COVID-19: The Community Pharmacist as a Frontline Staff

The emergence of the deadly coronavirus has had a lot of physical, emotional, and mental repercussions globally, with increased burden on health workers, especially those on the frontline of COVID-19 healthcare delivery. Some of these health professionals have faced the crisis head-on with unprecedented stress, deep uncertainty and anxiety, and even thoughts of taking their own lives. The enormous workload has pushed some of such workers in the West to commit suicide amid the crisis, possibly because they could not withstand the burden of this huge responsibility shelved on their shoulders.

Managing patients infected with the virus can be a daunting task coupled with an arduous call to detach from family in these times, while enduring the anxiety associated with not knowing when the pandemic will end. These professionals have been diligent in discharging their duties for God and country, risking their lives to save humanity. In the line of duty, some health professionals have who contracted the coronavirus, have been isolated, and taken through the ordeal of treatment without social support systems. Others are battling depression and anxiety alone, with some ultimately losing the battle. There are other health professionals who go through the trauma of not knowing whether they will contract the infection as well, with the fear of succumbing to the virus lingering.

The 2020 May Day celebration of all Ghanaian workforce was marked by virtual concerts and celebrations on several platforms with focus on honoring these heroes and heroines for their commitment to the fight even in the face of death. This was a step in the right direction as psychotherapists have described healthcare professionals as being at greater risk of mental distress with symptoms of stress, insomnia, mild depression, and anxiety. Pharmacists are a key part of the healthcare multidisciplinary team and have been researched to be the most trusted healthcare professionals. In responding to this global pandemic, pharma industries across the globe have come under immense pressure to team up with other key players in finding a vaccine. In several localities, community pharmacists have also come under intense distress to serve the public quality and affordable medicines to manage the coronavirus infection. This article seeks to highlight pharmacists as unsung heroes in this fight with a skewed focus on community pharmacists and the critical role they play.

Pharmacists have truly lived out their motto “amicus humani generis”, which means “friends of the human race”, to the core and deserve some accolades. In this write-up, I attempt to help the public appreciate the roles pharmacists have played and elaborate on some actions Ghanaian community pharmacists have undertaken to help “flatten the curve” despite the mental distress accompanying the discharge of their duties. The first two cases of COVID-19 were confirmed in Ghana on March 12, 2020, with an increased demand for immune boosters, hand sanitizers, and face masks, making the community pharmacy a focal point in the fight against COVID-19. During the time, pharmacists and their support staff experienced stress and exhaustion from long hours of standing to attend to clients, amidst feelings of anxiety. A lot of pharmacists went out of their way to procure hand sanitizers while others manufactured some at affordable prices to curtail the price hike that had entangled the market owing to increased demand. Currently, hand sanitizers have become very affordable, thanks to the initiative community pharmacists took.

Although scientists are uncertain about the mode of transmission of the virus, whether air-borne or not, pharmacists still have face-toface interactions with clients and educate the populace on preventive measures against the spread of COVID-19. Moreover, false information circulating on social media brought a lot of brouhahas, such that not even the overwhelming amount of credible information online could deter even the elite from being confused. Community pharmacists had to take on the task of educating their clients to stick to recommendations by WHO and the Ghana Health Service. Some of the myths pharmacists have dispelled include the following: “the virus affects only Caucasians and not blacks or Africans”, “introduction of 5G mobile networks facilitates the spread of the disease”, and “eating garlic or taking local gins with high percentages of alcohol (akpeteshie) kills the virus”. In this season, community pharmacists have adhered keenly to the precautionary protocols advocated by the WHO. Most have ensured that their workspace is clean and hygienic by constantly disinfecting surfaces, providing areas for clients to wash and disinfect their hands, providing hand-sanitizers at no cost to clients.

Managerial costs however has increased hitherto, yet no donations from NGOs and philanthropists are not channeled to pharmacies.The pandemic has also challenged community pharmacists to take up more roles in diagnosing and treating diseases not only of common occurrences. To avoid overwhelming hospital facilities, community pharmacies continue to serve as the first point of call whiles hospitals deal with emergencies only. This has led to a greater dependence on community pharmacists to serve the public’s healthcare needs. Occasionally, patients have been referred from hospitals to community pharmacies. Referrals are typically to a higher institution of care but COVID-19 has changed the narrative.

Most pharmacists have had to revisit their pharmacotherapy modules to meet head-on with this challenge. For years, community pharmacists have been the most over-trained yet most under-utilized healthcare professional; however, their expertise has been brought to bear in this era. A challenge being faced in diagnosing is the reluctance of clients to fully disclose health details to pharmacists. Some patients who suffer the flu and cold, suppress their urge to cough or even deny that they have been coughing or sneezing for the fear of being referred for COVID testing. Some cough and cold medications stocked before COVID-19 was recorded in Ghana are still on the shelves and staff are worried they may expire. Routine health checks including malaria tests and blood pressure, blood sugar, and body-mass index monitoring have been suspended in community pharmacies to reduce exposure to the virus. This has hampered the delivery of pharmaceutical care services since there is less evidence-based therapy. Pharmacist contact times with patients have also reduced drastically, thereby reducing the impact of pharmaceutical service delivery. The high demand for immune boosters and other supplements have made wholesalers consider certain items as cash purchases only. Consequently, struggling pharmacists who depend on the credit system face hardships. Other issues related to COVID-19 spread that pharmacists and their support staff face in these times is the insurgency of clients; clients wanting to touch medicines on shelves, coughing on counters without covering their mouths, and refusing to wash their hands before entering the pharmacy. Some patients are also indifferent to social distancing protocols and put other clients at the pharmacy, including themselves, at risk.

Public health experts believe that widespread testing for COVID-19 is important in identifying who is infected and who needs to be isolated, in order that interventions can be administered to the affected in a timely manner. Community pharmacists are in a prime position to test clients for COVID-19 after being adequately trained and mentally oriented to take up the challenge.

Therefore, the leadership of the health service should consider authorizing community pharmacists to perform COVID-19 tests, as this can contribute to better management of the disease and flattening the infection disease curve. However, is the Ghanaian pharmacist ready to take up this challenge? This and other questions need to be asked to have a proper roadmap to this effect.