The purpose of a Self-care Guide

Your home is your primary care centre.

The purpose of this guide is to help you in taking the best decisions for your own health and the health of your close friends and family during the coronavirus COVID-19 pandemic.

This guide will enable you to:

  • Learn the best ways to protect yourself
  • Take care of yourself
  • Learn the basic care to provide to your friends and family
  • Learn when and who to consult when you require care and services

Keep the guide at hand!

This guide is also available in French at Québec.ca/coronavirus.

How can I stay informed?

Coronavirus updates are available at Québec.ca/coronavirus.

Pay attention to the notices and follow the instructions from the government as relayed by the media (television, newspapers, radio, Internet).

The information provided in this document is based on a situation that evolves rapidly. Changes could possibly occur.

The coronavirus is very easily transmitted!

The COVID-19 pandemic

Definition

COVID‑19 is a disease caused by a coronavirus, a highly contagious virus that affects the respiratory tract. It is transmitted from one person to another.

A pandemic occurs when a new virus spreads throughout the world. Since humans are not protected against the new virus, a greater number of people become sick.

Transmission of the virus

The coronavirus (COVID‑19) is very easily transmitted by tiny droplets that are expelled into the air when an infected person coughs or sneezes.

If the person covers their nose and mouth, the droplets will land in the crook of their elbow or on their upper arm, mask or homemade face covering, handkerchief or facial tissue. We can become infected by the coronavirus (COVID‑19) when:

  • Our eyes, nose or mouth is in contact with droplets from an infected person who coughs or sneezes
  • We touch a contaminated object or surface with our hands then touch our face

Symptoms develop on average from 5 to 7 days after contamination, but may appear over a 2 to 12 day period of time. To be prudent, at least 14 days of isolation is recommended (see the “Prevention, Protection and Health Advice”).

Some people with no apparent symptoms or whose symptoms have not yet developed may unknowingly spread the virus.

Coronavirus propagates during close contact between people. Close contact can occur when:

  • Someone lives in the same home as an infected person
  • Someone provides care to an infected person
  • People gather in public places and meetings

Persons at risk

The majority of infected individuals recover without any special treatment.

Some categories of people are at risk of dying from severe respiratory complications of a coronavirus infection, such as pneumonia or acute respiratory syndrome.

The following categories of people infected by the coronavirus (COVID‑19) are at risk of dying:

  • People aged 70 or more
  • People with the following underlying conditions
    • Chronic heart diseases
    • Chronic pulmonary diseases
    • Cancer and/or weakened or deficient immune systems
    • Diabetes

Symptoms

Some people with no apparent symptoms or whose symptoms have not yet developed may unknowingly spread the virus.

The manifestations of a coronavirus (COVID‑19) infection can vary from slight to severe.

Frequent symptoms

  • Onset or worsening of a cough Fever
  • Extreme fatigue
  • Sudden loss of sense of smell without nasal congestion, with or without loss of taste
  • Runny nose or nasal congestion

Severe symptoms (1 case out of 6*)

  • Difficulty breathing (dyspnea)

* Based on information that was available when this publication was produced.

Other symptoms may also appear, such as a sore throat, headache, muscular pain, major loss of appetite and diarrhea.

What should I do when I have COVID‑19 symptoms?

  • Stay at home and avoid contact with others
  • Wash your hands frequently
  • Follow good respiratory hygiene practices:
    • Cover your mouth and nose when coughing or sneezing (elbow, upper arm or disposable paper tissue)
  • Go to Québec.ca/decisioncovid19 for assessment of your symptoms or call 1-877-644-4545 to be directed to the appropriate resource
  • If you have major difficulty breathing, call 911

You can also read the Instructions for people with COVID‑19 symptoms fact sheet, which is available on the Ministère de la Santé et des Services sociaux website.

Prevention, protection and health advice

How to prevent and protect against a coronavirus (COVID‑19) infection

No vaccine for coronavirus (COVID‑19) or medicine to treat the disease, currently exist. Prevention is the only way to protect yourself and protect others.

