Worries over promotion of COVID-19 testing in pharmacies

GPs, pharmacists and patients have expressed concern over the announcement of COVID-19 testing coming to Queensland pharmacies

As reported by AJP, the Palaszczuk Government announced on Wednesday that it would trial COVID-19 testing in pharmacies to increase testing capability in Queensland.

According to a Queensland Health spokesperson, the intention of the trial is to provide opportunistic testing of “minimally symptomatic” people already attending pharmacies for treatment.

The news came a few weeks after South Australia said it was rolling out a two-week testing pilot commencing at several metropolitan pharmacies – the first Australian state to do so.

SA Health stated it would not be promoting the pharmacy-based service during the pilot and would continue to encourage the community to visit a GP or dedicated testing clinic, to ensure only ‘incidental’ customers were captured by pharmacies.

However pharmacists and doctors have expressed concern after public announcements by the Queensland government that COVID-19 testing in community pharmacies will be promoted across the state.

For example, Queensland Premier Annastacia Palaszczuk announced the news of the trial on her Facebook page.

The Pharmacy Guild welcomed the announcement, with Queensland branch president Trent Twomey encouraging community pharmacies to take part in the trial over the coming months.

“Queenslanders are already presenting in community pharmacies with possible COVID-19 symptoms,” he said.

“It makes sense to opportunistically test those members of the community with possible symptoms, as they are already attending the pharmacy for their medications and healthcare advice.”

But PSA National President Chris Freeman said on Thursday that the announcement sent the wrong message to people who should be at home self-isolating when displaying symptoms of COVID-19, and raised concerns “for the safety and wellbeing of pharmacists, pharmacy staff and the general public”.

“We have continually asked members of the community not to enter a pharmacy if they are unwell and displaying COVID-19 symptoms,” he said.

We do not want people who potentially have COVID-19 wandering into a pharmacy to get tested.

“The concern is that this decision will put not only pharmacists at risk but those with chronic health conditions who regularly visit a pharmacy and are at higher risk of contracting COVID-19.

“The Queensland Government did not consult broadly with pharmacists and pharmacy groups and we do not want people who potentially have COVID-19 wandering into a pharmacy to get tested.

“People who have respiratory symptoms should be tested at a predesignated testing sites, and then stay home, not go to a pharmacy, which includes those with cold and flu symptoms who can access medicines through contactless options such as delivery, car-window parcel drop, third-party pick-up or family and friends.”

A/Prof Freeman said the reason health experts have recommended dedicated testing facilities is to limit unintended exposure to COVID-19 to other members of the general public. 

“There are a raft of problems to work through before this service could be safely offered safely to patients,” he said.

“It is essential that there is effective infection control and PPE available for healthcare workers running this service and guidance similar that that which exists for GP Respiratory Clinics conducting COVID-19 testing that would need to be adopted.

“Pharmacists and pharmacy staff must be protected from COVID-19 exposure or it places their community’s ongoing access to medicines and expert pharmacist care at risk.”

Doctor groups have also voiced worries over the proposal, saying it puts the safety of the public and pharmacy staff at risk.

“While the RACGP supports the principle of increased testing to help curb COVID-19, the safety of patients and the broader community needs to come first,” said Chair RACGP Queensland Dr Bruce Willett.

“Testing sites should limit exposure to the community and risk to nearby businesses – the RACGP’s guidelines for GP-led respiratory clinics state that access to the testing site must not require a patient to walk through another health facility or public space, as this risks infection spreading. Testing sites should not be located in a mixed-purpose location.

Dr Willett added that there are “genuine concerns” about whether pharmacists could ensure the safety of patients coming in for COVID-19 tests, the safety of their other customers, and pharmacy staff.

“We seek reassurance from the state government that the pharmacists involved in this trial will meet the necessary safety standards and receive the necessary training, and can provide a safe environment for any patients coming in for tests, as well as customers and staff,” he said.

Ms Palaszczuk stated that pharmacists will be provided with relevant training to conduct the testing, while a Queensland Health spokesperson told AJP that pharmacists and pharmacy staff involved in testing will use personal protective equipment and hygiene measures to protect themselves and other customers.

AJP has contacted Pharmacy Guild Queensland branch president Trent Twomey for comment on the controversy but had not heard back at the time of publication.

Backlash from pharmacists, public

Meanwhile some pharmacists are saying the risk of exposure to customers and staff from the trial is too high.

“The last thing I would want to do is encourage people who are potentially Covid positive to come into my pharmacy. I have STOP signs inside and outside the pharmacy encouraging patients who have been exposed or have symptoms to contact the National Covid hotline, or their GP by telephone,” one pharmacist commented on the AJP website.

“As I am writing this, my staff are all walking in to my office asking if we will be offering testing. They are all horrified and petrified that we will be offering Covid testing (the Premier said pharmacies will be offering Covid testing on the news) So I guess the general public is going to assume this is the case as well.”

Another pharmacist said: “Does anyone think that testing for Covid 19 in a retail environment a good idea? If you have cold/flu like symptoms please do not come into my pharmacy. Get tested at a designated outdoor testing area.”

A pharmacist with 20 years’ experience wrote: “Am I the only sane person in Australia that thinks this is the dumbest idea that community pharmacy or any public health service has ever had? Ever since March every doctors surgery in Australia has had signs up and messages on their websites and answering machines saying it is a requirement that if you are showing symptoms of COVID 19 DO NOT come into the surgery. Go and get tested at a proper testing centre instead. These measures were put into place to protect the workers and vulnerable people who come into those places. Of course community pharmacies response to people coming into the pharmacy while symptomatic is not don’t come in while you’re sick, its ROLL UP ROLL UP get your COVID 19 test here!”

Meanwhile many members of the general public are not taken with the proposal either.

Some comments on Premier Palaszczuk’s Facebook post include “Yeah cool, can’t wait to get Covid next time I’m picking up some Panadol” and, “Sorry but I will not shop in a pharmacy that has a testing facility attached”.

Another Queenslander said: “Not impressed with this. Most pharmacies are in shopping centres where elderly and people go to get scripts filled for underlying health issues. Now I don’t feel chemists are safe let alone surrounding unsuspecting shops.”

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  1. Tyson Clarke

    I have my doubts about this as well – but not for the reasons listed here.

    Australia is so fearful of a disease with a 99.96% survival rate, with an average death age of 80 – I don’t see the economy opening up any time soon – which is bad. So with an increase in testing, and consequent increase in positives (false or otherwise) – I don’t know if that’s something our culture is going to handle very well. It may end in hysteria.

    However, moving into cold/flu season – I don’t know how patients are meant to distinguish their symptoms from COVID without professional intervention – not to mention the financial impact on pharmacies.

    Perhaps if pharmacies with outdoor spaces available to conduct testing would work – but not in shopping centers.

    The use of airconditioning in confined spaces wouldn’t be ideal, and has higher potential to overwhelm health care.

    As always with any sort of in depth analysis, the answer is “it depends”. But if the goal is to reach herd immunity (and I’m starting to feel like Robinson Crusoe on this one) – that the media will overblow positive cases without spruiking negative cases (which will be well over 95%), and survival rates.

    It’s sad that we have to factor media response into health care….but we do.

  2. Willy the chemist

    World case fatality rate 3.4%
    US CFR 3.1% and 183,000 souls lost.
    Australia CFR 2.4% and likely to rise as we ride down the second wave in Victoria.

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