Considerations for Pharmacies during the COVID-19 Pandemic

Advise staff who are sick to stay home

Make sure that pharmacy staff who have fever or respiratory symptoms stay home and away from the workplace until they have recovered. Ensure that sick leave policies are flexible, nonpunitive, and consistent with

Filling prescriptions

Although the actual process of preparing medications for dispensing is not a direct patient care activity, the other components of medication dispensing such as prescription intake, patient counseling, or patient education may expose pharmacy staff to individuals who may have respiratory illness. In addition to following workplace guidance, pharmacy staff should:

• Provide hand sanitizer on counters for use by customers and have sufficient and easy access to soap and water or hand sanitizer for staff.
• Encourage all prescribers to submit prescription orders via telephone or electronically. The pharmacy should develop procedures to avoid handling paper prescriptions, in accordance with appropriate state laws, regulations, or executive orders.
• Filling and dispensing prescriptions does not require use of PPE. After a prescription has been prepared, the packaged medication can be placed on a counter for the customer to retrieve, instead of being directly handed to the customer. Other strategies to limit direct contact with customers include:
  • Avoid handling insurance or benefit cards. Instead, have the customer take a picture of the card for processing or read aloud the information that is needed (in a private location so other customers cannot hear).
  • Avoid touching objects that have been handled by customers. If transfer of items must occur, pharmacy staff should wash their hands afterwards with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer containing at least 60% alcohol. They should always avoid touching their eyes, nose, or mouth with unwashed hands.

Use strategies to minimize close contact between staff and customers and between customers:

• Use engineering controls where the customer and pharmacy staff interact, such as the pharmacy counter, to minimize close contact:
  • Minimize physical contact with customers and between customers. Maintain social distancing (6 feet between individuals) for people entering the pharmacy as much as possible. Use signage/barriers and floor markers to instruct waiting customers to remain 6 feet back from the counter, other customer interfaces, and from other customers and pharmacy staff.
  • To shield against droplets from coughs or sneezes, install a section of clear plastic at the customer contact area to provide barrier protection (e.g., Plexiglas type material or clear plastic sheet). Configure with a pass-through opening at the bottom of the barrier for people to speak through or share items, if feasible.
  • Frequently clean and disinfect all customer service counters and customer contact areas. Clean and disinfect frequently touched objects and surfaces such as workstations, keyboards, telephones, and doorknobs. To disinfect, use products that meet EPA’s criteriaexternal icon for use against SARS-CoV-2, the virus that causes COVID-19, and are appropriate for the surface .
  • Discontinue the use of magazines and other shared items in pharmacy waiting areas. Ensure that the waiting area is cleaned regularly.
  • For pharmacies with a co-located retail clinic, use signs to ask customers who have respiratory symptoms to wait for their appointment in a specific part of the store.
  • Promote the use of self-serve checkout registers and clean them frequently. Have hand sanitizer and disinfectant wipes at register locations for use by customers.

• Use administrative controls — such as protocols or changes to work practices, policies, or procedures — to keep staff and customers separated:
  • Promote social distancing by diverting as many customers as possible to drive-through windows, curbside pick-up, or home delivery, where feasible.
    • Large, outdoor signage asking customers to use the drive-through window or curbside pick-up can be useful.
    • Include text or automated telephone messages that specifically ask sick customers to stay home and request home delivery or send a well family member or friend to pick up their medicine.
  • Limit the number of customers in the pharmacy at any given time to prevent crowding at the pharmacy counter or checkout areas.
  • Pharmacists who are providing patients with chronic disease management services, medication management services, and other services that do not require face-to-face encounters should make every effort to use telephone, telehealth, or tele-pharmacy strategies.
  • Close self-serve blood pressure units.

Reduce risk during COVID-19 testing

In the “CDC Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings,” there is guidance for collecting respiratory specimens.

Pharmacy staff conducting COVID-19 testing and other close-contact patient care procedures that will likely elicit coughs or sneezes (e.g., influenza and strep testing) should be provided with appropriate PPE. Staff who use respirators must be familiar with proper use and follow a complete respiratory protection program that complies with OSHA Respiratory Protection standard (29 CFR 1910.134). Staff should also have training in the appropriate donning and doffing of PPEpdf icon.