With early surges of flu, RSV, and different seasonal respiratory sicknesses which are piling on current elevated COVID circumstances, it has been a tough winter already—not simply due to all of the coughs and fevers, however as a result of it may be laborious to search out the medicines generally used to deal with these signs. The FDA is itemizing greater than 100 present and just lately resolved drug shortages, with others reported domestically, together with amoxicillin, Youngsters’s Tylenol, and Tamiflu.

“We’re getting extra callbacks from pharmacies as a result of they do not have the prescription that we have written,” says Erin Fox, senior pharmacy director on the College of Utah Well being in Salt Lake Metropolis. “I’m listening to from plenty of fellow physicians throughout the nation that they’re experiencing the identical factor.”

The explanations for the shortages are a fancy mixture of provide chain points, surging demand, and a hoarding impact that occurs when folks know provides are low, specialists say. Including to the issue are persistent myths and misconceptions about which medicines are wanted, when, and for which individuals.

“Shortages are a time after we try to sort of triage these medicines to the individuals who will profit essentially the most from taking them,” says Nipunie Rajapakse, a pediatric infectious illness doctor on the Mayo Clinic in Rochester, Minn.

Because the infection-laden winter drags on, specialists say that higher understanding the function that medicines play in treating numerous sicknesses may relieve nervousness about empty pharmacy cabinets, scale back the harms of pointless treatment use, and enhance provide for folks most in want.


Reviews of influenza began to spike in October 2022. By early December, the US was experiencing certainly one of its earliest and most extreme flu seasons in years. As circumstances surged, so did demand for Tamiflu, additionally known as oseltamivir. The antiviral, in response to the CDC, is really useful most for folks at excessive threat from creating extreme circumstances of influenza—a broad class that features children underneath two, adults 65 and up, pregnant and immunocompromised folks, and people with bronchial asthma, kidney illness, or different underlying situations.

However anybody can get a prescription for it. And because the flu raged, the treatment grew to become tough to return by in a wide range of locations. Some pharmacies struggled to maintain Tamiflu in inventory, and folks reported calling a number of shops to get prescriptions stuffed because the clock ticked: Tamiflu is simplest if began as quickly as doable and inside 48 hours of the onset of signs.

Regardless of that sense of urgency, Tamiflu is unlikely to be the miracle treatment that individuals might count on. In a complete evaluate of 20 research encompassing greater than 24,000 folks, researchers with the unbiased Cochrane Collaboration reported in 2014 that the drug decreased the length of signs in adults by a mean of 16 hours—which meant that individuals have been sick for about six days as an alternative of seven.

The drug didn’t make any important dent in symptom length for teenagers. Nor did it scale back the danger of hospitalization or different problems, like pneumonia, bronchitis, or ear infections. However there have been uncomfortable side effects, some critical. The drug elevated the danger of nausea and vomiting by 4 p.c in adults and 5 p.c in children. In some circumstances, Tamiflu brought about psychiatric signs, resembling melancholy, delusions, and panic assaults.

Even amongst these in high-priority teams, information are nonetheless not clear on how a lot of a distinction the drug makes, Fox says. “It’s positively not a cure-all,” she says, and never with the ability to get it’s typically not the tip of the world. “It does not imply that you will find yourself within the hospital. It in all probability goes to imply that you just’re not going to have that chance to get higher half a day earlier.”

Acetaminophen and ibuprofen

Fevers can appear scary, significantly in little children and particularly when numbers begin creeping effectively above triple digits. However misconceptions go each methods about how and when a fever must be handled with treatment.

One fantasy is that therapy is important to scale back the danger of problems like seizures in kids—a perception that’s not supported by the majority of proof, says Rajapakse. Febrile seizures are triggered by a fast rise in temperature reasonably than the excessive temperature itself, she says, so by the point the fever spikes, it’s too late for the treatment to make a distinction. Some research present potential prophylactic profit, she says, however most counsel that giving acetaminophen or ibuprofen across the clock “doesn’t essentially forestall a febrile seizure if it will occur.”

On the flip aspect is the idea that acetaminophen impairs the physique’s personal immune-strengthening response to deal with a fever. However specialists say these medicines are usually not highly effective sufficient to close down your immune system and folks shouldn’t attempt to combat off a fever with out aid in the event that they’re feeling terrible.

