Toronto Public Health is reviewing updated measures and guidelines from the Ontario government. Some information on this page may change accordingly, so please check back for updates. For more information, see updated guidance on testing and case and contact management.

Last updated: January 11, 2022 at 5 p.m.

In response to high case levels, the Ministry of Health has shifted to a surge model for case and contact management with the focus on protecting the most vulnerable.  COVID-19 cases associated with high risk settings (e.g. hospitals, long-term care) ) are the focus of case, contact, and outbreak management during this surge. The provincial COVID-19 Case, Contact and Outbreak Management Interim Guidance: Omicron Surge information is available online here.

Due to the surge in cases, Toronto Public Health will only be following-up with contacts affiliated with high-risk settings. All other close contacts should refer to this page for the most up-to-date guidance.

This page provides directions for individuals who are considered close contacts of COVID-19, including the following:

  • Individuals who live with, or are close contacts of, persons who have tested positive on a PCR, Rapid Molecular, or Rapid Antigen test
  • Individuals who live with, or are close contacts of, persons who have been told by Toronto Public Health that they have a probable case of COVID-19
  • Individuals who live with, or are close contacts of, persons who have certain symptoms of COVID-19 – refer to the symptoms page for more details

If your child is a close contact of someone who has COVID-19, find out how to care for them safely.

If you are a close contact of someone who has COVID-19 and you cannot safely self-isolate in your own home, you may be eligible to stay at the Toronto Voluntary Isolation Centre.

In response to the evolving COVID-19 situation related to the Omicron Variant of Concern, on December 17, the Ministry of Health has shifted to a high surge model for case and contact management with the focus on protecting the most vulnerable.  As such, COVID-19 cases associated with high risk settings ) are the focus of case, contact, and outbreak management during this surge. These settings include hospitals, health-care settings, congregate living settings. The provincial COVID-19 Case, Contact and Outbreak Management Interim Guidance: Omicron Surge information is available online here.

To date, Toronto Public Health has been investigating each COVID-19 cases and following up on their close contacts. Until further notice, COVID-19 cases will be initially contacted by the Provincial Workforce to provide instructions for isolation, testing, and informing household and other close contacts, and case assessment to determine if the individual has attended a high risk setting. If a COVID-19 case is related to a high-risk setting, the case will be returned to Toronto Public Health for follow-up of contacts associated with the high-risk setting. Close contacts of cases will be asked to isolate regardless of vaccination status.

If you are a household contact of someone with COVID-19, you must self-isolate regardless of your vaccination status. This is required under the Health Protection and Promotion Act.  If you fail to self-isolate, you could be fined under the Act. Please review information about the COVID-19 Self-Isolation Class Order.

Your self-isolation can end when your household member with COVID-19 ends their isolation, provided you do not have any symptoms of COVID-19. If you develop symptoms of COVID-19, refer to the symptoms page for guidance.

You must self-isolate even if you are fully vaccinated and have received a booster dose. Self-isolation means that you must stay home – for information on how to safely self-isolate read How to Self-isolate.  If you cannot isolate at home, you may qualify to stay at the Toronto Voluntary Isolation Centre (TVIC). Call (416)338-7600 or visit our website. You can stop self-isolating if you do not have any symptoms at the end of your isolation period.

Refer to the Ministry flow chart on page 13 for further guidance.

If you are a non-household contact of someone with COVID-19 (i.e. you do not live with them), you may need to self-isolate. To determine if you need to self-isolate, and for how long, please visit Ontario.ca/exposed. For example, if you have a weak immune system, you should self-isolate for 10 days after you last had close contact with the person with COVID-19.

Those that are required to self-isolate must do so as directed by the Health Protection and Promotion Act.  If you fail to self-isolate, you could be fined under the Act. Please review information about the COVID-19 Self-Isolation Class Order.

Self-isolation means that you must stay home – for information on how to safely self-isolate read How to Self-isolate. If you cannot isolate at home, you may qualify to stay at the Toronto Voluntary Isolation Centre (TVIC). Call (416)338-7600 or visit our website. You can stop self-isolating if you do not have any symptoms at the end of your isolation period.

