Objective: COVID-19 challenged information exchanged globally, including interlibrary loan (ILL) procedures and processes. This research focused on resource-sharing networks used by Health Sciences Libraries (HSL) before and during the COVID-19 pandemic to identify changes in ILL and Document Delivery (DD) processes both in lending and borrowing. Methods: From nine academic and association HSL who had participated in a prior study of DOCLINE usage, researchers requested institutional-level de-identified data on ILL and DD during the early pandemic period March-August 2020 and the comparison period of March-August 2019. We compared the journal article request data with previously reported findings from DOCLINE aggregated data. Results: Regarding the number of requests from the nine institutions, five saw a decrease, while four saw an increase. The average rate of journal borrowing decreased by 67.1% (standard deviation (SD) 31.7%) per library, and lending decreased on average by 44.7% (SD 68.2%) per library. Document delivery, on average, decreased by only 1.9%, though this varied widely (SD 45.5%). ??For the data on monographs loaned during the pandemic, there was a predominance of single request titles unfilled across 2019 and 2020 (n = 1631; 93.5%). Conclusion: The predominance of single request titles unfilled during the pandemic when libraries limited their sharing of physical materials argues for a deeper exploration of controlled digital lending of materials held in print. The findings across this study and its related investigations (Lloyd et al., 2022; Bakker et al., 2023) on the impact of the pandemic on resource sharing can inform and enhance preparedness planning, future resource sharing workflows and messaging, budgeting, evidence-based collection development, and dialog with content copyright holders about digitization priorities.