Ontario’s Ministry of Health is allowing pharmacies to conduct COVID-19 tests on symptomatic patients for the first time and tests could get underway as soon as this week.

A senior government official told CP24 the program is free for the subject, voluntary and open to any willing pharmacy in the province.

It will involve on-site PCR COVID-19 swab tests as well as a drop-off program for specimens collected at home, similar to the system being implemented at public schools across the province.

An internal document sent to Shoppers Drug Mart pharmacy employees and obtained by CP24 this week says they will be able to accept symptomatic high-risk close contacts of those already diagnosed with COVID-19 and those with symptoms, by appointment only.

“We know there is some anxiousness about this news and want to assure you that the safety of Pharmacy Teams, Patients and customers remains of utmost importance,” a memo sent to Shoppers pharmacists states. “With this in mind, we are working through the support and infrastructure required to enable the safe delivery of symptomatic testing in stores, including access to PPE, space requirements, and the (standard operating procedures) required to deliver this service safely and effectively.”

Staff at pharmacies have been told that up to 138 Shoppers locations already approved to conduct asymptomatic COVID-19 testing could begin offering first appointments for symptomatic individuals as early as Wednesday.

A pharmacist who was not authorized to speak to the media told CP24 they were concerned that bringing symptomatic individuals into a pharmacy setting, which frequently welcomes the elderly and immunocompromised to pick up prescriptions and children too young to wear face masks, presented an unacceptable risk.

They also expressed concern about proper ventilation and air filtration throughout each pharmacy where symptomatic testing will take place.

“Pharmacies need to be safe for seniors, immunocompromised people and parents with unvaccinated little ones, who all need and deserve to get their prescriptions without extra fear of being exposed to COVID. Sending symptomatic people that we suspect have COVID into that setting is going to cause fear and anxiety, and we can only hope it doesn’t result in vulnerable people getting COVID,” NDP Leader Andrea Horwath said in a statement released on Tuesday afternoon. “I’m calling on Doug Ford to pause this new program at least until the risks and safety protocols can be clarified.”

The document from Loblaws, which owns Shoppers Drug Mart, was authored by a senior director in the company’s health and wellness department. It says pharmacies will be able to accept symptomatic patients, provided they wear a mask for the entire time they are within the pharmacy. Staff completing specimen collection will be wearing gowns, gloves, surgical masks and eye protection, with a requirement to don protective items and dispose of them after each interaction with a symptomatic person.

Each participating Shoppers pharmacy will be sent one high-efficiency particulate air (HEPA) filter to run in the enclosed area where symptomatic specimen collection will take place.

The document says pharmacies with space issues will be able to administer vaccines and conduct other duties in the same room as they swab symptomatic patients for COVID-19, provided “required sanitation protocols are followed in between services.”

Staff will not be allowed to swab symptomatic patients outdoors as an added safety measure.

Testing of asymptomatic individuals will be allowed in the same room as symptomatic individuals, provided “the required sanitation protocol is followed.”

If the participating pharmacy cannot spare an enclosed room to conduct specimen collection, they can use “privacy screens to increase overall capacity for services, as long as patient privacy can be maintained.”

The Ministry of Health said it expects specimen collection to occur in a dedicated space, with attention paid to time separation of appointments and ventilation throughout the participating location.

In response to possible customer backlash over the new testing effort, the company says it is “working closely with our communications team to help support messaging for this program and the important role that pharmacies are playing in providing access to testing for Patients, along with the safety precautions that will be in place to protect Associates, their employees, and Patients.”

The Ministry of Health said it expects pharmacies conducting symptomatic testing to have ample signage warning all customers that it is taking place.

Ontario Premier Doug Ford said the public be confident the tests will be done in a safe manner.

“When you walk in, we still have a masking policy in place – they’re going to have dedicated lines going in to the pharmacy – we’re going to throw everything we can at it and I think the pharmacies were one of the saviours during the pandemic.”

“I have confidence they will do a fine job.”

Asked about the plan, Toronto Mayor John Tory said he is supportive of any effort to increase testing, but that safety measures must be followed.

“A lot of it has to relate to common sense and that’s common sense by people but also the businesses that are doing this,” he said. “So one hopes that if this is going to be going on, appropriate precautions are taken to make sure that those who might be more vulnerable are not put in the same place as those who are coming to get tested who might be carrying the virus.”

Other Canadian provinces allow asymptomatic testing at pharmacies, but Ontario appears to be the first jurisdiction in Canada to allow people with symptoms, which often include cough and can sometimes include nausea or vomiting to attend pharmacies for tests.

When asked about the new testing effort, including what is planned to warn other customers about symptomatic tests occurring and whether staff could don respirator masks during specimen collection, Loblaws referred all questions to Ontario’s Ministry of Health.

The Ministry of Health official said the province will soon set up a webpage listing pharmacies participating in the program.