Queensbury, NY—In early March, a pharmacist working at the CVS Pharmacy in Queensbury, New York, tested positive for COVID-19. That, and some other situations around the country, have reminded pharmacists of the risk they and their staffs face showing up for work every day.

In a press release, CVS said the Warren County, New York, Health Department informed the company that pharmacy patients are considered to be at low risk and the prescriptions dispensed from the drugstores do not represent a risk to customers.

“As a matter of precaution, we are assisting the state and county health departments contact patients who received prescription medication on the days our pharmacist worked at this location (March 2 and March 4) so that they can monitor their health and, if they choose, return and replace medications they were dispensed on those days,” according to the press release.

The company said the pharmacist and his coworkers who were exposed were placed under quarantine consistent with CDC prevention guidelines and put on paid leave. In addition, the store, which reopened on March 8, was closed for cleaning in order to disinfect and sterilize the premises following established protocols and CDC guidelines.

In another case, a civilian employee at Redstone Arsenal near Huntsville, Alabama, tested positive for coronavirus. The facility identified the patient as a civilian who works for the pharmacy at Fox Army Health Center on Redstone Arsenal. Employees there self-quarantined.

Concerns also were raised about pharmacists who attended the Great Lakes Infectious Disease Conference earlier this month at Ferris State University’s College of Pharmacy in Grand Rapids, Michigan.

According to a Ferris State press release, a conference attendee tested positive for the virus. The college urged everyone at the conference to self-isolate or self-monitor through March 21.

All of this has intensified the question of what pharmacists can do to protect themselves and their staffs.

Recently, the Washington State Pharmacy Association (WSPA) issued guidance on some effective strategies. Washington has had more time than most states to develop such plans, having announced the first confirmed case of COVID-19 in the United States in January.

“Pharmacies are essential to the health of Washington State residents, as timely and accurate medication delivery is foundational to the treatment of acute and chronic diseases,” the WSPA said in a statement. “Therefore, it is essential that we maintain the health of pharmacy staff so that pharmacies can maintain their operations.”

Among the suggestions is that pharmacies should implement strategies to prevent person-to-person transmission of infection.

Frequent, effective handwashing, use of hand sanitizer, and wiping frequently touched surfaces with an EPA-approved biocide should be common practices, according to the guidance, and staff is advised to maintain a distance greater than 3 feet from patients, and greater than 6 feet for patients actively coughing.

The WSPA also advises that pharmacists explain to customers the importance of sick patients staying home, sending a friend to the pharmacy instead, or using the drive-through when possible. It adds that, currently, “SARS-CoV-2 virus has a relatively low estimated transmission rate of 0.5% in the general public.”

The guidance also urges that all pharmacies develop a contingency plan to stay open with high absenteeism due to illness. Unless at risk for severe illness, they do not need to be tested for COVID19 or seek care, according to the CDC.

In Ohio, the Department of Health Director Amy Acton, MD, MPH, strongly recommended that all pharmacies immediately take the following actions:
• Use calming and reassuring language when patients ask for information.
• Have a fact sheet available to answer questions from patients on prescription refills, emergency supplies, payer coverage of medications, and other prescription-related information.
• Encourage people to buy cold medicines now, so they will not have to go out if they develop COVID-19.
• Establish a process for older adults, pregnant women, and individuals with chronic health conditions to pick up medications without waiting in line.
• Report unusual patient complaints, surges in symptoms of fever, cough, or respiratory distress, or surges in sales volumes of cold and flu medications, OTC pain killers, or hand sanitizer.
• Implement infection control procedures, especially for clinic waiting areas:
a) Make sure staff maintain a distance of 3 feet from asymptomatic patients and at least 6 feet from those actively coughing.
b) Regularly clean and disinfect counters, waiting areas, and other spaces where public interaction occurs with an EPA-approved disinfectant. Clean at least every hour or after every 10 patients, whichever is more frequent.
c) Place alcohol-based hand sanitizer next to the checkout window so people can sanitize their hands after using common items, like the pen used to sign for prescriptions.
• Monitor all staff for sickness regularly. Take temperatures once per shift and send them home if they have symptoms of a respiratory infection.
• Update sick leave policies to place employees on sick leave if a family member is sick and to develop a post-illness return-to-work procedure.
• Provide recommended actions for unprotected exposures (e.g., not using recommended personal protective equipment, an unrecognized infectious patient contact).
• Know your active standing orders, collaborative practice agreements, and memorandums of understanding. Know the most up-to-date timelines on when you may be receiving certain capabilities or products (vaccines, therapeutics, testing).

The group has created a COVID-19 Checklist for Pharmacies available here: 

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