Keeping up with COVID (I'm not, actually)

I haven’t blogged in a while. Because I haven’t been keeping up. Between tracking the insanity that was the vaccine rollout, the ever-changing eligibility rules, the ever-changing guidelines, the emergence of adverse effects and more, who has time for anything else? Recently I’ve been seeing some posts and questions in social media—some by pharmacists, some aimed at pharmacists—that show we are all struggling to keep up. Questions about third doses from pharmacists (Can we give a third dose now if they’ve received two heterologous doses, as they are concerned about travel?). Questions about mixing and matching (on Twitter, a lawyer shared that a pharmacist had asked a patient to sign a handwritten waiver because mixing doses was dangerous). And there’s much more. I don’t blame either pharmacist in these cases. How on earth can any of us keep up with this situation? I find myself feeling confident in the vaccines: in their eligibility, the recommendations, the roll out. But I know nothing, zilch, nada about testing. My knowledge about one aspect of the pandemic has come at the cost of learning more about other aspects. There are numerous resources available to us, but often finding them is nothing short of Herculean. If it helps anyone out there, I want to share a few resources that I have found incredibly helpful: The Community Pharmacists Network Canada Facebook Group. James Morrison (fellow UofT 1T0 alum!) has amassed a group of over 6,000 pharmacists, technicians and assistants from across Canada who share insights and information. Ask questions here. Great group! University of Waterloo COVID19 Health Resources. This is an amazing page with many resources. If I may, I’d like to direct you to scroll down to the bottom where you’ll find “other resources.” I was pulled into an ad hoc working group that includes our own powerhouse Dr. Kelly Grindrod of UWaterloo Pharmacy, immunologists, allergists, hematologists, family physicians and epidemiologists as well as health communicators to create these documents for guidance on dose mixing, safety and more. Check them out here: https://uwaterloo.ca/pharmacy/health-resources/covid-19-health-resources Twitter. I have never found a better way to communicate. Yes, you need to block out the noise. But there are so many amazing experts on there who know their stuff. Follow Kelly Grindrod, Shelita Dattani, Amir Imani, Randy Luckham, Kyro Maseh, Justin Bates, the OPA, CPhA, UWaterloo Pharmacy, UofT Pharmacy, Pharmacy U and Pharmacy Practice + Business for pharmacy content (yes, sorry for the heavy Ontario focus – if you are out there on Twitter not in Ontario, I’m also on there and would love to follow you!). For non-pharmacy content, check out Dr. Menaka Pai, Dr. Samira Jeimy, Holly Witteman, Sabina Vohra-Miller, Noah Ivers, Andrea Chittle, Tara Kiran, Samantha Yammine, Dr. Jennifer Kwan, Isaac Bogoch and others that these people interact with. Join your provincial professional association – Their websites are full of useful information, resources and toolkits. The dollars you spend on membership also help with advocacy (we aren’t all where Alberta is with practice and compensation!). Over this past while, simply keeping up has felt like a full-time job. And keeping up is only part of it… I keep saying that I am surviving, not thriving, and that is the truth. But the relationships I’ve formed with many of the people above have been sustaining, and in some cases, are saving me mentally—helping me manage my own anxiety and guilt with this vaccine roll out (expiring doses anyone?) And on that note, I am going to switch gears and say something I think many need to hear: Expiring doses are NOT ON US. Have you spent hours calling/tracking down a patient trying to finish a bottle of vaccine? The COVID vaccine world of late July is not the same as the world we were in back in late June. We always knew that there would be a time when supply outpaced demand. Truthfully, it came earlier that I expected. Mentally, I was not prepared for what that looked like. The local public health unit had given me many doses to meet our demand, but when demand slowed I realized many would expire and I was nearly sick to my stomach. A physician I met on Twitter told me straight out: “That is not on you, Kristen.” Those words saved me. They helped me reframe wasted doses into given doses. It’s time to focus less on the five doses that might not be used by the expiry date and instead on the one I did administer that likely saved a life. If I didn’t have any vaccine in store to give, because I can’t use up an entire vial in a day, I wouldn’t be able to reach that one person today. I wouldn’t have doses available when the vaccine-hesitant finally decide to walk through my doors. Yes, Canada needs to redirect shipments to countries in need. Yes, manufacturers need to start packing PFS that won’t expire. But until then, a single request for a vaccine means I’ll open a vial, mix it up, administer one dose and have five remaining. If I can move those, great. But if I can’t, I’m going to celebrate the dose I gave, not the ones tossed at the end of the day. I may not be able to keep up with everything, but here's what I know for sure: I am doing my very best.

Keeping up with COVID (I'm not, actually)

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Kristen Watt

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