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Disaster Logistics: Drug Distribution During Time of Crisis

Lessons learned by government and industry from the 2017 hurricane season.

The 2017 hurricane season saw one of the worst string of natural disasters to hit Texas, Florida, U.S. Virgin Islands and Puerto Rico between August and October. Needless to say, the storms taxed both government agencies and the private sector in a far greater way than ever predicted or planned for.

Puerto Rico, in particular, still lacks power and basic infrastructure, and the storms also knocked out drug producing facilities, leading to medicine shortages across the country that continue to this day.

There is a tendency to think if we get the hospitals up and running, a community is on its way to recovery. But what about pharmacies? Dialysis clinics? Nursing homes? And the myriad of other health services designed to keep people from having to go to the hospital in the first place? 

And, what about drug distribution? The website RxOpen.org shows which pharmacies are operating in a disaster zone. But does it matter if you know which pharmacies or hospitals are open if no medicines are getting through?

Key challenges were lack of water, no generators or faulty generators, as well as limited fuel availability. Oddly enough, Puerto Rico had at least a three-and-a-half-week supply of diesel, but there were no roads to deliver the fuel. Nor did anyone know where critical generators needing diesel were located.  

Patient outcomes and mortality in Puerto Rico were directly tied to these issues. There was a 47% increase in deaths due to sepsis because of a lack of antibiotics, 45% increase in deaths due to pneumonia, and a 43% increase in deaths from other respiratory issues due to lack of oxygen and other medical gasses. Diabetics experienced a 31% increase in death as a result of a lack of refrigeration for insulin and other drugs.

Serious life-and-death business

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