I have had the privilege of working with Dr. Mark Duncan closely on many patients who want to venture outside the standard treatments.
We have built an excellent working relationship and a collection of successful experiences improving health outcomes.
One avenue is compounding — the custom formulation of ingredients by pharmacists. Compounding is a great way to tailor a solution to an individual.
For compounding to work, step one is for the prescriber to understand the terrain. Understandably, many don’t — there simply isn’t enough time to consume all the conventional medical literature and alternative approaches. So, for many the process stops before it starts.
A few of these compounds are so effective and safe, in addition to not requiring lab work, we want to share with a broader population.
Prescriptive Optimization (Aaron’s Health Coaching Site) now offers virtual consults with Dr. Duncan to clinically screen for appropriateness of two exciting compounds.
Clioquinol is a topically applied zinc based medication that nourishes the prostate. Lowering zinc ties to declining prostate function. We see multiple nightly trips to the restroom — devastating sleep — reduced to 1 or none within days!
Synapsin is a nose spray with a combination of two ingredients nourishing the brain. One is an anti-inflammatory, the other is an energy precursor. The combo combats brain fog and fosters a pronounced improvement in deep sleep. Stress causing brain inflammation. Know anyone with a little stress?
More may come on line soon.
If you know anyone who can benefit from less nighttime pee stops or unrelenting brain fog, you now have an option.
Simply fill out the consult form on the Prescriptive Optimization site. After submitting, it lands you at Island Drug where you can choose pickup or mail. Currently, we only mail in WA state. Then, if Dr. Duncan approves, a prescription is faxed in to Island Drug. Our compounding lab will begin work soon after.
Volunteers coming in working feverishly to beat back a pandemic. To reunite families.
A community staying engaged with the ever-changing circumstances of vaccine supply ups and downs. Expressing overwhelmingly appreciative sentiments — many shed tears of joy. Some give gift cards to volunteers or handwritten notes to staff. Even food from time to time.
County staff/departments supporting our efforts every day. Even cooperatively engaging first responders and volunteers alike to put on two successful mass clinics at the high school (another tomorrow). State DOH staff taking our calls and emails advocating supplying our community this valuable resource. These experiences motivate our team to perform at a high level every day. And sacrifice to be at work extra hours despite leaving exhausted.
We are proud to play a role in vaccinating our neighbors at home and in the broader Puget Sound region. We are proud to be part of this community effort.
We started the week feverishly adjusting schedules. Allocations were slashed, so we pushed appointments back.
Then on Monday a surprise. Just like drawing a certain card in Monopoly:
How we proceeded with the extra doses
After discussion with multiple WA Department of Health employees, we adopted the go forward plan. They allowed us to keep the vaccine. But, we had to get it in arms quickly. If not, we might not get additional shipments. Or, it might get diverted elsewhere — like we saw in January when supplies moved to Skagit.
This is from a recent DOH email this week:
Advice conveyed included permitting unadvertised walk-ins.
We moved forward.
You see, this is a government-owned vaccine. While we could have proceeded with just our appointments only, that would’ve been risky. That is if our goal is to vaccinate as many people as possible going forward — and it is.
Second Dose Orders
From the beginning, second doses were supposed to be allocated automatically. However, the state has experienced some challenges. They are actively updating internal procedures to correct. However, our second doses for the week of Feb 8 appear to be in peril — temporarily we expect.
Inexplicably, our 700 dose order for this week was rejected. Even though Sunday (Jan 31) we took steps to communicate with state staff way ahead of fulfillment. Unfortunately, they had an internal communication interruption of some kind.
We have been in contact with state and county officials thru this weekend even to ensure they rectify the situation. The correction may not occur in time for doses to be administered this week. Detailed documentation of first doses administered for the corresponding time period is in the hand of state officials. We anticipate getting the weeks of Feb 8 and Feb 15 booster doses together — hopefully.
Here is another communication from the state:
So, we will not be canceling second dose appointments, but they will be moved around to match vaccine arrival dates when confirmed.
What if I get my second dose late?
First, don’t worry! It may actually end up being more beneficial, at least according to an epidemiologist who advocates delaying second doses:
“Minnesota epidemiologist Michael Osterholm said Wednesday that he will ask federal health officials to re-examine COVID-19 vaccine data with an eye toward delaying the second dose so more people can quickly receive first shots.
Osterholm, speaking before a Minnesota House health committee, said immunity protection improves with many other vaccines when doses are spaced out by months.”1
Another article conveys a similar message :‘WHO: Amid short supplies, vaccine doses can be 6 weeks apart’2
We have talked with Skagit and Island County Health officer Dr. Howard Leibrand. He also communicated that delaying the second dose a bit is of no concern.
So, while we work to ensure the state sends us your second doses, please be assured your COVID-19 immunity status is not in jeopardy.
Your Every Day Mass Clinic Vaccination Destination
We hear a lot about ‘mass clinics’ for Covid Vaccination across the country. Unfortunately, it seems that as politicians stand up mass clinics in big cites, supplies available locally wane.
