Coronavirus disease (COVID-19) Archived

Thank you for visiting the BC Pharmacy Association's COVID-19 information page for pharmacists and the public.

The BC Pharmacy Association has amalgamated all its COVID-19 daily, weekday updates into a single page to create a one-stop shop for pharmacists, health-care workers, patients and the public to access.

As the COVID-19 situation remains fluid, the BCPhA is collaborating with our partners and stakeholders in government, among regulators, insurers and the health-care teams within community pharmacies across B.C. to collect the most accurate, most up to date information. 

Highlighting the most important information for B.C.'s pharmacies

By now, there is a wealth of information being presented to community pharmacies during COVID-19. Recognizing the amount of information can be staggering, the BC Pharmacy Association is shifting its efforts to redevelop our online resources for pharmacists in a more user-friendly format.

Starting today, the BCPhA's COVID-19 updates will be published three times a week, instead of daily during weekdays, to focus on the most useful information for pharmacies and to permit BCPhA staff time to reorganize previously published but relevant information into more easily accessible formats.

Information may change over time. If you have questions about something you've read here or elsewhere, please contact us directly at info@bcpharmacy.ca.

The BC Pharmacy Association has been notified by several members that they have been contacted by suspected scammers. During the COVID-19 pandemic, the BCPhA understands pharmacies are seeking alternative suppliers for Personal Protective Equipment (PPE). It is important to remember to exercise due diligence when interacting with any alternative supplier.

We have contacted a number of suppliers, however many do not have inventory in stock. We have also heard from members who found their own suppliers and placed orders four weeks ago and the masks have not yet arrived. To avoid this type of situation, we will only list suppliers who have supplies on hand and ship within a short timeframe upon order.

Please check back as we will be listing suppliers immediately as supplies are in stock.

Surgical or respirator masks

The BC Pharmacy Association is monitoring inventory with six suppliers. Two suppliers have indicated they will have supplies by end of April. Once supplies are available again, we will list these suppliers.  

Face shields

Second Barrier - Sleek Signs, Regina
Tina Hasfjord
(306) 731-2924
hasfjordt@sasktel.net
Item: Face Shields
Minimum Qty: 25 masks
Cost: $18.90 for 25 units, down to $13.92 for 20,000 units
Delivery: Orders are shipped next day by FedEx Canada wide. We have a current capacity to ship 5,000 per day but have built in capacity to ramp to 50,000 per day. We are running three shifts, 24/7.
We have an online ordering system at www.secondbarrier.com

Group purchase for face shields

We understand that face shield vendors have a minimum purchase requirements of 25. Most pharmacies have a small numbers of staff members and do not require a large number of masks. If we can get enough interest, we will make a bulk-order and will distribute it to pharmacies who are interested in ordering.

Face shields will work out to around $20 per shield after shipping and handling. That amount is to be determined and we will confirm with your pharmacy to see if your pharmacy is still interested before making the purchase.

We have discussed with many vendors the last few weeks and most do not have inventory immediately in stock. The supplier we identified that has inventory in stock is https://secondbarrier.com/

Please complete the survey no later than Friday, April 24.

I am interested in the group-buy offer

COVID-19 testing criteria for health-care workers has been updated. The previously issued Provincial Health Services Authority criteria (referenced below) for testing has now been replaced by the BC Centre for Disease Control criteria for testing.

Mild respiratory symptoms

• No COVID-19 test required. (LTC workers: COVID-19 test required. If positive, follow return to work criteria under the positive test results section at the bottom of this page.)

Fever of ≥38°C or new onset or exacerbation of cough or shortness of breath

• COVID-19 test required.

Previous criteria (replaced on April 14, 2020):

• Fever and cough or shortness of breath (new/worsening – not pre-existing),

OR two of the following symptoms: fever, cough, shortness of breath, diarrhea, fatigue/malaise, rhinorrhea

The BC Centre for Disease Control has released guidance for the Cleaning and Disinfection of Eye/Facial Protection.

The document covers how to safely clean and disinfect two types of equipment: reusable eye protection (goggles, safety glasses and faceshields without foam) and faceshields with visor and foam.

The disinfection procedure requires:

• exam gloves
• clean cloth
• soap and water
• disinfectant wipes

For the full set of instructions, please visit the BCCDC website.

Information on the cleaning of surfaces is also available

The BCCDC has also made available a document for environmental cleaning and disinfectants for clinic settings, which can be applied to surfaces within pharmacies. The document also includes a list of disinfecting agents and working concentrations known to be effective against coronaviruses.

To access instructions for the cleaning of surfaces, click here.

Highlighting the most important information for B.C.'s pharmacies

By now, there is a wealth of information being presented to community pharmacies during COVID-19. Recognizing the amount of information can be staggering, the BC Pharmacy Association is shifting its efforts to redevelop our online resources for pharmacists in a more user-friendly format.

Starting April 20, the BCPhA's COVID-19 updates will be published three times a week, instead of daily during weekdays, to focus on the most useful information for pharmacies and to permit BCPhA staff time to reorganize previously published but relevant information into more easily accessible formats.

Information may change over time. If you have questions about something you've read here or elsewhere, please contact us directly at info@bcpharmacy.ca.

The requirement for a patient signature on the Frequent Dispensing Authorization form (HLTH 5378) is temporarily suspended effective April 17. Pharmacists are asked to indicate patients' verbal assent on the form by writing the word "COVID" where the patient's signature would go.

For blister packs, PharmaCare asks pharmacists to accommodate four weeks' supply as opposed to one.

For the Smoking Cessation Program Declaration and Notification form (HLTH 5464), signatures are also suspended if there is verbal assent from a patient. Pharmacists are also asked to indicate "COVID" in the area where patients sign.

• Forms must be retained
• Patients should be asked to sign the forms where it is feasible
• Alternatively, pharmacists may contact the prescriber to request a new prescription, which has weekly or daily dispense indicated on the prescription

For both forms, pharmacists should ensure that patients are aware of the contents of the declaration to which they are verbally assenting.

For more information, please see the April 17 PharmaCare newsletter.

On April 16, the BC Centre for Disease Control and the Ministry of Health issued a clarity: the mass gathering order, which prohibits gatherings of more than 50 people, does not apply to grocery stores.

Large grocery stores are still expected to follow appropriate physical distancing, particularly in areas where people may congregate, such as in line-ups, entryways, checkout counters and product pick-up locations.

The full statement from the BCCDC and Ministry of Health is available here.

The Pharmacy Examining Board of Canada (PEBC) is rescheduling Part I (MCQ) of the Pharmacist Qualifying Examination from May 2020 to Aug. 4 and 5, 2020. Emails will be distributed to candidates registered for the original May 2020 exam.

Part II (OSCE) of the Pharmacist Qualifying Examination for May 2020 has been cancelled.

The PEBC is currently planning to hold the next Part II exam in November 2020, as scheduled, but is delaying the opening of new applications for that exam.

There is currently no change to the June 26 Pharmacist Evaluating Examination, but COVID-19 remains a factor for its feasibility.

More information will be made available in the "Latest News" section of the PEBC website.

A recording has been made available by the University of B.C. for those who missed a virtual B.C. COVID-19 Symposium on April 9, 2020.

The symposium covered the following topics:

• Diagnostics, genomics and transmission dynamics
• Clinical trials and patient management
• Epidemiology and public health response
• Social dynamics, communications and trust
• Development of therapeutics and vaccines

Access the Recording Here

An increased demand for salbutamol inhalers during the COVID-19 pandemic has resulted in shortages and limited supply for the product in Canada, according to Health Canada.

Salbutamol is used in the treatment of conditions such as asthma, chronic obstructive pulmonary disease (COPD). Health Canada is advising that patients should keep taking their regular medication to maintain their respiratory conditions, to reduce the need for salbutamol.

More information is available on Health Canada's website.

The BC Centre for Substance Use has released a document for health-care providers serving patients who have alcohol use disorder or are withdrawing from alcohol.

The document contains information for prescribers, the types of medications involved in the treatment of alcohol withdrawal, considerations for medication delivery and more.

Download the document at the BCCSU website.

The College of Pharmacists have submitted proposed amendments to the Ministry of Health to permit a community pharmacies to fill verbal prescriptions transcribed by another pharmacist (in a different setting), if the written record includes:

• the name and regulatory college ID number of the practitioner
• the name, college ID number and signature of the pharmacy registrant who received the verbal prescription

The amendments are being proposed to address a barrier where hospital discharge prescriptions transcribed by hospital pharmacists, via verbal authorization from a practitioner, are often not accepted by community pharmacies due to requirements in the Health Professional Act's Community Pharmacy Standards of Practice.

More information is available on the College's April Board Highlights.

It has been a month since this pandemic began here in British Columbia, and we know how busy pharmacists and pharmacy teams have been delivering the critical services needed to British Columbians in your community.

Every Monday through Friday, the BCPhA will send out daily updates on the latest information we have received that will help pharmacists during this time. We also continue to update our COVID-19 resources and information on our website.

Information may change over time. If you have questions about something you've read here or elsewhere, please contact us directly at info@bcpharmacy.ca.

On April 9, 2020, BC Pharmacy Association (BCPhA) partnered with the BC Centre for Substance Use (BCCSU) on a webinar with information specific to pharmacists who are serving substance users during the COVID-19 pandemic, including information about the new provincial clinical guidance.

Speakers included:

• Dr. Mona Kwong, Pharmacy Advisor and Director, Addiction Pharmacy Fellowship, BCCSU
• Ann Johnston, Manager, Pharmacy Practice Support, BCPhA
• Guy Felicella, Speaker, Guy Felicella Consulting

The recording is now available on the BC Pharmacy eTraining portal.

Start eTraining

The BC Pharmacy Association is continually updating our resource for financial assistance during COVID-19. This relief, made available through various levels of government, includes information on Employment Insurance, Canada Emergency Response Benefit, the BC Emergency Benefit, subsidies for business owners and more.

New financial relief programs announced by the federal and provincial governments this week include:

• For individuals: The Canadian Emergency Response Benefit has been expanded to include Canadians making up to $1,000 a month, seasonal workers and individuals whose Employment Insurance has run out.
• For families: Temporary Emergency child care is available for essential workers aged infant to 5 years.
• For businesses: The Province is providing enhanced relief for businesses by reducing most commercial property tax bills by an average of 25%, along with new measures to support local governments facing temporary revenue shortfalls as a result of COVID-19.

To access the financial help resource, click here.

The Ministry of Health and the BCPhA have agreed to reallocate a total of $110,000 in funding from Health Canada for pharmacist OAT training to provide funds for BC community pharmacies to help offset the cost of the purchasing and installation of physical barriers (e.g. Plexiglass) between pharmacy staff and patients during the COVID-19 pandemic. The funding will be allocated based on the number of applications received.

Application criteria:

• Any licensed pharmacy in BC that has purchased and installed a physical barrier between January 28 and April 30, 2020.
• Successful applicants will receive up to the same level of funding, not exceeding the cost of the barrier purchased.
• Proof of purchase must be uploaded

Application must be received before end of day May 8, 2020

Required for application:

In order to complete the application, you will need:

• Your pharmacy information including name, address and PharmaCare Site ID#
• Proof of purchase for the purchasing and installation of physical barriers
• If you are submitting for more than one pharmacy (bulk submission), you will need to upload a list of all the pharmacies using this template.

Access Support Fund

It has been a month since this pandemic began here in British Columbia, and we know how busy pharmacists and pharmacy teams have been delivering the critical services needed to British Columbians in your community.

Every Monday through Friday, the BCPhA will send out daily updates on the latest information we have received that will help pharmacists during this time. We also continue to update our COVID-19 resources and information on our website.

Information may change over time. If you have questions about something you've read here or elsewhere, please contact us directly at info@bcpharmacy.ca.

The Ministry of Health and the BCPhA have agreed to reallocate a total of $110,000 in funding from Health Canada for pharmacist OAT training to provide funds for BC community pharmacies to help offset the cost of the purchasing and installation of physical barriers (e.g. Plexiglass) between pharmacy staff and patients during the COVID-19 pandemic. The funding will be allocated based on the number of applications received.

Application criteria:

• Any licensed pharmacy in BC that has purchased and installed a physical barrier between January 28 and April 30, 2020.
• Successful applicants will receive up to the same level of funding, not exceeding the cost of the barrier purchased.
• Proof of purchase must be uploaded

Application must be received before end of day May 8th, 2020

Required for application:

In order to complete the application, you will need:

• Your pharmacy information including name, address and PharmaCare Site ID#
• Proof of purchase for the purchasing and installation of physical barriers
• If you are submitting for more than one pharmacy (bulk submission), you will need to upload a list of all the pharmacies using this template.

Access Support Fund

Health Canada is temporarily approving the use of technical-grade ethanol for the production of hand sanitizer. Canadian hand sanitizers are normally made with food-grade ethanol or United States Pharmacopeia (USP) ethanol, however, the change is being made due as Statistics Canada data from March shows sales of hand sanitizer in Canada increased seven times that month.

Technical-grade ethanol has more impurities than USP and food-grade ethanol, including acetaldehyde. hand sanitizers containing acetaldehyde can pose health risks if used more frequently and for a longer period than directed.

Manufacturers that use technical-grade ethanol in their hand sanitizers must provide additional information on their product labels to support the safe use of these products. This includes:

• clearly indicating that technical-grade ethanol is included as an ingredient;
• specific directions for use and warnings that these products are intended for adult use only, that they should not be used on broken or damaged skin, that they should not be used by women who are pregnant or breastfeeding, and that they should not be inhaled; and,
• information on how to report any adverse reactions to Health Canada.

More information is available on Health Canada's website.

From CBC News:

B.C.'s provincial health officer says that mass testing continues to be an ineffective strategy to slow transmission of COVID-19 because it has a false negative rate as high as 30 per cent in people who are infected but don't show symptoms.

At her daily briefing on Monday, Dr. Bonnie Henry said testing is not as sensitive as health officials expected it to be earlier in the crisis.

"The testing, unfortunately, doesn't tell us the whole story. People can be negative one minute and positive within an hour ... The false negative rate can be as high as 30 per cent early on in infection."

For the full story, visit CBC's website.

The B.C. Government has again extended its state of emergency, which it has done since March 18. Declarations of provincial states of emergency may be issued under the Emergency Program Act, and grants government extraordinary powers during the pandemic. The provincial government can extend the province's state of emergency 14 days at a time, and the latest extension brings the state of emergency through April 28.

