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Bulletin | Covid-19

Canadian Health Sector: COVID-19 Update

Fasken
Reading Time 14 minute read
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Health Law bulletin

This bulletin summarizes key legislative changes, government orders and other significant developments in response to the COVID-19 outbreak affecting health care providers and organizations across Canada during the past two weeks.[1]

Measures implemented by governments across Canada focus on safely reopening businesses and services, including in the health care sector, while continuing work to reduce new infections, recover from the outbreak and support frontline workers. Restrictions continue in sectors that have been hardest hit - particularly long-term care. Certain provinces have introduced legislation to replace temporary emergency orders.

For additional information and insights visit the Fasken Coronavirus (COVID-19) Knowledge Centre. In addition, see our previous bulletins summarizing health sector updates across Canada in March 2020, up to April 5, 2020, up to April 12, 2020, up to April 19, 2020, up to April 26, 2020, up to May 3, 2020, up to May 17, 2020, up to May 31, 2020 and up to June 14, 2020.

Alberta

Effective June 12, 2020, the Chief Medical Officer of Health issued an order, rescinding a number of her previous orders, as part of the province's Stage 2 launch. A person in Alberta can attend a location where any business or entity is operating, except a business or entity listed in the order (children's play centres, amusement parks and nightclubs), subject to taking public health measures. Stage 2 includes more surgeries and the resumption of wellness services such as acupuncture and massage therapy.

Effective June 15, 2020, the Government of Alberta announced that pharmacists in the province can dispense up to a 100-day supply of prescription medication (up from a 30-day limit). Pharmacists are expected to use their discretion for specific drugs that still have shortages or supply chain issues, and government, industry, pharmacy organizations, and other health sector partners continue to monitor supply levels.

Alberta's state of emergency ended on June 15, 2020. On June 18, 2020, the government introduced Bill 24, the COVID-19 Pandemic Response Statutes Amendment Act, which allows some pandemic response efforts to continue beyond the declared public health emergency and introduces new measures to support the reopening of Alberta's economy. Bill 24 received Royal Assent on June 26, 2020. Among the measures included in Bill 24 are:

  • an extension of arrangements that allow a health care facility to limit employees to working at one site;
  • a new regulation-making authority to support orders of the Chief Medical Officer of Health; and
  • additional powers for the province and municipalities to suspend or modify permit requirements for temporary facilities such as drive-thru COVID-19 testing sites (to address COVID-19 and future pandemics).

On June 23, 2020, the Alberta government announced a $10 million investment in targeted serology testing that will help track the spread of COVID-19 through voluntary public health studies. Additionally, Alberta Precision Laboratories (owned by Alberta Health Services) will offer serology (antibody) testing for specific clinical purposes and serology research studies.

On June 27, 2020, the Alberta government announced an investment of $14.2 million a month – over $170 million total – in additional funding to extend supports previously announced for residents and staff in long-term care homes, designated supportive living facilities and seniors lodges. Funding will pay for enhanced staffing and extra cleaning supplies, and address lost accommodation revenue.

British Columbia

On June 17, 2020, British Columbia's Provincial Health Officer released a letter addressed to businesses looking to test employees for COVID-19. In it, she confirmed that, in British Columbia, the recommendation is that only symptomatic individuals and individuals otherwise identified by a health professional should be tested, and routine testing of asymptomatic people is not recommended. Serological testing is recommended for public health and research only.  If businesses do test their employees, they still must continue to comply with public health measures to prevent transmission. The Provincial Health Officer also reminded employers of the laboratory accreditation process. 

On June 22, 2020, the province introduced Bill 19, the COVID-19 Related Measures Act. The Act will formalize necessary ministerial orders created in response to the pandemic as the state of emergency is lifted. Previous orders will be extended for either 45 or 90 days after the end of the state of emergency. The Act will also allow the government to extend orders for up to one year after the Act is brought into force, if required to respond to a second wave.  The Act enables the government to make regulations that will provide protections from civil liability related to COVID-19, which may be used to protect service providers from liability when they follow public health orders and guidelines. The state of emergency in British Columbia has currently been extended to July 7, 2020 by an order issued on June 23, 2020.

