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States Say Some Doctors Stockpile Trial Coronavirus Drugs, for Themselves States Say Some Doctors Stockpile Trial Coronavirus Drugs, for Themselves
(2 months later)
Doctors are hoarding medications touted as possible coronavirus treatments by writing prescriptions for themselves and family members, according to pharmacy boards in states across the country.Doctors are hoarding medications touted as possible coronavirus treatments by writing prescriptions for themselves and family members, according to pharmacy boards in states across the country.
The stockpiling has become so worrisome in Idaho, Kentucky, Ohio, Nevada, Oklahoma, North Carolina, and Texas that the boards in those states have issued emergency restrictions or guidelines on how the drugs can be dispensed at pharmacies. More states are expected to follow suit.The stockpiling has become so worrisome in Idaho, Kentucky, Ohio, Nevada, Oklahoma, North Carolina, and Texas that the boards in those states have issued emergency restrictions or guidelines on how the drugs can be dispensed at pharmacies. More states are expected to follow suit.
“This is a real issue and it is not some product of a few isolated bad apples,” said Jay Campbell, executive director of the North Carolina Board of Pharmacy.“This is a real issue and it is not some product of a few isolated bad apples,” said Jay Campbell, executive director of the North Carolina Board of Pharmacy.
The medications being prescribed differ slightly from state to state, but include those lauded by President Trump at televised briefings as potential breakthrough treatments for the virus, which has killed at least 675 people in the United States and infected more than 52,000.The medications being prescribed differ slightly from state to state, but include those lauded by President Trump at televised briefings as potential breakthrough treatments for the virus, which has killed at least 675 people in the United States and infected more than 52,000.
None of the drugs have been approved by the U.S. Food and Drug Administration for that use. Some of them — including chloroquine and hydroxychloroquine — are commonly used to treat malaria, lupus, rheumatoid arthritis and other conditions.None of the drugs have been approved by the U.S. Food and Drug Administration for that use. Some of them — including chloroquine and hydroxychloroquine — are commonly used to treat malaria, lupus, rheumatoid arthritis and other conditions.
Pharmacists around the country have been swapping stories on social media about the spike in prescriptions written by doctors for themselves or their families.Pharmacists around the country have been swapping stories on social media about the spike in prescriptions written by doctors for themselves or their families.
“I have multiple prescribers calling in prescriptions for Plaquenil for themselves and their family members as a precaution. Is this ethical?” one person wrote on Sunday in a Facebook group for pharmacists, referring to a brand name of hydroxychloroquine. Others weighed in — some noting similar experiences — and expressed their hesitancy to dispense such prescriptions.“I have multiple prescribers calling in prescriptions for Plaquenil for themselves and their family members as a precaution. Is this ethical?” one person wrote on Sunday in a Facebook group for pharmacists, referring to a brand name of hydroxychloroquine. Others weighed in — some noting similar experiences — and expressed their hesitancy to dispense such prescriptions.
“I got called a communist for telling a prescriber, who was trying to call it in for themselves, no,” someone posted on Friday in another Facebook group for pharmacists.“I got called a communist for telling a prescriber, who was trying to call it in for themselves, no,” someone posted on Friday in another Facebook group for pharmacists.
Carmen Catizone, executive director of the National Association of Boards of Pharmacy, said state boards across the country were “trying to stop the hoarding and inappropriate prescribing, but balancing what patients need.” Mr. Campbell, of the North Carolina board, said medical boards and associations had to get involved as well to curb the behavior of prescribers.Carmen Catizone, executive director of the National Association of Boards of Pharmacy, said state boards across the country were “trying to stop the hoarding and inappropriate prescribing, but balancing what patients need.” Mr. Campbell, of the North Carolina board, said medical boards and associations had to get involved as well to curb the behavior of prescribers.
The American Medical Association denounced the practice in a statement from its president, Dr. Patrice Harris.The American Medical Association denounced the practice in a statement from its president, Dr. Patrice Harris.
“The A.M.A. is calling for a stop to any inappropriate prescribing and ordering of medications, including chloroquine or hydroxychloroquine, and appealing to physicians and all health care professionals to follow the highest standards of professionalism and ethics,” she said.“The A.M.A. is calling for a stop to any inappropriate prescribing and ordering of medications, including chloroquine or hydroxychloroquine, and appealing to physicians and all health care professionals to follow the highest standards of professionalism and ethics,” she said.
Dr. Harris also noted that the country’s health care professionals “continue to demonstrate remarkable leadership every day,” and can look to the organization’s code of medical ethics for guidance.Dr. Harris also noted that the country’s health care professionals “continue to demonstrate remarkable leadership every day,” and can look to the organization’s code of medical ethics for guidance.
