Although the COVID pandemic has ended, the World Health Organization continues to keep track of COVID-19 cases. In the last 28-day period there has been a 38% increase in COVID-19 cases. With COVID-19 on the rise, it can trigger some memories for many people. During the pandemic it is safe to say that everyone’s life was impacted. The way we learn has changed, the way we work and the way we socialize. This led to physical and mental health decline in many people. Health was affected when people had the virus, but also because of the new way of living. The lack of movement and having little to do with all the time at home led for some increased weight. For those who like to socialize, quarantining led to a decline in mental health.
Speaking on personal experience, the pandemic did play a large role in my physical and mental health. My classes became remote, limiting my daily outings and socializing with friends. The doctor's office I worked in had to shut, leaving me without a job. My siblings and parents were all home and it seemed like there was nothing to do. There was also the time when my family got COVID. It started with my dad and spread to the rest of us within days. The days my dad laid in bed barely able to breathe are days I cannot forget.
Thinking of the possibility of COVID arising again does make me worry. It is not a time I want to relive. I do think however, that we can learn from the past. Using our past experiences, we can find ways to protect ourselves and loved ones from losing ourselves like many did a few year ago. I conducted a short survey and sent it out. One of the questions was asking if the pandemic had negatively affected them in one way or another. All participants had answered this question with yes, regardless of age, gender and ethnicity. Follow up questions were more specific, asking if the effect was on physical health, mental health, relationships, schooling and employment. The two that were most affected were school and employment. That may be due to the rules set in place where people had to quarantine and keep a 6 foot distance between one another. The next two were physical and mental health. Many said the most noticeable change was weight gain during the pandemic. Many are active at the gym, sports and generally in social settings. With all that taken away, many felt as though they no longer had the option to be physically active, leading to a decline in their physical health.
Mental health was a large struggle among many. People of all ages fought against depression. Unemployment was unfortunately something many had to deal with and that can lead to stress and worry on how to support oneself as well as dependents. The lack of social gatherings deprived people of seeing one another, further hurting mental health. Therapy sessions which can be helpful in person, did not feel as genuine to many online and were not as helpful. Relationships were actually least negatively affected. One comment was that many partners do not actually spend enough time together and quarantine gave partners that time in which they needed to strengthen the relationship.
Thank you Dr. Twam for sharing your experience with covid-19. Very thought provoking.
In the fall semester of 2019, I emailed my resume to a local independent pharmacy near my house. I was told they didn’t need any new staff at the moment, but would keep my resume on hand. I subsequently began working as a receptionist at a GI clinic. When the COVID-19 quarantine started in March, the clinic temporarily closed, and its staff received additional pay for two weeks. It was during this time that the pharmacy I had previously contacted reached out to me. They had faced staffing shortages due to employees leaving amid COVID-19 concerns.
With no prior pharmacy experience as a pharmacy student, I quickly accepted their offer. Classes were remote, so I started working 5-7 days a week at two of their locations, adapting to the evolving COVID-19 guidelines. We implemented a no-entry policy for customers, providing prescriptions either at the door or through deliveries. This one-and-a-half-year experience as a pharmacy technician during the beginning of the pandemic was incredibly informative and educational.
In the fall of 2021, as on-campus classes resumed, I reduced my work hours but continued with weekend shifts. During this time, I noticed a pharmacy intern position at a nearby Walgreens and decided to try something new after feeling that I had exhausted my learning opportunities at the independent pharmacy. I gained certification for immunization administration but found that working at Walgreens differed significantly from the independent setting and was less enjoyable. Soon after, a classmate introduced me to a different independent pharmacy, and I got a position there. By this time, COVID-19 restrictions had eased, and life was returning to pre-pandemic norms.
During the summer of 2022, I completed my IPPEs at an independent pharmacy where few wore masks. Despite my precautions, I contracted COVID-19 within two weeks. After recovering, I continued to experience lingering symptoms, including coughing, wheezing, and chest congestion for over a year. The staff at the rotation considered this infection a "rite of passage," but I was concerned about potential long-term complications due to their lack of mask usage and adherence to safety protocols.
