Memo: Fall/Winter Readiness and Response 2024/25- Updates

Dear primary care colleagues,  

Thank you for your ongoing dedication to support your patients through this Fall and Winter respiratory illness season. Your work in primary care is foundational to keeping patients safe and healthy in their homes and communities. We appreciate your continued efforts to keep your patients aware of how and where to access care, including care outside office hours and during the holidays, and other care options such as Health811 and local services in your region.  

Current forecasts suggest that this year’s flu season will follow a relatively typical pattern in regards to timing and similar to last year’s season, with flu increasing in early to mid-November and peaking in January. This year’s RSV season is running at least a month later than the last two years, suggesting a peak in late December or early January. COVID-19 remains unpredictable due to the ongoing emergence of new variants; it is currently circulating at similar levels to this time last year and is expected to surge in early January following the holidays, as in previous years.  

New this year is the expanded provincial infant RSV prevention program, which includes all infants and those children up to 24 months old who are at high risk of severe illness from RSV (it previously was solely for high-risk infants). We know primary care will play a critical role in the delivery of the RSV prevention program, alongside public health and hospitals.  

To help support you in your work, we are sharing a summary of updates and guidance as well as information on provincial and regional programs that can support care.

Fall/Winter Response Planning Resources

Health811 and Regional Virtual Urgent Care Programs

Health811

For non-urgent health inquiries and questions including those regarding respiratory illnesses, all patients can access Health811 24 hours a day, seven days a week, to receive health advice from a registered nurse, locate local health services, check their symptoms online and find trusted health information. People in Ontario can call 811 (TTY: 1-866-797-0007), chat online or access resources online at ontario.ca/health811.

Regional virtual urgent care programs

These programs provide access to virtual care services delivered by nurse practitioners. This service is intended to be used by people in Ontario without a primary care clinician or those who may be having trouble accessing care through their designated primary care clinician. The hours of operation, availability and types of care offered at the listed regional virtual urgent care programs may vary. Patients should choose the regional program in the area they live. More information can be found on their respective websites or from a Health811 advisor:

RSV Prevention Programs: Infants, High-Risk Children & Older Adults

Ontario’s publicly funded RSV prevention programs are focused on all infants (<12 months) and high-risk children (<24 months) as well as high-risk older adults – two groups at greatest risk from serious RSV illness.

Infant and High-Risk Children RSV Prevention Program

The RSV prevention program has now expanded to include:

  • Infants born in 2024 prior to the RSV season (prior to October 2024), who will need to be immunized either in primary care or through their public health unit
  • Infants born in the 2024/25 RSV season (late October 2024 to end of March 2025), who will be offered RSV monoclonal antibody in hospital prior to discharge
  • Children <24 months who are higher risk in their second RSV season who will need to be immunized either in primary care, through their local public health unit, or through pediatric hospital programs.

For more information, see the Ministry of Health’s Infant and High-Risk Children RSV Prevention Program.

Two RSV products are available for this program: Beyfortus (Nirsevimab), a monoclonal antibody for infants and high-risk children, or Abrysvo, an RSV vaccine for pregnant individuals who are 32 to 36 weeks pregnant and who will deliver near the start of or during the RSV season. Beyfortus administered to infants is currently the preferred product based on efficacy, length of protection (up to six months), and good safety profile. There is no added benefit to the infant to receive both products.

Both products are available to order from public health units as single-dose syringes. Midwives can administer Abrysvo but do not have the authority to administer Beyfortus without a medical directive. Patients who have a midwife-led birth out of hospital may not have access to a medical directive for administration. These newborns should be directed back to their primary care clinician or to a local unattached program for care to ensure Beyfortus can be administered.

The Provincial Council for Child and Maternal Health has created patient facing resources including a factsheet available in a number of languages.

For clinician resources:

  • Centre of Effective Practice's RSV resources toolkit provides guidance for primary care clinicians including how to implement in practice, and EMR search tools.
  • Ontario Medical Association's physician webpage for resources covering billing information, clinical guidance, past webinars and patient resources.

High-Risk Older Adult RSV Vaccination

The High-Risk Older Adult RSV Vaccine Program is targeted for high-risk individuals and settings. RSV vaccination (Arexvy & Abrysvo) is available and publicly funded for those who are 60 years and older and at highest risk (see current eligibility).

Those 60 years and older who do not qualify for the publicly funded RSV vaccine can purchase it at a pharmacy with a prescription from a physician or nurse practitioner; this vaccine can be administered by a pharmacist.

COVID-19 Testing, Vaccination & Treatment

COVID-19 Testing

COVID-19 testing has transitioned to a test-to-treat model this year to align COVID-19 testing eligibility (inclusive of both rapid antigen tests and PCR testing) with COVID-19 treatment eligibility. As a result, COVID-19 testing should only be available to:

  • Ontarians eligible for COVID-19 treatment (i.e., symptomatic individuals who are immunocompromised, or 65 years of age or older, or those with high-risk medical conditions)
  • People in high-risk and some congregate living settings (e.g., long-term care), to support outbreak prevention and management

Patients who are eligible for publicly-funded COVID-19 testing can visit contact their primary care clinician or pharmacist to learn about test availability and to arrange to take a test.

