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Quick to Action Against the Coronavirus 2019-nCoV Outbreak

作者2020-04-09 09:14未知
Journal Pre-proof
 
Community pharmacist in public health emergencies: Quick to action against the coronavirus 2019-nCoV outbreak
 
Carolina Oi Lam Ung
 
PII: S1551-7411(20)30118-2
DOI: https://doi.org/10.1016/j.sapharm.2020.02.003 Reference: RSAP 1447
 
To appear in: Research in Social & Administrative Pharmacy
 
Received Date:  9 February 2020
 
Accepted Date:  9 February 2020
 
 
Please cite this article as: Lam Ung CO, Community pharmacist in public health emergencies: Quick to action against the coronavirus 2019-nCoV outbreak, Research in Social & Administrative Pharmacy (2020), doi: https://doi.org/10.1016/j.sapharm.2020.02.003.
 
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© 2020 Published by Elsevier Inc.

 
 

Community Pharmacist in Public Health Emergencies: Quick to Action Against the Coronavirus 2019-nCoV Outbreak

 
Carolina Oi Lam Ung carolinaung@um.edu.mo
State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, Room 2058, N22 Building, University of Macau, Taipa, Macao

 
 

Community Pharmacist in Public Health Emergencies: Quick to Action Against the Coronavirus 2019-nCoV Outbreak

 
 Abstract: 
       The 2019-nCoV infection that is caused by a novel strain of coronavirus was first detected in China in the end of December 2019 and declared a public health emergency of international concern by the World Health Organization on 30 January 2020. Community pharmacists in one of the first areas that had confirmed cases of the viral infection, Macau, joined the collaborative force in supporting the local health emergency preparedness and response arrangements. This paper aimed to improve the understanding of community pharmacists’ role in case of 2019-CoV outbreak based on the practical experiences in consultation with the recommendations made by the International Pharmaceutical Federation on the Coronavirus 2019-nCoV outbreak.
Keywords: 2019-nCoV, outbreak, community pharmacy, pharmacist, Macau
 
      Macau confirmed its first case of the 2019-nCoV infection on 22 January 20201 and as of 8 Feb2020, there were 10 confirmed cases in the city2. The 2019-nCoV is a novel strain of coronavirusthat  was  first  detected  in  the  city  of  Wuhan,  in  the  province  of  Hubei  China.  With casesconfirmed earlier in its neighboring cities of Shenzhen and Zhuhai in mainland China, the smallcity is vulnerable to the spread of the virus and has escalated the health emergency preparednessand response arrangements soon after the reports about a cluster of pneumonia-like illnesses withunknown causes in Wuhan came into light in the end of December 2019. On 5 January 2020, thelocal government swiftly took the lead in coordinating and communicating actions across varioussectors.3 To support infection prevention and control overseen by the health department,departments of economy and finance, police service and customs, information, tourism, gaming,social welfare, consumer protection, municipal affairs, education formed partnerships to step upborder control and surveillance, execute isolation and quarantine measures, promote personaland environmental hygiene, ensure medical and daily supply stability and monitor the pricing,deliver public and tourist education, and disseminate accurate up-to-date information on a unified platform. This  echoed the recommendations  made in the 2019 Novel Coronavirus  (2019-nConV):   Strategic    Preparedness    and   Response    Plan    published   by   the    World Health Organization on 3 February 2020.4 During the previous 6 weeks, the stages of “preparedness”,“high risk of imported cases”, “imported cases” and possibly “local transmission” in an infection outbreak had been experienced (Figure). The highest alert is now on to try to avoid or minimize the last stage of “community transmission”, a highly challenging task considering the possible existence of super spreaders.5
 
      At a professional level, while many doctors and nurses were fighting the uphill battle in the frontline, pharmacists at community settings also played an important part in the prevention of the spread of the 2019-nCoV outbreak and contributed to the overall emergency management. Apart from ensuring the stable supply of key medicines and becoming the information hub about the coronavirus infection, being the most common first point of contact, community pharmacists were also charged with the responsibility of early detection and appropriate referral. They also played a key role in implementing the government arrangement of “The Guaranteed Mask Supply for Macao Residents Scheme” which highlighted the importance of public-private partnerships and data exchange at times of emergency. On 30 January 2020, the World Health Organization (WHO) declared the emergence of 2019-nCoV, a public health emergency of international concern calling on all countries to take urgent measures to contain the respiratory disease6 as the spread has already extended to at least 24 countries7. It is speculated that pharmacists in many cities and countries are finding their ways to contribute to the collaborative forces   in   combating   the   spread   of   the   virus.   On   5   February   2020,   the   International Pharmaceutical Federation (FIP) issued the “Coronavirus 2019-nCoV outbreak: Information andinterim guidelines for pharmacists and the pharmacy workforce” to provide relevant information and guidelines on coronavirus outbreaks for pharmacists and the pharmacy workforce.8 This paper aimed to improve the understanding of community pharmacists’ role in case of 2019-CoV outbreak by sharing the experiences in Macau in consultation with the FIP guideline.
 
