Fintan Moore explains why he didn’t previously participate in the flu vaccination scheme and why that may now change
While I think the introduction of the annual flu vaccination service into Irish pharmacy was generally a positive move, I have never participated in the scheme myself. My main reason for not getting involved was that I didn’t think the time, workload and expense of running the service were justified by the level of the fees on offer. My back-of-envelope calculations reckoned that the fees earned for vaccinating the first 40 or 50 patients each year would simply be covering the cost of training, the time spent training and the adrenaline pens required to be available while injecting. I then had to factor-in that my pharmacy turnover is at a level that only justifies a single pharmacist being on duty most of the time, so in order to have a pharmacist free to vaccinate, I would have to increase the level of pharmacist cover, which would eat considerably into any extra profit generated by the service.
However, I am arguing the toss with myself this year on whether or not to get involved because I believe that the health service will be coping with serious levels of Covid-19 infection, whether this materialises as a general wave or in significant localised clusters. A bad flu season on top of this would create even greater pressure on both hospitals and primary care, so I have a sense that I should be ‘doing my bit’ to help. Having said that, the flipside of the coin throws up the fact that there has never been a worse time financially or operationally to get involved in vaccinating people.
Taking the financial issue first, assuming that the fees set by the HSE do not improve, there will be extra costs involved this year due to the PPE requirements. It will be more difficult than usual to vaccinate a steady flow of patients due to hygiene and disinfection protocols. Even sorting the paperwork will be less straightforward. All this will combine to make the service less economically viable.
From an operational point of view, the ongoing necessity for social distancing will make it unlikely that people can wait in the pharmacy in advance of getting the jab, so an appointment system will be needed, adding to the difficulty of running smoothly. So as I weigh it up, I am sliding further away from getting involved, unless the fee on offer is considerably better and reflects the full costs of participation and the risk involved.
The Government can find money when it suits them, so I have no intention of getting my heartstring played and being suckered into this scheme for an inadequate fee.
The masked avenger
The recommendation that masks or face-coverings should be worn in confined public settings has gained enough traction that it is a legal requirement in many places. However, the number of ways that Joe Public can find to make a mockery of the whole concept would be funny if the consequences weren’t so potentially serious. If ever there was an argument to be made for teaching logic and critical reasoning in schools as a separate subject, there is a wealth of data being accumulated at the moment to support the hypothesis.
At least one-quarter of the people I see wearing masks don’t cover their noses. I reckon only a fraction of people sanitise their hands before and after handling the mask. Every day I watch people walk across the car park outside my pharmacy wearing masks, sometimes even correctly, but on entering the pharmacy they then pull the mask down to talk to us — my Perspex screens have become one of my all-time favourite purchases. A lot of non-pharmacy workplaces permit visors rather than masks, which is a dubious option to begin with, but the people wearing visors more often than not shove them so far up their heads that they look like golfing caps — so unless they are in danger of being sneezed on from above by a six-foot-six basketballer, then they are really wasting time and plastic.
The same logic-defying behaviour applies to people wearing gloves, but worse. The gloves seem to imbue the wearer with the idea that they are immune from any pestilence, so at this point, every time I see somebody wearing them, I assume that they will have no idea whatsoever of how to behave hygienically, and that they will touch as many surfaces as possible with their hands. If they present me with a prescription, I treat the piece of paper as if it was delivered by a carrier-pigeon direct from a laboratory In Wuhan.
Winter of discontent
2020 has been a helluva ride so far, but one of the few lucky breaks we have collectively received was that the coronavirus outbreak landed during a mild March, followed by a prolonged spell of dry, warm weather. This facilitated social distancing by letting pharmacists close their doors completely or allow limited numbers inside, but in either scenario, patients could wait outside in relatively comfortable weather. If the crap hits the fan with a severe second wave in October or November, this kind of wait management will be a whole different ball-game, so we should probably be thinking ahead to what can be done.
The other issue that’s going to crop-up is that the fact that wearing masks and gloves in public is now normal is a dream come true for a whole horde of shoplifters, armed raiders, vandals and pretty much any other kind of low-life you can think of. For years I have had an access control on my door as a security measure, but until last March, anybody trying to get in wearing a mask would have been left outside on the assumption that he or she also had a knife. Now we have to decide if the guy at the door wearing a mask is being socially responsible or is actually a scumbag.
In these long summer days, it’s easier to see details and decide that their demeanour is non-threatening, but when the dark winter days come round, that will get more difficult. Roll on, 2021… maybe.