*For medical professionals only
Patients, volunteers, hospitals, and businesses are all working hard – Shanghai is solving the problem of dispensing drugs.
On April 18, there were actually 19,442 new cases of local positive infection in Shanghai, down from the previous two days. Pudong New Area, Songjiang District and Qingpu District generally showed a continuous downward trend.
The battle against the epidemic has reached the most critical moment.
And right now, "there's a very big problem to solve." "Shangguan News" published an article on April 18 saying that in recent days, the Shanghai rumor-busting platform has received a large number of messages from citizens asking for help, saying that the drugs are about to be discontinued." Citizens asked how to obtain drugs during the lockdown period, and what reliable and fast solutions were available. ”
Among them, the drug problem of diabetic patients is more prominent.
According to the Shanghai Health Commission in 2020, the prevalence of diabetes among people aged 35 and over in Shanghai reached 21.6%.
At present, only a small number of pharmacies can purchase diabetes treatment drugs within medicare that require cold chain, such as incretin and insulin. Most patients need to go to the hospital for an in-person consultation and prescription. However, during the period of closure and control, hospitals and communities strengthen management, and patients may not even be able to go out of the community door, and the pressure to obtain drugs has increased sharply.
Under the control, what makes diabetics more anxious than food shortage is the medicine that cannot be replenished in time.
Anxiety: I don't know why the medicine was not dispensed
The "True Story Project" published the story of Zhou Wenlong, an old man in Shanghai.
The article said that 79-year-old Zhou Wenlong did not marry and have children. The monthly pension is more than 5,000 yuan, and 1/5 is used to purchase diabetes and other treatment drugs. His neighborhood began lockdown on April 1. After 6 days, there were very few medications left to treat diabetes.
Zhou Wenlong tried to call the neighborhood committee to reflect on the difficulty of dispensing drugs. After the other party agreed, he did not know why the medicine was not dispensed. There were also times when the phone went unanswered.
Zhou Wenlong was not annoyed. On the one hand, his condition is still stable. On the other hand, he feels that it is normal for his needs not to be solved: "A neighborhood committee is responsible for more than 1,000 households, and it is too busy to die." [They] simply don't have much of a break, so you can't blame them, are you right? ”
While he is "saying good things" for others, his body is already uncomfortable because he "takes less medicine".
At the beginning of this year, "Popular Science China" published an article by Dr. Ding Jingjing of the General Medicine Department of Shanghai Tongren Hospital, saying that the harm of diabetes mainly lies in complications. Among them, acute complications are mostly induced by infection, irregular medication and sudden drug discontinuation, which are mainly manifested as metabolic acidosis, hypertonic coma, hypoglycemic coma, etc., and the mortality rate is also quite high.
Under the weibo "anti-epidemic help" super talk, some netizens posted that the elderly with diabetes in their own homes appeared in a state of hypoglycemia coma due to the closure and control of drugs, and their blood sugar was as low as 1.1 and 1.6. Others said that family members may have developed complications, "fasting blood glucose 13 started, eyes began to blur, and inflammation was red and swollen." ”
Status: The problem of difficulty in dispensing medicines is common
As early as early April, the news came out of the press conference on epidemic prevention and control in Shanghai to ensure the basic medication of patients with chronic diseases such as hypertension and diabetes.
Based on articles such as Caixin Network, ideally, the guarantee process should be guaranteed by the district medical institutions in the district with the assistance of the village committee, or the community arranges volunteers to guarantee it through the dispensing of drugs. The patient will give the medication information and medical insurance card to the community, who will summarize and centralize the dispensing.
However, in reality, many links may encounter resistance, resulting in the failure of drug purchase.
The lack of manpower between the community and volunteers is one of the important reasons. "Our volunteers who help dispense medicines are also very hard, but there is still a demand gap." "Health Times" quoted Ji Jing, secretary of Tianlin Eleventh Village in Xuhui District, as saying that there are 1,755 households and 4,000 residents in the local area, and there are many elderly people. There are 7 community service workers, almost 1 person coordinating the needs of 1,000 people. Some elderly people living alone do not use mobile phones, can not directly send out the demand for medicine, volunteers have to go to the door and collect information.
Third, after the city was sealed, Shanghai's manpower and transportation resources could only be maintained at less than 1/10 of the original. Many pharmacies are unable to ship in time due to warehousing sealing, logistics elimination, etc. The warehouse of Shanghai Neptune Star Pharmacy Co., Ltd. (hereinafter referred to as "Shanghai Neptune") is located in Songjiang District, Shanghai. According to the requirements of epidemic prevention, only 1 staff member is allowed to enter and operate the warehouse during the day every day.
Even if the warehouse can be shipped, patients will not be able to get the medicine due to insufficient transportation capacity.
On March 2 this year, Xiao Chen, who lives in Songjiang, Shanghai, became one of the first Shanghainese to be "sealed and controlled.". Xiao Chen is the Channel Manager in Shanghai of Eli Lilly's China Business Team, and his daily job is to ensure the supply of drugs in more than 1,200 hospitals and more than 100 pharmacies in Shanghai, including diabetes treatment drugs.
At the beginning of the isolation, Eli Lilly began to actively seek domestic and foreign transportation resources to ensure the safe landing of imported drugs, establish an inventory mechanism in advance, and ship 2-3 batches of drugs in the past period into 1 wholesale to Shanghai, ensuring about 60 days of medication.
The drug arrived in Shanghai, but it could not be delivered to the patient. "The few remaining major operating pharmacies are left with only one or two staff members. As soon as they go out, they may face the risk of 'attrition', pharmacies may be closed, and no one dares to take this risk. Xiao Chen recalled.