Currently, I work weekends at another pharmacy, founded by a former coworker from my initial pharmacy job. As COVID-19 cases rise, more people are wearing masks again, and I've noticed an increase in patients seeking prescriptions for medications like FlowFlex, Paxlovid, acetaminophen, ibuprofen, robitussin DM, and benzonatate.
Thank you for sharing your experience Dr. Yu Feng Lin. Sounds like you made the best of the bad situation covid-19 presented to all of us. A story of resilience in the face of adversity.
Although the Covid-19 pandemic is pretty much under control at this point in time, I had a very interesting working experience when this disease first started to spread in 2020. At the time, I was working at a small private pharmacy near my home in Staten island. When we first heard the news that this deadly disease was spreading fast, we didn’t know how to react. We would originally see people coming in for masks and gloves, but at one point we couldn’t even purchase them from the wholesaler due to shortages. My pharmacy started to come up with ideas that would promote social distancing, but that’s all we could really do. Nobody knew much about how quickly this virus would spread and when.
My parents both worked in the hospital setting and as soon as my boss found out that I was in constant contact with a nurse who worked in the ICU and a pulmonologist who was firsthand battling this disease with his patients, they started to panic. In addition, my boss was a very strange germaphobe who slowly realized that I soon too, may bring this virus into his pharmacy… and that’s when everything started to change.
I came into work one day and he asked to speak with me privately. He told me that for unfortunate reasons, I would have to refrain from coming into work till further notice. At first, I didn’t understand what was happening. I never did anything wrong, but the Pharmacist explained that he was concerned for the health of his staff and patients, despite the fact that I was not even sick with covid! Long story short, he basically gave me an undesired leave of absence because he was afraid that I would infect him with the corona virus due to exposure to my parents.
That’s when I realized that this man was crazy and that I needed to find a new job. In a way, this was a great experience for me because I wanted to venture out and explore different areas of pharmacy. Eventually, I was able to get a job as a pharmacy intern at a compounding pharmacy where I was able to mix solutions, make suppositories from scratch, and crush different types of medications into the desired compound.Surprisingly, after a few months, my original boss from the private pharmacy actually ended up contacting me to come back to work. I was shocked to hear back from him but didn’t take it to heart because he was terrified at the time and was only trying to protect himself and his family.
Thank you Tommy for sharing your experience. Was a pleasure meeting you and your partner, Jerry, yesterday for lunch at The Sweet Sap in Flushing. The work at your independent community store sounds very interesting, you had said many dialects are spoken with your patients. Thank you for your brave work and perseverance during the covid pandemic.
During the COVID pandemic, the globe went a messy plate. I remembered the fact that I was watching news from the internet about outbreak of COVID-19 in China. The Chinese people struggled and news were conveying a message of emergency and anxiety. However, the rest of the world did not take it seriously enough. When China settled down the mess and controlled the pandemic, the other nations just started to experience the nightmare. That was the beginning of 2020. And then, COVID-19 spread through the globe, including the United States of America.
I have to take classes online for the second half of spring 2020 semester, which was second half of my 5th year. At the same time, I kept to work in my independent pharmacy in Flushing to help more patients in needs. Those with hypertension, diabetes, gout, arthritis, dementia, psychological issues, Parkinson’s disease, and other chronic health problems, were all able to pick up medications during the pandemic. I managed to clean the environment to make sure my patients receiving medications with minimum risk of being infected by COVID-19. Under the pressure of dangerous circumstances, professionalism grew inside my heart. I always tell my patients not to be overwhelmed. As long as you wear a mask, wash hands frequently, avoid social gathering, and stay home most of the time, you would be ok. Some patients were Chinese immigrants and had read news about how bad it was in China. They were scared to come in to pick up medications. Usually, they left as soon as possible. So, the pharmacy was safe and my co-workers were all healthy. The hard time will carry out the hardest stone.
First and foremost, I appreciate everyone’s prior responses about their COVID-19 work experiences a lot and I applaud us all for getting through this! We should all be proud of our achievements and I genuinely hope that we are. We all had different novel experiences but the most important thing is that (I firmly believe) the worst is over. We need to take the past as a learning experience for the future and view (possible) silver linings to not take anything for granted. Now here’s more about my personal experience.
