REGIONAL RISK TOOL and TIPS

Escalating Advice Based on Your Region’s COVID-19 Infection Experience for
Communicating, Cleaning, Handwashing, Ventilating, Distancing, Screening, and Masking

This page provides a tool to determine your local infection risk and corresponding tips for COVID-19 prevention in non-healthcare workplaces.

  • based on Public Health Ontario published** COVID-19 reported case counts
  • graphs the 14-day rolling count divided by population for a rate per 10000 in each Public Health region
  • regional infection risk levels are classified into 5 categories (coloured bands)
  • escalating set of tips, based on risk, to protect your workplace from COVID-19
  • plus daily summary Regional Risk Table At A Glance

 

Ontario COVID-19 Regional Risk Tool:

Risk Legend

Minimal risk – low to absent community transmission

Controlled risk – some sporadic community activity – controlled occasional minor outbreaks

Some community risk – regular sporadic activity – controlled occasional larger outbreaks

Wider community risk – regular activity – periodic outbreaks

High risk – uncontrolled community transmission &/or outbreaks

* These tools translate Reported case data published by Public Health Ontario as a 14 day count per 10 000 population to understand and compare Ontario regional SARS CoV-2 transmission risk.  Recent numbers can be delayed and are less reliable, particularly over weekends, so risk may be underestimated
** The Ontario Framework Category is an estimation of the official provincial colour-coding as explained in Covid-19 Response Framework: Keeping Ontario Safe and Open (see slide 9) based only on the weekly incidence rate per 100,000 but absent the other factors considered locally (e.g. % positivity of daily tests, the reproductive number (Rt – the number of new cases traced from each known case), the number and status of outbreaks, trend in cases without an epi connection, hospital and ICU capacities, and, PHU capacity for contact tracing).   We are also not able to assign “Grey – Lockdown” since this category is based on a judgement call by local authorities.  Therefore, the ON categories assigned in this table may not necessarily align with the official version but are provided for translation and reconciliation with Prevention Tips below.

COVID-19 Colour-coded Prevention Tips

How to use this tool:

  1. Find your public health region and click it in the list below the graph (multiple possible, so click all regions that apply to your workforce)
  2. Note the current colour band of your region (i.e. look at the furthest right point of the line, corresponding to today’s date; pick the highest band if multiple areas)
  3. Based on that colour band, go through the 7 Key COVID-19 Tip Topics below to make sure you’re doing what you need to
  4. *Note: when your regional risk is in a higher band, you should also be doing everything suggested for those previous (e.g. if you’re in the yellow band, also do everything blue and green)

 

Regional Risk Table At A Glance

RankRegion Public Health Unit (PHU)Regional Infection Risk Level*ON Framework Categories**
1Chatham-Kent Health UnitHigh riskCONTROL
2Lambton Public HealthHigh riskCONTROL
3Eastern Ontario Health UnitHigh riskCONTROL
4Windsor-Essex County Health UnitHigh riskRESTRICT
5Southwestern Public HealthHigh riskRESTRICT
6Hamilton Public Health ServicesWider community riskPROTECT
7Sudbury & District Health UnitWider community riskPROTECT
8Huron Perth District Health UnitWider community riskPROTECT
9Peel Public HealthWider community riskPROTECT
10Brant County Health UnitWider community riskPROTECT
11Niagara Region Public Health DepartmentWider community riskPROTECT
12Wellington-Dufferin-Guelph Public HealthWider community riskPROTECT
13Ottawa Public HealthWider community riskPROTECT
14York Region Public Health ServicesWider community riskPROTECT
15Haldimand-Norfolk Health UnitWider community riskPROTECT
16Middlesex-London Health UnitSome community riskPROTECT
17Timiskaming Health UnitSome community riskPREVENT
18Simcoe Muskoka District Health UnitSome community riskPROTECT
19Toronto Public HealthSome community riskPROTECT
20Region of Waterloo, Public HealthSome community riskPROTECT
21Kingston, Frontenac and Lennox & Addington Public HealthSome community riskPROTECT
22Hastings and Prince Edward Counties Health UnitSome community riskPREVENT
23Halton Region Health DepartmentSome community riskPROTECT
24Peterborough Public HealthSome community riskPROTECT
25Durham Region Health DepartmentSome community riskPREVENT
26Renfrew County and District Health UnitSome community riskPREVENT
27Grey Bruce Health UnitSome community riskPREVENT
28North Bay Parry Sound District Health UnitSome community riskPREVENT
29Haliburton, Kawartha, Pine Ridge District Health UnitSome community riskPREVENT
30Leeds, Grenville and Lanark District Health UnitControlled riskPREVENT
31Northwestern Health UnitControlled riskPREVENT
32Algoma Public Health UnitMinimal riskPREVENT
33Porcupine Health UnitMinimal riskPREVENT
34Thunder Bay District Health UnitMinimal riskPREVENT

* These tools translate Reported case data published by Public Health Ontario as a 14 day rolling count (divided by population to create a rate per 10 000 people) to understand and compare Ontario regional SARS CoV-2 transmission risk.  Recent numbers can be delayed and are less reliable, particularly over weekends, so risk may be underestimated.

