Masking and PPE

Find out more about PPE and where and when to use it

Masking policies

Public Health Ontario recommends 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.

The CPSO addresses patient refusal to wear a mask in their COVID-19 FAQs for physicians. Their response states:

  • If you have a masking policy and you encounter a situation where a patient declines to wear a mask, sensitively explain the expectation in your practice that a mask be worn. However, some patients may have health conditions that make it difficult or inhibit their ability to wear a mask
  • It is important that all patients receive the care they need and are not unnecessarily being denied access or being redirected to other parts of the system that are experiencing significant challenges
  • While most in-person care can be provided safely with appropriate precautions, you can also choose to provide virtual care, if appropriate
  • Another option is to modify how you see unmasked patients, such as asking them to wait outside until an exam room is available or choosing to see them at certain times only, like the end of the day
  • Whether patients are exhibiting symptoms of COVID-19 or not, all patients can be safely cared for in person with appropriate precautions. Donning appropriate PPE, isolating patients, or providing care during set times (e.g. end of day), will help enable you to provide care
  • Physicians are reminded of their duty to provide care in urgent situations and that redirecting patients to other parts of the system may exacerbate existing and significant resource challenges.
  • Physicians are not expected to tolerate verbal abuse or threats of physical violence and can take appropriate steps in these instances to defer or delay non-emergent care. If a patient uses abusive or threatening language or is physically violent, you also have the option of ending the patient-physician relationship in alignment with the CPSO’s 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 with COVID-19 patients

N95s are recommended, along with eye protection, gloves and gown, when providing care to suspected or confirmed COVID-19 patients. Alternatives to a fit-tested, seal-checked N95 are a non-fit tested N95 or respirator, or a well-fitting surgical mask (if not performing an aerosol generating medical procedure). Airborne precautions continue to be recommended when performing aerosol-generating medical procedures.

The following guidance on the use of PPE is from Public Health Ontario. Individual institutions may also have their own PPE policies above and beyond those recommended here (such as universal masking).

PHO PPE recommendations

  • Surgical/procedure 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 recomeends 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 COVID-19 and other respiratory illnesses should wear a surgical or procedure mask.

If the patient has suspected or confirmed COVID-19, a non-fit tested N95 or equivalent can be provided as an alternative to a surgical mask to them and their accompanying caregiver.

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:

  1. Engage an external fit testing provider. 
  2. 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.

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Resource
COVID-19 guidance: PPE for health-care workers and health-care entities (MOH)
Recommendations for use of PPE for care of individuals with COVID-19 (PHO)

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