BETHESDA, MD 05 January 2010—In the aftermath of Hurricane Katrina, which hit Louisiana in 2005, the federal government started changing its master plan regarding disasters.
For one, the National Disaster Medical System (NDMS) returned to the Department of Health and Human Services after four years within the Federal Emergency Management Agency, part of the Department of Homeland Security.
Now, the National Pharmacist Response Team program is in "transition" to a new program, said Commander Michael P. Bourg, chief pharmacy officer at Health and Human Services’ Office of Preparedness and Emergency Operations, who is looking for volunteers.
Diverse disaster needs. This new program, which lacked a formal name and structure as of early December, will help the government better prepare for and respond to a diversity of disasters, including hurricanes, tsunamis, and even security events, Bourg said.
The original National Pharmacist Response Team program, begun in 2002, was designed as regional units that would assist in distributing and administering chemoprophylaxis and vaccines to hundreds of thousands of Americans.
"What we’re doing is redefining [pharmacists’ participation] to help better meet our mission requirements," Bourg said.
Lee Joffee, one of the leaders of a National Pharmacy Logistics Team that reports to Bourg’s office, said the role of pharmacy in NDMS has "evolved dramatically" since Hurricane Katrina.
In the past year, Joffee has deployed to Hawaii, North Dakota, Texas, the District of Columbia, American Samoa, Guam, and Puerto Rico.
Command-and-control role for new team. Bourg said the Office of Preparedness and Emergency Operations "prestages" pharmaceutical caches and kits of ready-to-assemble pharmacies in areas of the country at higher risk for disasters. The purpose is to shorten the lead-time for disaster response.
As lead pharmacy officer, Bourg has pharmacists and pharmacy technicians assigned to help manage the caches and kits before and during a disaster.
"We have pharmacists and technicians that will deploy . . . near the disaster scene [who] help facilitate getting caches and kits and medical supplies to that region," he said.
Each cache has 300–350 different kinds of products, Bourg said, and is intended to supply a Disaster Medical Assistance Team with the full range of pharmaceuticals needed for a disaster response.
As a Disaster Medical Assistance Team and its pharmacy personnel dispense and administer pharmaceuticals from a cache, Bourg said, he needs other pharmacists to monitor usage and report back to him. With this information from the field, he looks for trends, identifies pharmaceuticals that the team may run out of, and contacts vendors that can resupply the cache.
Joffee said he went to North Dakota in the spring of 2009 in anticipation of a swollen river breaching the levees and flooding a community.
"As the command-and-control element," he said, "you go in, you talk to the local board of pharmacy, make arrangement for our pharmacists to practice properly there so that we follow all their rules and regulations, and get the equipment in and staged, get it ready."
Bourg said he starts moving pharmacy personnel, caches, and kits into position even before the local news stations report an imminent storm.
For example, when a storm comes off the coast of Africa, he said, "we’re watching."
"Two or three days before it even gets close to U.S. Virgin Islands, we’re pushing stuff out the door," Bourg said. "We’re moving people, pharmacy personnel, out the door. We’re moving pharmaceutical caches out the door. We’re reaching out to our vendors. We’re lining up transportation and where it’s coming from."
Dispensing role, with a twist. In deploying a Disaster Medical Assistance Team, Bourg said, NDMS assigns pharmacists to the team to perform "their typical pharmacy role."
But Joffee, who graduated from pharmacy school about 30 years ago and now works in a mail-order specialty pharmacy in New York, described the role of pharmacists on a disaster-response medical team as "very, very nontraditional."
"To me, that’s the optimum job," he said. "And it’s where you get to be the kind of pharmacist that probably most of us wanted to be when we were in pharmacy school. You’re serving on a team of 35 people . . . doctors, nurses, paramedics, and you are truly their drug resource."
In the days after Hurricane Katrina made landfall, Joffee said, his disaster-response team had limited pharmaceutical resources yet needed to treat hundreds of critically ill patients a day.
"The doctors would truly depend on you to come up with treatment regimens, given what we had to work with," he said.
As for storage of the pharmaceuticals, the teams had makeshift pharmacies (see photo).
In transition. According to the Public Health Service’s Pharmacy Professional Advisory Committee, the National Pharmacist Response Team program was expected to consist of 10 regional teams of about 200 civilian pharmacists apiece.
The Joint Commission of Pharmacy Practitioners Working Group on Emergency Preparedness, of which ASHP was a member, agreed to sponsor the teams.
Joffee suggested that pharmacists and pharmacy technicians interested in joining the new National Logistics Response Assistance Team (LRAT), which has a national pharmacy logistics component, read about NDMS at www.hhs.gov/aspr/opeo/ndms/join/index.html and indicate their LRAT interest in an e-mail to ndms@hhs.gov.
