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Middlesex-London Health Unit

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Frequently Asked Questions - COVID-19

There are a lot of questions about COVID-19. We’ve gathered a list of frequently asked questions and answered them below.

 
COVID-19 Vaccination for Children and Youth

It’s okay to have questions about the COVID-19 vaccine for children and youth. We want you to have the best information available when making a decision about your child's vaccination. Please download and read the Ontario Government’s resources below.

Can my child who is between the ages of 5 and 11 receive their seasonal influenza (flu) vaccine at the same time as their COVID-19 vaccine? If my child receives the pediatric COVID-19 vaccine (Pfizer-BioNTech Comirnaty 10mcg) for their first dose and the adolescent/adult COVID-19 vaccine (Pfizer-BioNTech Comirnaty 30mcg) for their second dose, will they be considered fully vaccinated?
Which COVID-19 vaccine will my child receive? What are exemptions from vaccinations for children and youth?
My child is 11 years old and will be 12 years old when they receive their second dose of COVID-19 vaccine. Which vaccine will they receive for their first dose? Can I get an exemption for COVID-19 vaccine for my child/youth?
Vaccinations
How many doses of COVID-19 vaccine should I get? What are breakthrough cases?
What does it mean to be a "fully vaccinated individual"? Why should I still get the COVID-19 vaccine if I can still get ill and pass COVID-19 to others?
I received an mRNA vaccine for my first dose. Will I get the same mRNA vaccine for my second dose? Can adults get exemptions for COVID-19 vaccination in the workplace?
Are mixed vaccine schedules safe and effective?

Who is responsible for creating and enforcing workplace policies for mandatory COVID-19 vaccine?

Is it okay to mix Moderna and Pfizer vaccines to complete my vaccine series?

My child is starting university. Can they get an exemption for the COVID-19 vaccine?

Where will my COVID-19 vaccine occur? How do I get a medical exemption from receiving the COVID-19 vaccine?
I've re-booked my vaccine appointment at a mass vaccination clinic or received my dose in a different setting (e.g. pharmacy). Do I need to cancel my original appointment at the mass vaccination clinic? Can the COVID-19 vaccine be administered at the same time as other vaccines?
How long should I wait to get a COVID-19 booster dose after having COVID-19? What is the recommended time interval between the COVID-19 vaccine and other vaccines?
I have already had COVID-19. Should I still get the COVID-19 vaccine? A business or public setting is requiring proof of vaccination. How do I obtain my proof of vaccination?
Is it safe to get the COVID-19 vaccine if I'm breastfeeding?  
Is it safe to get the COVID-19 vaccine if I'm pregnant or planning to pregnant?  
About COVID-19
What is a coronavirus? How soon after being exposed to COVID-19 would symptoms occur?
What is COVID-19? How is COVID-19 diagnosed?
What are the symptoms of COVID-19? Is there a treatment for COVID-19?
Can COVID-19 be spread from person-to-person? Is there a vaccine for COVID-19?
  What is a COVID-19 Variant of Concern (VOC)?
Preventing the Spread of COVID-19
What can members of the public do to prevent the spread of COVID-19? Can I wear a face shield instead of a face covering?
Where are face coverings required? Can I gather with other people?
What is a face covering? What is the COVID Alert mobile app?
How do I wear a mask?  
Testing
Where can I find information about COVID-19 testing in London and Middlesex County? Can I use a Rapid Antigen Test instead of getting a PCR test if I have COVID-19 symptoms or have been told that I am a close contact of a positive case?
How many COVID-19 PCR tests are completed each day in Middlesex-London? I have symptoms of COVID-19, took a Rapid Antigen Test, and the results were negative. Can I go to work/school?
I tested positive for, or had symptoms of,  COVID-19. Once I have completed my self-isolation period, do I need a negative COVID-19 test before returning to work and/or provide my employer with a letter when my isolation is over? What do I do if my employer requires one? I do not have COVID-19 symptoms but I have been informed that I am a close contact of a positive case. Can I use a Rapid Antigen Test to see if I have COVID-19?
I tested positive for COVID-19. If I get re-tested after my period of self-isolation, will I still test positive? If so, does that mean I’m still contagious?  
Self-Isolation and Quarantine
What does self-isolating mean? How do I report someone who is not quarantining after international travel?
When should I self-isolate? I tested positive for, or had symptoms of, COVID-19. Once I have completed my self-isolation period, do I need a negative COVID-19 test before returning to work and/or provide my employer with a letter when my isolation is over? What do I do if my employer requires one?
How long must I self-isolate? I tested positive for COVID-19. If I get re-tested after my period of self-isolation, will I still test positive? If so, does that mean I’m still contagious?
What does quarantining mean?  
When should I quarantine?  
Travel
I plan on travelling outside of Canada. What do I need to know? If I recently travelled outside of Canada, what should I do?
I plan on travelling outside of Ontario to another province or territory in Canada. What do I need to know? How do I report someone who is not quarantining after international travel?
Close Contacts
Someone who tested positive for COVID-19 has informed me that I am a close contact. What should I do? I think I may be a close contact of someone who tested positive for COVID-19 because I visited a facility or location where there was a case. What should I do?
I am a close contact of someone who is a close contact of someone who tested positive for COVID-19. What should I do?  
 

