What’s the difference between a COVID-19 exposure, an outbreak and enhanced surveillance?

Exposure: Generally, if you have spent more than 15 minutes within six feet of someone who is infectious with COVID-19, you are considered to have been exposed. However, this will NOT be considered exposure if appropriate PPE is worn.  Note: exposure does not mean that a transmission has occurred, it means there is a risk that a transmission occurred.

Outbreak: An outbreak is called by Public Health when there is evidence of a transmission of COVID-19 from one person to another within a unit or a facility. It doesn’t matter if the transmission was between health-care workers, patients/residents or both. Only a medical health officer can declare an outbreak. They take into account information from infection control, occupational health and other available data to determine the likelihood of a transmission having occurred.

Enhanced surveillance: This term applies to long-term care facilities only. A facility would enact enhanced surveillance when one of its health-care workers has COVID-19 and worked at the facility within 48 hours of their symptom onset. The facility might implement testing of individual staff and residents, and also put in place pre-emptive measures, such as separation of staff and reminders around health checks, to prevent an outbreak from happening. 

Note that these definitions continue to evolve based changing circumstances. They are current as of November 27, 2020.

How are PHC staff alerted if there is an outbreak?
If there's an outbreak on your unit, you will receive an email from your unit’s leadership. There is a new system in place to email professional practice leaders, contracted staff and physicians which helps ensure anyone associated with the unit is aware of the outbreak. If there is an outbreak at another unit or facility, PHC Communications will send out a bulletin or post information to the PHC COVID-19 website
How will I be notified if I’ve been exposed to someone who tested positive for COVID-19?

If there has been a potential exposure in your unit or clinic, IPAC and OH&S will work with the clinical leadership of your unit to assess the risk level. If everyone was following all the protocols and wearing appropriate personal protective equipment, the risk of COVID-19 transmission is low.

You will not be notified unless you were one of the people exposed, in which case, you will be contacted by Public Health.

Is there a process in place for supervisors/managers if a staff member tests positive?

Yes. OH&S will reach out to the manager if one of their staff has tested positive for COVID-19. The staff person must remain off work and in self-isolation until cleared by Public Health. This is a confidential process and the manager should not share information about who tested positive or who was exposed.

The staff person will be contacted directly by Public Health if they test positive for COVID-19. Public Health will begin contact tracing and inform OH&S.  OH&S follows up with the employee and the employee’s manager to find out if everyone was following PPE protocols and physical distancing. OH&S will send that information to Public Health to assist Public Health in making a determination of whether other staff, patients or residents were exposed (see definition of an exposure above).    

What do I do if I’ve been in contact with someone who tests positive for COVID-19?

If you have been in contact with someone who tests positive for COVID-19, Public Health will be in touch with you as part of contact tracing.  Public Health will determine if there is a risk that you were exposed to COVID-19 and if you need to self-isolate and get tested.

If Public Health determines that you need to self-isolate, please call EARL, inform your manager and provide any documentation to OH&S.

If you are a household member or a sexual contact of an individual who has tested positive for COVID-19, you should self-isolate until you are contacted by Public Health. If this is the case, please call EARL and inform your manager that you are waiting for direction.

If you are not directed to self-isolate, you may continue to come to work, following all PPE and IPAC protocols. Monitor yourself for symptoms and get tested should any symptoms (no matter how mild) arise.

What do I do if I’ve been in contact with someone who tests positive for COVID-19, but I haven’t been contacted by Public Health and I start to develop symptoms?
  1. Tell your manager
  2. If at work, finish any essential care tasks you are in the middle of, then go home and self-isolate.  You should also go for testing. 

  3. If your symptoms develop when not at work, stay at home and self-isolate and go for testing. If you are working at St. Paul’s Hospital or Mount Saint Joseph Hospital when your symptoms develop, you can go to the emergency room for your test. Otherwise, please visit a community testing site.

What if I test positive for COVID-19?
Public Health will contact you and advise you to remain in self-isolation at home for 10 days from symptom onset or until cleared by Public Health. You will also be contacted by OH&S to confirm when you last worked and if you followed all PPE and physical distancing protocols. They will also provide any additional information or support if you need it. Please call EARL to report your absence.
How do I self-isolate appropriately at home if I live with other people?

If you have been directed by Public Health to self-isolate, they will offer some guidance. In general, try to stay in a separate room as much as possible. Don’t share dishes or other items.