Over the past weeks, the government has used its emergency powers to introduce legal requirements for self-isolation, creating a supply hub to speed up delivery of medical supplies and protective equipment, and more.

As British Columbia heads into the April long weekend...

Normally, this would be a time when many of us would be visiting friends and family, perhaps taking a little personal time for ourselves to celebrate the first months of the year. This year, we know many of you will instead be on the front-lines, delivering critical health-care services in your community.

We want to thank each and every one of you for your continuing dedication to your patients and to your profession. The BC Pharmacy Association will continue to stand with you during this pandemic.

Information may change over time. If you have questions about something you've read here or elsewhere, please contact us directly at info@bcpharmacy.ca.

The BC Pharmacy Association wants to hear from pharmacy teams who would like to be part of a video campaign to show the public what is happening inside pharmacies during the COVID-19 pandemic.

Right now, across British Columbia, thousands of community pharmacists and their teams are out there, risking themselves for the greater good in the fight against the COVID-19 pandemic. We know the services you provide are crucial to the lifeblood of British Columbians. 

We know you are doing all of this despite facing a lack of personal protective equipment supplies, despite being stretched to the limit to deliver medicines, and despite managing increasingly frustrated patients. 

We want to show all of British Columbia your ongoing selflessness. 

Are you part of a pharmacy team that has drastically changed your day to day in order to keep serving British Columbians? Does your heart swell with pride watching your teams demonstrate extraordinary care, doing far more than what is required of them? We want to hear from you.

If you would like your pharmacy to be considered for the campaign, please email communications@bcpharmacy.ca.

Selected participants will be contacted by the BCPhA. You will be then asked to:

• Coordinate a date, location and time for filming
• Identify participants among your team who will be appearing on camera
• Identifying patients who may wish to speak positively of your pharmacy team on camera
• Discuss with the BCPhA on the most positive aspects of your team’s contribution during the COVID-19 pandemic to capture on video

We understand staffing levels continue to be a concern. We have received a number of questions from employers regarding the hiring students, particularly those who had jobs lined up prior to the COVID-19 state of emergency. 

The BCPhA has prepared a small FAQ to answer some of these questions:

What is a pharmacy student's scope of practice?
A Student Pharmacist Registrant can actually practice to the same scope as a full pharmacist, but only under the supervision of a full pharmacist approved by the registration committee for that purpose. Students should only practice within the limit of their knowledge and skills irrespective of this scope. For a student to administer injections, the full pharmacist providing direct supervision also needs to be certified to administer injections. 

What will happen to fourth year students this year since they cannot take the Pharmacy Examining Board of Canada (PEBC) exam in May?
They will be eligible to register as a Temporary Limited Pharmacist or Limited Pharmacist. We anticipate these students to register as a Temporary Limited Pharmacists since there are no College registration fees other than the criminal record check fee of $28. Temporary Limited Pharmacists can practice to the same scope as a full pharmacists, but only under the supervision of a full pharmacist approved by the registration committee for that purpose.

Do Student Registrants and Temporary Limited Pharmacists require insurance if they are practicing under direct supervision of a full pharmacist?
Yes, they need their own insurance coverage. The exception is when you are on a practicum as a student, you are covered by UBC’s General Liability insurance.

How do I hire a Student Registrant or Temporary Limited Pharmacist?
Corporate members can access the BCPhA's Hire-A-Pharmacist section or post on our Job Board.

If you have any questions, please contact Vince Lee, Director, Member Services, at vince.lee@bcpharmacy.ca 

An opinion column was published by the BC Centre for Disease Control and the Offices of the Provincial Health Officer and Deputy Provincial Health Officer on sustained community transmission of COVID-19 in B.C., and how B.C.'s response may look like in the months ahead.

Below is an excerpt from the British Columbia Medical Journal:

"If sustained local transmission occurs, the focus of the intervention will shift. Testing for COVID-19 will decrease even as community cases increase, as we shift from containment to mitigation. People with mild symptoms consistent with COVID-19 (or with other respiratory illnesses), in whom knowledge of the infectious agent would not change management, will be asked to self-isolate without testing. Testing capacity will focus on severe cases and on sentinel surveillance, which will allow us to estimate the total disease burden and monitor trends in disease activity in our communities."

BC Medical Journal

Thank you for your continued work during this pandemic.

The BC Pharmacy Association knows how much work every member is putting in to make sure patients are supported during the COVID-19 pandemic. We continue to advocate for members’ needs during this time, and we hear from many of you about the strains facing the pharmacy right now – the lack of access to medications, communications with patients and prescribers and lack of personal protective equipment because of a worldwide shortage.

Since March 13, we have been publishing the COVID-19 daily update because news changes quickly.

Information may change over time. If you have questions about something you've read here or elsewhere, please contact us directly at info@bcpharmacy.ca.

The COVID-19 pandemic has put considerable stress on all parts of the health-care system, including pharmacy.

Many patients on regular medications typically get a three-month supply when they go to the pharmacy. Over the last few weeks, many patients have been receiving only 30 days of their medicine. Some patients have raised questions about this temporary measure.

The decision by most pharmacists in B.C. and across Canada to do this is driven by the need to ensure that there is a reliable supply of medications over the next few months for as many patients as possible.

The demand for medications in communities and in hospitals in the last few weeks has risen dramatically. This rapid increase has made it difficult for pharmacies to get the amount of medications they need. 

Adding to the uncertainty, it remains unclear whether there will be more than the usual amount of drug shortages in the days and weeks ahead due to supply disruptions overseas.

Dispensing 30 days’ supply of medication is an action pharmacists are taking to ensure as many people as possible can access the medications they need now and in the next few, likely unpredictable, months.

On April 3, British Columbia’s Provincial Health Officer Dr. Bonnie Henry said she and Minister of Health Adrian Dix were aware that some people are concerned about dispensing fees and government is looking at ways to address the issue for those who need support.

B.C.’s community pharmacists continue to work hard to respond appropriately to the extraordinary challenges the COVID-19 pandemic has presented.

Keith Shaw, PharmD, MBA
President, BC Pharmacy Association

The BC Centre for Disease Control and the University of British Columbia have put together a virtual symposium with Dr. Bonnie Henry and a wealth of other health workers contributing during the COVID-19 pandemic.

More information is available on the UBC website.

Topics will include:

• diagnostics, genomics and transmission dynamics
• clinical trials and patient management
• epidemiology and public health response
• social dynamics, communications and trust
• development of therapeutics and vaccines

The symposium is on Thursday, April 9, at 1:30 p.m. to 4:00 p.m.

Join the symposium at: https://ubc.zoom.us/j/3372370119

The Canadian government is calling on volunteers to help in the following areas:

1. Case tracking and contact tracing
2. Health system surge capacity
3. Case data collection and reporting

Most of the work can and will be performed remotely from home and hours of work will be flexible based on volunteers' needs and availabilities.

Volunteer applications are being accepted until April 24, 11:59 p.m. Pacific Time.

Who can apply: Persons residing in Canada.

Apply Online

Thank you for your continued work during this pandemic.

The BC Pharmacy Association knows how much work every member is putting in to make sure patients are supported during the COVID-19 pandemic. We continue to advocate for members’ needs during this time, and we hear from many of you about the strains facing the pharmacy right now – the lack of access to medications, communications with patients and prescribers and lack of personal protective equipment because of a worldwide shortage.

Since March 13, we have been publishing the COVID-19 daily update because news changes quickly.

Information may change over time. If you have questions about something you've read here or elsewhere, please contact us directly at info@bcpharmacy.ca.

The College of Pharmacists have made additional amendments to Professional Practice Policy 71 to temporarily permit non-pharmacists to deliver opioid agonist treatment during the COVID-19 pandemic.

Regulated health professionals who are not pharmacists may now deliver opioid agonist treatment (OAT), as long as they are:

• authorized by a pharmacist to do so
• possessing the scope and competence to assess the patient, and where required, witness the ingestion of OAT

In exceptional circumstances where neither a pharmacist nor a regulated health professional is available to deliver OAT, a pharmacist may authorize a pharmacy employee to deliver OAT to a patient, as long as they have:

• the knowledge and competence to recognize situations where it is unsafe to provide OAT to a patient
• the appropriate knowledge and competence to provide witnessed ingestion (where applicable)
• the knowledge and competence necessary to identify the patient

Regulated health professionals and pharmacy staff should refer to:

• Professional Practice Policy 54 for guidance on confirming patient identity.
• Professional Practice Policy 66 for assessment requirements (can be done over the phone or by virtual means) and on documentation requirements

Additionally, OAT delivery on behalf of a pharmacist must meet Health Canada's requirements:

• Deliver the controlled substance to the individual identified in the prescription or to a person responsible for that individuals care (Despite this, the College has determined that OAT cannot be delivered to any other person but the patient)
• Obtain in writing a note from the pharmacist identifying the name of the individual providing the delivery, the name and quantity of the controlled substance to be delivered, and the place of delivery; and,
• Have the above note as well as a copy of this exemption while providing the delivery.

The BC Pharmacy Association has put together a resource to help pharmacists understand the changes announced by the College of Pharmacists on March 26, 2020 to permit pharmacists to act in the best interests of patients who require controlled drugs and substances, including Opioid Agonist Treatment medications.

This resource was updated on April 7, 2020.

Note: Professional Practice Policy 58 (Adapting Prescriptions) does not include adapting (e.g. renewing) a prescription for narcotic, controlled drugs or targeted substances. If a change to a prescription for one of these categories of drugs is warranted, the pharmacist must contact the original prescriber to discuss modifying the original prescription.

Download Resource

The College of Pharmacists of BC has decided to cancel the June 2020 sitting of the Jurisprudence Exam (JE). The JE is held three times a year, in February, June and October, and its completion would be regularly required for registration as a pharmacist or pharmacy technician in B.C.

The College is exploring alternative dates and if an alternative date is identified, it will be posted on its Jurisprudence Exam page.

Wholehealth Pharmacy is hosting a webinar Q&A with a pair of Italian pharmacists. The Mediterranean country is among the worst hit by the COVID-19 pandemic and had been in a national lockdown since March 9, with many non-essential services closed while pharmacies kept operating to serve the public.

Speakers:

• Antonio Lombardi, pharmacist and owner, from Castellammare di Stabia
• Davide Foroni, pharmacist, from Naples
• James Morrison, director of pharmacy excellence, Wholehealth Pharmacy Partners

When: Wednesday, April 8, 12 p.m. Pacific Time
Where: Online. Register here.
Cost: Free

Register Now

CPhA’s Barry Power and Shelita Dattani joined representatives from the Canadian Association of Emergency Physicians, the Canadian Federation of Nurses Unions and the Canadian Medical Association to update the Standing Committee on Health (HESA) on the Canadian response to COVID-19. 

You can read the CPhA's remarks here.

As part of the CPhA's remarks, there were a few notable COVID-19 caused drug shortages. An excerpt take from the remarks is reproduced below:

Currently, Health Canada has identified 3 such COVID related severe shortages:

1. First is Hydroxychloroquine, of the subject of much press, having been touted by some prominent figures as a cure to COVID. While there is currently no evidence that this is the case, the demand in hydroxychloroquine is now making it difficult for patients who rely on this drug for conditions like rheumatoid arthritis or lupus.
2. Second is inhalers used for asthma and COPD. The demand for inhalers in the last few months has increased significantly for both hospitals as they prepare for COVID and in the community setting as people stockpile medications.
3. Third are medications being used in hospitals – particularly the sedative medications used in ICU settings for ventilated patients – drugs such as fentanyl and propofol

The BC Pharmacy Association would like to continue receiving photos of empty pharmacy shelves, particularly for critical medications, to educate the public and government about the ongoing impacts of COVID-19 on pharmacy shelves.

Please submit photographs of pharmacy shelves that are under or out of stock, that would have traditionally carried medications such as those identified by the CPhA as facing severe shortages due to COVID-19. To submit your photo, please email communications@bcpharmacy.ca.

Thank you for your continued work during this pandemic.

The BC Pharmacy Association knows how much work every member is putting in to make sure patients are supported during the COVID-19 pandemic. We continue to advocate for members’ needs during this time, and we hear from many of you about the strains facing the pharmacy right now – the lack of access to medications, communications with patients and prescribers and lack of personal protective equipment because of a worldwide shortage.

Since March 13, we have been publishing the COVID-19 daily update because news changes quickly.

Information may change over time. If you have questions about something you've read here or elsewhere, please contact us directly at info@bcpharmacy.ca.

The BC Pharmacy Association is supporting upcoming graduates, retirees, non-practicing pharmacists, and pharmacists and pharmacy students from another province who are choosing to step up during the COVID-19 pandemic by registering as a Temporary Registrant with the College of Pharmacists of BC.

To support the Temporary Registrants, the BCPhA is offering special liability insurance for just $200 per year plus GST, which works out to $17.50/month. This special rate includes the ability to receive a pro-rated refund so you only end up paying for the time you need the insurance, whether that's a month, three months, or even longer.

For pharmacy students who wish to work in a pharmacy outside of UBC practicums, you also require malpractice insurance as your UBC General Liability insurance only covers you for, “University-sponsored activities such as practica and approved University sports activities, are covered, subject to certain policy exclusions.”

To register for insurance, click the link below.

If you have any questions, please contact Vince Lee, Director, Member Services at vince.lee@bcpharmacy.ca.

Temporary Registrant Insurance

The BC Centre on Substance Use (BCCSU), in partnership with BCPhA, are calling out to compile a list of community pharmacies in all health authority regions of the province to determine services that could support patients on opioid agonist therapy. The list of community pharmacies will be continually updated and information will be posted online on the BCCSU page.

This survey will take only 5 minutes to complete.

Some of the responses (clearly identified in the question description sections) will not be made publicly available for privacy reasons. If you have any question or would like to have your information updated, please email us at lisa.parvin@bccsu.ubc.ca.​

To access the survey, please select the link below:

Take the Survey

We are aware there is a shortage of some over-the-counter medications and that pharmacies may have encountered difficulties in sourcing some prescription medications.

We would like to collect your photos of your medication shelves to share with government and the public through information campaigns.

This sort of poll, while informal, would offer an opportunity to give the public and government a pair of eyes in every pharmacy that shares a photo to promote a better understanding of why medication supply management is crucial to keeping British Columbians healthy and safe during this pandemic.

