Pharmacists in Disasters

In this episode of Doing Disasters Differently: The Podcast, host Renae Hanvin speaks with Dr. Libby McCourt about the critical role of pharmacists in disaster preparedness and response. She shares insights from her research, experiences during disasters, and how the healthcare sector can better integrate pharmacists into emergency management systems. 

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Transcript

Renae (00:25) 

Hello. In this episode, I'm talking with Dr. Libby McCourt about pharmacists in disasters. Now, a little bit about Libby. So she's actually Dr. Elizabeth McCourt, but Libby, now that we are bridging ties. 

She's a clinical pharmacist researcher and disaster preparedness expert whose work has helped shine a light on the critical role pharmacists play before, during, and after disasters. Her PhD examined the preparedness of Australian pharmacists for disasters and emergencies, and following deployments during events including Cyclone Debbie, her research has focused on strengthening disaster preparedness, pharmacy practice. 

And the integration of pharmacists into emergency management systems. She's passionate about ensuring one of Australia's most accessible health professions is recognised as an essential part of disaster resilience and he here for that. Now, I always like to share how we met. So Libby and I met quite recently as we're both part of an expert advisory group for a resilience project being delivered by the Pharmaceutical Society of Australia in the ACT. 

There's some really cool stuff coming with that. And as many of you know, I love pharmacists and chemists given their critical role in community well-being and also the role they play in connecting people in communities. So when I heard Libby and her experience, I clearly decided we had to become professional best buddies. And welcome to the episode, Libby. I can't wait to talk to you and hear more. 

Dr Libby McCourt (01:54) 

Thanks, Renae. I'm so excited to be here and chatting with you. 

Renae (01:58) 

Now, Libby, for people who have never really thought about it before, what role do pharmacists actually play before, during and after a disaster? And what's the difference between a pharmacist and a chemist? 

Dr Libby McCourt (02:11) 

great question. I'll start with your second question, actually. So the difference between a pharmacist and a chemist is that chemists are usually have degrees in chemistry and so a lot of the work that they do is around all types of chemicals so that might be pesticides, the stuff that we clean with, like it can be anything. Whereas pharmacists do a pharmacy degree and they are specifically focused on medicines and they are medicine experts. So while medicines are chemicals or chemical compounds we use them therapeutically and pharmacists really get taught about how to integrate those medicines into patients' everyday lives and care. So there is a little bit of overlap that there is a distinct difference between them and historically we have usually, chemist is a bit of a historical word that we used to use for pharmacists, but they're a bit more distinct now. 

Renae (03:04) 

So should I be using pharmacists more than chemists now? I think 

Dr Libby McCourt (03:07) 

And it's confusing because we do have like chemist warehouse and things like that. I think for most people it's synonymous, but I think most people, pharmacists in Australia would identify as pharmacists. 

Renae (03:19) 

Yeah. Yep. Okay. Love it. there you go. Doing Disasters Differently. I'm now going to change my language. So what role do pharmacists play before, during, and after a disaster? 

Dr Libby McCourt (03:28) 

Yeah, great question. And I think pharmacists are a little bit of the unsung heroes of health response to disasters. They have so much that they can do before, during and after. One of my colleagues who I work with quite closely on a lot of disaster stuff is Dr. Caitlin Watson, and she did her whole thesis on the roles pharmacists can play in disasters. And she identified 42 roles, and that was before the COVID pandemic. So I'm sure there's a lot more added on now. 

pharmacists in the community are usually a central point of people's health. Like you said, one of the most accessible health professionals in our communities. And so they see everything from small kids to older adults and everything in between. You see those people who come in who've had skateboard accidents who just sort of mosey into the store and you help them out with patching them up. 

So in terms of before a disaster, have an important role to play in teaching people how to be prepared for a disaster, like 

Would you respond if you got evacuated from your home? Would you be ready in terms of your medicines? I think whenever we're thinking about being evacuated, we often think about getting the dog, getting the kids, getting the photo album, but we don't necessarily think about ourselves and our health. And what are you going to do if you forget to bring your anticoagulant along with you? Chances are you miss a few doses and you might end up in hospital with heart complications, which would be awful. So there's a really important role in that before. 

