Message from the Deputy Premier and Minister of Health

COVID-19 has had a significant impact on everyone. During these unprecedented times our government has made the health, safety and wellbeing of Ontarians our top priority as we navigate through the evolving pandemic situation.

Throughout the summer, our government has been working hard to ensure Ontario has the necessary resources in place to build the capacity we need to be ready for a second wave of COVID-19 and the upcoming flu season.

Ontario’s Keeping Ontarians Safe: Preparing for Future Waves of COVID-19 is a comprehensive plan to ensure our province is prepared.It sets out a series of steps to prevent, identify and respond to any outbreak scenario.

Our partners across the health sector have demonstrated remarkable responsiveness to the COVID-19 outbreak. They’ve done so by simplifying the purchase of personal protective equipment, supporting the staffing of long-term care homes and assessment centers, expanding virtual care options, and by breaking down long-standing barriers to achieve better connected care, both in support of patients and our brave frontline heroes. The compassion, commitment and dedication from frontline health care workers is truly admirable and the appreciation for their heroic efforts is shared amongst all Ontarians.

Building on lessons learned from the first wave of COVID-19, Ontario’s fall preparedness plan was developed in collaboration with our health care partners to ensure our actions and resources directly supports their needs to keep Ontarians safe. This includes:

  • Maintaining public health measures
  • Implementing the largest flu immunization campaign in Ontario’s history
  • Identifying, managing and preventing outbreaks quickly
  • Reducing health service backlogs safely
  • Preparing for any surges in COVID-19 cases
  • Recruiting, retaining, training and supporting health care workers, while also continuing to engage families and caregivers

Our government will continue to work with all of our partners to protect the people of Ontario in our fight against COVID-19. Together, we will defeat this virus.

Sincerely,
Christine Elliott Deputy Premier and Minister of Health

Fall preparedness plan for health, long-term care and education keeping Ontarians safe: preparing for future waves of COVID-19

The province’s top priority has been and will always be protecting the health and well-being of all Ontarians.

Ontario’s swift and decisive response, including being one of the first provinces in Canada to declare a state of emergency, helped to quickly flatten the epidemic curve. The vast majority of Ontarians have been key to this progress by diligently following public health measures to limit the spread of this virus.

From the outset of the pandemic, the actions taken to enable the health system to respond quickly and effectively to COVID-19 have made a big difference in reducing the transmission of COVID-19 and in the treatment of those who were ill. Among the difficult, but necessary actions taken to protect the health of Ontario residents were enacting emergency orders to reduce the size of public gatherings, close schools and non-essential businesses temporarily, and restrict the movement of health care workers to no more than one congregate setting.

Other critical actions in the fight against COVID-19 included:

  • Significantly expanding testing and contact tracing capacity
  • Establishing over 150 assessment centres province wide
  • Ramping up domestic production of personal protective equipment
  • Launching a massive public awareness campaign to inform the public about the measures they could take to protect themselves and their loved ones
  • Giving health care organizations the hiring and staffing flexibility they need to address surges in cases
  • Implementing the COVID-19 Action Plan for Protecting Long-Term Care Homes to protect the province’s most vulnerable seniors and those who care for them
  • Delivering the COVID-19 Action Plan for Vulnerable People to better protect those living in high-risk settings including shelters and other congregate settings
  • Providing free local child care to frontline and essential workers during the initial period of the crisis
  • Developing over 180 workplace safety and public health guidance documents to help essential businesses operate safely and help other businesses safely reopen
  • Removing Ontario Health Insurance Plan (OHIP) limitations to ensure that everyone has access to essential health services
  • Launching the collection of race-based data to help Ontario understand how COVID-19 is affecting different communities
  • Adapting funding models to support virtual delivery of more health care services

The province was able to gradually and safely reopen businesses, services and public spaces, and reunite residents in care settings with their loved ones. However, as recent case numbers in Ontario and across Canada have shown, the province’s fight with COVID-19 is far from over. Across the country and in Ontario, many regions are entering the early stages of a second wave of COVID-19.

To ensure preparedness for this and future surges and waves of COVID-19, Ontario has developed a comprehensive plan to prepare our health care system for the challenges of the fall, including additional pressures for flu season, the need to clear the backlog in surgeries and procedures, and continuing to ensure all Ontarians have access to quality care when and where they need it. The first wave of COVID-19 has further exposed the inherited challenges the province is facing, including hallway health care, ongoing staffing shortages, and insufficient case and contact management preparedness.

Overcoming these challenges and fortifying the front lines of our health care system has been and continues to be a top priority for the province at this critical juncture. The plan was developed throughout the summer in consultation with the Chief Medical Officer of Health and health experts, and the government is already taking action to address the next wave of the virus.