I work as a pharmacy intern at Montefiore Hospital in the Bronx. Every hospital was indeed hard-hit, especially unfortunately in underserved areas such as Flushing (I know that my friends at the New York Presbyterian Hospital at this location had a lot of hurdles to overcome) and the Bronx. In March of 2020 we thought the same thing as everyone else- oh, just a couple of sick patients. This isn’t that bad, right? And then the numbers started growing, growing, and growing- exponentially at that it felt at one point. What felt like peak COVID to us was towards the end of April. As a pharmacy intern, we are scheduled to work only every other weekend. I braced myself and went to work. It felt quite surreal. Temperature check, step one. Questionnaire, step two. Distribution of proper PPE, step three. Even scrubs were given if need be, but my plan was to dump my clothes straight in the washer when I got home anyway so I didn’t bother.
As a pharmacy intern, we have many different roles as we are able to do any shift that a pharmacy technician is allowed to do. I like to view the hospital workflow so predominantly do a shift that requires me to be on the floors and have communication with the nurses in order to deliver medication in a timely manner. Needless to say, there was a completely different feeling during the peak of COVID. Seeing contamination warning stickers on every single patient room, the nurses in hazmat suits, the look of fear in everyone’s eyes- yet they were all doing their job with zero complaints. Why? Because they wanted to. As healthcare professionals, we should all inherently have it in our hearts to better the field and be there for what matters the most- the patients. Albeit it was extremely scary going upstairs, I did it because I needed to and followed protocol diligently and fortunately never got sick.
I will say this though- I never thought that I could be a nurse and that definitely was 110% affirmed during this pandemic. As healthcare professionals, even though we share the same core values, we all have different roles in better assisting patients. The amount of compassion and being so selfless to the extent that they would risk their own lives to save someone else’s- that’s truly heroic and I feel honored to work and know many nurses who are the most gracious human beings I know. Now fortunately the hospital is doing better in the sense that there are obviously a lot fewer COVID cases as vaccines have been FDA-approved. Let’s get back to humanity- slowly but surely!
I feel like my overall COVID-19 work experience at the independent pharmacy hasn’t changed too drastically. The most noticeable changes are the extra precautions to protect the employees and store customers, such as temperature checks, mask mandates, physical barriers, and hand sanitizer dispensers everywhere. The pharmacy workflow has also changed with more deliveries being made and less patients stopping by in person. Patients are also asking for their medications to be delivered with other household items that the store sells since they are unable or unwilling to go outside and shop for themselves. The beginning of the pandemic early into 2020 was a bit more strange since people weren’t sure if they should be taking COVID-19 seriously and nobody was required to wear masks yet. It wasn’t until later into 2020 and 2021 that I started to see the COVID-19 deaths among our patients. I would receive phone calls from family members asking to cancel prescriptions since the patient has passed away. They would even bring the deceased family member’s medications for us to dispose of in the pharmacy. The whole situation is heartbreaking and I express my sympathy when I see them in person. It angers me when I see people come up to the counter without wearing a mask properly so I have to tell them to adjust it so that it covers their entire nose and mouth. Now that we are well into the pandemic, people are more compliant about wearing masks so I have to remind people less often. I long for the days of normalcy again without wearing masks and being able to freely talk with patients about positive things. I also worry about how the pandemic will affect my job search after graduating and getting licensed but so far, I plan to remain at this independent pharmacy until I get employed elsewhere to get as much work experience as I can.
COVID-19 has undoubtedly required lifestyle changes, affecting my educational and work life tremendously as a student in healthcare. Many students have needed to work extra hours, risking infection on the frontlines and worrying about transferring that exposure back home to family. The pressure to work more stemmed from the need to do our part in healthcare to put a halt to the pandemic as well as pressure to make ends meet financially with parents being laid off. All this was on top of satisfying our academic standards as students. Without dabbling too deep into politics and for lack of better terms, I feel that our country was ill-prepared and did a less than mediocre job in enforcing CDC guidelines to shorten the pandemic. This past year, I’ve been in scenarios where I was forced to scavenge for my own PPE while being overworked and on occasion, been verbally threatened as well as physically attacked for enforcing masks and social distancing with unruly disbelievers of the virus. This issue stems deeper than what’s in front of us and is definitely not new. The ignorance and racism in this country has always been prevalent but it is now that we have the technology that it is captured and shared so quickly and frequently.