During a disaster, think I've talked to so many pharmacists who have tried to maintain the operations of their pharmacy and just being there to provide people with the medicines they need, give health advice and make sure that people are keeping safe and well in a disaster. So I know that in Brisbane whenever we were doing flood cleanups like pharmacists were there giving out disinfectant buckets like this is how you stay safe while you're helping with cleanups. So there's just like so much pharmacists can do all the way from acute care to chronic disease management. 

Renae (05:29) 

It's so critical. And I think again, I always think about, you know, disasters and the systems and et cetera, et cetera. But we really need to be thinking differently about these stakeholders like pharmacists who are in our communities and so central because they have such a critical role to literally saving lives as well. I mean, you know, cleaning the cleanups, et cetera. But so many people, if they don't have that. 

access to daily medicines or, preventative medicines, et cetera. Like it's literally life or death. 

Dr Libby McCourt (05:58) 

Yeah, definitely. And I know in my own practice after disasters, I've seen people almost rationalizing their medicines. So they might be on two pain medicines. And they might say, well, I couldn't get this one and the pharmacy is now closed or my doctors not here, my scripts run out. And so they might start taking double the dose of the other pain medicine, not realising that actually they're not equivalent. And by double that dose, like I saw someone horrifically who'd double their dose of a pain medicine that they probably shouldn't have. And they fell over and hit their head and ended up in the emergency department. there's just like a lot of, and I understand people are under stress, it's really hard to think logically and clearly and if you can't get into your GP or if your local pharmacy is closed and you're left with maybe... one medicine, like which one should like, what do do? so pharmacists can really provide excellent advice in how to continue your medicines before, during and after a disaster and also help you source those things. We are experts at scrounging around and finding medicines and finding how to get them to you, whether that be I've heard stories of people using boats, helicopters, all sorts of creative ways in disasters to get people the medicines that they need. 

Renae (06:45) 

Yeah. We love, yeah, getting the tinnies out. That's where the Aussies you know, helping each other comes right into it. Now, your PhD focused on the preparedness of Australian pharmacists. What surprised you most during your research and what did you discover that the rest of the emergency management sector needs to hear? And I'm sure there's probably a little bit. 

Dr Libby McCourt (07:29) 

Yeah, I think whenever I did my PhD, I think there was two things that really surprised me and that really related to the internal piece and being personally prepared yourself and even thinking about how you would respond to a disaster, which it sounds so inherent, but it wasn't necessarily something I've thought about before. And how do you think about disasters yourself. Like if my house was to be threatened by bushfires, at what point am I evacuating? At what point am I not going to work? And what point am I X, Y, Z? So really that internal pace, but also the supports around you played a really important role in pharmacist preparedness. So if I worked in an environment where I didn't feel like my colleagues were ready, like my boss cared, like people in the community needed me to be there, I was less like, to be prepared which was really surprising and it wasn't necessarily 

Having, well, experience does help, but like knowing that you can rely on a team and knowing the people around you are prepared. Increase your own preparedness, regardless of whether you have experience in a disaster or not, which is really surprising, but makes so much sense in a disaster because I think that social cohesion is something that pulls us through and helps recovery as well, like helps our communities to recover from a disaster. So I found that surprising at the time. And then on reflection, I was like, why am I surprised by this? Of course, would be the case. And I think as well that external, almost government level of preparedness is an important piece in how prepared pharmacists can be. So we can be open for our community, we can be there, but we do need government support to be able to do that. So many years ago, whenever I was speaking to pharmacists about keeping their pharmacies open and operational, a lot of the feedback that I got was that they weren't deemed an essential service. generators would go to the GP clinic, which is fantastic, the GP needs lights on too.  

they need Electricity be a right script, see people, see what they're doing. But then the pharmacy was told that they weren't an essential service. So then we have scripts coming from the GP to the pharmacy and the pharmacist is there by torchlight, trying to like write out the labels and pick the right medicine and all of this sort of carry on. So it's really funny to have one as essential and the other not when they're so intertwined and reliant on each other to because the doctor can sit there prescribing all day. But if your pharmacy is not open to supply the medicine, then there's no point in doing it really. And vice versa, the pharmacy can be open all day but if they don't have a GP to refer people to or to get scripts from then they are limited in what they can do. They can do stuff but like not as much as they can with our medical colleagues there. 