COVID-19 Vaccinations for Children and Youth

Can my child who is between the ages of 5 and 11 receive their seasonal influenza (flu) vaccine at the same time as their COVID-19 vaccine?

At this time, the National Advisory Committee on Immunization (NACI) recommends that children who are between the ages of 5 and 11 years old should wait to receive the COVID-19 vaccine until at least 14 days before or after any other vaccine, including the flu vaccine. This is a precautionary measure.

Read the National Advisory Committee on Immunization (NACI) recommendation and summary.


Which COVID-19 vaccine will my child receive?

Currently in Middlesex-London all children and youth between the ages of 5 and 17 will receive a formulation of the Pfizer-BioNTech Comirnaty COVID-19 vaccine.

Children who are between the ages of 5 and 11 years old will receive the pediatric formulation which is 10mcg. The child must be 5 years old or older on the day of their appointment in order to receive the vaccine.

Youth who are 12 years of age and older will receive the formulation authorized by Health Canada for adolescents and adults which is 30mcg.

Please note that the formulation an individual receives, whether the pediatric vaccine (10mcg) or the adolescent/adult vaccine (30mcg), is based upon the individual’s age, and not their size.


My child is 11 years old and will be 12 years old when they receive their second dose of COVID-19 vaccine. Which vaccine will they receive for their first dose?

With Health Canada’s approval of the Pfizer-BioNTech Comirnaty vaccine for children between the ages of 5 and 11, children who are 11 years old will now receive the pediatric Pfizer-BioNTech COVID-19 vaccine (10 mcg) instead of the Pfizer-BioNTech COVID-19 vaccine (30 mcg) authorized for adolescents and adults 12 years of age and older, even if they are turning 12 by the end of this year.

If a child is 12 years old at the time of their second dose of COVID-19 vaccine, they will receive the Pfizer-BioNTech Comirnaty COVID-19 vaccine (30 mcg) authorized for adolescents and adults 12 years of age and older.

Please note that the formulation an individual receives, whether the pediatric vaccine (10mcg) or the adolescent/adult vaccine (30mcg), is based upon the individual’s age, and not their size.

The Middlesex-London Health Unit recommends that everyone who is eligible to receive the COVID-19 vaccine do so soon after they become eligible. Children who are 11 years of age but will be turning 12 soon are not advised to wait until they are 12 in order to receive the vaccine authorized for adolescents and adults. The vaccine authorized for children 5 to 11 years of age is safe, effective, and shown to produce a good immune response, similar to the response seen in young adults 16 to 25 years of age who receive the adolescent/adult formulation of the vaccine.

Read the National Advisory Committee on Immunization (NACI) recommendation and summary.

For more information on the COVID-19 vaccine in children and youth, please visit: https://www.healthunit.com/covid-19-vaccine-children-and-youth


If my child receives the pediatric COVID-19 vaccine (Pfizer-BioNTech Comirnaty 10mcg) for their first dose and the adolescent/adult COVID-19 vaccine (Pfizer-BioNTech Comirnaty 30mcg) for their second dose, will they be considered fully vaccinated?

Yes. According to the National Advisory Committee on Immunization (NACI): “Children who receive the pediatric formulation of the Pfizer-BioNTech COVID-19 vaccine (10 mcg) for their first dose who turn 12 by the time of their second dose may receive the adolescent/adult formulation of the Pfizer-BioNTech COVID-19 vaccine (30 mcg) to complete their primary series. If a child who has turned 12 by the time of their second dose receives the pediatric formulation (10 mcg), their series should still be considered valid and complete.”


What are exemptions from vaccinations for children and youth?

In Ontario, children are required by law under the Child and Early Years Act, 2014 (children under 4 years old attending licensed childcare) and Immunization of School Pupils Act (those aged 4-17 attending school) to be up to date on certain vaccinations based on the Ontario publicly funded schedule in order to attend licensed childcare or school. If children cannot get their vaccinations either due to risk of serious illness or ideological reasons, parents can follow the exemption process available at: www.healthunit.com/immunization-record-review

At this time, the COVID-19 vaccine is not currently a required vaccine under the Child and Early Years Act, 2014 or Immunization of School Pupils Act. Students who are not immunized against COVID-19 do not require an exemption at this time.


Can I get an exemption for COVID-19 vaccine for my child/youth?

COVID-19 vaccines are not currently a required vaccine under the mandatory for school or daycare attendance under the Child and Early Years Act, 2014 or Immunization of School Pupils Act. Exemptions are required only for vaccines specified under these laws. If this information changes, it will be available on the Health Unit website.

 

Vaccinations

How many doses of COVID-19 vaccine should I get?