With an investment of $2.8 billion, this comprehensive and evidence-based plan focuses on preventing illness and protecting communities by identifying six key areas of focus:

  1. Maintaining public health measures
  2. Implementing the largest flu immunization campaign in Ontario’s history
  3. Identifying, managing and preventing outbreaks quickly
  4. Reducing health service backlogs safely
  5. Preparing for any surges in COVID-19 cases
  6. Recruiting, retaining, training and supporting health care workers, while also continuing to engage families and caregivers

The province released the COVID-19: Long-term care preparedness (PDF) which includes nearly $540 million in long-term care investments to prepare long-term care homes for a second wave of COVID-19. Ontario’s investments in long-term care will help homes enhance infection prevention and containment, support adequate staffing, manage operating costs related to COVID-19, and help people on the long-term care waitlist stay in their own homes longer through an innovative community paramedicine pilot program in development.

Responding to new challenges

Heading into the fall, Ontario’s health system is facing a number of challenges that were not present at the time of the initial COVID-19 outbreak:

  • Flu season – The fall flu and cold season will increase demands and pressures on the health care system while also leading more patients to seek testing.
  • Health service backlogs – The COVID-19 outbreak resulted in the tough but necessary decision to suspend surgeries, diagnostic imaging scans and other routine health services.
  • Overcrowding – There are growing hospital and emergency department volumes as health services resume; this is exacerbated by infection prevention and control recommendations that reduce the use of shared accommodation to maintain distancing between patients.
  • Reduced long-term care capacity – To ensure infection prevention and control, there has been a reduction in shared accommodations in long-term care homes, which leads to more people remaining in both the community and hospital beds while awaiting transfer to long-term care homes.
  • Health human resources shortages – COVID-19 exasperated an already difficult situation. Our frontline health care providers were already stretched prior to COVID-19 and the ability to attract and train new health care providers in various sectors has been challenging. There is a need to expand the workforce so there are appropriate health care staffing levels in the right places, such as in home and community care and in other community settings especially long-term care.

Scenarios for the next wave

The Ministry of Health, working with epidemiological experts, scientific advisors and information from the Public Health Agency of Canada, has developed scenarios for what COVID-19 levels could look like this fall. Keeping Ontarians Safe enables Ontario to have sufficient public health and health care capacity to respond to each of these scenarios.

These possible scenarios use scientific modelling to help estimate how an infectious disease might take place. This does not predict what will happen but helps explain what may happen in certain situations.

Slow burn

Smaller second wave; a few localized outbreaks that are quickly contained.

Peaks and valleys

Moderate second wave; some areas with little impact while others with localized outbreaks; infections in congregate settings.

Fall peak

Large second wave that targets health care systems in areas with high population density; regional and local outbreaks that are hard to contain; severe outbreaks in congregate settings.

As we have already seen, with a resurgence of COVID-19, either locally or provincewide, targeted action may be taken to adjust or tighten public health measures. Data that will be considered when making these decisions include case counts and rates, the number and type of outbreaks, hospitalizations and admissions to intensive care units, the public health sector’s capacity to conduct rapid case and contact management, health system and testing capacity, and consultation with local medical officers of health.

The public health measures implemented would be as targeted as possible and would depend on the situation, such as whether it is individual outbreaks in institutions or workplaces, multiple outbreaks in identifiable settings or widespread community transmission. The return to an earlier stage of provincial reopening, or even regional approaches to tightening would be avoided in favour of organization-specific or localized changes. For example, a specific workplace or organization could be closed for a period of time or have additional public health measures or restrictions applied, or a certain type of higher-risk business in a local area might be closed until trends in public health indicators improve. However, if province-wide measures must be taken to protect the health of Ontarians, the provincial government, in consultation with health officials, will not hesitate to take action.

For schools, the government has made $1.3 billion in resources available to school boards to support the safe return of students, teachers, and education staff to classrooms this fall.

For early years and child care, the province is investing over $234.6 million to help safely reopen child care and EarlyON centres through support from the federal Safe Restart Agreement. This is in addition to provincial and federal funding that has ensured the sustainability of the child care sector and is supporting the safe reopening of centres across Ontario. Together, these significant investments will help child care operators, EarlyON Child and Family Centres, and First Nations Child and Family Programs increase cleaning and infection control, ensure staff have access to personal protective equipment, promote physical distancing, purchase additional cleaning supplies, and support staffing needs.

While public transit agencies like Metrolinx and Ontario Northland Transportation Commission (Ontario Northland) would continue to operate their vital services through future waves of the pandemic, services may be temporarily reduced in line with a reduction in ridership. In the case that public health measures are tightened or there are renewed requirements for organizations to limit workplace capacity, agencies would continue to ensure their vital transportation services are available to get essential workers where they need to go in the safest manner possible. Metrolinx has implemented more than 40 new safety measures, from mandatory face coverings to enhanced cleaning and disinfecting to dividers between seats, to ensure the safest trip possible. Ontario Northland has introduced mandatory face coverings, increased cleaning, limited seating capacity and introduced passenger health screening prior to boarding.

The province has further provided the province’s 110 municipalities with transit systems an additional $15 million for enhanced cleaning. This funding is in addition to the up to $4 billion made available through the federal Safe Restart Framework for Ontario’s municipalities, with $2 billion dedicated to helping communities keep transit systems running safely.

