For the publisher,
Quarantine to control outbreaks of infectious diseases such as COVID-19 has long been used by Australia and involves restricting the movement of individuals or groups suspected of having been exposed at home or at a designated facility.1, 2 We describe a role of clinical pharmacist serving quarantined passengers on two separate occasions – involving an international cruise ship and an international flight, respectively – where approximately 200 returning travelers each performed a mandatory 14-day quarantine on the trip. Rottnest Island, 20 km off the port of Fremantle. .
Rottnest Island has approximately 330 permanent residents, but can accommodate 15,000 people during peak tourist periods.3 The island has basic medical services: a nursing station with two nurses and a general store with a Schedule 2 poison control permit and a limited range of drugs.
The Western Australian Medical Assistance Team (WAMAT) is a multidisciplinary health support team dispatched to disaster sites in the short term.4 WAMAT was deployed to Rottnest Island to provide medical management of passengers during the two quarantine periods. Tourists have been evacuated and quarantine zones have been established. WAMAT typically includes doctors, registered nurses, paramedics, and logisticians, and pharmacists are not routinely included. For the first period of quarantine involving elderly cruise ship passengers, a pharmacist was asked to help with the expected high drug load. After this successful deployment, WAMAT also asked the pharmacist for the subsequent quarantine.
Passengers in quarantine filled out health questionnaires upon arrival. Medication replenishments used “The Commonwealth’s Special Authority for Emergency Supply of Schedule 4 Medication During COVID-19” and was authorized by the pharmacist. The new prescriptions were handwritten by the WAMAT doctor, reviewed by the pharmacist, and emailed to Fiona Stanley Hospital (FSH), a quaternary hospital with governance for the nursing station, for deliverance. The drugs were delivered in sealed boxes via the passenger ferry.
WAMAT staff provided daily medical rounds, including assessing passengers in their quarantine accommodation for symptoms of COVID-19.
- Identification and triage of passengers at risk on the basis of health questionnaires.
- COVID-19 test.
- Regular medication replenishment; medication reconciliation through liaison with health care providers (community pharmacies, general practitioners and community mental health clinics).
- Primary health care advice regarding: seasonal allergies, constipation, cystitis, thrush, hemorrhoids, conjunctivitis and analgesia.
- Advice on choosing antimicrobials, managing pain, insomnia, cold chain breaks, and storing refrigerator items.
- Supply of sharps containers to insulin dependent diabetics.
Several important roles of the pharmacist have been identified during the phases of prevention, preparation and response to disasters;5 however, to our knowledge, there is no description in the literature of the pharmacist’s contribution to the management of patients during quarantine periods in the event of a pandemic.
The demand for pharmacists to be included in the WAMAT team during the second quarantine deployment is recognition of the unique skills they provide, especially when access to standard medical care is limited.
Declaration of conflicts of interest
The authors have no conflicts of interest to declare.