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

COVID-19: Information for Pharmacy Professionals

Page Updated September 10, 2021

Latest updates:

- Made changes to reflect up to date information in the following section: COVID-19 Testing and Screening in Community Pharmacies

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.

The College has made changes to our operations as a result of COVID-19 – please see the news post for more information.

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)

Vaccinations for Pharmacy Professionals

The Ontario government announced mandatory vaccination policies for high-risk settings such as hospitals, requiring employees, students, volunteers and contractors to be either fully vaccinated or undertake regular testing for COVID-19 and complete an education session about the vaccine. While this announcement does not apply to those working in community pharmacies—but does apply to pharmacy professionals working in identified high-risk settings—the College continues to strongly encourage all pharmacy professionals to receive both doses of a COVID-19 vaccine as a way to protect themselves and their patients.

GUIDANCE AND REPORTING

Guidance on Pharmacy Professionals Wearing Masks

At a July 20, 2020 special meeting, the College’s Board of Directors considered positions on the use of masks in pharmacies to decrease the likelihood of the spread of COVID-19.

Following a discussion on potential options, which are outlined in the Board briefing note, the Board decided that the College should continue actively supporting the guidance and policies made by provincial and municipal authorities respecting mask use and expects pharmacy professionals to abide by this requirement to prevent exposure and spread of COVID-19. Their decision reaffirms the College’s approach to sharing appropriate resources and guidance with registrants since the start of the pandemic.

To support the Board’s decision, 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)
COVID-19: Guidelines for Pharmacists and the Pharmacy Workforce (International Pharmaceutical Federation) – See pages 9-14 for recommendations on masks
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)

The following FAQ was provided by Public Health Ontario.

Q: Should pharmacists wear PPE when dispensing medications?

A: COVID-19 is transmitted via droplets during close, unprotected exposure, and when in direct contact with surfaces and fomites that have been recently contaminated with the virus. Studies have documented the presence of virus on surfaces in the environment of patients who have tested positive for COVID-19 however the relative importance of indirect contact transmission (i.e. droplets spreading from a patient to an environmental surface to another individual) is uncertain. For further details please refer to PHO’s What we know so far about…COVID-19 Transmission Through Large Respiratory Droplets and Aerosols.

In the proposed scenario, the pharmacist/pharmacy technician or assistant is asymptomatic and is preparing non-sterile, non-hazardous medications using proper equipment/procedures in the absence of close contact with patients or other pharmacy staff. The risk of contaminating the medication and/or medication container and then subsequent transmission to patients consuming the medication would be very low, especially with proper hand hygiene, environmental cleaning and equipment disinfection processes in place. The use of PPE is unlikely to further reduce risk for routine medication preparation in this scenario. However, where there is a requirement for universal masking in publicly accessible spaces, the pharmacist/pharmacy technician may need to wear a mask depending on where the medication preparation space is located.

Provincial Guidance for Pharmacies

The COVID-19 Guidance for Pharmacies (updated June 19, 2020) from the Ministry of Health includes information on screening and reporting, occupational health and safety, and links to other resources.
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.
The Ministry is also keeping healthcare providers informed of the latest discussions at the COVID-19 Command 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. If they are experiencing COVID-19 symptoms, they should call Telehealth Ontario at 1-866-797-0000 or their local public health unit.

Public Health Reporting Requirements

Under Ontario’s Health Promotion and Protection Act, COVID-19 is a disease of public health significance, in addition to other communicable and virulent diseases such as measles. Any registrant who forms the opinion that a patient has or may have COVID-19 must report this information to their region’s public health unit or medical officer of health as soon as possible. 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-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 of Asymptomatic Persons in Community Pharmacies outlining the College’s expectations of pharmacists in community pharmacies collecting samples for laboratory-based real-time PCR COVID-19 testing. The guidance serves as a supplement to the Ministry of Health and Public Health requirements, and will help ensure the continued safety of all individuals accessing the pharmacy’s services.

For information on publicly-funded laboratory-based PCR testing in pharmacies, refer to the Ministry of Health Executive Officer Notices regarding Specimen Collection for COVID-19 Testing of At-Risk Asymptomatic Persons through Ontario Pharmacies.

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 information on publicly-funded antigen POCT in pharmacies for patients who meet the current Provincial Testing Guidance, please refer to the Ministry of Health Executive Officer Notices regarding Publicly Funded COVID-19 Antigen Point-of-Care Testing in Ontario Pharmacies.

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 Ontario. 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. However, changes to provincial regulations under the Pharmacy Act which enable pharmacists in Ontario to renew and adapt prescriptions (including de-prescribing) for controlled substances (narcotics, controlled drugs and targeted substances) are set to be revoked on April 7, 2022. The College is exploring this further with the government, and will continue to provide updates.

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.

COVID-Related Treatment Dispensing

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.

Prescriptions To and From Prescribers Working Remotely

Prescription Requests to Prescribers Working Remotely

Pharmacy professionals should keep in mind that faxing requests to prescribers may not be the most effective method of communication at this time, as prescribers may not have access to fax machines if they are working remotely.

To facilitate timely patient care, we encourage registrants to work to their full scope of practice. Currently, pharmacists, interns and registered pharmacy students (under the supervision of a pharmacist) have the authority to renew prescriptions for the purpose of continuity of care as described in the Initiating, Adapting and Renewing Prescriptions Guideline. As always, registrants should use their professional judgment in determining the appropriateness of the prescription.

Prescriptions from Prescribers Working Remotely

Many prescribers are working remotely from hospitals and clinics throughout the pandemic and may not be able to provide prescriptions in the usual manner. Registrants receiving these prescriptions should assess them as a whole, including the content and appropriateness specific to the patient, and use their professional judgment to determine their authenticity and validity to dispense. If there is uncertainty that the prescriber has authorized the order, the pharmacy professional may decide to follow up with the prescriber, clinic or hospital directly.

For guidance on determining the authenticity of a prescription, please review the College’s position statement on Authenticity of Prescriptions Using Unique Identifiers for Prescribers and the Faxed Transmission of Prescriptions Policy.

Pharmacists who receive emailed prescriptions directly from a patient are encouraged to collaborate with the physician to ascertain the prescription’s authenticity and/or determine how best to securely receive the prescription via established channels (i.e. fax, verbal, electronically, etc.) directly from the prescriber. See June 17 e-Connect for more information.

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 August 11, 2021) the Quick Reference Public Health Guidance on Testing and Clearance, including recommendations related to healthcare workers return to work. The Ministry of Health Management of Cases and Contacts of COVID-19 in Ontario (updated August 11, 2021) document provides more detailed information in this regard.

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:

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.

Post-Consumer Returns

The Office of Controlled Substances (OCS) has issued a bulletin providing pharmacists with information on temporary exceptional measures in light of the COVID-19 pandemic for post-consumer returns containing controlled substances.

The bulletin contains a number of recommendations to allow for reduced contact between consumers and pharmacists when returning products that may contain controlled substances to a pharmacy. Pharmacists are still required to do their best to ensure post-consumer returns containing controlled substances remain secure.

If you have any questions, please contact Health Canada’s Office of Controlled Substances at hc.compliance-conformite.sc@canada.ca.

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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