To protect vulnerable populations, the province is delivering over $510 million through the Social Services Relief Fund to help municipal partners and charitable organizations continue to deliver critical frontline services at shelters and other congregate settings, as well as implement public health measures to keep staff, residents and clients safe.

While Ontario is prepared for the next wave of COVID-19, the best way to combat this virus is to continue to follow strong public health advice that reduces the risk of transmission and helps keep Ontarians safe.

Help Stop the Spread

COVID-19 is spread mainly from person to person through close physical contact. These everyday actions remain the best line of defence in helping to reduce exposure to the virus and protecting your health:

 

  • Wash your hands often with soap and water or alcohol-based hand sanitizer
  • Sneeze and cough into your sleeve
  • Avoid touching your eyes, nose or mouth
  • Avoid contact with people who are sick
  • Stay home and away from others if you are feeling sick, even if you have mild symptoms. If you have symptoms or think you have been exposed to COVID-19, get tested
  • Practice physical distancing – stay home as much as possible and limit outings, and stay at least two metres away from anyone you do not live with or is outside of your social circle
  • Wear a face covering where required or when physical distancing of two metres is not possible
  • Ensure you are keeping to the public and private gathering limits (indoor and outdoor)
  • Download the COVID Alert for free from the Apple and Google Play app stores. This new app lets users know if they may have been exposed to the virus.

Objectives to focus and track Ontario’s preparedness

Ontario’s plan to address impending health care challenges, including being prepared for a second wave of COVID-19, is guided by six key objectives to prevent illness, protect Ontarians’ health and build capacity across the health system.

Maintain public health measures (funding: $1.376 billion)

Continue to adhere to foundational public health measures as the province continues to enhance and expand efforts to test, trace and isolate new cases of COVID-19

Increased lab and testing capacity

Accomplishments
  • Established a provincial lab network with current capacity for 40,000 daily tests
  • Established comprehensive testing across the province
  • Established over 150 assessment centres
  • Tested more than 92% of long-term care staff and 97% of long-term care residents
  • Long-term care homes to continue with staff testing at least twice a month
  • Consistent improvements in the turnaround time for tests
  • Invested $710 million to expand laboratory capacity and reduce testing backlogs
  • Invested $360 million to support existing assessment centres and add more testing locations and capacity
Actions underway
  • Increasing testing capacity to conduct up to 50,000 daily tests, with additional capacity to surge up to 78,000 daily tests as needed to support ongoing provincial reopening
  • Expanding testing locations to provide access to Ontarians for testing, including assessment centres and other community settings (mobile testing centres and pharmacies)
  • Proactively adopt new testing technologies as they become available, like saliva tests or point of care testing techniques
  • Ensure long-term care homes continue to implement the provincial testing strategy for residents and staff

Increase case management and contact tracing capacity

Accomplishments
  • Provided hundreds of additional contact tracers to support public health units in contact tracing through an agreement with the federal government
  • Launched COVID Alert, the country’s made-in-Ontario exposure notification app
Actions underway
  • Complete rollout of new case and contact management system across remaining public health units
  • Continue to build additional human resource capacity for case management and contact tracing
  • Continue to encourage people to download the COVID Alert app

Strong public health measures to prevent transmission

Accomplishments
  • Public health advice has guided the province’s public health measures, public awareness campaigns and regional reopening based on key public health indicators, testing, case and contact management and epidemiological evidence (e.g., A Framework for Reopening our Province)
  • Launched a robust public awareness campaign to educate the public on how to keep themselves and their families safe
  • Good public compliance with public health measures (e.g., physical distancing, widespread use of face coverings)
Actions underway
  • Health behaviour surveillance to see if people across Ontario are following the public health measures and to help understand how to better communicate the importance and benefit of continuing to follow public health measures
  • As needed, modify public health advice and actions based on epidemiological evidence and health behaviour surveillance data

Measuring success – maintaining public health measures

  • Faster turnaround time for testing: 80% of test results delivered within 48 hours
  • Maintain test positivity rate under 3%
  • Ensure sufficient case management and contact tracing capacity to continue reaching 90% of cases within 24 hours
  • Compliance with public health measures (based on health behaviour surveillance data)

Immunize against flu (funding: $70 million)

To help reduce the number of flu-related hospital admissions, Ontario will implement the largest and most comprehensive flu immunization campaign in the province’s history

Ensure sufficient vaccine supply

Accomplishments
  • Ordered 5.1 million doses of flu vaccine. This is 700,000 more doses for this flu season than the estimated net usage last season
  • Increased order for the high-dose flu vaccine for seniors by 110,000, bringing the total quantity for this fall to over 1.3 million doses. This is over 218,000 more doses than last season
Actions underway
  • Purchase additional flu vaccine doses if required and available through the national vaccine bulk procurement program
  • Secure early delivery of flu vaccine doses by working with federal government and other jurisdictions
  • Prioritization of early vaccine shipments to the province for long-term care homes and hospitals

Effective vaccine distribution in appropriate places (e.g., pharmacies)