To speak on my personal experience, I’ve maintained both jobs at CVS Pharmacy as well as Curaleaf this past year. I’m fortunate that I did not contract COVID-19 despite my constant exposure. I’ve put myself in the shoes of my patients and offered to package basic necessities along with their medications before I sent them out for delivery. Recently, I’ve been assisting at COVID clinics with CVS Pharmacy, administering on average 150 Pfizer vaccines daily. When I provided consultations for my patients at Curaleaf, I prioritized the financial aspect when determining the formulation and dosage that works best with their prescription regimen as medical cannabis is not paid for by insurance but rather out of pocket via cash or debit. Credit is not an acceptable form of payment as medical cannabis is not yet federally legal. I’ve worked 7 days a week since the start of the pandemic and have had many breaking points, but I think it’s safe to say that I’ve gotten the swing of things. I’ve grown not only as a healthcare professional but as a person. I regularly attend therapy to be the healthiest me I can be and met some amazing people. My coworkers are now family to me and I couldn’t be happier to be where I am today. Healthcare is amazing and I’m so proud to be a part of it.
When sent home from school in early March, I was able to head back home and work at my local Rite Aid. Masks were only mandated for those having symptoms of COVID at the time, so I was working with no PPE on. Looking back at that, I cannot believe how dangerous and careless I had been at the beginning of the pandemic.
Fast-forward to the end of April when cases were still climbing. At that point, Rite Aid was opening an outdoor testing site at a location in Albany. I had begun to help at the testing site and demonstrating to patients how to self-administer the COVID test in the comfort of their car. Although risky, I was able to help my community. This was when everything was still shut down and there was a mandate for Long Term Care facility workers needed to be tested twice weekly. I had become familiar with those getting tested regularly and it was lovely talking to people from a safe distance. It was then when I realized how much the loneliness of the pandemic was getting to me. Mental health concerns for both healthcare workers and those staying at home during this pandemic began to noticeable rise. Although data is still being collected about the ongoing effects of the pandemic, in July a survey was done and 53% of adults in the United States reported that their mental health has been negatively impacted due to worry and stress over the coronavirus. This number had increased from 32% when done in March.
I have the privilege of working at a store that now is giving COVID vaccines to individuals over 65 years old. When phase 1b rolled out on January 11, 2021, I was called by the pharmacist begging me to come in to help. That day, all five pharmacy lines were lit up and the phone rang off the hook from the time we opened at 9 am to when we closed at 9 pm. An error was made on the Department of Health Website, telling patients to call our store to set up an appointment. When in reality, Rite Aid did not have the vaccine in stock yet, and we did not have the system at the store level to schedule appointments for qualifying patients. This left both patients and every staff member frustrated with each phone call. In the weeks that followed, we still get many calls from patients inquiring about signing up for the COVID vaccine, but we finally have a system down so the process runs more smoothly. We are now giving 30 vaccines to patients every day. It was also just released on Friday that since my store has a drive-through, we will now be conducting COVID tests as well.
The easy accessibility of patients to direct healthcare is a reason I have found my passion as a pharmacist in the community setting. What I didn’t realize is that we are the most accessible healthcare during a healthcare crisis as well and how that impacts my day to day job. We are on the front lines to help a much larger population of patients who don’t need to be hospitalized. We are providing medical knowledge to our patients and recommending therapy preventing them from having to go see their medical doctors. I am lucky to be able to begin my career with a company I have worked for since 2016, and I am so lucky to be a part of the solution to this pandemic. While offering COVID vaccines and COVID tests on top of our already busy days may be a lot to at first, I am excited to further skills to perform under stressful situations as well as be a constant in the community to offering accessible healthcare.
Chidambaram P. The Implications of COVID-19 for Mental Health and Substance Use. Kaiser Family Foundation. August 2010. https://www.kff.org/coronavirus-covid-19/issue-brief/the-implications-of-covid-19-for-mental-health-and-substance-use/. Accessed January 25, 2021.
