COVID-19
Information for Patients and Families

Coronaviruses are a large family of viruses which may cause illness in animals or humans. In humans, several coronaviruses are known to cause respiratory infections ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). The most recently discovered coronavirus causes coronavirus disease COVID-19.

Some human coronaviruses spread easily between people, while others do not.

Your risk of severe illness may be higher if you have a weakened immune system. This may be the case for:

• Older individuals
• People with chronic disease (for example: diabetes, cancer, heart, renal or chronic lung disease)

COVID-19 is the infectious disease caused by the most recently discovered coronavirus. This new virus and disease were unknown before the outbreak began in Wuhan, China, in December 2019.

The most common symptoms of COVID-19 are fever, tiredness, cough and shortness of breath. Some patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhea. These symptoms are usually mild and begin gradually. Some people become infected, but don’t develop any symptoms.

Most people recover from the disease without needing special treatment. Older people, and those with underlying medical problems like high blood pressure, heart problems or diabetes, are more likely to develop serious illness. People with fever, cough, sore throat and difficulty breathing should seek medical attention.

People can catch COVID-19 from others who have the virus. The illness can spread from person to person through small droplets from the nose or mouth which are spread when a person with COVID-19 coughs or exhales. These droplets land on objects and surfaces around the person. Other people then catch COVID-19 by touching these objects or surfaces, then touching their eyes, nose or mouth. People can also catch COVID-19 if they breathe in droplets from a person with COVID-19 who coughs out or exhales droplets. This is why it is important to practice physical distancing by staying at least 2 metres apart from other individuals.

The World Health Organization (WHO) is assessing ongoing research on the ways COVID-19 is spread and continues to share updates.

Studies to date suggest that the virus that causes COVID-19 is mainly transmitted through contact with respiratory droplets and not through the air.

The main way the disease spreads is through respiratory droplets expelled by someone who is coughing. The risk of catching COVID-19 from someone with no symptoms at all is very low. However, many people with COVID-19 experience only mild symptoms. This is particularly true at the early stages of the disease. As such, it is possible to catch COVID-19 from someone who has, for example, just a mild cough and does not feel ill. WHO is assessing ongoing research on the period of transmission of COVID-19 and will continue to share updated findings.

Quarantine means separating a person or group of people who have been exposed to a contagious disease but have not developed illness (symptoms) from others who have not been exposed, in order to prevent the possible spread of that disease. Quarantine is usually established for the incubation period of the communicable disease, which is the span of time during which people have developed illness after exposure. For COVID-19, the period of quarantine is currently 14 days from the last date of exposure. Someone who has been released from COVID-19 quarantine is not considered a risk for spreading the virus to others because they have not developed the illness during the incubation period.

The risk of catching COVID-19 from the feces of an infected person appears to be low. While initial investigations suggest the virus may be present in feces in some cases, spread through this route is not a main feature of the outbreak. WHO is assessing ongoing research on the ways COVID-19 is spread and will continue to share new findings. Because this is a risk, however, it is another reason to clean hands regularly, after using the bathroom and before eating.

Based on available evidence, children do not appear to be at higher risk for COVID-19 than adults. While some children and infants have been sick with COVID-19, adults make up most of the known cases to date. To learn more about who is most at risk for health problems if they have COVID-19 infection, please visit the Public Health Agency of Canada’s Risk and Prevention page.

We do not currently know if pregnant women have a greater chance of getting sick from COVID-19 than the general public. With viruses from the same family as COVID-19, and other viral respiratory infections, such as influenza, pregnant women have had a higher risk of developing severe illness.

• Practice physical distancing. Stay a safe distance of 2 metres away from other people.
• Wash your hands often with soap and water or use an alcohol-based hand sanitizer. Alcohol-based hand sanitizer ranges in concentration from 60-90% alcohol content. A minimum of 70% alcohol content is recommended for health-care settings, and a minimum of 60% alcohol content is recommended for personal use.
• Avoid touching your eyes, mouth and nose as much as possible.
• Avoid contact with people who are ill and their items.
• Cover your coughs and sneezes with a tissue. If you don't have a tissue, cough or sneeze into your upper sleeve or elbow, not your hands. Wash hands after coughing and sneezing.
• Maintain a healthy lifestyle, including a healthy diet, exercise and enough sleep, to enhance your body's immune system.
• Stay home and only leave the house for essentials like groceries, medicine and medical appointments. If you're over the age of 70 you should stay home and rely on family and social supports as much as possible for essential needs.
• See the following guidance on self-monitoring and self-isolation from the Public Health Agency of Canada for more information.

In November 2021, a new variant of the SARS-CoV-2 coronavirus emerged, and was named Omicron by the World Health Organization (WHO). WHO currently lists the omicron as a variant of concern.

We are still learning about this new variant, but we do know that Omicron is infecting between four and eight times more people than the Delta variant, and has rapidly become the dominant strain in the province.

The symptoms of the Omicron variant are similar to other variants of COVID-19. The most common symptoms include:

• fever (a temperature of 37.8 degrees Celsius or higher) and/or chills
• cough, including a barking cough or croup (continuous, more than usual, making a whistling noise when breathing)
• shortness of breath (out of breath, unable to breathe deeply)
• decrease or loss of taste or smell
• Nausea, vomiting and/or diarrhea
• Muscle aches, joint pain and/or extreme tiredness

The Omicron variant spreads more easily and rapidly than other variants of the COVID-19 virus. Although vaccines may be somewhat less effective against infection from the Omicron variant, a third dose of the COVID-19 vaccine can substantially increase protection. As well, two doses of the vaccine will still likely provide strong protection against severe illness. The risk of severe illness is dramatically higher in people who are unvaccinated.

More data is needed to know if Omicron infections, and especially reinfections and infections in people who are fully vaccinated, cause more severe illness compared to other COVID-19 variants.

Some groups are at higher risk of getting COVID-19 and experiencing more severe symptoms. You may be in an at-risk group if you:

• are 50 years old or older;
• are getting treatment that weakens your immune system (for example, chemotherapy, medication for transplants, corticosteroids, TNF inhibitors);
• have a condition that compromises (weakens) your immune system (for example, lupus, rheumatoid arthritis, other autoimmune disorder);
• have a chronic (long-lasting) health condition (for example, diabetes, emphysema, asthma, heart condition);
• regularly go to a hospital or health care setting for a treatment (for example, dialysis, surgery, cancer treatment).

Although vaccines may be somewhat less effective against infection from the Omicron variant compared to past variants, a mRNA COVID-19 vaccine will likely provide strong protection against severe illness for individuals with two vaccine doses, and substantially increase protection for individuals with a third dose. The risk of severe illness is dramatically higher in those who are unvaccinated.

Active research is ongoing, but current evidence and expert opinion suggests that most of the existing treatments for COVID-19 infection will be effective against infection with the Omicron variant.

Vaccines remain the best public health measure to protect people from COVID-19, slow the transmission, and reduce the likelihood of new variants emerging. The best evidence at this time shows that a third dose of a COVID-19 vaccine provides the best protection against the Omicron variant. As of Monday, December 20 2021, all individuals age 18 and older in Ontario and received their second dose at least three months (84 days) ago are eligible for a third dose of COVID-19 vaccine.

We strongly encourage you to receive all three doses of a COVID-19 vaccine. Please follow all current public health restrictions and recommendations including wearing a mask, practicing physical distancing, washing your hands, getting tested if you have symptoms and getting vaccinated.