Masking and PPE

Masking policies

Public Health Ontario provides guidance on universal masking for patients and visitors and for health-care workers providing direct patient care during periods of high risk for respiratory virus transmission, including fall and winter.

As private entities, health-care practices may choose to adopt a masking policy for staff. A masking policy can require staff to continue universal masking unless they have an accommodation under the Ontario Human Rights Code, such as a medical exemption.

In addition to requiring masking for staff, health-care practices can also require masking for patients. Patients should be informed of this expectation when making an appointment, and your office should have masks available to provide if needed.

Masking FAQs

The Ministry of Public and Business Service Delivery, on behalf of the Ministry of Health, has an online portal for ordering PPE, swab kits and rapid antigen tests from the Ontario government stockpile. Community-based physicians are encouraged to email the Ministry of Public and Business Service Deliver at sco.supplies@ontario.ca to get set up with an account.

If you have an existing account, sign in to PPE supply portal to order PPE, swab kits and rapid antigen tests from the provincial stockpile. The ordering process via the eHealth Ontario portal has ended.

As a private enterprise, you have the right to adopt a masking policy that requires your staff to wear a mask in the workplace. If you have a staff member who refuses to comply with the masking policy, you can terminate their employment; however, unlike at critical points of the pandemic, it is no longer clear that a mask mandate would be upheld if legally challenged. Additionally, if your staff member has a condition that prevents them from wearing a mask, then requiring them to wear a mask becomes a human rights issue and termination is not permitted. Appropriateness of requirement to mask would also likely be evaluated in light of community spread at the time.

If a patient refuses to wear a mask, assess what actions are appropriate in the circumstances. In general, it is inappropriate to deny necessary, urgent in-person care solely because a patient refuses to wear a mask. The CPSO notes that physicians have a duty of care when care is urgently needed, and that most in-person care can be provided safely with appropriate precautions; however, you can:

Provide virtual care, if appropriate
Modify how you see the patient (e.g. ask them to wait outside until an exam room is available or see them at certain times only, like the end of the day)

If the patient uses abusive or threatening language or is physically violent, you can take appropriate steps to defer or delay non-emergent care. In some circumstances, you may consider whether ending the physician-patient relationship would be appropriate and aligned with CPSO policy.

Set expectations by posting masking posters for your office door and exam rooms.

Access French masking posters for your office door and exam rooms.

PPE use when providing direct care for patients with acute respiratory infections

A well-fitting medical mask is recommended, along with eye protection, gloves and gown, when providing care to patients who screen positive for acute respiratory infections. A fit-tested seal-checked N95 respirator may also be used based on point of care risk assessment such as when performing an aerosol generating medical procedure (AGMP).

Public Health Ontario provides guidance on the use of PPE in their Best Practices for the Prevention of Acute Respiratory Infection Transmission in All Health Care Settings document. Individual institutions may also have their own PPE policies above and beyond those recommended here (such as universal masking).

PHO PPE recommendations

Medical mask
Eye protection is required if the patient is unmasked at any point during the visit, otherwise, use clinical discretion
Consider wearing gloves when administering vaccines if the skin on your hands is not intact; you are administering intranasal or oral vaccines; and/or you are administering Bacille Calmette-Guérin (BCG) vaccine

Public Health Ontario recommends that asymptomatic patients and visitors are encouraged to wear a mask during periods of high respiratory virus transmission risk (for example, during respiratory virus season or when community transmission rates of COVID-19 and other respiratory illnesses are high and/or increasing). During periods of non-high risk, masking for asymptomatic patients and visitors can be considered.

Patients with symptoms of any respiratory illness should wear a medical mask.

Additionally, patients with suspected or confirmed measles should be isolated from others immediately. Only staff with documented immunity from measles should provide care to these patients.

Choosing PPE in hospital and long-term care homes

Physicians and other health-care workers in hospitals and long-term care homes can use their professional and clinical judgment, based on their point-of-care risk assessment, to determine what health and safety measures are required in the delivery of care, including use of an N95 respirator. The public hospital or long-term care home cannot unreasonably deny access to the appropriate PPE.

Employer responsibilities: wearing and using PPE safely

If you work in a health-care organization, your employer or workplace must provide training on how to properly wear and use PPE, including how to put it on (don) and take it off (doff) safely. As an employer, you have a responsibility to ensure your staff are educated on how to wear and use PPE safely.

Public Health Ontario PPE resources

Fit testing N95s

Options for fit testing staff include:

Engage an external fit testing provider.
Identify staff to become designated fit-testers and participate in train the trainer education provided by Public Services Health & Safety Association

Employers can fit test staff to masks available through regular suppliers, or if needed, request N95 supply to support fit testing from the provincial stockpile. Ensure that you have fit testing support available before you request masks for fit testing.

Expired or donated respirators may be provided for fit testing. Members should confirm the expiry date of any supply received.

Resources

Best Practices for the Prevention of Acute Respiratory Infection Transmission in All Health Care Settings

Routine Practices and Additional Precautions in all Health Care Settings

Additional products and services available for members

OMA members get access to exclusive savings from our partners. Explore these relevant resources, products and services.

Find a supplier

Use the Practice Support Directory (member-only content) to find PPE vendors.

Use the directory

PPE office poster

A poster that provides health-care workers COVID-19 and measles PPE recommendations.

Access the poster

Masking poster

A poster for patients for your office door or exam rooms. Also available in French.

Use the poster