All close contacts should self-monitor for symptoms for 10 days after the last time they had close contact with the person who has COVID-19. If you develop symptoms of COVID-19, refer to the symptoms page for guidance. Testing is not needed for most close contacts – see the testing section for more details.

Even if you are not isolating, you should not visit any high-risk settings (e.g. hospitals, long-term care homes, or congregate living settings) or individuals who may be at higher risk for illness (e.g. older adults, those with a weak immune system) for 10 days since the last time you saw the person with COVID-19.

Refer to the Ministry flow chart on page 13 for further guidance.

Due to the widespread transmission of COVID-19 in Toronto, there are not enough PCR tests available for everyone who is a close contact. If you develop symptoms, testing may be available to particular groups – see the Testing page for more details. Students and staff at a school can use a PCR home test kit provided by the school.

Most people no longer require testing to confirm they have COVID-19. PCR testing is available for those at increased risk of severe illness and for those living or working in highest risk settings.

If you have a Rapid Antigen Test (RAT) at home, you can also administer it to yourself.

Based on the results of your PCR or RAT, do the following:

Positive PCR/RAT

  • You have COVID-19. If you have had at least two COVID-19 vaccines or are under the age of 12, you must self-isolate for at least 5 days from when you started to feel unwell and until your symptoms have been improving for 24 hours. If you have nausea, vomiting, diarrhea, or abdominal pain you must wait 48 hours once your symptoms are improving before ending self-isolation.  If you do not have any symptoms of COVID-19, you must self-isolate for 5 days from when you had a positive test.
  • If you are have not had at least two COVID-19 vaccines and are 12 years old or older or if you are immune compromised, you must self-isolate for 10 days from the onset of symptoms, or from the date of your test (whichever was earlier).
  • Your household contacts must self-isolate for the same amount of time you are self-isolating
  • A positive rapid antigen test (RAT) is highly suggests that an individual has COVID-19 and does not need to be confirmed by a PCR/rapid molecular test
  • A positive rapid antigen test (RAT) does not need to be reported to Toronto Public Health
  • You may stop self-isolating after 5 days (at 11:59 p.m.) if:
    • Your symptoms have been improving for 24 hours (48 hours for nausea, diarrhea, or stomach pain)

Negative Rapid Antigen Test (RAT)

  • If you do not have symptoms of COVID-19 – you do not need to self-isolate
  • If you have symptoms of COVID-19, it is still possible you have COVID-19 and you must continue to self-isolate
  • Refer close contacts to guidance
  • If another rapid antigen test (RAT) is available, repeat the RAT in 24-48 hours
    • If the second RAT is also negative, then you most likely do not have COVID-19 and you can end self-isolation when your symptoms have been improving for 24 hours (48 hours for nausea, diarrhea, or stomach pain)
    • Your household members can also stop self-isolating if both of your rapid antigen tests (RATs) are negative, as long as they do not have symptoms of COVID-19 – if they have symptoms of COVID-19, they should follow the directions above for people who are symptomatic

Negative PCR

  • If the PCR test is Negative, then you most likely do not have COVID-19 and you can end self-isolation when your symptoms have been improving for 24 hours (48 hours for nausea, diarrhea, or stomach pain)
  • Your household members can also stop self-isolating if both of your PCR is negative, provided they do not have symptoms of COVID-19 – if they have symptoms of COVID-19, they should follow the directions above.

If you are a close contact who lives or works or attends a High-Risk setting, there are unique requirements that apply to you. Please visit the High-Risk page for more details.

 

If you are a close contact of someone who has COVID-19 and you cannot safely self-isolate in your own home, you may be eligible to stay at the Toronto Voluntary Isolation Centre.

If your symptoms feel worse than a common cold, call your health care practitioner or Tele-Health Ontario at 1-866-797-0000.

People who are experiencing at least one of the symptoms of COVID-19 and have ANY of the following signs of severe illness, you should seek immediate medical attention:

  • Shortness of breath
  • Chest pain
  • Weakness
  • Lethargy or drowsiness
  • Dizziness

If you do not feel well enough to take personal transport, call 911:

The following infants and children should also be assessed in the emergency department:

  • Infants under 3 months of age with fever or trouble breathing or appear unwell
  • Children and infants over 3 months of age with any of the following:
  • Fever longer than 7 days
  • Fast breathing or trouble breathing
  • Bluish skin colour
  • Not drinking enough fluids
  • Not waking up or not interacting
  • Being so irritable that the child does not want to be held
  • Fever with a rash
  • Constant vomiting
  • Immune compromised with a fever

Before going for in-person medical care, tell them that you likely have COVID-19.

