Azithromycin concentrations decreased over the study period (weekly samples, Figure ). Azithromycin is only sometimes used in combination with hydroxychloroquine and is more frequently used to treat bacterial respiratory infections which typically decline in the spring . Acetaminophen, which can be used to treat COVID-19 symptoms such as fever and headache, had limited availability during the pandemic, likely due to increased demand . Correspondingly, acetaminophen sludge concentrations increased in our weekly sample analysis (Table , Table ).