If a fever reaches 105, it’s time to go to the emergency room, says Megan Ranney, an emergency doctor on the Brown College College of Public Well being in Windfall, Rhode Island, who provides that aspirin isn’t protected for teenagers.

Beneath emergency ranges, Rajapakse recommends treating for consolation. She typically sees toddlers within the clinic with 103 levels fever who’re operating round and feeling nice, and she or he doesn’t suggest treatment in these circumstances. “Then you’ll be able to see a toddler who has a decrease fever however who’s fairly depressing, who may not be consuming and consuming a lot, who’s waking up so much at evening, who’s uncomfortable,” she says. “That is a really affordable state of affairs to deal with a fever in that youngster.”


Amoxicillin is a go-to workhorse in pediatrics that’s used to combat bacterial ear infections, pneumonia, and strep throat, with comparatively few uncomfortable side effects, says Rajapakse. However a scarcity of amoxicillin has compelled docs to prescribe different antibiotics that could be tougher to tolerate or may not work as effectively in opposition to the micro organism inflicting infections.

The scarcity highlights ongoing points with extreme antibiotic prescriptions. A couple of third of antibiotics prescribed to folks of all ages are both completely pointless or prescribed incorrectly, research present—which incorporates utilizing the flawed drug, dose, or length of therapy. The scarcity started simply because the U.S. Facilities for Illness Management and Prevention and the World Well being Group have been ending up every week of conferences devoted to lowering overuse of antibiotics.

“It’s a continuing problem,” Ranney says. “Each time we begin to make somewhat progress, we fall backwards once more.”

Pointless antibiotic use not solely raises the danger for allergic reactions, kidney issues, and uncomfortable side effects like diarrhea in individuals who take them, Rajapakse says. The follow additionally provides micro organism alternatives to develop drug resistance, which is dangerous to society.

One purpose the issue persists is that individuals mistakenly imagine they want antibiotics for issues like ear infections or ongoing coughs, even when viruses are prone to blame. “I can not inform you what number of sufferers present up within the ER saying, ‘I’ve had this cough for 2 weeks. I do know that I simply want an antibiotic,’” Ranney says. “We all know that if we do not prescribe it, they are going to go to another person who will.”

Given how busy suppliers are, Rajapakse says, it may be faster for them to prescribe one thing than to take the time to elucidate why folks may not want treatment. It may also be tough to get it proper and tempting to err on the aspect of warning. About 90 p.c of sore throats are attributable to viruses, for instance, however 10 p.c are an indication of strep throat, which wants antibiotic therapy to stop future problems.

To cut back pointless antibiotic use, Rajapakse advises mother and father to ask suppliers if their youngster is a candidate for watchful ready as an alternative of demanding or instantly accepting a prescription, and specializing in different methods to alleviate signs, together with acetaminophen or ibuprofen, popsicles, humidifiers, and nasal saline. “There are many issues that households can do that do not contain taking an antibiotic whereas their kid’s immune system fights off the virus,” she says.

Even when this flu season ends, drug shortages are prone to stay an ongoing difficulty, researchers say, as they’ve been an issue for years. In 2018, effectively earlier than COVID struck, the FDA pulled collectively a activity drive that recognized a number of causes of the drug-shortage disaster, together with a scarcity of incentive for drug firms to provide much less worthwhile medicine and logistical challenges that impede the market’s capability to get well after disruptions. Though the group’s report additionally recommended options, resembling monetary incentives to provide lower-cost medicine and transparency about when shortages are occurring, the issues persist.

Preparation might help folks climate the ups and downs. Specialists suggest retaining a small provide of over-the-counter medicines (no hoarding!) available in case you get sick. Enhance your arsenal of non-drug methods for feeling higher, like lukewarm baths or tea with honey. Perceive your loved ones’s explicit threat degree so you understand for those who’ll wish to search a prognosis as quickly as you are feeling ailing and be prescribed antivirals shortly for those who want them.

It’s all the time a good suggestion to follow good well being habits, Ranney provides. “Get your flu shot. Get your booster for COVID. Ensure you wash your arms and put on masks, significantly in crowded indoor areas,” she says. “The easiest way to keep away from needing medicines is to keep away from getting sick within the first place.”