Our staff demonstrated this week we can stand up our own mass clinic.
2900 doses administered as a company this week
Clinton ran about 100 per day this week in scheduled 10 shot per hour appointments.
La Conner had plans to vaccinate, but their 200 approved doses never shipped (still don’t know why, awaiting reply from the state).
Now, about Oak Harbor.
Our order came in about 10a Monday. We started vaccinating at noon. Five hundred people received their vaccines in half a day’s work. Not bad.
Tuesday, we had some double-booked appointments by design. Staff performed efficiently and we vaccinated 750. Wednesday, we didn’t have double bookings in the morning, but did in the afternoon. Ended at approximately 650.
Thursday, we started with 990 doses in the fridge, with eyes toward getting them done. Double bookings on the calendar all day, including many advanced forward from Friday’s schedule. And, as described above, we began accepting people without appointments as well. In order to get thru this number of doses, we had to keep people moving. News spread and by the afternoon, people were flocking.
We got thru 870 doses and had to end vaccinating. The remaining doses were held for second dose appointments.
Another fun fact, Wednesday and Thursday, we only had two pharmacists to vaccinate vs three Monday and Tuesday.
Quite simply, our staff was fantastic.
Further, the customers were amazing.
To get through this number, it took a cooperative effort. People who had appointments came at the right time, and used the text message arrival process. Once in the store, everyone (staff and customers) worked together seamlessly to keep moving.
This was an example of a community coming together and advancing public health.
What we learned
Our team worked hard to revamp the customer flow inside. Two distinct queues at opposite ends of the store allowed paperwork to happen separately from the vaccine line. Six-foot spacing markers were placed throughout the lines. It worked. So, the first thing we learned was how to optimize efficiency in our space.
Secondly, we now know our throughput capacity. What this means going forward is we can increase the number of appointments per hour. Our throughput was approaching 100 per hour at times. When we get allocations, we will condense appointments and maximize throughput. So, despite us having to push people back a number of weeks, we will be able to condense moving forward. We can drive 3 weeks worth of the default appointment spacing into one week if sufficient supplies arrive.
Policy Maker Engagement
Last week we encourage you to reach out and dialog with elected officials — many did. The Governor instructs DOH personnel on vaccine allocations. His office is the area of critical focus. Please continue reaching out.
One engagement our team has made is Congressman Rick Larsen’s office. His team has contacted the Governor’s office on our behalf multiple times. Our discussions and performance contributed to the content in this letter submitted to the President’s office even!
Our team was one who stepped up to help an assisted living facility in Oak Harbor get vaccinated.
Please continue engaging our elected officials to help deliver vaccines locally so our citizens don’t have to venture to mass clinics far away.
Natalia and her group work the front part of our Oak Harbor store. This group has put forth enormous efforts to not only get people thru the vaccine line, but field questions — even when the answers aren’t what they want to give.
We are all in this together.
Please understand that the entire team at Island Drug & La Conner Drug are working hard to get as much vaccine distributed to the community as possible. We are also working hard to communicate maximally along the way.
We still have staff adjusting the schedule to match supply allocations for the upcoming week at this late hour on a Sunday, it is a total team effort.
Thanks for reading/watching. We hope to see you in store for a vaccine soon!
As are most these weeks lately, we had a dynamic experience this week.
We had light orders arrive. But, proceeded to make do with what we had.
Our La Conner store received a supply from Skagit County. Our team there worked hard vaccinating all day Tuesday.
This site joined Oak Harbor as a state approved Covid-19 vaccination site. Expect more local opportunities soon as direct shipments are forth coming. Stay tuned to email!
On Tuesday, we went onsite at a local assisted living facility to vaccinate staff and residents. Their national service failed to show as scheduled, so Island County sent us vaccine to get the job done.
Then a mini adventure.
There wasn’t as many residents available as originally scheduled. So, we had a little excess after. Problem is, after cracking a vial, the Moderna vaccine changes to a 6 hour expiration. Our staff worked hard to do ensure 40 doses didn’t expire and waste. They called people in close proximity to the store since we had an hour complete injections. Whew!
On Wednesday, we moved up appointments, in order, to go thru our small allocation for the week.
Island County Health Department expressed a desire in providing local access for South Whidbey residents — a sentiment we share! ICHD issued us vaccine for offering at our new Clinton location. We quickly and directly notified residents eligible for 1B with South Whidbey addresses. On Friday we stood up a vaccine clinic for the first of three consecutive business days, completing this Tuesday.
Clinton also received approval from the state. Shipments will be allocated directly on South Whidbey in the future.
Technology Developed & Deployed
As our experience grows, so do our adaptations. Delivering vaccine efficiently during this pandemic and its social distancing guidelines presents challenges.
With thousands successfully vaccinated, and many lessons learned, we worked to bring a new level of efficiency.
The bottleneck with our first clinics was at the entry and paperwork verification stations. Directing traffic required much repeating and strain on the vocal cords.
