Home Regulations & Standards COVID-19: Information for Pharmacy Professionals

COVID-19: Information for Pharmacy Professionals

Page Updated April 11, 2022

Latest updates:

- Made changes to reflect up-to-date information on dispensing publicly funded Paxlovid™ (Patient Care section, COVID-Related Treatment Dispensing)

Important Reminders:

- As the pandemic continues to evolve, registrants are reminded to review and keep up-to-date on guidance from the Ministry of Health, including monitoring ONEMail accounts for updates.

This page provides the latest updates on COVID-19 for pharmacy professionals and is updated frequently. The College continues to collaborate with the Ministry of Health, public health officials and other health system partners and professional associations to inform and support pharmacy professionals.

For the College’s latest email updates on COVID-19, please visit the e-Connect page of our website.

If you are a patient, please visit the COVID-19 Information for Patients webpage.

On January 13, 2021, the provincial government amended Ontario Regulation 107/96 under the Regulated Health Professions Act (RHPA), exempting a part A pharmacist, intern, registered pharmacy student or pharmacy technician from subsection 27 (1) of the Act for the purpose of administering a coronavirus (COVID-19) vaccine by injection.

The College has developed a guidance document titled Administration of COVID-19 Vaccine by Pharmacy Professionals which outlines expectations and resources for pharmacy professionals administering COVID-19 vaccines and serves as a supplement to the Executive Officer Notices and other COVID-19 vaccine-relevant guidance from the Ministry of Health, below:

Ministry of Health COVID-19 Vaccine-Relevant Information and Planning Resources
Ministry of Health Executive Officer Notices Regarding Vaccine Administration in Pharmacies (updated regularly):
- Administration of Publicly Funded COVID-19 Vaccine in Ontario Pharmacies – Eligibility
- Administration of Publicly Funded COVID-19 Vaccine in Ontario Pharmacies – Billing
- Questions and Answers for Administration of Publicly Funded COVID-19 Vaccine in Ontario Pharmacies

Helpful Resources

Resources for Healthcare Professionals

Vaccine Confidence

Supporting Vaccine Confidence in Indigenous Peoples (National Collaborating Centre for Infectious Diseases)
Vaccine Hesitancy and Other COVID-19 Challenges – Lessons From Behavioural Science (Neighborhood Pharmacy Association of Canada, February 22)
Immunizing Children with Confidence (Children’s Healthcare Canada)

GUIDANCE AND REPORTING

Guidance on Pharmacy Professionals Wearing Masks

The College will continue to provide pharmacy professionals with relevant guidance and updates as they become available. The following is a list of selected resources:

Personal Protective Equipment (PPE): Suggested Best Practices for Pharmacies During the COVID-19 Pandemic (Canadian Pharmacists Association)
Universal Mask Use in Health Care (Public Health Ontario)
Focus on Universal Mask Use in Healthcare Settings and Retirement Homes (Public Health Ontario)
COVID-19 medical masks and respirators: Information for health professionals (Public Health Agency of Canada)

In acknowledging the vitally important role pharmacies continue to play during the pandemic even as public health measures are being lifted, the College strongly encourages the continued use of masks in all pharmacies through to the end of June 2022 to further protect patients and staff, particularly when interacting with patients and providing professional services.

Provincial Guidance for Pharmacies

The Ministry of Health webpage for healthcare providers provides important updates and resources.
COVID-19 Health Care Resources from Public Health Ontario, including infection prevention and control guidance.
Management of Cases and Contacts of COVID-19 in Ontario
The Ministry is also keeping healthcare providers informed of the latest discussions at the Health Coordination Table, whose role is to oversee and provide strategic direction to guide Ontario’s response, informed by input from stakeholders and other experts.
For the latest case numbers in Ontario, visit the Status of Cases in Ontario webpage.

Patients and members of the public should be directed to the Ministry’s COVID-19 self-assessment.

Public Health Reporting Requirements

As outlined in the Ministry of Health’s COVID-19 Provincial Testing Guidance, positive rapid antigen test results do not require confirmatory testing in most settings, or reporting to the public health unit, unless otherwise recommended by the public health unit or sector specific guidance.

Other than rapid antigen tests and self-test kits, positive COVID-19 tests performed using a Health Canada approved test or an assay validated by the laboratory must be reported to the local public health unit as per the LSCCLA’s Reg 682 and/or under the Health Protection and Promotion Act. You can find the contact information for your local public health unit using the Ministry’s Public Health Unit Locator.

Hospital pharmacists and technicians should be familiar with the hospital’s policy and procedures, including the expectation of pharmacists, if any, for reporting suspected cases of COVID-19 among inpatients and outpatients.