1  Knowing about the coronaviruses


      To many people,  the  memories  about  severe acute respiratory syndrome (SARS)  and the recent outbreak of Middle East respiratory syndrome (MERS) were still fresh and worrisome. SARS was caused by a novel betacoronavirus that emerged in Guangdong, China in November 2002.9 It resulted in more than 8000 human infections and 774 deaths in 37 countries during 2002–03.10At that time, SARS hit hard on the neighboring city of Hong Kong which resulted in 1755 confirmed cases including 300 fatal cases11 but no cases were identified in Macau. On the other hand, MERS, caused by a different kind of novel coronavirus, was first detected in Saudi Arabia in 201212and was responsible for 2499 human infections and 861 fatalities since September 2012. When scientific evidence suggested that the virus responsible for the pneumonia-like disease spreading fast across China in December 2019 was closely related to SARS and MERS,any miscommunication could easily spark panic among the general public.
      Out of the hundreds of coronavirues, 7 of them are known to cause human disease and only 3 of the 7 can have more serious outcomes in people including SARS, MERS and 2019-CoV.13Similar to SARS and MERS, patients infected with 2019-CoV exhibited symptoms of viral pneumonia including fever, difficulty breathing, and bilateral lung infiltration.14In the most severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death.15However, the disease may occur with mild symptoms only, including: low- grade fever, cough, malaise, runny nose, sore throat but without any warning signs16,17, which made early detection challenging. Epidemiological evidence shows that 2019-nCoV can be transmitted from person to person among close contacts possibly through respiratory droplets.The acute respiratory infection has an incubation period of 2 to 14 days before any symptoms show. Preliminary data report 11% lethality among hospitalized patients.16 At the time of this manuscript’s  authorship,  there  was  no  specific  medicine  or  vaccine  for  coronavirus  2019-nCoV.17,18According to the cases  identified in  Macau, the impact of 2019-CoV on human  health appears to be mild, and the first patient with the confirmed diagnosis had full recovery and been discharged on 6 February 2020.19
 
         Such information is important for community pharmacist to know, convey and employ. Being able to address the public enquires with accurate up-to-date information about the local situation and the overall infection  progress  is the  key to  build  trustful relationship  with  them at troubled times. This will in turn improve the outcomes of educating the public about the preventative measures of the 2019-CoV outbreak and the early recognition of symptoms. As FIP suggested, “community pharmacies in outbreak-affected and unaffected countries are often the first point of contact  with  the  health  system  for  those  with  health-related  concerns  or  simply  in  need  of
information and reliable advice. “8

        2  Practicing and educating about personal and environment hygiene
        Pharmacists, like any other health professionals, are responsible for providing safe and ethical care to the public in accordance to the professional standards at all times. Implementation of infection  prevention and  control practices in the  community pharmacy can  help  both  staff  and customers feel safe and at ease inside the premise. More importantly, it is critical for ensuring personal safety, reducing the risks of transmitting the virus between people, and preventing the spread of infection through contacts of items in the pharmacy. For this, pharmacy managers will need to ensure the correct and regular practice of hand hygiene among all staff members, and to ensure all the necessary facilities are installed and hand hygiene products readily available for use.20 Additionally, regular cleaning of surfaces and items will also help to eliminate the
potential sources for spread of infection.21 Pharmacy staff should be encouraged to educate all customers about hand hygiene, infection prevention and control strategies as instructed by the government. All these preventative measures at the community pharmacies were exceptionally important for pharmacies visited not only by local residents but also tourists from around the world. Similarly, the personal and environmental practice by the public should be reinforced whenever possible and community pharmacists are well-positioned to do so more than any other health professionals.
 
