A Return to Normalcy

Editor’s note: On Friday, March 10, the editor in chief of the Cochrane Library released a statement on the findings of the review mentioned in this article, stating that the conclusion many have drawn—that masks do not work—is “an inaccurate and misleading interpretation,” given the limitations in the primary evidence.

You’ve all read my stories about my Grandpa Joe, the blacksmith. His beloved wife Ositha died in 1950 from complications of type 2 diabetes (T2D). She died before the days of oral sulfonylureas, metformin, GLP-1 agonists, SGLT2 inhibitors, and the other myriad T2D treatments that are now available. Grandma bore 8 children, all of whom survived into adulthood. Five of these 8 children got married and had families ranging from 3 to 6 kids. At Christmas gatherings, my Grandpa Joe would frequently say, “If only Ositha could be here.”

Grandma Ositha was born in 1893 and lost several siblings during the flu outbreaks in the late 1890s. Her first child was born in 1921, just after the 1918 influenza pandemic. She always had a healthy respect of the dangers of the flu, and long before the days of flu shots and antiviral medications, Grandma did what a lot of mothers did: She used folk medicine to protect her kids. My mom remembers her mother pulling out the asafetida bags, filling them with that pungent-smelling herb, referred to in the vernacular as “devil’s dung.” The bags were small pouches that were worn around the neck to ward off the flu. It might sound ridiculous today, but Grandma Ositha used all that she had to protect her kids from influenza.

A century later, we still have our own beliefs, but this time about COVID-19. There is no doubt that this virus was deadly to some members of society, particularly our elderly individuals with comorbid conditions. Three years later, most of us have had enough of COVID-19, especially those of us who weathered the storm and worked “on the bench” every day. Pharmacists were on the front lines of managing the pandemic and are anxious to get back to normal. Pharmacists, like my wife Denise, operated several vaccine clinics that immunized 2400 patients over the course of several Saturdays. She and her volunteers exposed themselves to thousands of individuals to help restore us to normal with vaccines.

But still, many are not ready to return to life as it was in 2019. Some individuals are still masking, but results of a Cochrane Library report published in January 2023¹ indicated that mask wearing in the community setting makes virtually no difference. These individuals have deep-seated beliefs and want to stay isolated; no amount of data or real-life experiences will change their mind. They have had all vaccines and boosters available, all in the name of getting us back to normal, but the level of fear we all had in March 2020 continues to be part of their psyche.

When I see the results from the Multistate Pharmacy Jurisprudence Examination and the NAPLEX, I would have to say that online teaching is not effective in training the next generations of pharmacists. In 2022, only 78% of graduates from all Accreditation Council for Pharmacy Education–accredited pharmacy programs were able to pass these competency exams.² That means 22%— almost one-fourth of students who have borrowed and paid hundreds of thousands of dollars for their education—have graduated but have yet to realize their dreams of becoming a pharmacist. I feel these kids are the collateral damage of the COVID-19 crisis. The easy way out is to blame them, saying that the caliber of students just isn’t what it was 10 years ago. But if that’s the case, how did they ever get admitted to pharmacy school?

I think we have all learned many lessons in the past 3 years. Although we need to be supportive of those who still fear COVID-19, their desires to isolate should not be acceptable when this behavior impacts others. Before we finally put away the masks and the asafetida bags for good, we all need to get back to real-life instruction and person-to-person contact and do what our massive vaccination efforts were meant to do—get us back to normal. Normal won’t get here soon enough.

Peter Kreckel, RPh, practices community pharmacy in Lemont Furnace, Pennsylvania.

References

1. Statement on ‘physical interventions to interrupt or reduce the spread of respiratory viruses’ review. Cochrane Library. March 10, 2023. Accessed March 13, 2023. https://www.cochrane.org/news/ statement-physical-interventions-interrupt-or-reduce-spread-respiratory-viruses-review

2. North American Pharmacist Licensure Examination passing rates for 2020-2022 graduates. National Association of Boards of Pharmacy. January 31, 2023. Accessed March 13, 2023. https://nabp.pharmacy/ wp-content/uploads/2021/03/NAPLEX-Pass-Rates-2022.pdf