The 2020 saga of the United States Postal Service goes something like this: In March, the COVID-19 pandemic hit the country full-force. Americans started shopping for more products online, resulting in a backlog of shipments. Then, in June, the new U.S. Postmaster General implemented controversial cost-cutting measures, including the removal of mail sorters and employee overtime pay limits. These changes sparked nationwide chaos—from a partisan political uproar to reports from panicked citizens concerned about their delayed mail (think: packages arriving a whole month late!).
If you’ve been ordering only non-essential items through the mail, these delays are an inconvenience for sure. But for the millions of Americans who rely on mail-order medications to keep their chronic health conditions in check, this could be a life-and-death crisis. New data pulled from the 2017 National Poll on Healthy Aging found that one in four Americans over 50 years old receives at least one medication by mail. This includes people with diabetes, cardiovascular disease, and other conditions that put them at increased risk for serious COVID-19 infection.
A Pandemic Necessity
Rashid Chotani, M.D., vice president of Medical Affairs at CareLife Medical in Fairfax, VA, explains that social distancing guidelines have ramped up the need for mail pharmacy services. “Individuals with health conditions like cardiovascular disease, diabetes, and lung disease or COPD are advised to avoid pharmacies, as visiting a pharmacy potentially exposes them to the risk of acquiring COVID-19,” he explains. “Most of them are relying on mail delivery.”
If you’re already at high risk for serious COVID-19 complications, the last thing you want to do is increase your risk by spending time in crowded spaces. Research has shown that indoor spaces are most dangerous for viral spread.
Even if you wanted to pick up your meds in-person, your insurance may not allow it. The National Poll on Healthy Aging found that 35% of those who receive medications by mail are required to do so by their insurance plan. “It is also important to note that many elders get their medications at lower price from mail-away pharmacies and getting these medications on time is a crucial lifeline for them,” Dr. Chotani says. Even a few days of mail delays can disrupt monthly medication refill schedules.
Medications & COVID-19 Risk
Here’s the other unfortunate reality: If your chronic condition isn’t well-managed with medication, you could be at higher risk of complications if you do catch COVID-19. (We know… adding insult to injury.)
Dr. Chotani breaks it all down: “Individuals with chronic conditions must take their medications regularly and on time, as not taking them places them at risk for hospitalization due to their existing comorbidities, even without COVID-19,” he says. “If someone with a chronic disease acquires COVID-19, that puts them at an even higher risk [of hospitalization]. Not having access to medications for their chronic conditions or comorbidities due to delay in mail delivery exponentially increases this risk.”
Fortunately, this crisis is not falling on deaf ears. On Aug. 25, the American Diabetes Association and 20 other national health groups released a statement urging the USPS to re-instate delivery standards to protect vulnerable patients from serious health complications. These groups included other big names like the Arthritis Foundation, the American Lung Association, the National Kidney Foundation, and Susan G. Komen.
Tracey Brown, CEO of the American Diabetes Association in Washington, D.C., explains why the organization decided to speak out. “Diabetes was an epidemic in this country before the COVID-19 pandemic,” she says. “With people living with diabetes dying at a disproportionate rate because of COVID-19, our focus and mission all along has been to help people living with diabetes thrive.” Brown notes that diabetes patients need a variety of prescriptions and supplies, including insulin, which is literally essential to their survival. “When you start to think about anything that is going to be disruptive to people getting their medication, it becomes a real issue.”
The statement points out that in 2019, the USPS shipped 1.2 billion prescriptions to patients across the country. And in March, the number of mailed prescriptions increased by 21% from the previous year. Even more concerning is the fact that mail delays can disrupt the environment of the drugs during shipment. For instance, if a biologic drug needs to be refrigerated, it may not be able to withstand weeks at room temperature sitting in a warehouse.
What You Can Do
Be prepared and be proactive. You may not be able to control the decisions of the USPS, but Brown suggests keeping close track of when you will need your medications could help tremendously. “The planning is necessary,” she says, “not waiting until you’re out of a thing to actually refill, having 90-day supplies on hand, and accounting for a little longer time [in transit].” Keep a calendar on hand with the dates you’ll run out of medication, so you’ll be able to plan before it gets down to crunch time.
“Many insurance plans, including Medicare, have relaxed the refill limitations so patients can obtain larger quantities of medications,” Dr. Chotani says. “I suggest calling your pharmacy and/or insurance plan to find out what quantities are now allowed. Be sure to request a refill several days in advance of when the current supply runs out and allow extra time for the mail delivery.”
Talk to your doctor about your concerns and see if they have suggestions, whether that’s referring you to a safe drive-in pharmacy or prescribing your medications slightly in advance. “We can’t control the system,” Brown says, “but with the information and knowledge we do have, [we can help] people be more prepared and control the things they can control.”