This article first appeared in the St. Louis Beacon, June 1, 2012 - Disaster experts in St. Charles County are looking for volunteers to test a drive-through plan for distributing antibiotics in a large-scale biological attack. Participants in the June 28 exercise won’t get fries with that, but they will get a Chick-Fil-A sandwich. The St. Peters location is providing 500 lunches for those who complete the drill.
Part of an effective disaster plan is dispensing antibiotics in a timely manner. People exposed to anthrax or other air-released spores typically develop symptoms within 48 hours. After symptoms occur, which almost always happens within 72 hours, patients must be hospitalized.
The drive-through concept has been tested in parts of Illinois but never in the metropolitan St. Louis area. At least 500 drivers are needed to assess the plan, according to St. Charles County community health director Gil Copley.
“If we have enough people to come to the exercise, we can test our plan to find out what works and doesn’t work, and what sort of works and needs to be fine-tuned,” Copley said.
Allergic reaction to meds severe, but rare
The exercise will take place from 11 a.m. to 1 p.m. in a parking lot on the south side of Mid Rivers Mall, directly across the street from the St. Peter’s police department.
Volunteers will be needed to wind their way through the line as well as to transport medicine and other supplies from a central location to the cars. They’re encouraged to sign up before the event, but drive-up participants can also show up the day of the exercise.
The county encourages carpooling. Everyone in a vehicle will be considered an independent participant, and there is no check for residency. In an actual emergency, people from surrounding areas would also be served.
Distributors will give one person enough medicine for up to eight family members. Participants cannot pick up for neighbors and friends because screenings for allergies, pregnancy, height, weight and age are best done with a family member, according to Copley. In a an actual attack, however, verification would be minimal.
“Our primary objective, if there should be should be such a public health emergency, would not be to worry if somebody is lying to us,” Copley said. “Hopefully, if they were, they’d get the antibiotics to someone who needs them.”
The chief allergy concern is penicillin, which is contained in each of the two antibiotics -- doxycycline and ciprofloxacin -- that would be dispensed in an attack. In rare cases, penicillin causes potentially fatal anaphylactic shock in those who are allergic. A more likely symptom would be a rash or upset stomach and diarrhea.
The window for giving antibiotics may be even smaller than 48 hours because time may pass before patients realize they’ve been exposed. Once symptoms appear, the mortality rate from Anthrax is 50 percent -- even with the best treatment. A widespread attack affecting many people and filling hospitals would make exposure more deadly, Copley said.
For those reasons health officials are willing to take the chance of triggering the rare allergic reaction.
“Thats why there’s so much of an emphasis on getting this out and accepting the risk that some people may be allergic to the medicine and could be harmed,” Copley said. “The alternative is so much worse.”
In a real emergency, medical professionals at the drive-through sites would direct those with allergies to another pick-up site for alternative antibiotics.
Those without family transportation would also get antibiotics. The plan is to first distribute the medicine through several drive-ups, depending on the extent of exposure, and then deliver to those who can’t come.
A biological attack is not likely to affect the entire county but only a portion, such as those who are gathered inside a particular public place, like a shopping mall or stadium.
To register for the exercise or for information about joining a group of medical volunteers called the Medical Reserve Corps, contact Joe Morin with the St. Charles County health department at 636-949-7554.
Wrapped sandwiches will be available at the drive-through for the first 500 volunteers, but all participants will be fed.
“If we’re lucky enough to get more than 500 people, they’ll get coupons for a sandwich,” Copley said.
