COVID-19 Personal Protective Equipment and Barriers

BC Pharmacy Association: COVID-19 Checklist for Pharmacies now available for download

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

Plexiglass fund for pharmacies available

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

Protective face shields bulk-ordering instructions

The BC Pharmacy Association is organizing a bulk-order of protective face shields for pharmacy staff and will distribute it to pharmacies who are interested in ordering.

The BCPhA is organizing a group-buy as 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.

Face shields must be purchased in sets of 5 units and will work out to around $24 per shield after shipping and handling.

Ordering Instructions

To order through BCPhA’s group buy, please visit: https://docs.bcpha.ca/fsorder

For more information on the BCPhA’s group buy, visit: https://docs.bcpha.ca/ppe-supply

If your pharmacy is purchasing more than 25 masks, it is preferred that you purchase directly from the vendor. For direct orders of 25+: Contact Tina Hasfjord at (306) 731-2924 or hasfjordt@sasktel.net

Identifying genuine masks and respirators: information from U.S. Centers for Disease Control and Health Canada

From the United States CDC:

The United States Centres for Disease Control and Prevention have released a counterfeit respirator alert as there continues to be an overwhelming demand for NIOSH-approved N95 respirators worldwide.

The CDC is continually updating its website with alerts of counterfeit respirators, including names of counterfeit products and counterfeit approval numbers being used. You can access a list of counterfeit respirators identified by the CDC here.

NIOSH-approved respirators have an approval label on or within the packaging of the respirator, in addition to an abbreviated approval on the respirators themselves. Approval numbers can be verified on the NIOSH Certified Equipment List. NIOSH-approved respirators will always have one the following designations: N95, N99, N100, R95, R99, R100, P95, P99, P100.

 

From Health Canada:

Medical N95 respirators are considered Class I medical devices by Health Canada and are manufactured or imported by companies that hold a Medical Device Establishment Licence. NIOSH-certification is considered by Health Canada to be an appropriate quality standard for N95 masks used in health-care settings. All N95 respirators certified by NIOSH must have an approval number stamped on the mask, represented as TC-84A-####n.

Non-medical N95 respirators are similar to their medical counterparts, but have not been tested for fluid resistance of any type. If alternatives are not available, non-medical N95 masks may be used in health-care settings

Equivalent-alternative N95 respirators have been identified by Health Canada as similar to NIOSH-approved N95 respirators. These products include KN95 respirators that meet GB Standards of GB 2626-2006, GB 2626-2019, and GB 19083-2010.

Surgical masks are categorized under three classifications of the American Society for Testing and Materials. They do not offer the same level of filtration as N95 masks.

  • Level 1 (low) - venous pressure splash
  • Level 2 (moderate) - arterial pressure splash
  • Level 3 (high) - high-velocity procedures, orthopedic surgery

More information can be found on Health Canada's website.

Personal Protective Equipment update from BC Centre for Disease Control and Ministry of Health

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.

BC Centre for Disease Control releases guidance for community and hospital pharmacies

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

British Columbia reprocessing used N95 respirators

In its April 8 Personal Protective Equipment Bulletin, the BC Centre for Disease Control directed all health authorities, long-term care facilities and assisted living facilities to collect used N95 respirators that are not soiled or damaged for reprocessing.

The reprocessing of N95 respirators is considered a pilot project and sterilized respirators will be stored and only used when new N95 or equivalent respirators are not available. The N95 respirators are being sterilized using the STERRAD technique.

More information can be found in the BCCDC Bulletin

BC Pharmacy Association continues to work with government to identify supplies of personal protective equipment

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.

BCPhA Recorded Webinar: COVID-19 exposure in the pharmacy: Protecting the pharmacist and pharmacy staff

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

CPhA 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: Watch here
Cost: The webinar is free for all pharmacists.

Canadian Pharmacists' Association releases personal protective equipment suggested best practices for pharmacies

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.

Health Canada temporarily approves use of technical-grade ethanol in hand sanitizer products

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.

Health Canada expands access to disinfectants, hand sanitizers and personal protective equipment

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):

Health Canada exemptions

More information on Health Canada's expedited access to these products is available on the Health Canada Recalls and Alerts page. https://healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2020/7262…

List of suppliers for see-through barriers at pharmacy counters

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.

Making your own hand sanitizer? See the WHO's how-to guide

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

More from Sobeys Inc. and Loblaw Companies Limited

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.

Personal Protective Equipment: BCPhA engaging with senior levels of government

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.

Provincial Health Officer Dr. Bonnie Henry provides update on personal protective equipment: 'burn rate ... is much higher than we would have expected'

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

Some Pharmasave, Sobeys pharmacies installing plexiglass shields during COVID-19 pandemic to protect staff, customers

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)

Study examines COVID-19 survival on surfaces

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.