It is recommended that individuals stay up to date with their COVID-19 vaccine doses. This means receiving all recommended COVID-19 vaccine doses, including any booster dose(s) when eligible. Learn more →

The number of doses of COVID-19 vaccine you should get for the best protection against COVID-19 depends on a number of factors:

1) The COVID-19 vaccine you receive

Different COVID-19 vaccines require a different number of doses for you to receive a complete primary series. The most common vaccines approved for use in Canada require two doses for a complete primary series: Pfizer-BioNTech’s Comirnaty, Moderna’s Spikevax, and AstraZeneca. The Johnson & Johnson Janssen vaccine requires one dose.

Booster doses are now available for everyone 12 years of age or older in Ontario and second booster doses are available for anyone 60 years of age or older as well as for First Nation, Inuit & Métis individuals and their non-Indigenous household members aged 18 and over.  A booster dose is an additional dose to a completed primary series and is strongly recommended to maximize your immune response against the Omicron variant.

2) Health conditions and Vulnerable Populations

Individuals who are immunocompromised are recommended to receive three doses of COVID-19 vaccine to complete their primary series. Learn more about which health conditions are eligible.

Additionally, Individuals who live in high-risk settings and are vulnerable are also recommended to receive three doses of COVID-19 vaccine. These individuals include: residents of long-term care homes, retirement homes, and Elder care lodges and older adults living in other congregate settings (e.g. assisted-living facilities, chronic care hospitals, naturally occurring congregate retirement settings, congregate senior’s apartment buildings, congregate settings for people with developmental disabilities, mental health and addictions issues, etc.).

Booster doses are now available for these individuals, which would be a fourth dose.


What does it mean to be a "fully vaccinated individual"?

It is recommended that individuals stay up to date with their COVID-19 vaccine doses. This means receiving all recommended COVID-19 vaccine doses, including any booster dose(s) when eligible. Learn more → 

There are some settings, policies, legislation, directives, and orders which may still require you to be "fully vaccinated".  In these instances, in order to be considered "fully vaccinated" in Ontario 14 days must have passed after an individual has received either:

  • the second dose of a COVID-19 vaccine which requires two doses to be considered a "complete vaccine series"; or
    • Two-dose vaccines include: Pfizer-BioNTech Comirnaty, Moderna Spikevax, and AstraZeneca
      • With vaccine interchangeability, a complete vaccine series can consist of a different COVID-19 vaccine for the first dose than for the second dose. For example, receiving Pfizer for a first dose and Moderna for the second dose is considered a "complete vaccine series."
  • the first dose of a COVID-19 vaccine which requires a single dose to be considered a "complete vaccine series"; or
    • Janssen (Johnson and Johnson) is the only COVID-19 vaccine approved by Health Canada for use in Canada that requires a single dose.
  • One or two doses of a COVID-19 vaccine not authorized by Health Canada, followed by one dose of a COVID-19 mRNA vaccine authorized by Health Canada (i.e. Pfizer or Moderna); or
  • Three doses of a COVID-19 vaccine not authorized by Health Canada

Learn more →


I received an mRNA vaccine for my first dose. Will I get the same mRNA vaccine for my second dose?

The National Advisory Committee on Immunization (NACI) has determined that the mRNA vaccines (Pfizer and Moderna) are interchangeable. This means that receiving a different mRNA COVID-19 vaccine for your second or booster/third dose than for your first dose is safe and effective for protecting against COVID-19.

If supply allows, and the mass vaccination clinic you attend has the same vaccine as your previous dose(s) available, you will be able to receive the same vaccine for your next dose.


Are mixed vaccine schedules safe and effective?

Receiving an mRNA vaccine (Pfizer-BioNTech or Moderna) after receiving AstraZeneca for your first dose
The National Advisory Committee on Immunization (NACI) now recommends that “an mRNA vaccine is now preferred as the second dose for individuals who received a first dose of the AstraZeneca/COVISHIELD vaccine.” This is based upon studies that suggest a better immune response, including against variants of concern, when the mRNA Pfizer-BioNTech vaccine is provided as the second shot. Since the Pfizer and Moderna vaccines are considered interchangeable, the second dose can also be of Moderna. Furthermore, evidence continues to support this mixed vaccine schedule is safe.

Receiving different mRNA vaccines for your doses
The practice of mixing similar vaccines from different manufacturers for different doses (known as a heterologous vaccine schedule) is not new, is used when vaccine supply or programs change, and is consistent with the guidance of the National Advisory Committee on Immunization (NACI).

Basic foundational vaccine principles inform that similar vaccines from different manufacturers are interchangeable when they:

  • are authorized for the same purpose
  • are authorized for the same populations
  • have similar schedules
  • have similar, or produce similar, types of antigens
  • have similar vaccine safety profiles
  • provide similar immune response and protection

Pfizer and Moderna meet all these criteria and are essentially the same vaccine, just produced by a different manufacturer. Therefore, there is no reason to believe that mixing mRNA COVID-19 vaccines will result in any decrease in safety or immune response. Due to this, NACI has declared the two mRNA vaccines to be interchangeable. Results from ongoing studies, including Canadian data, is also closely monitored by NACI to ensure ongoing safety and to make any updated recommendations.

More Information


Is it okay to mix Moderna and Pfizer vaccine to complete my vaccine series?

Yes. Pfizer and Moderna are essentially different brands of the same vaccine, and you will have the same protection against COVID-19 regardless of what you get for your first or second dose.

