Medical Partners

COVID-19 Protocols For Sports & Entertainment

The Government of Ontario and Toronto Public Health have implemented guidelines with regards to protecting the health and safety of Ontario's facilities during COVID-19. These are recommendations as well as descriptions of mandatory safety and health standards and are intended to assist administrators in providing a safe and healthy facility or venue.

No Wait Medical Partners focuses on the need to follow appropriate guidelines during work shifts and while at home.


General Responsibilities



Assess the hazards to which your staff, workers, and visitors may be exposed; evaluate the risk of exposure and select, implement, and ensure workers use controls to prevent exposure. Follow local public health for location specific instructions.


1. Implement Basic Infection Prevention and Control (IPAC) Measures



-Hand Hygiene

  • Promote frequent and thorough hand washing, including providing employees and customers with a place to wash their hands. If soap and running water are not immediately available, foam alcohol-based hand rubs containing 60-90% alcohol should be provided. Regular hand washing or using of alcohol-based hand rubs are necessary. Hands should be washed when they are visibly soiled and after removing any Personal Protective Equipment (PPE).


  • Provide resources and environment that promotes personal hygiene, including tissues, no-touch trash cans, hand soap, disinfectants, and disposable towels to clean surfaces. Post hand washing signs in restrooms. Ensure clean toilet and hand washing facilities. Fill hand sanitizer dispensers regularly. Disinfect frequently touched items, including door pulls and toilet seats often.


-Respiratory Etiquette

  • The importance of covering coughs and sneezes with a tissue should be emphasized. Afterwards, throw the tissue away into the trash and perform hand hygiene.


  • Avoid touching the face, especially with unwashed hands.


-Source Control

  • Staff and visitors should wear non-medical masks over their nose and mouth to prevent them from spreading the virus, though it is not PPE. Cloth face coverings should not be placed on children younger than 2 years old, anyone who is incapacitated or otherwise unable to remove the cloth face covering without help, and people who cannot tolerate them based on underlying health and/or behavioral issues. Ontario's universal masking document explains the safe use, limitation, and care of non-medical masks.


-Enhanced Sanitation

  • Maintain regular housekeeping practices, including routine cleaning and disinfecting of surfaces, equipment, and other elements of the environment. When equipment must be shared, instruct staff and older children to use alcohol-based wipes to clean before and after use. When cleaning tools and equipment, staff should consult manufacturer recommendations for proper cleaning techniques and restrictions (e.g., concentration, application method and contact time, PPE).



  • Develop a disinfection schedule or routine plan, especially for high contact areas like restrooms. Ensure sufficient stocks of cleaning and disinfecting supplies to accommodate ongoing cleaning and disinfection. High touch areas should be cleaned and disinfected (e.g. doorknobs, display cases, equipment handles) more frequently, at least twice daily and when visibly soiled). Plexiglass barriers should be cleaned routinely (e.g. daily) using a cleaning agent that will not compromise the structural integrity or function of the barrier.

Donation

2. Hazard Controls



-Elimination/Substitution


  • When feasible, replace in person visits with virtual or telephone ones to avoid face-to-face interaction; prevent unnecessary visits.


  • Offer contactless payment options such as e-transfer, tap, credit and debit. If using a debit machine, sanitize after each use or use a replaceable covering.


-Engineering/System Controls


  • Space out furniture to facilitate physical distancing. In washrooms, close every other stall, sink, or urinal.


  • Install partition barriers such as plexiglass when physical distancing is not an option.


  • Maximize the outdoor air ratio of the heating, venting and air conditioning (HVAC) systems and ensure they are up to American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) standards.


-Administrative Controls


  • Provide easily acceptable waste receptacles for used wipes and other disposable protective equipment.


  • Stagger shifts, breaks, arrivals, and departures to allow for physical distancing and more cleaning time. Minimize the need for waiting by spreading out appointment times, and/or ask the clients to wait in their car.


  • Assign staff to monitor and manage lines inside and outside the venue, and to remind guests to keep 2 metres apart.


