Some U.S. nursing home residents face delays for COVID-19 vaccines despite extreme risk

By Lisa Baertlein and Deena Beasley

LOS ANGELES (Reuters) – A former Arkansas health official is sounding alarms about the pace of coronavirus vaccines being administered to residents of long-term care facilities under a U.S. plan that puts major pharmacy chains CVS and Walgreens in charge of many of the shots.

Fewer than 10% of doses allocated to those Arkansas seniors have been administered, according to the state health department. The two pharmacies are working with about 40% of the state’s facilities. Some of those were told that they were scheduled for February or March, said Dr. Joe Thompson, former Arkansas surgeon general and chief executive of the Arkansas Center for Health Improvement

“This is not acceptable,” said Thompson. “We’re seeing a failure in deployment by CVS and Walgreens.”

Federal health officials in recent days have urged broadening vaccine eligibility to tens of millions of Americans to speed the national inoculation program rollout. Meanwhile, seniors at some long-term care facilities – who account for about 1% of the U.S. population but 40% of COVID-19 deaths and were supposed to be at the front of the line – continue to wait.

State and local officials and long-term care operators in states including Florida, California, Arizona, Indiana and Pennsylvania told Reuters they have turned to alternative providers for vaccinations for their residents or staff because the pharmacy chains were scheduling shots weeks out.

Some 75,000 long-term care facilities signed up to receive vaccines from CVS Health Corp and Walgreens Boots Alliance Inc under the U.S. Centers for Disease Control and Prevention’s (CDC) Pharmacy Partnership Program.

“I think they face serious bandwidth issues in terms of scheduling,” said David Grabowski, a Harvard Medical School professor and healthcare policy expert. “I find it very distressing that we haven’t been doing this more rapidly. This is really a matter of life or death.”

Arkansas Governor Asa Hutchinson in a statement on Thursday said the two pharmacy chains assured him that all long-term care residents assigned to them would be vaccinated by the end of this month.

Many states prioritized homes with patients requiring medical care, which contributed to delays at other long-term care facilities.

CVS said it plans to finish all shots at assigned facilities within nine to 12 weeks of the first dose. That means states like California, Florida, Arizona, Alabama, Oklahoma and Pennsylvania, which were among the last to activate the second-phase of facility vaccinations, may not be finished until April.

“State decisions on which facilities are activated when have a significant impact on timing,” CVS spokesman T.J. Crawford said, noting that the company has administered 1 million shots and is on track with its federal agreement.

Others hurdles included confirming vaccine availability, the winter holidays, vaccine hesitancy and fresh COVID-19 outbreaks, the companies said.

That resulted in “a little bit slower start than what we were hoping for. Now that we’ve gotten past the first of the year, you’re seeing a quick and rapid acceleration,” said Rick Gates, Walgreens’ senior vice president of pharmacy and healthcare. The company has done more than 500,000 shots and expects to be done by March.

‘OVERWHELMED BY THE SHEER VOLUME’

Meanwhile, central Florida’s Seminole County is deploying mobile clinics to some assisted living facilities.

“We went because they either have not been contacted by the private providers or they had concerns because of some type of issue,” said county emergency manager Alan Harris.

“CVS and Walgreens, I think, are overwhelmed by the sheer volume of long-term care facilities in Florida,” Harris said.

The state of Florida has hired health services firm CDR Maguire to take over vaccinations at about 1,900 assisted living facilities that CVS or Walgreens had scheduled on or after Jan. 24.

Los Angeles County opted out of the CVS-Walgreens partnership and is asking facilities that can to pick up and administer vaccine themselves. In Northern California’s Contra Costa County, nonprofit Choice in Aging joined John Muir Health and Kaiser Permanente in pitching in to help.

Choice in Aging is targeting facilities with six or fewer beds in historically underserved communities. “This is a population that is never prioritized,” said Choice in Aging CEO Debbie Toth.