The interchangeability of mRNA vaccines has been supported by experts at both the Public Health Agency of Canada and the National Advisory Committee on Immunization. Interchangeability means that you can receive either the Pfizer or Moderna mRNA vaccine as your second dose, regardless of the type of vaccine you received for your first dose. Learn more →


Where will my COVID-19 vaccine occur?

Vaccinations are delivered in London and Middlesex County in three ways:

Mobile / Pop-Up Clinics 

Pop-up Vaccination Clinics are being held around London and Middlesex County by the Middlesex-London Health Unit.
See the schedule →

Vaccination Clinics

For clinic information, including dates, times, and locations click here.

Pharmacies

For a list of participating pharmacies, please visit: COVID-19 pharmacy vaccine locations. Book directly through the pharmacy, either through calling them or using their online booking system, if available.


I've re-booked my vaccine appointment at a mass vaccination clinic or received my dose in a different setting (e.g. pharmacy). Do I need to cancel my original appointment at the mass vaccination clinic?

Yes, it is very important that you cancel your original second-dose appointment so that your appointment time can be given to someone else.

To cancel a COVID-19 vaccine appointment call 226-289-3560 (9:00 a.m. to 5:00 p.m., Monday to Friday)


How long should I wait to get a COVID-19 booster dose after having COVID-19?

People for whom a booster dose of vaccine is recommended, and who experienced a COVID-19 infection after a primary series, may receive a booster dose three months (90 days) after their symptoms started, or after testing positive.


I have already had COVID-19. Should I still get the COVID-19 vaccine?

Yes, even if you’ve already had and recovered from COVID-19, it is still important for you to get a complete COVID-19 vaccine series, regardless of how severe your illness was. With the emergence of COVID-19 variants it isn’t clear whether having already had COVID-19 will provide adequate immunity against future infections. What we know is that having a complete COVID-19 vaccine series provides excellent protection against the novel coronavirus and its variants.


Is is safe to get the COVID-19 vaccine if I'm breastfeeding?

Yes. There is no risk of the virus being transmitted through breast milk as none of the COVID-19 vaccines contain any live virus. The vaccine will help a mother to build antibodies that can be passed through breast milk to the baby to help protect them against COVID-19.

For more information, check out the Ministry of Health's Vaccination in Pregnancy & Breastfeeding Patient Decision-Making Tool or speak with your primary care provider.


Is it safe to get the COVID-19 vaccine if I'm pregnant or planning to get pregnant?

Yes, it is safe to get the COVID-19 vaccine if you're pregnant or planning a pregnancy. It is recommended that pregnant individuals (in any stage of their pregnancy) be vaccinated as soon as possible.

For more information, check out the Ministry of Health's Vaccination in Pregnancy & Breastfeeding Patient Decision-Making Tool or speak with your primary care provider.


What are breakthrough cases?

A breakthrough case of COVID-19 is someone who gets COVID-19 even though they have been fully vaccinated. As the case counts of COVID-19 increase, it is expected that more breakthrough cases will occur. Individuals who are considered breakthrough cases become less sick than individuals with COVID-19 who were not vaccinated, and are much less likely to require hospitalization or die. Therefore, getting vaccinated is still very important to protect yourself and others from severe illness.


Why should I still get the COVID-19 vaccine if I can still get ill and pass COVID-19 to others?

Although not perfect, the COVID-19 vaccine still reduces the chance you will get COVID-19, and will dramatically reduce the chance that you will require hospitalization or die from COVID-19. The vaccine is the single most effective way to protect yourself and those around you.


Can adults get exemptions for COVID-19 vaccination in the workplace?

The Middlesex-London Health Unit cannot provide COVID-19 vaccination exemptions. Employees should speak with their employer and/or primary care provider as individual institutions or employers/workplaces may have policies related to mandatory vaccinations.


Who is responsible for creating and enforcing workplace policies for mandatory COVID-19 vaccine?

It is up to the workplace to set and enforce COVID-19 vaccine-related policies. The Middlesex-London Health Unit can provide guidance to workplaces in creating and implementing those policies, but the Health Unit is not responsible for mandating or enforcing these policies. As such, the Middlesex-London Health Unit does not change or override employers’ policies.

For more information on developing a Mandatory COVID-19 Vaccination Policies, visit: www.healthunit.com/mandatory-covid-19-vaccination-policies


My child is starting university/college. Can they get an exemption for the COVID-19 vaccine?

Policies related to COVID-19 vaccinations set out by institutions, such as universities or colleges, are created and enforced by the institution itself. Universities dictate their COVID-19 policies and the Middlesex-London Health Unit does not overturn or provide exclusions to those policies. If a student has concerns about the COVID-19 vaccination, they should speak with their institution’s student health services and/or their primary care provider.


How do I get a medical exemption from receiving the COVID-19 vaccine?

If you are eligible for a medical exemption, please contact your health care provider.

Please note: A medical exemption must be complete and supplied by a physician (designated as "MD") or by a registered nurse in the extended class (designated as "Registered Nurse (Extended Class)", "RN(EC)", "Nurse Practitioner" or "NP").


