Fintan Moore observes that while 2020 was a year to be forgotten, it also spawned advances and accelerated change

It’s safe to say that most people will be happy to see the end of 2020 and hope that 2021 will see a corner turned on the coronavirus crisis. The hope is probably justified, given the potential for the massive vaccination programme rolling out across the globe. With a lot of work and a bit of luck, the potential is there to see a return to normal social life, visits to vulnerable relatives, crowds at sporting events and the enjoyment of foreign travel.

However, when the history of 2020 gets written, there may be a recognition that there were some positives on the balance sheet. In the same way that other ugly events in history like the two World Wars and the Cold War spurred technological advances, the Covid pandemic has also accelerated change. The main adaptations have seen a rapid progression in remote working and meeting, achieving changes that would otherwise have taken years to happen, if at all.

Similarly, in the world of pharmacy, we have seen a huge shift in the use of technology. After a couple of decades of chat about emailing prescriptions with nothing happening at the coalface, we had healthmail functioning within a couple of weeks when the crap hit the fan. Healthmail is not perfect, but it shows the potential for proper e-prescribing. It still makes me smile whenever a healthmailed prescription arrives for a controlled drug, especially methadone.

After all these years of us pharmacists being expected to treat hand-written controlled drug prescriptions as if they were sacred pieces of parchment issued from a supreme being and requiring devoted care and attention, it’s great to just print the prescription ourselves from the email. Ironically, the emailed prescriptions are actually more secure, with less potential for messing about than the paper ones.

However, when the history of 2020 gets written, there may be a recognition that there were some positives on the balance sheet

The challenge for the future will be to take the best aspects of the changes inspired by the pandemic, and as the pandemic recedes, to resurrect the best aspects of the old ways of living and working. A lot of travel for meetings has been shown to be a waste of effort when a Zoom call can achieve the same result, but there will be times when old-style face-to-face discussions are more beneficial. Similarly, many GP visits are superfluous when a simple repeat prescription is needed, but these routine visits can sometimes lead to a diagnosis of other problems that may elsewise have escaped attention.

There could be a happy medium achieved if patients could be issued with 12-month prescriptions for conditions such as high blood pressure or cholesterol, subject to checks being done in the pharmacy to flag any issues. This would require a new model of co-operation and payment, but the potential is there. Rather than writing off 2020 completely as the year from hell, we should appreciate the times it showed us that we can get a lot done when we’re allowed to cut through the bullshit and do it.

A Problem of Scales

The pandemic has seen a huge death toll in many countries across the world, with the United States in particular being one of the worst-hit by any metric used. At time of writing, the death toll stands at 287,000 people, which is an appalling loss of life, five times more than the casualty figure for the Vietnam war. What is even more remarkable in my opinion is that the annual number of deaths in America due to obesity is higher again, at 300,000. So logically, the fear, distress and mayhem caused by the coronavirus should get redeployed to this chronic ongoing threat, but that is never going to happen.

The Americans certainly won’t be alone in that. Here in Ireland, we are rapidly evolving obesity levels to match our cousins across the Atlantic, so we can expect a comparable death toll in the years to come. If even a fraction of the money we are spraying at the coronavirus was spent each year on the promotion of healthy eating, we might improve the statistics. However, the sad reality is that the Government spend in this area will always be dwarfed by the tsunami of junk-food advertising.

The rising chatter about ‘body positivity’ is another string to this bow, with a message encouraging people to be happy to stay overweight, and more importantly to the junk-food companies, keep up the calorie intake to make that happen. Nobody should ever be victimised because of their weight, but it is also wrong to deliberately encourage unhealthy lifestyles.

Not to be Sniffed At

The uptake on the nasal flu vaccination for children was a lot lower in my pharmacy than I had anticipated. That wasn’t helped of course by the appalling way that vaccine delivery was prioritised to pharmacies that had vaccinated in previous years, so while I was waiting for supplies, some of the names I had on my list got hoovered-up by other pharmacies or GPs.

Most of the children that I vaccinated were absolutely fine, and accepted the reassurances that the little spray up each side of the nose would be fine and over in no time. However, the few resistant kids could be pretty determined, and there was a two-year-old who would have needed an exorcism before a vaccination. Overall, I have to say that I have a new-found level of respect for dentists who have to get into wee mouths rather than nostrils, and do work that can cause pain — rather them than me. There are times that it’s worth remembering that as jobs go, pharmacy isn’t that bad.

<strong>Fintan Moore</strong>
Fintan Moore

Fintan Moore graduated as a pharmacist in 1990 from TCD and currently runs a pharmacy in Clondalkin.