At Kristen's Pharmacy in Southampton, Ont., the day begins with staff shuffling in for their COVID-19 symptom screenings, temperature checks and daily rapid tests. Doors and phone lines open at 9 a.m., and from then until roughly noon, it's "utter pandemonium," according to owner and pharmacist Kristen Watt.
Eight phones ring off the hook; the pharmacy takes both walk-ins and appointments; people drive from 70 kilometres away because they can't get a slot at their local COVID-19 testing site.
Pharmacy workers across the country are struggling with what has become an unbearable workload, particularly in recent weeks, as provinces speed up the rollout of COVID-19 vaccine boosters and ramp up the distribution of rapid tests — all to fight the Omicron variant.
At pharmacies where patients can get vaccinated, tested and pick up a rapid-test kit, the influx of walk-ins, phone calls and demand for appointments has been non-stop. The stack of paperwork that piles up with every test and shot can take hours to fill out.
And that's all on top of a pharmacist's ordinary, non-pandemic duties.
"There's no other way to put it right now: We are just burnt out," Watt said.
"We are dealing as much as we can with everything we can, because on top of all this COVID stuff, our regular job of being pharmacists and dispensing medications and taking care of our patients hasn't changed."
Sudden eligibility changes 'ill-advised,' says pharmacist
There was a lull in pharmacy activity in Ontario in the fall, when 90 per cent of the province's eligible population was vaccinated and boosters were not yet available to the wider public, said Justin Bates, CEO of the Ontario Pharmacists Association.
What's happening now is what he refers to as the "peak of the surge." There's enough vaccine for everyone, but the volume of demand means that getting a jab in every arm will take time.
Since February, community pharmacies across Canada have administered 12 million doses of COVID-19 vaccine — including first, second, third and pediatric shots, according to a report released earlier this month by the Neighbourhood Pharmacy Association of Canada and Canadian Pharmacists Association.
Though drugstores are capable of delivering a vaccination service, it's up to the provinces to give notice when there are changes in eligibility requirements. And eligibility requirements have been in near-constant evolution in recent weeks.
Pfizer's pediatric vaccine was approved for children aged 5 to 11 on Nov. 19. Then, several provinces expanded booster eligibility to those over 50 — only to expand it to those over 18 shortly after. On Dec. 15, Ontario slashed the required interval between second and third shots in half, giving even more people eligibility for booster appointments.
(That's not to mention the introduction of a free rapid-test kit handout program in Alberta and Quebec pharmacies, where doorways are plagued by long lines and demand outweighed supply.)
WATCH | Pharmacists describe burnout, high demand at pharmacy locations across Canada:
In Ontario, the changes might have been manageable with advance warning — but pharmacists say the province often announces its plans to the public before informing them of any changes.
"I feel privileged to help," said Toronto pharmacist Kyro Maseh. "The problem is with the sudden expansion of eligibility [comes a] sudden surge, sudden demand. That was ill-advised, in my opinion, and is unmanageable during this time of the year when everyone is taking [time] off."
Maseh says his pharmacy, Lawlor Pharmasave, is currently prioritizing booster shots for those over 50.
Bates believes the government can help by offering financial support to pharmacies, supporting workers with mental health resources and reducing the administrative workload.
Pharmacies under pressure to help fight new variant
Pharmacies are typically the most accessible health-care provider for Canadians, said Danielle Paes, chief pharmacist officer of the Canadian Pharmacists Association (CPA).
"We're able to care for so many Canadians," she said. "But it also poses a bit of a challenge because we are so accessible, and so we have many, many people just picking up the phone or walking into the pharmacy."
That's led to a countrywide burnout problem with pharmacies — many of them small businesses, she noted. Most are completely overwhelmed and lacking the capacity to meet current demands.
WATCH | Pharmacist says it's unfair for pharmacies to shoulder burden of vaccine rollout:
Canadians trust pharmacies to provide COVID-19-related health care, according to data collected by the CPA.
A November 2020 survey of 1,500 Canadian residents found that the majority agree pharmacists know how to safely administer a vaccine, that pharmacists are knowledgeable about vaccines, and that pharmacies are both a safe and sufficiently private place to get vaccinated.
The flip side is that in many cases, community pharmacies have become the first point of contact for all things COVID-19. And the sheer volume of work has maximized in recent weeks as provinces introduce new measures to halt the spread of the Omicron variant.
"I think I'm more tired this week than I have been the entire pandemic," said Watt, who ran a 1000-shot drive-in clinic on Sunday.
With cold and flu season also underway and holidays approaching, the surge in vaccine delivery has made this an especially challenging period for pharmacy workers.
At Maseh's pharmacy, staff are skipping lunch and working on holidays to meet the demand.
"A lot of people are not able to take time off anymore. A lot of people are opening up early, staying late. And that, in my opinion, is not a fair thing to do," said Maseh. "This is not a way to reward health-care professionals that were there helping out from the beginning."