Effective June 24, 2020, British Columbia is in Phase 3 of the province's Restart Plan. Phase 4 is conditional on global availability of a vaccine, community immunity or treatment.

Manitoba

On June 15, 2020, the Government of Manitoba announced that it had issued an order extending the province-wide state of emergency for a further period of 30 days.

On June 16, 2020, the Manitoba government announced the expansion of the Risk Recognition program to include more frontline workers who were exposed to added risk during the pandemic. Payment is available to part-time and full-time workers in certain private and public sector areas, including health care.

The Chief Provincial Public Health Officer issued new public health orders on June 18, 2020 and on June 25, 2020, respecting self-isolation on arrival in Manitoba, COVID-19 prevention (including gathering limits and re-opening) and travel to Northern Manitoba and Remote Communities (removing restrictions). The June 25 orders terminated and replaced the June 18 orders (prior orders are all available at https://www.gov.mb.ca/covid19/soe.html). The current public health orders allow individuals who are self-isolating under federal or provincial health orders to visit a family member or friend who has a life-threatening disease in a health care facility, if the facility permits them to do so and they are not displaying any symptoms of COVID-19.

The Third Phase of Manitoba's Restoring Safe Services plan began implementation on June 21, 2020.  As part of the Third Phase, occupancy limits of 50% of normal business levels or one person per 10 square metres can be lifted for regulated and non-regulated health professions. Measures to ensure that members of the public are reasonably able to maintain a separation of at least two metres, with the exception of brief exchanges, remain in place.

On June 22, 2020, the Manitoba government announced that the province will develop outdoor, all-season visitation shelters near personal care homes to allow residents to safely have visits with their families and friends. 

On June 23, 2020, the Manitoba government announced investments in new diagnostic equipment for health care facilities to allow Manitobans to access care closer to home.

New Brunswick

On June 19, 2020, the Government of New Brunswick announced that its COVID-19 recovery plan is moving to the third (Yellow) level for all areas of the province except Zone 5 (Campbellton region).  The Yellow level includes the gradual reopening of more businesses and activities while working to prevent a resurgence of the virus.  Indoor visits with one visitor at a time for residents of long-term care facilities are now permitted, if the facilities are able to do so (unless the visitor requires support, in which case two visitors at a time will be allowed).  Effective June 26, 2020, Zone 5 moved fully into the Yellow level with the rest of the province.

On June 25, 2020 the State of Emergency mandatory order was renewed and revised under the authority of New Brunswick's Emergency Measures Act.

Newfoundland and Labrador

On June 15, 2020, the Government of Newfoundland and Labrador released details on its COVID-19 Essential Worker Support Program. This program, which is cost-shared with the federal government, will provide a one-time payment to individuals who meet eligibility criteria and who work in professions included in the Government of Canada's "Guidance on Essential Services and Functions in Canada During the COVID-19 Pandemic" document, including health care workers.

The government issued an order, effective June 16, 2020, extending the province's public health emergency for a further period of 14 days.

On June 17, 2020, the Chief Medical Officer of Health issued a Special Measures Order (General - Alert Level 3) (Personal Care Home Visitation Amendment) amending the visitation restrictions in personal care homes. Effective June 10, 2020, visitation is limited to one designated person per resident where the visit occurs inside the home, except for exceptional circumstances including visiting a resident at end of life.  Further, on June 17, 2020, the Chief Medical Officer of Health also issued a Special Measures Order (General - Alert Level 3) (Assisted Living Facilities Visitation Amendment) amending the visitation restrictions in assisted living facilities, effective June 10, 2020, which mirror those with respect to personal care homes.

On June 18, 2020, the Government of Newfoundland and Labrador assented to the Act to Amend the Medical Care and Hospital Insurance Act.