Please submit photos by emailing them directly to communications@bcpharmacy.ca.

The Canadian Society of Hospital Pharmacists' B.C. Branch has created a series of short videos with information on medications during the COVID-19 pandemic.

The following videos have been made available to date:

Role of Statins NEW!
by Dr. Ricky Turgeon, BSc(Pharm), ACPR, PharmD

COVID19 Virus Stability and Transmission
by Dr. Kelly Grindrod, BSc(Pharm), PharmD, MSc

Should We Avoid Corticosteroids?
by Dr. Megan Harbin, BSc(Pharm), PharmD, ACPR

Should Patients Discontinue Their ACEi/ARBs?
by Dr. Arden Barry, BSc, BSc(Pharm), PharmD, ACPR

Role of Hydroxychloroquine
by Dr. Gregory Mah, BSc(Pharm), PharmD

Does Ibuprofen Worsen COVID-19 Infection?
by Dr. Doson Chua, BSc(Pharm), PharmD, FCSHP, BCPS, BCCP
 

Upcoming topics to look forward to include:

• Vaccine development 

Thank you for continuing to support your patients during the COVID-19 pandemic.

As we enter a new month of the fight against the COVID-19 pandemic, the BC Pharmacy Association remains committed to advocating for the needs of pharmacists. We will continue to keeping our members up-to-date with the latest changes impacting British Columbian pharmacies.

Information may change over time. If you have questions about something you've read here or elsewhere, please contact us directly at info@bcpharmacy.ca.

We want to see what is inside pharmacies during this time of increased demand on pharmacy services and medication supplies.

Over the past few weeks, the BC Pharmacy Association has been receiving individual reports pharmacies across the province may be having trouble keeping their shelves stocked.

In an effort to collect more information, the BCPhA is calling on all community pharmacies to send in photographs of your over-the-counter and dispensary shelves.

Submit Your Photos

We are aware there is a shortage of some over-the-counter medications and that pharmacies may have encountered difficulties in sourcing some prescription medications.

We would like to collect your photos of your medication shelves to share with government and the public through information campaigns.

This sort of poll, while informal, would offer an opportunity to give the public and government a pair of eyes in every pharmacy that shares a photo to promote a better understanding of why medication supply management is crucial to keeping British Columbians healthy and safe during this pandemic.

Please submit photos by emailing them directly to communications@bcpharmacy.ca.

In its March 29 Personal Protective Equipment Bulletin, the provincial government shared that it is developing a "complementary PPE Framework" for the protection of community health-workers, including pharmacists.

"The Ministry of Health and PHSA Supply Chain, BC’s central, provincial purchasing and procurement organization, are working to ensure that medical supplies and PPE are being managed and shared across the health care system, and prioritizing distribution to ensure availability in the most critical situations.

The focus is currently on conserving existing PPE while actively procuring additional supply through any and all avenues. Work is underway to develop a complementary PPE Framework for the protection of health care workers in home and community settings, including community physicians, midwives, pharmacists, long term care facility workers and nurse practitioners."

The BCPhA will continue to advocate for the provincial government to allocate supplies of PPE to community pharmacists, and will continue to update the ongoing situation.

The current PPE Risk Assessment Level for B.C. is Stage 4, out of a possible six stages of severity, with six representing the highest level of severity for PPE shortages. More information can be found in the Ministry of Health's COVID-19: Emergency Prioritization in a Pandemic Personal Protective Equipment (PPE) Allocation Framework document.

Stage 4 (Current) - All PPE levels remain intact but at least one item will be depleted within a matter of days.

• Expired n95 masks can be used
• N95 masks can be reused where there are airborne precautions
• Health-care workers to keep PPE on between patient encounters
• Same set of mask/eye protection should be used for entire shift, unless it becomes wet damaged, or soiled

Stage 5 - One PPE item has been depleted

• Health-care workers to start disinfecting and reusing single-use PPE using UV light, steam or chemical cleaning
• Keep PPE on between patient encounters; clean it if it's been taken off before donning again
• Use of PPE approved under standards from other countries

Stage 6 - Multiple PPE items have been depleted

• Implement homemade PPE
• Use of PPE that has not been evaluated or approved

During Stage 4 to Stage 6, the provincial government is prioritizing access to PPE, with the following priority categories, with "1" representing the highest priority.

1. Critical Care Staff
2. Staff working on COVID-19 cohorted units or wards
3. Emergency and primary care workers
4. Long-term care settings

More information can be found in the Ministry of Health's COVID-19: Emergency Prioritization in a Pandemic Personal Protective Equipment (PPE) Allocation Framework document.

In 2017, the College of Pharmacists of BC brought into effect a number of changes to enhance security of pharmacies, including a requirement that community pharmacies install "physical barriers" such as locked gates, grillwork, locked cabinets, doors and shelving units, to prevent access to pharmacies by non-registrants when a full pharmacist is not present. (See Section 11.1 (2)(b) and (2.1) of the Pharmacy Operations and Drug Scheduling Act Bylaws)

Initially, all pharmacies were required to meet these changes by April 21, 2020. Due to the COVID-19 pandemic, the College is extending the deadline to install physical barriers to Dec. 31, 2020.

More information is available on the College's website.

The BC Pharmacy Association has partnered with the BC Centre for Substance Use on a webinar with information specific to pharmacists who are serving substance users during the COVID-19 pandemic.

Speakers:

• Dr. Mona Kwong, Pharmacy Advisor and Director, Addiction Pharmacy Fellowship, BCCSU
• Ann Johnston, Manager, Pharmacy Practice Support, BCPhA
• Guy Felicella, Speaker, Guy Felicella Consulting

When: Thursday, April 9 (5 - 6 p.m. Pacific Time)
Where: Online - register by clicking here
Cost: Free

Register Now

Thank you for continuing to support your patients during the COVID-19 pandemic.

As we enter a new month of the fight against the COVID-19 pandemic, the BC Pharmacy Association remains committed to advocating for the needs of pharmacists. We will continue to keeping our members up-to-date with the latest changes impacting British Columbian pharmacies.

Information may change over time. If you have questions about something you've read here or elsewhere, please contact us directly at info@bcpharmacy.ca.

Highlights from the April 1, 2020 PharmaCare Newsletter

Urgent coverage needs for First National Health Authority clients

The First Nations Health Authority (FNHA) will reimburse pharmacists a $10 service fee for FNHA clients experiencing coverage issues, using the Transitional Coverage Request (TCR) manual claim process form. The TCR form is updated with a checkbox to indicate whether the coverage issue is related to COVID-19.

PIN 3642005 - TCR Payment - this PIN will show on payment statements from Pacific Blue Cross where a patient is on Plan W but can’t get immediate coverage for a medication, including medical supplies and equipment, so pharmacy can provide item and get coverage by FNHA/PBC. The $10 payment for this PIN is in addition to the drug cost and dispensing fee.

PIN 3642006 - MSP Enrolment - this PIN will show on payment statements from Pacific Blue Cross where a patient does not have Plan W as their primary drug plan. The pharmacist can submit a TCR with the client’s PHN, status number, date of birth and address, indicating that the client requires Plan W enrolment, and be reimbursed $10 from FNHA.

Direct-acting oral anticoagulants now covered for new patients

PharmaCare is covering direct-acting oral anticoagulants (DOACs) for all patients newly starting anticoagulation during the COVID-19 pandemic. Previously, DOACs were a Limited Coverage Benefit under PharmaCare. New patients starting anticoagulation will be covered indefinitely.

PharmaCare notes DOACs are as effective as warfarin for anticoagulation treatment for the following conditions:

• prevention of ischemic strokes in patients with atrial fibrillation
• prophylaxis of venous thromboembolism
• treatment of deep vein thrombosis
• treatment of pulmonary embolism

As a result, PharmaCare is making this coverage available in case regular lab testing (which is required for warfarin, and not required for DOACs) is not safe or accessible for patients who would otherwise be prescribed warfarin during the COVID-19 pandemic.

The BC Pharmacy Association recognizes that there is a need for an informational resource for pharmacy teams to, at a glance, access information about coverage from private insurers during the COVID-19 pandemic.

Three documents have been made available.

• Early Refill Policies from Private Payers
• Policies on 30-day Supplies from Private Payers
• Emergency Supplies from Private Payers

BC Pharmacy Association Past President Chris Waller was interviewed by CTV News Vancouver on April 1, 2020, which reported on how the BCPhA has requested Dr. Bonnie Henry and Minister of Health Adrian Dix to consider pharmacists in the allocation of personal protective equipment supplies for health-care workers.

The BCPhA's position is that pharmacists are also essential front-line health-care workers and would benefit from receiving PPE supplies in order to protect their staff's health and safety while serving the public during the COVID-19 pandemic.

You can read the story, or watch the broadcast, using the link below.

CTV Vancouver - April 1, 2020

With the burden on pharmacists raising amid the ongoing COVID-19 outbreak, pharmacies may be looking for additional help. We have over 1,000 pharmacists across Canada ready to join your team. Not only that, ShiftPosts will be waiving all posting fees for the month of April for BC Pharmacy Association members.

Thank you pharmacists across B.C. for the work you do every day and every hour for your patients and communities across the province, especially during the COVID-19 crisis. 

PHARMACY OWNERS, MANAGERS AND RECRUITERS
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Hiring a relief pharmacist has never been easier:

1. Post a shift — Pharmacies can post shifts in minutes
2. Find a match — Our algorithms find matches in seconds
3. Get a Pro — View profiles and select the applicant you want

Pricing:

• Complimentary for the month of April, in support of the current COVID-19 crisis.

PHARMACISTS
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ShiftPosts offers:

• No fees for pharmacists and low fees for the pharmacy means pharmacists get to keep more of the pay
• Set your wage and preferences to get the exact shifts you want
• Credential Validation — All candidates are pre-screened through interview, reference and credential checks.
• Two-Way Ratings — Accountability improves quality. Rate each other after shifts.
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Hire-a-Pharmacist is a service offered by the BC Pharmacy Association.

Whether you are looking for full-time, part-time or relief shift, post your resume today on the BCPhA Hire-A-Pharmacist page and make yourself visible to more than 900 Corporate members who are pharmacy owners.

How to submit postings?

After filling out the available forms in the links below, a BCPhA staff member will review the posting.

After approval, the posting will be available on the hire-a-pharmacist or hire-a-technician page. After a period of time, a notification will be sent to the member to either renew or remove the posting.

Job postings are free and unlimited for Corporate members. General members pay a fee of $1,000 plus GST for a 30-day posting. Resume postings are free.

• Post a Resume
• Browse Resumes
• Post a Job

We appreciate that this is a confusing and stressful time.

We know it appears information is changing constantly. The BC Pharmacy Association's daily weekday update will continue to seek out the latest and most accurate information for pharmacists, health-care workers, patients and the public.

Information may change over time. If you have questions about something you've read here or elsewhere, please contact us directly at info@bcpharmacy.ca.

We will continue to do our best to provide the latest and most accurate information.

The BC Pharmacy Association is aware that there is inconsistent coverage provided by private insurers who do not yet support 30-day limits on dispensing being adopted by pharmacies across Canada, and those that do support 30-day limits in their coverage.

Over the recent days, the Association has collected information from a number of private insurers to present information on each insurer's policy on providing coverage for 30-day supplies, rather than the patients' maximum fill limit. The document, which will be updated as needed, contains information from the following insurers:

• Pacific Blue Cross
• TELUS Health
• Green Shield
• Express Scripts
• Claim Secure

30-Day Supply and Private Insurer Coverage

The following insurers have also provided verification that they will pay for emergency supply claims submitted by pharmacists during the COVID-19 pandemic. Pharmacists may provide emergency supplies in accordance with Professional Practice Policy 31.

• Pacific Blue Cross
• TELUS Health
• Green Shield
• Express Scripts

Private Insurers Coverage of Emergency Supplies

University of B.C. pharmacy students along with other health science students across the province are volunteering their time to support the healthcare community during the COVID-19 crisis.

They are looking to assess the need for a prescription delivery service to help pharmacies safely deliver medications particularly to elderly and immunocompromised patients. They understand that some pharmacies may already have delivery services available, but that the additional support is needed due to high volumes so would like to see if they can supplement this effort and also provide an option for pharmacies that may not already have this in place in order. The service will exclude OAT and cold-chain.

This goal of this service would be to fill an unmet need in the community - it would be temporary, non-profit, and would abide by College guidelines. 

If you are interested, please fill out the following form to help them determine need and feasibility:

Delivery Support Form

The College of Pharmacists of BC has approved Temporary Registration to permit pharmacy professionals to provide pharmacy services during the COVID-19 pandemic.

There are four classes under temporary registrations. Their eligibility requirements are reproduced below. Eligible applicants are asked to apply through the College's Temporary Registration Application Process.

For more information, see the College of Pharmacists of BC's website.

1) Temporary Pharmacist

• Those who are registered as equivalent of full pharmacist in another jurisdiction in Canada or the United States, and have no restrictions/limitations/conditions on practice
  OR
• Former registrant who was a full pharmacist within past three years
  OR
• Non-practising pharmacist registered as a full pharmacist within the last three years

2) Temporary Pharmacy Technician

• Those currently registered as the equivalent of a pharmacy technician in another jurisdiction in Canada, and have no limitations/restrictions/conditions on practice
  OR
• Former registrant who was registered as a pharmacy technician within the last 3 years
  OR
• Non-practising pharmacy technician who was registered as a pharmacy technician within the last 3 years.

3) Temporary Limited Pharmacist

• Pharmacy graduates who have completed their Structural Practical Training (SPT) requirements but not all the required assessments for registration
  OR
• Pharmacy graduates who have completed their Jurisprudence Exam, PEBC Evaluating (if applicable) and Qualifying Exams, but not their SPT

4) Temporary Student Pharmacist

• Pharmacy students enrolled in a recognized pharmacy education program outside B.C.

We appreciate that this is a confusing and stressful time.

We know it appears information is changing constantly. The BC Pharmacy Association's daily weekday update will continue to seek out the latest and most accurate information for pharmacists, health-care workers, patients and the public.

Information may change over time. If you have questions about something you've read here or elsewhere, please contact us directly at info@bcpharmacy.ca.

We will continue to do our best to provide the latest and most accurate information.

