Looking back on Covid-19 (is it too early to say that)?

What effects did Capital Chemist pharmacies experience during March, April, May 2020?

The impacts of Covid-19 were first felt HARD in March. Society knew that some sort of lockdown was coming; an anxious public, quite reasonably, felt there was a degree of security in getting “one extra”.

• March saw a 30% increase in volumes of prescriptions processed, and a 40% increase in volume of items sold.

The profession's'response to this was to introduce restrictions on those “one extra” prescriptions; this saw volumes return to normal in April and May. It should be noted that the supply chain of pharmaceuticals in Australia relies heavily on overseas imports; a massive increase in volume can quickly see supply chains depleted which puts public health at risk.

• Sales of salbutamol inhalers (Ventolin, Asmol) increased by 250%.

This led to the very real risk that a patient with an acute asthma attack might not be able to access a life-saving puffer. The response from regulatory authorities was to institute a recording system with a limit of one puffer per patient, along with a need for a defined diagnosis or history of lung disease.

• Sales of hydroxychloroquine increased by 255%.

Notwithstanding the lack of evidence for this product as a treatment for Coronoavirus, sales soared. This led to the risk of a patient with a “traditional” need (e.g. lupus, rheumatoid arthritis) having to go without. Our group responded by quarantining stock for patients with a historical need and sharing supplies between stores to get an even spread. Regulatory bodies responded by limiting the ability of a doctor to prescribe this product by specialists to patients with defined, pre-existing needs.

• Children’s paracetamol sales soared by 230%. In some stores by 600%!

Existing shortages in this major category were further impacted by the increase in demand. To minimise effects, paracetamol for children was moved behind the counter to ensure access to those with acute need; sales were limited to one unit per patient, and where different strengths were available advice on the correct dosage could be given. At most times product was available but not every brand, flavour or strength.

• Adult paracetamol sales doubled.

Whether it was concern about shortage of raw ingredients (from China and/or India) or urban myths suggesting that Panadol could cure Covid, sales increased. However there was always product on the shelf; in some cases sales had to be limited to one pack per patient.

• Thermometer sales increased by 500%; oximeter sales increased by 1000%.

A temperature check before entering a workplace has become common; oxygen concentrations are believed to be an indicator of worsening lung disease, often before patients are aware.

• Home deliveries increased by 600%.

All our stores do home deliveries; some on an ad hoc basis, others with a formal delivery vehicle, dedicated staff, uber-style tracking apps. Many stores formalised their delivery processes to manage contactless patient engagement. Other entrants in that marketspace tried to muscle in (e.g. the “free” Australia Post delivery system) however they failed many patients. Pharmacy deliveries are best left to the pharmacies; medicine deliveries are time critical and often can’t be left till tomorrow, nor returned to an inaccessible depot on the other side of town.

• Influenza vaccine demand increased by 700%.

Sadly supplies ran out by early April; new supplies were intermittent during May, but a strong supply chain was re-established in early June.

Traditional cold and flu treatment sales plummeted; the paradox of increased hygiene and social distancing means that common cold and influenza is almost non-existent at the moment. Now we know why grandma always told you to wash your hands!

Other different behaviour we saw in stores:

Online ordering of prescriptions to “Skip the Queue” came of age; previously this was a small part of our daily workflow but grew to become a significant component of our prescription business. Click and Collect/Pay in Advance grew exponentially with strong customer engagement, supported by the delivery option for vulnerable people.

• Enrolments in MedAdvisor grew by 350%!
• Orders placed through MedAdvisor grew by 50%
• Pay in advance was around one-third of these orders.

Normally such change would take months to implement. But, because Capital Chemist staff are superheroes, it just happened, implemented within days, forever changing the ways we provide healthcare to our communities. And all while we were rearranging our physical layout, our rosters, our workflow, our teams and managing to keep our mental health intact!