- Updated the tool to reflect the latest guidelines in Toronto as well as the general recommendations in the Alberta, BC and Ontario tools. Please note that there is not a universal consensus in terms of how the questions should be asked or even what the recommendation should be in terms of testing. However, we have updated the tool to reflect the key recommendations shared across all the tools, while also collecting and documenting a useful history for clinicians.
- Updated the previous indication for COVID-19 testing (symptoms + (occupational exposure or age/comorbidity) to advise the patient to instead call for advice. The guidelines for this decision aren't yet universally accepted in the country. The current recommendation among the Toronto hospitals is to keep these patients isolated at home rather than sending them in for testing, due to the risk of contracting or spreading the virus.
- Updated the symptom-but-no-risk message to be clearer regarding the advice against testing: "Since you have symptoms, it is possible that you have the COVID-19 virus. However, testing is currently not recommended due to the risk of exposing yourself or others the virus."
The guidelines suggest it is better for these patients to self-isolate at home.
- Changed the lethargy question to: "having a very hard time waking up or feeling confused with decreased consciousness", since many patients do not know what "lethargy" means. (Consistent with the Toronto symptom checker.)
- Changed the weakness question to say "severe", i.e. "severe weakness that impairs your ability to carry out activities of daily living (such as showering, preparing meals, and dressing)" - to limit false positives sending patients to the ER.
- Attached below is an assessment algorithm for Toronto Public Health from Mar 16. Please note that its recommendation 3) for testing does not reflect the symptom checkers' recommendations because it is designed for individuals who have already presented to an assessment centre. According to ID specialists at the Toronto hospitals, for individuals still at home, the risk of going in for testing is believed to outweigh the benefit and will quickly exhaust the testing and PPE supply.