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The History of Pharmacy During Global Crisis Nathan Karlan, PharmD Candidate, Class of 2021 | University of Iowa College of Pharmacy
The role of the profession of pharmacy has changed drastically over the course of the last century, yet the commitment to providing great patient care when needed most has always remained constant. The current COVID-19 pandemic has placed pharmacists on the front lines of one of the deadliest pandemics in the last 100 years, and, although putting themselves at risk, they have stepped up in heroic ways to provide care to their communities. However, this is certainly not the first time the profession of pharmacy has had to adapt during a global crisis. From the 1918 Spanish Flu pandemic to World War II, the way pharmacists conduct themselves during times of global crisis plays a tremendous role in advancing the profession for the future. The current COVID-19 pandemic is no exception. The way pharmacists across the country are currently adapting to provide care to patients and their communities will undoubtedly shape and advance the profession for years to come.
1918 Spanish Flu
Pharmacies in the early 1900s looked significantly different than they do today. Druggists, as they were called at the time, often owned small retail shops focusing on compounding non-sterile medications such as magnesium citrate and salicylates. These drug stores were staples in small town communities, allowing people to pick up their medications as well as a variety of other supplies such as handmade gifts, soda, and even groceries. While greatly respected by members of the community at the time, the role of pharmacists as solidified healthcare providers was brought about by the spread of the 1918 flu pandemic. At the time, very little was known about infectious disease in general, and the influenza virus was not a reportable disease. Spreading from avian origin, the so-called Spanish Flu ravaged soldiers fighting in World War I over in Europe, and it eventually spread to the U.S. in the spring of 1918. By the end of the year, an estimated 28% of the American population had contracted the flu, with deaths reaching 650,000 people. The death toll worldwide was even more
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| The Journal of the Iowa Pharmacy Association
Alexander Fleming at Work Courtesy, St. Mary’s Medical School Hospital, London
staggering with 500 million (a third of the global population) contracting the virus, killing over 50 million. Drawing parallels with the current pandemic, hospitals at the time were overwhelmed, and makeshift hospitals were erected to manage overflow. The government issued nation-wide lockdowns, schools closed, and people looked to pharmacies to provide essential medications and other services. Various articles written in a popular pharmacy newsletter at the time, The Druggist Circular, described the ways in which pharmacies across the country adapted to patients’ needs during the pandemic. Given the time period’s limited knowledge of infectious disease, pharmacies began providing holistic approaches to help prevent the flu’s spread, including the widespread use of camphor as an odorant. Because doctors were so consumed with treating pandemic patients, people were often sent to their pharmacy to receive treatment for everyday ailments. Pharmacies rearranged the nonmedication sections of their stores to allow for greater compounding of prescriptions. Medications such as magnesium citrate, phenacetin, and salicylates were in high demand, and pharmacists met these demands head-on. Pharmacists also played an instrumental role in public health by advising people to stay home, limit their contact with others, and self-