Accomplishments
  • For the first time in Ontario’s history, help improve access by allocating high-dose flu vaccines for seniors to pharmacies
  • Close to 3,200 pharmacies participating in the flu vaccine program. This is 200 more than last season
  • Engagement with key stakeholders and partners on planning, delivering and promoting the flu vaccine
Actions underway
  • Planning vaccine program delivery with public health units focusing on high priority settings such as long-term care homes, hospitals, retirement homes, congregate living and other vulnerable population settings
  • Enhancing vaccine distribution and delivery for pharmacies to accommodate increased volumes, and maximize delivery of vaccines via primary care providers

Increase vaccination coverage, particularly for vulnerable populations and health care workers

Accomplishments
  • Allocated early shipments of flu vaccine to long-term care homes, hospitals and retirement homes
Actions underway
  • Public education and targeted flu campaign

Measuring success – flu immunization and other vaccines

  • Higher number of doses distributed this year in comparison with the 2019/2020 season
  • Higher estimated vaccine uptake in comparison with the 2019/2020 season

Quickly identify, manage and prevent outbreaks (funding: $30 million)

Stop the spread of COVID-19 through the quick and effective management of outbreaks

Early identification of outbreaks to prevent community spread

Accomplishments
  • Developed a COVID-19 surveillance strategy to monitor the disease and detect cases and outbreaks in a timely manner, including priority settings such as schools and long-term care homes
  • Launched a new case and contact management system, customized for Ontario, to improve data quality and timeliness, implemented across 31 of 34 health units, eliminating the use of Public Health Information System (iPHIS) for COVID-19 case and contact management in all health units
  • Established a Rapid Response Table comprised of public health experts, to help address outbreaks and support public health units in outbreak planning and response
  • Appointed Dr. Dirk Huyer as Coordinator, Provincial Government Response, to coordinate the province’s efforts to prevent and minimize COVID-19 outbreaks in a number of sectors, including the education, child care, agriculture, long-term care and health care sectors
  • Launched a new cross-government committee, chaired by Dr. Huyer, to ensure alignment and coordination of plans and responses across ministries and sectors, supporting the government’s health and public safety objectives
  • To support all long-term care homes, staff and residents during these difficult times, the government has taken action to ensure that long-term care homes can:
    • Have the flexibility and funds to enforce social and physical distancing measures, such as increased bed availability to provide isolation rooms
    • Rapidly hire PSWs, nurses and other frontline staff they need, when they need them
    • Restrict movement of staff between homes and other health care settings to limit the spread of the virus
  • The government has also taken measures to:
    • Partner with hospitals to support homes with medical expertise in infection prevention and control
    • Enable hospitals to deploy health professionals to homes experiencing critical staffing shortages
    • Limit the admission of residents to ward rooms where any outbreak is more difficult to contain
Actions underway
  • Undertaking regular surveillance activities to better target prevention and response efforts
  • Proactive testing, including testing of all symptomatic and asymptomatic staff, and symptomatic residents, in long-term care homes.
  • Continuing to enhance reporting for key sectors where outbreaks might occur, including schools
  • Reconvened the Long-Term Care Incident Management System (IMS) structure in September. The Long-Term Care IMS table monitors the data and organizes efforts to make rapid decisions that support long-term care homes in need. This includes those struggling to control outbreaks, complete infection prevention and control assessments, ensure appropriate staffing levels, access personal protective equipment (PPE), and complete the testing of long-term care home residents and staff
  • Meeting urgent staffing needs through our Health Workforce Matching Portal, which matches a pool of workers with open positions at long-term care homes and hospitals across the province.

Strong partnerships and protocols to support provincial and local actions and responses

Accomplishments
  • Regional integrated planning and refinement of outbreak protocols
  • Deployment of hospital and other partner infection prevention and control (IPAC) resources to support long-term care homes
  • Created an outbreak ‘toolkit’ to support strong local responses
Actions underway
  • Practice outbreak response protocols and response structures through virtual simulation exercises

Isolation capacity to provide access to people without the ability to self-isolate

Accomplishments
  • Continued implementation of the COVID-19 Action Plan for Vulnerable People to better protect those living in high risk congregate care settings including homes serving those with developmental disabilities, shelters for survivors of gender-based violence and human trafficking and children’s residential settings
  • Piloted a project by Toronto Public Health for people who cannot self-isolate in their family homes
Actions underway
  • More than $510 million provided through the Social Services Relief Fund to municipal Service Managers and Indigenous Program Administrators to protect vulnerable populations, including supporting physical distancing and enhanced infection control measures in congregate settings, and isolation facilities

Measuring success – identifying, managing and preventing outbreaks

  • Rapid containment of outbreaks
  • Fewer and less severe outbreaks in congregate and other high-risk settings, including long-term care

Safely reduce health service backlogs (funding: $283.7 million)

Ensure the health system’s ongoing ability to reduce the backlog of surgeries while effectively managing COVID-19 and the flu season