Resources from Associations

A number of pharmacy associations have made their COVID-19 resources available to all pharmacy professionals, including:

PATIENT CARE

COVID-Related Treatment Dispensing

Dispensing publicly funded Paxlovid™
As of April 12, 2022, all pharmacies with a Health Network System (HNS) account are able to dispense publicly funded Paxlovid™ (nirmatrelvir/ritonavir) treatment to eligible Ontarians. Pharmacists must ensure they have sufficient knowledge, skills and expertise when dispensing any medication including Paxlovid™. Pharmacists are reminded that every prescription must be reviewed for completeness and appropriateness, and to review patient personal health information for drug therapy problems, drug interactions, therapeutic duplications and any other potential problems.

For more information, please reference the resources below:

Advisories on Hydroxychloroquine, Chloroquine and Ivermectin

COVID-19 Testing and Screening in Community Pharmacies

See the Ministry of Health COVID-19 Guidance for the Health Sector – Symptoms, Screening and Testing Resources

COVID-19 Testing (Laboratory Based PCR Testing)

The College has created GUIDANCE – COVID-19 Testing in Community Pharmacies outlining the College’s expectations for Designated Managers, registrants and community pharmacies opting to provide COVID-19 testing (including the specimen collection required to perform a test) to the public. This guidance is intended to be used alongside, and not in place of, the Guidance: Testing of Individuals in Pharmacies provided by the Ministry of Health (MOH) which oversees the province’s response to COVID-19.

For information on publicly-funded laboratory-based PCR testing in pharmacies, refer to the Ministry of Health Executive Officer Notices.

COVID-19 Screening (Antigen Point-of-Care Testing (POCT))

On March 3, 2021, section 10 of Reg. 683 under the Laboratory and Specimen Collection Centre Licensing Act was amended and, as a result of the exemptions enacted, any person may collect specimens for COVID-19 point-of-care testing. When performed by pharmacy professionals, the Standards of Practice and Code of Ethics expect registrants to recognize and work within the limits of their competence and to only practice when they have the appropriate knowledge and skill to do so safely. Training materials for conducting antigen POCTs are available from Ontario Health.

For these and any other COVID-19 testing and screening initiatives, please refer to Ministry of Health COVID-19 Guidance for the Health Sector – Symptoms, Screening and Testing Resources. For further inquiries, please send an email to: PublicDrugPrgrms.moh@ontario.ca.

Registering your Pharmacy to Distribute Rapid COVID-19 Tests

Pharmacies can register with the Government of Canada to become COVID-19 rapid test distributors to small and medium-sized organizations who want to implement workplace screening for their employees.

Tests will be provided free of charge by the Government of Canada and pharmacies may charge up to $14 per box of 25 tests to cover the cost of training and handling.

Interested pharmacies can register to distribute tests through the Government of Canada portal. For more information, visit the Government of Canada’s webpage on free test kit distribution through pharmacies.

Controlled Drugs and Substances Act (CDSA) Exemption

Health Canada has extended the temporary Controlled Drugs and Substances Act (CDSA) subsection 56(1) class exemption authorizing pharmacists to:

Accept a verbal order from a prescriber for a controlled substance.
Transfer a prescription for a narcotic or controlled drug to another pharmacist in Canada. If it has already been transferred, it may be transferred to another pharmacist.
Transfer a prescription for a benzodiazepine or other targeted substance to another pharmacist. If it has already been transferred, it may be transferred to another pharmacist.
Refill a prescription for a benzodiazepine or other targeted substance if more than one year has elapsed since the date it was written
Renew a prescription for a controlled substance.
Adapt a prescription for a controlled substance, including part-filling or de-prescribing.

Health Canada’s section 56 (1) exemption from the Controlled Drugs and Substances Act has been extended for another five years to September 30, 2026. To align with this extension, amendments to O. Reg. 202/94 (General) made under the Pharmacy Act, 1991 have been approved by the Ontario government. These changes continue to temporarily allow pharmacists to renew and adapt prescriptions for controlled drugs and substances until September 30, 2026.

Health Canada has also issued:

Please contact Health Canada for questions concerning the exemption at HC.compliance-conformite.SC@canada.ca.

CDSA Exemption – OCP Resources for Pharmacy Professionals

To support the profession in adapting to these temporary CDSA changes, the College has updated a number of resources for pharmacy professionals to reflect these interim measures:

COVID-Positive Patients

Currently, the Ministry’s COVID-19 Guidance for Pharmacies states that: if a patient screens positive [for COVID-19] over the phone, the patient should be advised to get someone from outside of their household to pick up their medications, or the medication should be delivered to the patient (if this service is available) without direct contact with the patient.

