Mississippi Public Health Emergency Response 1999-2024 PDF

Pharmacists in Public Health Ashton Smith, PharmD Licamied Macklin, PharmD 1 Content Emergency Preparedness o Radiological, biological, chemical, natural disaster Zoonotic Diseases o E. Coli, Lyme disease, tuberculosis, rabies, etc. Endemics and Pandemics Roles in Public Health 2 Objectives Describe...

Pharmacists in Public Health Ashton Smith, PharmD Licamied Macklin, PharmD 1 Content Emergency Preparedness o Radiological, biological, chemical, natural disaster Zoonotic Diseases o E. Coli, Lyme disease, tuberculosis, rabies, etc. Endemics and Pandemics Roles in Public Health 2 Objectives Describe what emergency preparedness is and what it entails Describe zoonotic diseases and their effect on public health Explain the importance of pharmacists in emergency preparedness Present opportunities for students and pharmacists to be involved in public health 3 Preparedness Goals The national preparedness goal is to have “a secure and resilient nation with the capabilities required across the whole community to prevent, protect against, mitigate, respond to, and recover from the threats and hazards that pose the greatest risk.” 4 Radiological Emergencies Nuclear Plant Accident 5 Natural Disaster 6 Chemical Release 7 Biological Attack 8 Public Health Emergencies Disease outbreak Pandemic influenza COVID-19 West Nile SARS Natural disasters Tornadoes Hurricanes Wildfires Ice storms Man-made disasters Anthrax Plague Tularemia Smallpox Weapon of mass destruction event Bomb Chemical attack Nuclear attack 9 Bioterrorism Bioterrorism is intentional use of infectious biological agents, or germs, to cause illness or death MSDH works closely with hospital emergency rooms throughout the state, looking for clusters of sick patients which could indicate release of a biological agent The federal government maintains a large stockpile of pharmaceuticals, including antibiotics, that are effective against likely bacterial bioterrorist agents. In the event of an attack, medication would be rapidly available 10 “All disasters start and end at the local level” Truong, H.A., Bresette, J.L., & Sellers, J.A. (2010) The Pharmacist in Public Health: Education, Applications, and Opportunities. Washington, DC: American Pharmacists Association. 11 MS Public Health Emergency Response 1999-2024 2003 1999 MSDH receives federal funding for Smallpox Plan. The Office of Emergency Planning and Response is created. 2001 September 11, 2001 12 MS Public Health Emergency Response 1999-2024 2004 Hurricane Charley Hurricane Frances Hurricane Ivan Hurricane Jeanne Tropical Storm Matthew Chiron Flu Vaccine Shortage/Mass Vaccination 2005 Hurricane Katrina Hurricane Rita 13 MS Public Health Emergency Response 1999-2024 2006 Tropical Storm Alberto 2008 Hurricane Gustav 2009 H1N1 Swine Flu Pandemic Hurricane Ida Jackson Water Crisis Severe Winter Weather Event 14 MS Public Health Emergency Response 1999-2024 2010 BP Gulf Coast Oil Spill Jackson Water Crisis Yazoo County Tornado 2011 MS River Flood Event Yazoo Tornado Smithville Tornado 2012 Hurricane Isaac 2013 Hattiesburg Tornado 15 MS Public Health Emergency Response 1999-2024 2014 Winter Weather Events Louisville/Tupelo Tornados Ebola 2016 Zika 2015 Winter Weather Events 16 MS Public Health Emergency Response 1999-2024 2017 Weather events 2018 Tropical Storm Gordon March 11, 2020 Coronavirus (COVID-19) global pandemic February 14, 2021 Winter Weather Event April 12, 2020 Weather events (flooding, tornadoes) 17 MS Public Health Emergency Response 1999-2024 August 2022 Jackson water plant failure March 2023 Rolling Fork Tornado 18 Emergency Support Functions (ESFs) 19 OEPR The MSDH Office of Emergency Planning and Response safeguards the health of individuals, ensures the delivery of essential health and medical services, and prepares health professionals for all types of emergencies and natural disasters. 