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Zoe Stefanadis, RPh

105 Conner Drive, Suite 1200
Wilshire I Building
Chapel Hill, NC 27514
Telephone: (919) 967-8805
Fax: (919) 967-8205

COVID-19: A Shared Public Health Crisis

Pharmacist Zoe Stefanadis has a unique perspective for viewing the COVID-19 pandemic. “While I certainly am aware of its impact on pharmaceutical aspects,” she says, “my background in public health leads me to appreciate how broad the impact is on all parts of our lives—to understand how this disease affects all of us in so many ways. We truly are all sharing in this crisis. No one is untouched.”

Pharmacist Zoe Stefanadis

Ms. Stefanadis, owner of Chapel Hill Compounding, started her career working in Upper Cumberland Regional Health Center in rural Appalachia. “My experience there introduced me to community related health problems—and helped me understand the complexity of providing health care. Dispensing medicine in that setting, for example, meant that physical barriers—such as long travelling distances—needed to be overcome, and the challenges were not only to determine the right medications for patients but to develop proper delivery systems of those meds.

“And, now,” she observes, “we are certainly witnessing the power of a disease to affect all parts of our lives. What we also need to do is to find ways to address the problem of the virus that take into account all those connections.”

First Steps: Providing Services Safely

It was her public health perspective that assisted Ms. Stefanadis in making timely and wise decisions upon learning that a novel Coronavirus was spreading throughout the U.S. “We, as a pharmacy, are seen as essential workers, so first and foremost, we had to ensure patient as well as employee safety,” she says. “Because of my background, once I became aware of the pandemic, I implemented strict guidelines, such as our closed-door policy, as well as how the pharmacy was going to function inside. We did all this, even before any guidelines came down from our governor or the CDC.”

Upon entering the pharmacy, the first thing employees do is wash their hands according to CDC guidelines, then don gloves and masks. They separate personal belongings, disinfect all work surfaces, have hand sanitizer available, and social distance as much as possible. “Fortunately, all those measures were in place before we became a closed-door pharmacy—so our hours never had to change,” she states. “Next, we began to call all of our patients to let them know that we’re not allowing people inside, but we are offering curbside service and shipping. We call our patients to let them know that their prescriptions are ready. If they choose, payments can be processed by phone to limit physical contact. The only thing we have to work with are the knowns. I’m not a fearful person, but I was concerned for our compromised patients. By implementing these safety procedures, we did everything we could to protect the public, our patients, and each other.”

Like many practices and businesses, another problem they encountered initially were supplies—gloves and masks became a real issue. “As we moved forward,” says Ms. Stefanadis, “we started planning how much PPE—protective personal equipment—we would need. We all heard how desperately hospitals were in need, but essential workers in the private sector also needed PPE.”

When there was a shortage of hand sanitizer, they started making it and offered it to their patients. “We still do that,” she says. “Being a firefighter’s mom, I asked for donations so that we could supply the fire department with hand sanitizer. It was a bit difficult to procure alcohol, but we wanted to assure that public health services were supplied, as well as our patients. People still needed to get out, go to the grocery store, the pharmacy. As a community pharmacy, we wanted to be able to help them do that with a sense of safety.”

Supporting Patients through the Crisis

“As we move forward,” says Ms. Stefanadis, “we want to make sure that people understand that we’re still open; we’re still available for phone consultations regarding medications and supplementations; and we continue to provide medications and even hormone testing. People who are already established should continue taking their medications. We want to make sure that they know that we are here for them.

“Chapel Hill Compounding is not equipped to do COVID-19 testing,” she says, “but we’ve done a lot of research to see how we can play a role. Perhaps the most important thing that everyone can do in this vulnerable time is to protect and support their immune systems. This can be as simple as making sure they’re eating well—and especially ensuring that they are getting sufficient support from the vitamins and minerals that play key roles in our immune systems. Vitamin D is one example; a lot of COVID-19 patients seem to feel worse for months, and it appears that low vitamin D levels may contribute to their symptoms. We encourage people to boost their immunity with vitamin D, vitamin C, and zinc. We keep our over-the-counter supply well stocked and remind people as they pick up their prescriptions that they should take these supplements to boost their immune systems.”

She also noted the need to support people emotionally through this pandemic. “As humans, it’s normal to feel anxiety and depression under these very trying circumstances,” she says. “And it’s important to seek mental health support in these times if these problems increase. People should also know that they can reach out to their pharmacist if they have anxiety, depression, or problems sleeping. Chapel Hill Compounding carries over-the-counter supplements for all these issues, and we can also offer patients natural, helpful sleep aids, that are not addictive.”

Looking Ahead

“This virus is unique,” observes Ms. Stefanadis, “or, at least, is still remarkably unknown. It’s still very hard to predict exactly how to respond to it, prevent it, or treat it. In the last several months, we’ve seen different patterns—in the US and around the world—in its spread. A few months ago the impact in places like New York and Washington state were terrifying; now the numbers in those places appear to have hit their peak and are declining. At the same time, the numbers in Arizona, Texas, Florida, California and other areas, including North Carolina, are setting daily records. It’s very interesting to see how each state responds to those numbers.

“While it’s hard to predict exactly what lies ahead, the one thing that we are absolutely sure of is that this virus is transmitted person-to-person. As a scientist, I’m hoping—as we all are—that science will soon find the answers to our questions about how to prevent and treat this terrible disease. That will take time. But it’s also clear, from the science, that two simple measures—wearing masks and maintaining social distancing—can make a huge impact in terms of reducing the spread of the disease. So even as we wait for better answers about the accuracy of testing for antibodies, and for the development of a vaccine, we can all make a significant contribution to containing the virus—by simply keeping our distance and wearing masks.”

Drawing on her knowledge of public health issues, Ms. Stefanadis says that she expects that there will be a second wave of COVID-19—beyond what we’re seeing now. “We’re still dealing with the first wave; when flu season hits in the fall and winter, this is likely to resurge. We need to be ready for it. I hope that people will see where we’ve been and hopefully see what we can do as individuals. Masks definitely need to be worn out in public. I wear a mask all day, making sure I go outside every so often to take a few deep breaths of fresh air. We’re fortunate in North Carolina that our weather isn’t severe. We can work in our yards and take long walks for exercise and fresh air daily, year-round. Exercising for mental and physical well-being is essential. And don’t give up on your regular health care. Just because COVID-19 is here, doesn’t mean other health issues disappear.

“It’s sad that it’s COVID-19 that has brought the world together through this shared experience,” observes Ms. Stefanadis. “We’re all dealing with the same problems and fears; hopefully we can also come together to solve this problem. We should be learning from each other—what’s working well for other countries, what’s not, and follow scientific research. Then we can try and discover our new normal. No one knows what the timeline is going to be, so it can be scary. You should never feel like a victim. Knowledge is always important—empower yourself as much as possible.”