PPE plays ‘mitigating role’, but not only factor

Some pharmacists are having to isolate for weeks despite wearing full PPE when exposed to an infectious patient, a measure that is “crippling” the workforce, says one owner

As pharmacies in Western Sydney are being battered by COVID-19 positive cases, strict rules around case contacts are also impacting their ability to service the community.

Western Sydney pharmacy owner Catherine Bronger has told AJP that pharmacists are being forced to isolate despite wearing full personal protective equipment (PPE) while serving patients.

Ms Bronger’s pharmacies have been slammed by multiple positive cases over the past few months. She recently just finished 14 days in isolation herself, “even though when I served this patient I was in full PPE and outside”, she said.

She is aware of other pharmacists in the area who have also been impacted by the measures.

Ms Bronger pointed out that the Health Direct government website says: “Healthcare workers and other contacts who have used full PPE and taken recommended precautions to control infection while caring for infectious confirmed COVID-19 cases are not generally considered to be primary close contacts, provided that appropriate PPE has been worn and there has not been any breaches”.

“NSW Health hasn’t given pharmacy the same clarity and in fact aren’t even considering the protective measures some pharmacists are putting in place,” she said.

This is crippling to our workforce especially as we roll out vaccines.

“We need clarity around if pharmacy staff are in full PPE with appropriate training—would they be treated as other healthcare professionals in other settings like testing clinics, vaccine hubs or hospitals?”

A staff member at Catherine Bronger’s 24-hour pharmacy wearing full PPE.

A NSW Health spokesperson told AJP that the department conducts a risk assessment each time it is notified of a new venue associated with a confirmed case of COVID-19, to determine whether the exposure is deemed a ‘casual’ or ‘close’ contact.

“A close contact is someone who has been in close enough proximity to a person with COVID-19 while they were infectious that there is a reasonable chance they too will be infected with COVID-19,” they said.

“NSW Health treats all contacts, both close and casual, of a known case the same – regardless of who they are when determining the appropriate public health response,” they said in response to Ms Bronger’s query.

“PPE worn during an exposure is always a consideration in this risk assessment.

“In some cases, PPE has a mitigating role however all aspects of the interaction, including proximity and duration must be carefully considered in that risk assessment.”

The spokesperson added: “It is also important to note the risk assessment can change as more information becomes available and a close contact venue may be re-assessed to be a casual contact venue and vice versa.”

Meanwhile Pharmacy Guild NSW branch president David Heffernan warned that the state “could suffer a workforce crisis”.

“[Community pharmacies] are still enduring onerous conditions,” he told AJP earlier in the week.

“Under these conditions, once they become a close contact some pharmacies have had to close their doors and just do phone orders and deliveries only.

“And they can’t vaccinate if they have to shut their doors – despite NSW Health pleading and asking people not to come in with symptoms,” he said.

“And if you’re asymptomatic and you don’t know you’ve got it, you might be going in for a vaccine and all of a sudden the person giving a vaccine is a close contact.”

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