Rapid antigen tests, personal protective equipment (PPE) and vaccine ancillary supplies (syringes, needles, alcohol swabs, etc.) continue to be available through the Provincial PPE Supply Portal at no cost. For assistance in creating an account or accessing an existing account, or for any questions about orders and shipment, contact sco.supplies@supplyontario.ca.

Ordering publicly funded PCR testing for use in office can be done using the Public Health Ontario COVID-19 and Respiratory Virus Test Requisition form. For help filling out the form, use these instructions.

The Ministry of Health website has summary information on COVID-19 testing and antiviral treatments.

COVID-19 Vaccination

COVID-19 vaccination is available to the general public for all individuals 6 months of age and older at no cost.

The publicly funded COVID-19 vaccines available for the 2024/2025 season include Moderna KP.2 for those ≥6 months of age and Pfizer KP.2 for those ≥12 years of age. Please note, COVID-19 XBB vaccines were withdrawn from market effective Sept 1, 2024. The Novavax JN.1 vaccine will not be available this season.

Patients can book a COVID-19 vaccine at participating pharmacies or local public health unit community clinics via public health unit websites, the COVID-19 vaccination booking portal or by calling the Provincial Vaccine Contact Centre at 1-833-943-3900 (TTY: 1-866-797-0007 toll free) from Monday to Friday (excluding holidays) from 8:30 a.m. to 5 p.m. EST.

Primary care clinicians who wish to access COVID-19 vaccines for their patients should contact their local public health units. The Ministry of Health has created a summary of patient-facing COVID-19 vaccination information.

For more information, see the Ministry of Health’s webpage for clinicians.

COVID-19 Treatment

COVID-19 treatment with nirmatrelvir/ritonavir (Paxlovid) or remdesivir is recommended for individuals with mild to moderate COVID-19 symptoms who have a positive PCR or rapid antigen test and who are at high risk of severe outcomes. Continue to communicate in advance with your high-risk patients about a plan to access antiviral treatment, should they test positive.

Remdesivir is available to patients in the community through Ontario Health atHome (formally known as Home and Community Care Support Services). See information on referral forms and procedures.

Ontario Health’s website has guidance and resources for health care providers, including Recommendations for Antiviral Therapy for Adults with Mild to Moderate COVID-19. The website also includes an updated resource for accessing antiviral treatments for COVID-19 in the community.

Influenza Testing, Vaccination and Treatment

Influenza testing will not be available to primary care clinicians in the community setting. For information on testing in hospital and long-term care settings, see the Public Health Ontario test information index on respiratory viruses (including influenza).

Influenza vaccination is available to the general public for all individuals 6 months of age and older who live, work, or attend school in Ontario. The vaccine can be safely co-administered with the COVID-19 vaccine, RSV vaccine or RSV monoclonal antibody. For more information, visit 2024/2025 Ontario Universal Influenza Program.

For up-to-date information on influenza antivirals (e.g., Tamiflu), visit the Public Health Ontario webpage on influenza.

Regional Support for Primary Care

Ontario Health Teams (OHTs) and Primary Care Networks can play a crucial role in supporting the management of respiratory illnesses, ensuring timely access to care, and supporting clinicians in their practices, and particularly with unattached patients.

Engage with your local OHT to become involved in a Primary Care Network. Refer to the guidance on primary care networks in OHTs and reach out to your Ontario Health region if you need contact information for your local OHT.

Ontario Health regions can provide support and partnerships to system partners, including for primary care through the Fall and Winter. For questions, see below for a list of contacts by region.

Region Contact
Central Dr. Mira Backo-Shannon (mira.backo-shannon@ontariohealth.ca)
East Dr. David Zelt (david.zelt@ontariohealth.ca)
North East and North West Dr. Paul Preston (paul.preston@ontariohealth.ca)
West Dr. Jennifer Everson (jennifer.everson@ontariohealth.ca)
Toronto Rose Cook (rose.cook@ontariohealth.ca)

Need this information in an accessible format? 1-877-280-8538, TTY 1-800-855-0511, info@ontariohealth.ca. Document disponible en français en contactant info@ontariohealth.ca

TO: Primary care clinicians and administrators
FROM: Dr. Elizabeth Muggah, Senior Clinical Advisor, Primary Care
CC: Dr. Sacha Bhatia, Executive Vice President, Primary and Community-Based Care, Zahra Ismail, Vice President, Primary Care and Person-Centred Measurement, Dr. Chris Simpson, Chief Medical Executive and Executive Vice President, Scott Ovenden, Chief Regional Officer, East and Toronto, Susan deRyk, Chief Regional Officer, Central and West, Brian Ktytor, Chief Regional Officer, North East and North West
DATE: November 13, 2024

Last Updated: June 18, 2025

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