  • Minimize traffic flow in common spaces (e.g. hallway markers, limit number of people in elevators).


  • Improve circulation inside by opening windows and doors. To prevent blowing droplets onto people and surfaces, limit the use of low ceiling fans and refrain from using pedestal fans.


  • Increase the frequency of commonly touched surfaces. Remove nonessential frequently touched items (i.e., books, service menus, pens).


-Personal Protective Equipment (PPE)


  • PPE can be used by trained personnel to lower the risk of transmission as a last option if other controls are not sufficient.


3. Screening



  • Everyone regardless of symptoms should wear a cloth face covering until leaving the facility when activities permit.


  • Post screening information on a website, send an email containing screening requirements, or consider mailing by post if the client does not have access to the other methods.


  • Active Screening


    • Facilities should identify individuals with fever or symptoms consistent with COVID-19 Workers should use Screening Tool for Workplaces before each shift and self-monitor for symptoms. Patrons should use the COVID-19 self-assessment tool or a modified tool online (e.g., app, SMS, or email) before coming onto premises when having a prebooked visit.


    • Screeners should be behind an engineering barrier such as a plexiglass screen. If that is not possible, they should maintain a 2 metre distance from the person they are screening and wear droplet/contact precaution PPE such as gloves, gown, surgical mask, and eye protection. Have ABHR, tissues, and a no-touch lined waste basket available.


  • Passive Screening


    • Post signage for passive screening at entry points for people to self-identify if they screen positive.


  • Symptoms/Positive Screen


    • Anyone with symptoms or recent close contact with someone who tested positive should be encouraged to self-isolate and get tested, or call telehealth (1-866-797-0000).


    • Staff or patrons who become unwell in the facility should be instructed to separate themselves from others, leave the facility using private transportation if possible, self-isolate, and get tested at an assessment centre.


  • Contact Tracing


    • Post signage for passive screening at entry points for people to self-identify if they screen positive.


4. Testing



More instructions can be found at the COVID-19 Provincial Testing Guidance Update.


  • Symptomatic


    • Whenever symptoms consistent with COVID-19 are present, a test is recommended.


  • Asymptomatic & Risk Based


    • Should be done when the person is in contact with someone who tests positive for COVID-19, is part of an outbreak investigation.


  • Positive Tests


    • Employers must report occupationally acquired infections within 72 hours of receiving notice to the Workplace Safety and Insurance Board. Employers who receive notice that their worker has tested positive due to workplace exposure must give notice to the Ministry of Labour, Training and Skills Development, Workplace’s joint health and safety committee (or health and safety representative), and Worker’s trade union, if applicable, within four days.


No Wait Medical Partners enables safe and timely triage, antibody testing, monitoring, contact tracking and containment of suspected or confirmed COVID 19 positive employees. No Wait Medical Partners contributes to limiting exposure and risk management and enables contact tracing for suspected COVID-19 positive employees.


5. Support for Employees



  • Mental health support should be provided to all employees, including access to an employee (and family) assistance program (EAP/EFAP) if available. Additional comping resources include the Centre for Addiction and Mental Health and Canadian Mental Health Association. Emergency communications plans should be developed, including a forum for answering employees' concerns and internet-based communications, if feasible. Other support factors to consider include parenting, meals, and non-punitive sick policies.


No Wait Medical Partners is available to provide psychological supports, including mental health support, and psychoeducation.


Right one: No wait medical could help find a third-party mental health provider upon request.


6. Education



  • General Education


    • Post signs covering social distancing, hand hygiene, respiratory hygiene, cough etiquette, and COVID-19 signs and symptoms.


  • Staff Training


    • Training should be conducted in languages spoken by workers.


    • Staff should be trained on the signs and symptoms of COVID-19 with an explanation of how the disease is potentially spread, including the fact that infected people can spread the virus even if they do not have symptoms.


    • Provide staff with up-to-date education and training on COVID-19 risk factors and protective behaviors (e.g., cough etiquette, proper hygiene practices, and care of PPE). Staff should clearly be instructed on mandatory masking policy, and understand who is exempted, with proof of exemption not being required.


    • Train staff who need to use protecting clothing and equipment, and on how to examine it, put it on, use/wear it, and take it off correctly, within the context of their current and potential duties. Content should emphasize having clean hands before facial contact. Training should be conducted virtually or maintain social distancing.


    • Emphasis should be placed on the need for staff to report any safety and health concerns.


7. Absenteeism



  • Flexible sick leave policies should allow staff to stay at home in the event of sickness, possible exposure, or caring for someone who is sick. Evaluate whether the work duties can be done through telework. Before returning to work, staff should notify their Occupational Health and Safety Department.


  • Administration should inform and encourage staff to self-monitor for signs and symptoms of COVID-19 if they suspect possible exposure.


  • Staff who have symptoms should notify their supervisor and be encouraged to stay home, and a note from their healthcare provider does not need to be provided in order to validate illness, or their ability to return to work. Sick leave policies should be flexible and consistent with public health guidance and with No Wait Medical Partners, and employees should be made aware of these policies. Employees should not return to work until the criteria to discontinue home isolation are met, in consultation with No Wait Medical Partners. Prompt identification and isolation of potentially infectious individuals is a critical step in protecting employees and customers.


  • Staff who are well but who have a sick family member at home with COVID-19 should notify their supervisor and consult with No Wait Medical Partners regarding the mandatory precautions. Policies should permit employees to stay home to care for sick family members, including sick children or children who are in schools or day care centers that have been closed, or who have immunocompromised family members, and are afraid to come to work because of fear of possible exposure.


  • Staff concerns about pay, leave, safety, health, and other issues that may arise during infectious disease outbreaks should be addressed, and employers are encouraged to work with insurance companies (e.g., those providing employee health benefits) and local health agencies to provide information to staff and families about medical care in the event of a COVID-19 outbreak.


No Wait Medical Partners will provide daily follow up on employees who are self-isolating at home, and on what their expected return to work dates will be.


Sports and Recreation



Facilities for sports, including community centres, gyms, fitness and recreation studios (e.g., yoga, dance) may open when following regulations and guidance. All gatherings are subject to following 2 metres of physical distancing between members of the public, including gatherings where capacity limits do not apply (e.g., tennis courts, swimming pools, and shooting ranges). Develop mandatory mask regulations for the facility and train staff on the policy.


8. Stage 2



  • Do not provide/permit: indoor fitness or exercise classes, dance competitions, access to areas with weights and exercise equipment, activities that would have participants come within 2 metres of one another, and spectators.


    • Personal physical fitness or sports trainers may not use gyms to provide their services, except for a gym in the trainer's or patron's home.


    • Team sports may not be played except for training sessions for members of a sports team, not including games.


    • Locker rooms, change rooms, showers and club houses in the facility must be closed, except for the purpose of accessing equipment storage, a washroom or providing first aid; they may be used for their intended purposes in conjunction with a pool, splash pad, spray pad or wading pool.


  • The number of public members in facility for a class or organized activity cannot exceed 10 people indoors or 25 people outdoors, with each activity taking place in a separate room or outdoor area.


  • Dance classes may be provided for teaching dance techniques if all participants are pre-registered for the classes and appropriate precautions are taken.


  • Equipment must be cleaned and disinfected between each use.


9. Stage 3



Fitness facilities (e.g., gymnasiums, health clubs, community centres, multi-purpose facilities, arenas, exercise studios, yoga studios) may open, but are subject to regulations. Exceptions for capacity, team sports, and equipment rules must have a return to play plan approved by the Office of the Chief Medical Officer of Health (e.g., Canadian Elite Basketball League, Canadian Football League, Major League Baseball, Major League Soccer, National Basketball Association, National Hockey League, National Lacrosse League).


  • Capacity


    • Persons not engaging in team sports must always be spaced 2 metres apart, regardless of the facility.


    • If the facility can meet the social distancing requirement of 2 metres apart between participants, they have capacity restrictions. Indoor venues are allowed up to 50, outdoor venues are allowed up to 100, members of the public or spectators.


  • Team Sports


    • May be allowed if there is no physical contact between players or modified to not have physical contact.


    • Leagues may have 50 or less people for players to play within the league. For teams with more members, players may be divided into 50 person groups and not be permitted to play with other teams or groups.


  • Equipment


    • If the sport cannot disinfect fixed equipment in a facility between uses or at the end of a game, it is not permitted.


    • Supplies given to users of the facility must be disinfected after each use.


10. Mitigating Risk



  • Implement hazard controls to allow physical distancing and prevent congregation, as well as sector specific return to play guidelines.


  • Additional Elimination/Substitution Controls


    • Expand online options to reduce in-person instruction and offer longer hours to reduce peak demand.


  • Additional Engineering/System Controls


    • Space workout equipment to allow for 2 metres between each unit. Consider more space for high intensity equipment like treadmills or ellipticals. Consider installing nonpermeable partitions between equipment.


    • Reduce music volume and use microphones instead of shouting.


  • Additional Administrative Controls


    • Schedule to allow for intervals of time between each class. Stagger staff schedules to facilitate physical distancing


    • Encourage members to arrive prepared for the activity and encourage them to wait in their personal vehicle before waiting in line with a face mask.


    • Discourage cheering, singing, and yelling as it increases the risk of spreading droplets.


    • Require physical distancing except when necessary for teaching and instruction that must be provided within 2 metres. When within 2 metres of another person, wear a mask and gloves if needed to provide protection.


    • Implement screening measures and protocols for when someone feels unwell. People who develop symptoms or test positive for COVID-19 should notify all their contacts within the last 48 hours.


11. Equipment



  • In addition to disinfecting equipment between uses, implement IPAC Enhanced Sanitation measures.


  • Suspend hard to disinfect equipment lending and encourage patrons to bring their own supplies.


  • Rental services should be modified or suspended. Disinfect rented items between each use. If offering towels, they must be washed between 60 Celsius and 90 Celsius, with clean and dirty towels in labelled, separate containers.


  • Fountains should be limited to refilling bottles only.


12. Sports Fields and Multi Use Fields



  • Sports Fields and Multi Use Fields will not be sanitized, including their nets, scoreboards, goalposts, furniture, fences, fountains, and other components.


  • Participants should refrain from contact outside of sports (e.g. high fives, handshakes) and during sports. Sports that have contact as an integral component are not yet permitted.


  • Clean washrooms, if available, according to Public Health guidelines.


  • Ask staff, athletes, and patrons to bring bottled water as fountains and bottle refilling stations may be closed.


13. Toronto Water Facilities



  • Develop a clear masking policy that states masks must be worn when not in the water, such as on deck and in other areas of the facility, and ensure staff are instructed clearly.


  • Lifeguards should not be expected to monitor for COVID-19 risk mitigation measures; assign these duties to other staff members.


  • First-aid and resuscitation's risk of transmission may be minimized with staff training on safety measures. Physical distancing measures should not compromise patron's safety.


  • Screening


    • Facilities with a Class A or supervised Class B pool should have in-person, clearly designated active screening areas.


    • Facilities with a Class B pool, spa, wading pools, or splash pads should encourage self-screening prior to entry if in-person screening is not available.


  • Contact Tracing


    • Personal information may be collected voluntarily under informed consent for COVID-19 contract tracing purposes for use by Toronto Public Health and must be protected and destroyed after 30 days. Information should include their name, date, check in and check out time. Call 416-338-7600 if a staff, bather, or spectator has tested positive, or if there has been an exposure concern at the facility.


    • Class A pools-ask for contact information, such as email or phone number, in addition to the information listed above.


    • Class B pools-use a sign-in book and require unit number in addition to the information listed above.


Entertainment



Many other forms of entertainment involve many people gathering in one place, which increase the risk of COVID-19 transmission. Guidance is intended to supplement and not replace local, state, territorial, federal, and tribal laws, rules, and regulations.


1. Stage 2



In Toronto, modified Stage 2 guidelines will remain until at least early November.


  • Do not provide/permit:


    • Indoor cinemas, performing arts centres and venues are not permitted except for rehearsing or performing a recorded or broadcasted performance with conditions: no spectators on premises, performers and workers maintaining a distance of 2 metres apart from one another except for the performance or for health and safety purposes, and singers, brass instrument players and wind instrument players from one other performers by an impermeable barrier, like a plexiglass partition.


  • Capacity


    • Physical distancing must always be maintained. Indoor capacity applies to fully or partially indoor events.


    • Social gatherings, meetings, and events are restricted to 10 people indoors and 25 people outdoors, with no more than 6 people seated at a table in a rented space. Drive-in cinemas, concerts, and other performance arts are exempt from these capacity restrictions.


    • Religious services, rites or ceremonies, and wedding ceremonies or funeral services are restricted to up to 30% of the venue's room capacity indoors and 100 people outdoors.


2. Stage 3



Performance arts include concerts, artistic events, theatrical performances, or other performances.

  • Capacity


    • Physical distancing must always be maintained. Indoor capacity applies to fully or partially indoor events.


    • In performances, spectators must be able to maintain 2 metres of distance from one another and cannot exceed 50 persons indoors and 100 persons outdoors.


    • Drive-in cinemas, concerts, and other performance arts are exempt from the capacity restrictions outlined above.


  • Performers


    • Singers, brass instrument players and wind instrument players should be separated from spectators by an impermeable barrier, like a plexiglass partition.


    • Performers and employees must maintain 2 metres of distance from other people except when it interferes with their duty (e.g., rehearsal or performance, selling admission, food or beverages) or for health and safety purposes.


  • Social Distancing

    • Have measures (e.g. tape on floors/sidewalks, create 1-way routes in halls, partitions, 2 metres between seats, and signage on walls) to allow a 2 metres of distance between staff and visitors and minimize face-to-face contact.


    • Signage explaining social distancing should be posted highly visible locations (e.g. entrances,restrooms, dining areas, classrooms, auditorium).


    • Have workers guide visitors in organized entrances and exits to prevent congregation.


3. Mitigating Risk



  • Additional Elimination/Substitution


    • Consider virtual entertainment options.


    • Encourage online or phone ticket purchases. Use contactless transaction options or pre-payment.


    • Cancel activities that do not permit social distancing or other appropriate controls (e.g. moshing, autographs, backstage access). Limit customer capacity if necessary to facilitate a distance of 2 metres between people.


    • Consider removing food services. If food is provided, consider prepackaged or individually wrapped food items


  • Additional Engineering/System Controls


    • Use stanchions to direct walkway traffic in cinemas.


    • Provide extensions for microphones if interviewing members of the public for proper distancing.


  • Additional Administrative Controls


    • If possible, designate one set of equipment for each person, otherwise disinfect equipment before and after use.


    • The maximum number of guests may be calculated using one person for every 4 square meters of floor space accessible to the public. Venues should use a booking system and not allow public access.


    • For cinemas and performance venues in Stage 3, consider specific showtimes for different audiences and encourage guests to not arrive more than 15 minutes before showtime.


    • Designate workers to oversee physical distancing, indoor and outdoor lines, and prevent congregation in common areas (e.g., lobbies, concessions, washrooms).


    • Create 1-way entrances and exits using signage and arrows; encourage guest to leave by alternate exits instead of going through the lobby.


    • Develop masking requirements if local health officials or municipal by-laws have not implemented regulations. In Toronto, staff, performers, and guests must wear a mask or face covering indoors.


4. Drive-in and Drive-thru



  • Motor vehicles must be positioned 2 metres away from other motor vehicles.


  • Persons other than employees of the facility must remain in their vehicle with exceptions to purchase admission, food, or beverages, accessing a washroom, or for health and safety purposes.


