FAQs: COVID-19

• Do physiotherapists still need to perform COVID-19 screens with patients?

  While the Ministry of Health no longer requires PTs to complete the Ministry's COVID-19 patient screen, the College's Infection Control and Equipment Maintenance Standard requires physiotherapists to identify and minimize any risks caused by infections in their practice.

  Physiotherapists must use current and generally-accepted infection prevention and control measures that are relevant to their practice setting. This requires physiotherapists to:

   •  Maintain current knowledge of infection prevention and control measures

   •  Consider the risks of transmission among patients, self, other health professionals, and staff before each patient interaction

   •  Incorporate the appropriate infection prevention and control measures based on the risks of transmission

   •  Ensure that there are appropriate written infection prevention and control protocols in their practice setting

  PTs or their employers may choose to use the Ministry of Health COVID-19 Patient Screening Guidance document as part of their risk assessment. If a physiotherapist does not use the screen, they will need to determine how they will gather the necessary information to determine the level of risk of COVID-19 or other infection and what actions should be taken to reduce risk e.g. using appropriate PPE, delaying in-person care, etc. 

  Also review the Interim Infection Prevention and Control Measures based on COVID-19 Transmission Risks in Health Care Settings from Public Health Ontario for more information.

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• Do patients have to wear masks? Can I refuse treatment if they don’t wear a mask?

  Physiotherapists should follow guidance from the Infection Control and Equipment Maintenance Standard, which states that physiotherapists must use current and generally-accepted infection prevention and control measures that are relevant to their practice setting. Public Health Ontario recommends universal masking in all healthcare settings while COVID-19 continues to circulate in our communities.
  
  

  If the patient does not want to wear a mask, the PT should be sensitive to that. Some patients may have a medical condition and have difficulty tolerating a mask. 

  Discuss why a mask is recommended and provide them with alternatives if appropriate. Consider adaptations to practice, rather than refusal to provide care. Virtual care may be more appropriate for this patient at this time or other alternatives such as a home exercise program. 
   
  If the options above are considered and all possible adaptations have been refused, you can opt to not treat the patient without a mask. Document your conversation and the options provided to the patient in the patient record.  
   
  Providing or Refusing Care Standard 

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• Can I restrict in-person care to only vaccinated patients?

  No. In-person care can be provided safely — even in the absence of a negative test result or vaccination — by taking appropriate precautions, including screening patients and using necessary PPE. 
   
  While you can encourage eligible patients to follow Public Health’s advice to be vaccinated, patients cannot be denied access to necessary in-person care based solely on their vaccination status. Safety concerns can be mitigated by ensuring the correct safety precautions are in place. 

  In rare circumstances where you cannot provide in-person care to the patient, ensure the appropriate steps are taken to ensure access to care. This includes:  

   •  Using virtual care to provide what you can or help triage and re-direct patients as needed. 

   •  Coordinating with colleagues to help provide coverage for in-person care. 

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• Can I ask my patients if they have been vaccinated?

  On August 26, 2021, the Ministry of Health updated their Patient Screening Guidance Document to include asking as a background question “Did the person receive their final (or second) vaccination dose more than 14 days ago?” 

  A patient’s vaccination status is their private and personal health information, and they can choose to share that information with you or not. 

  If a patient chooses to not share their vaccination status with you, you should assume the answer to the background question is ‘no’ and proceed with the screening questions as directed.   

  Review the updated COVID-19 Patient Screening Guidance Document. 

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• What do I need to consider with regards to screening when working with children in schools?

  The Ministry of Health has removed their COVID-19 guidance for health care providers working as primary care providers as well as in schools.  

  In the absence of direct guidance from the MOH, we rely on our Infection Control and Equipment Maintenance Standard which states that physiotherapists must use current and generally-accepted infection prevention and control measures that are relevant to their practice setting. This requires physiotherapists to:

   •  Maintain current knowledge of infection prevention and control measures 

   •  Consider the risks of transmission among patients, self, other health professionals, and staff before each patient interaction 

   •  Incorporate the appropriate infection prevention and control measures based on the risks of transmission

   •  Ensure that there are appropriate written infection prevention and control protocols in their practice setting

  A physiotherapist should consider performing a Point of Care Risk Assessment prior to providing any in-person care.  If a physiotherapist is unable to confirm an active negative screen, this should be considered when choosing the appropriate PPE to wear while providing care. 

  IPAC Guidance on use of PPE and COVID 

   

   

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