Influenza Surge Planning: Recommendations for Health Care Providers

Advisory Alert

October 2, 2019

* Cette information est seulement disponible en anglais.

To: Community Health Care Providers

Re: Influenza Surge Planning: Recommendations for Health Care Providers

With influenza season fast approaching, communities can expect increased demand on the health system. Below are some key recommendations for health care providers that may mitigate and assist in preparation for these health system pressures. Further information from the Ministry of Health on the upcoming influenza season and readiness activities can be found on our website at:

1. Offer the influenza vaccine

All health care providers should receive the influenza vaccine. Encourage vaccination of your eligible patients, six months of age and older, without contraindications, with an age-appropriate influenza vaccine. The vaccine is particularly important for individuals at high risk of complications due to influenza infection. Information on the publicly funded flu vaccines available for the 2019/20 influenza season through the Universal Influenza Immunization Program (UIIP) are available at

2. Offer early antiviral treatment to symptomatic patients at high risk of complications (regardless of their vaccination status)

Please consider the timely administration of antivirals (e.g. oseltamivir or zanamivir), where indicated, in accordance with current guidelines from the Association of Medical Microbiology and Infectious Disease Canada, available at:

When influenza is known to be circulating in the community, laboratory confirmation of influenza is not required prior to administration. Ideally, treatment should be started within the first 12 to 24 hours of symptom onset. Effectiveness is reduced when initiated more than 48 hours after symptom onset but may be considered. Encourage your high-risk patients with influenza-like-illness (ILI) to seek prompt care. Please also consider making plans for timely antiviral drug access such as providing advance prescriptions to be filled when symptoms occur. Public Health Ontario has updated guidance on antiviral usage, available at:, and a supporting Q & A fact sheet, available at:

3. Prepare for an increased demand for health care services

Advise your patients how and where they should access health care if they need it. If possible, keep office hours open during the holiday season to accommodate the anticipated increase in visits. Offer patients information on how and when to access an appropriate level of care during times when your office is closed. Consider making this information available on your office voice mail, your website, and on your social media pages. Direct patients to TeleHealth at 1.866.797.0000 for further care options.

4. Make simple changes in your office environment to decrease the spread of infection

Enhance infection control practices in your practice as outlined in Public Health Ontario’s best practice document Infection Prevention and Control for Clinical Office Practice, available at:

This includes screening patients for signs of illness, using personal protective equipment (based on your assessment of risk), having hand hygiene supplies at point-of-care, enhancing environmental cleaning, having healthy workplace policies which promote respiratory etiquette, and staying home when sick.

5. Encourage your patients to protect themselves from influenza

Additional strategies to prepare for influenza season surge can be found on our website at

Should you have any questions, please contact the Control of Infectious Diseases Program at 705.522.9200, ext. 301 (toll-free 1.866.522.9200).


Ariella Zbar, MD, CCFP, MPH, MBA, FRCPC
Associate Medical Officer of Health and Director, Clinical Services

Seasonal Influenza Update from the Ministry of Health


Seasonal Influenza Update CMOH Memo FINAL 2019-09-25 shared EN


Seasonal Influenza Update CMOH Memo FINAL 2019-09-25 shared FR

This item was last modified on October 2, 2019