Living with COVID: Transition of Public Health Management

Released on February 3, 2022

The Omicron wave requires a shift in public health management of the pandemic in Saskatchewan.  The outbreak and case management protocols that were effective in previous waves of the pandemic in identifying and limiting transmission are no longer as effective with the speed of Omicron's transmissibility.  Public health strategy and resources must be realigned to focus on those at highest risk of severe COVID-19 outcomes.

Two elements have significantly altered the role of public health at this point in the pandemic event.  In Saskatchewan there is widespread access to vaccinations and booster doses, as well as free, at-home rapid testing.  Vaccinations, including the third/booster dose have dramatically decreased the risk of severe outcomes for most residents.  At-home rapid testing has enabled individuals to self-manage, given the prevalence of asymptomatic or mild illness for the majority of those who contract Omicron.  Residents now have reasonable self-management tools to safely navigate day-to-day activities. 

Based on the significant amount of information all jurisdictions now have on the risk, transmission and severity of COVID-19, public health can realign provincial resources to prioritize its strategies to manage the current variant while continuing to deliver other essential public health programs and services and support the on-going response of the health care system. 

This transition is necessary as Saskatchewan prepares to manage COVID-19 in the long-term.  Necessary COVID-19 surveillance and public health planning will continue, particularly as potential new variants may emerge.

Testing At-Risk Residents - Call HealthLine 811
With most Omicron COVID-19 cases resulting in mild illness, these cases can be self-managed with self-testing and self-isolation. Saskatchewan Health Authority (SHA) PCR testing will be reserved for priority populations at elevated risk for severe outcomes, which include:

• Hospitalized patients, those admitted or transferred between acute, long-term care or personal care homes
• High risk populations as ordered by the medical health officer: residents in long-term care, personal care homes and congregate living facilities; and international or travellers from areas of concern
• Priority symptomatic persons: health care workers or essential workers who have a negative rapid antigen test but remain symptomatic; those with chronic illness (diabetes, history of cancer, cardiac failure, etc.)
• Symptomatic people living or working in First Nation and Métis communities 
• Surgical patients with symptoms or a positive rapid antigen test if scheduled or expecting to receive surgery within the next 90 days
• Pregnant patients who are symptomatic and more than 30 weeks gestation 
• Symptomatic immunocompromised individuals including all transplant donors and recipients prior to and post-transplant; all oncology patients prior to, receiving or post chemotherapy
• Newborns born to COVID-19-positive parents, prior to discharge

Additionally, health care workers and essential workers as defined under the current public health order with negative rapid antigen results who remain symptomatic will continue to be eligible for PCR tests to protect Saskatchewan's essential services.

Medical health officers may order PCR testing as part of outbreak investigations, particularly in at-risk settings like long-term care and personal care homes, and other congregate living facilities. 

Residents who require PCR test results for travel, insurance claims including potential Workers' Compensation Board claims, or in lieu of proof of vaccination, will be required to purchase a test from a private lab service provider for that documentation. 

Free rapid antigen tests are available at approximately 600 locations around the province, with Indigenous Services Canada and the Northern Inter Tribal-Health Authority receiving a supply for First Nations communities.   The province of Saskatchewan has requested more than four million rapid antigen tests from the federal government for each of February and March to ensure a secure supply.

With PCR testing eligibility focused on at-risk populations, the SHA is adjusting PCR testing locations to ensure access while returning frontline health care workers to home positions to support post-pandemic service delivery. 

Effective Monday, February 7, all COVID-19 PCR testing will be by appointments made through HealthLine 811. 

While the online appointment booking system will be discontinued February 7, walk-in and drive thru testing sites will be discontinued over the coming week.  Services provided through SHA testing and assessment centres will be redistributed to primary care sites through the month of February. 

Outbreak Management
The Omicron variant of COVID-19 is more transmissible with a very short incubation period and many cases remain asymptomatic.  This makes contact tracing and case management protocols less effective in preventing transmission. Public health will continue to investigate severe cases and shift resources to focus on outbreak management in settings where the risk of severe health outcomes is highest.

Public health will continue to investigate outbreaks in acute care settings, long-term care and integrated facilities, personal care homes, correctional facilities and congregate living settings including shelters and group homes.  Outbreaks in long-term care and personal care homes will continue to be publicly reported at Saskatchewan.ca/covid-19. 

While outbreaks related to public mass gatherings/events, places of worship, workplaces, daycares, and educational settings will no longer be investigated, these venues and organizations will continue to be supported by local public health with transmission mitigation planning and standard surveillance protocols.  

On-Going Surveillance to Support Public Policy
COVID-19 surveillance will now align with reporting for other communicable diseases.  Indicators continue to be monitored and contribute to routine surveillance for COVID-19, influenza and other respiratory illnesses. 

Starting the week of February 7, public health will begin reporting COVID-19 epidemiological information weekly on Thursdays.  This weekly integrated epi report will provide the new laboratory-confirmed cases, deaths, tests, and vaccination information overall and by zone.  The provincial COVID-19 dashboard will be discontinued and its information archived.

Public Health Orders
The current public health orders will remain in place at this time but are subject to review.  This includes mandatory masking in all indoor public spaces including schools; mandatory self-isolation for all confirmed cases; and proof of vaccination or negative test requirements for public access to a list of establishments, businesses and event venues.

Stay Safe - Protect Yourself and Your Community 
Living with COVID-19 requires all residents to continue the measures we know to work.  While safe and effective vaccine and rapid at-home testing are widely available and are important public health interventions, all other personal preventive measures remain important to preventing transmission.

• Immediately self-isolate and self-test with even the mildest cold- or flu-like symptoms.
• Wear your best mask whenever you are outside your home or when meeting friends and family you know to be at high risk for severe COVID-19 outcomes.
• Get vaccinated, including your third/booster dose as soon as you are eligible.

Living with COVID-19 means all residents should be self-monitoring, self-testing and self-managing to help prevent transmission.

-30-

For more information, contact: