Pandemic Preparedness Plans for Pharmacies

During the COVID-19 pandemic, the continuity of medicine supply was ensured in pharmacies through well-structured pandemic preparedness plans. The recent health crisis revealed critical vulnerabilities in national healthcare systems, including shortages of essential supplies such as masks and hand sanitizers, which pharmacies had to produce themselves.

In response to the lessons learned, the National Pandemic Plan (NPP) was revised to better equip the healthcare sector for future crises. Originally formulated in 2005 based on recommendations from the World Health Organization (WHO), the NPP has undergone several updates, with the latest version focusing on COVID-19 introduced in 2020. As of 2024, the Federal Ministry of Health (BMG) has taken the lead in pandemic protection efforts, transitioning the NPP to an exclusively online and interactive format.

States have developed their own pandemic plans based on the NPP, refining measures to suit local conditions. Pharmacies had previously established their pandemic response strategies as early as 2017, initially in anticipation of a potential influenza outbreak. The Federal Union of German Associations of Pharmacists (BAK) provided guidance on risk management in pharmacies, which proved invaluable during the COVID-19 crisis.

The measures outlined in the plan addressed crucial operational queries, such as preparing pharmacies for health emergencies, managing patient flows, and implementing protective measures. Peggy Ahl, head of quality assurance at ABDA, noted that while the procedures were beneficial, not every recommendation could be executed precisely as planned.

For instance, the use of protective plexiglass barriers, which became common during the pandemic, was originally proposed in the influenza pandemic plan back in 2016. At that time, there were doubts about its acceptance among pharmacy staff, as it required significant adjustments to the workspace. However, the necessity of such barriers was quickly recognized and widely adopted during the pandemic.

In addition to the pandemic preparation, a detailed FAQ document titled 'COVID-19 Pandemic - Questions Regarding Pharmacy Operations' was created, providing over 30 pages of updated guidance on pharmaceutical practices during the pandemic. This document addressed critical concerns and offered operational support for pharmacy managers in quarantine.

To safeguard pharmacy staff from infection, the pharmacy management is tasked with implementing specific protective measures. The BAK updated its 'Recommendations for Occupational Safety Measures in Activities Involving Biological Agents' to include guidelines specific to operations during the COVID-19 pandemic.

Furthermore, the pharmacy hygiene standards were revised to incorporate additional protocols necessary in the event of a pandemic. Updated in May 2022, these guidelines provide detailed procedures for cleaning, disinfection, and personal hygiene, specifying exactly what needs to be done, when, and by whom.

Looking ahead, ABDA's Ahl stated that the protocols for occupational safety and hygiene would be readily accessible should another pandemic arise, provided the virus transmission remains consistent with droplet infection methods. The existing documents and FAQs will continue to serve as operational guidelines.

Regarding the production of disinfectants in pharmacies, current regulations remain restrictive. During the COVID-19 pandemic, a temporary exemption was granted at the state level, which allowed pharmacies to produce disinfectants. However, under normal circumstances, each production request must be individually approved, a process that is both lengthy and bureaucratic due to EU regulations governing biocides. To expedite future responses, ABDA is currently advocating for a more permanent exemption at the EU level.

It is widely accepted that another pandemic will eventually occur, making it imperative for healthcare providers to be prepared and informed about necessary actions and restrictions.