Renae (10:19) 

hundred percent. And you think about it, like, you know, I remember during COVID, like banks were considered essential services. So a pharmacist absolutely would be, you know, absolutely essential. And I think what I've taken from what you just said is things like, I guess the pharmacist needs to also have their own business operations because you know they are a business and an entity and their supply chains and, you know, power or backups and all that kind of stuff. But then also the notion of social capital and as everyone knows, that's a big passion of what we're doing in terms of creating Australia's national framework and online mapping tool is that, when communities are preparing for disasters and disruptions together, so as a pharmacist with the business next door, with your customers, with your employees, you know, connected communities are more resilient than affluent communities. We know all the research from Professor Daniel Aldrich. and I often talk a lot about the pharmacists are so connected because you know who's needing what medicines and who might be vulnerable and who hasn't been here on a Wednesday to pick up their, you know, so you're so further ahead in terms of being connected. So it's a great, I guess, champion in the community as well to lead preparedness as well. Now, pharmacists are often one of the only healthcare professionals people can access quickly during a disaster, obviously when their lights are on and when they're recognised. Why do you think their contribution has traditionally been overlooked in emergency planning? So you've talked about obviously GPs. 

Do think it's changed a bit or do you think that pharmacists are still not quite recognised in the system of planning for emergencies? 

Dr Libby McCourt (11:48) 

Yeah, I think it has changed a bit. Whenever I finished my PhD in 2019, so a very auspicious time to be finishing a PhD on disaster preparedness, I think that pharmacists weren't recognised as much. And I think primary care in general was quite underappreciated. I think when people thought of disasters and emergencies, they immediately thought of hospital response, not realising that most people are walking well as we describe and often go to their primary care physicians and the pharmacy and those establishments mean to be well prepared in order to avoid people having to go to the hospital and causing bigger problems and higher costs to the health system and getting into more strife themselves. Like if you can go to the pharmacy and sort out your pain medicines, then you don't have to fall over and hit your head and end up in the emergency department with bad outcomes. So I think it has changed since then. And I think it's been a combination of COVID and of people sharing and recognising their stories from primary care. I think this is something that I see a lot in disaster management is I'll speak to GPs or pharmacists or nurse practitioners working in the community who've responded to disasters in their community, floods, earthquakes, whatever it is. And when you say like, who have you shared this with? And they're just like, well, it's just the work I do. Like a pharmacist, of course, I'm going to be there for my community. So they don't necessarily think to publish it or share it with a news outlet or anything like that. So I think in terms of getting the word out there that these are important health professionals to be in the community and to be open and operational and disaster. I think that was probably one of the big things, but I think we're getting better at sharing those stories and recognising. And I think COVID has played a role in that. Before, like one of the parts of my thesis was that I went down to the Diebel Institute in Canberra and did a health policy research piece on pharmacist response to pandemic influenza. So this was pre COVID. didn't know. Yeah. And I went through all of the state and territory plans to see did you mention pharmacists because pharmacists can do a lot in a pandemic as we now know. Yeah. But I was looking for key things like immunization distribution points for antivirals. And it was shocking the number of states and territories that did not mention using pharmacists, they would mention GPs, they would mention nurses, hospital, not pharmacists. And that was something I sort of like called out in that report and then two years later we got the pandemic. And I'm actually really interested to go back and look at people's plans again and see if pharmacists do get a mention. Because we saw in the pandemic that they were a central point of and continue to be for our seasonal influenza vaccination. They are medicine supply experts. So if you want to get medications out to a community, starting with your pharmacy is a good place to go. 

