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In December 2019, a novel coronavirus started an outbreak which led to a pandemic. Later, this novel coronavirus became known as COVID-19. As cases of infection rose globally, public health measures were taken to reduce the spread and harm from infection, including physical distancing, masking, and vaccination. While the strategies work better together, vaccination is still the most effective protection against severe COVID-19.

Although pandemic restrictions have been lifted, COVID-19 still exists worldwide, with new variants meaning cases and outbreaks still occur, and often come in waves throughout the year.  COVID-19 infections increase in the fall each year, when other respiratory illnesses, like the flu and Respiratory Syncytial Virus (RSV) also increase. If you have symptoms of any respiratory viral infection, take the Ontario Ministry of Health’s COVID-19 Self-Assessment for recommendations on what to do next. For more information, visit the Provincial website.

Health care providers can find more information about COVID-19 on our COVID-19 Information for Health Professionals webpage.

Learn more about COVID-19 vaccines.

Like other respiratory viruses, COVID-19 is spread by:

  • Respiratory droplets that come out of your nose and mouth when you breathe, talk, cough or sneeze
  • Aerosols, which are tiny respiratory droplets that can stay in the air longer
  • Close contact with other people in crowded indoor spaces is a common way that viruses spread through respiratory droplets
  • Touching something with the virus on it, then touching your mouth, nose or eyes

Using layers of protection can prevent the spread of respiratory viruses.

Symptoms of COVID-19 Infection

COVID-19 and other respiratory viruses share common symptoms, including: 

  • Fever 
  • Cough 
  • Shortness of breath or trouble breathing 
  • Runny nose or nasal congestion 
  • Headache 
  • Extreme fatigue or tiredness 
  • Sore throat 
  • Muscle aches or joint pain 

Other symptoms characteristic of COVID-19 infection include: 

  • Decreased or loss sense of taste or smell 
  • Gastrointestinal symptoms (such as vomiting or diarrhea) 
  • Abdominal pain 
  • Decreased or lack of appetite 

Long COVID

Long COVID, or post-COVID-19 condition (PCC), occurs when symptoms or health issues persist for three or more months after a COVID-19 infection, without another explanation. Individuals with long COVID are no longer contagious. While anyone who contracts COVID-19 can develop long COVID, it is more common in adults, especially women and those with pre-existing conditions, though children can also be affected. The risk increases for those who were hospitalized but can also occur after mild or asymptomatic cases. Repeated COVID-19 infections may further raise the risk.

Symptoms of long COVID can be different for everyone, and can change over time, but common symptoms include: 

  • Feeling tired 
  • Trouble sleeping 
  • Trouble breathing 
  • Cough 
  • Headaches 
  • Changes in mood 
  • Muscle and joint pain or weakness 
  • Fast or irregular heartbeat 
  • Menstrual cycle changes 
  • Stomach pain, diarrhea 
  • Loss of taste and/or smell 
  • Skin rashes 
  • Difficulty with memory, thinking or concentration (“brain fog”, or children having new difficulties learning at school) 

The best way to prevent long COVID is to avoid infection and getting vaccinated. Studies show that people who are vaccinated with two or more doses are less likely to get long COVID and that getting vaccinated continues to protect people even after having a COVID-19 infection. 

Newer research is showing that antiviral treatment taken at the beginning of a COVID-19 infection may also lower the risk of getting long COVID. See the “Diagnosis & Treatment” tab below for more information. 

Isolating

If you have symptoms, stay home (self-isolate) whether you have tested or not. Follow provincial guidance on isolation duration and masking. Notify close contacts, especially if they are high risk for getting very sick from a COVID-19 infection. Stay home until you are fever-free and symptoms are improving for at least 24 hours (or 48 hours if you have gastrointestinal symptoms such as vomiting and/or diarrhea). After isolating:  

  • Wear a well-fitted, high quality mask when out in public for 10 days from when your symptoms started 
  • Avoid non-essential visits to vulnerable individuals (e.g., seniors) and highest risk settings (e.g., hospitals, long-term care) for 10 days from when your symptoms started

Breastfeeding (also known as chest feeding) your baby is recommended even if you have COVID-19. This is because breast milk has many health benefits for babies, including protection from different illnesses.