Once, a patient called a landline at a pharmacy and no one answered. Later, it was learned that only 1 employee of the pharmacy was "on duty", but when he was moving goods, he sprained his foot, and could only move a little bit, and it was slow to answer the phone.
To this end, Eli Lilly joined hands with two partners with green passes, Shanghai Medicine and Sinopharm, to deploy The delivery guarantee of Lilly drugs in advance to ensure the smooth passage of drugs into the hospital. At the same time, it began to cooperate with Shanghai Neptune Star Pharmacy Co., Ltd. and Sinopharm Holdings Nusmus Pharmacy Shanghai Chain to deploy insulin supply and distribution guarantee work in pharmacies, and to help seal patients solve the problem of lack of medical care and drugs through cooperative pharmacies, and to broaden the channels for drug purchase as much as possible.
settle
In the early morning of March 30, a group called "Shanghai Medical Emergency Relief Shared Documents" (hereinafter referred to as "Shared Documents") was launched.
Among the hundreds of pleas of help that were initially collected, there were diabetics who had discontinued their medications, and there were severe uremia patients who were in urgent need of dialysis... "It is often young people who fill out the help documents who are seeking medical treatment for the elderly at home. The Surging Figures wrote.
Dong Yi (pseudonym) and Xu Yixing are both volunteers for the operation of "Shared Documents". In their view, elderly helpers have common underlying medical conditions, such as diabetes, and need to take medication for a long time. Once the community is closed and there is a shortage of medicines in the home, it is difficult for them to buy medicines. "Young people can use all kinds of network software, and the elderly can't use it, or even have heard of it." The crux of the problem is the mismatch between resources. ”
Photo caption: As of 15:00 on April 19, the "Let's Help You Shanghai Anti-epidemic Mutual Aid" website received a total of 5,686 requests for help, 39.3% of which were "resolved".
On April 14, a Weibo user posted a "super talk on anti-epidemic help", saying that his father was a diabetic for more than a decade and had been relying on injections and medication to stabilize blood sugar. At present, the needle is almost exhausted, the medicine is transported in the cold chain, and the hospital that dispensed the drug in the past cannot be registered. "Is there any way or channel to buy this medicine?"
Five days later, she posted the progress and said that "there is medicine", "the pharmaceutical company called to inform that there are two hospitals that can be matched..."
Eli Lilly has a "U-Walk Diabetes Care Program (LCCP)" that provides diabetics with blood glucose records, medication reminders, and online guidance from doctors. Before the closure of Shanghai across the river, the department also called all diabetic patients included in the LCCP one by one through the 400 hotline to inform various drug purchase channels. "The more patients can contact a pharmacy, the more peace of mind they can give a family."
Patients, volunteers, hospitals, and businesses are all working hard – Shanghai is solving the problem of dispensing drugs.
According to the "21st Century Business Herald", major pharmaceutical e-commerce platforms have opened the "Shanghai area drug shortage registration" service, launching guarantee services including chronic disease sequels, enterprise group epidemic prevention supplies and exclusive procurement channels for drugs.
According to the spirit of the Notice on Matters Related to Promoting the Resumption of Business of Retail Pharmacies to Ensure supply, as of April 13, 1,105 retail pharmacies have been opened in Shanghai, and another 1,033 pharmacies are gradually resuming business. These pharmacies are distributed in 16 districts and counties of Shanghai and can provide drug supply for various districts, towns and communities.
As of now, at least 32 operating pharmacies in Shanghai are selling incretin or insulin. According to an internal document, Sinopharm Holdings Health Care (Shanghai) Pharmacy Co., Ltd., located in Zhongshan West Road, Changning District, Shanghai, can "deliver medicines to home" and can also buy drugs in stores. "Shanghai Sea King" is divided into 6 core drug purchase groups according to region. After the patient submits the request, the drug can be delivered to the nearest self-pick-up pharmacy the next day, and can be distributed by volunteers or errand runners after picking up the medicine.
On April 19, Shanghai issued the "Notice on the Medical Procedures for Shanghai Citizens During the Epidemic Prevention and Control Period (Shanghai Pneumonia Prevention and Control Office [2022] No. 409)", which once again clarified that all streets and towns, villages, medical institutions at all levels, emergency centers, etc. in the city are not allowed to use the negative nucleic acid verification certificate as a restriction on entering and leaving the community for medical treatment, transferring patients and receiving treatment. All medical institutions should do a good job in ensuring the supply of drugs according to clinical needs, combined with the scope of diagnosis and treatment of the institution, the characteristics of the specialty and the drug needs of residents in the jurisdiction, and timely purchase and equip relevant drugs.
According to the information collation, there are 85 medical institutions that open diabetes-related outpatient clinics and can prescribe treatment drugs.
Source:
[1] It is difficult to buy medicines and seek medical treatment, and it is difficult to protect the 5.33 million elderly people in Shanghai under the epidemic!
[2] During the period of Shanghai sealing, what should I do if it is difficult to buy drugs and dispense drugs? Journalists experience it firsthand: these channels can be tried. Shangguan News
[3] 21 Feature| Self-Help and Mutual Assistance: Shanghai Multi-Party Cooperation to Alleviate the Difficulty of Chronic Disease Patients to Purchase Drugs.21st Century Business Herald
[4] Diabetes is not to be underestimated, and these points must be understood. People's Daily - Popular Science China
[5] Shanghai Medical Aid in a shared document. Surging characters
[6] In Shanghai, one website, 4,000 reasons for help. Daily People
[7] The prevalence of diabetes in adults in Shanghai was 21.6% of patients who received treatment, and their blood glucose control was not up to standard. China News Network
Source: Medical community
Table: "Medical Community" Arrangement
Editor-in-charge: Zheng Huaju
Proofreader: Zang Hengjia
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