The BC Pharmacy Association is aware of reports that some pharmacists have been told by prescribers not to provide emergency refills, and instead require patients to call or visit their doctors.

During the COVID-19 pandemic, pharmacists have been requested by the Ministry of Health and the College of Pharmacists to provide emergency refills to provide medications to patients as needed to avoid non-essential physician and pharmacy visits and free doctors to treat COVID-19 cases.

The BCPhA will continue to support pharmacists in providing these refills/adapt prescriptions as requested by the provincial government, especially if a patient has taken the time to call ahead to your pharmacy.  

Pharmacists can provide up to 30-day emergency supplies as per PPP-31 and adapt prescriptions as per PPP-58, if in the best interest of the patient.

Patient concerns on 30-day supply

The BCPhA has received feedback from members about patients who have concerns around the 30-day supply issue. We understand many patients are used to receiving a 90-day supply of their medications for chronic conditions. However, these are not ordinary times.

We know community pharmacists are working hard to ensure that all patients get a supply of their medication as concerns around drug shortages continue.

We are doing our best to get the message out to the public about the reason for 30-day supplies and will continue with public messaging to patients. We are discussing with the Ministry of Health about what options there are so a 30-day supply doesn’t create a financial hardships for some patients.

The College of Pharmacists of BC has approved Professional Development and Assessment Program (PDAP) exemptions for the remainder of 2020. This means Continuing Education (CE) submissions will not be required for registration from March 31 to December 31, 2020.

Normally, each pharmacy professional must complete a minimum of 15 hours of CE each year, including five hours of accredited learning. PDAP exemptions are also granted to pharmacists and pharmacy technicians who wish to be reinstated after being non-practising and/or former status for less than 90 days.

More information is available on the College of Pharmacists' website.

For questions related to PDAP, contact the College’s Professional Development department at prodev@bcpharmacists.org.

The BC Centre for Substance Use has released new clinical guidance for healthcare providers to stem the spread of COVID-19 and respond to the ongoing overdose emergency. 

To reduce the risk of transmission, the guidance outlines steps that prescribers, pharmacists and care teams can take to support the provision of medications – including safe prescription alternatives to the illicit drug supply – to be delivered directly to patients, along with telemedicine for clinical assessments.

Vancouver Coastal Health (VCH) Resources:

VCH has developed resources to help prescribers and pharmacists implement the new provincial guidelines to support the needs of people who use drugs and are needing support in the management of withdrawal symptoms during COVID-19.

Pharmacists and prescribers can also consult the VCH Overdose Outreach Team (OOT) at 604-360-2874 (Mon- Sun, 8am – 8pm)

• Pharmacist Guidelines for Risk Management in the Context of Dual Public Health Emergencies (VCH Implementation Guidelines)

The Canadian Society of Hospital Pharmacists' B.C. Branch has created a series of short videos with information on medications during the COVID-19 pandemic.

The following videos have been made available to date:

COVID19 Virus Stability and Transmission NEW!
by Dr. Kelly Grindrod, BSc(Pharm), PharmD, MSc

Should We Avoid Corticosteroids? NEW!
by Dr. Megan Harbin, BSc(Pharm), PharmD, ACPR

Should Patients Discontinue Their ACEi/ARBs?
by Dr. Arden Barry, BSc, BSc(Pharm), PharmD, ACPR

Role of Hydroxychloroquine
by Dr. Gregory Mah, BSc(Pharm), PharmD

Does Ibuprofen Worsen COVID-19 Infection?
by Dr. Doson Chua, BSc(Pharm), PharmD, FCSHP, BCPS, BCCP

Upcoming topics to look forward to include:

• Vaccine development 
• Role of statins  

UBC pharmacy students along with other health science students across the province are volunteering their time to support the health-care community during the COVID-19 crisis.

They are looking to assess the need for a prescription delivery service to help pharmacies safely deliver medications particularly to elderly and immunocompromised patients.

They understand that some pharmacies may already have delivery services available, but that the additional support is needed due to high volumes so would like to see if they can supplement this effort and also provide an option for pharmacies that may not already have this in place in order. 

The service will exclude OAT and cold-chain.

This goal of this service would be to fill an unmet need in the community - it would be temporary, non-profit, and would abide by College guidelines. 

If you are interested, please fill out the following form to help them determine need and feasibility:

Delivery Support Form

Canadian Pharmacists Association releases 30-day supply explainer video

We know that the current 30-day supply recommendations may be difficult for some patients to understand. CPhA has developed an explainer video to help pharmacists tell their patients why this recommendation has been made, and why it is so important that we all work together to protect the medication supply for all Canadians. The video is available in English and in French and can be shared on your website, in emails or on social media.

Webinar: PPE Best Practices During COVID-19

The webinar will cover best practices for using personal protective equipment (PPE) to protect pharmacy staff during the COVID-19 pandemic. The discussion will focus on appropriate use, donning, doffing, disposal and various scenarios where PPE might be required.

Speakers: Shelita Dattani (CPhA), Kamran Nisar (PharmaChoice), Christina Adams (Canadian Society of Hospital Pharmacists), Karey Shuhendler (Canadian Nurses Association) and Glenn Rodriguez (Pharmacy Association of Nova Scotia)
When: Thursday, April 2 (9 a.m. to 10 a.m. Pacific Time)
Where: Register here
Cost: The webinar is free for all pharmacists.

The BC Pharmacy Association has put together a resource to help pharmacists understand the changes announced by the College of Pharmacists on March 26, 2020 to permit pharmacists to act in the best interests of patients who require controlled drugs and substances, including Opioid Agonist Treatment medications.

This resource was updated on March 30, 2020.

A summary of the changes are described below. For full details, please visit the College of Pharmacists of BC's website.

1. Transferring prescriptions to other pharmacists
2. Permitting verbal orders for a new prescription or refill an existing prescription
3. Faxing of controlled prescription program forms
4. Delivery by pharmacy employees. (This does not include OAT)

To access the BCPhA resource, click on the link below.

The BC Centre for Disease control has released a guidance document for pharmacists, providing support for many of the COVID-19 safety measures pharmacists across British Columbia have already adopted in their pharmacies.

The document, released on March 28, goes over the following:

• responsibilities of community pharmacists to provide pharmaceutical care, produce and distribute medications, contribute to the effective operation of the pharmacy and to understand where to access the latest national and provincial information on COVID-19
• General advice
• Personal protective equipment
• Pharmacy procedures for owners and operators
• Staff education and patient education

Download the BCCDC Guidance Document at the link below:

COVID-19 Guidance for Community and Hospital Pharmacies

College of Pharmacists of BC registrar Bob Nakagawa was recently interviewed by media on the Joint Statement warning against the use of unproven medications. The conversation covered the following areas:

• drug supplies during COVID-19
• dispensing fee concerns from patients having to do more frequent visits to the pharmacy
• agents picking up medications for multiple patients
• untested medications for COVID-19

Have a listen at the link below:

Bob Nakagawa interview

The BC Pharmacy Association is continually updating our resource for financial assistance during COVID-19. This relief, made available through various levels of government, includes information on Employment Insurance, Canada Emergency Response Benefit, the BC Emergency Benefit, subsidies for business owners and more.

To access the financial help resource, click here.

We appreciate that this is a confusing and stressful time.

We know it appears information is changing constantly. The BC Pharmacy Association's daily weekday update will continue to seek out the latest and most accurate information for pharmacists, health-care workers, patients and the public.

Information may change over time. If you have questions about something you've read here or elsewhere, please contact us directly at info@bcpharmacy.ca.

We will continue to do our best to provide the latest and most accurate information.

Pharmacists are considered essential workers during the COVID-19 pandemic in British Columbia. The Emergency Management BC office and the Provincial Health Officer has determined that pharmacists are a direct-to-public health service, and that pharmacies themselves are considered essential health service providers.

The B.C. government has declared that as pharmacies are an essential service, they should and are encouraged to remain open, while following the orders and guidance provided by B.C. Public Health Officer Dr. Bonnie Henry to protect the safety and health of their staff and patients.

The following additional information may impact pharmacists and their teams during the COVID-19 pandemic:

• Health workers during the COVID-19 pandemic receive priority testing
• Licensees of long-term care facilities, along with workers and contractors, will be reporting their staff and contractors' names, contact informations, Social Insurance Numbers and additional information using instructions as directed by the Provincial Health Officer, by midnight, March 28, 2020
• Employees, contracted workers and volunteers are ordered to only work in one long-term care facility, unless given an exemption by the Medical Health Officer. This order was put into effect on March 26, 2020

The College of Pharmacists of BC is seeking feedback for proposed amendments to bylaws under the Health Profession Act to allow temporary registration for retired and non-practising pharmacy professionals, and temporary limited and student pharmacists.

The proposal was put together in response following a call from B.C. Public Health Officer Dr. Bonnie Henry requesting all health regulators to begin emergency registration of non-practising or retired health-care professionals.

The bylaw amendments permit temporary registration for pharmacy professionals if the registrar or College board declares there to be immediate need for pharmacy services due to threat of serious harm to public safety, health, or welfare, or at the request of provincial and federal authorities.

Temporarily registered pharmacists, under the amendments, will have valid registration for up to six months and has allowances for the College registrar to extend the end date of temporary registrations.

To submit comments to the College for feedback, follow the instructions below:

Comments on proposed changes to regulatory college bylaws may be submitted by email, feedback form or regular mail. These submissions should be addressed to the attention of the Director of Policy & Legislation.

Download: Feedback Form
Email: legislation@bcpharmacists.org
Fax: 604-733-2493 or 800-377-8129

Mailing Address:
Bob Nakagawa, Registrar
200 - 1765 West 8th Avenue Vancouver, BC V6J 5C6

The College of Pharmacists has posted this response in their Frequently Asked Questions, on the topic of whether pharmacy teams can forgo patient signatures for their OAT accountability log, in order to maintain social distancing.

Below is an excerpt from the College:

Please take all precautions you can, including disinfection, restricting contact, etc. If you are making procedural changes in the best interest of your patients and your staff's health, please ensure you document your temporary policy and that it is understood by all staff.

There are many changes that the College are reviewing, in coordination with the Ministry of Health and Health Canada. Please continue to monitor our website and email communications for updates regarding this issue.

The BC Pharmacy Association has been notified by several members that they have been contacted by suspected scammers. During the COVID-19 pandemic, the BCPhA understands pharmacies are seeking alternative suppliers to keep store shelves stocked. It is important to remember to exercise due diligence when interacting with any alternative supplier.

In the latest example, the BCPhA learned that a member was offered the sale of a substantial amount of personal protective equipment by a supposed manufacturer. Upon closer inspection, it appears the seller was attempting to misrepresent themselves as a legitimate supplier.

Health Canada is also warning against false or misleading health products being sold for COVID-19. The Government of Canada has published a list of hand sanitizers and disinfectants that meet Health Canada’s requirements, and provides guidance on the use of masks and respirators during the COVID-19 outbreak.

The BC Pharmacy Association recommends the following tips to protect yourself from being a victim of scam:

• Check the vendors' business registrations
• Look up regulator certificate numbers to ensure the information matches
• Consider phoning vendors back through credible contact listings to confirm that a caller is legitimate
• There is a worldwide shortage of PPE. If the offer seems too good to be true, that is a sign to be extra vigilant

If you believe you have been the victim of a scam targeting pharmacies, or an attempted scam, please consider sharing the information to protect your colleagues through info@bcpharmacy.ca.

As an increasing number of practitioners and pharmacies rely on verbal or faxed prescriptions during the COVID-19 pandemic, it is increasingly important for pharmacy teams to be vigilant for illegitimate prescriptions.

Pharmacy teams should ensure:

• the prescription was faxed from the physician's office and not by a patient
• all requires aspects of a prescription (date, signature) are included
• that the patient's identification is confirmed
• that the prescription has not already been filled elsewhere through the patient's PharmaNet profile

More information is available on the College's website to help pharmacies guard against prescription fraud.

The BC Centre on Substance Use (BCCSU), in partnership with BCPhA, are calling out to compile a list of community pharmacies in all health authority regions of the province to determine services that could support patients on opioid agonist therapy. The list of community pharmacies will be continually updated and information will be posted online on the BCCSU page.

This survey will take only 5 minutes to complete.

Few of the responses (clearly identified in the question description sections) will not be publicly available. If you have any question or would like to have your information updated, please email us at lisa.parvin@bccsu.ubc.ca. ​

To access the survey, please select the link below:

Survey to Identify Pharmacies Offering OAT Delivery

The Canadian Pharmacists' Association has released a new resource, Personal Protective Equipment (PPE): Suggested Best Practices for Pharmacies During the COVID-19 Pandemic.

With contributions from pharmacists and other health care professionals, these best practices are based on current available evidence and will be updated as required.

We appreciate that this is a confusing and stressful time.

We know it appears information is changing constantly. The BC Pharmacy Association's daily weekday update will continue to seek out the latest and most accurate information for pharmacists, health-care workers, patients and the public.

Information may change over time. If you have questions about something you've read here or elsewhere, please contact us directly at info@bcpharmacy.ca.

We will continue to do our best to provide the latest and most accurate information.

The BC Pharmacy Association has discussed with the B.C. Ministry of Health to confirm that pharmacy professionals are designated as health-care workers and are eligible for priority testing. The Ministry asks pharmacy team members to refer to the provincial government's list of essential services to confirm their status as essential health-care workers.

New information has been issued by the Public Health Services Authority (PHSA) so all health-care workers who meet the symptomatic requirements are able to be tested for COVID-19. The PHSA has also made available their list of COVID-19 Community Collection Centres along with contact information for health-care workers to use, which can be accessed through the PHSA website.

The BCPhA has posted the testing criteria below.

1) Testing will NOT be done for asymptomatic individuals.

2) Testing criteria includes:

• Fever and cough or shortness of breath (new/worsening – not pre-existing),
• OR two of the following symptoms: fever, cough, shortness of breath, diarrhea, fatigue/malaise, rhinorrhea.

3) If testing is required, see contact information for the list of testing centres in your health authority (COVID-19 Community Collection Centre – updated frequently).

4) Immediately after testing, return home and self-isolate. You will receive a phone call with your results.

5) Further instructions will be provided by the public health officer.

Some testing centres may yet to have been notified that pharmacy staff are eligible to be tested for COVID-19. Please submit reports to info@bcpharmacy.ca if you meet the criteria, but have been turned away from testing.

