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Table 1 Summary of the risks and recommendations

From: Risks to the community pharmacists and pharmacy personnel during COVID-19 pandemic: perspectives from a low-income country

Risk Category Recommended mitigation measure(s)
Risk of infection from an infected patient walking into the pharmacy High risk i. Use full PPE* [33] for suspected cases as defined by WHO
ii. Notify the Ministry of Health on provided contact details
iii. Disinfect the pharmacy after the Ministry of Health taskforce has taken over
Risk of transmission when providing point of care tests High risk i. Sanitise hands with alcohol-based sanitiser before and after performing the test
ii. Staff performing tasks that result in direct contact with patients should put on full PPE* [33]
iii. All patients walking into the pharmacy to put one mask, cloth mask, or even a homemade mask
Risk from contact with patient personal items such as prescriptions, clinic book, and laboratory results slips High risk i. Use of drop boxes or mobile platform to order drugs
ii. Use of latex gloves when handling items from patients
iii. Use of alcohol-based sanitiser after dispensing [30, 34]
Risk due to high volume of people walking into the pharmacy Moderate risk i. Use of a mobile platform to order drugs from the pharmacy and deliver the drugs [20, 34]
ii. Use of physical barriers on doorways and allowing a few into the pharmacy depending on size
ii. Enforcing social distancing in and out of the pharmacy by placing tape on the floors marking areas patients should stand
iii. Serving patients and customers from the dispensing window
iv. Reduce interaction between pharmacy staff and clients by encouraging payments by mobile platforms
v. All customers being served in the pharmacy to put on masks
Risk of infection when travelling to work Moderate risk i. Staff rotation where staff teams take turns to come to work
ii. Provide masks for staff which should be put on when travelling to and from work
Risk of infection when receiving stock Moderate risk i. Designate days for receiving stock
ii. Staff members responsible for receiving stock to wear mask and latex gloves
iii. After receipt of new stock, staff to wash hands with soap or alcohol-based sanitiser
Risk due to small size of pharmacy and working surfaces Moderate risk i. Serving customers from the window
ii. Staggering the customers that come to pharmacy by allocating time slots to regular customers
iii. Regular cleaning of working surfaces with disinfectant
Risk due to lack of guidance Low risk i. Responsible pharmacy professional and regulatory bodies to issue timely guidance documents
ii. Pharmacist to consult international or regional guidance documents such as WHO guidance
Risk of pressure to dispense off-label drugs Low risk i. Medicines Regulatory Authorities to issue evidence-based timely guidance on the dispensation of chloroquine and other drugs suggested for use in the management of COVID-19
  1. *Full PPE includes a gown, gloves, face mask, and a face shield or goggles