Impact of Distributing Med Kits

Impact of Distributing Med Kits

 

 

Author: Manisha Samy

MedKits, is the pre-deployment of medications (Houck). In the case of an anthrax bio-attack, these prophylaxis pharmaceuticals stored with first responders, individual homes, and local hospitals can potentially relieve the understaffed points of dispensing (PODs) distribution channels that local and state health departments have developed as anthrax preparedness and the delay time for push packs to arrive. Although the Bravata et al study modeled at what point push packs were ineffective, it did not consider the addition of MedKits in conjunction to PODs. The Houck et al study develops a model to estimate the impact of deploying MedKits in a community ad if it has the ability to reduce mortality in both cases where push packs are timely and delayed.

The Houck study classifies an exposed individual to an anthrax attack into either the incubation stage, prodromal stage, fulminant stage, and/or death. The incubation stage marks an individual who is infected with anthrax but is asymptomatic. In the Houck study, those individuals who are in the prodromal stage are aware of infection and can either seek primary treatment through a POD site or by utilizing a MedKit if they possess one. As mentioned in the Bravata study, dispensing sites have a fixed capacity of prophylaxis doses so the Houck model sets a local stockpile of 50,000 doses in addition to push pack doses for an urban city. It assumes that those who adhere to treatment will not become ill which is a 100% for those who begin treatment at the prodromal stage or later. They assume that those who begin treatment in the incubation stage will not adhere to treatment. The model was run on various models, including one in which those unexposed used MedKits for fear of infection. Those who take MedKits without exposure use medication that could have been reserved for those who were actually infected.

The results of the study underscore that regardless of the number of MedKits distributed, some number of deaths is unavoidable. There was a mortality rate of 8.2% even with a small attack (50,000 people exposed), the smallest number of potential exposed people ( 1% of those not exposed = 49,500), a 90% treatment adherence rate, and the availability of a push pack within 12 hours and no delay. Thus, confirming Bravata et al’s conclusions that deaths result from delays in attack detection and time to start prophylaxis and adherence to treatment.

In large attacks, timeliness in push pack arrivals helped reduce mortality, albeit by a narrow margin. This leads me to the conclusion that MedKits are not as effective as push packs or treatment from a POD if the addition of MedKits does not lower this amount. The study focused only on urban settings. Perhaps MedKits provided in rural areas may be more useful where local dispensing centers have a higher likelihood of possessing lower dispensing capacities. Also, information may travel faster in smaller tight-knit communities, allowing people to become aware of an anthrax attack and thereby seeking treatment faster. It seems that rather than focusing on MedKits, it is more essential to focus strategic efforts on making sure push packs are delivered in a timely manner, especially n situation where there are multiple attacks.

The Houck study did not consider the costs of providing MedKit either. The cost of purchasing, deploying, and replacing MedKits may be a lot higher than simply increasing the capacity of a POD. Issues of equity can also emerge if there are not enough MedKits to provide to every household. Although MedKits seem to inefficacious in large cities, perhaps it may be more cost-effective in rural towns where the cost of maintaining local inventories staffing may be higher than simply giving all individuals access to MedKits until VMI deployments.

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Houck, Michelle L., and Jeffrey W. Herrman. "Preparing for an Anthrax Attack: The Impact of Distributing MedKits." Proceedings of the 2011 Industrial Engineering Research Conference 480th ser. (n.d.): n. pag. Abstract. (2011): n. pag. Print.