As health care providers and patients adjust to new procedures with the appearance of the coronavirus COVID-19, the Auburn University Harrison School of Pharmacy’s Dr. Spencer Durham, who was named to Gov. Kay Ivey’s Coronavirus Task Force, offers some tips and practices.
Q: What are some best practices for pharmacists to secure their pharmacy and protect themselves and patients?
Durham: Pharmacies and other health care centers are not going to close during the COVID-19 crisis, and pharmacies need to take extra measures to ensure that patients and staff do not acquire the virus. While there are a number of ways to accomplish this, some basic measures can be very helpful. For example, a pharmacy staff member can screen patients for symptoms before they enter the pharmacy. If they are symptomatic, they can be directed to a particular waiting area in the pharmacy, or someone could bring their medications directly to them.
Additionally, some pharmacies are offering curbside pick-up, and drive-thru options should be encouraged. Another suggestion is for pharmacies to place hand sanitizer at the entrance so that patients can use it when they enter and exit to help reduce the spread of germs.
Q: What should I look for in cleaning solutions/materials to make sure I am sufficiently sanitizing?
Durham: There are a number of cleaning products that are effective against COVID-19. The EPA has released a list of products (List N) that have the capacity to kill the virus. If the EPA registration number on the product is on the list, then that product is effective. Some products specify on their label that they are active against coronaviruses, and these products are generally able to be used. Hand sanitizers must be at least 60% alcohol in order to kill COVID-19.
Q: As a health care provider, if I encounter someone I suspect of having COVID-19, what should I do?
Durham: Anyone who has symptoms of COVID-19 should be referred for immediate testing. This can be done by the patient’s primary care provider, who will perform the test and have it sent for evaluation. Additionally, there are a number of sites across Alabama where tests are being performed. Anyone can call the Alabama COVID-19 24/7 hotline at 1-888-264-2256 to learn about testing sites and hours of operation.
Q: What if I want to make hand sanitizer in my pharmacy? How can I do that and where do I look for regulations?
Durham: Commercially available hand sanitizer is already in short supply due to the COVID-19 crisis. During this shortage, pharmacies are able to compound hand sanitizer, and both the FDA and the USP have issued guidance on this process. This can be found on their websites:
- FDA — https://www.fda.gov/media/136118/download
- USP — https://www.usp.org/sites/default/files/usp/document/about/public-policy/usp-covid19-handrub.pdf
Unfortunately, the materials required for compounding may also be in short supply during this crisis.
Q: How should I properly social distance while carrying out my duties?
Durham: Social distancing while performing direct patient care is always a challenge, but there are some basic precautions that can help. In the community setting, patients should be kept six feet away from the pharmacy counter so as to minimize exposure of the pharmacy staff; a line on the floor should be placed to indicate a distance of six feet.
For staff who have to have direct contact with patients, gloves and a mask should be worn, and hand washing should occur before and after every patient encounter. Again, other methods of prescription delivery, such as curbside pick-up and drive-thru windows, should be encouraged to minimize person-to-person proximity.
Q: How have rules and laws changed in the wake of COVID relating to refills and the ability to help patients reduce the number of times they have to get out?
Durham: The Alabama Board of Pharmacy has acted swiftly to allow pharmacists to provide emergency 30-day refills of chronic or maintenance medications. This is important so that patients do not have to go directly to their health care provider for refills and they can practice safe social distancing.
Q: Are there any existing medications that may help patients? Any to avoid?
Durham: There are currently no pharmacologic therapies for the treatment of COVID, and a vaccine is not yet available. A number of drug therapies are under investigation, including hydroxycholoroquine because it is effective against certain other coronaviruses. However, the evidence at this time is limited and it cannot be recommended yet with confidence. Hopefully, more data will be coming out over the next few weeks.
There is also some evidence that NSAIDs, such as ibuprofen, may actually exacerbate COVID-19 symptoms and should be avoided. The evidence for this is also limited at this time, but the current recommendation is that acetaminophen should be used for fever and other symptoms associated with COVID-19 as opposed to NSAIDs.
Q: Do you have any online resources that could help?
Durham: Information related to COVID-19 is changing on a daily basis, so it is important to stay as up-to-date as possible. The CDC website is the best source for the most updated information. The FDA website is also a good source for updated information. From a health care provider standpoint, ASHP has opened many of their resources to providers even if they are not members of ASHP. Finally, the APA website has many resources for pharmacists in the state of Alabama related to the COVID-19 crisis.
Centers for Disease Control and Prevention
American Society of Health-System Pharmacists
This story originally appeared on Auburn University’s website.
