Lori Walsh: Pharmacies across South Dakota have been feeling the effects of the Coronavirus. The efforts to fill prescriptions in a timely manner have been tested and several facets of the pharmacy departments across the state have been challenged. Jessica Strobl is director of pharmacy services at Lewis Drug. She joins us today to discuss how Covid-19 is affected, what she and her staff do. Jessica Stroble, welcome. Thanks for being here.
Jessica Strobl: Thank you so much for having me. I appreciate it.
Lori Walsh: All right. This has changed how everybody does business and tries to do business in a way that keeps their employees safe and on the job. Let's start there and tell me about some of the adaptations and efforts that have been made to keep operations going.
Jessica Strobl: Yeah, that's a great place to start because as you mentioned, all businesses are having to mitigate the risk and change the way they're doing things to keep their employees safe and healthy, and also their customers safe and healthy. And so at Lewis Drug and with community pharmacies throughout the nation, we're all working together to determine what are the best ways to accomplish those things. And obviously, we've talked numerous times about, how fluid of a situation, this is, how things can change quickly. But in the meantime, the most important thing that community pharmacies are trying to do is join in with the nation on encouraging sick people to stay home. We're really pushing our drive-through services when patients need to get their medications refilled. We're trying to ramp up our drive-through services to allow patients to get things that we normally wouldn't pass through that drives through a window to get out there as well, to help patients get products that we normally wouldn't send through the drive-through, but just to help them keep stocked at home on over the counter medications, personal care items.
We're doing our very best to help patients achieve the shopping that they need with less time in the store. Lewis Drug and many community pharmacies throughout the nation are also kind of showing how important they are by delivering and mailing medications. Sometimes that's not something that community pharmacies are known for. When people think of mailing prescriptions, they think of mail order pharmacies, but your local community pharmacies can also get the medications to your home by delivery or mail and if you have a question, if your pharmacy is able to provide those services, just go ahead and give them a call, ask if they would be willing to.
A lot of those services ended up being free. Lewis Drug has implemented the ability to sometimes deliver or mail things. We normally wouldn't have before this crisis started and I think a lot of community pharmacies throughout the nation are doing the same. Another thing that community pharmacy is doing is trying to keep people separated within their locations. Just like many retailers are throughout the nation. Trying to help people remember to physically distance themselves, by six feet is the current recommendation. So we're marking our waiting areas, we're trying to move chairs apart. We're really trying to just help people stay in the store as short a time as possible. In order to do that, like you mentioned, filling prescriptions in a timely fashion has changed significantly throughout this. One thing we're really encouraging is patients to call in, call in their refills they need, call and ask with questions.
We want to be here for you and we will be here for you throughout this entire crisis. But if we're able to provide services over the phone where we normally would have wanted to see you face to face, that's a much better idea. Give us a call, ask those questions, tell us what you need. We can even take your payment over the phone so that if you don't want to pass the credit card through the window or read a credit card number off, there's a lot of services that we can do over the phone that we're really trying to, to ramp up efforts to decrease any touching, any passing things, passing open prescription bottles or empty prescription bottles. If we can avoid that, we're doing our best to, to get people in and out as quickly as possible.
Lori Walsh: Let's talk for a little bit about being prepared for some of those things that might come up. And I asked this question because it personally impacted me early in March. My daughter has asthma and she was in New York City and we had to get some extra, regular asthma medication onboard for her and had no idea the hoops that I was about to have to jump through because it just, certain things had not occurred to me that would be difficult to do or to get. Medication that, one pharmacy didn't have, for example. So what I thought was an easy thing turned out to be complicated. Talk to people a little bit about planning ahead, because some of us are used to waiting till our medication is low and then stopping by the pharmacy to pick up a refill. That's changed in a lot of ways. Talk to folks a little bit about planning ahead and trying to work through some of those challenges before they happen.
