Weathering the Storm: Pharmacists Exemplify Resilience in the Wake of Natural Disasters
In the aftermath of natural disasters, pharmacists play an essential role in the disaster relief team.
On August 11, 1940, a category 2 hurricane rolled into Beaufort, South Carolina. The storm moved from the coast to inland Georgia, then unexpectedly moved north through the Appalachian Mountains and into western North Carolina to bring 5 days of severe rainfall, equating to approximately 21 inches of rain. This hurricane was dubbed one of the worst storms the mountain area in North Carolina has ever seen.1,2
Come September 2024, Hurricane Helene dropped approximately the same amount of rain within 48 hours in some areas, according to Corey Furman, PharmD, pharmacist and president of Boone Drugs Inc in North Carolina.
“We knew it was going to be a flood, but we didn’t know it was going to be this level. No one expected the worst flooding we’d ever seen,” Furman said in an interview. “It was difficult for us to be prepared for this level of event, but we did everything we could to be prepared for a basic flood. Then it got worse.”
Hurricane Helene Hits Black Mountains in North Carolina
When the severity became apparent, Furman and his team activated their emergency preparedness plans, ensuring that the inventory and records were protected. Additionally, they utilized generators to maintain medication storage requirements and coordinated with suppliers for expedited deliveries. At approximately 11 am, Furman shut down every location of his pharmacies.
Jonna Munroe, PharmD, co-owner of HealthRidge Pharmacy in Black Mountain, North Carolina, alongside her husband, Taylor Jones, PharmD, learned of the hurricane on the Monday before the storm hit on Friday morning. “A patient told me about it in [the] process of trying to counsel them on their medicine. He was like, ‘Yeah, I got to go do this stuff to get Montreat College ready for this hurricane that might happen,’ and I was like, ‘Oh, that’s news to me,’” Munroe said. She added that until the storm hit, she did not quite know the severity expected for their area in Black Mountain.
Images provided by Corey Furman for use by Drug Topics.
Munroe stated that it is incomprehensible to describe the level of severity that the community experienced. Their pharmacy has always been prepared for severe weather with generators and gas, but they only had 5 gallons of gas stocked up for Hurricane Helene, which she stated was not nearly enough. They were without power and water for almost 2 weeks, and no one was prepared for or even understood that this could be the result of the storm.
“[The hurricane] shifted, and the eye of the storm ended up going right over us,” Jones said in an interview. “Weather is the only thing I think about [that is] never right, but you never think that it’s going to be this bad.”
Emergency Preparedness in the Wake of Natural Disasters
“Our emergency preparedness is we’re going to be able to get there no matter what, and that’s what happened,” Jones said. “No matter what, as long as we’re alive, we’ll make it; we’ll make it happen between the 2 of us, and that’s what we had to do.”
The days following Hurricane Helene were some of the worst. The emergency preparedness plan could only do so much when no one anticipated the severity of the storm. Jessi Stout, PharmD, owner of Table Rock Pharmacy in Morganton, North Carolina, said there is not much her pharmacy could have done to prepare for the storm. Looking back, she would have made sure that the generator they bought was onsite, but at the time, she did not expect to use it.
Images provided by Corey Furman for use by Drug Topics.
As for Furman and Munroe, satellite communication was vital. With the power out, the cell phone towers quickly followed approximately 72 hours after the storm. What was spotty communication at best became complete silence. Munroe’s pharmacy invested in Starlink, which is a compact, portable kit that connects to the internet via satellite.
“If we didn’t have Starlink, we would [not] have been able to serve nearly as many needs to patients because we wouldn’t have been able to get online to order stuff,” Munroe said. “I would just advise every small business owner [to] just have that in place before a natural disaster happens.”
Akash Alexander, PharmD, clinical assistant professor in the Department of Pharmacy Education and Practice at the University of Florida in Orlando, said that pharmacists should have a list of local and regional pharmaceutical manufacturers, drug distributors, pharmacists, and pharmacy technicians to help fill the gap of a shortage in the event of a natural disaster. Maintaining an immediate call list is essential to keeping emergency supplies stocked, according to Alexander.