      Routine hand hygiene is essential for preventing the spread of the virus and requires the correct use of alcohol-based formulation.21However, community pharmacists encountered a major issue soon after the news about the potential spread of 2019-CoV to the city – a foreseeable short supply of hand hygiene products which were all imported products. Community pharmacy is often one of the major retail outlet of such products and is expected to play the important role of ensuring the availability of such products in the pharmacy. Ever since the first diagnosis of 2019-CoV,  the  supply  of  various   disinfection   products,  such  as  alcohol,  alcohol   hand   rub, and disinfectant, has been tight. The over-reliance on importation exposed the public health to substantial vulnerability. Community pharmacists continued to seek new product sources but without success. On 7 February 2020, the local government stepped in and commissioned two local pharmaceutical manufacturers to produce disinfectant products.22On reflection, instead of being less than proactive, community pharmacists could have taken steps to try to prepare alcohol-based handrub formulations. Some of them indicated the lack of knowledge and therefore lack of confidence to do so. The underlying problem was indeed the lack of knowledge about where to locate reliable instructions of preparing such formulations. A step-by-step guide for production of handrub formulations at pharmacy bench had been provided by the WHO23 and re-iterated in the Annex 4 of the FIP guideline8. It is important for community pharmacists to get familiarized with the procedure and to ensure all the necessary reagents and devices are available
in the pharmacy.
 
         3. Implementing “The Guaranteed Mask Supply for Macao Residents Scheme”
         One of the most unforgettable lessons learnt from the SARS outbreak was that wearing a mask could offer protection against SARS and other viral infections alike.24According to the WHO,wearing a surgical mask, in combination with hand hygiene and other preventative measures, isone of the prevention measures to limit the spread of 2019- nCoV in affected areas.25 More importantly, stable accessibility of this protective gear was considered a key to stability in the society. This posed another vulnerability for the city as the supply of surgical mask totally relied on external sources. On this matter, community pharmacists in Macau were positioned to do three things: (1) help consumers differentiate surgical masks from other types of face masks not made for protection against virus transmission; (2) control the price of surgical masks within reasonable price range; and (3) help implement “The Guaranteed Mask Supply for Macao Residents Scheme” in response to the new government policy.
 
       Many types of face masks are available in the local market and online. Misinformed choice of face masks that are not designed to offer protection against viral transmission would cause a false sense of security and hamper the defense mechanism at the society level. Unlike ordinary face masks, surgical masks were required to demonstrate their performance in terms of bacterial filtration efficiency, differential pressure, resistance to penetration by synthetic blood, sub-micron particulate filtration efficiency and/or flammability as stipulated in the WHO guideline and national standards.26-28 The spreading of the new coronavirus infection inevitably drove demands for protective masks and community pharmacists should play a reliable gatekeeper in advising about the right choice and stocking the appropriate surgical masks for the intended purposes. In addition, by selling the surgical masks within the reasonable price range, the community pharmacies set the reference price which could help counteract irrational pricing elsewhere. Pharmacists’ self-conscious about upholding ethical and professional responsibilities towards the safety of the community was evident across the community setting and should be continually encouraged.
 
       One of the policies the government put in place to allay fears of surgical mask shortage and
dissuade people of the need to stockpile supplies was the “The Guaranteed Mask Supply for Macao Residents Scheme” in which community pharmacy played a key role in the smooth implementation. After the first coronavirus case was confirmed in the city on 22 January 2020, the local government ordered 20 million masks and announced a controlled distribution through pharmacies.29 According to the scheme, each local resident and person on working visa could buy a  maximum of  10  surgical  masks  every 10  days  for  only 8  patacas  (US$1)  at contracted pharmacies as long as they presented their valid identity card. Moreover, the government had set up a webpage with updates every 15 minutes of the number of surgical masks available at different pharmacies and their contact details for the convenience of the buyers.30This scheme was feasible due to the preexisting partnership between the government and the participating pharmacies. Fifty-six of the 294 community pharmacies in Macau joined the public-private partnership and became the contracted pharmacies to share the dispending duties and pharmaceutical care for patients from the public health institutes long before the outbreak. In order to monitor the pharmacy stock take of pharmaceutical products as required in the partnership agreement, an IT system was installed so that the data about the purchase and sales of those pharmaceutical products were collected during each transaction at the pharmacy and immediately submitted to the central data system in the government for real-time monitoring purposes. With this system already in place before the 2019-CoV outbreak, only minor adjustment was needed to include government-provided surgical masks on the monitoring list, and make such information publicly available on the official website. While the community pharmacies were the components of this “The Guaranteed Mask Supply for Macao Residents Scheme” and the IT system being the infrastructure, it was really the data that ensured the connectivity of the system for it to run smoothly and serve the purpose. Community pharmacists, therefore, played the role of custodian in data availability and accuracy.
 
