Being the most accessible healthcare professionals in our society during the COVID-19 pandemic has its tolls on pharmacies and their staff. Even in countries on complete lockdown, grocery stores and pharmacies remain open. While this is our time to shine and show our commitment to serving the public, it is also important that we are protecting ourselves and our pharmacy staff at the same time.

With limited supplies, as hand sanitizers, disposable gloves and face masks, are shorted, it has become even more difficult for pharmacies to ensure that they are operating under sanitary conditions.

Here are some practices I have incorporated in my pharmacy to help reduce our personal risk of catching COVID-19:

1. Wash your hands with soap. All. the. time.

Of course, the number one recommendation from WHO, the CDC, and all other healthcare organizations is my first suggestion. Hand washing and wiping surfaces (e.g. with rubbing alcohol) is essential:

• After serving a customer, even if you don’t believe any physical contact was made
• After touching the surface of any item that is commonly touched by others, including:
  • Counters (e.g. pick-up and drop-off)
  • Credit card machines
  • OTC items
  • Door handles
  • Keyboards and mouse
  • Phones
  • Pens (try keeping a pen on you to avoid sharing pens)
• After receiving any item from a customer, such as:
  • Prescriptions
  • MONEY
  • Parcels
  • Envelopes
• Before touching your face (e.g. for an itchy nose)
• Before eating anything (even popping a tic-tac or piece of gum)

The recommendation is to wash your hands with soap for at least 20 seconds (i.e. singing Happy Birthday twice). If soap and water is unavailable, use a hand sanitizer that contains at least 60% alcohol. For sanitizing surfaces use soap and water, rubbing alcohol, alcohol swabs, or cleaning/disinfectant supplies (e.g. Lysol).

Hand sanitizers are hard to come by these days. Here is a recipe provided by WHO and approved by the FDA to make your own hand sanitizer:

ETHANOL BASED (1000 mL formula):

ISOPROPYL ALCOHOL BASED (1000 mL formula)

2. Keep a good “social distance” from patients.

It is currently recommended to avoid close contact with people by maintaining a 6 foot distance from others. In your pharmacy, ensure that you are talking to patients behind a counter. Commonly, pharmacists tend to lean into the counter to be closer to patients while counselling on medications. Avoid this practice by stepping a few inches behind the counter.

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If a patient is requesting OTC medications, gather all information at the counter, then retrieve the medication yourself from the shelf while the patient waits at the counter. This will allow you to avoid coming into close contact with the patient, and will prevent them from covering more ground within the pharmacy.

Remember to wash your hands after each encounter with a patient.

3. Reduce traffic into your pharmacy.

People are still visiting different pharmacies hoping to find hand sanitizers, face masks or toilet paper available. To avoid unnecessary traffic, post signs outside the pharmacy stating that those items are unavailable.

Consider increasing delivery services to patients instead of having them pick up their prescriptions at the pharmacy. To protect delivery drivers as much as possible, check with the patient if the medications can be left outside their door.

If feasible, offer weekly blister pack patients at least 1 month’s supply of their blister packs. To help manage this increased workflow during the initial changes of preparing multiple blister packs per patient, try staggering the changes over the next few weeks. Also consider discussing with patients switching to vials if they are capable of managing their medications over the next few months.

NOTE: This is not a recommendation for stockpiling of medications. A one month supply of medications for patients who are due for refills is reasonable to reduce the number of visits a patient needs to make to the pharmacy in the upcoming months. Unreasonably early refills and requests for unnecessarily large amounts of medications should be avoided.

4. Avoid sending patients for unnecessary physician visits.

Patients should not have to visit their physician or other prescribers for a renewal of their chronic medications. If a physician refuses fax renewals or verbal orders, consider renewing a prescription via adaption (if allowed under your province’s regulations) or providing an emergency supply of medication. Remember to document sufficiently your reasoning for doing so.

Having patients avoid physician visits will protect them from potentially acquiring the virus from sick patients at the clinic, which will also in turn protect the pharmacy staff when they come into contact with the patient and their hardcopy prescription. It will also ease the strain on the health care system by allowing physicians to see patients with urgent and pressing concerns requiring a physical visit.

5. Stay as healthy as possible!

To keep your own immune system up, remember to stay healthy. Exercise (at home preferably – avoid gyms), eat nutritious, balanced, healthy meals and take breaks whenever you can.

Pharmacies are very busy right now, and pharmacy staff are under a lot of pressure to meet the demands from the public. Make sure to unwind when you get home to take a mental and physical break from the stress of work. Also ensure that you are getting enough sleep.

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Wishing all pharmacists the best during this time.

Do you have any tips for pharmacists to protect ourselves from COVID-19 while working in community practice? Drop a comment below.