Outpatient hydroxychloroquine prescribing at a large academic health system during the COVID-19 pandemic

To the Editor—The coronavirus disease 2019 (COVID-19) pandemic has attracted widespread attention to experimental treatments, including the antirheumatic drug hydroxychloroquine, raising concerns about its supply for patients already taking the drug for non–COVID-19 indications.1 Currently, multiple manufacturers have reported shortages of hydroxychloroquine.2 We report an exploratory analysis of hydroxychloroquine prescribing in outpatient and urgent care clinics of a large academic health system in northern California. The CDC guidance has recommended that patients request larger prescription drug quantities to minimize pharmacy visits.3 However, the American College of Rheumatology has suggested limiting outpatient prescription refills of hydroxychloroquine to a 30-day supply as a potential mitigation strategy for any supply disruptions in select circumstances.4 Our analysis was observational in nature, and further interpretation is limited by several factors. [...]these results are unique to practice paradigms of a single health system and are subject to regional epidemiology of COVID-19.

The effectiveness and costs of nonpharmaceutical interventions for COVID-19 containment: A border discontinuous difference-in-difference approach.

We examine the effectiveness and costs of alternative nonpharmaceutical interventions (NPIs) for COVID-19 containment. Using a border discontinuous difference-in-difference approach, we find that the enforcement of rigid NPIs reduces the number of new COVID-19 cases by 10.8% in China, comparied with cities with less NPIs. Among the three NPIs, contact tracing is much more effective than the other two NPIs, namely, public information provision and social distancing. The connections of mayors to the upper-level politicians reinforce the city's implementation of rigid NPIs. These networks also serve as an informal signaling channel to the neighboring cities, encouraging the adjacent cities to impose strict NPIs to curb the spread of COVID-19. We further estimate the long-term costs of the NPIs - a net present value of 2153 yuan per child in the human capital loss attributed to more prolonged school closure alone.

Sustained Reduction in Urgent Care Antibiotic Prescribing During the Coronavirus Disease 2019 Pandemic: An Academic Medical Center's Experience.

We compared antibiotic prescribing before and during the -coronavirus disease 2019 (COVID-19) pandemic at 2 academic urgent care clinics and found a sustained decrease in prescribing driven by respiratory encounters and despite transitioning to telemedicine. Antibiotics were rarely prescribed during encounters for COVID-19 or COVID-19 symptoms. COVID-19 revealed opportunities for outpatient stewardship programs.