Can the COVID-19 vaccine be administered at the same time as other vaccines?

Yes, the COVID-19 vaccine may be administered at the same time as, or any time before or after, any other vaccines, including the influenza (flu) vaccine for individuals 12 years of age or older.

Children who are between the ages of 5 and 11 years old should wait 14 days before or after receiving any other vaccines to receive their COVID-19 vaccine.


What is the recommended time interval between the COVID-19 vaccine and other vaccines?

The COVID-19 vaccine may be administered at the same time as, or any time before or after, any other vaccines, including the influenza (flu) vaccine for individual 12 years of age or older.

Children who are between the ages of 5 and 11 years old should wait 14 days before or after receiving any other vaccines to receive their COVID-19 vaccine.


A business or public setting is requiring proof of vaccination. How do I obtain my proof of vaccination?

Effective March 1, 2022, the Provincial Government has lifted proof of vaccination requirements in all settings. Businesses and other settings may choose to continue to require proof of vaccination. Proof of vaccination can be downloaded from the Provincial Government by visiting covid-19.ontario.ca/get-proof.

 

About COVID-19

What is a coronavirus?

Coronaviruses make up a large family of viruses that circulate in both humans and other animals. Human coronaviruses are common and are usually associated with mild illness, similar to the common cold, and can spread easily between people. There are some coronaviruses that have spread from animals to humans, which have caused more severe illness in humans, such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS).

The risk of developing severe disease from the 2019 novel coronavirus may be higher if you have a weakened immune system. This may be the case for:

  • older people, and
  • anyone with chronic disease such as diabetes, cancer, heart, renal or chronic lung disease.

What is COVID-19?

On December 31, 2019, health authorities in China identified a new (or novel) coronavirus (referred to as 2019-nCoV), after several reported cases of pneumonia in Wuhan, China. On February 11th, 2020, the World Health Organization (WHO) officially named the new illness COVID-19, where COVI stands for coronavirus, D stands for disease and 19 represents 2019, the year it was first identified in people.

It is believed that COVID-19 originated in another animal. It is the seventh strain of coronavirus.


What are the symptoms of COVID-19?

If you are a student or staff member screening for symptoms prior to going to school or child care, please complete the COVID-19 School and Child Care Screening Tool

If you are not a student or staff member of a school or child care setting and you think you have symptoms of COVID-19, take the COVID-19 self-assessment to help determine next steps.

For full symptom details, please review: COVID-19 Reference Document for Symptoms

Symptoms of COVID-19

Most Common Symptoms of COVID-19 that Require Immediate Self-isolation and, If Eligible, COVID-19 Testing

Fever (temperature of 37.8°C/100.0°F or greater)

Chills

Cough that's new or worsening (e.g. continuous, more than usual if chronic cough)

Not related to other known causes or conditions for which current symptoms do not represent a flare-up/exacerbation related to infection (e.g. COPD)

Barking Cough, making a whistling noise when breathing (Croup)

Not related to other known causes or conditions

Shortness of breath (dyspnea, out of breath, unable to breathe deeply)

Not related to other known causes or conditions (e.g. asthma)

Decrease or loss of smell or taste (new olfactory or taste disorder)

Not related to other known causes of conditions (e.g. seasonal allergies, neurological disorders)

Two or More of the Following Symptoms of COVID-19 Require Immediate Self-Isolation and, if Eligible, COVID-19 Testing

Muscle aches or joint painthat are unusual or long lasting

Not related to other known causes or conditions (e.g. sudden injury, fibromyalgia)

Extreme tiredness, lethagry, or malaise that is unusual (Fatigue, lack of energy, generally feeling unwell)

Not related to other known causes or conditions (e.g. depression, insomnia, thyroid dysfunction)

Nausea/vomiting/diarrhea
Not related to other known causes or conditions 

Sore throat (painful / difficulty swallowing)
Not related to other known causes or conditions 

Runny nose
Not related to other known causes or conditions (e.g. returning inside from the cold)

Stuffy nose
Not related to other known causes or conditions (e.g. seasonal allergies)

Headache that is new and persistent, unusual, unexplained, or long-lasting
Not related to other konwn causes or conditions (e.g. tension-type headaches, chronic migraines)

Other Symptoms That May Be Associated with COVID-19 and Should Be Monitored

Abdominal pain that is persistent or ongoing
Not related to other known causes or conditions (e.g. menstrual cramps, GERD)

Pink eye
Not related to other known causes or conditions

Decreased or lack of appetite
For young children and not related to other known causes or conditions

Anyone with severe respiratory illness, or a medical emergency should call 9-1-1 immediately. Advise them of your symptoms.

Signs of severe respiratory illness include:

  • Severe difficulty breathing (struggling for each breath, can only speak in single words)
  • Severe chest pain (constant tightness or crushing sensation)
  • Feeling confused or unsure of where you are
  • Losing consciousness

Can COVID-19 be spread from person-to-person?

Coronaviruses can spread when the droplets due to cough or a sneeze from an infected person are breathed in deeply by anyone who is in close proximity to the infected person; similar to how the flu and other respiratory illnesses are spread.