The CPSO has advised its registrants that patients who are in self-isolation or isolation due to a confirmed or potential positive COVID-19 test should be told to stay home rather than enter a pharmacy to fill a prescription, which would put the health of other patients and pharmacy professionals at risk.

Physicians have also been advised to send the prescription to the patient’s pharmacy of choice and explain the patient’s situation. Physicians are permitted to share information about the patient’s COVID-19 status with the pharmacist, as the pharmacist is a member of the circle of care and the information being shared is pertinent to the provision of care. The patient and pharmacy can then arrange for delivery of the medication or for it to be picked up by a designate, such as a friend, who does not live in the same household.

Pharmacy professionals should exercise professional judgment to determine the most appropriate process based on the circumstances at hand.

Drug Shortages

The federal Minister of Health has made an interim order which allows for the exceptional importation and sale of drug and medical devices that do not fully comply with Canadian requirements but are manufactured according to comparable standards. This order is intended to prevent or alleviate the effects of shortages directly or indirectly related to COVID-19.

For more information, please review the Interim Order and the Explanatory Note.

The CPhA has published Drug Shortages: A Guide for Assessment and Patient Management and the University of Saskatchewan has a Drug Shortages page with helpful information.

Medical Assistance in Dying (MAiD)

In response to the shortage of injectable drugs for the purposes of MAiD, during the COVID-19 pandemic, the Restocking of Drugs used for MAiD during COVID-19 Policy (applicable only to hospital pharmacies) was created to describe the College’s expectations in this regard. Unused injectable MAiD drugs previously dispensed by a hospital pharmacy may be restocked if done so in accordance with the regulations outlined in the Drug and Pharmacies Regulation Act, DPRA, O. Reg. 264/16, s.32 and the expectations set out in the policy.

Emergency Care

During public health emergencies, pharmacy professionals are more likely to encounter situations where patients require emergency care in order to prevent or reduce risk of imminent severe harm. In such circumstances, pharmacists may apply professional judgement to address the patient’s immediate needs and provide care, such as emergency prescribing, in addition to what is currently permitted within current scope of practice related to adapting and renewing prescriptions (see the College’s Initiating, Adapting and Renewing Prescriptions guideline).

An example of this would be prescribing a rescue/reliever inhaler for a patient suffering from an acute asthmatic reaction or rendering first aid or other temporary assistance in an emergency, as enabled and expressed within the Regulated Health Professions Act (s. 27 and s.29). This is further supported by the College’s Code of Ethics.

The College is supportive of pharmacists meeting the needs of their patients when medical care is urgent and the risk of not providing assistance is far greater to the patient than providing immediate care.

Managing Opioid Agonist Treatment (OAT)

CRISM Guidance

The Canadian Research Initiative in Substance Misuse (CRISM) has developed six national guidance documents to address the urgent needs of people who use substances, service providers and decision makers in relation to the COVID-19 pandemic.

Access the six guidance documents.

CAMH Guidance

The Centre for Addiction and Mental Health (CAMH) has provided new guidance to pharmacists and prescribers for dispensing and prescribing of OAT that will assist in the provision of collaborative patient care during COVID-19 pandemic.

Prescription Delivery

When providing delivery of prescription medications, Designated Managers should be mindful of the intended outcome of the signature requirements of the DPRA outlined in the Delivery of Prescriptions Fact Sheet, which includes ensuring the prescription is dispensed to the right patient and that opportunity for loss/theft is minimized.

Operationally, there may be more than one way to accomplish this, which is left to the professional judgment of the pharmacist. Documentation of the reason for not obtaining a ‘wet’ signature from the patient or their agent is recommended.

Pharmacies that may have existing operational processes requesting patients/agents to sign documentation in other situations should consider alternative methods of documentation that would achieve the same purpose.

Providing Influenza Immunization Services

Suggested Best Practices for Community Pharmacies Providing Influenza Immunizations During the COVID-19 Pandemic (Canadian Pharmacists Association)
Guidance for influenza vaccine delivery in the presence of COVID-19 (Public Health Agency of Canada)

Pharmacies that have a UIIP agreement for the 2021/22 influenza season may request an allocation of the Ministry of Health’s PPE supply for administration of flu vaccines via the Remedy online intake form.

Virtual Care

The Virtual Care Policy (June 17, 2021) describes the College’s expectations of pharmacy professionals when providing virtual care. The Information and Privacy Commissioner’s Guideline – Privacy and Security Considerations for Virtual Healthcare Visits provides additional considerations. The Ontario Pharmacists Association has developed a Guide to Providing Virtual Care to Patients in Pharmacy to assist pharmacy professionals with navigating the operational aspects of virtual care provision.

