The following questions and answers incude updates that have been added since the printed versions were distributed with the kits. This page will be further updated as new questions arise during the distribution process.

• What is an Emergency Infection Control Kit?
• The letter says not to open the kit unless it is an emergency. How will I know if it is an emergency?
• What is in the kit?
• Who decided what is included in the kits?
• Why don't the kits contain more items?
• What happens in an emergency when I run out of supplies?
• Why don't the kits contain N-95 respirators?
• Why are hospital settings not receiving these kits?
• Why are additional community providers such as home care nurses not being supplied with these kits?
• Are these kits being provided to First Nations communities?
• Do any of the supplies have an expiry date?
• Where should I store the kit?
• I am no longer a practicing physician or midwife, but have received a kit. Why did I receive a kit and what should I do with it?

The kit is a sealed box containing essential infection control products for droplet spread diseases. It is being distributed to all Community Health Centres, midwives and community-based physicians in Ontario. These kits are intended for large-scale infectious disease emergencies such as an influenza pandemic. They should only be opened in an emergency.

These kits are to ensure that your office has the capacity to protect you, your staff and patients during a health emergency. They are to be used in an emergency only and are not intended to replace the day-to-day infection control procedures and equipment used to protect patients and staff against febrile respiratory illnesses such as seasonal influenza.

A relevant health emergency includes a significant infectious disease outbreak/epidemic in your community which :

• causes a rapid depletion of your existing infection control supplies
• exceeds the surge capacity in supplies and equipment which you should routinely have in place
• disrupts supply chains in your region so that supplies can not be replenished rapidly enough to ensure your protection.

The primary goal of these infection control kits is preparedness for an influenza pandemic. However, you may also access the kit in the event that another health emergency meeting the above criteria arises. Please note that given the pandemic focus of this initiative, there is currently no ongoing replenishment strategy in place for non-pandemic use.

The kit contains the following :

• six bottles of hand sanitizer, 500 ear-loop procedure masks, 200 non-latex exam gloves, six pairs of protective (reusable) glasses, 20 disposable gowns and two canisters of surface sanitizer wipes
• communication materials for you to post in your office for your patients, as well as information fact sheets for your staff.

The ministry consulted with representatives from the Ontario Medical Association, the Ontario College of Family Physicians, and the Provincial Infectious Diseases Advisory Committee. The items were chosen for their infection control properties, comfort, and ease-of-use to protect you, your staff and your patients from droplet spread infection.

The kits are intended to be a first response initiative to protect you, your staff, and patients at the onset of a health emergency. Kits are designed to assist your office for the first seven-10 days, during which time more supplies should be available through your regular suppliers. In the case that supplies are unavailable or supply chains cease to function, supplies will be available through the Ministry of Health and Long-Term Care.

The ministry continues to review stockpiling options and processes to ensure that health care providers and facilities will have continued access to supplies. More details regarding planning for the central ministry stockpile will be available in the next edition of the Ontario Health Plan for an Influenza Pandemic (OHPIP).

Please note that in the OHPIP, the ministry recommends that health care facilities maintain a one-month stockpile of essential supplies and equipment. While it is more difficult for smaller community clinics to achieve this, they should ensure that they routinely have enough personal protective equipment on hand to accommodate the demands in their practices, as well as some surge capacity. The ministry's centralized stockpiles are intended to supplement facility-level stockpiles only when they have been exhausted.

Current scientific advice states that procedure/surgical masks provide appropriate protection for dropletspread pathogens (such as influenza), rather than the N-95 respirators used in SARS. The Ministry of Labour supports the provision of procedure/surgical masks for droplet protection. The majority of international jurisdictions currently recommend surgical masks rather than N-95 respirators for an influenza pandemic.

The ministry decided to provide frontline health care workers such as family physicians, physicians whose offices are outside of a hospital setting, and midwives with pre-existing emergency response capacity. Larger institutional settings such as hospitals and long-term care homes are easier to reach during an emergency than community offices. After their own resources are depleted, they will be provided for from a central ministry stockpile.

The primary goal of these kits is to equip those small independent practices which A) do not have access to a greater infrastructure to help support their supply and equipment needs and B) may be difficult to quickly locate and contact in an emergency. In addition, particular attention was paid to those providing primary care, as they may be most likely to see patients first presenting with symptoms. Larger overarching agencies such as homecare agencies or services with multiple community sites were not included in this initiative. The ministry recommends that health care settings develop and maintain a one-month supply of essential supplies and equipment such as personal protective equipment.

Please note that the kits are designed for a clinical setting in which patients are being seen, not for broader community service settings.

The kits are targeted to individual community physicians and midwives - i.e. those who work outside of a hospital setting - regardless of what community they practice in, and including aboriginal midwives. In addition to the Community Health Centres, Aboriginal Health Access Centres will also be receiving kits. Nursing stations, however, are federal responsibilities and at present there is no plan to provide them with kits.

The MOHLTC continues to work with the Provincial Territorial Organizations, the Chiefs of Ontario and the First Nations and Inuit Health Branch of the federal government to address health emergency issues of common interest.

Yes, some supplies, particularly the hand sanitizer and surface cleaner, have an expiry date. When this expiry date approaches, communications will be released providing direction around use of goods approaching their expiry dates, and strategies for replenishment.

The Emergency Infection Control Kit is intended for infectious disease emergencies and as such should be easily accessible from your office. The ministry recommends storing the kit on site to ensure easy access. Although space is at a premium in some offices, the ministry encourages offices to find creative storage solutions to ensure the kit remains on site.

The Ministry relied on information from a number of sources to identify those providers who are currently practicing. However, retirement is not always officially recorded. If you are retired or no longer seeing patients, so have no need for the kit, please contact us at emergencyickits.moh@ontario.ca and arrangements will be made for the return of the kit. You will not incur any shipping expenses associated with the return.

CritiCall Ontario provides a 24 hour call centre for hospitals to contact on-call specialists; arrange for appropriate hospital bed access and facilitate urgent triage for patients
1-800-668-4357

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