The first restrictions were imposed last week in Idaho. The board there imposed a temporary rule barring pharmacies from dispensing two drugs — chloroquine and hydroxychloroquine — unless the prescription includes a written diagnosis of a condition that the drugs have been proven to treat. The rule also limits prescriptions to a 14-day supply unless a patient has previously taken the medication.The first restrictions were imposed last week in Idaho. The board there imposed a temporary rule barring pharmacies from dispensing two drugs — chloroquine and hydroxychloroquine — unless the prescription includes a written diagnosis of a condition that the drugs have been proven to treat. The rule also limits prescriptions to a 14-day supply unless a patient has previously taken the medication.
“We wanted to try to get out in front of that as early as we could,” said Nicki Chopski, executive director of the board in Idaho, where pharmacists began reporting a significant uptick in prescriptions for the medications last week. The prescriptions, she said, were being written by doctors for themselves and their family members, often in large quantities with refills.“We wanted to try to get out in front of that as early as we could,” said Nicki Chopski, executive director of the board in Idaho, where pharmacists began reporting a significant uptick in prescriptions for the medications last week. The prescriptions, she said, were being written by doctors for themselves and their family members, often in large quantities with refills.
Texas adopted a similar rule on Friday that included another malaria drug — mefloquine — as well as the antibiotic azithromycin, commonly known by its brand name, Zithromax Z-Pak. That drug has been mentioned by Mr. Trump as another potential treatment for the coronavirus when taken in conjunction with the anti-malarial hydroxychloroquine. The effectiveness of the treatment is unproven.Texas adopted a similar rule on Friday that included another malaria drug — mefloquine — as well as the antibiotic azithromycin, commonly known by its brand name, Zithromax Z-Pak. That drug has been mentioned by Mr. Trump as another potential treatment for the coronavirus when taken in conjunction with the anti-malarial hydroxychloroquine. The effectiveness of the treatment is unproven.
Updated June 5, 2020
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Allison Benz, executive director of the Texas State Board of Pharmacy, said pharmacists were reporting an unusual increase in prescriptions for these drugs written by doctors for themselves, their family members and their office staff. As in Idaho, patients who legitimately need medications for conditions that the drugs have been proven to treat will not be restricted from getting them as a result of the new rule, Ms. Benz said.Allison Benz, executive director of the Texas State Board of Pharmacy, said pharmacists were reporting an unusual increase in prescriptions for these drugs written by doctors for themselves, their family members and their office staff. As in Idaho, patients who legitimately need medications for conditions that the drugs have been proven to treat will not be restricted from getting them as a result of the new rule, Ms. Benz said.
In an emergency meeting Sunday morning reported by the Columbus Dispatch, the Ohio Board of Pharmacy barred pharmacists from dispensing the drugs to treat the coronavirus unless a person had tested positive for the virus, or the request had been approved directly by the pharmacy board’s executive director.In an emergency meeting Sunday morning reported by the Columbus Dispatch, the Ohio Board of Pharmacy barred pharmacists from dispensing the drugs to treat the coronavirus unless a person had tested positive for the virus, or the request had been approved directly by the pharmacy board’s executive director.
In a statement, CVS said that pharmacists were to use their “professional judgment to determine whether a prescription was valid and appropriate to dispense,” noting that pharmacists would comply with any applicable state board regulations.In a statement, CVS said that pharmacists were to use their “professional judgment to determine whether a prescription was valid and appropriate to dispense,” noting that pharmacists would comply with any applicable state board regulations.
A spokeswoman from Walgreens said its pharmacists would follow the requirements of the state where they practice, also noting that the company had issued guidelines for dispensing two of the drugs in highest demand, chloroquine and hydroxychloroquine. Walgreens will allow only a 14-day supply for new prescriptions in order to help ensure that the medications remain available for those who need them, the spokeswoman said.A spokeswoman from Walgreens said its pharmacists would follow the requirements of the state where they practice, also noting that the company had issued guidelines for dispensing two of the drugs in highest demand, chloroquine and hydroxychloroquine. Walgreens will allow only a 14-day supply for new prescriptions in order to help ensure that the medications remain available for those who need them, the spokeswoman said.
Instead of instituting rules, some states are offering general guidelines for pharmacists facing the dilemma.Instead of instituting rules, some states are offering general guidelines for pharmacists facing the dilemma.
The Kentucky Board of Pharmacy encouraged pharmacists to “use professional judgment” in addressing whether a pharmacist should fulfill requests from physicians who are “writing prescriptions for themselves and their family members in large quantities,” according to a memo detailing Frequently Asked Questions on the board’s website.The Kentucky Board of Pharmacy encouraged pharmacists to “use professional judgment” in addressing whether a pharmacist should fulfill requests from physicians who are “writing prescriptions for themselves and their family members in large quantities,” according to a memo detailing Frequently Asked Questions on the board’s website.
The guidance goes on to say that the pharmacists can determine if a “valid patient-prescriber relationship exists,” while also urging the pharmacists to consider if there is enough of the drugs in stock to treat patients with rheumatoid arthritis who need it on a regular basis.The guidance goes on to say that the pharmacists can determine if a “valid patient-prescriber relationship exists,” while also urging the pharmacists to consider if there is enough of the drugs in stock to treat patients with rheumatoid arthritis who need it on a regular basis.