The below are excerpts from the March 26, 2020 PharmaCare Newsletter.

Pharmacists may have received conflicting information regarding the days supply permitted for any dispense. Different policies have been implemented across Canada, and across different public and private payers to manage perceived or real supply issues. Pharmacies may also have encountered local, demand-driven shortages that require them to dispense smaller amounts than they would normally.

PharmaCare policy is that fills should be up to the maximum days’ supply wherever possible. If this policy conflicts with what is feasible given the pharmacy’s on-hand supply, the pharmacy may fill an amount less than the maximum days’ supply indicated in PharmaNet or on the written prescription. 

As noted in the PharmaCare audit section below, at this time, PharmaCare audit will not scrutinize dispenses that are less than the written prescription, and if smaller dispenses are required for supply management, additional dispensing fees may be claimed for subsequent dispenses to complete the fill.

PharmaCare: Special Authority Adjustments during COVID-19

Effective March 26, 2020, PharmaCare has implemented the following changes to ensure efficient access to medications and promote patient safety during the COVID-19 pandemic:

• More staff are available on the Special Authority (SA) phone lines, to help resolve issues with faxing requests because the prescriber is not in the office.
• Temporary manual extensions are available over the phone for select drugs where infusion dates are already planned, and the prescriber is not available for completion of renewal request.
• Automatic uploads in PharmaNet to extend SAs for many limited coverage drugs that are expiring between now and July 1, 2020. 

More information on the March 26, 2020 PharmaCare Newsletter.

BC Pharmacy Association President was interviewed by Kamloops Radio NL host Jeff Andreas on what has been happening in pharmacies during the COVID-19 pandemic, on topics including:

• the pharmacists' role in ensuring the drug supply remains available to British Columbians
• the differences between 30-day supplies of emergency refills for self-isolation and regular refills for those on chronic medications
• how the BCPhA is calling for a 30-day supply for all prescriptions in B.C.
• patients' concerns about dispensing fees during COVID-19

Listen to the interview through the link below:

Radio NL Interview

The College of Pharmacists of BC has issued information on pharmacists who are looking to work from home, or otherwise must effect a temporary closure of their pharmacies during the COVID-19 pandemic.

For pharmacists seeking to work from home:
The College's instructions are that clinical tasks such as counselling are not restricted to the physical pharmacy site, but patient confidentiality should be considered. Pharmacists are not permitted to store scheduled medications in locations other than licensed premises.

For pharmacies that require a change in operating hours:
Pharmacies are advised to notify the public of any change in operating hours and notify the registrar of the College via the pharmacy's eServices profile.

For pharmacies facing an unanticipated temporary closure:
Full instructions from the College for temporary closures is available here. For pharmacies facing a temporary closure of up to 90 consecutive days, the pharmacy manager is required to complete all the steps under the Pharmacy Operations and Drug Scheduling Act, section 18(2)(dd), which is reproduced below.

In the event of an unanticipated temporary closure due to unforeseen circumstances, which is permitted for no more than 90 days,

1. notify the registrar of closures of 15 to 90 days in accordance with the policies approved by the board,
2. where possible, contact all patients whose prescriptions are ready for pick-up to advise of the closure and provide them with the opportunity to obtain their prepared prescriptions,
3. where possible, notify patients, the public, and local prescribers of the closure and alternate means of obtaining essential pharmacy services during the closure in accordance with the policies approved by the board,
4. apply for a new pharmacy licence if the closure will exceed 90 days, and 
5. return any prepared prescriptions in the pharmacy to inventory and reverse those prescriptions in PharmaNet; 

SFU Morris J. Wosk Centre for Dialogue presents Conversations That Matter. Join veteran broadcaster Stuart McNish each week for an important and engaging Conversation about the issues shaping our future.

Are pharmacists an underutilized health care resource in the fight against the Coronavirus? Annette Robinson and Derek Desrosiers from the BC Pharmacy Association joins a Conversation That Matter about a health care resource that may be overlooked during the COVID-19 pandemic.

Click the link below to access the video:

Conversations That Matter

Pharmacists may now provide emergency supplies of controlled drugs and substances, including Opioid Agonist Treatment medications, to patients with expired prescriptions. Some of the changes are described below. For the full list of changes, please visit the College of Pharmacists of BC's website.

1) Transferring prescriptions to other pharmacists
The College Board has amended Section 8(3)(a) of the Community Pharmacy Standards of Practice to allow for the transfer of a prescription for controlled drug substances to other pharmacies licenced in British Columbia. 

2) Permitting verbal orders for a new prescription or to extend or refill an existing prescription
The College Board has amended Section 19(6) of the Pharmacy Operations and Drug Scheduling Act (PODSA) Bylaws to permit pharmacists to dispense drugs included in the controlled prescription program upon receiving a verbal order from a practitioner, if doing so is permitted under a section 56 exemption to the Controlled Drugs and Substances Act.

It is important to note that when taking verbal prescriptions in community practice, a registrant must make a written record of the verbal authorization in accordance with Section 6(7) of the Community Pharmacy Standards of Practice, as well as applicable federal legislation.

This written record MUST include: 

• The pharmacist’s signature or initial
• The name of the practitioner providing the verbal order.
• The practitioner’s college identification number 

3) Faxing of controlled prescription program forms

The College Board has also amended Section 7(3) of the Community Pharmacy Standards of Practice to allow pharmacists to dispense prescriptions received by facsimile transmission for drug referred to on the Controlled Prescription Drug List in exceptional circumstances.

We know it appears information is changing constantly. The BC Pharmacy Association's daily weekday update will continue to seek out the latest and most accurate information for pharmacists, health-care workers, patients and the public.

Information may change over time. If you have questions about something you've read here or elsewhere, please contact us directly at info@bcpharmacy.ca.

We will continue to do our best to provide the latest and most accurate information.

On March 25, the College of Pharmacists of BC, the BC College of Nursing Professions and the College of Physicians and Surgeons of BC issued a joint statement to warn against the use of anti-malarial, antibiotic and antiviral therapies to treat COVID-19 patients.

The Colleges jointly urged health professions to resist pressure around unproven and potentially dangerous uses of existing medications. The Colleges also specifically warned against the use of hydroxychloroquine for COVID-19, as its demand for COVID-19 treatment could result in dangerous consequences for patients who need hydroxychloroquine for the treatment of conditions such as lupus and rheumatoid arthritis.

To read the full joint-statement, please visit the College of Pharmacists website.

Missed our webinar on March 24? See the recording!

At the end of the webinar, participants will be able to:

• Identify exposure risks in the pharmacy associated with COVID-19
• Implement controls in the pharmacy to reduce potential exposure to COVID-19
• Recognize ways to keep yourself protected during the COVID-19 outbreak.

About the Speaker: Saleema Dhalla

Saleema completed her Masters of Occupational and Environmental Hygiene at UBC. She has designed and executed systems at the provincial and national level to reduce workplace injuries and improve employee well-being. Saleema has held three roles at SafeCare BC, the health and safety association which supports healthcare workers in long-term care and home and community care. Her roles include the Director of Workplace Health and Safety Programs and Acting Chief Executive Officer, and most recently the Sr. Director of Development and Strategic Engagements. 

Please Note: A BCPhA account is required to register for this event. If you do not have a login account or if you are unsure if you have a login, please fill out the Account Creation Form and a member of the BCPhA team will contact you. Accounts can be created free of charge with valid College registration.

To access the course:

1. Click the "Access Course" link below
2. Click "Start eTraining" to login
3. Select the "courses" tab
4. Click on the course "Coronavirus Exposure In The Pharmacy" to begin

Access Course

The BC Pharmacy Association is aware that some patients have put forward concerns that 30-day limits on emergency refills could result in patients paying more for their medications, due to dispensing fees incurred for multiple trips.

The College of Pharmacists of BC has put out some advice in response to this question. More information is available at the College's Frequently Asked Questions for COVID-19 page.

My pharmacist is insisting on dispensing only one month of my chronic medication which is resulting in me paying more. Is this allowed?

We are recommending no more than a one-month’s supply for most people in order to help reduce the potential strain on the drug supply chain. However, we would expect pharmacists to use their professional judgment based on each patient’s situation to determine what is appropriate. In particular, for patients with compromised immune systems or who have an increased risk of more severe outcomes from COVID-19 – they may require a longer supply to enable them to safely self-isolate at home.

Under ordinary circumstances, on a yearly prescription someone could, in theory, pay out-of-pocket for amounts over what either PharmaCare or a third-party insurer would reimburse. We are asking pharmacies to not accommodate these requests at this time to help reduce the risk of drugs shortages.

It would ultimately be a business decision with regards to dispensing fees and would be at the discretion of the individual pharmacy.

The BCPhA has compiled a list of suppliers available to sell physical see-through barriers for pharmacies who are looking for their own solutions to protect the health and safety of their patients and staff.

The list is an ongoing work-in-progress and will be updated with additional vendors as they are identified. Due to the worldwide shortage of personal protective equipment such as masks, many pharmacies are searching for alternative options to meet their needs.

If your pharmacy is aware of additional vendors for physical counter-top barriers and you would like the information to be shared, please contact communications@bcpharmacy.ca.

To access our resource for suppliers and installers of plexiglass physical barriers, please click here.

B.C. Provincial Health Officer Dr. Bonnie Henry provided an update on March 25 with respect to the ongoing efforts by B.C. government to source supplies of personal protective equipment (PPE). Dr. Henry said over the past week, she has seen a "dramatic increase" in the use of PPE by health-care workers particularly as more people are admitted to hospital for COVID-19.

To watch Dr. Henry's March 25, 2020 press conference, click here.

The BC Pharmacy has provided a transcription of Dr. Bonnie Henry's public statement below:

In the past week, we have seen a dramatic increase in use as we have more people with COVID-19 in hospitals, and we understand the absolute need to keep people safe. But the burn rate as we call it is much higher than we would have expected and we are putting in place measures now to try and control that to be more efficient and effective in how we’re using PPE.

We have new shipments on order. We’re looking at things like alternative supplies across the board, alternative ways of preserving personal protective equipment so it is available, both now and in the future. And we’re at a bit of critical phase with personal protective equipment. This happened quite quickly. We have had a number of supplies on order for some time. Some have arrived, thankfully, and we are actively looking at how we can get as much as we can in the short term. But we are looking at alternative supplies and ways of managing to be more efficient with PPE and more of that will come out over the next coming days.

In response to a reporter's question on the severity of the PPE shortage, Dr. Henry provided the additional information below:

It’s a reflection of how challenging it is for health-care workers to feel very vulnerable as we are working in these situations, worrying about getting sick ourselves, worrying about passing it on to our families, our homes. But also being able to care for people effectively. And it’s is a challenge that we have nine long term care facility outbreaks where additional protections are needed in those facilities and now we have increasing numbers of people in hospital and that is going through way more personal protective equipment than we expected.

We are on a tenuous level right now. But we do have a plan for that. We’ve had a plan for a number of months about how to address that and there are things that we can do that we’ve seen being done in other places that are based on evidence: around how we can cohort patients, for example, so people don’t have to change their masks or respirators or eye protection between each patient, because you’re dealing with everybody who has the same thing.

There are things that we will be doing over the coming days and we can have more details once we’ve worked it out with the health-care worker leaders and with our hospital leaders over the next 24 to 48 hours. We are also absolutely looking at all aspects of things that we can do to increase our stockpiles of personal protective equipment, particularly there is good evidence that you can reuse certain types of equipment if it’s been cleaned appropriately and we’re looking at how we can do that. We’re also looking at alternate supplies from around the world.

Dr. Bonnie Henry, March 25, 2020
Public press conference

The Canadian Society of Hospital Pharmacists' B.C. Branch has created a series of short videos with information on medications during the COVID-19 pandemic.

The following videos have been made available to date:

Does ibuprofen worsen COVID-19 infection?
by Dr. Doson Chua, BSc(Pharm), PharmD, FCSHP, BCPS, BCCP

Role of Hydroxychloroquine
by Dr. Gregory Mah, BSc(Pharm), PharmD

Should patients discontinue their ACE Inhibitors and ARBs?
by Dr. Arden Barry, BSc, BSc(Pharm), PharmD, ACPR

We know it appears information is changing constantly. The BC Pharmacy Association's daily weekday update will continue to seek out the latest and most accurate information for pharmacists, health-care workers, patients and the public.

Information may change over time. If you have questions about something you've read here or elsewhere, please contact us directly at info@bcpharmacy.ca.

We will continue to do our best to provide the latest and most accurate information.

Dear Colleague,

At the time of writing, British Columbia, indeed all of Canada is on the brink. The brink of a pandemic about to test our preparation, our resolve, our society. The pandemic has circled the globe, from China to Europe to our home here on the West Coast of North America. Seemingly uncontrolled it spreads, affecting thousands. 

I can tell you that in the coming weeks and months, perhaps right now as you are reading this, the world needs leaders and role models; our profession needs leaders and role models. Anyone can captain a ship in calm seas. Competence and courage are revealed in times of struggle. Whether we like it or not, whether we are “ready” or not, we are about to find out who we really are.

Fear spreads quickly and there are many examples of that for us to witness on the evening news or when scrolling through our social media feeds. Pharmacists are one of the most trusted professionals and our actions are examples for others to follow. As a pharmacist, you are a leader and have influence over the behaviour of many. With this in mind, I encourage you to carefully consider how you respond to challenges that you will be faced with as this pandemic moves through our communities.

Pharmacists are leaders by example, but inside our businesses and individual pharmacies, we need leaders who are able to stand up and take on the complex tasks of managing a potential emergency. Hoarding, panic buying, high prescription volumes, and staff absences will create obstacles that will be impassable without calm consideration towards proactive problem-solving. Whether your formal job description requires you to manage these issues or not, we all have a role to play in supporting and leading through change.    

Staying positive, taking care of ourselves, being kind to each other, and having empathy for our patients has never been more important. Eventually, this too will pass. Years from now, we will discuss with each other who was where and what happened when and the fine details of the time of the COVID-19 pandemic. We will be unique in that we were the front line of pharmacy during “the pandemic”. When people ask us what we did to help during that time, what will we say? Will we be proud of our contribution? You are the profession. Your actions in the coming days and months will decide the answer to the questions above and define what it means to be a pharmacist like never before.  

