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Under the Codeemployers and unions, housing providers and service providers have a legal duty to accommodate the needs of people with disabilities who are adversely affected by a requirement, rule or standard.

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In the operationalization of this guidance, it is recognized that each PHA may have unique approaches to implement individual and community-based measures, based on jurisdiction-specific considerations. Principles and concepts outlined in The Canadian pandemic influenza preparedness: Planning guidance for the health sector were used as a foundation in the development of this guidance. This guidance does not apply to any health care settings, for which specific infection prevention and control guidance is available. This guidance considers the Canadian context, is based upon the best available scientific evidence and expert opinion, and is subject to change as new information becomes available on effectiveness of PHM, vaccine effectiveness and coverage, or transmission of SARS-CoV-2 variants of concern VOC.

In interpreting and applying this guidance, it is important to recognize that the health, age, economic, social or other circumstances e. It is recommended that this guidance be read in conjunction with relevant PT and local legislation, regulations and policies.

PHM are non-pharmaceutical interventions used to reduce community transmission of SARS-CoV-2, thereby reducing the of persons who are infected and reducing the demand for health care services to a manageable level, while continuing to provide services for urgent non-COVID health care needs.

PHM are usually implemented in combination, known as layering, as combinations of PHM are more effective than single measures on their own.

The PHM outlined in this guidance include personal preventive practices recommended for individuals, management of cases of COVID and their high-risk contacts, and community-based measures to protect groups and the community at large. These consequences include extensive social, psychological, and economic impacts, particularly on Indigenous Peoples and populations whose circumstances increase their vulnerability, including people at risk for more severe disease or outcomes from COVID, persons with disabilities, persons who are racialized, among others at increased risk Reference 1 Reference 2 Reference 3 Reference 4.

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Adherence to PHM and sustainability over time may be influenced by a variety of factors, such as contextual e. This is particularly relevant for persons who are racialized who can be disproportionately impacted by the implementation of PHM. The length of the pandemic and the resulting pandemic fatigue may also impact adherence to PHM Reference 6. To promote adherence to measures, messaging should be adapted depending on the age, sex, gender, ability status, parental and caregiving responsibilities, and other socioeconomic or identity factors of individuals Reference 7 Reference 8 Reference 9.

8. duty to accommodate

For example, men are more likely than women to report low levels of concern about the COVID pandemic, including men in the highest risk age groups Reference Women are more likely than men to report high levels of stress in their lives, in part because the pandemic may have exacerbated the gender division of unpaid family work, and women are more likely to have caregiving responsibilities e.

Public education and communication strategies that consider these factors, and are tailored to other relevant factors, are critical in promoting adherence to PHM. See further details on these strategies in Appendix A. Infected individuals generate respiratory droplets and aerosols, which can be transmitted to others.

Activities that are more likely to generate respiratory droplets and aerosols include: heavy breathing e. The droplets vary in size from large droplets that may fall to the ground relatively quickly near the person who is infected, to small droplets called aerosols which may remain suspended in the air and travel on ambient air currents Reference 13 Reference The risk of transmission via respiratory aerosols is greater Free sex contacts s car wash Toronto poorly ventilated indoor environments where there is a high density of people and extended duration of contact Reference The relative infectiousness of droplets of different sizes, and the amount of virus in respiratory droplets needed to cause infection i.

Infectious droplets or aerosols may come into direct contact with the mucous membranes of another person's nose, mouth, or eyes, or they may be inhaled into the nose, mouth, and airways, with smaller aerosols penetrating deeper into the lungs. The virus may also spread when a person touches another person e.

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Transmission of SARS-CoV-2 may vary depending on factors such as age, infectiousness, presence of symptomsillness severity, and characteristics of the virus itself e. There is no evidence to date to suggest differences in mode of transmission of circulating VOC. Environmental factors Reference 14settings, and specific activities can contribute to the risk of viral transmission, including enclosed spaces, especially those with poor ventilation, crowded settings, and close interactions.

Settings where these factors overlap or involve activities such as singing, shouting or heavy breathing e. Examples of these settings include family gatherings and other social gatherings, religious services, funerals, and choir practices, as well as in occupational settings including health care facilities and meat processing plants Reference 15 Reference 16 Reference 17 Reference The duration of exposure in such settings is also likely to increase the risk of transmission.

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Social determinants, such as housing that is below standards, overcrowding, adverse working conditions, and poor nutrition put groups such as persons who are racialized, people living in poverty, Indigenous Peoples, and persons with disabilities, among others, at increased risk. It is likely that multiple modes of transmission occur; however, on a population level, close-range and direct interactions are higher risk than distant interactions. Interactions that take place in indoor settings, particularly if poorly ventilated, are higher risk than those that take place in outdoor settings.

Transmission can occur during interactions of any duration; however, the longer the duration the higher the risk. The implementation of these measures has varied across the country owing to differences in the timing and intensity of COVID activity and other jurisdiction-specific considerations. Using a risk management approach helps to weigh the potential advantages of particular interventions against their disadvantages and other consequences.

