By Maryn McKenna Flu meds and prescription drugs have been in short supply all winter—but the problem goes back over a decade. Parents of small children have faced a persistent problem this “tripledemic” winter: They’ve headed out to pharmacies and supermarkets, looking for cold drugs and fever reducers to counter Covid, flu and RSV, and discovered the shelves were bare. And it hasn’t just been over-the-counter drugs in short supply: The antibiotic amoxicillin, used to treat strep throat and scarlet fever, is scarce in the US and the UK. What’s been worse: Discovering this isn’t a one-time interruption that might resolve quickly—with luck, while your child could still benefit. According to records at the US Food and Drug Administration, amoxicillin supplies have been low since the end of October, and pharmacy experts say colleagues were struggling with stock-outs from the beginning of that month. And it's not just treatments for seasonal infections that are out of stock. According to the FDA, 191 drugs—antibiotics, cancer treatments, anesthetics, Adderall, and other pharmaceuticals—are currently in shortage or in the process of being restored to the market. This isn’t a Covid-caused, temporary aberration. Experts have been ringing the alarm since at least 2011. Put another way: The US drives drug innovation for the rest of the world, but it can’t keep what it develops on pharmacy shelves. It’s a stubborn problem—composed of procurement slowdowns, proprietary information, and policy shortfalls—that no one has been able to fix. Coping with drug shortages is such a regular occurrence that “it's almost its own subspecialty in pharmacy now,” says Susan Davis, who is an associate dean for pharmacy at Wayne State University. “It’s something that people have as part of their job description, trying to manage shortages, which is unfathomable.”

Beginning Thursday, airline passengers coming to the U.S. from China will need a negative COVID-19 test. It can either be a PCR or an antigen test, but it must be taken within two days of departure. Some say testing is necessary to keep Americans safe. However, Chinese authorities say science doesn't support the requirement. Dr. Paul Kilgore, associate professor in the Wayne State University Eugene Applebaum College of Pharmacy and Health Sciences and co-director of the Center for Emerging Diseases, discusses his thoughts on continued COVID testing requirements. “I personally think we should be putting our efforts into other areas. The testing requirement is something we’ve tried in the past, and it didn’t really show or demonstrate great impact or effect.” Kilgore said he doesn’t think countries would be imposing testing requirements if China was more forthcoming with its data. “I view public health as 80% politics and 20% science. Part of public health that’s so important is engagement, communication – the sharing of information. If we can actually get back to that, we may not need the testing of passengers before they get on an airplane…”

By Jess Thomson  The one universal truth is that every living thing eventually dies.  It may seem like a terrifying prospect, a great unknown, but by learning about every stage of the process, we can take some of the mystery out of our final moments, and what happens to our bodies afterwards. For someone who has been approaching death due to age or ill health, their body will slowly begin to shut down. In the weeks prior, they may experience greater fatigue and lose their appetite, while in the days before, they may lose control of their breathing. Some people have a burst of energy in their final days or hours hours, before growing more tired. "Prior to death, body temperature may increase or decrease depending on the conditions of the patient. The patient may also experience hypostasis, which is the settling of blood in the dependent areas of the body," Mark Evely, director of the mortuary science program at Wayne State University. 

By Robin Erb  Birth control pills, patches and vaginal rings could soon be available through more Michigan pharmacists, bypassing a doctor’s appointment. Under “long-standing” authority in Michigan, pharmacists have been able to enter into collaborative practice agreements with doctors to obtain prescribing rights, said Mary Beth O’Connell, a professor of pharmacy practice at Wyane State University. But most community-based pharmacists do not have such collaborative practice agreements in place to cover birth control, she said. O’Connell said that, ideally, the Michigan Pharmacists Association wants a law change that would give pharmacists prescribing authority for birth control without collaborative agreements. For the Pharmacists Association, changing Michigan law would be preferable because it would be less vulnerable to politics and changing administrations. “Bottom line, we want this as a service that can be provided at all community pharmacies,” she said.

By Jeanna D. Smiley  Long COVID can cause persistent COVID-19 symptoms including loss of smell, fatigue, mood changes, and brain fog in addition to disorders of the heart, kidneys, and lungs. These symptoms emerge or continue at least one month after a SARS-CoV-2 infection. It is estimated that 7.7 to 23 million Americans may have developed long COVID, a condition also called post-acute COVID or chronic COVID. While researchers have observed that vaccines have been effective in fending off some of the worst long COVID symptoms, they also found that mild breakthrough COVID-19 infections can trigger lingering, severe symptoms of long COVID even in vaccinated people. Dr. Joseph A. Roche, an associate professor in health sciences at Wayne State University agreed that vaccines do not replace other risk reduction methods for COVID-19. He pointed to a paper he authored, which urges “continued nonpharmacological risk-reduction measures…to complement vaccination efforts.” In his research, Dr. Roche cited mathematical models which predicted that such measures should stay in place for a year, even after the population reaches ideal vaccination levels.  

This week, the Biden administration is launching a test to treat COVID program. High-risk patients with COVID symptoms will be able to walk into hundreds of pharmacies for a free COVID test and walk out with a free course of pills. The program, according to some experts, is limited in scope. COVID pills are new, and they come with prescribing challenges. Pfizer’s Paxlovid can interfere with many commonly prescribed drugs and cause health problems. Merck’s molnupiravir comes with precautions due to reproductive risks. Independent pharmacies say they can help. “Pharmacists are medication experts. We have been managing drug interactions and dose adjustments routinely for decades. We could handle this,” said Susan Davis, a pharmacy professor at Wayne State University’s Eugene Applebaum College of Pharmacy and Health Sciences.  

As co-directors of the Wayne State University Center for Emerging Infectious Diseases, Marcus Zervos, M.D., Teena Chopra, M.D., M.P.H., Paul Kilgore, M.D., M.P.H., and Matthew Seeger, Ph.D, share their perspectives on lessons learned from the COVID-19 pandemic. The experts discuss parallels between previous pandemics, exacerbated health disparities, a lack of response and resource coordination, the dangers of misinformation, and ways the public health system can better prepare for future pandemics. Together, the co-directors assert that if we learn from this pandemic, our post-COVID-19 world will be more resilient, health disparities will be reduced, and our public health system will become stronger.