Despite how uncontrollable the COVID 19 pandemic seems to be, I suggest we are able to control the most important aspect of our humanity, that thing that makes us who we are; our compassion, caring and empathy. Using our expertise to help each other, our employers and our patients is something we can all be proud of when we say we were a practicing pharmacist during the 2020 pandemic.

Your peer and colleague,

Dr. Keith Robert Shaw, B.Sc., Pharm.D. MBA.

The BC Pharmacy Association has received clarification from the B.C. Ministry of Health that pharmacists are considered health-care workers for priority COVID-19 testing.

1. Pharmacists who have COVID-19 symptoms are asked to call 811
2. Identify yourself as a pharmacist with symptoms who is seeking to be tested for COVID-19

If you are a pharmacist with symptoms who has called 811 and was NOT directed to a testing site, please contact info@bcpharmacy.ca so the report may be shared with the Ministry of Health.

Self-isolation guidelines were recently updated. If a pharmacy staff member believes they have symptoms of COVID-19, new guidelines are asking for a self-isolation period of 10 days following the initial start of symptoms.

Following 10 days, if temperature is normal and other symptoms have resolved, the affected person may return to their normal routine. More information is available in this Interim Guidance document (March 23, 2020) from the B.C. Centre for Disease Control.

The BC Pharmacy Association has also confirmed with Vancouver Coastal Health that its employees are also following these new guidelines to self isolate for 10 days, rather than 14, after initial start of symptoms.

The BC Pharmacy Association has written to the College of Physicians and Surgeons of B.C. to request that the College of Physicians direct physician prescribers against prescribing hydroxychloroquine for patients and themselves.

The BCPhA is taking the position that prescribing hydroxychloroquine is not appropriate as there is no proper evidence that the drug can be used as a prophylaxis for COVID-19.

The College of Physicians has been advised that our members are using their authority to refuse to fill prescriptions that they are concerned will represent a harm to the patient or are simply inappropriate.

The BCPhA has written the offices of Provincial Health Officer Dr. Bonnie Henry and Minister of Health Adrian Dix to urge their offices to prioritize the health and safety of pharmacists and their patients. The Association informed Dr. Henry and Minister Dix that due to the worldwide shortage of personal protective equipment (PPE), community pharmacies have been relying on their own solutions such as plexiglass walls, disposable draping on counters and physical distancing markers on floors to protect themseles and their patients.

The Association is asking that Dr. Henry and Minister Dix prioritize community pharmacy teams when allocating the distribution of PPEs.

Other concerns the Association is requesting Dr. Henry and Minister Dix to examine include requesting that a 30-day supply limit be put in place for all prescription medications in B.C., additional direction on community pharmacy procedures following an exposure to COVID-19, and access to COVID-19 testing for pharmacists.

Below is an excerpt from the College website:

The College is asking for your feedback on proposed amendments to the Pharmacy Operations and Drug Scheduling Act Bylaws that would enable the temporary exemption made by Health Canada to permit practitioners to verbally prescribe prescriptions for controlled substances.

Please provide your feedback as soon as possible as a shortened public posting period has been requested from the Minister of Health to implement these bylaw changes as soon as possible to support patients during the COVID-19 pandemic.

Background

To support continuity of care to patients during the COVID-19 Pandemic, Health Canada has issued a temporary exemption for prescriptions of controlled substances, to maintain Canadians’ access to controlled substances as needed for medical treatments.

As part of the temporary exemption, made under the Controlled Drugs and Substances Act (CDSA), Health Canada will permit practitioners to verbally prescribe prescriptions for controlled substances.

To submit comments, please follow the below instructions:

Comments on proposed changes to regulatory college bylaws may be submitted by email, feedback form or regular mail. These submissions should be addressed to the attention of the Director of Policy & Legislation.

Download: Feedback Form
Email: legislation@bcpharmacists.org
Fax: 604-733-2493 or 800-377-8129

Mailing Address:
Bob Nakagawa, Registrar
200 - 1765 West 8th Avenue Vancouver, BC V6J 5C6

The BC Pharmacy Association has updated its COVID-19 Guidance, Prevention and Control Strategies document for pharmacies. The document was last updated on March 24, 2020.

The guidance includes measures drawn sources including the College of Pharmacists of British Columbia, the Ministry of Health and the BC Centre for Disease Control.

The BCPhA COVID-19 Guidance, Prevention and Control Strategies checklist document will be regularly updated, and provide guidance for pharmacies in the following areas:

• Creating an emergency preparedness plan
• Adjusting pharmacy operations
• Preventative/protective measures for staff and patients
• Best hygienic practices
• And more

The BC Pharmacy Association has adapted reduced-store hours signs shared by Pharmasave Drugs (National) Ltd. for our members.

During the COVID-19 pandemic, we understand many pharmacies are reducing hours due to the pandemic's impact on staffing and the increased measures many pharmacies are taking to keep their staff and patients safe and healthy.

Community pharmacies are encouraged to make use of the reduced hours signs to help communicate any changes to regular pharmacy working hours to patients.

To download the reduced hours poster, click on the link below.

Download Reduced Hours Poster

Missed the webinar? See the recording!

Join BC Pharmacy Association Vice-President Annette Robinson along with University of Waterloo pharmacy professor Kelly Grindrod and McKesson Canada's Smita Patil on this COVID-19 webinar for pharmacists.

Managing COVID-19 Day-to-Day: More Answers to Pharmacists' FAQs attempts to address pharmacists' latest questions while continuing to provide patient care during the COVID-19 pandemic.

To access the recording, click the link below.

Access the Webinar

- Last updated March 24, 2020

We know it appears information is changing constantly. The BC Pharmacy Association's daily weekday update will continue to seek out the latest and most accurate information for pharmacists, health-care workers, patients and the public.

Information may change over time. If you have questions about something you've read here or elsewhere, please contact us directly at info@bcpharmacy.ca.

We will continue to do our best to provide the latest and most accurate information.

The BC Pharmacy Association continues to have discussions with the provincial government to identify supplies of personal protective equipment for community pharmacies during the COVID-19 pandemic. The provincial government says it is partnering with the federal government on bulk purchasing and securing additional supplies from communities, industries and international sources.

On March 22, the B.C. Attorney General's office provided a temporary authorization for distillers in B.C. to manufacture alcohol-based hand sanitizer, with the intention that the distillers will be able to donate or sell the hand sanitizer produced.

BCPhA continues working to establish a maximum 30 day supply limit

The BCPhA continues its work in consulting with the Ministry of Health and the College of Pharmacists to call for a maximum 30-day supply limit. Currently, the status quo in B.C. allows a maximum of 30-days for emergency refills for the purposes of social distancing for COVID-19.

The BCPhA is seeking a maximum 30-day supply limit for all dispenses to ensure British Columbians can continue to access an adequate supply of medications over the coming days and weeks.

The College of Pharmacists of BC has issued a flow chart to help community pharmacies to determine whether or not pharmacy staff are exempt from self isolation.

The flow chart takes into account steps that pharmacy staff members should consider following returning from travel outside Canada, and how pharmacy staff should assess contacts with high-risk individuals in escalating levels of contact.

On March 20, the College also issued clarity to advise pharmacy teams on self-isolation, to define who critical pharmacy staff are, and also the roles of managers and owners. You can find that notice here.

College COVID-19 Flow Chart

BC Pharmacy Association Vice-President Annette Robinson was interviewed by Global BC host Jennifer Palma on the topic of medication supplies during the COVID-19 pandemic on March 21, 2020.

Global asked a few questions, including on the following topics:

• The types of emergency provisions pharmacists have to provide emergency medications
• Whether patients have to go to their existing, regular pharmacy
• Whether pharmacists are challenged by COVID-19 to attend work
• Drug supply impact due to COVID-19
• Patients stockpiling medications
• Social distancing in pharmacies

To see the full interview, visit Globalnews.ca.

For the second portion of our video on COVID-19 with Annette Robinson, we are making available a lengthier video with frequently asked questions from patients.

Community pharmacies are encouraged to view, share and repost the video to educate the public during the COVID-19 pandemic.

See Video

Some pharmacies across Canada are adopting plastic shields to protect both patients and pharmacy staff during the COVID-19 pandemic.

While pharmacists in B.C. are recommended to use proper hygiene practices including practicing social distancing, frequent handwashing and the use of personal protective equipment, we understand many pharmacy staff members are still concerned for their personal health and safety.

A number of pharmacies across the country are now adopting transparent barriers that offer some protection for staff and patients.

A link is available to order acrylic barriers.

Here are some tips shared from Pharmasave Drugs (National) Ltd.:

We have compiled some images to show what some pharmacies and retails stores are doing to help with appropriate social distancing keeping staff and the public safe. To see images of what Pharmasave locations across Canada are doing, click here.

Some examples include:

• X’s appropriately spaced on the ground using tape or large stickers/notes
• Tape or rope at chest level across consultation booths
• Tape on ground to mark 2 meters (6 feet) away from dispensary and other staff areas
• Signage to inform patients
• Place a table or other form of a distance barrier in front of the dispensary area that is sturdy and the same level as counters to add distance
• Clear Plastic drop sheet to cover dispensary to protect staff from customers

Other points to consider:

• have a safe area outside of the store for people to wait (ensure they can still maintain social
• distance of 2 meters (6 feet)
• Mark the area with tape on the ground and have a staff member (perhaps using a number clicker to
• count) to manage entry
• Mandatory hand sanitizer usage before entering the store
• Designated specific hours for those in your community that are more vulnerable (i.e., seniors and
• immunosuppressed)

Sobeys Inc. will be installing plexiglass barriers during the COVID-19 pandemic at its stores across the country. The installation of these barriers was announced by Sobeys President and CEO Michael Medline on March 20.

In a statement, Sobeys said the barriers will also be available at pharmacy counters.

Yes, we will be providing plexiglass shields at our pharmacies as yet another safeguard to protect our teammates and customers. Thursday night (March 19), we began to install the shields in stores and pharmacies and will work around the clock to get them up. However, they will not be at every location immediately, but we are installing them as quickly as we can.

On March 21, Loblaw Companies Limited executive chairman Galen Weston said his company was also going to install plexiglass shields at checkout counters, but it was not clear whether or not pharmacy counters will also receive the barriers.

The Canadian Pharmacists Association has released a statement warning against the prescribing and dispensing of chloroquine or hydroxychloroquine to otherwise healthy patients for the prevention of COVID-19. While there is a study on the topic, the CPhA is recommending that the use of chloroquine or hydroxychloroquine for COVID-19 should be restricted only to hospital settings.

For the CPhA's full statement, see here.

With the growing COVID-19 pandemic, Green Shield Canada (GSC) has received numerous inquiries from both plan members and pharmacies around our policies concerning medication refills. To minimize the risk of drug shortages as a result of COVID-19, some officials and pharmacy organizations, including the Canadian Pharmacists Association, recommend dispensing no more than a 30-day supply of medication, unless clinically justified.

To ensure patient access to care and medication supply is not compromised during this critical time, GSC supports the recommendation from the Canadian Pharmacists Association to limit dispensing to a 30-day supply and is relying on pharmacists, as front-line healthcare providers, to use their professional discretion when deciding on the most appropriate days’ supply to dispense to any given patient. To that end, and until further notice, we are temporarily lifting the requirement to dispense maintenance medications in a 90-day supply during the COVID-19 pandemic.

Where dispensing of an early refill is necessary to enable self-isolation, but the claim is rejected by the adjudication system as an early refill, use of the intervention code MK = good faith emergency coverage established will enable the claim to be processed. In all cases where MK is used to enable claim adjudication, pharmacies are expected to clearly document the rationale for use to avoid subsequent audit. 

To read the full statement from GSC, click here.

The BC Pharmacy Association's daily weekday update will continue to seek out the latest and most accurate information for pharmacists, health-care workers, patients and the public.

Information may change over time. If you have questions about something you've read here or elsewhere, please contact us directly at info@bcpharmacy.ca.

We will continue to do our best to provide the latest and most accurate information.

The BC Pharmacy Association has released a video of BCPhA Vice-President Annette Robinson addressing the public during the COVID-19 pandemic.

Our message to the public is that pharmacists are here to ensure patients have access to medications, whether for their regular refills, for prescription renewals or for emergency supplies of medication.

Members are welcome to use the video in their social media feeds, for in-store displays and to share with colleagues and members of the public.

See the Video

The BC Pharmacy Association has developed a document to support community pharmacies to continue operating during the COVID-19 pandemic, while protecting their staff and patients as much as possible. The guidance includes measures drawn sources including the College of Pharmacists of British Columbia, the Ministry of Health and the BC Centre for Disease Control.

The BCPhA COVID-19 Guidance, Prevention and Control Strategies document will be regularly updated, and provide guidance for pharmacies in the following areas:

• Creating an emergency preparedness plan
• Adjusting pharmacy operations
• Preventative/protective measures for staff and patients
• Best hygienic practices
• And more

Download: COVID-19 Guidance, Prevention and Control Strategies

Updated March 20, 2020

The College of Pharmacists of BC has put together some advice for pharmacists to answer questions on self-isolation requirements for health-care workers such as pharmacists, clarity on who is critical to the functioning of a pharmacy, and the responsibilities of managers and owners with respect to this advice.

The below excerpts are taken from the College's full notice.

Self-isolation advice for pharmacy professionals

Pharmacists and pharmacy technicians may be exempt from the 14-day self-isolation requirement after travel outside of Canada, if they are considered critical to the operation of their organization/pharmacy.  

Who is Considered “Critical Pharmacy Staff”?

Determination of whether or not an individual pharmacists or pharmacy technician is critical to the delivery of essential services is the responsibility of the pharmacy manager. If the pharmacy manager is in self-isolation or is otherwise unavailable, this determination is the responsibility of the pharmacy owner. Pharmacists and pharmacy technicians who have not been deemed critical to the operation of their pharmacy MUST observe the 14-day self-isolation requirement after returning from travel outside of Canada on or after March 12, 2020. 

What is the role of pharmacy manager and owners?

As leaders of organizations providing essential services, pharmacy managers and owners are responsible for ensuring that their staff follow the required 14-day isolation protocol after returning to Canada, unless their absence will make the delivery of essential services impossible. 

The decision to provide an exemption to any individual pharmacist or pharmacy technician must be based on a comprehensive risk assessment as laid out in the Order from The Provincial Health Officer. 

Pharmacy managers and owners must prioritize protective measures for any staff members that have been given an exemption. 