The CDC on Thursday said 26% of the 4.7 million vaccine doses allocated for long-term care sites had been administered, lagging even the woeful 36% of the 30.6 million available nationwide.

West Virginia, which opted out of CDC Pharmacy Partnership, did extensive planning and tapped its existing network of long-term care pharmacies to quickly vaccinate nursing home residents in an all-hands-on-deck effort, said Dr. Michael Wasserman, former president of the California Association of Long Term Care Medicine.

“Community pharmacies absolutely should be involved,” said American Pharmacists Association CEO Scott Knoer. “I wish they would have been from the get-go.”

(Reporting By Lisa Baertlein and Deena Beasley; additional reporting by Carl O’Donnell in New York; Editing by Peter Henderson, Bill Berkrot and Jonathan Oatis)

Amazon launches online pharmacy in new contest with drug retail

By Jeffrey Dastin

(Reuters) – Amazon.com Inc. on Tuesday launched an online pharmacy for delivering prescription medications in the United States, increasing competition with drug retailers such as Walgreens, CVS Health and Walmart.

Called Amazon Pharmacy, the new store lets customers price-compare as they buy drugs on the company’s website or app. Shoppers can toggle at checkout between their co-pay and a non-insurance option, heavily discounted for members of its loyalty club Prime.

The move builds on the web retailer’s 2018 acquisition of PillPack, which Amazon said will remain separate for customers needing pre-sorted doses of multiple drugs.

Shares of pharmacy chains, drug wholesalers and grocers fell before the bell. Amazon’s shares were up nearly 2% at $3,190.99.

Over the past two years, Amazon has worked to secure more state licenses for shipping prescriptions across the country, which had been an obstacle to its expansion into the drug supply chain, according to analyst notes from Jefferies Equity Research.

The company founded as an online bookseller has disrupted industries including retail, computing and now potentially pharmaceuticals, drawing criticism of its size and power from labor groups and lawmakers along the way.

TJ Parker, PillPack’s CEO and vice president of Amazon Pharmacy, said in a statement the retailer aimed to bring “customer obsession to an industry that can be inconvenient and confusing.”

The company faces entrenched competition from Walgreens Boots Alliance Inc, CVS Health Corp, Walmart Inc, Rite Aid Corp., Kroger Co and others. Take-up of online ordering of drugs has been low, according to market research from J.D. Power.

Amazon injects a new look and feel into a space that has been dominated by a few large mail order pharmacies like CVS, Cigna Corp and UnitedHealth’s Optum, analysts from brokerage Evercore ISI said in a note.

“Consumers have historically not warmed to mail delivery of prescriptions, as customer service has been a weaker point of this service,” they added.

Shares of Walgreens Boots Alliance, Rite Aid and CVS tumbled between 8% and 12%, while those of drug distributors Mckesson Corp., Cardinal Health Inc. and Amerisourcebergen Corp were down 2% to 5%.

Should Prime members prefer buying in person, Amazon said its discounts on non-insurance purchases apply at more than 50,000 brick-and-mortar pharmacies – including those run by rivals. Inside Rx, a subsidiary of Cigna’s Evernorth, administers that benefit, Amazon said.

Still, the pandemic may help bring drug orders online. E-commerce has surged this year as governments told people to stay home to stave off infections of COVID-19, and Prime members – more than 150 million globally – may be receptive to buying medication online now that it’s from Amazon.

The company said Prime subscribers get up to 80% off generic and up to 40% off brand drugs when they pay without insurance, as well as two-day delivery.

Amazon’s online pharmacy is not yet available in Illinois, Minnesota, Louisiana, Kentucky, and Hawaii, a spokeswoman said.

(Reporting By Jeffrey Dastin in San Francisco and Caroline Humer in New York; Additional reporting by Manojna Maddipatla and Ankur Banerjee in Bengaluru; Editing by Lincoln Feast and Sriraj Kalluvila)

Flu season prep, complicated by COVID-19, starts early this year

By Carl O’Donnell

(Reuters) – Healthcare providers, including CVS Health Corp., are kicking off flu vaccinations early, ordering extra shots and aiming to add tests that check for both the annual flu and COVID-19, pharmacy executives and experts told Reuters.

