On March 11, 2020, the World Health Organization declared that COVID-19 was a pandemic. Since then, countries, cities, and communities have struggled to contain and prevent COVID-19 from overwhelming healthcare systems.
In this edition of Full Scale, our articles explore what the pandemic revealed about Canada’s drug supply, how pharmacists and pharmacy technicians have contributed to the vaccination effort, and the difference pharmacy teams made by providing asymptomatic testing to Albertans in the summer of 2020. In our Full Scale podcast, ACP president Dana Lyons and registrar Greg Eberhart discuss how the COVID-19 pandemic became the catalyst for pharmacy teams to deliver care in new ways and how this will affect the future of how pharmacy services are delivered.
First, a look at how community pharmacies established themselves as essential health hubs while access to health services became limited.
Community pharmacies: Alberta’s health hubs
The public’s access to care was reduced through the pandemic as many healthcare providers limited their patient encounters. Albertans still needed care and sometimes a different kind of help; throughout the pandemic, their community pharmacy was still available to them. Pharmacists and pharmacy technicians truly became the most accessible healthcare practitioners to help satisfy these needs.
How did pharmacists respond? One Edmonton community pharmacist said he had to offer a wide range of care all in one place.
“When the stay-at-home order came out, there was an initial surge in demand,” explained Eddie Wong. “I think pharmacists, in a sense, were almost like a sport utility vehicle or a Swiss Army Knife, we had to wear many hats during this time to help our patients. We had to adapt.”
Eddie discovered he needed knowledge he never thought he would need.
“I had to know what all the different types of hand sanitizer were,” recalled Eddie. “I was a sommelier in hand sanitizer.”
Eddie was aware that his patients needed more than health care, and he took this responsibility very seriously.
“We were a big disseminator of information – I found that I got a lot of questions, and I always had to be on top of the news,” said Eddie. “Before every shift, I made sure I had read all of Dr. Hinshaw’s (Alberta’s chief medical officer of health) updates, and I knew what was open to the public and what was closed.”
Yik Chow is a community pharmacist in Edmonton. He also noticed fluctuations in pharmacy traffic.
“In March 2020, there was a steady increase in prescriptions due to the 30-day supply limit for critical supply medications, and the curve slowly flattened as these limits were lifted,” explained Yik. “There was another spike when COVID vaccinations started in March 2021, but this influx has now stabilized.”
Alberta’s pharmacists were well positioned to expand the care they were able to offer the public during the pandemic, thanks in part to the scope of practice pharmacists have in the province.
ACP issued more than 30 COVID-19 guidance documents to support pharmacy teams meet the needs of Albertans in different ways, while complying with ACP’s standards, Code of Ethics, and provincial and federal legislation.
“The expanded scope of practice allowed us to go above and beyond to care for our patients, and it allowed us to wear many hats,” said Eddie. “But along with that comes great responsibility.”
To support Alberta Health’s asymptomatic COVID-19 testing in pharmacies, ACP temporarily enabled the collection of throat swab specimens by regulated members in October. Because of these temporary authorizations, Eddie was able to help his patients with asymptomatic testing.
He was also able to help some patients who had lost their jobs and were moving back to their home province. Eddie needed to transfer their existing prescriptions, and one patient needed her prescription for a controlled drug extended.
“For example, when a patient has run out of refills for a diabetic medication, we can renew or extend the prescription, and put it under our name,” said Lauren. “While doing that though, pharmacists still have the responsibility to assess the indication, efficacy, safety, and compliance. If a patient is long overdue for bloodwork and their previous A1Cs were not within range, this is a perfect opportunity for the pharmacist to also provide the patient with a lab requisition.”
Eddie was also able to step in and fill a role left vacant when nurses were reallocated to help with COVID-19 vaccinations. Previously, the nurses had administered rabies vaccine for Animal Health Technology students at NAIT. Eddie was able to step in and provide these vaccinations. His assistance ensured the students didn’t miss out on their practicums in veterinary clinics.
Eddie had another new experience: helping someone who couldn’t get in touch with their physician. He felt a sense of satisfaction being able to respond and help patients in ways he hadn’t before.
“It was a renewal for a patient with an ongoing benzodiazepine prescription, and they were unable to reach their doctor due to the limited hours in the initial days of the pandemic,” explained Eddie.
For Lauren, being able to provide the level of care enabled in Alberta was a rewarding experience.
“Patients appreciated the effort and work we put in to help them understand their medications and medical conditions,” said Lauren. “For some patients, it was not until the pandemic that they realized the extent of pharmacists’ scope of practice.”
At a time when they were needed the most, Alberta’s pharmacy professionals already had the training, qualifications, scope of practice, and guidance from ACP needed to quickly step into the void to create health hubs and ensure the well-being of Albertans.