** The Ontario Framework Category is an estimation of the official provincial colour-coding as explained in COVID-19 Response Framework: Keeping Ontario Safe and Open (see slide 9) based only on the weekly incidence rate per 100,000, but absent the other factors considered locally (e.g. % positivity of daily tests, the reproductive number (Rt – the number of new cases traced from each known case), the number and status of outbreaks, trend in cases without an epi connection, hospital and ICU capacities, and, PHU capacity for contact tracing).   We are also not able to assign “Grey – Lockdown” since this category is based on a judgement call by local authorities.  Therefore, the ON categories assigned in this table may not necessarily align with the official version but are provided for translation and reconciliation with Prevention Tips below.

 

COVID-19 Colour-coded Prevention Tips

 

Communicating:

  1. Develop a written, site-specific COVID-19 Workplace Safety Plan with worker (Health & Safety Committee or H&S Rep) participation and share it all workers.
  2. Organize a respectful system of notification to supervisors, and/or alerting workers of possible/confirmed cases – be careful to balance confidentiality with the need to know
  3. Share exposure, risk & response information quickly and transparently – building trust
  4. Develop and implement a COVID-19 Workplace Safety Plan that is responsive to levels of current regional, community and individual risk – allowing enough flexibility to accommodate for individual special needs and reasonable preferences
  5. Adjust absenteeism policies, paid workplace leave arrangements and workloads to make sure that workers feel able to stay home when they feel unwell
  6. Provide flexibility/support for workers with challenges at home (relational, economic, health-related, etc.)
  7. Encourage questions and dialogue to address potential (or perceived) protective needs
  8. Provide training on the Virus, Risk Assessment & Hierarchy of Controls (HOC) for COVID-19 (Elimination (Distancing), Engineering (Ventilation), Administrative (Cleaning, Screening) & PPE including application to prevention and protection in the context of site, operations and activities
  9. Clearly specify the conditions under which the workplace will scale back occupancy, or be shut down along with plans and procedures for restart

 

Cleaning & Disinfecting:

  1. Establish an escalating protocol for cleaning surfaces – based on regional community risk level (use common cleaning agents more frequently when risk is lower; save the more potent/toxic chemicals for when the risk is higher)
  2. Clean touch points and surfaces on a regular basis
  3. Ensure any workers handling cleaning chemicals are adequately trained (WHMIS hazard specific) to use them appropriately and safely; review and implement SDS recommendations with appropriate ventilation, mixing ratios, labelling, equipment & procedures (e.g. standing times), and PPE)
  4. Use HEPA vacuum, minimize carpeted flooring
  5. Clean & disinfect touch points, shared washrooms & surfaces (including floors depending on occupancy levels & traffic) more frequently and:
    1. Check if chemicals being used are on approved COVID lists e.g. Health Canada
    2. Select less toxic, environmentally friendly options
    3. Check with users and occupants for any adverse reaction (skin/breathing)
  6. Surface swipe sampling can be done but is very expensive, better to address potential contamination with deep cleaning and/or multi-day closure (seek Public Health guidance).

 

Handwashing:

  1. Make handwashing convenient and easy (wash stations)
  2. Encourage cough/sneeze etiquette – provide tissues & garbage cans
  3. Provide accessible paper towels at all wash stations
  4. Provide hand sanitizer at entrances and other gathering or transiting locations (e.g. elevator, waiting room)
  5. Organize breaks and scheduling to allow regular handwashing (especially in dirty environments where hand sanitizer is not sufficient)
  6. Place cough/sneeze etiquette and proper hand hygiene signs at entry points and every wash station
  7. Increase frequency of hand washing as your regional risk level rises
  8. Consider purchase or installation of hands-free trash receptacles, soap and towel dispensers, door openers, and other similar equipment.

 

Ventilating:

  1. Regularly clean HVAC unit and ensure proper maintenance and filter changes
  2. Ensure building and exhaust fans run continuously (e.g. thermostat setting at “ON” instead of “AUTO”) to maximize the amount of fresh air coming into the building
  3. Boost washroom ventilation and air changes
  4. Keep windows open whenever possible where it doesn’t interfere significantly with HVAC’s operation
  5. Review Ventilation Checklist with JHSC/HSR & HVAC technician or expert
  6. Maintain relative humidity between 40-60% where feasible
  7. Adjust the ventilation system to increase outdoor air supply (adjust thermostat to allow for less temperature control during weather extremes) – ensure occupant originating CO2 levels are 500-800 ppm (lower better)
  8. Install minimum of MERV 13 or 14 filters – check to ensure air volume is not significantly compromised
  9. Use one or more portable MERV 13, 14 or HEPA air filters if ventilation can’t be increased, they are suitably sized and adequately maintained
  10. Organize washroom break schedules to allow distancing and leave enough time between users to allow air changes
  11. Consider UV disinfection in air handling units with appropriate safety precautions.
  12. Keep ventilation in building running on low even when unoccupied and/or several days before re-entry