Flu vaccination for the fall has taken on increased urgency because of the potential for serious complications if patients contract both viruses at once.

Vaccine makers will provide nearly 200 million flu vaccines to the United States this year, potentially 20% more than is typical, said LJ Tan, chief strategy officer for the Immunization Action Coalition, a nonprofit that promotes vaccination.

CVS expects to more than double the number of flu shots it provides to around 18 million people and Walgreens Boots Alliance Inc. is stockpiling extra vaccines, the companies told Reuters.

Drugmaker AstraZeneca Plc. on Thursday announced its first shipment of its FluMist vaccine in the U.S. and said it has increased production of doses in the U.S. by over 25% more than previously planned.

Failure to inoculate for the flu could also strain the United States COVID-19 testing capacity, which is still below the 6-10 million daily tests needed, Reuters has reported.

“If we can eliminate the dynamic of people getting symptoms and their first reaction is ‘is this the seasonal flu or is this COVID,’ it can take demand off of COVID-19 testing,” CVS Chief Executive Larry Merlo told Reuters.

Merlo added that CVS is working to obtain tests that screen for both viruses simultaneously. U.S. regulators approved a joint COVID-19 and flu test in July.

The same people who are most vulnerable to risks from COVID-19, such as the elderly and those with respiratory conditions, are also at greatest risk for the flu, Tan added.

The U.S. healthcare system is already expected to be strained in the fall by a resurgence in COVID-19. The Institute for Health Metrics and Evaluation is anticipating an uptick in COVID-19 cases in the coming months, resulting in around 300,000 total deaths by December, up from the current figure of roughly 160,000, and a nearly 75% increase in hospitalizations.

There is evidence that social distancing measures for COVID-19 reduce the transmission rate of the flu as well, according to the U.S. Centers for Disease Control and Prevention, meaning that continued measures in the U.S. could potentially slow flu transmission this season.

However, efforts to inoculate patients for the flu could be complicated by the need to safeguard patients and healthcare workers from COVID-19.

“If a patient has a fever or other symptoms associated with illness, they will be referred to their healthcare provider and immunizations will be deferred,” a Walgreens spokeswoman told Reuters.

CVS plans to begin inoculating patients earlier than usual – possibly by the end of this month – to get a jump start on preparing for this year’s flu season, which usually starts around October.

However, studies show there is a risk that getting inoculated against the flu too early can leave a patient vulnerable to contracting the virus later on in winter, if the shot wears off.

Other physicians are also starting this month, though it will still take months to fully distribute all the needed inoculations, Tan said.

The flu vaccine “comes out over time so you want to make sure people continue to seek flu vaccines” through Thanksgiving and beyond, Tan said.

(Reporting by Carl O’Donnell; Editing by Peter Henderson, Aurora Ellis and Bernadette Baum)

Target, CVS, Walgreens to require customers wear masks at U.S. stores

(Reuters) – Target Corp, CVS Health Corp and Walgreens Boots Alliance Inc said on Thursday they would require customers wear face coverings while shopping at their U.S. stores, adopting a widely accepted way to curb the spread of the coronavirus.

The move by consumer-facing companies comes as virus cases continue to surge in the United States and deaths exceed 137,000.

On Wednesday, Walmart Inc, Kroger Co and Kohls Corp had decided to implement the policy at all their outlets.

Target said it would launch the policy from August 1, with an exception for those with underlying medical conditions and young children.

Local and state regulations already require shoppers at over 80% of its stores to wear face masks, the retailer said.

Walgreens’ policy will come into effect on Monday, with the company saying it will add store signage and intercom messages to remind shoppers of the new rule.

CVS will also launch the rule at its pharmacies from Monday, but said it was not asking its employees to act as enforcers.

