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Interim guidance for community pharmacies on COVID-19, including prevention of infection. For further information on infection prevention and control, please refer to the NSW Health and Clinical Excellence Commission websites.
On March 19 2020 the Commonwealth Government announced that community pharmacists will be required to enforce new limits on the dispensing and sale of selected prescription and over-the-counter medicines. This new measure was adopted to ensure equitable access to medicines for all Australians in light of the observed increases in demand for medicines due to the COVID-19 pandemic. The decision was developed in consultation with, and supported by the Pharmacy Guild of Australia and the Pharmaceutical Society of Australia and received support from the National Pharmaceutical Services Association.
Community pharmacists are now required to:
In addition, pharmacists are strongly encouraged to limit dispensing and sales of all other medicines to one months’ supply or one unit. Dispensing of multiple repeats is permitted only for valid Regulation 49 prescriptions. PBS Regulation 49 must be used sparingly and only in exceptional circumstances in accordance with the legislated criteria. If pharmacists have doubts about the appropriateness of particular Regulation 49 prescriptions they should discuss this with the prescriber.
Limits on pharmacy sales will be accompanied by limits on orders from wholesalers, to ensure equitable distribution of stock, including to regional and rural pharmacies.
Supply of quantities that are not clinically required for an individual may be illegal under the NSW Poisons and Therapeutic Goods Regulation (S 23, 34, 79) and contravene Pharmacy Board Professional Practice guidelines.
For practical advice for pharmacists for managing the supply of medicines in the pandemic and assisting patients in home isolation and for social distancing, refer to Advice for pharmacists for managing the supply of medicines in the pandemic and assisting patients in home isolation. A one-page summary is also available.
When someone who has Coronavirus Disease 2019 (COVID-19) coughs or exhales, they release droplets of infected fluid. Most of these droplets fall on nearby surfaces and objects – such as benches or telephones. People could become infected with COVID-19 by touching contaminated surfaces or objects – and then touching their eyes, nose or mouth. If they are standing within 1.5m of a person diagnosed with COVID-19 they could become infected by breathing in droplets coughed out or exhaled by the infected person. In other words, COVID-19 spreads in a similar way to all respiratory viruses like the common cold and influenza.
Most persons infected with COVID-19 experience mild symptoms and recover without medical intervention. However, some go on to experience more serious illness and may require hospital care. Risk of serious illness rises with age: people over 40 seem to be more vulnerable than those under 40. People with weakened immune systems and people with chronic conditions such as diabetes, heart and lung disease are also more vulnerable to serious illness or complications.
Infection prevention and control precautions for COVID-19 will also help prevent the spread of other common infections which present to pharmacies and protect your patients and staff. Community pharmacies are recommended to implement these precautions and hygiene measures as soon as practicable.
On presentation to the pharmacy, the symptomatic patient should:
Pharmacy staff are advised to not wear face masks (neither surgical masks or P2/N95 respirator masks) as a precautionary measure. P2/N95 respirator masks are not required to be worn by patients unless they are immunocompromised and have been directed to do so by their treating specialist. Unless masks are used correctly they are unlikely to protect against airborne pathogen spread.
Regular environmental cleaning in the pharmacy is important for reducing the risk of transmission of pathogenic organisms, it is particularly important in containing the risk of spread of COVID-19. Contamination on surfaces touched by staff and patients is one of the main ways that COVID-19 spreads.
Pharmacy staff can ensure that the pharmacy is clean and hygienic by cleaning surfaces using a detergent and disinfectant. This can be either by a 2-step cleaning/disinfecting process, or using a product that combines both steps.
There are no additional controls required for disposing of waste, follow routine processes for disposal. Ensure closed bins are provided for safe disposal of tissues by staff and patients.