Expand capacity to reduce health service backlogs

Accomplishments
  • Provided guidance and parameters to the health sector for a safe restarting of non-emergency surgeries and procedures
  • Used existing data sources to estimate backlog and develop strategy to address the surgical backlog
  • The Provincial Primary Care Advisory Table worked with various stakeholders on the development of guidance to primary care providers for fall and winter 2020. This includes guidance for primary care providers to proactively manage the backlog of services such as cancer screening and routine immunizations, and to prioritize appropriate in-person services that resulted from the delay in patients seeking care
Actions underway
  • Providing funding for additional surgeries (including cancer, cardiac, cataract, and orthopaedic procedures) to take place during extended hours and additional diagnostic imaging hours
  • Address backlog through innovative channels such as the use of alternate health facilities that can deliver additional publicly funded surgical and diagnostic imaging services
  • Maintain current operations for hospital capacity and add beds as needed to support increased surgical activity in hospitals
  • Implement innovative solutions to address the surgical backlog, including: working to initiate a centralized waitlist and a program to optimize the use of the operating rooms to improve the use of existing resources and increase the number of surgical procedures in hospitals by hundreds on average per year, and improve patient flow by leveraging available surgical capacity in each region
  • Support the opening and accelerated ramp up of the Cortellucci Vaughan Hospital and establish a regional approach to addressing surgical backlog in the Ontario Health Central Region.
  • Hospital projects that have recently been completed or reached substantial completion include Groves Memorial Hospital, CHIGAMIK and Waypoint community health hub in Midland, Brockville General Hospital’s Phase II Redevelopment Project and CAMH Phase 1C Client Care Building and Centre for Discovery and Knowledge Exchange.

Shoring up PPE and critical health supplies to ensure continued delivery of care

Accomplishments
  • Amidst strained global supply, secured sufficient PPE to support current projected demands, as well as COVID-19 modelling scenarios
  • Regional distribution model to ensure effective distribution of PPE and other clinical supplies and equipment
  • Established Ontario-based manufacturing supply sources of critical medical supplies such as hand sanitizer, gowns, face shields and masks, including N95 respirators from 3M and ventilators from Linamar and O-Two Medical Technologies
Actions underway
  • Allocate PPE to support restart and ramp-up of primary care and community health providers
  • Support health service providers in maintaining an adequate supply, and providing access to regional stockpiles to reduce reliance on provincial emergency allocations
  • In addition to ongoing support to health care providers, and topping up of supplies in emergency situations, provide all long-term care homes with a supply of PPE for up to two months, as a precaution against surges.
  • Continue to support and develop domestic supply of PPE sources.

Measuring success - safely reduce health service backlogs

  • Reduced backlogs with a focus on key priority areas (e.g. cancer, cardiac, orthopedic, cataract surgeries, as well as critical diagnostic imaging procedures such as MRI and CT)
  • Continued month-over-month increases in procedures and surgeries performed throughout 2020-21
  • Patient wait times for priority procedures and diagnostics start to decrease
  • Percentage of health sector setting with adequate PPE supply
  • Continue to procure PPE and sustain a minimum of four weeks of emergency provincial pandemic stockpile

Prepare for surges in COVID-19 cases (funding: $457.5 million)

Ensure that the health system is prepared to respond to any surges of COVID-19 without interrupting routine health services

Increase community capacity to reduce pressure on hospitals

Accomplishments
  • Provided virtual nursing and rehab home care services for patients, with over 240,000 visits since the COVID-19 outbreak began
  • More than 39,000 Ontarians have accessed virtual mental health supports available provincially through the government’s investment of $26.75 million in emergency mental health and addictions funding
  • Expanded integrated models of care to support patients transitioning from hospital to home or the community, with over 20,000 patients being served in 2020-21
  • Provided virtual check-ins through community-based service providers for vulnerable home care clients – many of them seniors – who have been housebound during the pandemic
Actions underway
  • Transition 20,000 seniors and patients from hospital beds to long-term care beds and alternative care
  • Provide $100M for high intensity home care services for up to 850 alternate levels of care (ALC) patients, allowing them to receive care in more appropriate home and community settings:
    • 120,000 nursing and therapy visits
    • 1.4 million personal support worker (PSW) hours
  • Increase PSW capacity in home care and long-term care
  • Expand community paramedicine services to enhance home care for high needs clients

Expand digital health and virtual services

Accomplishments
  • Ensured the continuity of patient care with enhanced access to virtual care – done through the creation of temporary fee schedule codes that insured physician phone and video patient visits under OHIP and fee codes for virtual care visits
    • Ontario has invested over $745 million for virtual care services since March 2020. More than 24,000 physicians have provided phone and video visits to approximately 5 million patients.
Actions underway
  • Continue to prioritize patient access by continuing to expand appropriate virtual care across all sectors
  • Expand use of virtual care in home and community care
  • Launch a health data platform to study the impacts of COVID-19 and generate insights to help manage pandemic response
  • Establish a single phone number for 24/7 non-urgent health care, information and support
  • Enable hospitals to deliver virtual appointments for pre-and post-surgery appointments

Develop contingency plans to ensure health system readiness for potential surges; add bed capacity to resume surgical procedures and manage ALC patients