While many companies have recommended masks for months, they were hesitant to make it a requirement over fears of drawing the ire of shoppers, especially after several videos posted online showed confrontations between customers and store staff.

“What we are asking is that customers help protect themselves,” CVS said in a statement.

(Reporting by Uday Sampath in Bengaluru; Editing by Anil D’Silva and Arun Koyyur)

CVS ramps up drive-through coronavirus testing sites with faster kits

CVS ramps up drive-through coronavirus testing sites with faster kits
By Michael Erman

(Reuters) – CVS Health Corp , called on by the Trump administration last month to help test Americans for infections from the new coronavirus, said it was launching two offsite testing locations with Abbott Laboratories’ faster diagnostic kit and would be able to handle 1,000 tests per day.

Testing for COVID-19, the serious respiratory illness cased by the new coronavirus, has been held back by a lack of test kits and other equipment. While more than 300,000 people in America have tested positive for the new coronavirus, officials believe a shortage of kits has undercounted cases.

Testing, including at drive-through sites like these, is also seen as a key component for U.S. workers and restarting the economy as most states have ordered many non-essential businesses to close.

Executives from Walmart In, Walgreens Boots Alliance Inc  and Target Corp also said in March as part of the government announcement that they would start this testing.

In recent weeks, CVS and Walgreens had said that they each had a pilot site running.

CVS’ two new drive-through COVID-19 testing sites in Georgia and Rhode Island will use the new Abbott tests, which can work in 15 minutes, and that up to four more locations to follow.

“We want to get some experience under our belt with these sites and understand exactly sort of what the volume looks like,” CVS Chief Medical Officer Troy Brennan said in an interview.

Brennan said the company expects to announce a third testing site in a different state on Tuesday and could launch up to three more sites afterward.

Brennan said it was changing the pilot model it had tested – a single-lane drive-through in the parking lot of one of its stores. The new testing sites will be located at Georgia Tech university and the other will be in the parking lot of a casino in Rhode Island.

CVS will supply personnel from its MinuteClinic unit to oversee the testing. The states will provide security and protective equipment.

The testing is currently available at no cost to patients and is being paid for by the federal government, CVS said.

Walgreens said last week on a conference call with analysts that it had a pilot running in Chicago that was doing about 150 tests a day under the direction of the government. Target said in March that because CVS handled the pharmacy operations in its stores, it would partner with them to bring any sites online.

(Reporting by Michael Erman and Caroline Humer; Editing by Nick Zieminski and Alistair Bell)

U.S. Supreme Court turns away religious bias claim against Walgreens

By Andrew Chung

WASHINGTON (Reuters) – The U.S. Supreme Court on Monday handed a victory to Walgreens, turning away an appeal by a fired former Florida employee of the pharmacy chain who asked not to work on Saturdays for religious reasons as a member of the Seventh-day Adventist Church.

The justices declined to review a lower court ruling in Darrell Patterson’s religious discrimination lawsuit that concluded that his demand to never work on Saturday, observed as the Sabbath by Seventh-day Adventists, placed an undue hardship on Walgreens.

Patterson, who had trained customer service representatives at a Walgreens call center in Orlando, was fired in 2011 after failing to show up for work on a Saturday for an urgent training session.

The case tested the allowances companies must make for employees for religious reasons to comply with a federal anti-discrimination law called Title VII of the Civil Rights Act of 1964. The law prohibits employment discrimination based on race, color, religion, sex and national origin.

Under Title VII, employers must “reasonably accommodate” workers’ religious practices unless that would cause the company “undue hardship.”

(Reporting by Andrew Chung; Editing by Will Dunham)

CDC warns residents in eight U.S. states of cut-fruit Salmonella outbreak

Under a very high magnification of 12000X, this colorized scanning electron micrograph shows a large grouping of Gram-negative Salmonella bacteria. REUTERS/Janice Haney Carr/CDC/Handout

By David Shepardson

WASHINGTON (Reuters) – The head of the U.S. Food and Drug Administration on Sunday urged residents of eight U.S. states to check for recalled pre-cut melon that is linked to an outbreak of Salmonella.