Avoid contact

Ensure physical distancing of two metres at all time—it’s the main way for you to protect your family and friends. However, for children under the age of 16, physical distancing of one metre applies. Physical distancing directives are different for school settings and only apply there.

It is also important to avoid hugging, shaking hands and kissing. Your child should avoid hugging visitors, particularly when they are deemed vulnerable to the virus.

Sharing toys by children is tolerated, even though avoiding this is preferable, especially since children often put toys in their mouth. Toys should be disinfected both before after use by a child. This means that using toys that are easily cleaned is recommended. Moreover, children should wash their hands before and after sharing toys.

If a close friend or family member presents COVID-19 symptoms, contact with their personal objects (glass, dishes, etc.) must be avoided and they must be asked to observe hygiene etiquette and wash their hands after coughing or sneezing. As much as possible, maintain safe distancing.

Wash your hands OFTEN

Frequent hand washing is the best way to protect yourself and others from coronavirus (COVID‑19). Teach your children and close friends and family the right way to wash their hands.

When should I wash my hands?

As often as possible, but especially:

  • Before I touch my face (eyes, mouth, nose)
  • After I cough, sneeze or blow my nose
  • Before and after I provide care to a close friend or family member
  • When my hands are visibly dirty or after I touch a dirty object
  • Before and after I prepare meals
  • Before and after I eat
  • After using the toilet
  • Before and after going to a public place
  • Before putting on a mask or homemade face covering and after removing it

What do I use to wash my hands?

It is recommended to wash hands with lukewarm water and soap or with at least 60% alcohol-based gel, foam or liquid sanitizer.

Wear a mask or homemade face covering

Children of 10 years of age and higher must wear a mask or face covering over the nose and mouth in the following situations:

  • When someone else is in the same room, less than two metres away
  • When going to a care facility such as a hospital, clinic, doctor’s office or family medicine group office
  • In schools during movements outside classrooms and in common areas (from grade 5 elementary)
  • When on public transit and school transportation vehicles
  • In closed or partially covered public places where masks are mandatory*
  • In public settings whenever proper physical distancing is not possible

Masks and face coverings are recommended for children between 2 and 9 years of age but NOT for children under the age of two.

Wearing a mask or face covering along with other protective measures such as proper hygiene is mandatory.

Self-isolate

Self-isolate for 14 days after returning from a trip abroad or 10 days after the onset of my symptoms.

Self-isolation can end when the minimum 10-day period is over and the following is true:

  • No fever for at least 48 hours
  • No other symptoms for at least 24 hours except for cough and loss of smell, which may continue for a longer time.

You can transmit the virus even if you have no symptoms.

Precautions and care

Rest

If you have coronavirus symptoms, feel weak and fatigued, rest will help you fight the disease. Limit your contact with others until you have no more symptoms. You can go back to your normal activities when your state of health allows you to.

Medical consultation

If you are followed on a regular basis for a health issue such as cancer, keep all booked appointments. Contact your health professional if you need to consult about a medical issue.

Drink frequently

Frequent drinking is important because fever causes perspiration and major loss of liquids.

You should drink at least 1.5 litres of liquids every day.

You can drink cold or warm liquids, as you prefer. Avoid alcoholic beverages and liquids like coffee or tea that contain caffeine, as well as soft drinks.

Alcohol and caffeine will cause you to urinate more often and increase loss of liquids.

Watch out for these signs of dehydration:

  • Extreme thirst
  • Dry mouth and tongue
  • Infrequent and/or dark urine
  • Dizziness, confusion and headaches

Protect your entourage

If you have symptoms:

  • Self-isolate in a bedroom to avoid contaminating others
  • Sleep and eat meals alone in your bedroom
  • Only use one bathroom  and clean it after each use
  • Cover your nose and mouth when sneezing or coughing, ideally with a facial tissue. Wash your hands right after
  • If you do not have any facial tissue, cough or sneeze into your elbow or upper arm, which are not in contact with people or objects
  • Spit into a facial tissue
  • Throw away facial tissues into a garbage bag in a trash can with a lid. Keep used tissues away from children
  • Do not allow visitors in the house

Continue with these measures for 10 days from the onset of your symptoms and ensure that you have had no fever for at least 48 hours without using fever medication, and have an improvement of symptoms for at least 24 hours before resuming normal activities except for cough and loss of smell, which can last longer. Activities can then be resumed.

