On May 26, 2020, Ontario's Chief Medical Officer of Health released an updated Directive #2 for health care providers which allows for a gradual restart of previously deferred health care services.

The updated Directive #2 revokes the previous version issued on March 19, 2020, which required health care professionals to cease or reduce to minimal levels all non-essential and elective services. The updated Directive #2 follows on Ontario's Stage 1 reopening plan, announced on May 14 for the gradual reopening of health care and community services.

The updated Directive #2 allows for health care services to resume, provided that certain requirements are met:

  • Compliance with COVID-19 Operational Requirements: Health Sector Restart ("Operational Requirements")
  • Consideration of which services should continue to be provided remotely and which can safely resume in-person with appropriate hazard controls and personal protective equipment ("PPE")
  • Adherence to the principles of proportionality, minimizing harm to patients, equity and reciprocity
  • Alignment with guidance from applicable health regulatory colleges
  • Compliance with the Occupational Health and Safety Act and its Regulations

The Operational Requirements set out "measures that must be in place in order to meet public health guidelines and promote a safe environment for the provision of in-person health services". The Operational Requirements address a number of matters, including:

  • Limiting the number of in-person visits for the safety of health care providers and their patients
  • Encouraging implementation of virtual and/or telephone consultations as well as modifications to service delivery where possible
  • Risk assessments to be conducted prior to restarting in-person health care services and before each patient interaction
  • Occupational health and safety measures, including containment of hazards, patient/visitor/staff screening, workplace adaptations to allow for physical distancing and appropriate hygiene and required PPE precautions
  • Infection prevention and control
  • Patient testing criteria
  • Providing care to patients who screen positive for COVID-19
  • Protocols, including reporting requirements, in the event of staff illness
  • Maintenance of critical supplies and equipment including drugs and PPE
  • Essential visitors

The Ministry of Health emphasizes that the Operational Requirements are not intended to take the place of legal advice. Health service providers and organizations will need to consider their local circumstances and weigh the needs of the community with the risks of operation in determining whether and when to resume in-person health services. It is recommended that health care providers and organizations consult their legal advisors to ensure a risk-managed approach to in-person service resumption in compliance with applicable laws, directives and guidelines.

Originally published May 29, 2020.

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