“Weather is the only thing I think about [that is] never right, but you never think that it’s going to be this bad.” — Taylor Jones, PharmD
“Expanded hours with limited resources can put higher demands on an already strained workforce, with pharmacists and other health care professionals working on the front lines, and this has led to burnout, and it did lead to negatively impacting their mental health,” Alexander said. “For patients, they might have worked very hard to manage their chronic conditions, have it under control, and now, due to a situation that is completely out of their control, due to disrupted access to their lifesaving medications, it can lead to uncontrolled chronic conditions, and that itself can lead to stress.”
Serving the Community in the Days After
Safety became an immediate concern as soon as the severity of the storm was understood. Munroe’s home was surrounded by oak trees that were 200 years old, Furman was faced with impassable roads, and Stout felt the effects of the unsettling silence without internet, cell service, and power.
As an immediate reaction, the full extent of the damage was not known. Once the hurricane subsided, the residents of western North Carolina started to understand what their needs were, and one place they found themselves was their local independent pharmacy.
“We still opened our doors and tried to serve patients as best as we could, which just meant manually writing down credit card information to process later. For patients who already had prescriptions ready, we manually recorded all that information,” Stout said. “We had one patient who came in and bought all these snacks to take to her neighbors, and we just jotted down her credit card information. We were lucky at our pharmacy that we did get power back late that day. We had someone come by who wasn’t even a patient just to charge her phone.”
For Furman, one of the most significant concerns was approximately 5 days after the storm, when his pharmacy had an urgent need for additional oxygen tanks for patients with respiratory conditions. Many patients did not have power, so they relied on oxygen tanks, but due to limited transportation, patients would pick up extra tanks without returning the empty ones. Luckily, Furman’s pharmacy can fill tanks onsite, but they began to run short on the tanks. Local respiratory providers and pharmacies in North Carolina began to donate tanks to the pharmacy so that they never ran out.
Images provided by Corey Furman for use by Drug Topics.
“We were at the pharmacy all day, just doing everything possible to get medicine into the hands of people who needed it, and if they were showing up, then it was pretty critical medicine,” Munroe said. “People weren’t showing up for stuff they didn’t need, and they would be waiting in our pharmacy line.”
As pipes were breaking, drinking water was hard to come by, with many of the local grocery stores flooding and roads closing due to damage. Basic supplies were running low, beyond much-needed medication, such as insulin and oxygen. Organizations such as Samaritan’s Purse became essential to deliver medication, food, water, and temporary shelters for locals. Furman noted that the organization is still in North Carolina today. Many of the pharmacies partnered with other local health care providers to refill medication and provide emergency prescriptions for their patients.
In the midst of the crisis, a pharmacy benefit manager (PBM) audited Stout’s store, so she wrote to them that they were in the middle of a natural disaster. She posted about it on social media and sent it to her state legislators, and the PBM eventually cancelled the audit and most other audits in North Carolina due to the hurricane.
A Long Way to Go in the Aftermath
“Black Mountain has recovered a bit more. It’s not [that] everything is normal here,” Munroe said. “Swannanoa, [North Carolina], on the other hand, is still not functioning the way it once did.”
Many people living in the area still lack permanent housing as well as permanent power, according to Furman. There is still a lot of debris in the area and a need to return to normal infrastructure. Tree limbs are still on the road, but Furman noted that the community response was overwhelming to begin to put the community back together.
Two chain community pharmacies are still closed, and one plans not to reopen, according to Stout. There are still some community areas, such as the local park, where there is flag football, baseball, and soccer, that still need to be rebuilt, and it could affect children and their activities in the coming years.
“We knew it was going to be a flood, but we didn’t know it was going to be this level. No one expected the worst flooding we’d ever seen.” — Corey Furman, PharmD
Furman highlighted the resilience and support of the community, not only for pharmacies but for the community in general. Pharmacists play an incredibly large role in disaster relief.
“When most organizations consider the medical need in a disaster response, the first thing that they say is, ‘Well, we want doctors,’ and then they say that ‘we want nurses.’ After that, they’ll say things like, ‘Of course, first responders’ in that avenue as well, and then dentists fall into the category. Somewhere buried at the bottom of that list, someone might say, ‘Hey, what about a pharmacist?’” Furman said. “In every disaster relief that I’ve ever been to, when I left the comment, [it] was not necessarily about me or any of [my] abilities…but the resources of having a pharmacist [and] how beneficial that was to the team. The need for pharmacy in disaster relief is very significant, and I encourage everybody to get involved.”
