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EDMUND G. BROWN JR.
Governor

State of California—Health and Human Services Agency
California Department of Public Health


March 25, 2021


TO:
Pharmacies and Pharmacy Staff

SUBJECT:
Guidance for Pharmacies and Pharmacy Staff



This guidance document was originally released on May 13, 2020. The guidance was updated on March 25, 2021 to reflect:

  • Current information about transmission and guidance on face coverings, to highlight the Cal/OSHA COVID-19 Emergency Temporary Standard which became effective November 30, 2020, and to provide updated resources. 


COVID-19 is a disease caused by a coronavirus. The virus is thought to spread when a person who is infected with the virus is in close contact with another person. It spreads through respiratory droplets or small particles, also known as aerosols, produced when an infected person coughs, sneezes, sings, talks, or breathes. These particles can be inhaled into the nose, mouth, airways, and lungs and cause infection. This is thought to be the main way the virus spreads. It is also possible that a person could become infected by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes. There is evidence that an infected person who has no symptoms or has not yet developed symptoms can spread the virus to others, which is called asymptomatic transmission.       

Our best community and individual defenses against COVID-19 are to get an authorized COVID-19 vaccine, wear a mask or face covering over our nose and mouth in public, and keep 6 feet of distance or more from others. In addition, washing our hands frequently, avoiding touching our eyes, nose, and mouth with unwashed hands, avoiding being around sick people, and staying at home as much as possible will help avoid spread of the virus. 

Pharmacists and pharmacy workers have been designated "Essential Critical Infrastructure Workers." Pharmacy staff can minimize their risk of exposure to the virus that causes COVID-19 and reduce the risk for customers by using the principles of infection prevention and control and physical distancing. In addition, pharmacy employers should be aware that the Cal/OSHA COVID-19 Emergency Temporary Standard is in effect as of November 30, 2020.

When Serving Customers:

  • Require customers to wear a cloth face covering when in the pharmacy, in accordance with the California Department of Public Health (CDPH) Guidance on the Use of Face Coverings.

  • Ask sick customers to stay home and send a well family member or friend to pick up their medicine, or arrange for home delivery for medications, if available.

  • Encourage customers with high risk of severe disease to arrange for alternate methods of picking up their medications, including sending a well family member or friend or home delivery.

  • Minimize physical contact with customers and between customers. Maintain physical distancing (6 feet between individuals) for people entering the pharmacy as much as possible.

  • Limit the number of customers in the pharmacy at any given time to prevent crowding.

  • Place a plastic shield in front of dispensing areas to shield against droplets.

  • Place marks on the ground to instruct waiting customers to remain 6 feet back from the counter, other customer interfaces, and from other customers and pharmacy staff. 

  • Establish a process for older adults and at-risk customers to pick up medications without waiting in line, if feasible.

  • Recommend that customers use the drive-thru window, if available, for prescriptions and healthcare supplies. Curbside delivery could be utilized if there is no drive-thru to minimize exposure.

  • Consider offering home delivery service or mailing prescriptions, if feasible.

  • Regularly clean and disinfect door handles, counters, customer waiting areas, credit/debit card devices, and other spaces where public interaction occurs with an EPA-approved disinfectant

  • Place alcohol-based hand sanitizer next to the cash register or check out area so people can sanitize their hands after using common items like pens and credit/debit card devices.

  • Close self-serve blood pressure units, or clean and disinfect between users, if feasible.

  • While the Board of Pharmacy has no authority to waive any requirements by a third-party payer, the Board has no issue with a customer giving a pharmacy member authority to sign the customer's name in their presence for receipt of a prescription.

For Pharmacy Staff:

  • Ensure that staff wear a facemask or cloth face covering when in the pharmacy. Medical or surgical facemasks are preferred over cloth face coverings for healthcare personnel for source control and to protect the wearer. If there are supply shortages, facemasks should be prioritized for use by healthcare personnel who need them as personal protective equipment (PPE), due to the increased risk that healthcare personnel may be exposed to infected persons. 

  • Ensure staff engage in frequent hand hygiene (i.e. routinely washing hands with soap and water for at least 20 seconds). Avoid touching eyes, nose, and mouth.

  • Ensure staff self-monitor for illness by checking for fever, respiratory, and other symptoms listed by the Centers for Disease Control and Prevention (CDC). Any staff member exhibiting flu-like systems or respiratory illness should stay at home. Any staff member who develops symptoms while at work should go home.

  • Staff should avoid touching items that have been handled by customers, such as insurance cards. If items must be touched, staff should wash their hands or use hand sanitizer afterwards.

  • Encourage prescribers to submit prescription orders by telephone or electronically so that staff do not have to handle paper prescriptions.

  • Point-of-care services (immunization, measurement of blood pressure, etc.) should be avoided for customers with symptoms of COVID-19 and postponed if not urgent for those without symptoms. If point-of-care services are carried out, the customer must wear a facemask or cloth face covering in accordance with the California Department of Public Health (CDPH) Guidance on the Use of Face Coverings. Staff performing such services should wear PPE in accordance with the employer's safety protocols for the service being performed and follow proper hand hygiene. Additional information on pharmacy staff protection while performing close-contact pharmacy care services is available in CDC's Guidance for Pharmacists and Pharmacy Technicians in Community Pharmacies during the COVID-19 Response.

  • Pharmacists providing medication management services and other services that do not require face-to-face encounters should make every effort to use telephone, telehealth, or tele-pharmacy strategies.

Resources

Centers for Disease Control and Prevention (CDC)

California Department of Public Health (CDPH)

Division of Occupational Safety and Health (Cal/OSHA)