20 Strategic National Stockpile (SNS) The mission of the Strategic National Stockpile (SNS) is to deliver critical medical assets to the site of a public health emergency severe enough to cause local supplies to run out. 21 22 Strategic National Stockpile (SNS) 23 SNS Supplied Countermeasures Based on Category A Threat Agents Smallpox Anthrax Botulism Viral hemorrhagic fevers Plague Tularemia And other threats Nerve agents, pandemic influenza, radiological, etc. Changes directed by Biomedical Advanced Research and Development Authority (BARDA) 24 High Priority Agents/Diseases Category A Smallpox Anthrax Botulism Viral hemorrhagic fevers Plague Tularemia Category B Brucellosis Salmonella Typhus fever Category C Emerging diseases such as Nipah virus and hantavirus 25 Point of Dispensing (POD) Mississippi has plans in place to use Open (public) POD sites as well as Closed (private) POD sites to ensure that pills or vaccines can be dispensed rapidly Must deliver to 100 percent of the population within 48 hours The goal is to enroll as many Mississippians into the Closed POD system as possible, thereby reducing lines in Open (public) POD sites. Point of Dispensing (POD) Medical oversight personnel required ○ physician ○ pharmacist 27 Pandemics "an epidemic that occurs worldwide, across international borders, affecting a large number of people Influenza A (H1N1) in 2009, COVID-19 in 2020, Ebola virus in 2013 28 Emergency Response During COVID-19 Pharmacists at the Drive Thru and Other COVID-19 Vaccination Clinics 30 Pharmacists Managing COVID-19 Therapeutics 31 Additional Therapuetics 32 33 Zoonotic Diseases E.Coli (more specifically, O157) Transmitted fecal-oral route via contaminated foods Tuberculosis Transmitted inhalation route via contaminated persons airborne particles Lyme Disease Transmitted via infected blacklegged tick bite Rocky Mountain Spotted Fever Transmitted via bites from specific species of ticks Plague Transmitted via flea bites, contact with contaminated flesh or fluid, or infectious droplets Rabies Transmitted via direct contact or exposure to an infected animal 34 35 What does this mean for you as a future pharmacist? 36 Pharmacists in Public Health MSDH currently employs approximately 22 fulltime pharmacists throughout the agency Pharmacy operations (Ryan White, Tuberculosis, etc.) Specialty Pharmacy (URAC-Accredited) Opioid and Substance Use Disorder Program Aids Drug Assistance Program (ADAP) Immunizations Antibiotic Stewardship/Epidemiology Academic Detailing Program Residency Program 340B 37 Pharmacists in Public Health Specialty Pharmacy accreditation through URAC What does that mean? Track quality measures Emphasizes individualized patient care and safety Potential additional PBM contracts 38 Pharmacists in Public Health Specialty Pharmacy focuses on high-cost medications used to treat complex or rare medical conditions MSDH pharmacy offers specialty pharmacy service for the HIV/STD program 39 Pharmacists in Public Health Handle all active and latent TB cases throughout the state of Mississippi (adult and pediatric) 40 Medications for Substance Use Disorder (MSUD) Launched in 2022 at county health departments Purpose: improve access to care for opioid use disorder via telehealth MSDH provides no or low cost medication-assisted treatment (MAT) Pharmacy will dispense and ship prescribed medications to the client’s home Partnered with the UMMC Department of Psychiatry and Human Behavior to provide behavioral health interventions for our patients 41 MSUD 42 Naloxone 43 Naloxone Naloxone kits requested through a web-based Naloxone Request Form ○ $0 out-of-pocket cost to the patient and will be shipped directly to the patient’s home or to the local county health department