If you have COVID-19 and are breastfeeding, you should:

  • Clean your hands before and after breastfeeding, expressing breastmilk and caring for your baby
  • Wear a well-fitted face mask while breastfeeding and whenever you are within six feet of your baby while you are contagious
  • Monitor your baby for symptoms of COVID-19
  • Take care of yourself. Drink plenty of fluids, eat regularly throughout the day and make sleep/rest a priority
  • Follow all self-isolation instructions above

If your symptoms feel worse than a common cold, call your health care practitioner or call Health811. 

If you have ANY of the following signs of severe illness, you should seek immediate medical attention: 

  • Shortness of breath 
  • Chest pain 
  • Weakness 
  • Lethargy or drowsiness 
  • Dizziness 

If you do not feel well enough to take personal transport, call 911. Before going for in-person medical care, tell them that you likely have COVID-19. 

The following infants and children should also be assessed in the emergency department: 

  • Infants under 3 months of age with fever or trouble breathing or appear unwell 
  • Children and infants over 3 months of age with any of the following: 
  • Fever longer than 7 days 
  • Fast breathing or trouble breathing 
  • Bluish skin colour 
  • Not drinking enough fluids 
  • Not waking up or not interacting 
  • Being so irritable that the child does not want to be held 
  • Fever with a rash 
  • Constant vomiting 
  • Immune compromised with a fever 

Rarely, children can get an inflammatory condition that impacts the blood vessels, called vasculitis. This condition presents prolonged fever, abdominal pain, red eyes, nausea, vomiting, diarrhea, and rash. It needs medical attention. 

COVID-19 Infection During Pregnancy

Getting COVID-19 while you are pregnant puts you at higher risk of getting very sick and being hospitalized. It may increase the following risks: 

  • To you: 
    • Ending up in the ICU (Intensive Care Unit) or on a ventilator 
    • High blood pressure 
    • Getting a C-section (caesarean birth) 
  • To baby: 
    • Premature birth (giving birth too early) 
    • Ending up in the NICU (Neonatal Intensive Care Unit) 
    • Having a low birth weight 
    • Stillbirth 

If you are pregnant and have symptoms of COVID-19 or have tested positive, speak to your healthcare provider as soon as possible to find out if you are eligible for treatment. 

Seeking Medical Attention for Long COVID

Talk with a health care provider who can assess you and review your symptoms if you think you have Long COVID. There is currently no specific treatment for Long COVID, but a health care provider can give you advice and support on how to manage your symptoms. 

Diagnosis

COVID-19 is diagnosed with laboratory tests using a sample collected from the nose or throat by a health care professional or another trained individual. The laboratory will process these tests to determine if a person has the COVID-19 virus.  

In Ontario, publicly funded COVID-19 testing (rapid antigen tests and PCR testing) will only be available to:

  • Individuals eligible for COVID-19 treatment (i.e., symptomatic individuals who are immunocompromised, or 65 years of age or older, or those with high-risk medical conditions).
  • People in high-risk and some congregate living settings (including long-term care homes) and other specific populations to support outbreak prevention and management.

To find out about test availability and to arrange to take a test, individuals meeting the above criteria should contact their primary care provider or pharmacist.

Rapid Antigen Tests

The distribution of free rapid antigen tests kits to the public has been discontinued by the Provincial government. Toronto Public Health will no longer order or distribute rapid antigen test kits.

Expired Rapid Antigen Tests

TPH would recommend discarding test kits if they have expired.

As noted by Health Canada, “Rapid tests are medical devices, which means they have an expiry date. This is known as a shelf-life. Health Canada authorizes the shelf-life of rapid tests and has granted several shelf-life extensions. The expiry date is determined by the manufacturer and is printed on the labelling during the manufacturing process. However, expiry dates may be impacted by shelf-life extensions even after products have been distributed. Contact the manufacturer of your rapid test to confirm its expiry date”.

