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Laws requiring masks to be worn in shops and other indoor settings in England were lifted on Monday (July 19), the so-called freedom day.

However, many community pharmacists were concerned that the lifting of all restrictions might have come in a bit too early as the rate of coronavirus infections was still on the rise across the UK.

Amid predictions that the country could soon have more new cases each day than it did at the height of a second wave of the pandemic earlier this year, pharmacy owners and staff were also sceptical about managing people who could walk into their pharmacies without wearing a face covering.

Incidentally, NHS England announced last week that pharmacies, along with all other healthcare settings, would need to continue to adhere to all precautions and measures taken during the lockdown, beyond July 19.

Jaipreet Johal, owner of Calow Pharmacy, said: “Thankfully, NHS England decided last week it will be mandatory to continue with the infection control procedures in healthcare settings, whereas in our workplace there will be no changes in terms of social distancing and everything remains the same as earlier. That was our plan anyway, but thankfully, NHS England made it mandatory.”

Graham Phillips, superintendent pharmacist of Manor Pharmacy Group, felt the end of restrictions was much needed to curb the damages done by the lockdown – to people’s mental health, to their access to the NHS and to the economy.

“In the long term, I think Sajid (Javid) is right. We have to learn to live with this; we can’t run away from this virus and lock ourselves up forever,” he said.

Amish Patel, director of Hodgson Pharmacy in Kent, said: “It’s a tough decision for Boris (prime minister Boris Johnson). I understand we need to open up the country. However, I am also slightly concerned with the rise in cases and what that means to health, in particular things like long Covid. I remember reading one article which suggested that 10 per cent of people get long Covid.”

“I feel it is too early to be celebrating freedom day. There are still cases and deaths on the rise,” said Sachin Shah, superintendent pharmacist at Jackmans Pharmacy in Hertfordshire.

“Freedom day” doesn’t exactly feel it meets the title,” said Yasmine Haq, a pharmacist with the Knights Pharmacy group. “With the cases still being apparent and some businesses still fearing Covid, I’ve noticed many are keeping certain regulations in place to protect themselves, as well as their customers and patients.”

She added: “The impact throughout the pandemic has tested us as a profession and I’m proud to say we have prevailed in providing ‘on the spot’ healthcare advice when other sectors have not been able to do such things. The impact of the social distancing regulations being lifted will certainly be a test due to people not respecting wishes of each premise.”

Increasing workload and challenges

Pharmacists fear that this decision would increase the number of cases and it would impact their workload.

“We (pharmacists) will continue to be the unsung heroes,” said Phillips, adding: “I can’t tell you how many clients have come in and said, well, ‘I need my blood pressure check, my GP can’t do it, because of Covid but he says that you will.’ Why is it okay to send all those clients to the pharmacy?”

Patel said: “If the cases continue to rise, that’s going to impact pharmacy, people seeking advice, people wanting to know what to do, what can they expect with symptoms? How can they help the symptoms? Is there anything they can do to aid recovery? And these are all questions that actually, we don’t have a lot of answers to either.”

“The workload of pharmacists will only increase due to mismatched responses from the public. Along with more services opening back up and patients venturing out more, it’ll only amplify the demand on community pharmacy,” said Haq.

Phillips stressed: “The NHS doesn’t recognise all the additional things that we’re dealing with. It only looks at the volume of prescriptions, and that’s just the tip of the iceberg.”

The major challenges for the pharmacists would be dealing with the consequences of freedom day and managing people seeking advice on Covid. “Post freedom day, there may be an increased number of cases, and therefore, there’s a potential for staff to become infected outside of work, which could have an impact,” warned Johal.

According to Phillips, managing people’s expectations and managing workload would be major challenges after freedom day.

“The challenge for us is going to be managing people, (wearing of) face masks for safety in the premises as well. We’re still adhering to social distancing as much as possible in the pharmacy. So I think the biggest challenges are going to be having those odd patients and making them understand that and accept those are the rules for coming into our pharmacy,” said Patel.

Haq revealed: “I’ve known and witnessed pharmacists and their staff being verbally abused for trying to enforce the mask wearing and social distancing measures. The obvious challenge would be the increased workload. I think that this is managed by pharmacy staff to the best of their abilities but pressure by patients and other healthcare sectors to get prescriptions done much sooner than it takes to generate a prescription will be a major problem.”

Precautions

Pharmacists have ensured that they will continue to encourage their staff and customers to wear masks on the premises and maintain social distance.

At Patel’s pharmacy, he is requesting all customers or patients to wear a face mask. He said, “All my staff continue to wear face masks; we still have the screens up as well. Going forward, may be in a week or so, I do expect there will be some people that will not be happy about it, I’m sure of it. But it’s Monday, it’s a quiet day. By the end of the week, we will have had one or two people not happy about being told to wear a mask.”

His pharmacy has a guidance radio as well, which says that in a healthcare setting, people should still wear a mask. There are additional posters up in the pharmacy to say, ‘you must wear a mask when entering this pharmacy’.

“We can only request that they wear a mask. But at the same time, the safety of my staff is the most important thing. So if anyone becomes rude and challenging, then I’ve said just let it be, get them out of the pharmacy as quickly as possible, and apologise to anyone else in the pharmacy.

We’re not the police and even the police are powerless now with freedom days because it is only guidance, not law. So there’s very little we can do. Just do our best to request at least patients wear their masks,” said Patel.

Shah said, “We still have signs in the window and on the TV screen enforcing the message that face masks are required to enter the pharmacy.”

Haq said she would enforce the mask-wearing policy in healthcare settings for the time being, but said, “however, I do respect it is an individual’s choice at the same time.”

“Some customers are all for it, protecting themselves and others and some unsurprisingly have not. Most people seem to see it as a “way of life” now and I cannot imagine going back to certain aspects of the job without wearing PPE.”

With regards to speculations of rising abuses against the pharmacists, Haq said: “There has been a rise in abuse throughout lockdown and as restrictions are being lifted. It seems as though tensions are high, people aren’t expecting the queues or waiting times anymore, which, with the ever-increasing demand on community pharmacists, we are just expected to deal with.”

She concluded: “It’s sad to think that customers/patients jump to such abuse and feel the need to subject someone that’s only protecting and serving their health requirements in this derogatory way. Abuse of all kinds towards healthcare workers should be strictly not tolerated.”

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