 

Distancing:

  1. Distancing become more important as the regional infection risk increases; have an escalating plan to respond to changes in local community transmission
  2. Rework tasks and processes to minimize contact
  3. Install barriers with appropriate communication & reach safeguards to protect workers in open offices or public facing services
  4. Control traffic to minimize contact (with clear directional & distance signage or floor markings) when risk requires
  5. Stagger occupancy, encourage and actively support working at home where possible, virtual meetings, limit office occupancy to 1 person/office
  6. Minimize and/or carefully manage travel (check regional infection levels along the route and at the destination) – consider the comparative risk associated with different modes of travel (e.g. public transit vs. private vehicle)
  7. Define and organize cohorts/social bubbles at work
  8. Control occupancy (limit #, schedule, control entrance/exit, screen if necessary, etc.)
  9. Shut down workplace except for essential services, and work from home where possible

 

Screening/tracking/risk assessment:

  1. Monitor Community status – use this COVID-19 Regional Risk Tool to know the risk in your community, watch the regional health unit statistics; monitor the local COVID news (e.g. number of cases active, sources of infection, type of transmission, outbreaks)
  2. Encourage use of the Health Canada COVID Alert app
  3. Risk assessment – what is the current likelihood that anyone in the workplace may encounter someone with an infection?
    1. Monitor community rates of infection daily and get to know the local infection patterns: e.g. travel related, low level occasional/sporadic (known case connected), outbreak (transmission confined to facility/location), general community (not connected to known cases)
    2. Review job, activity or contact time exposure risk assessment eg. OHCOW or BOHS tools and plan to reduce or control
    3. Encourage workers to minimize and personally track their network (bubble) of contacts (the higher the number, the more frequent, the higher the risk);
    4. When the local risk warrants, begin to educate and encourage self-monitoring of high risk activities/locations within each worker’s social bubble (e.g. commuting, visits to HC or LTC facilities, social events, team sports, spectator, worship or cultural gatherings, travel to/through higher risk areas, etc.)
  4. Implement an escalating (community risk based) self-screening system.
  5. Properly train and support workers to self-screening for symptoms, track contacts, and be alert to home or working conditions (or protocols) that elevate risk
  6. Encourage/support workers with potential COVID contacts, or those who are symptomatic, or sick, to work from home; communicate openly, respectfully and be sure to maintain medical confidentiality
  7. Institute active symptom screening (e.g. entry interview or measurement of visitor/worker temperatures with appropriate medical follow-up for positive screens) – be aware that collecting personal health information requires careful oversight and confidentiality safeguards – these measures should only be implemented if there is a significant risk of community transmission
  8. Consider Implementing COVID-19 testing requirements and protocols for high risk situations (i.e. outbreaks) and/or clearance before a return

 

Face covering/Masking:

  1. Monitor community (and operational or activity) risk levels; organize face covering/mask supply
  2. Ensure workers and visitors know that masking is required if distancing is challenged
  3. Encourage creative options for face coverings to accommodate individual comfort and physical/psychological challenges (provide face shield options)
  4. Practice good hand hygiene when donning, doffing, storing and disposing of masks
  5. Consider universal masking (as source control) where community (or operational) risk level warrants (or is legally required) –(Masking may be optional if/when community infection risk is low, other safe-guards along the hierarchy of controls are in place, and if not otherwise mandated)
  6. Use fit-tested N95 respirators (or better) if aerosol exposure is a significant risk (due to population, operation, activity, time or site parameters); generally only for essential work, since otherwise workplaces likely closed

 

Background & Further Information

SARs-CoV-2 is a highly infectious virus causing mild illness in many, but 20% face serious disease and 3- 5% might die. People are both the potential source (or “hazard”), and the possible victims to be protected, which makes prevention harder. It is an occupational, public, and environmental health problem which further complicates things. This page takes a practical, risk-based approach to prevention, building from regular strategies that are part of a healthy and safe workplace to more targeted (and potentially restrictive) controls. It also recognizes the importance of addressing the virus from a framework of Occupational Health & Safety (where everyone shares responsibility and needs to work together, particularly reinforcing hazard communication, duty of care, and the rights to know and participate) as well as applying the Hierarchy of Controls (Elimination/Substitution ? Engineering ? Administrative ? Personal Protective Equipment). More detailed guidance can be found on OHCOW’s COVID-19 Resources page, as well as the OHCOW Workplace COVID-19 Risk Management (Control Banding) Matrix which aligns US OSHA Workplace/Job Risk Levels with escalating protections and controls.

OHCOW gratefully recognizes the contributions of Kendra Oudyk, Chris Oudyk, and Brian Conroy (from the Canadian Centre for Occupational Health & Safety (CCOHS)) for their contributions in constructing this webpage.