Points of Dispensing in Public Health Emergencies AKPHA Annual - PDF document

1/27/2019 Points of Dispensing in Public Health Emergencies AKPHA Annual Convention Sheraton Anchorage Sunday February 10th, 2019 OBJECTIVES: • Review the background and history of the Public Health Emergency Preparedness (PHEP) program • Discuss response roles and responsibilities at the federal, state, local, and tribal levels • Recognize how Alaska responds to public health emergencies • Outline the state’s medical countermeasures plan with a focus on community prophylaxis • Identify ways pharmacists, technicians and pharmacies can assist in response via their employer or as a volunteer through Alaska RESPOND 1

1/27/2019 Exercise Exercise Exercise • https://www.youtube.com/watch?v=mxNKTjNpzJk Public Health Emergency Preparedness (PHEP) 2

1/27/2019 News Headlines and Reports over the Years News Headlines and Reports over the Years (CNN) -- A letter found by police in the mailroom of the New York Post newspaper has tested positive for anthrax and has the same postmark as anthrax-laced letters sent to Sen. Tom Daschle and NBC News anchor Tom Brokaw, an FBI official said Saturday. (Oct 21, 2001) 3

1/27/2019 News Headlines and Reports over the Years The Washington Health Department is investigating additional cases of possible anthrax infection, including one person connected to the Brentwood mail facility who has been hospitalized. People began stockpiling Cipro, an antibiotic that is typically recommended for the treatment of anthrax. Talk swirled about the possibility of a large-scale anthrax attack. What if it was scattered over a city? Blown into the ventilation system of a skyscraper? “Never forget,” read the bumper stickers and T -shirts after September 11, 2001. But there was another terrorist attack against the United States that began later that month, the anthrax attacks that spread through the U.S. Mail. News Headlines and Reports over the Years 4

1/27/2019 News Headlines and Reports over the Years History and Progression of Public Health Emergency Preparedness Program 5

1/27/2019 The Evolution of the PHEP Program Public Health Preparedness Capabilities 6

1/27/2019 Response Sequence of Events Roles and Responsibilities PODs & Storage & Local State Federal RSS Site Transport Treatment Centers 7

1/27/2019 Strategic National Stockpile (SNS) “ To Prepare and support partners and provide the right resources at the right time to secure the nation’s health ” Program created in 1999 Portfolio of antibiotics, medical supplies, antidotes, antitoxins, antivirals, vaccines and other pharmaceuticals 12 Hour Push Pack 8

1/27/2019 ·Managed Inventory ·Chempack ·Federal Medical Station ·12-hour Push Package Key steps of State Response 9

1/27/2019 DHSS Emergency Operations Center Incident Commander Liaisons Safety Officer Subject Matter Experts Plans Section Operations Logistics/Finance Chief Section Chief Section Chief State of Alaska Situation Unit Medical Task Finance Branch Leader Force DHSS Roles and Responsibilities During a Disaster Primary: Public Health and Medical Mass Casualty Mass Fatality Medical Surge Medical Logistics Coordination 10

1/27/2019 DHSS Emergency Operation Center Saturday December 1, 2019 Not an Exercise! Daily Situational Updates November Earthquake 11

1/27/2019 Deployable Resources Mission: To protect and promote the health of Alaskans. How Alaska Responds to Public Health Emergencies State MCM Plan 12

1/27/2019 Alaska’s Response • Request, Receive, Stage, Store and Distribute • Points of Dispensing (PODs): – Primary method to dispense medications to the public – Common areas located throughout the community (schools, community centers) – Managed and operated by the local public health centers • What this means to Alaska? – Up to 12 hours for SNS materials to reach Alaska – Two to four hours to pull medications and repackage for local distribution – One to four hours for delivery to local jurisdiction • We need a whole community approach DHSS MCM Distribution • Direct ship via ground to MOA PODs • Direct ship via ground to Mat-Su MSA & adjacent Regional Public Health Centers • Transshipped via ground to commercial air to outlying areas • National Guard/Civil Air Patrol assets requested when warranted • Geography, distance, weather, available resources and limited road network present challenges 13

1/27/2019 DHSS Public Health Centers State Plans: Community Prophylaxis 14

1/27/2019 Local Points of Dispensing Understanding The Process • Screening • Dispensing • Education 15

1/27/2019 Rx to People = PODs Dispensing sites are fixed locations where medications from the Strategic National Stockpile can be given out to people in response to a public health threat or emergency. An OPEN POD site is a location operated by a state/local public health agency that is open to everyone who lives or works in that community. OPEN PODs are meant to serve the entire public. A CLOSED POD site is a location that is operated by a private business/agency for a specific population (i.e., its employees and their families). CLOSED Dispensing Sites are not open to the public. Points of Dispensing – POD • Listen for announcements regarding designated POD location • Radio, television, newspaper, internet, social media, etc. • Based on Anchorage’s population an estimated 8-14 PODS will be required/opened depending on staff availability • Current POD locations for Municipality of Anchorage ??? 16

1/27/2019 Dude, where’s my POD??? CLOSED PODS - ANCHORAGE OPEN PODS - ANCHORAGE Municipality of Anchorage - Agreements HIGH SCHOOLS - FIRST MIDDLE SCHOOLS - SECOND · BARTLETT · BEGICH JBER 40,000 · CHUGIAK · CENTRAL Providence Hospital 10-12,000 · DIMOND · CLARK · EAGLE RIVER · GIRDWOOK Alaska Regional 3,500 · EAST · GOLDENVIEW ANMC (Pending) 3,000 · SERVICE · GRUENING Anchorage School District 6,500 · SOUTH · HANSHEW · WEST · MEARS Anchorage Fire Department 1,000 · MIRROR LAKE Anchorage Police Department 1,000 · ROMIG · WENDLER Approximately total accounted for: 67,000 (~22%) · Alaska Shield 2019 “Ragin’ Contagion” · Pills to Polar Bears 2015 · Local planners work with the State · Points of Dispensing (PODS) Drills and Exercise 17

1/27/2019 Alaska Shield 2014 How can Pharmacy profession help? • Pharmacies maybe called upon for dispensing MCM or administering vaccine • Pharmacist and technicians via employer’s participation • Pharmacist and technicians can register/volunteer with Alaska Respond 18

1/27/2019 Public Health and Private Sector June 2015 – Costco warehouse exercises dispensing medications based on an anthrax attack Alaska Medical Station • Federal Medical Station donated to Alaska ~ 2012/2013 • Set up in 50 Bed increments up to 250 • Modular deployment – medical surge support • Medical Supplies, pharmaceuticals and equipment for 3 days • Configured for rapid movement • Designed for: • non-acute care • Special needs care • Quarantine operations • Supplementing local healthcare infrastructure • Alaska Shield 2014 – Sumaritan’s Purse set up with full mobile surgery operations • Headquarters in Boone, NC – Humanitarian aid organization 19

1/27/2019 Tools in Response • Who’s open/functional? • Partner with HealthCare Ready organization • Recently activated during Hurricane Florence and Michael (East Coast), Hurricane Lane (Hawaii), California Wildfires Map Example of Rx Open 20

1/27/2019 Alaska Respond https://akrespond.alaska.gov/ 21

1/27/2019 Presenter Contact Info C.J. Kim Pharmacist Division of Public Health Section of Epidemiology 3601 C Street, Suite 586 Anchorage, AK 99503 (O) 907-269-8029 (F) 907-269-0472 Cj.kim@alaska.gov Questions? 22