PHARMACY PROFESSIONAL TRAINING, HEALTH AND SAFETY

Emergency Assignment Registration

The College has initiated emergency assignment registration to address the workforce need for additional pharmacists and pharmacy technicians that has arisen due to the COVID-19 pandemic.

In addition to emergency assignment registration, there are a number of reactivation and reinstatement options depending on the particular circumstance of the pharmacist or pharmacy technician. Please visit the College’s Returning to Practice webpage.

The government of Ontario is also recruiting experienced healthcare professionals. Please visit the COVID-19 Health Care Provider Recruitment webpage.

Illness and Return to Work

The Ontario Pharmacists Association (OPA) has produced a document that provides guidance related to return to work for pharmacy staff. Additionally, the Canadian Pharmacists Association has developed a list of key considerations for pharmacy managers/owners to help them prepare for next steps if a pharmacy staff member is exposed to or infected with COVID-19.

The Ministry of Health has also updated (as of February 3, 2022) guidance on COVID-19 Integrated Testing & Case, Contact and Outbreak Management, including recommendations related to healthcare workers return to work.

Mental Health Support

A variety of mental health resources and services are available to healthcare workers during the pandemic, including:

Personal Protective Equipment (PPE) Supply

The College supports pharmacy professionals having access to Personal Protective Equipment (PPE) during the COVID-19 pandemic, not only to protect their own health and safety, but those of their patients.

PHARMACY OPERATIONS

Infection Prevention and Control Resources

Please see the following resources related to implementing and maintaining infection prevention and control activities:

IPAC Measures Memo from Ontario’s Chief Medical Officer of Health (December 30, 2021)
Best Practices for Environmental Cleaning for Prevention and Control of Infections in All Care Settings (Public Health Ontario)
IPAC Recommendations for Use of Personal Protective Equipment for Care of Individuals with Suspect or Confirmed COVID-19
(Public Health Ontario)
Patient Safety and Infection Prevention and Control (Winter 2020 Pharmacy Connection article)
A Pharmacist’s Guide to Pandemic Preparedness, see Environmental Cleaning section (Ontario Pharmacists Association)
PPE: Suggested Best Practices for Pharmacies During the COVID-19 Pandemic (Canadian Pharmacists Association)
Infection prevention and control for COVID-19: Interim guidance for outpatient and ambulatory care settings (Public Health Agency of Canada)
Optimizing the Supply of PPE During the COVID-19 Pandemic (Ontario Health)

Pharmacy Operations

In the gradual restart of services, healthcare providers must comply with the requirements as set out in COVID-19 Operational Requirements: Health Sector Restart.

The Ontario Pharmacists Association has developed A Pharmacist’s Guide to Pandemic Preparedness which includes guidance on business continuity planning.

Sterile Compounding and Personal Protective Equipment Shortages

The College is providing guidance and information to support pharmacists and pharmacy technicians who are performing sterile compounding where there is a documented shortage of personal protective equipment (PPE).

As always, the priority must be both a sterile, quality compounded preparation and the protection of the personnel involved in compounding.

Review the Guidance on Shortages of Personal Protective Equipment (PPE) for Sterile Compounding During Coronavirus Pandemic.

Temporary Pharmacy Closures or Changes to Pharmacy Operating Hours

We have heard concerns from registrants regarding the continued operation of community pharmacies and the prospect of temporary closures if pharmacy staff are unable to work due to illness, self-isolation, or caring for loved ones. This can have a significant impact on patient care in remote and rural communities in particular. It’s an important issue that we take very seriously and continue to monitor.

In making these difficult decisions, the primary consideration of pharmacy operators must be to ensure continuity of care for patients. Patients need to be able to access their records, and it’s important that they are informed and understand how to access their medication in the event of a closure. Providing information about the location of alternate pharmacies and an emergency contact number (if available) can help facilitate continuity of care.

Registrants should also exercise their professional judgment to determine how best to assist patients prior to a temporary closure, such as renewing prescriptions to ensure they have an adequate supply and informing their primary care provider.

If your pharmacy needs to close temporarily due to staff shortage, illness or other circumstances, please complete the Notification Form for Temporary Closures and submit it to pharmacyapplications@ocpinfo.com. This will assist the College in monitoring the number of temporary closures and work with the Ministry of Health and others to address the issue and mitigate the potential impact on patients.

If you make adjustments to pharmacy operating hours please e-mail or call Pharmacy Applications & Renewals at pharmacyapplications@ocpinfo.com or 416-962-4861 ext. 3600.

Helpful Links

Public Health Agency of Canada

World Health Organization

Centre for Effective Practice - COVID-19: Clinical and Practical Guidance for Primary Care Providers

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