Pharmacies Could Hold a Key to Effective Disaster Response, Seasons, Spring 2001

With any luck, certain research underway at Samford University's McWhorter School of Pharmacy will never be fully tested. The school, in collaboration with the Alabama Department of Public Health and the Center for Disaster Preparedness [CDP] at the University of Alabama at Birmingham, is studying how best to respond to biological and chemical disasters, particularly those resulting from terrorist attacks.

However sensational such events may seem, they are both theoretically possible and increasingly likely. In fact, some terrorism experts believe a lethal biological or chemical attack in the U.S. is inevitable.

"I don't know if I'd go so far as to say it's a matter of when, not if," said McWhorter Assistant Dean Susan Alverson, a CDP executive committee member. "In fact, people tend to underestimate the technical difficulty of developing and successfully using a biological weapon such as anthrax or smallpox."

Such nightmare scenarios are theoretically possible, said Alverson, but not as likely as less technically ambitious chemical attacks, such as the Aum Shinrikyo cult's release of deadly Sarin gas on Tokyo commuter trains in 1995. That attack injured 5,000 people and killed 12. But a 1993 U.S. government study concluded that the successful airborne release of weaponized anthrax spores over a major city would be much worse.

Samford's role is to answer vitally important questions about how medical treatment would be delivered in the event of a biological or chemical disaster. Surprisingly, neighborhood pharmacies may be one key to effective response.

"The first thing we're trying to do is look at what [drug] stockpiles are available," said Alverson. "We want to survey all pharmacies, hospitals and wholesalers to see what's on hand on any given day so that if something happened in Mobile, for example, we could mobilize Birmingham, Huntsville, Anniston, etc."

Alverson said she and her colleagues also will study how Alabama and, by extension, other states, can most effectively use federally prepared "push packages," massive bundles of supplies designed for emergency airlift throughout the nation. Alverson said local pharmacies might help solve the significant logistical problems associated with unpacking, storing and distributing these shipments, each of which requires 5,000 square feet of storage space.

A developing third area of inquiry may answer one of the most fundamental questions of disaster preparedness; how to detect an unfolding crisis before it's too late to help. Alverson explained that identifying a biological terrorist attack is particularly difficult because biological weapons can create slow-motion medical catastrophes difficult to spot and contain.

At present, she said, "It could be days before we realize there's a problem." But she envisions a monitoring network built on the existing relationship between pharmacies and third-party payers. She said pharmacies report prescriptions as they are sold, and insurance companies collect that data every 24 hours. That makes it possible for experts stationed at those companies to monitor daily reports for spikes in certain kinds of prescriptions that could represent a disaster in progress.

Alverson said even the U.S. Office of Emergency Preparedness is waiting to see if such ambitious visions will lead to foolproof plans for disaster response. And foolproof they must be, because errors in planning could mean loss of life in the event of a real-world test.