Page 2 of 6: Physicians memo: Updates on masking requirement and flu season

Change to universal masking policy in off-site non-clinical buildings at Unity Health

Effective immediately, universal masking is no longer required in the following off-site, non-clinical areas at Unity Health:

• Li Ka Shing Knowledge Institute
• 2 Queen St. East
• 193 Yonge St.
• 250 Yonge St.

This decision was made in alignment with other TAHSN hospitals and updated guidance from the Toronto Region Hospital Operations Table (TR-HOT), after careful consultation with our Infection Prevention and Control (IPAC) and Workplace Health, Safety and Wellness teams. This change reflects current COVID-19 epidemiology and aims to achieve consistency with current public health requirements outside of high-risk settings.

Per the guidelines established by TR-HOT, universal masking is only optional in departments, services and research centres that are located in buildings where there is no patient care provided or that are not part of the main hospital buildings or other buildings that have mixed clinical and non-clinical areas. The four buildings listed above are the only departments at Unity Health that fit these criteria.

Masking continues to be mandatory in ALL other areas not listed above, including in our hospital buildings, Family Health Teams, Sunnyside Building at St. Joseph’s, off-site clinics that provide patient care and the Houses of Providence.

While universal masking is now optional in the LKSKI building, 2 Queen St. E, 193 Yonge St. and 250 Yonge St., masking is still recommended, especially when attending large gatherings. Clinical staff who visit the buildings listed above, whether for meetings, educational opportunities or other activities, should continue to mask to minimize the risk of transmitting illness to patients and colleagues who care for patients.

Effective immediately, physical distancing requirements have also been slightly adjusted. The Ministry of Labour continues to require physical distancing of 2 metres in all clinical areas and clinical staff break rooms and lounges but physical distancing can now be reduced to 1 metre in all other areas, including meeting rooms and cafeteria spaces.

These requirements apply only to activities and events at Unity Health. Staff, physicians and learners should follow public health requirements and recommendations when planning or attending off-site events, such as board meetings, foundation events or educational sessions outside of Unity Health.

If you have any questions, please connect with a member of our IPAC team via Switchboard/Locating.

Flu season is over: Changes to testing and IPAC precautions

Infection Prevention and Control can now announce that influenza season is over. The incidence of influenza has fallen to levels typically seen in the spring, and less than one per cent of influenza tests in Ontario are returning a positive result. The incidence of other respiratory viruses such as respiratory syncytial virus (RSV) are also decreasing, with RSV positivity now well below five per cent.

Clinicians can now stop ordering testing for these respiratory viruses routinely. Selective testing for seasonal respiratory viruses (e.g. influenza, RSV) remains reasonable for patients being admitted to hospital with a typical influenza-like illness, particularly if COVID-19 has been excluded. The microbiology labs will continue to process these specimens when ordered.

Testing of asymptomatic patients for influenza, RSV or other seasonal respiratory viruses other than COVID-19 is not indicated. If there is a clinical indication to order influenza or RSV testing, please note this when ordering. If there is no symptomatic indication for testing provided with the order, the microbiology laboratory will not process specimens for influenza or RSV testing

Infection control precautions

Patients admitted with COVID-19 or flu symptoms require Droplet-Contact precautions with an N95 respirator until COVID-19 testing is confirmed to be negative. If COVID-19 negative, the patient can be switched to standard Droplet-Contact precautions with use of a medical mask. IPAC will remove precautions from COVID-19 negative patients once fever has resolved for more than 24 hours and symptoms are improving as long as there are no other indications for ongoing precautions like Methicillin-resistant Staphylococcus aureus (MRSA).