Pharmacists in Wales have raised safety concerns over the need to handle paper prescriptions daily – fearing that direct contact with prescriptions may increase their risk of contracting the Covid-19 virus.

This follows published research suggesting that Covid-19 can survive on paper.

Superintendent pharmacist and owner of Wellness Pharmacy in Cardiff, Phil Bullen, told The Pharmacist that he was concerned for the safety of his staff and patients.

‘My fear is if an infected or asymptomatic patient brings in a script to my pharmacy, my staff could pick it up and get the virus on their hands. The virus could then spread between medicines, on the shelf, keyboards, staplers, and scissors which could lead to us potentially infecting patients and even each other,’ he said.

Locum pharmacist, Dylan Patel, working at St Brides Pharmacy in Barry, Wales, said he thought that other safety precautions put in place to avoid and limit transmission of the virus were made futile by the prospect of infected scripts entering the pharmacy.

‘We’re trying to take measures in the pharmacy to prevent spread, but there's that uncontrollable risk from patients.’

Without a digital prescription service, community pharmacies in Wales are still reliant on paper prescriptions.

NPA says concern is valid

A spokesperson from the NPA echoed the pharmacists’ ‘valid’ fears, adding that the concern can also apply to other material objects that pass through pharmacies, such as paper money and medicine packaging from wholesalers.

The association advised on using gloves when handling paper prescriptions, if they are available. ‘If pharmacy teams have a supply of gloves it is advisable that, if possible, they wear them at all times.’

‘When handling paper, with or without gloves, teams should be careful not to touch their face, eyes or ears afterwards. Pharmacy teams are advised to wash their hands regularly anyway. If pharmacies have plastic pockets, they can be used to minimise direct handling of prescriptions.’

However, pharmacy staff have said that washing hands after every interaction with patients and even wearing gloves is not always feasible.

‘It’s difficult to use gloves sometimes, they're not always practical while dispensing as the labels tend to stick to them, which slow us down,’ one pharmacist told us.

Expert opinion

Professor George Lomonossoff, a virologist at the John Innes Centre in Norwich, acknowledged the potential risk paper scripts pose and suggested pharmacy teams may be able to take photos of the scripts and use the picture to process the medicine request instead of the potentially infected paper handed in by members of the public.

He also stressed the effectiveness and importance of regular hand washing.

‘One important thing to remember is that the virus doesn’t penetrate through the skin - it’s when you touch your face after handling a contaminated item that problems arise, the virologist added.

A spokesperson from Public Health Wales said: ‘Theoretically the virus can live on paper, depending on how concentrated it is. To help stop the spread of infection, people should practice good hygiene with regular hand washing.’

A spokesperson for Community Pharmacy Wales said: ‘We understand contractor concerns on this matter and have been working toward the introduction of electronic prescribing as part of a new contract with Welsh Government.

'Negotiations were still ongoing when the crisis began, but you can be assured that once discussions resume that electronic prescribing will take on an additional priority as we agree on terms for the next decade.'

Microwave used to clean scripts

There is currently no advice available for community pharmacies in Wales on how to deal with potentially infected scripts.

In response to the lack of guidance, one pharmacist has started to microwave his scripts in the hope it will kill any infection living on the paper.

'There is no real scientific evidence to show that works,’ the pharmacist said, ‘but it’s better than nothing, we can’t use a disinfectant spray as the scripts are printed on paper.’

Last week, The Pharmacist reported that pharmacy staff have not been allowed into certain welsh branches of Morrisons during keyworker hours, despite being considered key workers by the government.

What’s happening in your area? Contact Isabel at [email protected] with any information that would be useful for us to share with community pharmacy colleagues