How the pharmacy responded to hurricane Ian

For a period of 48 hours after hurricane Ian, the five hospital outpatient pharmacies were the only operational pharmacies for the entire county and had to deal with a range of medication needs, John A. Armitstead, System Director of Pharmacy at Lee Health in Fort Myers, Florida, explains.

Mr Armitstead himself is a member of ‘Team A’, the team that staffs the hospital during the hurricane. “We have some advanced planning for the hurricane but then once the hurricane starts to hit, a variety of different events start to occur and you need to adapt your disaster plan with a dose of reality”, he says. As a leader, he finds it is better to be on site where he can establish a pharmacy command centre, check on his other sites and instigate adaptations to the emergency plans, if necessary.

After the hurricane, large numbers of patients came to the hospitals. Many required emergency treatments for puncture wounds. “Imagine that you have been in a house and let’s just say that the house has got three feet worth of water …… there’s either glass or nails or something like that, so now your skin is submerged in the water and you’ve got a puncture wound from either glass or some other foreign object ….. so the risk of an infection, of cellulitis, is quite high”, explains Mr Armitstead. Such patients require tetanus immunisation (if not up-to-date) and prophylactic antibiotics.

Another common scenario is disruption of treatment for patients with chronic conditions. “Let’s say that you’re a chronic obstructive pulmonary disease patient and you weren’t doing well before the hurricane and now you’ve got no electricity, no air conditioning, no lights in your home and now you’re struggling because also your nebuliser is not working because there’s no electricity”, he says.

Mr Armitstead emphasises, “It’s not like the hurricane passes and everything’s okay – you have to think of the loss of utilities ……. the first one that usually goes is electricity but don’t forget that we probably lost the internet too and then you’ve got [water] penetration”.  In addition, there may be no running water or sewerage.

In fact, after hurricane Ian, the only places with electricity were the hospitals, which each have emergency power plants. “The lights never went out at the hospitals. At each one of our five hospitals there was nothing more than a three-second delay in conversion to emergency power”, Mr Armitstead recalls.  The five hospital outpatient pharmacies were the only retail pharmacies open in Fort Myers for the first 48 hours post-hurricane. Had these not been available “people would have to leave the county to find a pharmacy that was open and had not only lights but their computer running [because] ….. with no computer you could almost not fill a prescription”, he says. The result was that these hospital pharmacies were the suppliers of prescriptions for outpatients throughout Lee County, a population of about one million people, he explains.

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