-Sobit Poudel
Novel corona virus is a newly discovered species of corona virus. They are a large family of single-stranded RNA viruses (+ssRNA) that can be isolated in different animal species. First identified in Wuhan city, the capital of Hubei province, China in December 2019, a respiratory illness due to novel corona virus, SARS-coV-2, termed COVID-19, is a pandemic infecting more than 2.8 million population across 210 countries worldwide. Most people infected with the COVID-19 virus will experience mild to moderate respiratory illness and recover without requiring special treatment. Fever (temp more than 100.4 0C), dry cough and fatigue are the most common symptoms followed by Pneumonia and shortness of breathing among later stages of cases. Since the symptoms are similar to flu or influenza, testing is only way to confirm the case. Around two hundred thousand deaths have been associated with this disease and risky populations are elderly or those with co-morbid conditions such as cardiovascular disease, diabetes, chronic respiratory syndromes or immune compromised patients. Pharmacists play an essential and unique role within the healthcare team to optimize patient care during this COVID‐19 pandemic.
Pharmacists and assistant pharmacist at community and hospital pharmacies are first point of contact and frontier health care provider to fulfill patient health care need. They can prevent the spread of the new coronavirus disease by advising the public and supporting the efficient management of infection by healthcare systems. Around the world, pharmacists are making sure that patients, particularly the vulnerable, receive their medicines despite the quarantines and lockdowns. They are continuing to ensure a robust and efficient medicines and medical product 0supply chain, in some cases compounding hand sanitizers themselves to relieve shortages.
In addition community pharmacies also perform whole staff training to provide pharmacy staff adequate knowledge on COVID-19 prevention and control. Guidance on the new workflow and emergency plans during the pandemic shall also be included. Additional clinical training should be provided for pharmacists on the diagnosis and treatment of COVID-19. Pharmacists can be enrolled in areas related to community patient populations, such as patient screening and referral criteria, methods for effective self-protection, counseling points of related medications, chronic disease management of the elderly, home care, psychological support etc.
When performing drug dispensing and patient interaction during the COVID-19 pandemic, pharmacists should pay extra attention to patient's self-protection and emotional situation. Pharmacists should provide consultation on proper self-protection skills or psychological support for the identified patients. In case, the pharmacy is short on a prescription medication, a therapeutic equivalent substitution can be considered for dispensing under patient's agreement to avoid additional traveling to other pharmacies.
Community pharmacy can also establish a collaborate relationship with its surrounding fever clinics and designated COVID-19 medical institutions for mutual patient information sharing during transitions of care. It can happen both ways. At the pharmacy, Pharmacists can make extra efforts to identify suspected patients based on clinical symptoms such as coughing and fatigue, and epidemiological history such as travel history to infected city or its surrounding areas in the past fourteen days. If such patient is identified, immediate isolation in a single room should be performed if possible and pharmacist can encourage and support the patient in seeking immediate medical treatment in designated institutions. On the other side, a 14-day isolated observation at home is recommended for COVID-19 patients discharged from medical institutions as they still have compromised immunity. Pharmacists can offer medication reconciliation, consultation and home care guidance for these patients to support their recovery at home.
Based on the need of community patients during the COVID-19 outbreak, patient education or consulting services can be provided by community pharmacists on disease prevention, COVID-19 early identification, and proper medication use. Scientific prevention and control knowledge of the COVID-19 can be provided to community patients through a variety of approaches. The content of such education should include but not limit to the selection and proper use of masks, hand hygiene, respiratory hygiene, selection and safe use of disinfection products, self-protection strategies outdoors and at the office.
Pharmaceutical care during the COVID-19 outbreak should possess different properties due to disease characteristics and related change in patients' need. Community pharmacies work as a strong supporter of patient's medication and protective equipment supply. Community pharmacists should be prepared to provide skilled and effective patient counseling services for patients to ensure medication safety and promote the overall COVID-19 pandemic control.
-Sobit Poudel
QA Officer
Quest Pharmaceuticals Pvt. Ltd