The following information has been adapted from the BC Centre for Disease Control's COVID-19 Patient ID and Assessment for Primary Care document and the British Columbia COVID-19 Symptom Self-Assessment Tool.

Download Poster: Suspected cases of COVID-19: Steps to take in the pharmacy

Step One: Identify

• If patient presents with respiratory symptoms (fever, cough, difficulty breathing), give patient a mask and/or ensure at least 2 metres distance between yourself and the patient.
• Ask patient to perform hand hygiene.  

Step Two: Isolate

• Place patient in designated area of the pharmacy with at least 2 metres away from other patients.
• Put on appropriate Personal Protective Equipment (PPE) e.g. gloves, mask, eye protection.
• Perform hand hygiene before and after patient care.
• If the pharmacy does not allow for physical distancing, ask patient to return to vehicle (where applicable) and speak over the phone.

Step Three: Assess

Use the B.C. COVID-19 Symptom Self-Assessment Tool to determine next steps.

• Assess signs and symptoms
• Inquire about travel history in last 14 days
• Inquire about contact with a person with COVID-19 (probable or confirmed)

Step Four: Decide

• If symptoms are severe, call 9-1-1 or send patient directly to emergency department
• If symptoms are manageable, advise patient to stay home and self-monitor symptoms within the next 14 days.
• If patient has travelled outside Canada within the last 14 days and/or been in contact with a person with COVID-19, advise patient to self-isolate and monitor symptoms within next 14 days.
• Advise patients to call HealthLink 8-1-1 if symptoms worsen.
• Provide patients resources on COVID-19
• Clean and disinfect surfaces touched by the patient.

Learning Objectives:

At the end of the webinar, participants will be able to:

• Identify exposure risks in the pharmacy associated with COVID-19
• Implement controls in the pharmacy to reduce potential exposure to COVID-19
• Recognize ways to keep yourself protected during the COVID-19 outbreak

About the Speaker: Saleema Dhalla

Saleema completed her Masters of Occupational and Environmental Hygiene at UBC. She began her career in the geochemical industry, implementing a safety program to account for a diverse range of occupational exposures and improve worker safety. She has also designed and executed systems at the provincial and national level to reduce workplace injuries and improve employee well-being.

Saleema also led the development and execution of a province wide initiative that standardized and improved the safety program at 300 locations across BC, gaining COR (Certificate of Recognition) certification and thus providing significant cost savings. As a safety professional, she has acted as a consultant to a wide array of businesses in many sectors, including healthcare, finance, and heavy industry.

Over the past three years, Saleema has held three roles at SafeCare BC, the health and safety association which supports healthcare workers in long-term care and home and community care. Her roles include the Director of Workplace Health and Safety Programs and Acting Chief Executive Officer, and most recently the Sr. Director of Development and Strategic Engagements. 

Registration Information

This event is complimentary to members. The fee for non-members is $50.

Please Note: A BCPhA account is required to register for this event. If you do not have a login account or if you are unsure if you have a login, please fill out the Account Creation Form and a member of the BCPhA team will contact you. Accounts can be created free of charge with valid College registration.

Register Now

Prime Minister Trudeau announced this week that the government will spend up to $82 billion, including $27 billion in direct support for Canadian workers and businesses. Please see below for a summary of additional economic measures to help Canadians affected by the novel coronavirus pandemic that are most relevant to BCPhA members.

Temporary Income Support for Workers and Parents 

For Canadians that don’t have paid sick leave who are sick, quarantined or forced to stay home to care for children. This income support will help by:

• Waiver of 1 week waiting period – Effective March 15th
• Waiver of medical certificate to access EI sickness benefits
• *NEW* Emergency Care Benefit – Available starting in April 2020
• Provides $900 bi-weekly for up to 15 weeks
• Will be administered through the CRA

Who is eligible?

• Workers, including self-employed, who are quarantined or sick with COVID-19 but do not qualify for EI sickness benefits
• Workers, including the self-employed, who are taking care of a family member with COVID-19, such as an elderly parent, but do not qualify for EI sickness benefits
• Parents with children who require care or supervision due to school closures, and are unable to earn employment income, irrespective of whether they qualify for EI or not.

Longer-Term Income Support for Workers

For Canadians who lose their jobs or face reduced hours:

• The Emergency Support Benefit will be providing $5 billion in support to workers who are not eligible for EI and who are facing unemployment. – Details to be updated.

Income support for individual who need it most 

Doubling the Goods and Services Tax credit

• One-time special payment by early May 2020
• Approximately $400 for single individuals and $600 for couples

Families with children

• Increase maximum annual Canada Child Benefit by $300 per child (only for 2019-2020 benefit year)
• $305 million for a new distinctions-based Indigenous Community Support Fund to address immediate needs in First Nations, Inuit, and Metis Nation communities.
• Six-month interest free freeze on repayment of Canada Student Loans for those currently repaying
• Helping senior’s who have been exposed to the volatile market conditions: Reducing minimal withdrawals for Registered Retirement Income Funds (RRIF’s) by 25% for 2020
• $157.5 Million for Reaching Home initiative supporting people experiencing homelessness Tax Deadlines
• For individuals the tax filing deadline is extended until June 1, 2020 (from April 30, 2020)
• If you owe taxes the revised deadline for payment is now deferred until after August 31, 2020

Mortgages

Canada’s big banks (BMO, CIBC, National bank, RBC, Scotiabank, and TD) will allow mortgage payment deferrals for up to six months. The mortgage deferrals will be done on a case by case basis without mention if the deferral is interest-free or simply just a delay. More details will be released on this in the coming days and will likely vary from bank to bank.

If you require mortgage deferral, please speak to your bank or your mortgage broker.

Business Support

The government is proposing to provide eligible small employers a temporary wage subsidy for a period of three months.

• Subsidy will be equal to 10% of remuneration paid during that period, up to a maximum subsidy of $1,375 per employee and $25,000 per employer.
• There is no mention as to what an eligible small employer is or what the conditions are yet.

This document will be updated as we have more information. Please check our resource page for regular updates.

A study from the National Institutes of Health, CDC, UCLA and Princeton University published in The New England Journal of Medicine examined how long SARS-CoV-2, which causes the COVID-19 disease, would survive in aerosols and various surfaces.

It found SARS-CoV-2 survives for:

• Up to three hours in aerosols
• Up to four hours on copper
• Up to 24 hours on cardboard
• Up to two to three days on plastic and stainless steel

For more information, visit the National Institutes of Health website, or the New England Journal of Medicine.

An open-label trial funded by the National Institute of Allergy and Infectious Diseases (NIAID) is taking place in Seattle, at the Kaiser Permanente Washington Health Research Institute. The Phase 1 trial will involve 45 adult volunteers, intended to evaluate different doses of an experimental vaccine called mRNA-1273.

The experimental vaccine will be tested over six weeks. It was developed by NIAID and Moderna, Inc., and has shown promise in animals, though this is the first trial to examine its use in humans.

The first volunteer received the experimental vaccine on Monday, March 16, 2020.

The information above was sourced from the National Institutes of Health. For more information about the study, visit ClinicalTrials.gov and search identifier NCT04283461.

As the pharmacy profession grapples with providing effective patient care while preventing the spread of infection during COVID-19, pharmacists have many new questions.

The Canadian Pharmacists Association is bringing together McKesson Canada’s Smita Patil, University of Waterloo pharmacy professor Kelly Grindrod and BC Pharmacy Association vice-president Annette Robinson (Pharmasave Pacific) to answer your latest questions on managing day-to-day during a pandemic.

Date: March 23, 2020
Time: 10 to 10:45 a.m. Pacific Time

This webinar is freely available to all pharmacists.

Register Now

Using a combination of alcohol, hydrogen peroxide, glycerol and water, it's possible for community pharmacies to make their own hand sanitizer. In fact, one of our members, the team at Lakeside Medicine Centre in Kelowna, has already made use of this formula to provide hand sanitizer to protect its staff.

The World Health Organization has provided instructions for small batches and 10 litre batches in two different formulations - one using ethanol and the other using isopropyl alcohol.

Click here to access the Guide to Local Production: WHO-recommended Handrub Formulations.

Last updated March 20, 2020

We appreciate that this is a confusing and stressful time.

We know it appears information is changing constantly. The BC Pharmacy Association's daily weekday update will continue to seek out the latest and most accurate information for pharmacists, health-care workers, patients and the public.

Information may change over time. If you have questions about something you've read here or elsewhere, please contact us directly at info@bcpharmacy.ca.

We will continue to do our best to provide the latest and most accurate information.

The COVID 19 pandemic is evolving quickly and the impact on community pharmacies is also evolving day to day. We are hearing from many members about the most pressing issues and communicating those to the Ministry and, as needed, the College of Pharmacists.

The Association is aware that the pressure on pharmacies is enormous and that efforts to meet increased demands is not easy. We know that patients are coming for early renewal of prescriptions, looking to have new prescriptions filled and that the volumes of prescriptions is unlike what pharmacies have seen before.

We also know that pharmacists are facing the same stress about the uncertainty of the situation that everyone is and this is particularly challenging in the face of such an increase on workload.

The Minister of Health and the Provincial Health Officer are being briefed each day on issues impacting pharmacy and we are assisting PharmaCare in understanding the changing landscape. Be assured that the Association is canvassing members to be sure we are in a position to clearly communicate the priority issues.

The two issues that we understand are of most importance now are security of medication supply and providing adequate protection for pharmacists who may come into contact with patients.

In terms of stability of supply, a number of other provinces have moved to limiting dispensing quantities to a maximum of 30 days for all medications. In our conversation with the Ministry today we explained the important contribution setting this limit in place in B.C. could have on maintaining access to all needed medications. 

Today's dispensing quantities remain as:

• Emergency supplies – up to 30 days’ supply
• Regular fills – Do not dispense more than the maximum days’ supply indicated on PharmaNet

PharmaCare asks pharmacists that:​​​​​​​

• Pharmacists should reduce visits to prescribers by providing up to 30-day emergency supplies to patients with expired prescriptions, using guidance from Professional Practice Policy 31. This may be repeated for another 30-day supply if necessary, and includes narcotics, psychiatric drugs and anti-psychotics for chronic conditions
• Manage stock appropriately. Do not dispense more than the maximum days’ supply indicated in PharmaNet. Do not over-order.
• Provide early fills so patients can self-isolate for a minimum of 14 days, and longer for seniors and patients who are at-risk
• Use intervention code "UF". The combination of the amount of medication patient has on hand in addition to the amount dispensed must not exceed the maximum days' supply
• All early fills, emergency supplies or other dispenses that are exceptional due to COVID-19 must be documented as "for COVID-19" or similar to avoid audit

The BC Pharmacy Association has been engaging with the provincial Ministry of Health and its federal counterpart to identify when and how sources of Personal Protective Equipment will be made accessible for community pharmacies. All parties are aware there is a worldwide shortage and we have been working with multiple levels of government to provide input on pharmacy priorities.

On March 18, the BCPhA, along with other provincial pharmacy associations and the Canadian Pharmacists Association, submitted an open letter to the Government of Canada to communicate our concerns about the health and safety of pharmacists working on the front-lines of this crisis. Specifically, we shared that:

• Current measures may not be enough to protect frontline pharmacists and the patients they serve.
• Government should recognize pharmacists as essential health providers with respect to the supply and allocation of Personal Protective Equipment
• The World Health Organization has recommended all health-care providers in direct contact with high-risk patients be wearing gloves, gowns and appropriate facial masks
• In the United Kingdom, government has been sending pharmacies gloves, aprons and masks

On March 19, Canada's chief public health officer said in the federal government's daily briefing that about seven million masks have been requested and there is a supplier in place to fulfill much of that demand.

Health Canada has issued a statement on March 19 providing exemptions to, as long as permitted within provincial/territorial scopes of practice, allow pharmacists to:

• Extend prescriptions
• Transfer prescriptions to other pharmacists
• Receive verbal orders from prescribers to extend or refill a prescription
• Deliver prescriptions of controlled substances to patient's homes or other locations where they may be self-isolating

These exemptions will be in place until Sept. 30, 2020 or until they are replaced by another exemption, or revoked entirely.

British Columbian pharmacists must comply with the scope of practice set out by the College of Pharmacists of BC. The College made changes effective March 17 to permit pharmacists to deliver Opioid Agonist Treatment medications to patients without prescribers' authorization, though prescribers are still asked to indicate if they have decided not to permit delivery to a patient; and pharmacists must still document and notify prescribers of decisions to initiate or stop OAT delivery.

On March 18, Health Canada took an interim measure to make available additional products that had previously not been available in the Canadian market due to not meeting current regulatory requirements. The interim measure provides exemptions to permit the sale of disinfectants, hand sanitizers and personal protective equipment that fall into the following two categories.

• products that are already authorized for sale in Canada but are not fully compliant with Health Canada requirements (e.g., English-only labelling, different packaging from what was authorized); and.
• products that are not authorized for sale in Canada, but are authorized or registered in other jurisdictions with similar regulatory frameworks and quality assurances.

The following products permitted to be sold in Canada under this interim measure that may not fully meet labelling, licensing or packaging requirements (e.g., some products may be labelled in English only or may be labelled only with a foreign identifier number instead of a DIN or NPN):

The World Health Organization has issued the following statement on social media regarding ibuprofen and COVID-19. On March, 18, in response to the question Could ibuprofen worsen disease for people with COVID19? the WHO said:

Based on currently available information, WHO does not recommend against the use of of ibuprofen. WHO is aware of concerns on the use of #ibuprofen for the treatment of fever for people with COVID19. We are consulting with physicians treating the patients & are not aware of reports of any negative effects, beyond the usual ones that limit its use in certain populations.

The Canadian Pharmacists Association (CPhA) has also issued some detailed information on this (March 17, 2020). Ibuprofen was noted as a concern following media reports from France that anti-inflammatory medications could be a factor in aggravating COVID-19.

Here are a few key points to keep in mind from the CPhA:

• Health Canada continues to recommend both ibuprofen and acetaminophen for treatment of fever due to COVID-19.
• Evidence to date suggests that older people (>60 years of age) and those with underlying medical conditions are at higher risk of severe COVID-19 disease. As NSAIDs should also be used with caution in these populations, it is reasonable to avoid NSAIDs in the elderly and in those with comorbid conditions (e.g., cardiovascular disease, renal disease, chronic respiratory disease). If the use of an NSAID is unavoidable in these patients, it should be at the lowest effective dose and for the shortest duration.