All household members should wear masks when they can’t maintain physical distance, wash their hands regularly and sanitize household surfaces often.

How do I know when I can return to work after experiencing symptoms of COVID-19?
You may return after 10 days from symptom onset if you feel well enough to work. But ultimately you need to follow the instructions from Public Health regarding when you are clear to go back to work.  If you are unsure if you are well enough to return to work, or have questions about returning to work, call OH&S.
Why is there a discrepancy between health authorities on what I should do if I’ve been in contact with someone in my facility/unit/department who tested positive for COVID-19? 
The discrepancy arises because being in contact with someone who tested positive for COVID-19 does not automatically mean you were exposed to COVID-19.  If a co-worker has COVID-19 and everyone in your facility/unit/department followed PPE and physical distancing protocols, the risk of exposure is very low.  Public Health, with input from IPAC and OH&S, will assess whether there was a risk of exposure and will determine if any staff should self-isolate.
When there is an outbreak at a PHC site, why can’t we know how many people are affected and if they are staff or patients/residents?
Disclosure of this information is at the discretion of Public Health.
Will staff be informed if one of their patients/residents tests positive? 

The results are available in the medical records. If you are providing care for this patient, you can find the results in microbiology section.

If you are not providing care to this patient, you will be notified by Public Health if you are considered a close contact who is required to self-isolate. No one will inform you if you are not considered a close contact.  If you are unsure and have questions, you can ask your unit lead, division or department leader. 

All staff MUST know the COVID-19 status of any patients/residents currently in care and know where to go to find that information as it impacts how care is provided.  The COVID-19 result is in the microbiology results section of Cerner.  A positive result does not automatically mean the person is still infectious.  Please discuss with the clinical team if you are unsure. 

Who needs to be notified if a patient/client/resident tests positive for COVID-19?
For tests done at PHC, the laboratory will notify Public Health.  If the result is done at another lab, please notify IPAC, the MRP and the clinical team. The IPAC team will do contact tracing for in-hospital contacts (both inpatients and those who have been discharged) and will work with Public Health.
Who needs to be notified if a staff member tests positive for COVID-19?
Public Health is notified if anyone tests positive for COVID-19, whether they are PHC staff or a member of the public. 
What are the cleaning and infection control protocols to help prevent the spread of COVID-19?
Please review Providence Healthcare’s infection control policies, including standard operating procedure for cleaning and disinfection of equipment/devices/surfaces.


What do I do if one of my staff advises me they had contact with a suspect case while at work? 
If one of your staff tells you that they were in contact with someone they think might have COVID-19, get in touch with IPAC and OH&S who will work with you to assess whether there has been an exposure risk for you, your staff and your patients/residents. IPAC and OH&S will consult with Public Health if required.
What should I do if one of my staff tells me they have been in contact with a person who has tested positive for COVID-19 and starts to develop symptoms?
  1. If they tell you during a shift, ensure they go home as soon as possible and self-isolate and get tested. If they contact you outside of a scheduled shift, advise them to stay at home, self-isolate and get tested.
  2. Advise them to get a COVID-19 test. If your staff member is working at St Paul’s Hospital or Mount Saint Joseph Hospital when their symptoms develop, they can go to the emergency room for their test. Otherwise, they should visit a community testing site.

What if one of my staff tells me they have been in contact with a person who tested positive for COVID-19 but they have not developed symptoms?
Staff can continue to work. Public Health and OH&S will be notified if a staff exposure is suspected and they will advise the staff person on next steps, including self- isolation and testing (if required). Staff should self-monitor for symptoms and not come to work if ill.
Who do I notify if one of my staff tells me they have tested positive for COVID-19?

Please inform IPAC and OH&S.

If one of your staff has tested positive, Public Health will contact the staff person to initiate contact tracing.  Public Health will also inform OH&S, who will contact the employee to explain the Public Health process and ask questions about the use of personal protective equipment and break time behaviours (e.g. was physical distancing always practiced when unable to wear a mask). 

Public Health will also contact IPAC and work with them on contact tracing.

Do I have to notify other staff on the unit/in my dept?
No, the fact a staff member has tested positive for COVID-19 is confidential. Public Health, OH&S and IPAC will advise you on next steps.
How do I code time off for the various types of leaves related to COVID-19?
Please click here to view the May 4, 2020 COVID Cost Tracking Update & Cheat Sheet
This page last updated Dec 3, 2020 4:42pm PST