Ontario is issuing stricter guidelines for screening visitors, volunteers, staff and residents at nursing homes to protect the frail elderly from serious illness and death that could result from infection with COVID-19.

The move comes after a nursing home in the Seattle, Washington, area experienced a high death rate amid an outbreak in that state where the new coronavirus had been circulating undetected for weeks and a worker in her 40s was found to have the illness. Canada’s first novel coronavirus death was at a British Columbia nursing home on Monday.

Health Minister Christine Elliott said Tuesday that the changes are part of efforts to ramp up preparedness for the potential person-to-person spread of the virus, which until now in Ontario has been limited to people who have travelled to coronavirus hot zones around the world and their household contacts.

“We don’t want anyone coming in from outside if they have the virus, to spread the virus to a population that is extremely vulnerable,” she told reporters. “Most of the residents have a number of co-morbidities so we want to make sure that they’re kept safe.”

While the majority of people who contract COVID-19 have mild cough and fever symptoms that go away with rest in self-isolation at home the virus can cause more serious illness and pneumonia in people with underlying health conditions such as lung or heart disease and diabetes, conditions that doctors call “co-morbidities.”

Nursing homes should now conduct “active screening” to check for symptoms, recent travel history and contacts with potential cases before people are allowed to proceed to their volunteer or paid jobs or visit residents.

Incoming residents will also be checked, be they new to the home or returning from hospital or other treatment centres or visits to family.

“It’s checking, having discussions with people that are coming in, questioning whether they have any concerns, whether they’ve done recent travel, whether they have any illnesses, any respiratory illnesses, if they’re coughing or have colds,” said Elliott.

One concern in the long-term care sector is part-time workers who work in more than one nursing home or other job, making it easier to spread any virus if they are ill.

Typically, nursing homes have sign-in sheets at the front desk and in times of respiratory outbreaks have protocols in place that ask visitors to stay away if they are ill. Viruses can spread quickly in nursing homes, which are monitored closely by public health officials.