Pharmacies should prepare for terrorist threats

Drug Store News,  May 20, 2002  by James Frederick

• E-mail
• Print
• Link

ORLANDO -- The tragic events of Sept. 11 brought home the critical importance of the health care community, including local pharmacy providers, to people affected by terrorist attacks or the threat of bioterrorism.

The Food Marketing Institute addressed the issue at its 15th annual Supermarket Pharmacy Conference here last month. In a presentation titled "Pharmacy's Role in Community Emergency Preparation and Response," three experts from pharmacy and government brought pharmacy leaders up to date on "what's going on nationally and what pharmacies can do," in the words of one of those speakers, Mitchel Rothholz of the American Pharmaceutical Association.

"It's not just the threat of bioterrorism or terrorism in general that we're concerned about," said Rothholz, vice president of professional practice for the APhA. "There are other emergency situations in this country that pharmacists respond to every day," including natural disasters, influenza pandemics and other emergencies. In all those cases, he said: "Pharmacists can make a difference. Our ultimate goal is serving the community, and the community is central to whatever we do as a profession."

Industry organizations' emergency coalition

In the wake of the September attacks, Rothholz said, the APhA and other groups, including FMI and the National Association of Chain Drug Stores, formed a coalition task force on emergency response. The group has focused on "what the pharmacist's role will be," he said, and on how to link with other health providers, emergency response units and the Department of Defense in the event of emergency.

"We identified several roles, based on ... the convenience of community pharmacy and that we already have an existing health care system in every community," said Rothholz. "We communicated that to the Congress and to the White House. Believe it or not, we are starting to get listened to."

Indeed, new federal emergency-response plans give local pharmacies a major role in getting needed drugs quickly into the hands of the public and ensuring their correct usage. The Model State Emergency Health Powers Act, prepared for the Centers for Disease Control and Prevention after 9/11, "identified roles for both pharmacists and pharmacies," Rothholz noted. But he and other speakers urged FMI pharmacy executives to draw up their own plans.

"One of the things we learned since 9/11 is we can't wait until an emergency happens before we step up to the plate and say we want to participate," he said. "We've got to plan ahead and figure out how each of us will interact with the system."

Charles Thomas, state pharmacy director of the Alabama Department of Public Health, said getting emergency medicines and other supplies where they're needed and into the hands of the public is "a complicated process" and requires preparation on the part of pharmacies and other health care providers. "It's very important that you educate your pharmacists in these weapons of mass destruction and in these processes, so they'll be familiar and able to give out useful information, he said. "People will absolutely go to the pharmacist, in some cases, before they go anywhere else."

Rothholz agreed that preparation is essential. For instance, he said, "If we have to do a mass immunization for smallpox, all health care providers are going to have to go through retraining." Administering the smallpox vaccine, he said, is "a completely different process."

In addition, said Rothholz, "Look at how you'll be able to move medicines when needed or how you'll communicate in an emergency situation. One thing we learned very clearly in 9/11 is that cell phones and land lines will go down in areas that are hit. So how do you communicate when those things happen? And in an emergency situation, how do you move pharmacists where they're needed?"

Those aren't idle questions. In the event of emergency, community pharmacists by the hundreds may be called into rapid-response service. Their role will be to get emergency medicines and supplies into the hands of patients-along with skilled counseling on the proper use and effect of those medicines-under conditions that may be chaotic or rushed. In some cases, they could be called to a central "hub" site designated by the government for drop-off an distribution of supplies; in others, they may simply work out of their own stores.

In an emergency, said Rothholz, emergency officials can also "come into any health care entity and claim your stock. They have to compensate you for it, but they can claim your stock and utilize your facility if they need to."

Sue Gorman, Pharm.D. and senior science officer for the CDC's National Pharmaceutical Stockpile Program, told listeners the government has geared up for rapid response to biological or other terrorist threats. For instance, she said, "We have enough stockpile to treat 12 million individuals for anthrax for 60 days." Besides antibiotics and other drugs, the stockpile also contains other emergency medications, such as diazepam and atropine, and agents for treating threats such as plague and smallpox, as well as medical supplies and other items.