      4. Active surveillance of suspicious cases
      All the imported cases of 2019-CoV infection in Macau were residents from Wuhan who fell ill during their stay in Macau. Considering the possibility of human-to-human transmission and the continuous  growth  of outbreak, the high volume of travel from  Wuhan  was considered  a  major threat to the effectiveness of infection prevention and control. Reinforcement of health inspection and isolation efforts at various cross-boundary checkpoints, mandatory requirements for all travelers from Wuhan to declare their health status, and tighter border-control took place immediately. While these measures aimed to step up the respiratory-disease-surveillance system, the potential risks of carrying and transmitting the virus by the Wuhan travelers who were still staying in Macau could not be dismissed. Early detection and referral of suspected cases were crucial to prevent large-scale community transmission. As mentioned above, the early symptoms could be mild and non-specific15,16, and community pharmacy could well be the first point of contact when the affected people sought basic medical aid for symptomatic relief. Community pharmacists, therefore, must be on full alert and be able to screen patients for any necessary referral.   The   guide   for   the   evaluation   of   patients   under   investigation   for   2019-nCoV recommended  provided  by  the  US  CDC  was  included  in  the  FIP  Guideline  and community
pharmacists should become familiar with the criteria recommended.8
 
      Conclusion
      Community pharmacists have a key role in preventing the spread of 2019-CoV virus. They are charged with key responsibilities of informing, advising and educating the community, maintaining a stable supply of pharmaceuticals and personal hygiene products, and screening of
suspected cases and making appropriate referral as required. As this or similar situations evolve, community pharmacists should remain engaged in the coordinated efforts and be readily adaptive to changes required in pharmacy practice. For pharmacists to assume a role in the health
emergency preparedness and response arrangements at community level, public private partnership and the application of real-world data have been shown to be vital.
References
1. Information Bureau, Macao SAR Government. Press release “Macao sparing no effort to prevent the spread locally of a new coronavirus” on 22 January 2020. https://news.gov.mo/detail/en/N20AV4AiJe?2; 2020 Accessed 09.02.2020
2. Information Bureau, Macao SAR Government. Press release “Updates on the new coronavirus” on 8 February 2020. https://news.gov.mo/detail/zh-hant/N20BHx8ATv?8; 2020 Accessed 09.02.2020
3. Information Bureau, Macao SAR Government. Press release “SAR government raises warning level for "unknown cause of pneumonia in Wuhan" to level III (heavier)” on 5 January 2020. https://news.gov.mo/detail/zh-hant/N20AEUUwwZ?9; 2020 Accessed 09.02.2020
4. World Health Organization. 2019 Novel Coronavirus (2019-nCoV): Strategic preparedness and response plan (draft as of 3 February 2020). https://www.who.int/docs/default- source/coronaviruse/srp-04022020.pdf; 2020 Accessed 09.02.2020
5. Gralinski L.E., & Menachery V.D. (2020). Return of the Coronavirus: 2019- nCoV. Viruses, 12(2), 135. doi: 10.3390/v12020135
6. World  Health Organization (WHO)  Emergency Committee. Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV). Geneva:WHO; 30 January 2020. https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-the- international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of- novel-coronavirus-(2019-ncov) ; 2020 Accessed 09.02.2020
7. World Health Organization. Novel Coronavirus(2019-nCoV) Situation Report-18. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200207-sitrep-18- ncov.pdf?sfvrsn=fa644293_2; 2020 Accessed 09.02.2020
8. International Pharmaceutical Federation. Coronavirus 2019-nCoV outbreak: information and interim guidelines for pharmacists and the pharmacy workforce. https://www.fip.org/file/4413; 2020 Accessed 09.02.2020
9. Peiris J.S., Guan Y., Yuen K.Y.. Severe acute respiratory syndrome. Nat Med 2004; 10 (suppl 12): S88–97
10. Chan-Yeung M., Xu R.H.. SARS: epidemiology. Respirology 2003; 8 (suppl): S9–14.
