Covid 2021 – Lessons from Dunkirk about unused resources. Think pharmacies

Jul 15, 2021

With the Covid Vaccination rollout in danger of stalling 18 months into the program, it is time to reconsider what underutilised Australian resources can be used to accelerate the rollout process.

The experience of the Allied Expeditionary Forces at Dunkirk provides a salutary lesson as to what may be required to avoid a significant calamity degenerating into a monumental disaster of epic proportions. Critical to the success of the operation was the commandeering of readily available, but underutilised, civilian maritime vessels of all shapes and sizes locked in the home ports because of the war. Some 650 of these previously underutilised vessels provided critical support for the 220 light naval warships available for evacuation.

The beneficial result was beyond wildest expectation. Initial estimates, based on historical conventional naval practices, had the number of troops capable of being evacuated at 20 to 30,000. In practice, 335,000 Allied troops landed back in England.

The Dunkirk message is clear: use of readily available underutilised resources and expertise can make a significant difference in a real crisis.

Covid Rollout & the PBS

With the Covid Vaccination rollout in danger of stalling 18 months into the program, it is time to reconsider what underutilised Australian resources can be used to accelerate the rollout process.

Recognising that one can always be wise in hindsight, it is reasonable to ask why the Covid Vaccination Program was not incorporated as part of the Pharmaceutical Benefits Scheme.

The PBS is a well tried and true delivery vehicle of community pharmaceuticals including vaccines. Service delivery is highly computerised and well researched by the Pharmaceutical Benefits Advisory Committee. Most importantly, PBS procedures and practices in the delivery of pharmaceuticals, including vaccines, are well understood by all those engaged in the supply and delivery chain.

Community Pharmacy

Failure to link the Covid Vaccination Program to the PBS has meant that, until very recently, the 5,700 community pharmacies throughout Australia were almost entirely excluded.

Ninety percent of community pharmacies have attained quality accreditation that has included the maintenance of cold chain protocols and procedures in the handling of vaccines. A significant proportion of community pharmacies are already actively involved in the supply and patient administration of influenza vaccines which require the same cautionary protocols and procedures as Covid vaccines.

As university graduates majoring in pharmacology, medicinal chemistry and pharmaceutics the 30,000 Australian pharmacists are well-placed to make a significant contribution to the delivery of vaccines at both the primary, secondary and tertiary level of production, supply and drug administration.

About 20,000 pharmacists are employed in local community pharmacies practising at the forefront of primary health care, dispensing over 300 million prescriptions per year. The average Australian visits their local community pharmacy 14 times a year on a walk-in walk-out no appointment necessary basis.

Hospital Pharmacy & Industrial Practice

The remaining 10,000 pharmacists are engaged in hospital pharmacy practice, pharmaceutical manufacturing, research, and education.

Clinical pharmacists, based in university teaching hospitals, are actively engaged in the training of medical interns and in the supervision of drug administration to patients. Hospital pharmacists are also highly skilled and experienced in aseptic sterile dispensing procedures in the provision of parenteral antibiotics, cytotoxics and intravenous nutrition solutions but to name a few.

The specialist skills of hospital pharmacists could well be used to significant advantage in the development and expansion of vaccination hubs and in the drawing up of unit dose syringes under aseptic conditions. Unit dose prepared under aseptic conditions by hospital pharmacists could be shuttled to vaccination hubs using established couriers and taxis within the requisite timeframes.

The Taking of Hard Decisions

Dunkirk also demonstrated that the taking of hard decisions can be a very necessary pre-requisite in avoiding monumental disasters.

The decision to divert the full resources of fighter command in support of Dunkirk at the expense of providing umbrella protection for civilian London and its metropolis is a case in point. Federation notwithstanding, attainment of a vaccination uptake sufficient to attain herd immunity throughout the Commonwealth should be assigned the highest priority. Most importantly, the willing both potential service providers and enthusiast volunteer recipients alike, should not be turned away.

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