Accomplishments
  • At the height of the first wave, the province added 1,035 acute care beds and 1,492 critical care beds and has taken steps to ensure hospitals have the staff available to care for a sudden surge in patients
  • Conducted simulation exercises with health and non-health sector partners to support integrated planning and refine surge protocols
  • Announced five new Ontario Health Teams (OHTs) that will support better coordinated care, with 17 more in approval. This is in addition to the existing 24 OHTs already providing care across the province
  • Active monitoring of ALC rates in hospitals and emergency department admission data
  • Maintained provincial hospital occupancy under 90% to date
Actions underway
  • Engaging in additional simulation exercises with health and non-health sector partners to support integrated planning and refine surge protocols
  • Develop surge response protocols for community organizations
  • Develop health system surge capacity in areas such as home and community care, new acute and critical care beds and the use of alternative settings
  • Continue resumption of surgical and diagnostic imaging procedures
  • Addressing the increased demand for mental health and addictions services across the lifespan by:
    • Expanding virtual mental health and addictions services, including services targeted to frontline workers;
    • Enhancing community-based services, including addictions, child and youth mental health, supportive housing, mental health and justice and live-in treatment services; and
    • Supporting Indigenous communities to meet the growing needs in their communities in a culturally safe way.

Support long-term care sector to be ready to respond to outbreaks

Accomplishments
  • Issued four emergency orders, introducing amended regulations and announcing an additional $270 million in emergency funding for prevention and containment of COVID-19.
  • Delivered the COVID-19 Action Plan for Long-Term Care Homes (PDF) to help stop and contain the spread of COVID-19 in the province’s long-term care homes. The government introduced more aggressive testing, screening, and surveillance, deployed specialized teams from hospitals, public health and the home care sector, recruited additional frontline staff, and increased personal protective equipment supplies.
  • Facilitated temporary management partnerships between Ontario hospitals and 13 long-term care homes since May, to help the homes manage resident care in response to COVID-19 outbreaks. For homes under management, the Ministry of Long-Term Care has created a transition framework to help effectively transition daily operations back to homes. A mandatory transition plan is required before the hospital exits the home. Following transition, the ministry, home licensee, hospital and Ontario Health continue to support and monitor the home
  • Launched an independent commission to investigate spread within long-term care homes, how residents, staff and families were impacted and the adequacy of measures taken by the province and other parties to prevent, isolate and contain the spread. The commission will also provide the government with guidance on how to help prevent help prevent the future spread of disease in long-term care homes
Actions underway
  • Investing a total of $405 million to help long-term care homes with operating pressures related to COVID-19 prevention and containment. This funding is already helping homes pay for staffing, infection control measures, additional supplies and personal protective equipment.
  • Investing $61.4 million for minor capital repairs and renovations in homes to improve infection prevention and control. Potential renovations may include minor renovations to support physical distancing, plumbing or water supply cleaning, upgrading HVAC systems or repairing or replacing furniture and equipment that cannot be fully cleaned.
  • Investing $40 million to support homes that have been impacted by the changes in occupancy numbers due to COVID-19 and are incurring staffing and other operating costs. As the sector has been directed to stop admissions of third and fourth residents to larger rooms, a key source of income for each operator will be impacted. This funding will help stabilize the homes through the transition to lower occupancy rooms
  • Investing $30 million in infection prevention and control staffing, consisting of $20 million for personnel and $10 million to fund training for new and existing staff

Continued preparation of schools and child care centres to be ready to respond to potential surges

Accomplishments
  • Announced $1.3 billion in COVID-19 resources available to school boards in support of the COVID-19 outbreak, including:
    • 100 million to hire more teachers to keep class sizes small
    • $90 million for PPE for staff and students
    • $62.5 million to hire 625 public health nurses to monitor for COVID-19 in schools
    • $23.6 million for testing
    • $79 million to hire up to 1,300 additional dedicated custodians and purchase cleaning supplies
    • $65.5 million for enhanced cleaning and safety measures for student transportation
    • $10 million for health and safety training of occasional teachers and education workers
    • $42.5 million to support students with special needs and provide student mental health supports
    • $50 million in one-time funding to support improved ventilation, air quality and HVAC system effectiveness in schools
    • $54 million to hire additional principals, vice-principals and administrative staffing supports to better deliver and oversee remote learning
    • $100 million to be responsive to local school board reopening plan priorities supporting a broad range of activities such as increasing the number of educators, custodians, additional bussing supports, and keeping class sizes small
    • $15 million to purchase approximately 30,000 technological devices for students
    • $44.5 million towards the school bus driver retention strategy
    • Up to an additional $11 million in funding to support school boards that do not have sufficient reserves to promote equitable school re-opening plans province wide
    • Up to $496 million by allowing boards to unlock reserves and access up to two per cent of their operating budget from their reserve funds. This funding can be applied to local priorities of each board, based on the immediate needs on the ground to prepare for the start of school
  • Released a COVID-19 Management Plan for Schools to help prevent and minimize outbreaks to keep students and staff safe
  • Provided $234.6 million in funding through the federal Safe Restart Agreement for child care and early years settings, which complements existing provincial and federal investments to help keep children and families safe in child care and early years settings
  • Issued strict health and safety guidance protocols for both sectors and continued to update them based on the latest health advice
  • Launched a voluntary, simple and fast online COVID-19 school screening tool for families, school staff and essential visitors
  • Supported the safe reopening of child care centres at full capacity across the province
Actions underway
  • Working to ensure that sufficient PPE is being delivered regularly to all 72 school boards and 10 education authorities and that child care centres have enough masks to operate safely, including delivering over 37 million pieces to date
  • Monitoring the hiring of an additional 625 public health nurses to support schools
  • Daily public reporting of cases at schools and child care centres
  • Continued co-ordination and collaboration with school, child care and public health sectors on outbreak preparedness, planning and response