The FDA and U.S. Centers for Disease Control are investigating an outbreak linked to 60 illnesses and at least 31 hospitalizations in five states. No deaths have been reported and the agencies urged residents in the eight states to throw out any melon that may have been recalled.

On Friday, Caito Foods LLC, a unit of SpartanNash Co, recalled fresh-cut watermelon, honeydew melon, cantaloupe and fresh-cut mixed fruit products containing one of those melons produced at a Caito Foods facility in Indianapolis.

The recalled products were distributed to Georgia, Illinois, Indiana, Kentucky, Michigan, Missouri, North Carolina, and Ohio and sold in clear, plastic containers at stores including Costco Wholesale Corp, Kroger Co, Payless, Owen’s, Sprouts, Trader Joe’s, Walgreens, Walmart Inc, and Whole Foods, a unit of Amazon.com Inc.

FDA Commissioner Scott Gottlieb in a Twitter post late on Sunday urged people in the eight states to check the “fridge and freezer for recalled pre-cut melon linked to Salmonella outbreak.”

Of the 60 cases reported to date, 32 were reported in Michigan.

“Reports of illnesses linked to these products are under investigation, and Caito Foods is voluntarily recalling the products out of an abundance of caution,” the company said in a statement, adding it “has ceased producing and distributing these products as the company and FDA continue their investigation.”

Salmonella can result in serious illness and produce significant and potentially fatal infections in young children, frail or elderly people and others with weakened immune systems the company said.

The CDC said evidence suggested that melon supplied by Caito Foods “is a likely source of this multistate outbreak.”

The investigation is ongoing to determine if products went to additional stores or states, the agencies said.

(Reporting by David Shepardson; Editing by Peter Cooney)

Tribute To Cop Killer Created Outside Shooting Site

A makeshift tribute to a man who waited in ambush at a Walgreens in Jersey City, New Jersey to kill police officers is being called “tasteless” by Jersey City officials.

Lawrence Campbell, 27, walked into a Walgreens store and took the gun from a security guard.  He told people in the store to leave and watch television because he was “going to be famous.”  He then ambushed and killed a rookie officer before being shot by other police.

Now, neighborhood residents have set up a shrine to the cop killer outside the store, with messages like “see U on the other side” and “Thug in peace.”

Even the widow of the killer is showing little remorse for the incident, telling News 12 New Jersey that while she was sorry for the family of the slain officer, if her husband was going to be killed he should have killed more police officers before he died.

Jersey City officials condemned the display and tried to say it’s not representative of the neighborhood.

“I firmly believe that the people who made the ignorant comments on the TV and the people who put up a memorial to a cowardly murderer who shot somebody in the head without giving him a chance are not representative of the people who live up there,” Police Director James Shea said.

Officer Melvin Santiago, 23, graduated the police academy in December.  He will be laid to rest on Friday.

Walgreens Employee Refuses To Print Bible Verses

A woman who ordered two prints online of Bible verses for her Bible study from her local Walgreens was told she couldn’t print them because Bible verses violated copyright law.

After a clerk told Kelly Taylor that they would not print her order, she received an e-mail that told her to contact a photo team associate.  When she called the number, she was told that printing Scripture violated copyright law.

She was given prints of the Bible verses after Fox News obtained copies of the e-mails between Taylor and store officials and provided them to Walgreens’ corporate offices.

A Walgreens spokesman then sent a statement to Fox News that the employee who rejected the printing of the verses was not acting on behalf of the company.

He went on to say the employee may have had concerns that graphic designs behind the verses could fall under copyright protection and that the whole situation could be resolved by Taylor signing a waiver of copyright law.

Taylor said she hopes the incident will be a teachable moment for Walgreens and that in the future Christians won’t be denied the opportunity to print Scripture verses.