On June 24, 2020, the provincial government announced that, effective June 25, 2020, Newfoundland and Labrador will enter Alert Level 2 of its COVID-19 "Alert Level System". The focus of Alert Level 2 is to control the transmission of COVID-19, while supporting the re-opening of more businesses, increasing social activities, and maintaining health system capacity. The regional health authorities will continue to allow more health care services to resume during Alert Level 2. Virtual care options continue to be available and are encouraged.

Northwest Territories

On June 23, 2020, the Government of the Northwest Territories announced that it has extended the Public Health Emergency and State of Emergency, effective June 24, 2020 and expiring on July 8, 2020.

Nova Scotia

On June 18, 2020, the Government of Nova Scotia issued a renewal of the provincial State of Emergency until July 12, 2020.

On June 26, 2020, an update to the Order under Nova Scotia's Health Protection Act was issued by the province's Chief Medical Officer of Health. Effective June 24, 2020, all residents in homes licensed by the Minister of Community Services under the Homes for Special Care Act are permitted to have community access in accordance with the terms and conditions set out in the "Disability Support Program Community Access Guidelines" dated June 24, 2020 (as may be amended from time to time).

Nunavut

The Government of Nunavut announced that, as of June 15, 2020, normal dental services are permitted to resume.  Specialty clinics, all non-essential travel for mental health clients and families, and all non-essential travel for families visiting clients in care are cancelled.  No visitors are allowed at long-term care facilities.

Ontario

On June 15, 2020, the Government of Ontario announced a proposed regulatory change to mandate reporting of data on race, income, language and household size for individuals who have tested positive for COVID-19.  The amendments to Paragraph 11 of Section 5 of the Reports Regulation under the Health Protection and Promotion Act, which are in force as of June 26, 2020,expand data collection in an attempt to stop the spread of COVID-19.  Those who have tested positive for COVID-19 will be asked for additional information.  Individuals can choose not to answer any or all of the questions.  The government emphasized that privacy will be protected as it is for all information collected on other diseases.  The amendments are intended to provide a more complete picture of the outbreak, reduce inconsistencies in data collection efforts, and inform effective public health practices and interventions in response to COVID-19.

On June 16, 2020, the government released a general workplace guide providing information on how to develop a workplace safety plan to create safer working environments during COVID-19. The guidelines are accompanied by 121 workplace resources, which include specific guidelines for various sectors, including long-term care.

On June 18, 2020, the government announced that the province is enhancing COVID-19 case and contact management measures to quickly test, trace and isolate cases. The strategy focuses on (i) ensuring all new cases and close contacts are identified early, contacted quickly, investigated thoroughly and followed up with daily for 14 days; (ii) supporting public health units with up to 1700 additional staff from Statistics Canada; (iii) improving technology tools by modernizing the Public Health Information System through the implementation of a custom-built COVID-19 case and contact management system; and (iv) launching a notification app to alert Ontarians when they may have been exposed to COVID-19.  The additional measures include a comprehensive case and contact management strategy, Protecting Ontarians through Enhanced Case and Contact Management, and, in partnership with the federal government, a new made-in-Ontario national app called COVID Alert.  The app, which can be voluntarily downloaded, will notify users anonymously if they have been exposed to someone who tested positive for COVID-19 in the last 14 days.  Ontario users will have quick access to the province's public health advice and resources and recommendations on any necessary actions.  Ontario's new case and contact management system will integrate with COVID-19 laboratory results from the Ontario Laboratory Information System to reduce the administrative burden on public health unit staff.

On June 23, 2020, the government filed an order (O. Reg. 299/20) under the Emergency Management and Civil Protection Act ("EMCPA") to expand the regional health units moving to Stage 2 of the province's reopening framework to include the City of Toronto Health Unit and Peel Region Health Unit.  The order is effective as of June 24, 2020.

On June 24, 2020, the government announced its extension of the provincial Declaration of Emergency under section 7.0.7 of the EMCPA to July 15, 2020.

On June 27, 2020, the government announced the extension of all emergency orders currently in force under s. 7.0.2(4) of the EMCPA until July 10, 2020. This decision was made in consultation with Ontario's Chief Medical Officer of Health to ensure the safe and gradual reopening of the province on a regional basis can continue as part of Ontario's Framework for Reopening the Province.

