Examples of Hierarchy of Controls implemented during COVID-19 pandemic in retirement home setting, Ontario.

Elimination: Rapid antigen test administered at point of entry for those who do not have documentation of two completed Covid-19 vaccinations. This is the only example of “elimination” applicable in this setting. Antigen testing is not effective at eliminating the risk of infection because it targets only one group of people and is only one measure used to control transmission in the chain of infection transmission.

Substitution: Not applicable. We are not able to “switch out the hazard” for something that carries no risk.

Engineering Controls: Plexiglass screens at reception to separate employees from residents, the public. Placement of alcohol based hand-rub throughout the building.

Administration Controls: Active screening, passive screening-signage and restrictive visitor policies. Designated area for screening. Policies for restricting entrances, cohorting of staff.

PPE: Procedural masks worn at all times along with eye protection. Mask, eye protection, gown and gloves worn when screening all who enter the building.