In the midst of a national pandemic, pharmacy schools face extraordinary challenges as they work to make alternate arrangements for rotations, determine how students will graduate on time and ensure that learning continues.
By Jane E. Rooney
The COVID-19 pandemic turned lives upside down for citizens around the globe. For pharmacy schools, as with most education institutions throughout the United States, this meant a drastic adjustment as administrators, faculty and students shifted to virtual learning arrangements for the foreseeable future. Although many institutions have experience with emergency planning for events such as natural disasters or short-term closures, a viral outbreak on this scale is unprecedented. “We never thought of a pandemic of this proportion,” said Dr. Wanda Maldonado, professor and dean, University of Puerto Rico School of Pharmacy, who is part of a COVID-19 Task Force appointed by the governor to provide guidance to the Department of Health. “This has taken a lot of effort from the task force. There were no protocols in place for guidance, as the spread of this disease is a fairly recent phenomenon.”
When it became clear in mid-March 2020 how quickly the virus was spreading, AACP joined several pharmacy advocacy groups in urging government agencies to adopt policy recommendations to empower pharmacists to support the nation’s response and assist patients. The four recommended measures were: authorizing test-treat-immunize; easing operational barriers to address workforce and workflow issues; addressing shortages and continuity of care; and reimbursing for services and removing barriers.
“A collaborative spirit is at work at the state and national level within pharmacy and also in our interprofessional community,” noted AACP CEO and Executive Vice President Dr. Lucinda Maine. “To have a substantive policy analysis produced and signed on by over a dozen national organizations in less than a week simply has no precedent. We have already seen the outcomes in terms of state pharmacy board waivers to address the needs we identified in that document. That is one of the most striking results of this collaboration.”
Maine added that AACP is striving to provide resources to individuals and institutions to help them through this crisis. “The pandemic has stimulated the most remarkable amount of cooperation, resource sharing and mutual support that I have ever witnessed,” she said. “From our co-hosting the initial series of webinars with ACPE for deans or their designates in mid-March to various sections and special interest groups using AACP Connect for problem solving and resource sharing, it is a testament to what wonderful people we have in the Academy.”
Here are the stories from several pharmacy schools around the country about how they made decisions and handled the restrictions brought on by COVID-19 in the early days of the outbreak in March. (This information was up to date as of press time in late April 2020.)
Puerto Rico was one of the first U.S. jurisdictions to impose strict measures to try to contain the coronavirus, enforcing a strict lockdown that began on March 15. At that point, all didactic courses at the University of Puerto Rico School of Pharmacy transitioned to online platforms, said Maldonado. “For experiential education, we made some adjustments. We went through a process of reassessing when these experiences would be offered and in which scenarios, since lockdown regulations are very tight. Our students were reassigned when we performed an assessment of the practice sites’ availability and students’ required experiences.” She expressed confidence that despite the pause in activity, graduating students will be able to meet their requirements to graduate on time.
She added that in many ways, the school and faculty are continuing with their academic duties. “Researchers from our school are allowed to go sporadically to continue with research investigations, so these are not affected, and they can continue with experiments that are ongoing. Some of them have external funding so they are allowed to provide continuity but while observing social distancing, with minimal personnel present. Currently, no students are involved unless absolutely required.”
The governor’s task force is considering protocols for pharmacists, physicians, long-term care institutions, nursing homes and other sites that need guidance in terms of prevention and mitigation of the pandemic. In addition to Maldonado, task force members include physicians of different specialties, epidemiologists and health services administrators. “The task force chair is the chancellor of our medical sciences campus,” Maldonado noted. “It’s a group of great variety that can provide input in terms of different types of expertise. For pharmacists, we have provided guidance in terms of how controlled substances should be managed as well as handling prescriptions given the updated DEA guidance and telemedicine regulations. We are also providing guidance on the use of hydroxychloroquine when deemed appropriate, and in order to preserve a supply for patients who use it for autoimmune diseases, among other pharmacy-related matters.”
In Seattle, which was one of the first areas in the United States to be affected by COVID-19, the University of Washington School of Pharmacy had to make quick decisions about how to move forward. “We had our first case back in January. Our first communication with students was Jan. 27,” said Dr. Jennifer Danielson, assistant dean, Experiential Education and Student Professional Development, and associate professor. “They did such a wonderful job taking care of that first patient and he was discharged. It gave Seattle a false sense of security. The school leadership sent information out to let people know the virus was out there and remind our students to follow hospital policies and procedures. We didn’t feel we needed to add extra layers of guidance. We reminded preceptors to make sure students knew what was going on. Then in late February it started blowing up.” At that point, she said, the school went into crisis management mode.
“We got a call from the first hospital [in King County] that had gotten hit really hard. They were the first to say that all the students have to leave,” she continued. “The pharmacy department was sad because they wanted to keep students. Then we started going into contingency mode. Every hour of every day over the next three weeks—we couldn’t seem to get ahead of it and make effective decisions about what to do for students. Our dean got involved, who has an advisory committee with representatives from many of the hospital systems. We got an agreement from the lead pharmacy directors to keep our students as much as possible. After a while some still found they had to let the students go. Our medical and nursing schools decided to take their students off rotations. They have more leeway in accreditation standards. This put pressure on us to remove our students. Our university hospital pharmacy department was the last one to let students go.”