  • Materials may only be exchanged between persons inside the same vehicle, workers of the facility, and for the sale of admission, food, or beverages.


5. Food and Drink



  • Establishments selling or serving liquor under a license or a special occasion permit must ensure that liquor is sold or served between 9 a.m. and 11 p.m. only and no liquor is consumed between 12 a.m. (e.g. midnight) and 9 am.


  • Venues serving food and drink must comply with regulations for restaurants and bars. Indoor dining is not permitted in Stage 2 areas such as Toronto.


  • Guests must remain seated within areas serving food and drink, except to use the washroom, arriving, departing, or for health and safety reasons.


  • Prepackaged or plated meals are preferred; self-serve and communal food services are not permitted in Stage 2.


Staff Guidelines



  • Employees can protect themselves and their co-workers from COVID-19 by taking IPAC measures. Employees are encouraged to forward any questions or concerns that they may have to No Wait Medical Partners.


Protecting Yourself and Others



-Hand Hygiene


  • Practice good hygiene. Wash your hands frequently with soap and water for at least 20 seconds, or if soap and water are not immediately available, then use an alcohol-based hand sanitizer that contains at least 60% alcohol and rubbing hands until they are dry. Avoid touching your face.
    COVID-19 Guidlines

    Click here


-Respiratory Etiquette


  • Follow the proper guidelines for covering coughs and sneezing (i.e., sneezing or coughing into a tissue or into the upper sleeve). Always wear a face mask while in the workplace, and the mask should cover your nose and mouth. Learn how to properly put on, use/wear, and take off protective clothing and equipment.


  • If possible, wear cloth face coverings protect others in case the wearer is unknowingly infected. Cloth face coverings should not be placed on babies and children younger than 2 years old, anyone who has trouble breathing or is unconscious, or anyone who is incapacitated or otherwise unable to remove the cloth face covering without help.


-Social Distancing


  • Maintain 6-feet of social distancing as work duties permit, and avoid physical contact with others, including other staff, students, or campers.


  • Use alternatives ways to shake hands upon entry, and it is important to not touch your face (i.e., mouth, nose, eyes).


  • Drive to facilities or parking areas individually; when possible, an avoid having passengers or foods.


-Daily-health checks


  • Determine if you have fever, respiratory symptoms (e.g. coughing, shortness of breath) or other symptoms in the past 24 hours. If so, stay at home and notify the COVID-19 point of contact.


What should I do if I become ill?



  • Notify your supervisor and No Wait Medical Partners immediately, complete the self-assessment (self-checker).


Resources:

Below are some resources on government approved guidelines around proper hygiene and cleaning practices, and the use of Personal Protective Equipment (PPE) for COVID-19.


Environmental Cleaning


Infection Prevention and Control



Screening


Self-Isolation


COVID-19 Fact Sheet


Mental Health Support


Non-Medical Masks


First-Aid and Resuscitation


Coaches Association of Ontario (2020). Returning to coaching: What the new changes mean (Coaches Ontario guidelines)


COVID-19 Guidance for drive-in & drive-thru events (Toronto Public Health guidelines)


COVID-19 Guidance for indoor & outdoor events & gatherings (Toronto Public Health guidelines)


COVID-19 Guidance for recreational water facilities (Toronto Public Health guidelines)


Facilities for sports and recreational fitness activities during COVID-19 (Ontario guidelines)


Guidance for sports & recreational fitness facilities. (Toronto Public Health guidelines)


Modified Stage 2 reopening guidelines (OMH guidelines)


Ontario moving additional region to modified Stage 2 (Ontario guidelines)


Ontario Return To Play


Permitting Sports Fields/Multi-Use Fields during COVID-19 (City of Toronto guidelines)


Rules for areas in Stage 3 (Ontario guidelines)


Sports, recreation and being active during COVID-19 (Ottawa Public Health guidelines)


Workplace Safety and Prevention Services. (2020). Guidance on Health and Safety for Television Film and Live Performance Sector During COVID-19 (WSPS guidelines)