The planet is at “acute risk” of devastating epidemics or pandemics – but how can pharmacists help?
The world is not ready to handle disastrous outbreaks at which it is increasingly at risk, a report by the Global Preparedness Monitoring Board (GPMB) has found.
Such epidemics or pandemics would not only cause loss of life, but upend economies and create social chaos, the report warns.
“Vulnerability is heightened by an increase in outbreaks occurring in complex humanitarian emergencies, as well as a novel convergence of ecological, political, economic and social trends including population growth, increased urbanization, a globally integrated economy, widespread and faster travel, conflict, migration and climate change,” it says.
Between 2011 and 2018, the World Health Organization tracked 1,483 epidemic events in 172 countries.
“Epidemic-prone diseases such as influenza, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), Ebola, Zika, plague, yellow fever and others, are harbingers of a new era of high-impact, potentially fast-spreading outbreaks that are more frequently detected and increasingly difficult to manage.”
All economies are vulnerable to such outbreaks; the report used the example of Guinea, Liberia and Sierra Leone, which lost an estimated US$2.2 billion in GDP in 2015 during the 2014-15 West Africa Ebola outbreak.
“While scientific and technological developments provide new tools that advance public health (including safely assessing medical countermeasures), they also allow for disease-causing microorganisms to be engineered or recreated in laboratories,” the report warns.
“A deliberate release would complicate outbreak response; in addition to the need to decide how to counter the pathogen, security measures would come into play limiting information-sharing and fomenting social divisions.
“Taken together, naturally occurring, accidental, or deliberate events caused by high-impact respiratory pathogens pose ‘global catastrophic biological risks’.
“The world is not prepared for a fast-moving, virulent respiratory pathogen pandemic.
“The 1918 global influenza pandemic sickened one third of the world population and killed as many as 50 million people— 2.8% of the total population.
“If a similar contagion occurred today with a population four times larger and travel times anywhere in the world less than 36 hours, 50-80 million people could perish.
“In addition to tragic levels of mortality, such a pandemic could cause panic, destabilise national security and seriously impact the global economy and trade.”
While the report does not specifically mention a role for pharmacists, they could have a significant role in helping to prevent or manage significant outbreaks, said Elizabeth McCourt, a Queensland pharmacist and PhD student who is investigating the role of pharmacists in disasters including pandemics.
“While pandemics affect multiple countries or continents, their spread and management are greatly affected by local and state management,” she told the AJP.
“Poor local and state management can mean increased disease spread, increased burden of disease and increased mortality, while good local and state management can mean the opposite.”
Ms McCourt said that pharmacists are essential in everyday health systems and are uniquely placed in the health care system to assist with the prevention and management of significant outbreaks by:
- “Being aware of the types of health emergencies that are likely to affect your place of practice, and think of how these may impact your usual services.
- “Be vigilant of odd or unusual symptoms which may require reporting to local public health.
- “Be prepared,” she says. “Preparing can be done by developing a plan for pandemic response, training staff in response and use of personal protective equipment, or undertaking a training exercise with other health professionals in the area.
- “Plan for safety and security. Pandemics are stressful and scary. Ensuring the safety of yourself, and those you work with should be a priority. Pandemic can bring new security threats as people seek medications and vaccinations which may be in short supply; it is important that this is considered when planning for pandemic response.
- “Acknowledge that staff shortages may occur during an outbreak either because people themselves are affected or are unwilling to work due to fear of the outbreak,” she advises. “Plan appropriately for how services will be provided if there are reduced pharmacists or support staff available. Think about what services may need to be ‘put on hold’ or delivered differently while a crisis is being managed.
- “Buddy up! Internationally some pharmacies have a ‘buddy system’ for emergency and disaster response with surrounding pharmacies. This ‘buddy system’ allows for sharing of resources (such as medications and staff) during a crisis. In a pandemic this ‘buddy system’ could be used to condense all pandemic services (such as antiviral dispensing) into one pharmacy, reducing the risk of otherwise well people being exposed to those that are infected.
- “Partner with those around you. A well prepared and responsive health workforce must be well connected to each other. Team up with other local pharmacies, GPs, hospitals, and government to discuss pandemic plans and actions. Discuss how you will communicate in an outbreak and how you can respond in a coordinated manner.”
Read the full GPMB report here.