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Pharmacies Warn A Second Wave Would Break Supply Chain For Customers — Like Nursing Homes

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Investigations into how long-term care facilities in New York and Connecticut handled the coronavirus pandemic has highlighted a major break in the supply chain for safety equipment. Representatives for nursing homes say both state’s pandemic response did not give them the same preferential treatment as hospitals to protect their vulnerable residents. Distributors were in short supply.

The governors blame a lack of national coordination — and say they will do whatever it takes to prevent a second wave of infection.

Bill Buchner, WSHU: Joining us now is Hossam Maksoud, CEO of Community Cares Rx , a pharmacy that serves long-term care facilities in the New York Tri-state area.

Hossam, thank you for joining, All Things Considered.

Hossam Maksoud: Thank you for having me.

BB: You stayed open during the pandemic, supplying nursing homes and assisted living facilities with prescription drugs and personal protective equipment. How has the supply chain fallen apart?

HM: Well, it was really a tremendous experience for us when COVID-19 hit the tri-state area. We usually dispense pharmaceuticals and surgical supplies. PPE was not really one of the major items that we usually stocked for these types of facilities. But, we ended up having no choice in trying to help our partners and provide them the needed PPE and attire.

BB: What is in short supply?

HM: We have a shortage of gloves, for example, that's the main shortage that we have. And N95 masks are not available through our wholesalers. There are other types of masks that are available. I'm not worried about what we have in shortage right now. I'm worried about what happens in the fall or winter, when a second wave of COVID will hit. And if it's not COVID, it will be the flu and there will be no difference. People will be also scrambling trying to find out where to get these supplies. Right now, most of our wholesalers have the items at limited supply. So, earlier if you’re ordering certain quantities, now you're limited to a few. But, I can tell you, we use some of the largest in the country, some of the largest wholesalers and they are rationing some of these supplies and some of them aren’t even in stock.

So, I know that officials are instructing to carry three months worth of PPE, which is good. But honestly, I'm still and many others like myself, worried about the chain supply and when pharmacies like us and maybe smaller facilities are trying to get the supplies or we can have any for us or not, and just those logistics of handling the supplies to these types of facilities, how is that going to happen? In the first wave when this happened, we will refer to the Department of Health, then from the Department of Health, we will refer to the County Department of Health, then the emergency offices. I mean, there is a lot of confusion when it comes down to actually getting these supplies to us in order to provide them the facilities with them.

BB: So, if there is a second wave, then it sounds like really there is no plan or preparation going on right now for that second one.

HM: I'm afraid to say yes, you are correct. I hear in the news, I hear from officials that they have a plan. But tell me what is the plan? Because I want to be confident that the plan will work. And it may work, you know, for certain types of providers, larger hospitals.

Are you going to get these to the small residential programs, the day care programs, the assisted living and the smaller nursing homes? What is the plan? And I am just going to be open with you and tell you okay, so what kind of supplies do you have? Can you give me numbers? Because if we have an X amount of patients in hospitals, or nursing homes or assisted living homes, okay, so what do we have to cover these people and for how long? So you know, you have to give me data to make me comfortable and confident that you have the numbers that you're talking about and the preparation that you need.

BB: Many of these long-term care facilities have been burdened with extra pandemic related costs. From the supply side, how can you help those facilities?

HM: Yes, I mean, you know, so it's all I mean, we, you know, some items that you we, for example, a thermometer that you used to buy for $3-$4, all of a sudden it goes up to $10. And if you're gonna pass this along, even with minimal charge, or at cost, that's, you know, double or triple the price already to these types of facilities. So they're really, really suffering tremendously with increased cost and then providing the residents and visitors with PPE and the most you can do is just probably pass along the price to them. I think, honestly, that the government should step in and provide enough financial support to cover these PPE, even if it's not within their anticipated budgets. So there is a larger piece to the whole puzzle in government assistance to give a tremendous surface and I think they need the support. You know, unfortunately you only hear some of the bad news and how they were not prepared for it, but really, you know, who was prepared for that? So, it's a mutual interest for everyone to come together and help each other at this time.

BB: How has this pandemic changed the way that you do business?

HM: Well, mentally, it's exhausting. Planning. It takes a lot of planning in terms of staffing, I mean, this is one thing I would like to emphasize on this call that staffing is a major issue. We don't have enough people to suffice our needs and our residents right now. I'm not just talking about the pharmacy, I'm talking about healthcare, in general. And some of the steps that you know, in terms of nurses are helping other states. So they, you know, hopefully we'll have some of them back in here. But it affected my business in certain ways. We, you know, we used to do business with some of the clinics that used to be open for the patients that are not open anymore. So, we have to find ways of delivering these medications to each single patient. So there is an increased cost in logistics and delivery and with staffing, we have to figure it out. Okay, that plan B of having staff working from home and making sure that you supply and provide IT and equipment for them to work off-site. And when they come to the site that the preparations you're going to be taking and the testing you're going to have to go through. So it is different, but you're gonna have to live with it, this is what it is, and you just have to adapt to the new era that we're living in.

BB: So, this would be the pharmacy of the future that you're talking about?

HM: Yeah, the pharmacy of the future will pretty much be a closed-door kind of a pharmacy. Lots of electronic transmission and communication. Right now, you know, with telemedicine but also tele consulting for the pharmacy part of it. If you need to see your pharmacist of preference, you have to see them from a screen. You know and hopefully, people will be comfortable with that. If it gets complicated for certain people who are not computer savvy, but there is a lot going to be happening at home for many people in the years to come.

Hossam Maksoud is CEO of Community Cares Rx Pharmacy, which supplies nursing homes and assisted living facilities with PPE and pharmaceuticals in the New York tri-state area.