Healthcare professionals and COVID-19
In Europe, many healthcare professionals are involved in the production, prescription and delivery of medicinal cannabis products. A number of them have been portrayed in this place. How did they survive the first months of the COVID-19 crisis?
Italy: home delivery spiked tremendously
Dr. Marco Ternelli – Farmagalenica SRL
Dr Marco Ternelli runs an Italian pharmacy, and he is specialised in compounding medication, among which is medicinal cannabis.
“In Italy we saw an increase in home delivery including medical cannabis. Because home delivery has taken a tremendous spike, patients need to have more patience than before as pharmaceuticals couriers take much longer to deliver than usual. In Italy, a medicinal cannabis prescription lasts only 30 days. So patients shouldn’t wait too long to contact their doctor to apply for a renewal. Otherwise, you’ll surely run out of medication before the pharmacy can deliver it to you.
During the lockdown, pharmacies in Italy were one of the very few activities left open, so we kept seeing people directly. We were continuously explaining and reassuring patients of what was going on.
They used to say ‘Biggest improvements come in hard times’. I have to admit I have seen some. In order to avoid people gathering at the doctor’s waiting room, all reimbursed medicines have been digitized. This means that the patient simply has to go to the pharmacy, show his medical ID or fiscal code and the pharmacist is able to digitally download all the prescriptions. We are waiting and hoping the same to happen for medical cannabis prescriptions. Unfortunately, being a controlled substance, it didn’t take part in the digital transformation.”
The Netherlands: “We stayed close to the patient, literally”
Paul Lebbink – Transvaal Apotheek
Paul Lebbink heads the Transvaal pharmacy in The Hague with eight other pharmacists. The Transvaal Apotheek was the first pharmacy in the Netherlands to produce and supply various varieties of cannabis oil, in line with the Dutch medicinal cannabis program.
“We see about 200 patients on average every day. Locking the pharmacy was not an option, because those people need medication. We immediately took measures to ensure that both patients and staff could be as safe as possible in our pharmacy. Plastic screens, possibilities for disinfection, a maximum of five patients who could be inside at the same time and of course the ‘one and a half meter rule’, to name just a few. And although the latter measure in particular is not easy with a limited floor space and a relatively large number of people, it has been possible to create a COVID-safe environment. In addition, we increased the number of deliveries in March and April. Every day, five couriers drove around to serve patients, which enabled us to reduce waiting times in the pharmacy.
The delivery of medicinal cannabis and medicinal cannabis oil has proceeded normally; In the Dutch medical cannabis chain, the organisations responsible for production and distribution have proven to be COVID-proof. As always, we were able to serve patients on time. Our own production and supply of cannabis oil has also been carried out according to plan. We also have not had any questions from patients about the alleged effect of medicinal cannabis in COVID-19. We would have reacted cautiously, because of course we only base ourselves on scientific evidence.
In the meantime, the rules in the Netherlands have relaxed somewhat again. The same goes for the rules in our pharmacy, because a ‘1,5 metre society’ is not what we want. We want to be close to the patients, literally.”
Denmark: “Online video consultation kept us open”
Dr. Tina Horsted – Pain Clinic Horsted
Dr. Tina Horsted runs a public clinic. She is the only doctor in Denmark who is specialised in prescribing medicinal cannabis, mainly to chronic pain patients.
“We have been open during the lockdown. We had a continuous steady flow through the crisis, as we developed a video-based online application to help new patients and keep up with ongoing medical controls. And it’s been working very satisfying, both for the patients and the clinic. The video format has more or less forced the patient and us to discuss the actual problem straight away. Patients, therefore, get more value out of their time. For the future, we will keep on doing more medical controls or lighter consultations via this application. Patients are relieved that they do not have to travel for each check-up. But of course, it can and will never replace an in-person consultation if this is required. In the clinic, we have well-designed glass panels, in the waiting room we have removed half of the chairs and all magazines, and there is no coffee. But people are now used to these percussions.
The Norwegian patients are starting to come back, but the Swedes have been coming to the clinical psychically during the whole period. With a special letter, provided by the clinic, they were able to cross the border.”