Measuring success – preparing for surges and support the delivery of routine health services

  • Lower hospital occupancy rates
  • Lower alternate level of care rate
  • Lower emergency department wait times for patients being admitted to hospital
  • Increased delivery of home care to more patients
  • Fewer and less severe outbreaks in long-term care homes
  • Enhanced access to mental health and addictions services and supports
  • Optimal number of virtual care services and number of virtual care interactions
  • Number of COVID-19 research projects supported by the Ontario Health Data platform

Recruit, Retain, train and support health care workers, families and caregivers (funding: $52.5 million)

Build up and stabilize the province’s health care workforce and support families and caregivers

Sufficient health human resources to maintain services and meet surge demands.

Accomplishments
  • Implemented a health workforce matching portal which made over 1,100 matches for over 1,000 employers across the health system, including 650 matches for long-term care homes
  • Instituted pandemic pay for frontline providers and support staff
  • Released a policy on September 2, 2020 that provides guidance to long-term care homes to connect caregivers with training, education and resources on protective personal equipment and infection prevention and control, so caregivers can care safely for their loved ones
Actions underway
  • Building a contingency health care workforce that can be flexible and quickly deployed
  • Adding 2,000 PSWs and over 800 nurses to the health system in areas of need, including long-term care, across the province
  • Investing in training for 160 supportive care workers to provide basic support services in home care and long-term care
  • Funding accelerated PSW training for 220 students with prior experience to get them practicing as PSWs in Ontario faster
  • Investing $2.8 million to extend the High Wage Transition Fund. In September 2019, the fund was extended while the government developed new programs to improve how long-term care is delivered in Ontario. The original end date of the fund was December 31, 2020. Due to the impact of COVID-19, the High Wage Transition Fund will be extended until March 31, 2021. This will ensure that gaps in long-term care staffing and funding can continue to be addressed during the pandemic
  • Extending staffing flexibility in long-term care through the extension of emergency orders in the Reopening Ontario Act, 2020
  • Supporting family members who provide essential care to long-term care residents by identifying them as essential caregivers and permitting them to continue visits even with new visitor restrictions in place effective Monday, October 5th, 2020.
  • Expanding the pool of available nurses, through these programs:
    • Nursing Incentives – The province will work with key nursing partners to strategically place nurses in long-term care homes identified as most in need. Nurses will be offered a financial incentive to work in a long-term care home
    • Nursing Graduate Guarantee – $18 million investment, which provides full-time salaries and benefits to over 600 nurses with a focus on recruiting in areas of need, such as long-term care homes
    • Attending Nurse Practitioner – provides funding to support the hiring of 15 additional nurse practitioners into long-term care homes

Stronger infection prevention and control (IPAC) supports to help providers and care settings in greatest need

Accomplishments
  • Rolled out IPAC tools, training and resources to support long-term care and other congregate settings including for clinical staff, non-clinical staff, family members, caregivers and inspectors
  • Established monitoring of IPAC gaps in congregate settings and remediation programs to increase IPAC knowledge and capacity
  • Established guidance and directive setting standards for IPAC measures and overall readiness to respond to outbreaks
Actions underway
  • Implementation of regional models to coordinate and deploy IPAC expertise in community settings, including long-term care homes, through the development of 25 new IPAC Hubs across the province
  • Investing $30 million for additional infection prevention and control personnel and related training for new and existing staff in long-term care homes
  • Expanding training, tools and resources available to frontline workers across the social services sector
  • Strengthening inspections and audits of high-risk settings
  • Developing models for minimum standards for IPAC leadership within different settings based on risk

Stronger occupational health services programs to promote worker safety

Accomplishments
  • Issued guidance and directives from the Chief Medical Officer of Health to ensure consistent approaches to protect health care workers and patients, based on the best evidence available
  • Obligated employers, through directives from the Chief Medical Officer of Health, to follow public health requirements and practices in dealing with COVID-19 patients
  • Significantly increased the supply and availability of PPE and medical equipment, including recently announced domestic manufacturing capacity of N95 respirators and ventilators, to keep our health care workers safe and support patient care
  • Deployment of hospital and other partner IPAC resources to support long-term care homes
  • Collaborated with labour unions to address important issues related to health care worker health and safety
Actions underway
  • Continuing efforts to bolster the supply of PPE to ensure the health and safety of health care workers
  • Providing all long-term care homes with a supply of personal protective equipment for up to two months. Continue to top up supplies of personal protective equipment in emergency situations
  • Continued monitoring of compliance to occupational health and safety directives, standards and legislative requirements
  • Development of a collaborative engagement model between government and labour representatives to identify, anticipate and address health care worker health and safety issues