Jessica Strobl: You bet. Thank you for bringing that up. That's a very good point because right now in the pharmacy world we are trying to mitigate any risk of running low on medications or not having available what patients need. And at this point, we have been able to do that. There have not been extreme shortages. However, when we have a lot of patients coming in at one time for particular medications and like you mentioned the asthma medications are a concern. We may not have, on the shelf what you need that day. So the best way to ensure that is to plan ahead, like you mentioned, keep an eye on all of your regular medications. It'll be very important for any patient who takes maintenance medication to continue to take that throughout this crisis, whether it be asthma, high blood pressure, cholesterol, we really need people to stay healthy.
Diabetes medications, we want them taking their regular medications. Even if it's not something you're associating with the virus itself. Plan ahead, make sure you don't run out. Right now, a lot of prescription, insurance companies are allowing overrides for patients to get a little more medication at in their home than they normally would. You may have a few weeks left of medicine and you're still able to call the pharmacy, get some extra on hand. There's a very fine line between the word hoarding, which we're definitely not condoning and being prepared. Just call your pharmacy, talk through that. Talk through your concerns about how much do I need to have on hand to get through this without having so much on hand that it could potentially keep other people who need that medication from getting it. Feel free to call any pharmacy with those questions and they can help you kind of walk through how we can make sure you have what you need available.
Lori Walsh: Have you seen shortages for medications that people thought might be a treatment for Covid-19 but there's no evidence that it is a treatment that people have been scrambling to try to get ahold of, which creates a shortage for other patients who really need that medication for another purpose, for the actual purpose that it was designed for, have you seen some of those challenges?
Jessica Strobl: Yeah, great question. Again, right when the news hit with certain medications that were a possible treatment for Covid-19 there was a bit of a rush or a little bit of hysteria associated with that. Luckily, we were able to get on top of that right away. A lot of States have now passed guidelines for pharmacies saying that we aren't going to fill mass prescriptions, we aren't just going to allow doctors to call in and say give all of my family members three months of this medication or that kind of thing. Or anyone who's ever been exposed, give them three months. We're not going to allow that and the States aren't going to allow that. So luckily we were able to get enough product on hand for our patients who need that medication for other diagnoses. Meanwhile, having some available if patients test positive.
The state boards of pharmacy has put out guidance in regards to needing to have a positive case or a diagnosis from a doctor to get those medications out now, rather than just having hysterical prescriptions filled because we do need to make sure we keep medications available for the patients who have been on those longterm for prior health conditions. And we also need to make sure we have them available then if someone tests positive and their doctor wants to try that treatment. So luckily at Lewis and I'm sure at other community pharmacies throughout the nation, we were able to get on top of that and the state boards of pharmacy have helped us with that effort so that we can have medications available for patients. In regards to other shortages, luckily so far everything has been going pretty well in that regard. The manufacturers have plenty on hand. At Lewis Drug, we've been, kind of stocking up in regards to a few of those things.
But once again the fine line of hoarding versus making sure we have products on hand and so far, but once again, fluid situation, we've been able to stay on top of all of those things. And I think it's a concern throughout the whole nation to make sure that people have access to the medications they need. And luckily we have a very strong support system with our national organizations, with the CDC and the Department of Health. And everyone's really been working together to make sure that patients are safe during this time. And we've appreciated that support and we've appreciated the professional pharmacy being allowed to be at that table and say, here are our concerns. Here's what we need to help our patients during this time.
Lori Walsh: Are there doctors who are writing prescriptions for things because we're hearing that there's no treatment for Covid-19 in that most of the care is supportive care? Has anything been approved for prescriptions? Are doctors writing prescriptions for medication based on anecdotal evidence or how solid is what we know about some of those things that are experimental at this point?
Jessica Strobl: So far what we've seen in South Dakota is pretty minimal in that regard. The problem with any new approval for a diagnosis for a medication is you definitely run into an ethical debate. Obviously, the studies, they haven't been around long enough to know a risk versus a benefit and that's the way we think through all medications in our businesses. What's the risk versus what's the benefit? And in regards to some of these treatments that are being tested, we don't have enough information to know is the benefit of taking these medications greater than the risk in regards to either side effects from the medications or not knowing if those medications will help with Covid-19. And so there's definitely an ethical debate involved as well. But because it's all we really have to go on at this point, we have very few studies to look at and our health care workers are working to try to determine, can these medications help people?