Keep your environment clean

Generally speaking, corona virus does not survive very long on objects. It can survive on surfaces from a few hours to several days depending on the type of surface (copper, cardboard, stainless steel, plastic are examples) and the ambient temperature and humidity.

Therefore, it is important that you clean counters, sinks, door handles and all other surfaces frequently touched by hands. Cleaning and disinfecting are very efficient ways of eliminating the virus.

Use soap and water or household cleaners to clean surfaces.

Use a 1/9 bleach-water solution or disinfectants.

For example, this means 10 ml of bleach to 90 ml of water.

If you are sick, your sheets, towels, cloths and dishware can be washed with those of others in the home using normal detergents.

Follow the instructions of the Ministère de la Santé et des Services sociaux provided in the media (television, newspapers, radio, Internet) Québec.ca/coronavirus.

Seek help

While many of us have the necessary resources to deal with a COVID‑19 situation, others may not. If you are concerned, do not hesitate to ask for or accept help. Talk about it with your close family members.

You can also dial 211 for help or ask your local CLSC to connect you with their home care and services resource.

Stay informed

Listen to the radio, watch TV, read the newspaper and/or go to the following government website often: Québec.ca/coronavirus.

The Ministère de la Santé et des Services sociaux will provide instructions for the population on health matters and to obtain care.

Always follow the government’s current notices and instructions, since the situation can change.

Basic information for your kids

Show them:

  • The right way to wash their hands with soap and water
  • How to sneeze and wipe their nose with disposable facial tissue
  • How to sneeze and cough into their elbow and onto their upper arm

Frequently remind them to stay away from other sick people and those who do not live with you.

Keep the Decision Fact Sheet close at hand. It contains advice on what to do in different symptom situations.

Workplace advice

Other help tools are available at Québec.ca/coronavirus.

Organize your work

As much as possible, work from home

If you must go to your place of work:

  • Wash your hands frequently with soap and water. If that is not an option, use an alcohol-based gel, foam or liquid hand sanitizer
  • Clean hard surfaces and objects in your work area that could be touched by your workmates
  • Do not shake hands, hug or kiss hello
  • Stay home if you are sick or have symptoms. Get informed about your employer’s return to work directives

Medication for relieving symptoms

Use medication intelligently

If you have no complications, coronavirus (COVID‑19) treatment does not require special medication.

Over-the-counter medication

Over-the-counter medication can be used to relieve coronavirus (COVID-19) symptoms. Before taking any medication, read the label carefully and only take the recommended dose. If you have a fever, take an acetaminophen cap such as Tylenol®. It is strongly suggested to ask your pharmacist for instructions before taking over-the-counter medication when you have symptoms.

Do not take medications with the same ingredients at the same time, such as Tylenol® and Tylenol Sinus®. Also avoid using nasal decongestants and nasal washes in case of loss of sense of smell.

If you have other health problems, ask your pharmacist for advice or call Info‑Santé 811 before taking over-the-counter medication.

Anti-inflammatories

NSAID anti-inflammatories used to alleviate fever that contain ibuprofen, such as Advil® and Motrin® may aggravate coronavirus disease (COVID‑19), but this information comes from clinical observations and has not been confirmed. If you are already taking anti-inflammatories and test positive for coronavirus, speak with your pharmacist, doctor or specialized nurse practitioner.

Relieving symptoms

Fever

Fever is one of the body’s defence mechanisms that help fight infection. Acetaminophen is recommended to reduce fever and make you more comfortable unless your health professional advises against it or you are allergic.