Retail Work Experience
Working in a community pharmacy during this pandemic has really created a number of challenges for us. I remember walking into the pharmacy for my regular shift on a Thursday and from the time we opened to the time we closed, in the span of 8 hours we had received what felt like over a hundred phone calls from doctor’s offices asking us if we had hydroxychloroquine in stock. Another problem that we faced was exposure to potential COVID+ patients. Masks weren’t available, patients were handing us their cards and there was no way for us to protect ourselves. Thankfully, we were able to put up a glass screen at the register and change our point of sale into a touch free system. We also closed our doors and only allowed one customer to enter at a time. All of these practices were done in order to ensure the safety of our patients and our employees. Other issues that we have run into during this time include delays in our wholesale orders being delivered, inability to ship patient medications, and overall shortages in supplies needed to prepare compounds.
I currently work at an independent pharmacy back home in New Jersey. During the COVID crisis, we are aiming to limit face to face interaction with customers. We have gone through multiple tasks to ensure this will happen. For example, we have now offered more delivery services. In addition to delivery services, we are offering curbside pickup for medications and allowing patients to pay ahead of time for their medications. This limits time for transactions to occur and avoid patients from coming inside of the pharmacy. In addition to this, we offer customers to call ahead if they need to shop for additional things inside of the store. Of course, proper protective material is provided to workers so they will stay safe while interacting with patients delivering medications. Hourly cleansing is also required and in between shifts as well to prevent cross contamination. These situations that occur I realize are very different from a hospital environment. Patient interaction is a core focus in a retail setting and limiting exposure provides a great hindrance to counseling on medications, etc. Many new solutions are being offered to combat this, such as telehealth services.
I work at a community pharmacy where suddenly, we started to get an immense amount of hydroxychloroquine prescriptions that were not prescribed for their FDA approved indications such as lupus erythematosus, rheumatoid arthritis and indicated for the prophylaxis of malaria in geographic areas where chloroquine resistance is not reported. Fortunately, the FDA/CDC was able to place a policy to restrict the inappropriate prescribing of this drug for off-label uses. My manager instructed us to only able to dispense for a patient with documented COVID-19 positive on the prescription or the patients are under a clinical trial. For me personally, I think the most stressful aspect is telling the patient that they can't get the medication because their conditions don't fit the requirements. Patients would respond very negatively. However, I can't blame them since they are not aware of the detrimental side effects. For every patient that requests prophylactic use, I made sure to let them know all the detrimental side effects of the medications first. Things that I always mention to my patients are implications of hepatic impairments, renal impairments, cardiac effects such as the risk for arrhythmia, increase risk of convulsions, as well as hematologic effects, have been reported with this drug. I realized that once I mention the possibility of eye damage, that's when my patients have less desire to get this drug.
After my rotation was shut down for 3 weeks due to the pandemic, I returned to work shortly after. The only difference I noticed at first was that the OR had locked their PPE in a closet to prevent staff from stealing them. I work in Suffolk County, which at the beginning of March had no reported cases. Later that day my director had a staff meeting to discuss what was coming and what the other Northwell hospitals were doing to prepare. The first policy change was that he was going to begin overloading the technician daily staff so that we could get ahead in batching medications, Pyxis loading and more. The second was that he was going to look into buying as much hydroxychloroquine as possible. He mentioned that the medication is cheap but knew the supply wouldn’t be able to meet the demand. The theory behind the use of hydroxychloroquine is that it may alter the pH at the cell membrane surface and inhibit viral fusion. It can also inhibit nucleic acid replication, glycosylation of viral proteins, as well as viral assembly and release. It is dosed at 400 mg twice daily orally for two doses, then 400 mg daily for five days. The major concern with this medication is the possibility of qtc prolongation, especially when given with other possible treatments.
The hospital is always changing as a result of this current pandemic. Yesterday, the hospital opened a new 60 bed ICU dedicated to treating critical COVID-19 patients. These patients were previously separated amongst several different units and it made delivering patient care quite tricky because some of these units were not previously used to hold critical care patients. This new ICU unit allows for us to ensure that medications are properly stocked and providers can easily have questions answered by the unit based pharmacist. While the number of deaths per day continue to downtrend and the number of discharges keep increasing, there are many patients still fighting their battle against COVID. Medications such as propofol, dexmedetomidine, fentanyl, midazolam and norepinephrine are being heavily relied upon and as a result there is an increased strain on the pharmacy to make these drugs. Nevertheless, pharmacists, technicians, and interns continue to work diligently to ensure that there is no lapse in providing patients with the care they need.