Treatment

Treatment is available for high-risk individuals to lower the risk of serious illness and hospitalization due to COVID-19 infection.  

Find out if you are eligible for treatment.

If you are eligible for treatment and start to have COVID-19 symptoms (even if mild) or have tested positive, talk to your health care provider as soon as possible. COVID-19 medications need to be taken within five to seven days of your symptoms starting to be most effective. Your health care provider will prescribe treatment and direct you to a local pharmacy to receive it. 

If your symptoms are severe, such as difficulty breathing or chest pain, call 911.  

If you are caring for or living with someone who has COVID-19: 

  • Clean your hands often by washing with soap and water for 15 seconds after being in contact with the person who has symptoms or using an alcohol-based hand sanitizer if soap and water is not available
  • Wear a well-fitted, high quality mask when caring for them and encourage them to wear a mask if possible (masks are not recommended for children under two years old)
  • Use gloves and eye protection if you have contact with the person’s body fluids (e.g. blood, saliva, vomit, urine or feces)
  • After providing care, take off your gloves before removing your eye protection and mask. Clean your hands after taking off each item
  • Place disposable used items in a garbage bin lined with a plastic bag, and clean your hands after handling garbage

If you are exposed to someone with COVID-19

If you have been told that you are a close contact, you do not need to self-isolate (stay home), unless you develop symptoms. For a total of 10 days from the last day you saw the person with COVID-19 you should: 

  • Self-monitor for symptoms of COVID-19. If you develop any symptoms, self-isolate (stay at home) and you may seek testing and treatment, if eligible
  • Wear a well-fitted, high quality mask, per provincial guidance, as much as possible unless you are temporarily removing it for essential activities (such as when eating in shared space at school/work) while still maintaining as much distancing from others as possible, and avoid activities where you have to remove your mask (for example, playing a wind instrument, sports that require removing your mask, dining out)  
  • Avoid non-essential visits to vulnerable individuals (e.g. seniors) and highest risk settings (e.g., hospitals, long-term care)

If you are a close contact who lives in a high-risk setting (e.g. long-term care, or other congregate setting), you may need to self-isolate.  

If you are a close contact who works/volunteers/attends a high-risk setting, and do not have any symptoms of COVID-19, you can continue to work while self-monitoring for symptoms for 10 days from your last exposure to the person with COVID-19. Speak to your employer and follow any additional workplace measures. 

After self-monitoring, Toronto Public Health recommends continuing preventive measures, such as handwashing and physical distancing. Wearing a well-fitted, high-quality mask in crowded or poorly ventilated indoor public spaces is recommended, especially around high-risk individuals like seniors or those with weakened immune systems. Masks are especially recommended for people at higher risk of getting seriously sick from COVID-19. Masks are still required in some settings.

If you live in Toronto and received a dose outside Ontario, and need to have your COVID-19 vaccine dose documented, please complete Toronto Public Health’s online form. You can document individual COVID-19 vaccines or a full series and you will need to submit proof of vaccination.

For vaccines received in other Canadian provinces and territories, proof of vaccination requires submission of an enhanced vaccination certificate with QR code. Please consult the relevant provincial or territorial website for information about how to obtain the enhanced certificate.

Some people vaccinated in Ontario received a vaccine from what is referred to as non-Ontario stock. This refers to a vaccine that was not allocated to Ontario or recorded in the provincial vaccine management system. Generally, these doses were delivered at institutions such as correctional facilities, military groups or embassies. People who received one or two doses of a vaccine from the non-Ontario stock may also document them through Toronto Public Health’s online form.

Need Help

If you need assistance documenting your COVID-19 vaccine or if you are not able to provide proof of your vaccination, please call Toronto Public Health at 416-338-7600 (TTY: 416-392-0658).