Fever is defined as follows:

  • Children 0-5 years old: 38.5 °C (101.3 °F) and higher (rectal)
  • Children 6 years and older: 38.1 °C (100.6 °F) and higher (oral)
  • Adults: 38 °C (100.4 °F) and more (oral temperature)
  • Seniors: 37.8 °C (100 °F) and more (oral temperature)

or

  • 1.1 °C higher than the normal temperature of an adult (does not apply to children)

Sore throat

  • Gargle with a glass of salt water: 2.5 ml (1/2 tsp.) of salt in 250 ml (1 cup) of lukewarm water (do not swallow)
  • Hard candy and/or lozenges, preferably sugar-free, may also relieve a sore throat

If you are sent to be examined by a health professional, be sure to take a complete current list of all your medications.

If medications are prescribed:

  • Be sure to follow recommended doses and other instructions
  • Reach out to your pharmacist or doctor if a problem arises when taking your meds
  • Always keep your medication in a dry location and out of the reach of children

Caring for sick children

Prevention, precaution and care for children are the same as for adults.

See a doctor

See a doctor in the following situations:

  • Your child is under the age of three months and has a rectal temperature in excess of 38.1 °C (100.6 °F) and higher, go to Québec.ca/ decisioncovid19 for symptom assessment or contact 1‑877‑644‑4545 or 811 to find out where to consult
  • Your child has a chronic disease or has a weakened or deficient immune system and has a rectal temperature in excess of 38.5 °C (101.3 °F) and higher, go to an emergency near you
  • Your child seems very sick, is listless and you have trouble waking him up, go to an emergency near you

Give appropriate medication

If your child is older than three months and has rectal fever in excess of 38.5 °C (101.3 °F) and higher you can administer acetaminophen (Tylenol®, Tempra®, etc.) in accordance with the instructions on the label and your child’s weight.

Make your child comfortable

Ensure that the child:

  • Is wearing light clothing
  • Rests a lot
  • Drinks enough and shows no signs of dehydration, especially in case of vomiting and/or diarrhea

Watch for the following signs of dehydration:

  • No urination over a six-hour period of time for babies (eight hours for older children)
  • Recessed fontanelles (soft spots on the top of babies’ heads)
  • Cold skin that does not regain normal shape quickly when pinched
  • Irritability, somnolence

If your child shows signs of dehydration, administer as needed rehydration solutions such as Pedialyte®, which is sold in pharmacies. Ask your pharmacist for advice.

Maintain room temperature at around 20 °C (68 °F).

Alerts

  • Always take your child’s temperature with a thermometer, preferably rectally if 5 years and under and orally if 6 years and older
  • Wait 30 minutes before taking the child’s temperature orally if he or she has eaten something cold or hot
  • Do not rub your child with alcohol to lower fever as it may be absorbed by the skin or enter the lungs and can be toxic
  • Do not give ibuprofen (Advil®, Motrin®, etc.) to children under the age of six months
  • Do not give acetylsalicylic acid (Aspirin®, etc.) to children or teenagers under the age of 18
  • Do not put a mask or handmade face covering on a child who is under the age of 2 years

Eldercare

Seniors are more susceptible to infection and complications due to the normal aging process. They also have a higher risk of dying from COVID‑19.

A coronavirus (COVID‑19) infection can manifest itself in different ways in seniors.

While seniors may have no fever, they may show the following signs of an infection:

  • Fast onset loss of autonomy (lower interest in participating in care, preparing meals, etc.)
  • Loss of appetite
  • Confusion
  • Sleepiness
  • Falling
  • Onset of incontinence
  • Increased agitation or sluggishness
  • Sleep disturbances
  • Irritability

Prevention, protection and care

The prevention, protection and care instructions shown in this guide also apply to seniors.

Seniors are at greater risk of the following:

Dehydration

Seniors are at greater risk of dehydration especially because the thirst sensation becomes less acute as we age. Seniors do not always think of drinking because they do not feel thirsty.

  • Remind seniors to drink frequently
  • Encourage them to take more liquids with meals and medications
  • Discourage seniors from drinking alcohol and beverages with caffeine

Malnutrition

Seniors need to increase their protein consumption when they have an infection.

