“Our American society is entering into a new reality when it comes to public health,” Michael Jackson, BPharm, EVP, and CEO of the Florida Pharmacy Association (FPA) told Drug Topics® in an email. As of today, Florida’s confirmed cases of COVID-19 have grown to 390, with 9 deaths from the pandemic.1
The novel coronavirus disease has now spread to every continent with the exception of Antarctica, and to each state in the United States, with global confirmed cases surpassing 227,000 to date. The United States is currently approaching 14,000 confirmed cases.
Some of the hardest-hit states, such as California, New York, New Jersey, Washington, and Florida, have a current combined confirmed case total of nearly 6000, over half of the country’s total COVID-19 count. Refer to Johns Hopkins University & Medicine’s Coronavirus Resource Center for updated counts or see our article on online coronavirus resources for more sources.1
Washington state has been hit particularly hard by the pandemic. Washington Governor Inslee announced today a statewide moratorium on evictions, suspended utility shut-offs, and waived late fees as many residents are out of work and unable to pay their rent during the outbreak.2 New York has experienced one of the most acute surges in confirmed COVID-19 cases in the country, with over 4000 cases, and 21 deaths.1 The state has added 2 drive-through testing centers in New Rochelle and Jones Beach State Park, which have helped alleviate patient capacity.3
Community pharmacies are especially vital during outbreaks such as COVID-19; this is primarily because community pharmacists remain on the frontlines of public health by serving as direct points of access for their patients.
“As patients, their families, and communities work together to “flatten the curve” amidst the COVID-19 pandemic, access medications to treat chronic diseases, behavioral health conditions, and over-the-counter symptom management is vital,” Ken Thai, PharmD, president of the California Pharmacists Association (CPhA), wrote in an email. “Pharmacists in communities across the state are upholding their oath to serve their communities to ensure that patients can live happier, healthier, and safer lives by bringing the care to the patients’ doorsteps whenever possible.”
Dr Thai added that, as grocery and convenience stores are forced to limit access, many neighborhood independent pharmacies are the last community resource for basic hygiene and health needs.
“Pharmacists can provide direct clinical consultation on managing symptoms with over-the-counter medications and be a direct line to primary care providers to authorize necessary refills for patients,” he wrote. “As the ability to test for active infections, immunizations, and treatments for COVID-19 become available, having access to a neighborhood pharmacy (usually within 5 miles or less) will increase access significantly thereby affording the state the ability to quickly and successfully beat this pandemic.”
Drug and supply shortages remain a concern. Thai explained the 3-pronged considerations in identifying drug shortages: “There are 3 areas to consider with potential drug shortages in relation to the COVID-19 outbreak: symptomatic treatment, maintenance of chronic health conditions, and disease treatment.”
Thai noted that, considering that the symptomatic presentation of COVID-19 has similar features as the common cold or flu, many OTC medications can be used.
“However, as members of the community preemptively purchase the medications to manage fever, coughs, and body aches, there is a steady demand put on the limited supplies that community pharmacies, chain drug stores, and grocery stores have in stock,” he wrote. “Anecdotally, we are starting to see the cold/flu aisles of stores being cleared out.”
“As for the management of chronic health conditions, the current supply and future supplies need to be considered. Patients and prescribers are requesting early refills and extra days’ supply with local counties requesting all non-essential community members to quarantine themselves. Most pharmacies are prepped with inventory to handle their normal prescription volume for typically 1 to 2 months; however, it will be on a case-by-case basis of certain medications potentially being out of stock in the pharmacy and also from drug suppliers. Another factor to consider is the future production of these medications as most of the active pharmaceutical ingredients (API) that drug manufacturers use comes from single source suppliers that had to halt productions amidst the outbreak.”
“Finally, treatment guidelines of COVID-19 infections have not been finalized, but preliminary studies out of France, suggest that chloroquine and hydroxychloroquine could be potential medications for fighting off the infection,” Thai said.4
According to Thai, local independents have already reported that the price of these medications from secondary suppliers is already increasing, which will be an emerging concern. Moreover, as vaccinations are developed, community pharmacies will be primed and ready to administer vaccines to the community, he added.
1. Coronavirus Resource Center. Johns Hopkins University & Medicine website. https://coronavirus.jhu.edu/map.html. Accessed March 19, 2020.
2. Coronavirus: Gov. Inslee places 3-day moratorium on evictions as case numbers increase. Kiro7 website. https://www.kiro7.com/news/local/coronavirus-gov-inslee-places-30-day-mo.... Accessed March 19, 2020.
3. N.Y. Now Testing 7,500 Per Day for Coronavirus: Live Updates. NY Times website. https://www.nytimes.com/2020/03/19/nyregion/coronavirus-new-york-update..... Accessed March 19, 2020.
4. Smith DK, Sullivan PS, Cadwell B, et al. Evidence of an Association of Increases in Pre-exposure Prophylaxis Coverage With Decreases in Human Immunodeficiency Virus Diagnosis Rates in the United States. Clinical Infectious Diseases. 2020, ciz1229, doi: https://doi.org/10.1093/cid/ciz1229
5. News & Press: WSPA News. Washington State Pharmacy Association website. https://www.wsparx.org/news/493599/WSPA-COVID-19-Resource-Page.htm. Accessed March 17, 2020.
6. WSPA Guidance to Pharmacy Practitioners for Safe Practice During COVID-19 Outbreak [news release]. Washington State Pharmacy Association website. https://www.wsparx.org/news/492218/WSPA-Guidance-to-Pharmacy-Practitione.... Accessed March 18, 2020.
7. Coronavirus-Resources for Pharmacists. Pharmacists Society of the State of New York, Inc. website. https://pssny.site-ym.com. Accessed March 18, 2020.
8. COVID-19: Resources & Updates. California Pharmacists Association website. https://cpha.com/covid-19-resources/. Accessed March 18, 2020.
9. COVID-19 Resources. Florida Pharmacy Association website. https://www.floridapharmacy.org/page/COVID19. Accessed March 18, 2020.