There is evidence of human-to-human transmission of this virus; and while some viruses are highly contagious, other viruses are less so. It’s not yet clear how easily COVID-19 spreads from person-to-person.


How soon after being exposed to COVID-19 would symptoms occur?

The World Health Organization advises that symptoms may appear in as few as two days, or as long as 10 to 14 days, after being exposed to someone with COVID-19. This time period is subject to change and may be updated as new information becomes available.


How is COVID-19 diagnosed?

Coronavirus infections are diagnosed based on laboratory tests performed by healthcare providers. Testing typically involves taking a swab of a person's nose.

If you think you might have COVID-19, visit London's COVID-19 Assessment Centres for more information on next steps.


Is there a treatment for COVID-19?

The oral antiviral Paxlovid has been approved by Health Canada for treatment of COVID-19. Learn more →


Is there a vaccine for COVID-19?

Multiple COVID-19 vaccines have been approved for use in Canada. For a complete list, please visit www.canada.ca.

Please note: not all approved vaccines are available in London and Middlesex County.  


What is a COVID-19 Variant of Concern (VOC)?

Generally-speaking, viruses mutate over time. This can result in different variants, or strains, of the virus. This may affect how easily it is passed from one person to another, its severity and symptoms, and how it responds to prevention strategies, treatment and vaccines.

SARS-CoV-2, the virus which causes COVID-19, has been found to be mutating and several strains have been detected. Some of these appear to spread more easily between people. These new strains of the virus are called variants of concern, or VOCs, and starting May, 2021 are labelled using letters of the Greek alphabet (alpha, beta, gamma, etc.).

Research into these variants of concern is ongoing. We continue to learn more about how easily they spread, the severity of illness they can cause, whether they may lead to increased hospitalizations, and how effective current vaccines are against them.

The latest variant of concern is labelled “Omicron” and was first identified on November 9, 2021 and designated a variant of concern by the World Health Organization on November 26, 2021. Research is ongoing into the Omicron variant, including how easily it spreads, the severity of illness it can cause, and the effectiveness of the vaccines against it. What is known is it carries the highest number of novel mutations compared to other VOCs.


What can members of the public do to prevent the spread of COVID-19?

  • Get vaccinated if you are 5 years of age or older. Learn more about how to get vaccinated 
  • Wear a mask / face covering in all indoor public spaces, such as businesses, facilities and workplaces, and anywhere else where physical distancing cannot be maintained
  • Self-isolate if you have any symptoms of COVID-19, even mild. Use the Self-Assessment Tool to determine if you should self-isolate.
  • Get tested, if eligible.
  • Wash your hands frequently with soap and water for at least 15-20 seconds or use a waterless hand sanitizer with at least 60 percent alcohol content
  • Cover coughs and/or sneezes with your sleeve or cough into your elbow
  • Clean and disinfect high-touch areas frequently

Where are face coverings required?

Effective Monday, March 21, 2022, face coverings are required in select high-risk settings, including:

  • public transit
  • healthcare settings
  • long-term care homes
  • congregate care settings.

For a complete list of settings and exceptions to masking requirements that may apply, click here.


What is a face covering?

A face covering can be a non-medical mask, medical mask, or a respirator. A respirator worn in the community doesn’t need to formally fit tested as is required in some occupational settings. Learn more →

Non-medical masks can be purchased or home-made and are typically made out of breathable fabric. The effectiveness of non-medical masks in preventing the spread of COVID-19 can vary based on many factors like material, construction, fit and proper use.

Some non-medical masks can help prevent the spread of COVID-19 similarly to medical masks if they:

  • fit securely to the head with ties or ear loops
  • have multiple layers, including at least 2 layers of breathable tightly woven fabric, such as cotton AND have an effective middle filter layer
  • maintain their shape after washing and drying
  • are large enough to completely and comfortably cover the nose and mouth without gaping
  • are comfortable and do not require frequent adjustments

In general, while non-medical masks can help prevent the spread of COVID-19, medical masks and respirators provide better protection. No matter which type of mask you choose, proper fit is a key factor in its effectiveness. Learn more →

NOTE: Face shields do not replace face coverings. Face shields may provide an additional layer of protection, but they should not be used in place of face coverings.


How do I wear a mask?

Make sure to properly wear, fit, remove, and clean or discard your mask / face covering. For more details, please visit www.canada.ca.


Can I wear a face shield instead of a face covering?

Face shields do not replace face coverings. Face shields may provide an additional layer of protection, but they should not be used in place of face coverings.

Face coverings, like cloth masks, must fit securely to the head and be large enough to completely and comfortably cover the mouth, nose and chin without gapping. Learn more →


Can I gather with other people?

Effective March 1, 2022 there are no limits on social gatherings.


What is the COVID Alert mobile app?

Please note: the COVID Alert mobile app is now retired. If you had the app downloaded, it can now be deleted. For instructions, please visit here.

 

Testing

Where can I find information about COVID-19 testing in London and Middlesex County?

