The rapid spread of the novel coronavirus (SARS-CoV-2) and the COVID-19 infection captured the world unprepared. Struggles with initial containment strategies led to a pandemic designation in March of 2020. As the pandemic progressed, challenges became overwhelming with the paucity, appraisal, and dissemination of data; prevention and treatment strategies; resource management; testing and vaccine development/distribution/administration efforts. Pharmacists, traditionally known for their dispensing roles in the community pharmacy setting, visibly stepped up to meet the fast-changing and dynamic needs of the COVID-19 pandemic. This chapter outlines the contributions of pharmacists during the pandemic with a deeper insight into the spectrum of roles that pharmacists are regularly engaged in within a range of settings. An explanation of the modified and expanded functions that the pandemic necessitated is presented against the background of evolution of the pharmacy profession and pharmacists through the past few decades.
TopIntroduction
In December of 2019, a cluster of pneumonia cases caused by a novel coronavirus, SARS-CoV-2, was reported in Wuhan, China (Guo et al., 2020). Within the first month, cases outside of China were reported in 18 countries, including the United States (World Heath Organization, 2020). At the onset, the primary containment strategy involved viral testing and screening. The initial efficiency and effectiveness of the containment response varied worldwide. Countries that were able to provide sufficient and accurate testing early, such as Australia, Japan, South Korean, and Taiwan, achieved some level of containment with the initial outbreak. Areas with delayed testing or general lack of response experienced a surge in the number of new cases and deaths (Schneider, 2020), prompting the World Health Organization to declare COVID-19 as a pandemic on March 11, 2020 (WHO, 2020). Failure of the primary containment efforts led to mitigation strategies such as regional stay-at-home orders, physical distancing, use of masks, and accelerated vaccine development (Adalja et al., 2020; Gostin & Wiley, 2020).
As the pandemic progressed, undue pressures were placed on healthcare systems globally. Exponential increases in COVID-19 cases resulted in depletion of resources such as personal protective equipment (PPE), acute care beds, ventilators, medications in addition to active pharmaceutical ingredients. Also, it resulted in a suspension of elective and chronic care services to reserve resources for COVID-19 patients (Centers for Medicare and Medicaid Services, 2020a; Cummings et al., 2020; Supady et al., 2021). With a rise in COVID-19 hospitalizations, cross-training of healthcare personnel was necessary to meet the increasing demands of acute care. Healthcare personnel in ambulatory care settings were shifted to acute care to support the volume of emergency room visits and hospital admissions (Centers for Disease Control and Prevention, 2021a). While the challenges of the pandemic changed throughout its course, pharmacists were well positioned to address the dynamic needs of education, supply and demand, patient care, and vaccine development, distribution, education, and administration.
The roles of pharmacists have been evolving in the last two decades (Pearson, 2007; Urick & Meggs, 2019), but their responsibilities, functions, and value drastically expanded during the dynamic climate of the COVID-19 pandemic (Goff et al., 2020; Gross & MacDougall, 2020; Skoglund et al., 2020). In the early stages of the COVID-19 pandemic, pharmacists were involved in appraising data, disseminating scientific findings, developing institution-specific treatment guidelines, and implementing alternative methods of delivering care and medications for patients with chronic illness. Given their ease of access, pharmacists have been an integral part of the COVID-19 testing and vaccination roll out. The remainder of this chapter will focus on these expanded roles with a foundational view of the profession’s evolution before and during the COVID-19 pandemic.