care homes are also required to report COVID-19 outbreaks to the Ministry of Long-Term Care (MOLTC).
Please follow the Ontario Science Table Guidance: Therapeutic Management of Residents of Long-term Care Homes with COVID-19.
While we aim to provide fully accessible content, there is no text alternative available for some of the content on this site. If you require alternate formats or need assistance understanding our maps, drawings, or any other content, please contact us at LRCT@toronto.ca.
COVID-19 treatments are now available.
Individuals must have a positive COVID-19 test to receive treatment (PCR or rapid antigen test [including self-administered]). The COVID-19 medications are recommended for patients who present within five days (Paxlovid) or seven days (Remdesivir) of symptom onset.
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.
All patients who meet the following criteria are eligible for Paxlovid, based on clinician judgement (refer to Ontario Health’s Access to COVID-19 antiviral treatment (Paxlovid): Information for primary care providers and other health care providers caring for patients in the community for details):
*Public messaging will encourage anyone who may be at higher risk of severe outcomes (based on the criteria listed below) to seek testing and an assessment (see Ministry of Health website and screener tool). Clinicians will need to assess these patients and determine whether treatment with Paxlovid is appropriate.
Key resources for clinicians to assess eligibility for Paxlovid:
NOTE: It is recommended high-risk patients are prescribed Paxlovid; patients should only receive Remdesivir if there are drug-to-drug interactions with Paxlovid
The following table summarizes the process for primary care providers to refer patients for COVID-19 therapeutics in Toronto:
| Hospital Name | Therapeutics Available | Referral Process For Primary Care Providers | For more information: |
|---|---|---|---|
| Michael Garron Hospital (MGH) | Paxlovid | Primary care providers should direct patients to walk-in or book an appointment for an in-person assessment at our Clinical Assessment Centre. A physician will be on site for assessment from Monday to Sunday, 11 a.m. to 6 p.m.
Additional notes:
|
Call 416-469-6858 or visit Michael Garron Hospital’s website |
| North York General Hospital (NYGH) | Paxlovid | Primary care providers should direct eligible patients to book an appointment at the NYGH Cough Cold and COVID Test Clinic where they will be assessed to determine eligibility for COVID-19 testing, and prescribed Paxlovid if appropriate. | Call 416-635-2509 or visit the North York Cough, Cold and Test Clinic. |
| Scarborough Health Network (SHN) | Paxlovid
Remdesivir (new patients (12 years and older) can be referred 7 days a week) |
Primary care providers who would like to refer eligible patients should:
Additional notes:
|
Call 416-281-7442 or visit Scarborough Health Network’s website. |
| University Health Network (UHN) &
Women’s College Hospital (WCH) (partnered to support the delivery of COVID-19 Therapeutics) |
Paxlovid
Remdesivir (new patients can be referred 7 days a week) |
If your eligible patient has been assessed and you would like to refer for Remdesivir, download the UHN Remdesivir Referral Form:
If your COVID+ patient needs a virtual assessment for treatment:
If your eligible patient needs an in-person clinical assessment by a physician:
If you are not sure or have more questions, please contact either clinic and we will help you. |
UHN Connected Care Clinic Call: 437-488-1650 or Email: COVIDCare@uhn.caWCH CCAC Call: 416-804-4083 or Email: CCACNavigator@wchospital.ca |
Although vaccines protect most people, some immunocompromised populations may have a reduced immune response to COVID-19 vaccination. Pre-exposure COVID-19 prophylaxis (prevention) may provide some protection for these patient populations.
Patient populations that should be prioritized for Evusheld are those who are least likely to mount an adequate immune response to COVID-19 vaccination.
In Ontario, Evusheld can be administered to individuals with the highest risk of a severe outcome from COVID-19, including:
To be eligible for treatment, patients must:
Before receiving Evusheld, eligible individuals should be screened to ensure they are not currently symptomatic or known to be infected with COVID-19. Individuals should also be screened to ensure they have no recent high-risk exposure to a confirmed or probable case of COVID-19 during the close contact’s period of communicability. PCR, rapid antigen, and antibody testing are not required prior to receiving Evusheld. Refer to Ontario Health’s Information about Evusheld (Tixagevimab and Cilgavimab) Reference for health care providers who may be prescribing or administering Evusheld.
There are various pathways to access Evusheld available to health care providers and patients. Health care providers who may be prescribing or administering Evusheld through these pathways should review Information about Evusheld (Tixagevimab and Cilgavimab) for more information.
Questions about Evusheld should be directed to your Ontario Health regional contact:
Probable and confirmed cases of COVID-19 must be immediately reported to Toronto Public Health by telephone at 416-392-7411 (after hours: 311), or by faxing TPH’s COVID-19 Reporting Form to 416-696-3477.
Complete the AEFI Reporting Form and fax it to 416-696-3492 or email it to AEFI@toronto.ca.