For information about COVID-19 PCR and Rapid Antigen Testing in London and Middlesex County visit: www.healthunit.com/covid-19-concerns.


How many COVID-19 PCR tests are completed each day in Middlesex-London?

For a daily update of the number of people seen at the London Assessment Centres, please see Summary of COVID-19 Cases in Middlesex-London and click on the "Testing" tab. These numbers do not include tests completed by others in the health care sector including hospitals, long-term care homes, and emergency medical personnel.


I tested positive for, or had symptoms of, COVID-19. Once I have completed my self-isolation period, do I need a negative COVID-19 test before returning to work and/or provide my employer with a letter when my isolation is over? What do I do if my employer requires one?

Clearance tests (i.e. a negative COVID-19 test) are not required to return to work once an individual who has COVID-19 has completed their period of self-isolation. Once an individual’s self-isolation period is complete, they are able to leave self-isolation and resume their normal daily tasks as long as they do not have a fever and their symptoms have been improving for at least 24 hours. Learn more about requirements for quarantining and self-isolation.

Employers are also encouraged to not require a letter from employees confirming they have completed their self-isolation period. The Middlesex-London Health Unit will not provide such a letter.


I tested positive for COVID-19. If I get re-tested after my period of self-isolation, will I still test positive? If so, does that mean I’m still contagious?

The self-isolation period for COVID-19 is based on the longest estimate of how long a person is contagious. Once a person completes their period of self-isolation they are no longer considered contagious. They may, however, continue to test positive for COVID-19 after their period of self-isolation. Public health will determine whether or not the positive test is an indication of a new infection and next steps.


Can I use a Rapid Antigen Test instead of getting a PCR test if I have COVID-19 symptoms or have been told that I am a close contact of a positive case?

For information on different testing options, visit www.healthunit.com/covid-19-concerns.


I have symptoms of COVID-19, took a Rapid Antigen Test, and the results were negative. Can I go to work/school? 

No, if you have symptoms of COVID-19 you should presume you have COVID-19 and follow the self-isolation requirements for individuals with COVID-19.

If you test negative on two subsequent rapid antigen tests within 24 to 48 hours of each other, it is unlikely that your symptoms are caused by COVID-19, in which case, you should self-isolate until your symptoms have improved for 24 hours (48 hours if your symptoms are gastrointestinal).


I do not have COVID-19 symptoms but I have been informed that I am a close contact of a positive case. Can I use a Rapid Antigen Test to see if I have COVID-19? 

No, if you have been informed that you are a close contact of someone who has tested positive for COVID-19, or you believe you may have been exposed to COVID-19, and you do not live with the individual with COVID-19, you should follow the requirements for close contacts

If you live with the individual who has tested positive for COVID-19 or who has COVID-19-like symptoms, follow the self-isolation requirements that apply to you.

 

Self-Isolation and Quarantine

What does self-isolating mean?

Self-isolation separates sick individuals with a contagious disease, like COVID-19, from people who are not sick to prevent the disease from spreading.

Self-isolation requires an individual to:

  • stay home, unless you need to get tested or require emergency medical care
    • do not use public transportation, taxis, or rideshares
  • avoid contact with others
    • do not have visitors unless they are essential 
    • stay in a separate room from others in your home, as much as possible, make sure shared rooms have good airflow, and use a separate bathroom if you have one
  • maintain physical distance
    • keep at least two metres distance and wear a mask if you are in a room with anyone else
    • others in a room with you should also wear a mask

Learn more →


When should I self-isolate?

You should self-isolate if:

  • you develop COVID-19-like symptoms.
  • you are contacted by the Health Unit and told to self-isolate
  • you receive a notification from the COVID Alert mobile app and the app advises you to self-isolate
  • you have been tested for COVID-19 and are waiting for results
  • you have tested positive for COVID-19 on either a PCR test or a Rapid Antigen Test (RAT)
  • you live with someone who has tested positive for COVID-19 or has COVID-19-like symptoms and you are unvaccinated or partially vaccinated.

Learn more →


For how long must I self-isolate? 

For information about how long your self-isolation period should last, please visit Self-Isolation Requirements


What does quarantining mean?

Quarantine separates and restricts the movement of people who do not have symptoms, but were exposed to a contagious disease, like COVID-19, to see if they develop symptoms. It is an important step to prevent the spread.

Quarantining requires an individual to:

  • stay home, unless you need to get tested or require emergency medical care
    • do not use public transportation, taxis, or rideshares
  • avoid contact with others
    • do not have visitors, even if you are outdoors
    • avoid contact with others in your household
  • maintain physical distance
    • keep at least two metres distance and wear a mask if you are in a room with anyone else
    • others in a room with you should also wear a mask
  • if staying in a hotel, do not use shared spaces such as lobbies, courtyards, restaurants, gyms or pools
  • avoid quarantining at home if you cannot separate from those living with you (e.g. a communal living setting, student dormitory with shared common spaces, shared small apartment, etc.)
  • monitor yourself for symptoms
    • take and record your temperature daily

When should I quarantine?

You must quarantine for 14 days if:


How do I report someone who is not quarantining after international travel?

