Abstract
Within the Ministry of Health, the Office of the Chief Medical Officer of Health is responsible for publishing the Ontario Public Health Standards, Protocols, and Guidelines which identify the minimum expectations for Ontario's 34 boards of health in public health programs and services delivery. The Recommendations for the Control of Respiratory Infection Outbreaks in Long-Term Care Homes, 2018 (aka. Respiratory Guide) is the current reference document that provides respiratory-specific information and best practices relevant to operationalizing and implementing the Infectious Diseases Protocol, 2022. In the wake of the COVID-19 pandemic, there is a need to update the Respiratory Guide to integrate still-relevant COVID-19-specific information published independently during the 2020-2022 period. Further, the pandemic has highlighted the extra challenges that congregate living settings face in the context of respiratory infections due to the close nature of contact between and within resident and staff populations. Thus, the new update aims to expand the scope of the document beyond long-term care homes to include other congregate living settings.
Two main documents were used as the basis of the update, namely the 2018 Respiratory Guide and COVID-19 Guidance: Long-Term Care Homes, Retirement Homes, and Other Congregate Living Settings for Public Health Units, 2022. A template for the new Respiratory Guide was developed and fields were populated with still-relevant sections of the two existing documents. Remaining sections were completed in consultation with other ministries, ministry partners, and senior staff. The draft was sent to a sample of stakeholders for review and feedback.
Assessment of feedback identified general themes of concern, including the role of health units, role of institutions and facilities, outbreak preparedness measures, and seasonal COVID-19 vaccinations. It was determined that the updating of the Respiratory Guide may be premature still and that more time was needed to observe endemic patterns of COVID-19 and emergence of new vaccine schedules and therapeutics. In response, the new Respiratory Guide was moved for publication to Fall 2023.