Proteins are found in meat, fish, legumes, eggs, milk products and nuts.

Seniors need to have protein-rich snacks in between meals and at bedtime.

Loss of autonomy

Remaining immobile while lying in bed or sitting in a chair for just 24 hours can have a major impact on loss of autonomy and the onset of complications.

As soon as possible, get the person up and moving, dress on his or her own, and perform personal hygiene and other daily activities in accordance with capacity. This will considerably reduce the risk of complications.

Care for people with disabilities

Persons with physical or mental disabilities or who have autism spectre disorder are among the most vulnerable members of society, since they may experience problems relating to mobility, communication, understanding situations or being able to protect themselves. Moreover, their medical and/or behavioural condition means that they have a higher risk of developing complications from COVID‑19 contamination. As such, providing them with acute or intensive care can be more complex.

Preventive measures and care precautions for people who have problems understanding and/or communicating are the same as for adult patients. However, support from parents, family caregivers or other providers of assistance is of primary importance to ensure the successful implementation of preventive measures if they have difficulties.

With this in mind, it is important to plan for communication methods that are adapted to the needs and characteristics of patients and ensure that they understand the current pandemic situation, how to protect themselves, why measures such as home isolation have been implemented and the importance of any eventual screening. Particular attention should be given to care related to tube-fed medication and access to home support when required.

Taking care of the patient

Persons with physical or mental disabilities or who have autism spectre disorder especially risk developing the following problems:

  • Bedsores: Vary the position often.
  • Loss of autonomy: Get the patient up as soon as they can move around and let them dress and perform personal hygiene tasks on their own, if possible. This also holds for their daily activities as they become capable, because it will considerably lessen the risk of complications.
  • Dehydration: Patients who need help with feeding have a higher risk of dehydration. As such, ensuring they drink regularly is very important.
  • Lack of organization of patients with behavioural or autism spectre disorders: Make certain that you put in place strategies for minimizing behavioural disorders and facilitating transitions to new daily routines.

Parents and/or family caregivers must also apply contamination prevention measures when using equipment and/or devices that are required to see to the patient’s needs. People who are not capable of removing their mask or face covering should not wear it.

Hygiene and prevention

Hand washing

  1. Wet hands
  2. Apply soap
  3. Rubs for 15-20 seconds
  4. Scrub nails
  5. Rinse
  6. Dry
  7. Use paper to shut the tap

Wash hands often, especially:

  • When they are visibly dirty
  • After sneezing or coughing
  • After you blow your nose
  • After using the toilet
  • After changing a diaper
  • Before preparing, touching or serving food
  • Before eating
  • Before putting in or taking out your contact lenses
  • Before putting on a mask or homemade face covering and after removing it

  • After moving garbage

Wash your hands with soap and water. Antibacterial soap is not required.

If soap and water are not available you can use an alcohol- based gel, foam or liquid sanitizer (at least 60% alcohol).

Take a little gel, foam or liquid sanitizer with your fingertips and rub both sides of your hands, fingers and in between your fingers. Continue to rub until your hands are dry without having used paper towels.

Alert

Sanitizers must be stored out of reach of young children. They can only be used occasionally and with supervision.

Respiratory hygiene

  1. Cover your mouth and nose with a tissue when coughing or sneezing.
  2. Throw the tissue in the garbage.
  3. If no tissue is available, cough or sneeze into your elbow or on your upper arm.
  4. Wash your hands often. If soap and water are unavailable, use a hand sanitizer.

Masks and homemade face coverings

Wearing a mask or face covering that covers the nose and mouth is mandatory on public transit and school transportation vehicles, in school during movements outside classrooms and in common areas (from grade 5 elementary) and in enclosed or partially enclosed public places for people age 10 and over. Go to Québec.ca/masque for details on locations where wearing a face covering is mandatory.

In all other public places which are not subject to the obligation to wear a mask or face covering but where physical distancing of 2 metres is not possible, wearing a face covering is strongly recommended. When you wear a mask or a face covering in public, you must also follow other safety measures, such as hygiene.