Now, all this is done with a little technology.
We developed a custom integration between our texting platform and internal secure team site (Microsoft Sharepoint).
The new procedure has customers send us a message upon arrival in the parking lot. This message creates an entry on our associates screen, where it preserves order. They can then validate appointments while customers wait in their car. When our associates assess enough spacing, they simply change a status on the page and a text summons patients into the verification line.
Our public phone numbers all accept text messages. So, upon arrival, customers text our keyword ‘AntiCovid’ and their full names to begin the process.
It worked great, and we are ready for bigger numbers as soon as vaccine arrives!
This post is on our new webpage. The old one finally gave way to traffic demands. We updated the name server entries Friday evening (the servers that tell browsers where to find a website at a particular address). If you had trouble accessing the site Friday, that would be the likely reason. If you are still having trouble, please power cycle your device and/or search google on how to flush dns.
We have combined the Island Drug and La Conner Drug sites into one. Both domain names now resolve to the same site. This will make it easier to keep the information current.
Let us know what you think!
Mass Vaccine Planning
We spent a little time discussing future options to bring ‘mass vaccine clinics’ to residents locally. Key players throughout the country worked on a plan for submission to state DOH showing people locally can pull it off. Basically, send people in county the vaccine, and we will work together to get it in arms efficiently.
We value being part of our incredible teams locally.
How do we put this delicately? Let’s go with not ideal.
Definitely unsurprising with all the news reports. But, we are not being issued sufficient supply to keep up with demand represented by appointments booked.
We will keep adjusting appointments to meet supply, while preserving everyones place in line.
Better yet, processeS.
We have made all our multiple filings to demonstrate demand and doses administered. Plus our inventory reporting. Even the newly added spots to report. For those keeping track, we now have three different places to report data, in addition to our internal pharmacy records.
Despite this, DOH still experiences challenges pulling data. We are actively working with them to ensure they understand how vaccine in our county is moving and being administered.
We will also be focusing our vaccinating efforts as early in the week as possible to ensure all reporting is posted by the time DOH looks to calculate the next weeks allocation.
Where to focus
We have had many discussions with DOH workers responsible for filling orders. They are putting in enormous efforts by all accounts.
The problem (and potential solution) lies with elected leaders. Particularly at the Governor level. DOH is provided allocation percentages. These percentages are woefully inadequate for our local communities.
We see ‘public-private partnerships’ and ‘mass vaccine clinic’ sites getting a lions share of the state allocation. By contrast, pharmacy and hospital percentages are both minimal. DOH staffers are left with trying to give multiple pharmacies across the state 100 or so doses each.
Pharmacies are the best access points for distribution — they are in every community. We are ready to continue vaccinating 500 or more people PER DAY PER LOCATION.
If you want to see these number locally, its time to get active.
Our local residents shouldn’t have to continue watching supply allocations be concentrated in locales and with businesses out of area.
Advocate for a more equitable process that focuses on a providers ability to quickly vaccinate. As an example, businesses that have shown the capacity to do hundreds per day, like say your local pharmacy?
Why this matters
Our pharmacists have interacted with multiple seniors during vaccine appointments where it is their first trip out of the house in a full year. We need vaccine here to help people get back to living.
A number of requests and questions presented deal with canceling or changing Covid Vaccine Appointments. Below you will find the tips manage your appointment(s) from your phone or computer independently.
The system will send two emails after confirmation, like so:
Depending on your email platform, a calendar entry may also appear (this example from outlook.com):
I can’t find any emails!
Two possibilities here.
It may have gone to a spam/junk or other folder in your email account. First, step is a search using the email address of our booking system account: CovidVaccineBookings@islanddrug.com:
The same emails from above appear. You can also use the same email query to search your calendar:
And, there is the March 26th entry from our example.
If neither of these locate any results, we experienced a technical issue around the system launch (Jan 9-12). So many bookings occurred, our Microsoft Office 365 service capped outbound confirmation emails. Unfortunately, those aren’t recoverable. Please send us a note with any cancellation requests if neither search tricks in #1 work.
The Magic Link
In each of the emails and calendar entries described above lies a magic link.
This link allows independent management (both modification and cancellation).
Let’s find ‘em…
Magic Link: Emails
Opening the first email example
You will find a Manage Booking Link:
Opening the second email example (with the calendar item attachment, and our logo at the top)
then scrolling to the BOTTOM of the message
you will find a ‘Change your appointment’ link
Magic Link: Calendar Entry
Opening your calendar entry, near the top, you will find a link called Manage Booking. This looks like the first email example just above.
Magic Link: When found and clicked
Thank you for using the Magic Link
With the desire for so many to be vaccinated against Covid-19, our incoming has been voluminous — even that is an understatement.
By using the features of this booking system independently, you allow our team the ability to focus on customers in store and those who need personal assistance by phone, email, or text.
Thank you again for being such superb partners as we work together as a broader community in advancing public health.