Tell your employer and/or school that you have been exposed to someone with COVID-19. If you are not self-isolating, follow all instructions from your workplace. High-Risk Settings may have additional requirements and/or require testing in order for you to attend work. See the High-Risk Settings and Essential Workers page for more information.

 

If you are identified as a close contact, you should arrange to get tested at a Community Assessment Centre. Close contacts should not get tested at a pharmacy or by using point-of-care (rapid) tests (e.g. through a workplace screening program or purchased from a pharmacy). Students and staff at public schools can use take-home/self-collection testing kits provided by their school.

You may need to be tested many times. Close contacts, including those that are fully vaccinated should:

  • Go for a first test as soon as possible
  • Go for a second test at least 7 days after you last had close contact with the person with COVID-19 (this is Day 7 of your 10 day isolation/monitoring period)
  • If your first test was 7 or more days after your most recent contact, you do not need to test a second time, unless you develop symptoms

You should also always get tested (even if it means getting tested again) if you develop any symptoms of COVID-19.

If you test positive at any time, TPH will contact you and you will not need further testing. If you are not already self-isolating when you test positive, you must start to self-isolate immediately. Find out what to do if you test positive for COVID-19.

Even if your tests are negative, you will need to continue to self-isolate for the full 10 days unless you are fully vaccinated or have had a recent COVID-19 infection and meet the criteria to be exempt from self-isolation.

You should monitor for the appearance of symptoms if you are a close contact of someone who has COVID-19, even if you are fully vaccinated or have had a recent COVID-19 infection.

You should always get tested (even if it means getting tested again) if you develop any symptoms of COVID-19, including new or worsening symptoms.

If you develop symptoms, you must immediately self-isolate if you are not already doing so, even if you are fully vaccinated. Your household members may also need to self-isolate.

Based on your test results and vaccination status, do the following:

  • If you test negative, you will need to continue to self-isolate for the full 10 days unless you are fully vaccinated or have had a recent COVID-19 infection and meet the criteria to be exempt from self-isolation
    • If you are fully vaccinated or have had a recent COVID-19 infection stay in isolation until your symptoms have been improving for 24 hours and you have no fever without taking fever-reducing medication (or 48 hours if you had any gastro-intestinal symptoms such as nausea, upset stomach, diarrhea)
  • If you test positive or indeterminate, remain in self-isolation and you will be contacted by Toronto Public Health

 

 

If you have completed your self-isolation period (as per above), and have not developed symptoms of COVID-19, you can stop self-isolating.  After you stop self-isolating you must continue to practise prevention measures, including physical distancing, wearing a mask, and washing your hands.

If you have questions about your self-isolation period or when you can return to work, call the COVID-19 Hotline 416-338-7600.

You may receive a text notification from Toronto Public Health if you are identified as a close contact of someone who has COVID-19.

The text message will be from 77000 and include a secure link to complete a personal assessment form. The form is voluntary and will take about 10 minutes to complete. You can opt out by texting STOP. After you complete the form, you may receive a call to confirm the information you submitted. If you have any questions about the form, you can call the COVID-19 Hotline at 416-338-7600.

The text messages are delivered by the Virtual Assistant tool, which is part of the Government of Ontario’s case and contact management system. It can be used on mobile devices and created for a mobile experience. All information collected through the tool is kept confidential and protected by Ontario’s health laws. It will only be used for public health purposes.

The Virtual Assistant tool is currently being used for close contacts of people who test positive for COVID-19, including non-household close contacts of people in the school community who test positive for COVID-19. Non-household close contacts of people in the school community who test positive will receive a phone call to confirm their enrollment in the Virtual Assistant before receiving any text notifications. Close contacts who are part of a dismissed school cohort will continue to be notified of the need to self-isolate through the school principal and will not be enrolled in the Virtual Assistant tool at this time.

The Virtual Assistant tool is also being used to notify people who have COVID-19.

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