Q&A: How the COVID-19 Pandemic Changed the Landscape of Pharmacy

During the COVID-19 pandemic, pharmacies underwent a transformation, rapidly expanding their services to meet unprecedented demand for vaccination and testing while facing significant challenges like staffing shortages and misinformation. Pharmacists emerged as trusted health care providers, leveraging their entire workforce—including technicians and student pharmacists—to administer vaccines, provide critical education, and maintain accessible health care services. The pandemic highlighted pharmacies' adaptability, with many implementing hybrid appointment models and playing a crucial role in community health education. Looking forward, the experience has opened opportunities for expanded clinical services, increased recognition as essential healthcare providers, and the potential for more comprehensive patient care models.

Jeffrey Goad, PharmD, MPH, president of the National Foundation for Infectious Diseases, reflects on the COVID-19 pandemic 5 years later.

Jeffrey Goad, PharmD, MPH, president of the National Foundation for Infectious Diseases, reflects on the COVID-19 pandemic 5 years later. | Image Credit: rost9 | stock.adobe.com

Drug Topics: Looking back over the past 5 years, what would you say was the single biggest challenge the pandemic posed to pharmacies?

Jeffrey Goad, PharmD, MPH: Well, I think the most significant challenge really was the unprecedented surge in demand for vaccination and COVID testing, which all the while facing staffing and [personal protective equipment] shortages. Pharmacies were not getting many types of vaccines or doing any point-of-care testing at the time had to really rapidly expand their role while managing burnout, evolving testing and COVID guidance, and patient misinformation. Many pharmacies also had to quickly train and deploy pharmacy technicians to help manage workflow, particularly for vaccine administration and COVID testing. In fact, the US PREP Act provided a federal framework for the expansion of vaccination testing and prescriptive authority, but when it went away, it was up to the states to make those changes permanent. Many did not. Student pharmacists were also important workforce players early on in the pandemic as hospitals kept students out and [ambulatory] care largely shut down. The community pharmacy, however, did not exclude student pharmacists, nor did they shut down.

Drug Topics: What lessons from the pandemic do you think will be most valuable for pharmacies moving forward, especially for independent community pharmacies?

Goad: I think one key lesson is the importance of adaptability and workforce optimization. Pharmacies that leverage their entire staff, including technicians and student pharmacists, for immunization and testing services, were able to scale operations more efficiently. The pandemic also underscored the value of diversifying services such as telehealth consultations and point-of-care testing, which many pharmacies successfully implemented.

Drug Topics: How did pharmacies successfully address the increased demand for vaccinations and testing, and what were some of the logistical hurdles they faced?

Goad: Pharmacies adapted by scaling operations. So what that means is they were implementing appointment scheduling systems, mobilizing technicians and student pharmacists to administer vaccines and perform COVID-19 tests. Many pharmacies initially relied on scheduled appointments to manage vaccine distribution efficiently, control patient flow, and prevent overcrowding. However, as demand fluctuated, many transition[ed] to allow walk-ins, which increased accessibility, but also introduced challenges in inventory management, staffing, and workflow efficiency. While appointment-based systems help pharmacists prepare to staff and allocate doses appropriately, they sometimes limited the vaccine uptake among individuals who preferred convenience. Some pharmacies implemented and now maintain a hybrid model, offering both scheduled slots and walk-in availability to balance efficiency and accessibility.

Drug Topics: How did patient counseling and education strategies adapt during the pandemic, especially with the influx of information and misinformation?

Goad: I think it's important to point out that has been for many years, but the Gallup Poll consistently ranks pharmacists as one of the most trusted professions. During the pandemic, pharmacists took on a crucial role as a frontline educator, countering misinformation with evidence-based guidance from the CDC and non-governmental organizations such as the National Foundation for Infectious Diseases. Many used social media, community outreach, and 1-on-1 counseling to dispel myths about COVID-19, vaccines, testing, and treatment. Additionally, all pharmacy staff played an important role in consistent messaging, managing vaccine appointment scheduling, and distributing educational materials, allowing pharmacists to focus on more complex consultations.

Drug Topics: What are the biggest opportunities and challenges you see for independent pharmacies in the post-pandemic landscape?

Goad: Well, I think it's been said before: never let a good pandemic go to waste. So it sounds horrible, but a silver lining here is that pharmacists really develop new skills, new ways of operating, but really what we look for now are, what are the opportunities for the future. Opportunities to expand clinical services, to include travel health clinics, test-to-treat, programs, chronic disease management, and medication therapy management. Challenges remain though in reimbursement for clinical services; there's workforce burnout, and of course, retention. Pharmacy must also consider how to effectively utilize pharmacy technicians, particularly, in immunization and testing services, as these roles proved essential during the pandemic and could be valuable moving forward.

Drug Topics: How do you think independent pharmacies can continue to play a vital role in community health and patient care in the future?

Goad: Pharmacies thrive on focusing on personalized patient care and filling gaps in health care access, particularly in rural and underserved areas. Expanding services such as point-of-care testing, long-term care partnerships, and medication synchronization programs will be key. Additionally, training and retaining skilled staff, including pharmacy technicians, will help improve efficiency and allow pharmacists to focus on more clinical services.

Drug Topics: Do you have any recommendations for policy changes or support systems that would help independent pharmacies better serve their communities?

Goad: Policy should address equitable reimbursement for clinical services and expanding the standard of care model as physicians have. The standard of care model allows pharmacists to provide patient care based on their training, credentials, and professional judgment, using their skills and knowledge to make decisions that are best for the patients rather than being limited by rigid state rules. It's essential to ensure that pharmacists are recognized as health care providers under federal and state laws that allow for Medicare and Medicaid reimbursement of pharmacists clinical services.

Drug Topics: Is there anything else you would like to add?

Goad: I think, really to summarize, the pandemic underscored that pharmacists are essential health care providers, not just medication dispensers. Moving forward, we must continue advocating for legislative changes, strengthening public trust, and ensuring pharmacists receive the support they need to sustain and expand their vital services. Pharmacy teams, including technicians, played a key role during the pandemic, and continued investment in workforce, training, retention, and development will be essential for the future.