For the most part, what we have seen is very few outpatient prescriptions for those. There has been some, but it's been relatively minimal where, if a patient is needing that treatment, if they're having severe symptoms, then I think those patients are being hospitalized. We are seeing fairly minimal amounts of those types of prescriptions come through. Even though we've had lots of patients saying they've tested positive, for the most part, treatment is stay at home, keep yourself away from others and just keep an eye on things, stay hydrated, continue all the hand washing efforts and all of those things.
Lori Walsh: Yeah, pharmacists are some of my favorite healthcare providers and I have had experiences in my past where I've brought a prescription to my local pharmacist who I really rely on for input and insight and they've said, I don't know about this one. You should probably ask your doctor this. And then gone back to the doctor. And it goes back to what you're saying with the pharmacist is at the table for care. They're part of that healthcare team. They're not just pulling pills off a shelf and handing you a vial. Do you feel as if pharmacists are being heard in this sort of nationwide and local conversation as part of this care team of dealing with people not only with Covid-19 or Coronavirus, but the massive other things that might be arising for people from, antianxiety medications to antidepressants to increase in blood pressure that now has to be dealt with? Do you feel like pharmacists are getting that voice and are working with the healthcare providers on the right footing?
Jessica Strobl: Yeah, I feel like in these unprecedented and these difficult times, I think pharmacy is getting our chance to really show our worth in the healthcare profession as a whole. Partly because of our ability to see patients or be there for patients. Unfortunately right now there's a lot of clinic appointments that are getting rescheduled. They have to do that. The clinics, the hospitals have to mitigate their risk, keep sick people away from their facility. That gives the pharmacist the chance to enter into that health care team. Can this patient be okay at home or does this patient need to be seen? So it's really allowing pharmacy to step up to utilize our training.
We're involved in vaccinations, which obviously we do not currently have for this virus. But in the future if a vaccination is developed, pharmacy will step right up and immunized people. And so, we've been appreciative of the ability of this has given us to really step up and show that we're there for patients. We're an essential healthcare provider and we also look forward to the future of working together on that healthcare team to get through this. And like you said to also, not just for the virus itself but for mental health, for physical health with other disease states, we really want to step up and do the best we can to prove our worth during this crazy time.
Lori Walsh: And the last question I want to close with before we let you get back to the incredibly busy day that you have before you is this notion of people who are on mental health, who are on an antidepressant or an antianxiety medication and who, because they didn't want to go to the pharmacy because they were so busy with the transition into working from home or their kids are at home right now, some of those people let their medications lapse and then learn very quickly, how much they really needed them. Talk specifically, before I let you go please, about people who are on maintenance medication for mental illness or mental health medication. How important is that to really be on top of that medication and communicate with your pharmacist and your healthcare provider about dosage and what your needs might be going into this really stressful time?
Jessica Strobl: Absolutely. Yeah, with any mental health disorder, depression, anxiety, sometimes it's easy to forget how important those medications are if they're keeping you healthy and then you stop taking them and realize how important they were. And that can be the same for other health states as well. But in the case of mental health and all of the stress and anxiety that's surrounding this virus, we're really just encouraging people to remember to take their maintenance medications, if they've been off of them and they realize now that they would like to get back on, give your pharmacist to call. They can help walk through the way to get back on the medications or refer you to a physician if needs be. And I think the speaker that you had on before me mentioned as well, we keep saying the word social distancing and we're trying so hard to maybe reword that to physical distancing because it's going to be more important than ever during these unprecedented times to have people available to talk to.
And you can do that while maintaining physical distance. A lot of our pharmacy meetings going through a Zoom platform or a digital platform. And you can do that with family and friends as well. And just remember that the pharmacy is certainly there for you with any questions, any concerns. We can help refer you to anyone you may need to talk to. And I think what's really going to get all of us through this in our nation and in our profession, is just being there for each other, working together. You see a lot of advertisements now that say apart, we are together and I think that's going to be just so important for everyone throughout this to just remember to stay kind and help each other out and meanwhile keep that physical distance.
Lori Walsh: Jessica Strobl is director of pharmacy services at Lewis Drug. Thank you so much for your time today. We appreciate it.
Jessica Strobl: Thank you so much for having me on.