August 2, 2004

The Pharmacist’s Role In an Age of Bioterrorism and Other Emerging Public Health Threats

Like many of us, these attacks caused Stergachis to re-evaluate. He started to analyze his role, the role of a pharmacist in this new world, when a second incident further impacted his sense of professional responsibility. Stergachis was in Washington DC shortly after anthrax was released through the nation’s mail system. Being on location, he learned about the efforts of pharmacists and other health professionals working hard to dispense antibiotics to the thousands of people potentially exposed to anthrax spores. As Stergachis puts it, he “sized up his values” after those two events and realized that he both wanted and needed to build upon his experience in pharmacy to do something “more consistent with the emergent needs within the public health sector.”

Stergachis joined UW faculty in the early eighties and served as chairman of the Department of Pharmacy from 1992-1998, while also maintaining an active faculty appointment in the Department of Epidemiology. In 1998, he left UW to help start drugstore.com as vice president and chief pharmacist. At drugstore.com, Stergachis learned a great deal about scalability, national distribution of medicines and developed large-scale clinical programs, such as patient self-checking of drug interactions and implementation of systems allowing email correspondence between patients and their pharmacists. This experience turned out to be the perfect compliment to his training and academic background and a valuable time of learning for what lie ahead.

In response to the terrorist attacks and anthrax scare of 2000, Stergachis identified a growing educational need and widening range of responsibility within the pharmacy profession. He began to speak locally on the role of the pharmacists in bioterrorism and public health and safety. In 2002, he was asked to put together a program on bioterrorism and pharmaceutics community for the World Economic Forum in New York City to explore the preparedness of the medical and public health community. In 2003, Stergachis left drugstore.com and joined the UW’s Center for Public Health Preparedness (CPHP). Based in the UW School of Public Health and Community Medicine, the CPHP is an academic epicenter for public health, focusing on improving the capacity of the public health workforce to prepare for and respond to terrorism and other emerging public health threats. Stergachis talked with numerous Washington state and local health officers to find out how pharmacists could better help them with their responsibility – his queries were met with much enthusiasm as to how the two groups could better work together and best prepare for man-made and/or natural disasters.

“The question we continually work to answer,” says Stergachis “is should a terrorist attack or emerging infection outbreak hit a community, how would the health community react? How would needs be met and people cared for in the most efficient and effective manner? And most importantly to us, what is the role of the pharmacists?” Stergachis provides the following suggestions to those wishing to address the latter:

The top five things you as a pharmacist can do:

  1. Know the health officer in your local health department
  2. Become familiar with agents of concern, their treatment and prophylaxis (prevention medicines) and their epidemiology
  3. Be willing to volunteer (put in the hours if need be to help set up and run mass dispensing clinics in your community)
  4. Get more involved – take training classes on emergency preparedness (see further information below).
  5. Get others more involved

Through funding from the Center for Disease Control (CDC) and the Health Services and Resources Administration (HRSA), Stergachis and others in his program are setting out to train a work force in new areas, areas of preparation for public health and safety in response to both natural (i.e. SARS) and unnatural (i.e. anthrax exposure) outbreaks within a community and across the nation.

Stergachis maintains that local pharmacies play a key role in any sort of emergency response. “Pharmacies are located within 5 miles of most residents,” says Stergachis, “they represent a resource during times of need and can also serve as a watchdog of unusual activity, for example reporting notable conditions or an unusual run of antibiotics.” Stergachis told of one case in the Midwest where a pharmacy noted an unusual sale of Pepto Bismol, upon further investigation it was found that the surrounding community had water quality issues with its drinking water.

Stergachis’ goal is to build both awareness of the need and an actual developed core of pharmacists who are a prepared, trained, willing and able, in conjunction with public health agencies, to combat the unfortunate events of natural or man-made threats to a community’s health and safety. At the local and state level, the Washington State Pharmacy Association (WSPA) Emergency Preparedness Committee, that he chairs, provides training and technical assistance to help the state and local health departments with planning for mass prophylaxis, antibiotic availability and distribution of vaccines etc, to entire communities.

Stergachis has taken his efforts national and most recently internationally, having just returned from Athens, Greece where he served as the only pharmacist on a team of public health and emergency response experts sent by the U.S. Department of Health and Human Services to participate in a joint session on Olympic preparations, co-sponsored by the Greek Ministries of Health and Public Order. The US team worked with representatives from the Government of Greece Ministry of Health and other ministries on an array of issues relating to emergency response and risk communications. The group shared ideas and compared techniques regarding strategies for responding to all kinds of public emergencies and hazards. The week-long planning session provided a firm foundation for future emergency response planning for the Greek Ministry of Health. Participants from both the United States and Greece benefited from the exchange of ideas.

Stergachis continues to educate and encourage pharmacy professionals to evaluate the role they play in the community and take necessary steps to ensure they are best equipped with the knowledge, contacts and materials needed should a disaster occur. He invites you and your colleagues to join him in this important effort. The payoff is a community and its pharmacists prepared to handle both natural and terrorist induced disasters, possibilities we need to plan for and ones that have widened the role and professional responsibility of the pharmacist.

Further Information:

Please consider taking a class to learn more about public health emergency preparedness and planning and the pharmacist’s role.

Pharmacy professionals
Washington State Pharmacy Association (WSPA) Emergency Preparedness Committee is an excellent source for information and resources relating to emergency preparedness. WSPA also offers continuing education classes on how best to deal with outbreaks of small pox and other nature disease disasters. For more information, please visit www.wsparx.org/emergencyprep

Pharmacy students
UW School of Pharmacy in conjunction with Public Health, Medex and Nursing offers the following courses on bioterrorism:

  • Bioterrorism Awareness for Health Professionals UCONJ 445 Winter
  • Bioterrorism Preparedness and Response for Health Professionals UCONJ 446 Spring

For more information, please contact Andy Stergachis or one of the course coordinators Randal Beaton, PH.D E.M.T at randyb@uw.edu or Mark W. Oberle, M.D., M.P.H. at moberle@uw.edu

Andy Stergachis, Ph.D., R.Ph. professor of epidemiology and affiliate professor of pharmacy, Northwest Center for Public Health Practice can be reached at the UW School of Public Health and Community Medicine at stergach@uw.edu

 

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