Prince Edward Island

The Government of Prince Edward Island has published an update to its Directive on Visitation to Long-Term Care Facilities and Nursing Homes.

The province's Chief Public Health Officer issued a Public Health Order, effective June 12, 2020, revoking and replacing its previous order issued on May 31, 2020.

On June 14, 2020, the Prince Edward Island government issued a renewal of the provincial State of Emergency until June 28, 2020.

On June 23, 2020, the Prince Edward Island government announced that the province will move to further relax restrictions as Phase 4 of the Renew PEI Together plan begins on June 26, 2020. In Phase 4, anticipated scheduled indoor visits with up to two individuals at one time and additional access for clergy will be permitted at both private and public long-term care facilities. Further, all non-urgent health care services will resume. On June 25, 2020, the province updated its Long-Term Care Facilities and Nursing Homes Staff Movement Order in accordance with the above.

Quebec

On June 17, 2020, the Government of Quebec issued an order renewing the public health emergency until June 23, 2020. An order issued on June 23, 2020 extended the public health emergency to June 30, 2020.

Also on June 17, 2020, the Minister of Health and Social Services issued an order, effective June 19, 2020, that supports the reopening of schools and certain businesses. The Government of Quebec issued an order with respect to reopening education, and certain other settings and work environments, on the same day. The Minister of Health and Social Services issued an additional order on June 19, 2020 with respect to additional work environments.

On June 22, 2020, Premier François Legault announced (in French only) adjustments to cabinet, including with respect to the role of the Minister of Health and Social Services.

On June 25, 2020, the Quebec government issued an order respecting social distancing (and exceptions) and gathering restrictions.

Saskatchewan

On June 16, 2020, the Saskatchewan government announced that Phase 4, Part 1 of the Re-Open Saskatchewan Plan would begin on June 22, 2020.  Part 2 is set to begin on June 29, 2020

On June 19, 2020, the Chief Medical Officer of Health issued a new public health order that supports Phase 4, Part 1.  Visitors continue to be restricted in long-term care homes, hospitals, personal care homes and group homes to family or designates visiting for compassionate reasons.  Requirements also remain in place with respect to working in more than one facility and for health screenings and other protective measures (see our previous bulletin).[2]  The Saskatchewan government has also posted a list, effective June 20, 2020, of critical public services, allowable business services and events, activities, and outdoor spaces.  Many health care services are considered critical public services. 

On June 23, 2020, the Saskatchewan government issued an update on how residents have been accessing virtual care during the pandemic.

On June 26, 2020, the Saskatchewan government announced a new personal protective equipment supply business in the province.

Yukon

On June 17, 2020, the Government of Yukon announced that dental professionals may offer full dental services in the territory beginning on July 1, 2020.  Dental professionals will be able to offer non-urgent services, including but not limited to:

  • initial or periodic oral examinations or recall visits;
  • routine dental cleaning and preventative therapies;
  • routine radiographs;
  • extraction of asymptomatic teeth;
  • aesthetic dental procedures;
  • dental implants;
  • restorative dentistry; and
  • non-painful chronic periapical lesions.

On June 23, 2020, the government published an updated guidance document on recommended practices and personal protective equipment for dentists and dental clinics.

Federal

Effective June 19, 2020, the Government of Canada issued an order amending the Minimizing the Risk of Exposure to COVID-19 in Canada Order (Mandatory Isolation), No. 2.

Effective June 21, 2020, the Government of Canada issued an order extending the effective date of a previous order restricting entry into Canada by foreign nationals arriving from the United States.[3]



[1] This bulletin addresses updates published up to 5:00 pm (EST) on June 28, 2020.

[2] Saskatchewan also has a number of updated resources for the health care sector, including family presence and screening guidelines and tools. Updates specific to visiting Saskatchewan Health Authority facilities are also available.

[3] Thank you to articling students Marissa Di Lorenzo and Rob Legge, and to summer law students Rachel Hung, Gordon Lee, Montana Licari, Sabrina Chang and Nicolas Kasting for their research assistance.

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