The CPhA monograph Nonsteroidal Anti-inflammatory Drugs (NSAIDs) contains detailed information on the contraindications, warning and precautions to consider when recommending or prescribing NSAIDs.

Over the past week, many increasingly severe restrictions have been put in place as B.C., and the country, prepares for the escalating onslaught of COVID-19.

The BC Pharmacy Association is committed to keeping its members and the public informed of the steps we are taking to ensure the latest and most accurate information is available.

Normally on Wednesdays, the BCPhA distributes a weekly newsletter for pharmacists called the Practice Update. The Practice Update will be amalgamated into the daily, weekday COVID-19 update for the duration of the pandemic.

All Practice Update subscribers will receive daily, weekday COVID-19 updates instead during this time.

Clarification on pharmacists' exemption from self-isolation

On March 18, 2020, Dr. Bonnie Henry clarified that pharmacists and other health-care workers are only conditionally exempt from self-isolation in certain situations while at work. Please see the following additional clarification from PharmaCare.

Additional clarification from PharmaCare:

Pharmacists may be exempt from self-isolation requirements after travel if they are critical to the operation of their organization/pharmacy. Pharmacists who have recently returned from outside Canada should self-isolate if they are not critical staff. If a pharmacist must work after travelling, they should self-monitor carefully and use a mask and gloves to protect others if they have any respiratory symptoms. PharmaCare Newsletter, March 18, 2020

COVID-19 pharmacy procedures from PharmaCare

Download the PharmaCare Newsletter here.

Pharmacies are being asked to help maintain the viability of our health care system by reducing the load on prescribers and helping to manage the drug supply. 

Pharmacies should make every effort to:

• Reduce prescriber visits by providing up to 30-day emergency supplies to patients with expired prescriptions (see PPP-31). This may be repeated for another 30-day supply if necessary. This includes narcotics, psychiatric drugs and anti-psychotics for chronic conditions.
• Manage stock appropriately. Do not dispense more than the maximum days’ supply indicated in PharmaNet. Do not over-order.
• Provide early fills to people so they can self-isolate for a minimum of 14 days – longer for seniors and other more vulnerable people. Use intervention code “UF”. Please note the combination of the amount the patient has on hand, plus the amount the pharmacy dispenses, may not exceed the maximum days’ supply

Process for Early Refills and Documentation

All early fills, emergency supplies, or other dispenses outside the norm due to COVID-19 MUST be documented as “for COVID-19” or similar, to avoid audit.

In all cases where a pharmacist submits a PharmaNet claim for an emergency or early fill, the pharmacist MUST document it appropriately (e.g. “early fill for self-isolation for COVID-19”) to avoid subsequent audit.

Last updated on March 18, 2020

The BCPhA is working on materials for members to use in interacting with patients, including posters, patient handouts and FAQs. We will make these available as soon as they are ready.

The BC Pharmacy Association has created patient-facing health and safety posters to educate patients arriving at pharmacies about the symptoms of COVID-19, and what to do to prevent the transmission of the virus.

To download the posters, please select a language:

Some pharmacies have contacted the BCPhA asking for patient-facing posters that ask patients with respiratory illness symptoms to wait outside the pharmacy, instead of going inside, to access service.

The BCPhA has created this poster for pharmacies who are committed to serving their patients who call in, either through curbside service, deliveries or other means. A space on the poster is available for individual pharmacies to fill in their phone numbers.

This poster is not intended to turn patients away without a thorough attempt to provide them the service they need.

After a press conference on March 16 by Minister Adrian Dix and Public Health Officer Dr. Bonnie Henry, media reported that patients could get their prescriptions “without a doctor’s note” to help relieve the burden on doctors’ offices.

Unfortunately some patients have misinterpreted this information. The BCPhA has issued a news release to provide some clarification, which has resulted in media coverage.

• COVID-19: Skip doc, see pharmacist for renewals - Aldergrove Star
• B.C. pharmacists commit to keep working - Tri City News
• COVID-19: Here are the criteria for having your prescriptions refilled without a note - Kamloops Matters
• Getting your prescriptions: Doctors visit not required for prescriptions refill during pandemic - Castanet
• B.C. pharmacists can refill regular medications, issue 30-day emergency supplies - City News / News 1130
• COVID-19 information, links, and impacts on local services - Ashcroft Cache Creek Journal

Last updated on March 18, 2020

McKesson, speaking to Global News, March 17:
Full article

Andrew Forgione, a spokesperson for the drug wholesaler McKesson, said the company was working with pharmacies, hospitals and manufacturing partners to promote responsible ordering and distribution during the novel coronavirus pandemic and COVID-19 outbreak.

“In recent days, we’ve taken proactive steps to support responsible ordering, including temporarily adjusting daily customer ordering for some medications and certain daily essentials,” Forgione said via email.

“It is unnecessary for Canadian consumers or retailers to mass order products. We encourage patients and customers to refill maintenance medications and seek healthcare essentials in a responsible manner to avoid unnecessary strain on the system.” More information from the full article.

Statement from Innovative Medicines Canada, March 18:
Full statement

Ottawa, March 18, 2020—As Canada responds to the global COVID-19 pandemic, some Canadians have expressed concern that they may not have access to the medicines they need, when they need them.

Based on the information we have received from our membership, which includes the majority of Canada’s research-based pharmaceutical companies, there are no COVID-19 related shortages being reported, or current constraints on their ability to supply medicines to Canadians. More information from the full statement.

Last updated on March 18, 2020

Effective immediately, pharmacists are permitted to use their professional judgement to deliver Opioid Agonist Treatment medications to patients if they feel it is safe, appropriate and in the best interests of the patients.

The changes, which effect Professional Practice Policy 71, were intended to take effect on April 1, 2020. Due to recent developments of COVID-19, the College decided to accelerate the implementation of these changes to March 17.

Prior to the changes, PPP-71 permitted pharmacists to deliver methadone to a patient's home only if authorized by a prescribing physician. With the change that is now in effect, the restriction that delivery must be authorized by a prescriber is removed. In addition, PPP-71 now also permits pharmacists to authorize delivery of OAT by buprenorphine/naloxone and slow release oral morphine, in addition to methadone.

Prescribers have been asked to indicate “Do Not Deliver” on the Controlled Prescription Program Form, or to contact patients' pharmacies directly, for patients where prescribers have decided to prevent delivery to a patient.

Pharmacists must still notify prescribers of decisions to initiate or stop OAT delivery. For complete information on the change, please visit the College of Pharmacists' website.

Last updated on March 18, 2020

Immunocompromised patients and those who exhibit symptoms or are under quarantine or self-isolation may not be able to attend the pharmacy for their witnessed dose or to pick up their carries.

The BC Centre on Substance Use has released opioid agonist treatment guidance for pharmacists. See the full document here.

• Pharmacists are asked to consider delivery of OAT medication to patients where appropriate
• Communicate stable and predictable hours of operation and delivery options to OAT patients
• Methadose, Metadol-D, and Sandoz Methadone (Sterinova) are all commercially available methadone 10mg/mL products that meet the Health Professions Act definition (section 25.91) of an interchangeable drug. For more information and key considerations when deciding on a formulation, please see the BCCSU Methadone Formulations Options Bulletin.
• In the context of the pandemic, Health Canada is preparing to issue additional exemptions under the Controlled Drugs and Substances Act (CDSA) for prescriptions of controlled medications, including OAT, as early as this week (week of March 16, 2020). The exemptions under consideration would permit pharmacists to extend prescriptions, transfer prescriptions to other pharmacists, and permit prescribers to issue verbal orders (i.e., over the phone) to extend or refill a prescription.

Last updated on March 18, 2020

Effective immediately, all in-person sessions at the BC Pharmacy Association are postponed indefinitely. This includes all Opioid Agonist Treatment workshops, Injections training workshops, and the BCPhA Annual Conference.

For those who have already registered for Conference, the BCPhA will be providing a full refund to all attendees and exhibitors who have already paid for the live event and will email you once the refund has taken place.

Training workshop registrants for OAT and Injections will be contacted by a member of the BCPhA team.

For more information, please contact info@bcpharmacy.ca.

Last updated on March 18, 2020

With the burden on pharmacists raising amid the ongoing COVID-19 outbreak, pharmacies may be looking for additional help.

If you are a pharmacist who is looking to help with the COVID-19 outbreak, Hire-a-Pharmacist is a great way to help you find pharmacies that need help. This service will make yourself visible to more than 900 pharmacy owners. Post your resume today!

Are you a pharmacy manager looking to hire in your pharmacy? View all resumes in your area, or post on our job board today!

Last updated on March 18, 2020

The College of Pharmacists of BC has put together a resource page for registrants pertaining to COVID-19. It can be found here.

BCPhA sends clarification to media on medication supplies from B.C. pharmacies

Over the past 24 hours, many BCPhA members have said a number of patients are visiting pharmacies requesting medications without a clear understanding of the regulations around renewals and emergency refills.

After yesterday’s press conference by Minister Adrian Dix and Public Health Officer Dr. Bonnie Henry, media reported that patients could get their prescriptions “without a doctor’s note” to help relieve the burden on doctors’ offices.

Unfortunately some patients have misinterpreted this information. The BCPhA will be issuing the following news release for distribution this afternoon.

BC Pharmacists message to patients on medication supplies during COVID-19 outbreak

MARCH 17, 2020 – British Columbia’s community pharmacists are committed to remaining available to patients in need during this COVID-19 outbreak, as we have been for other public health crisis in the past.

We remain steadfast in helping alleviate the burden on other parts of the health-care system and providing an adequate supply of medication for patients, who are being asked not to visit doctors’ offices for their prescription needs.

Over the past 24 hours, many patients have been directly visiting pharmacies, generally for one of two reasons:

1. They require an adequate supply of their regular medications in order to self-isolate; or
2. They have run out of their regular medications and need more.

While pharmacists are committed to ensuring every patient has an adequate supply of medication, they remain bound by existing regulations when providing medications without a new prescription. The following represent some of the criteria pharmacists must follow:

• Patients must already be taking the medication or have an existing prescription for their medication. Pharmacists can not provide a new medication to a patient without a previous doctor’s prescription.
• Generally this service is provided for medications used to treat chronic conditions.
• Patients who have an expired prescription can have that filled by a pharmacist. The pharmacist will work with the patient to determine the appropriateness and the amount of supply to provide them.

Patients who have run out of their medication or need more, should call ahead to their regular pharmacy to determine whether a pharmacist can provide the additional supply.

Patients are encouraged not to stockpile medications. Pharmacists aim to make sure all patients have access to their medications, so they are generally not providing more than a 30-day supply to support those who are self isolating.

Self-quarantine exemption

Last Friday, Dr. Bonnie Henry released a letter through the College explaining that health-care workers “who provide direct patient care” are exempt from self-quarantine after travelling. Members had questions on whether that included pharmacists.

Today the College issued a second notice to registrants on self-quarantine measures for those who have travelled aboard. Today’s notice makes clear that pharmacists are included in the exemption.

“Health care workers who return from travel and are essential to the delivery of patient care may return to work but should take additional precautions to reduce the risk to their patients, colleagues, and the public should they become symptomatic:

• Self-monitor daily for signs and symptoms of illness
• Wear a surgical mask at all times and in all areas of your workplace
• Follow Infection prevention and control protocols including diligent hand hygiene and the use of personal protective equipment when delivering patient care
• Reduce close contact with other health-care workers and avoid shared spaces where possible
• Avoid close contact with others when travelling to and from work and between shifts
• Self-isolate at home on days when not required at their workplace.

Additional precautions may vary by facility, health-care setting, or workplace based on the patient population being cared for and risk assessments made by regional or local public health officials, infection prevention and control experts.”

Pharmacist Renewals

Today B.C.’s Minister of Health Adrian Dix reiterated the role pharmacists can play in renewals and emergency refills in his address to British Columbians. 

Pharmacists should be ready and prepared to provide renewals and emergency supplies to patients using PPP-58 Medication Management (Adapting a Prescription) or Professional Practice Policy-31 Emergency Supply for Continuity of Care. Last week’s PharmaCare newsletter highlighted the need for pharmacists to use these authorities.

In consultation with the College and Ministry, we encourage pharmacists to provide emergency supplies with greater latitude where the principles of PPP-31 have been satisfied. For example, where an emergency supply is appropriate, where you might normally provide a 7-day supply, during this outbreak to ease the strain on the healthcare system provide a 30-day supply.

If you have questions about providing renewals or adaptations, please consider taking our FREE online course “Professional Services: Adapting Prescriptions”. 

Early Refills and Stockpiling

Further to last week’s PharmaCare newsletter, we would encourage pharmacists to avoid “topping up” a patient’s medications supply in excess of PharmaCare’s 100 or 30-day maximum supply policies. That is, a patient’s on-hand quantity should not exceed these limits. Additional limits on refills, renewals and emergency supplies may be issued in the coming days. We will update you as the situation evolves.

The distribution supply chain remains in good order and pharmacies should not over-order or stockpile at the local level, but rather should maintain their routine ordering process in discussion with their distributors.

Pharmacists are also reminded that if they serve Long-Term Care or residential facilities (including Plan B facilities) that staff should know and follow the infection control protocols for that facility when making deliveries.

Last Update: March 13, 2020 8:00 PM

As you are aware, the World Health Organization categorized the novel coronavirus (COVID-19) outbreak as a pandemic. 

Provincial Health Officer, Dr. Bonnie Henry, has directed event organizers to cancel any gathering larger than 50 people. 

More information coming soon about either postponing to a later date or a digital experience.

Last Updated: March 15, 2020 11:54 AM

Pharmacists and pharmacies across the province have been occupied with the COVID-19 pandemic. As a result, the Ministry of Health has confirmed that OAT training occurring after March 14 will be suspended until further notice.

The Ministry of Health will provide direction regarding when training sessions will resume, when they deem it reasonable in the context of general guidance from the Provincial Health Officer.

If you have already registered for one of the upcoming sessions, a representative from the BC Pharmacy Association will reach out to you. There will be no cancellation fees for participants.

Last Updated: March 13, 2020 8:00 PM

For updates to COVID-19, please check:

• Public Health Agency of Canada
• BC Centre for Disease Control

Last Updated: March 13, 2020 11:54 AM