11. SARS Expert Committee, The Hong Kong SAR Government. SARS in Hong Kong: from experience to action: summary report. https://www.sars- expertcom.gov.hk/english/reports/summary/files/e_sumrpt_sect1.pdf; 2003 Accessed 09.02.2020
12. Zaki A.M., van Boheemen S., Bestebroer T.M., Osterhaus A.D., Fouchier R.A.. Isolation of  a novel coronavirus from a man with pneumonia in Saudi Arabia. The New England Journal of Medicine, 2012; 367: 1814–20. doi: 10.1056/NEJMoa1211721
13. National Institute of Allergy and Infectious Diseases, National Institute of Health. Coronaviruses. https://www.niaid.nih.gov/diseases-conditions/coronaviruses; 2020 Accessed 09.02.2020
14. Wuhan Municipal Health Commision. Wuhan Municipal Health and Health Commission’s Briefing on the Current Pneumonia Epidemic Situation in Our City. http://wjw.wuhan.gov.cn/front/web/showDetail/2019123108989; 2020 Accessed 09.02.2020
15. Chen N., Zhou M., Dong X., Qu J., Gong F., Han Y., ..& ZhNG l., (2020). Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet, doi: 10.1016/S0140-6736(20)30211-7
16. World Health Organization. Advice on the use of masks in the community, during home care and in health care settings in the context of the novel coronavirus (2019-nCoV) outbreak. https://www.who.int/publications-detail/advice-on-the-use-of-masks-the- community-during-home-care-and-in-health-care-settings-in-the-context-of-the-novel- coronavirus-(2019-ncov)-outbreak; 2020 Accessed 09.02.2020
17. Lu R., Zhao X., Li J., Niu P., Yang B., Wu H., ... & Bi, Y. (2020). Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. The Lancet, doi: 10.1016/S0140-6736(20)30251-8
18. GSAID Database. 2020 Coronavirus. https://www.gisaid.org/CoV2020/; 2020 Accessed 09.02.2020
19. Information Bureau, Macao SAR Government. Press release “Full recovery of the first new coronavirus case in Macao” on 6 February 2020. https://news.gov.mo/detail/zh- hant/N20BFr6ANe?11; 2020 Accessed 09.02.2020
20. World Health Organization. WHO Guidelines on hand hygiene in health care: a summary. https://www.who.int/gpsc/5may/tools/who_guidelines-handhygiene_summary.pdf; 2009 Accessed 09.02.2020
21. World Health Organization. Hand hygiene: why, how and when? https://www.who.int/gpsc/5may/Hand_Hygiene_Why_How_and_When_Brochure.pdf; 2009 Accessed 09.02.2020
22. Information Bureau, Macao SAR Government. Press release “Updates on new coronavirus” on 7  February 2020. https://www.gov.mo/zh-hant/news/317427/; 2020 Accessed 09.02.2020
23. World Health Organization. Guide to local production: WHO-recommended handrubs formulations. https://www.who.int/gpsc/5may/Guide_to_Local_Production.pdf; 2010 Accessed 09.02.2020
24. The Hong Kong SAR Government. Wearing Mask. https://www.info.gov.hk/info/sars/en/facemask.htm; Accessed 09.02.2020
25. World Health Organization. Advice on the use of masks the community, during home care and in health care settings in the context of the novel coronavirus (2019-nCoV) outbreak Interim guidance. file:///C:/Users/carolinaung/Downloads/advice-on-the-use-of-masks-2019- ncov.pdf; 2020 Accessed 09.02.2020
26. The U.S. Food and Drug Administration. Surgical Masks-Premarket Notification [51-(k0) submissions. Guidance for industry and FDA staff. https://www.fda.gov/regulatory- information/search-fda-guidance-documents/surgical-masks-premarket-notification-510k- submissions; 2018 Accessed 09.02.2020
27. European standards. UNE EN 14683:2019+AC:2019. Medical face masks - Requirements and test methods. https://www.en-standard.eu/une-en-14683-2019-ac-2019-medical-face- masks-requirements-and-test-methods/; 2019 Accessed 09.02.2020
28. World Health Organization. Novel Coronavirus (2019-nCoV)v2 Operational Support & Logistics Disease Commodity Packages. https://www.who.int/docs/default- source/coronaviruse/dcp--ncov.pdf?sfvrsn=f5fe6234_4&download=true; 2020 2019 Accessed 09.02.2020
29. Information Bureau, Macao SAR Government. Press release “The Guaranteed Mask Supply for Macao Residents Scheme” on 22 January 2020. https://news.gov.mo/detail/zh- hant/N20AVJspef?14; 2020 Accessed 09.02.2020
30. Macao SAR Government. Special webpage against epidemics. https://www.ssm.gov.mo/apps1/PreventWuhanInfection/en.aspx#clg17311; 2020 Accessed 09.02.2020
 
 
 
 
 
 

 
   

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