Engage and educate patients, families and caregivers to support safety and high-quality care

Accomplishments
  • Resumed visits to long-term care homes and other congregate settings, with appropriate health and safety measures, to support resident well-being
  • Updated long-term care visitor policy to promote essential caregiver involvement to support better care and reduce isolation
  • Launched a training module on infection prevention and control designed for caregivers
Actions underway
  • Creating broader frameworks on the role of patients, families, caregivers, parents and the public as partners in the pandemic response
  • Making required testing for hospital, long-term care, and retirement home visits more convenient for visiting family members and caregivers by allowing pharmacy locations in the province to begin offering testing for asymptomatic individuals

Measuring success

  • Staffing levels and retention
  • Fewer and less severe outbreaks in long-term care and other congregate care settings
  • Reduction in health care worker preventable injuries and illnesses

Personal Protective Equipment (PPE)

Ontario continues to make progress in building its inventory of PPE to support the response to COVID-19 in several ways:

  • Timely delivery of PPE, as quickly as within 24-hours, to hospitals, long-term care and retirement homes, primary care providers and other facilities. This will support essential workers in all settings and ensure equipment is expedited to those most in need, to support re-opening and to prepare for a possible second wave of COVID-19
  • As a precaution against surges, Ontario is providing all long-term care homes with a supply of PPE for up to two months. The province will also continue to support providers that make requests for PPE, and top up supply of PPE in emergency situations
  • To support the first month of school operation, the government has delivered over 37 million supplies to Ontario’s 72 public school boards and 10 education authorities, including more than 19.5 million masks, 16 million gloves, 317,000 face shields, 320,000 bottles of hand sanitizer, and 218,000 containers of disinfectant, among other critical supplies
  • Since August 1, 2020, almost 22 million units of PPEor more than 9,400 shipments have been distributed across the health sector from the provincial PPE pandemic warehouse, and from the Ontario Health regional warehouses
  • The Government of Ontario and the Government of Canada reached a five-year agreement with 3M for the provision of 50 million N95 respirators annually beginning in early 2021 to meet current demand for frontline healthcare workers in Ontario and across Canada to eliminate our reliance on foreign countries to supply this key commodity
  • The province has supported the retooling of Linamar’s assembly line to manufacture ventilator components to produce 10,000 Ontario-made e700 ventilators. O-Two Medical Technologies partnered with Linamar Corp. and other partners, including Bombardier, to produce these lifesaving devices to enhance future preparedness and help patients with severe cases of COVID-19 and other respiratory illnesses
  • In March, the Premier launched the Ontario Together web portal appealing to Ontario’s manufacturers, entrepreneurs and innovators to provide essential supplies and equipment to support frontline workers in their fight against the pandemic
  • Through the Ontario Together portal, more than 19,000 emergency supplies leads have been converted into more than $320 million in purchases of critical supplies and equipment to support staff on the front lines including more than: 600,000 gowns, 421 million gloves, 111 million masks and over 2.7 million face shields

Transforming Ontario’s health system

  • A key part of Ontario’s plan to improve the patient experience and support better access to health care services was the creation of Ontario Health Teams and Ontario Health. Ontario Health Teams bring together health care providers to work as one team to improve patient outcomes, with better care coordination and 24/7 navigation of services.
  • The strong partnerships and integrated care established by Ontario Health Teams and Ontario Health improved the province’s ability to respond quickly and effectively to COVID-19 by simplifying the purchase of personal protective equipment, supporting the staffing of long-term care homes and assessment centres, expanding virtual care options and modernizing the supply chain for health. As Ontario Health Teams continue to expand across the province, these partnerships and their shared experience will also help better prepare the province for the next waves of COVID-19 and the upcoming flu season.

COVID-19 research

  • The government is investing $20 million through the Ontario COVID-19 Rapid Research Fund to advance research in key areas, such as vaccine development, diagnostics, drug trials and development, and social sciences. To date, the province has funded 35 proposals as an immediate response to engaging the research community on ways to fight COVID-19.
  • Where relevant, a portion of these funds will be used to cover costs associated with licensing and commercialization, including patenting of the valuable intellectual property generated by successful projects to ensure any economic outcomes from these proposals benefit Ontario’s economy, workers and researchers.
  • Ontario is also investing an additional $3.65 million in 16 other research projects that aim to support Ontario’s response to COVID-19. These projects focus on a wide variety of areas such as supporting the mental health and well-being of families and children, assessing the long-term health effects of COVID-19, the development of an app to better manage the care of patients, mental health and substance use service needs, and an evaluation of the effectiveness of wearing masks to block the virus.
  • The province currently leads the country with 22 clinical trials investigating COVID-19 vaccines and therapeutics. Ontario also has the largest share of the 59 clinical trials approved by Health Canada in the country.
Updated: September 23, 2021
Published: September 30, 2020