How to link patients with suspicious COVID-19 to health system from the community pharmacies? A route proposal.

Colombia confirmed its first case of the COVID-19 on March 6th, 2020. On March 16th, 2020, 54 cases have been confirmed (36 imported and 18 associated), therefore, Colombia is at highest alert, and it is now trying to avoid or minimize the last stage of "community transmission". We present a route proposal that shows how the community pharmacist may develop his responsibility to contribute to the early detection and appropriate referral of possible cases of the COVID-19. In the route have been considered three possible entrances depending on the needs of the users: anti-flu drugs, symptoms related to COVID-19 infection or the request for items for hygiene and prevention of transmission such as alcohol and face masks. Later, self-care education should be given, and the possible cases should be reported to the telephone lines designated by the mayor or the governor, continuing the healthcare process. Community pharmacies and pharmacy staff play a crucial role in minimizing the stage of "community transmission" of COVID-19, through properly detection and management of possible cases and customer education.

Coronavirus disease (COVID-19) is caused by the infection of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, WHO denotes the virus as “the virus responsible for COVID-19” or “the COVID-19 virus” in its communications to the public. Colombia confirmed its first case of the COVID-19 on March 6th, 2020. On March 16th, 2020, 54 cases have been confirmed (36 imported and 18 associated), therefore, Colombia is at highest alert, and it is now trying to avoid or minimize the last stage of “community transmission".

Like any other health professional, pharmacist at community settings also may play an important role in the identification and prevention of the spread of the COVID-19 outbreak. Therefore, community pharmacies may contribute to avoid or minimize the last stage of “community transmission”. In this way, on February 5th, 2020, the International Pharmaceutical Federation (FIP) issued the “Coronavirus 2019-nCoV outbreak: Information and interim guidelines for pharmacists and the pharmacy workforce” to provide relevant information and guidelines on coronavirus outbreaks for pharmacists and the pharmacy workforce.

The FIP also notes that “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”. In addition, a recent article concluded that: “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”.

Consequently, we present a route proposal that shows how the community pharmacist may develop his responsibility to contribute to the early detection and appropriate referral of possible cases of the COVID-19, whit the goal to contribute to prevention of the overall community spread of the virus in Colombia (Fig. 1 ).

Fig. 1

Route of attention of users with suspicion of COVID-19 in the community pharmacies.

In the route have been considered three possible entrances depending on the needs of the users: anti-flu drugs, symptoms related to COVID-19 infection or the request for items for hygiene and prevention of transmission such as alcohol and face masks. After the pharmaceutical interview, where the presence of fever, symptoms related to COVID-19 and the possibility of contact with people with suspicion or confirmation of the disease are evaluated, the care process is continued, by establishing communication with the telephone lines designated by the mayor or the governor or the provision of self-care education. We must take into account that in Colombia, the community pharmacies -pharmacies located in the neighborhoods and drugstores-are not articulated with the health system, therefore it is necessary to connect them to the process of healthcare that has been implemented to attend the possible cases of COVID-19. Hence, the aim of this route proposal is to coordinate the community pharmacy process with a unique route of healthcare for the detection and management of COVID-19 cases, in local, regional or national instances.

Besides to the application of the route proposed in this article, pharmacy managers must guarantee the education to all staff in the correct case management, as well as raising awareness of the importance of hand hygiene and cleaning of pharmacies after the care of a suspected case. Additionally, they need to ensure the availability of hand hygiene products.

Community pharmacies and pharmacy staff play a crucial role in minimizing the stage of “community transmission” of COVID-19, through properly detection, referral and management of possible cases and customer education about self-care to prevent the infection transmission, including hand hygiene, correct use of face masks, and evaluation of symptoms, accordingly to the government instructions.

CRediT authorship contribution statement

Pedro Amariles: Conceptualization, Writing - original draft, Writing - review & editing. Mónica Ledezma-Morales: Conceptualization, Writing - original draft, Writing - review & editing. Andrea Salazar-Ospina: Conceptualization, Writing - original draft, Writing - review & editing. Jaime Alejandro Hincapié-García: Conceptualization, Writing - review & editing.

Declaration of competing interests

None.