All travellers returning from outside Canada must quarantine for 14 days under a quarantine order from the Public Health Agency of Canada, unless they meet exemption criteria due to vaccination status or other exemption criteria. The federal government enforces this by following up and conducting spot checks to verify compliance.

To report non-compliance, contact local police. For London Police, the non-emergency phone number is 519-661-5670 or use the online reporting system. In Middlesex County, call the OPP non-emergency line at 1-888-310-1122 or submit a report at opp.ca/reporting.


I tested positive for, or had symptoms of, COVID-19. Once I have completed my self-isolation period, do I need a negative COVID-19 test before returning to work and/or provide my employer with a letter when my isolation is over? What do I do if my employer requires one?

Clearance tests (i.e. a negative COVID-19 test) are not required to return to work once an individual who has COVID-19 has completed their period of self-isolation. Once an individual’s self-isolation period is complete, they are able to leave self-isolation and resume their normal daily tasks as long as they do not have a fever and their symptoms have been improving for at least 24 hours. Learn more about requirements for quarantining and self-isolation.

Employers are also encouraged to not require a letter from employees confirming they have completed their self-isolation period. The Middlesex-London Health Unit will not provide such a letter.


I tested positive for COVID-19. If I get re-tested after my period of self-isolation, will I still test positive? If so, does that mean I’m still contagious?

The self-isolation period for COVID-19 is based on the longest estimate of how long a person is contagious. Once a person completes their period of self-isolation they are no longer considered contagious. They may, however, continue to test positive for COVID-19 after their period of self-isolation. Public health will determine whether or not the positive test is an indication of a new infection and next steps.

 

Travel

I plan on travelling outside of Canada. What do I need to know?

Other countries may require proof of a negative laboratory test result for COVID-19 prior to travelling there. Effective Friday, January 15, London's COVID-19 Assessment Centres will no longer be conducting tests for international travelling purposes. This is in compliance with a change in testing criteria from the Province of Ontario.  Individuals requiring testing for international travel clearance should consult their travel carrier for the most up-to-date information. For information on accessing a COVID-19 test in Middlesex-London for the purposes of international travel, visit: covidtestinglm.ca/london-locations-covid-19-testing-for-international-travel/.

Other countries may require proof of vaccination prior to entering.  It is important to note that each country decides what proof of vaccination is required, what types of vaccines they accept, and what number of doses they require.  You could be considered fully vaccinated in Canada, but not considered fully vaccinated in another country.  Always check the requirements of your destination country before travelling.

For information about travel requirements for entering Canada, please visit: COVID-19: Entering Canada requirements checklist.

For information about travel restrictions, exemptions, and advice visit: travel.gc.ca/travel-covid.

Effective June 20, 2022, federal travel requirements will be changing. Learn more →


I plan on travelling outside of Ontario to another province or territory in Canada. What do I need to know?

Some provinces and territories may have additional travel restrictions, for example, prohibiting non-essential travel into the province, limiting access to certain regions within the province, or mandatory quarantines. Please refer to the list of provincial and territorial websites for more information.

Effective June 20, 2022, federal travel requirements on domestic planes, trains, and ships will be changing. Learn more →


If I recently travelled outside of Canada, what should I do?

On March 25, 2020, the Government of Canada announced an Emergency Order under the Quarantine Act which requires people entering Canada to quarantine for 14 days and take a COVID-19 PCR test on day 8 of their return. If, while in quarantine symptoms develop, you must self-isolate and get tested for COVID-19.

Some travel restrictions, incuding mandatory 14-day quarantine, are eased for individuals who are fully vaccinated and entering Canada. Learn more →

For more details, see Coronavirus disease (COVID-19): Travel restrictions, exemptions and advice from the Government of Canada.


How do I report someone who is not quarantining after international travel?

All travellers returning from outside of Canada must quarantine for 14 days under a quarantine order from the Public Health Agency of Canada, unless they meet exemption criteria due to vaccination status or other exemption criteria. The federal government enforces this by following up and conducting spot checks to verify compliance.

To report non-compliance, contact local police. For London Police, the non-emergency phone number is 519-661-5670 or use the online reporting system. In Middlesex County, call the OPP non-emergency line at 1-888-310-1122 or submit a report at opp.ca/reporting.

 

Close Contacts

Someone who tested positive for COVID-19 has informed me that I am a close contact. What should I do?

Learn more about the requirements for close contacts →


I am a close contact of someone who is a close contact of someone who tested positive for COVID-19. What should I do?

If you do not have symptoms of COVID-19:

  • If you do not live in the same household as someone who has tested positive for COVID-19 or who has COVID-19-like symptoms, you do not need to self-isolate. Monitor yourself for symptoms and if symptoms develop, self-isolate immediately, presume you have COVID-19, and follow the self-isolation requirements for individuals with COVID-19.

If you have symptoms of COVID-19:


I think I may be a close contact of someone who tested positive for COVID-19 because I visited a facility or location where there was a case. What should I do?

If you do not have symptoms of COVID-19:

If you have symptoms of COVID-19:


 
Date of creation: January 27, 2020
Last modified on: June 17, 2022