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Sample List of Potential Pharmacy Public Health Roles at the Local or State Levels*

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Preparation Category Prepare for Cause Issues
PATIENT CARE
  Patient/visitor surge Patients may seek other sources of care and information if local hospitals closed or under quarantine

-Adjust staffing to handle increased traffic, phone calls, and other electronic communications (e.g., social media)

-Manage staff to accommodate revised or expanded responsibilities with appropriate sleep/rest cycles

-Prepare information for patients/visitors for education and awareness programs

- Report patient surges to key facility staff and public health officials

  Sicker patients Patients may be sicker than usual but barred from hospitals

-Review latest CDC information for education and awareness programs

-Help triage patients in accordance with institution emergency preparedness plan

-Inform key facility staff and contact local/state health departments for latest guidance and instructions (e.g., home quarantine)

  Worried well Patients who have respiratory symptoms but no history of exposure

-Provide information and reassurance through education and awareness programs

-Remind patients to get influenza vaccine for the 2019-2020 season if they have not already

  Requests for ineffective prevention and treatment options Remedies for self-treating COVID-19 may be requested by patients even though they are not effective Provide patients with most current treatment and prevention information.
  Team-based care Interprofessional expertise needed

-Collaborate with key players (e.g., microbiologist) and communicate on interprofessional issues needed to optimize patient care

-Be proactive and flexible in assuming new responsibilities within a pharmacists scope of practice

Preparation Category Prepare for Cause Issues
COMMUNICATION AND INFORMATION
  Challenges securing anticipated stocks of medications and supplies Supply chain disruption

-Report unusual sales volumes for medications or patient complaints

-Determine mechanisms for obtaining drugs not available on market (e.g., emerging investigational therapies) during regular and off-hours

-Report supply chain issues (e.g., drug shortages, PPE) to key facility staff and contact local/state health departments

  Requests to dispose of potentially contaminated medications Family members of potential Coronavirus cases may have unused medications they want to throw away Determine local/state health department recommendations for disposing of unused medication products that had been dispensed to a COVID-19 infected patient
Preparation Category Prepare for Cause Issues
PHARMACY OPERATIONS
  Rapid response kits Timely access to treatment

-For supportive care and as investigational therapies emerge, prepare rapid response kits containing information such as management algorithms, drug dosing and administration guidelines, and pharmacist contact numbers

-Make kits available in relevant patient care units such as emergency departments and intensive care units

  Leadership in medication use and safety Safe patient care Ensure that appropriate education and drug administration and dosing guidelines are available to guide medical, nursing, and pharmacy staff
  Revenue cycle management Fiscal solvency Drug waste tracked and reported to finance department to be considered for reimbursement by government (e.g., unused drug taken into isolation room discarded in a biohazard container)
Preparation Category Prepare for Cause Issues
INFECTION PREVENTION AND CONTROL
  Requests to dispose of potentially contaminated medications and supplies Family members of potential COVID-19 cases may have unused medications they want to throw away Determine local health department recommendations for disposing of unused medication products and supplies that have been dispensed to a COVID-19 patient (NOTE: The coronavirus is known to live on surfaces for hours or days, but it is also effectively killed by available disinfectants when properly used.)
  Policies and procedures Integrity of drug supply Develop or revise policies and procedures pertaining to drug delivery to meet infection control precautions
  Protecting workforce from exposure

-Healthcare workers are highly likely to become infected if they work closely with a COVID-19 patient

-Limiting exposure time and closeness can help prevent infection

-Orient and education workforce regarding infection control precautions

-Use standard and respiratory precautions

-Handle items associated with potentially exposed COVID-19 patients while wearing gloves

-Frequent hand washing

-Use face masks if counseling coughing or feverish patients

- Ensure that appropriate pharmacy staff have been medically cleared, fit-tested, and trained for respirator use.

-Use telephone for counseling

-Drop off prescriptions at home

-Bill via credit card to avoid handling checks or money

  Monitoring pharmacy staff -Fever, cough, and shortness of breath are early signs and symptoms of COVID-19

-Be prepared to take temperature of workers once a shift

-If fever, cough, and shortness of breath are present, send worker to designated COVID-19 clinic site

-If a family member is sick, put employee on sick leave

-Notify occupational health services

*Source: Adapted from Tables 3.5 and 3.6 (ASHP Pharmacy in Public Health: Basics and Beyond)

References:

CDC 2019 novel coronavirus resources: www.cdc.gov/coronavirus/2019-ncov/index.html

WHO: www.who.int/emergencies/diseases/novel-coronavirus-2019

Pharmacotherapy 2004;24(6):705-712

Ong SWX, Tan YK, Chia PY, et al. Air, surface environmental, and personal protective equipment contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a symptomatic patient. JAMA. Published online March 4, 2020. doi:10.1001/jama.2020.3227