These risk assessments take into a variety of factors such as local virus activity including VOC, the risk profile of their population, and health system capacity, which Free sex contacts s car wash Toronto balanced against broader societal and economic consequences of the PHM. Criteria and indicators to support PT decision-making on adjusting PHM are set out in Guidance for a strategic approach to lifting restrictive public health measures. PT governments have developed their own plans for adjusting PHM within their jurisdictions.

Vaccine-related factors that will influence adjustments to PHM include population vaccine coverage, as well as data on their effectiveness to prevent infection and to reduce transmission, and duration of protection from illness. Modelling suggests that even with limited relief of restrictive PHM there will be a ificant resurgence in cases Reference It will be important for FPT governments to use a risk-based approach when considering adjustments to PHM, weighing the social and economic benefits of lifting restrictive PHM against the consequences of a resurgence of cases from a more transmissible variant.

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It is recommended that PHA continue to reinforce and consider approaches that support adherence to personal preventive practices to help protect individuals from becoming infected and prevent virus transmission from those who are infected. Appendix A provides recommendations for communicating and educating the public on PHM. Public health follow-up should encourage, and when necessary enforce, appropriate isolation of cases and quarantine of contacts according to the guidance on Public health management of cases and contacts associated with COVID Reference It is recommended that individuals in the community be encouraged to plan ahead by maintaining a supply of essential medications, home supplies, and extra non-perishable food for themselves and all members of the household under their care in the event that they need to isolate or quarantine.

As it may not Free sex contacts s car wash Toronto possible for some individuals to acquire these supplies, it is recommended that PHA provide guidance on available resources and supports in their jurisdictions. Given evidence of transmission via respiratory droplets and aerosols, physical distancing continues to be important, especially in light of more transmissible VOC Reference 14 Reference 24 Reference 25 Reference 26 Reference Interactions that are in closer proximity may have a greater risk of transmission than interactions at a distance Reference It is recommended that PHA provide clear communications to the public on the rationale for physical distancing measures, and reinforce the importance of avoiding close proximity and direct contact between individuals who are not from the same immediate household.

Individual and community-based measures to mitigate the spread of covid in canada

Physical distancing includes:. SARS-CoV-2 can spread from individuals who are symptomatic, as well as those who are asymptomatic and pre-symptomatic. The use of non-medical masks that are well-constructed, well-fitting and worn properly play an important role in reducing the transmission of SARS-CoV-2 Reference 28 Reference 29 Reference 30 Reference Non-medical masks have been found to be effective for source control by preventing the infectious respiratory particles of a person who has COVID from coming into contact with others.

In addition, there is evidence that non-medical masks can provide some protection to the wearer from the infectious respiratory particles of others. It is recognized that there is a synergistic protective effect when both the infected and exposed individuals wear non-medical masks Reference 31 Reference The efficacy of a non-medical mask depends on breathability, filtration efficiency, and of critical importance, fit. Masks non-medical or medical that are loose fitting or gaping away from the Free sex contacts s car wash Toronto have been found to have lower filtration efficacy compared to tight-fitting masks with no gaps Reference Masks should completely cover the nose, mouth and chin without any gaps and should be held in place securely with ties or ear loops.

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It may be difficult to achieve proper fit if the mask wearer has certain types of facial hair. The fit of a reusable non-medical mask can be improved by adding a nose wire if it does not already have one or by adjusting the head ties or ear loops so that the mask sits closer to the face. Disposable masks medical or non-medical tend to have poorer fit, leaving gaps between the mask and face of the wearer. Some options to improve fit of disposable masks include modifying ear loops and tucking in the sides of the mask, layering a cloth mask over top of the disposable one, or using a mask fitter or brace Reference 34 Reference A medical mask should not be layered on top of another medical mask.

Well-fitting, two-layered masks comprised of different material types e. Studies have found that filtration efficiency is dependent on fabric quality e. The addition of a middle layer of filter-type fabric, such as non-woven polypropylene, is recommended to reduce transmission potential Reference Free sex contacts s car wash Toronto is important to balance the filtration efficiency of a mask with its breathability, as materials that have poor breathability can cause discomfort and will redirect air to flow from the edges of the mask i.

Non-medical masks constructed of more than three layers or made with non-porous materials e. Recommendations regarding the use of masks vary between jurisdictions.

PHAC recommends that non-medical masks be worn when individuals are in a shared space indoors and outdoors with others from outside their immediate household, or as advised by the local PHA. Masks alone will not prevent transmission of the virus, therefore it is recommended that masks be considered as an added layer of protection along with other mitigation measures e.

Medical masks make medical claims or Free sex contacts s car wash Toronto of reducing or preventing COVID infection for the user, in addition to providing source control to protect others from potential infectious particles of the wearer Reference In the community setting, there are specific circumstances when the use of a medical mask is recommended instead of a non-medical mask.

This includes for anyone diagnosed with or suspected to have COVID while in shared indoor and outdoor space with others, if receiving care, or if going out to seek medical care. Medical masks are also recommended for anyone who needs to provide care to someone diagnosed or has symptoms of COVID Individuals who are at risk of more severe disease or outcomes from COVID or are at higher risk of exposure because of their work or living situation should consider using a medical mask.

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It is recommended that the use of respirators e. All individuals required to use respirators should be fit tested and trained in their use.

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