Naloxone Leave Behind Kits ○ Provided to patients through EMS to target populations most vulnerable to a fatal overdose Naloxone for First-Responder Administration ○ MSDH offers KloxxadoⓇ to Mississippi’s First Responders for patient administration 44 Naloxone Each kit contains: 2 - doses of naloxone hydrochloride 4 mg nasal spray 2 - face shields 1 - card with naloxone spray instructions 1 - card with signs of an opioid overdose information 1 - storage case with hook 45 Academic Detailing MS ADAPT (Mississippi Academic Detailing and Provider Training) Program Outreach education technique conducted with clinicians to encourage evidence-based practice in order to improve the quality of care and patient outcomes Pharmacists and pharmacy residents deliver the detailing Email: [email protected] 46 Residency Program MSDH offers a twelve-month Postgraduate Year One (PGY1) Community-Based Pharmacy Residency Program accredited by the American Society of Health-System Pharmacists (ASHP) Health Services (ADAP, TB, Antibiotic Stewardship) Telehealth (Medication Therapy Management under CPA at UMMC Center for Telehealth) Independent Pharmacy (Flora Pharmacy & City Center Drugs) Health Protection (MSDH Office of Emergency Planning & Response) Specialty Pharmacy Leadership & Advocacy Research Teaching & Learning Certificate through the School of Pharmacy Academic Detailing 47 References Federal Emergency Management Agency [Internet]. Department of Homeland Security.[Updated 2012 Apr20; cited 2012 Apr 20]. Available from: http://www.fema.gov/pdf/emergency/nrf/National_Preparedness_Guidelines.pdf Centers for Disease Control and Prevention [Internet]. Department of Health and Human Services. [Updated 2012 May 3; cited 2012 Apr 23]. Available from: https://www.orau.gov/snsnet/ Truong, H.A., Bresette, J.L., & Sellers, J.A. (2010) The Pharmacist in Public Health: Education, Applications, and Opportunities. Washington, DC: American Pharmacists Association. Mississippi Emergency Management Agency [Internet]. Mississippi Emergency Management Agency. [Updated 2012 May 3; cited 2012 May 3]. Available from: http://www.msema.org/plans/cemp.html Mississippi State Department of Health [Internet]. Mississippi State Department of Health. [Updated 2012 May 3; cited 2012 April 25]. Available from: http://www.healthyms.com/ Inglesby TV, O’Toole T, et al. Anthrax as a biological weapon, 2002: updated recommendations for management. JAMA. 2002 May 1; 287(17):223652. Meselson M, Guillemin J, Hugh-Jones M, Langmuir A, Popova I, Shelokov A, Yampolskaya O. The Sverdlovsk anthrax outbreak of 1979. Science. 1994;266:1202-8. NCEZID: National Center for Emerging and Zoonotic Infectious Diseases [Internet]. Atlanta: Centers for Disease Control and Prevention (US). Anthrax; [updated 2009 Aug 26; cited 2013 Mar 18]. Available from: http://www.cdc.gov/nczved/divisions/dfbmd/diseases/anthrax/technical.html Nerve Agent Picture: http://www.glasistre.hr/vijesti/svijet/potvrdjeno-13-slucajeva-zaraze-sarinom-u-siriji-413532 Nuclear Reactor Picture: Radiological Emergency Preparedness | Division of Homeland Security and Emergency Services (ny.gov) Cyber Attack Picture: http://www.telegraph.co.uk/technology/internet/9112406/Dozens-of-suspected-Anonymous-hackers-arrested-in-worldwide-sweep.html Chemical picture: http://abcnews.go.com/blogs/headlines/2012/09/1-killed-dozens-hurt-in-japanese-chemical-plant-explosion/ Scenario picture: http://www.tinker.af.mil/photos/index.asp http://blogs.cdc.gov/publichealthmatters/2015/02/cdcs-chempack-program-the-stockpile-that-may-protect-you-from-a-chemical-attack/ Kelly H. The classical definition of a pandemic is not elusive. Bull World Health Organ. 2011;89(7):540-541. doi:10.2471/BLT.11.088815 48 QUESTIONS? Ashton Smith, PharmD [email protected] Licamied Macklin, PharmD [email protected] ov 49