Reopening of the Economy

Provinces and territories are starting to re-open the economy, including stores, schools, and outdoor activities. The following recommendations are based on age groups and are meant to help you consider the risks associated with activities outside of your home.

These recommendations are general guidance and should not replace the recommendations of your local public health agency or your doctor. If you are unsure and/or have any concerns, please talk to your doctor.

This guidance is based on the latest available evidence and cautious prudence to protect people living with IBD. It will likely change over time as new information becomes available and/or the risk of COVID-19 changes.

This page contains information on:

Adults age 20–64
Seniors over 65
Resources for Patients
Back to School Guidance is available here

Adults (20 - 64 years old):

The majority of adults in this age group tend to have mild COVID-19 disease. A large international registry of people with IBD who get COVID-19 has demonstrated that people with IBD generally do as well as other people of the same age, even among patients on immunosuppressives or biologics. Therefore, the Crohn’s and Colitis Canada COVID-19 Taskforce suggests that if your IBD is in remission, and you don’t meet the criteria below, you may return to work, even if you are using immunosuppressives or biologics.

The exception to this recommendation is people on steroids, those with severe active inflammation (a ‘flare’), and those who are malnourished.

If you are in remission and are otherwise healthy, you should follow the local public health guidance regarding returning to work and engaging in activities outside of your house. In general, adults who are in remission and feeling well may return to work.

There is uncertainty as to the risks posed by high-dose steroids (more than 20 mg of prednisone equivalent dose), severe active inflammation, and malnutrition in adults with IBD. In older adults, it appears that severe active inflammation and prednisone may increase the chances of having severe COVID-19. Consequently, we recommend a more cautious approach until more data becomes available to help guide decisions.

We recommend that people with IBD stay home and not engage in non-essential activities outside the home if they:

  • Have severe active inflammation (that is, people who were told by their doctor that the inflammation in their gastro-intestinal tract is severe and not yet under good control), or

  • Take steroid medications (more than 20 mg prednisone equivalent dose) (excluding steroid enemas or budesonide), or

  • Have moderate/severe malnutrition (that is, people who were told by their doctor that they are malnourished, and that malnutrition came as a result of active inflammation that isn’t yet under good control), or

  • Require parenteral nutrition (TPN or intravenous nutrition through a central line), or

  • Have other comorbidities that put him/her at risk of severe COVID-19 (as per local public health recommendations).

If you were recently diagnosed or have had a flare of IBD, but are now feeling well and tapered the dose of steroids to less than 20 mg per day, you may return to work outside the home.

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Seniors (65 years and older):

Adults in this age group may be at a higher risk of more severe COVID-19 disease. Registries studying COVID-19 in seniors with IBD have reported some cases of severe COVID-19 disease. The risk appears to increase with advancing age.

Unfortunately, the information in seniors with IBD is limited. Consequently, we recommend a more cautious approach until more data becomes available to help guide decisions. 

Consider continued self-isolation, especially if you:

  • Are using steroids (more than 20 mg/day prednisone equivalent dose),

  • Have severe active inflammation (that is, people who were told by their doctor that the inflammation in their gastro-intestinal tract is severe and not yet under good control), or

  • Have moderate/severe malnutrition (that is, people who were told by their doctor that they are malnourished, and that malnutrition came as a result of active inflammation that isn’t yet under good control), or

  • Receive nutrition through a central line (parenteral nutrition or TPN), or

  • ​Have other comorbidities that put you at risk for severe COVID-19. ​

If you do not fall in one of the above categories, please follow local public health guidance on physical distancing, wearing a mask, washing your hands often, and avoiding contact with large crowds. We recommend that people with IBD in this age group speak to their doctor or local public health office for individual guidance.

New data is emerging on a weekly basis and we will update our recommendations as we learn more about the risks of COVID-19 in seniors with IBD.

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resources for patients

The Crohn's and Colitis Canada COVID-19 Task Force has developed a letter of support for people affected by IBD that can be provided to employers and school administrators.

The letter outlines the impact of COVID-19 on people living with Crohn's or colitis, guidance for immunocompromised patients, and accommodations for work and school. Please click here to download a copy of the letter. 

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Last Updated: October 6, 2020

  • Canada has among the highest incidence rates of Crohn's and colitis in the world.
  • 1 in 140 Canadians lives with Crohn’s or colitis.
  • Families new to Canada are developing these diseases for the first time.
  • Incidence of Crohn’s in Canadian kids under 10 has doubled since 1995.
  • People are most commonly diagnosed before age 30.