Children under the age of 2, people whose particular medical condition prevents them from wearing a mask or face covering and people who are unable to put it on or take it off by themselves due to a physical disability, are exempt from this requirement..

If you are sick, stay at home. If you need to go to the hospital or a medical clinic, wear a mask or face covering until you are provided with a procedure mask.

If you have no symptoms but need to be in close contact with someone who has a fever or is coughing or sneezing, for example to provide care, you should wear a mask or face covering.

Wash your hands before and after using a mask or face covering. Remove the mask by grasping the elastic or string loops without touching the front of the mask or homemade face covering. Fold up the inside of the mask and place it in a sealable garbage bag. If you wear a homemade face covering, place it in a clean bag. You may wash the face covering with the rest of your laundry after removing it.

A cotton or similar fabric scarf can also be used but you will need to wash it every day.

  1. Place the mask or face covering on your nose and mouth with one hand. Use your other hand to attach the elastic or string loops of the mask behind your ears..
  2. Mold the mask or face covering to your nose.
  3. Position the bottom edge of the mask under your chin.

Change your mask or face covering whenever it becomes wet, dirty or damaged. Never touch your eyes, nose and mouth with your hands.

To print

My Medical Record

You can download a PDF file presenting a model of personal medical record (PDF 129 Kb).

Decision Fact Sheet

If you have COVID‑19 symptoms

Follow the instructions on this poster to help you take the optimal decision for you and your close friends and family. Always use proper hygienic and preventive measures to avoid contamination.

  • Wash your hands frequently
  • Cough or sneeze into the crook of your elbow, onto your upper arm or into a paper facial tissue, not your hands
  • Keep your environment clean

Adults

I have a fever (Fever ≥ 38 °C (100.4 °F) or ≥ 37.8 °C (100 °F) for seniors) or any of the following symptoms:

  • Onset or worsening of cough
  • Difficulty breathing
  • Extreme fatigue
  • Sudden loss of sense of smell without nasal congestion, with or without loss of taste
  • Muscular pain
  • Headache
  • Major loss of appetite
  • Sore throat
  • Diarrhea

I am an elderly person with geriatric symptoms (loss of autonomy, falling, confusion onset, agitation or sluggishness, loss of appetite, extreme fatigue, etc.).

Children

If your child has a symptom from this list:

  • Fever (with the temperatures currently listed according to age)
  • Cough (new or worsening)
  • Shortness of breath
  • Difficulty in breathing
  • Loss of taste or smell
  • Sore throat
  • Nausea
  • Diarrhea
  • Vomiting
  • Stomach aches
  • Congestion
  • Runny nose
  • Major fatigue
  • Severe loss of appetite
  • Muscle pain

Decision for adults and children

I stay at home and have my symptoms assessed at Québec.ca /decisioncovid19 or by calling 1‑877‑644‑4545.

Adults and children

I have a fever of 38 °C (100.4 °F) or higher (adult) or 38.1 °C (100.6 °F) and higher (child) and one or more of the following:

  • Persistent and/or increasing difficulty in breathing
  • Blue lips
  • Difficulty moving
  • Fever (baby less than three months of age)
  • Somnolence, confusion, disorientation, difficulty staying awake
  • No urine for 12 hours

Decision for adults and children

Go to the emergency room immediately.

If help is needed, call 911.

General Information

Services Québec

Coronavirus hotline

1‑877‑644‑4545 (toll free)

Deaf or hard-of-hearing persons

1‑800‑361‑9596 (toll free)

Important phone numbers

Your pharmacist:

Your doctor:

Your CLSC:

Keep informed. The Québec.ca/coronavirus website has up-to-date news.

Preventing infections: It’s a collective responsibility

  • Cough into your sleeve.
  • Wash your hands.
  • Keep your distance.
  • Cover your face

Québec.ca/coronavirus

Toll free: 1‑877‑644‑4545.

Updated edition produced by

Direction des communications du ministère de la Santé et des Services sociaux

The masculine used in this publication also refers to the feminine gender, and vice-versa.

© Gouvernement du Québec, 2020