Are you experiencing any of the following:
- Severe difficulty breathing (e.g., struggling to breathe or speaking in single words)
- Severe chest pain
- Having a very hard time waking up
- Feeling confused
- Losing consciousness
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Are you experiencing any of the following:
- Mild to moderate shortness of breath
- Inability to lie down because of difficulty breathing
- Chronic health conditions that you are having difficulty managing because of difficulty breathing
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Are you experiencing any of the following:
- Fever
- Cough
- Sore throat
- Runny nose
- Headache
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| Have you travelled to any countries outside Canada (including the United States) within the last 14 days? |
| Within the last 14 days did you provide care or have close contact with a symptomatic person known or suspected to have COVID-19? |
| Did you have close contact with a person who travelled outside of Canada in the last 14 days who has become ill (fever, cough, sore throat, runny nose or headache)? |
Close contact is defined as a person who:
- Provided care for the individual, including healthcare workers, family members or other caregivers,
- or who had other similar close physical contact without consistent and appropriate use of personal protective equipment; or
- Lived with or otherwise had close prolonged contact (within 2 metres) with the person while they were infectious; or
- Had direct contact with infectious bodily fluids of the person (e.g., was coughed or sneezed on) while not wearing recommended personal protective equipment.
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The Public Health Agency of Canada strongly urges anyone who has any of the following symptoms: fever, cough, sore throat, runny nose, or headache to ISOLATE at home or another suitable location.
