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| States Say Some Doctors Stockpile Trial Coronavirus Drugs, for Themselves | States Say Some Doctors Stockpile Trial Coronavirus Drugs, for Themselves |
| (6 days 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 22, 2020 | |
| A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico. | |
| The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. | The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. |
| The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. | The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. |
| So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. | So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. |
| 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. | 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. |
| A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. | A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. |
| 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. | 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. |
| 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. | 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. |
| 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. | 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.) | 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.) |
| 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’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. | 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. |