Below is a summary from the Ministry of Health Guidance for Primary Care (Version 7, November 9, 2020). 

Personal Protective Equipment (PPE)

Summary of required HCW precautions are displayed in the table below

ActivityHCW Precautions
Before every patient interaction HCW must conduct a point-of-care risk assessment to determine the level of precautions required
All interactions with and within 2 metres of patients who screen positive Droplet and Contact precautions:
  • Surgical/procedure mask
  • Isolation gown
  • Gloves
  • Eye protection (goggles or face shield)
  • Perform hand hygiene before and after contact with the patient and the patient environment and after the removal of PPE
All interactions with and within 2 metres of patients who screen negative
  • Surgical/procedure mask required
  • Use of eye protection (goggles or a face shield) should be considered
  • Perform hand hygiene before and after contact with the patient and the patient environment and after the removal of PPE

HCW precautions should take into consideration both COVID-19 and other potential communicable diseases as part of the point-of-care risk assessment. For patients who screen negative and are coming to the office/clinic for vaccine administration, a surgical/procedure mask should be worn, and eye protection should be strongly considered. Gloves should be considered (e.g. skin integrity and some vaccines) as per the Canadian Immunization Guide. In most cases gloves do not need to be worn except when: the skin on the vaccine provider’s hands is not intact; administering intranasal or oral vaccines due to the increased likelihood of coming into contact with a patient’s mucous membranes and body fluids; and/or administering Bacille Calmette-Guérin (BCG) vaccine.

General In-Office Masking and Eye Protection

Given community spread of COVID-19 within Ontario and evidence that transmission may occur from those who have few or no symptoms, masking (surgical/procedure mask) for the full duration of shifts for HCWs working in direct patient care areas is recommended. Read more about pre-symptomatic and asymptomatic transmission from the CEP here.

Masking is also recommended for HCWs working outside of direct patient care areas when interacting with other HCWs and physical distancing cannot be maintained. The rationale for full-shift masking is to reduce the risk of transmitting COVID-19 infection from HCW to patients or other office/clinic HCWs, at a time when no signs or symptoms of illness are recognized, but the virus can be transmitted. This is a form of source control.

The use of eye protection (e.g., goggles or a face shield) for the duration of a shift should be strongly considered in order to protect HCWs when there is COVID-19 infection occurring in the community. Primary care providers should be knowledgeable on the proper sequence of donning and doffing PPE.

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