Renae (14:51) 

Yeah, a hundred percent. I'm all about stakeholders and people and connections and who's in the room and who's not in the room. And I think a lot of the time the same people are creating policies and processes and not to take away from the policies and processes, but they don't change unless there's a change of thought or a change of identifying who were all the stakeholders. And I think, linking to the next question, you were deployed following Cyclone Debbie and you've also obviously studied lots of disasters and 

Clearly did your work before pandemic, knowing perhaps what was coming. And you mentioned, that they're not recognised as much in the sector, although that's in theory changing, which it should be, and that's a great thing to hear. But the biggest challenges pharmacists face when communities are isolated or healthcare systems are disrupted, like what are they? So when a pharmacist, you know, they're there to help and support and provide medicine, et cetera, to the community. But like, what are the pharmacists, what are the challenges that they face from those disruptions? 

Dr Libby McCourt (15:49) 

Yeah, I think there's a lot of them. So pharmacy and is and should be a quite a tightly regulated profession. We've got a lot of rules around, for example, a pharmacy can't open without a registered pharmacist there. So even if every other staff member can get to the pharmacy, if the pharmacist isn't there, you cannot open and operate. We also have very strict rules around how we store medicines, how to move medicines, how we can let medicines leave the pharmacy. 

And so there's a lot of regulation, and again, as there should be, that just becomes exponentially more challenging in a disaster. So if you can't pick up all your drugs and move them pretty easily, which we can't in pharmacy because we'll often have controlled drugs, we'll have things that need to be stored in a fridge at tight temperature ranges. 

There's a lot of operational challenges with that sort of work. And then there's just the everyday stuff that comes with the disaster. We're very reliant on electricity. Some of my older pharmacy colleagues remember having to write out or type out on their little typing machine patient labels. 

I've always been trained on the computer so I can dispense a medicine on the computer. I can hand write a label in a pinch, but these are skills that we don't necessarily, we're not practicing them every day are we? So handwriting stuff takes a lot longer to do. And then of course, the internet, we need our internet for our claiming of our medicines to see what history patients have to see what drugs they are. Pharmacists do generally if you say, it's the little one that sort of smells like peppermint, we know what you're talking about. lot of little white pills that don't smell like anything. identifying what drugs are, what people might be on. 

there's a lot of operational challenges that we have as long as well as all of those sort of personal ones like can you actually get into work who's looking after the children is the house okay like there's just so many levels to it and then there's also so much that you can do with reduced staff so there may be some pharmacists that work in community where they're the only staff in that community but there may be some pharmacies where they have five or ten people on at one time and if you're cut back to yourself one other person. What services can you provide realistically? Like how many scripts can you do whenever you're handwriting everything out? So there's a big slowdown in operations and then communication is a big one too. Again with power out, with phone lines down, how do you communicate with your doctor down the road and say hey Joe Bloggs is here and he needs his script for x y and z or we want to supply him with this medicine or we've run out of this one but if we change the dose slightly we could change him to this one. 

what do you think? These are all just like challenges of working in healthcare and the people that I've spoken to that do have good plans like there was one a few years ago down in Victoria and the community pharmacy and the GP were sort of at opposite ends of this long street and they just got a one of the pharmacy technicians on a bike and all they did all day was cycle back and forth between the GP relaying messages dropping off scripts like saying where people were up to and but that's something they'd sort of decided to do before the disaster so they knew they were like we have a disaster we need a runner and so phone lines went down the road between them was open they were just like all right get the bicycle off you go 

Renae (19:15) 

But that's so I mean that's gold. And at the end of the day, you know, you don't know what kind of disaster or disruption is going to hit. But if you can understand, well, we need to communicate and so we're gonna have to have someone who can kind of help that because we are further away. So whether you know it's a flood or however it might be, I mean, that's gold because we talk so much about, I guess, community resilience and you know, the whole, focuses about, getting communities and businesses resilient and ready for whatever disruptions come because we know there's going to be more and they're going to be different and unexpected. But it sounds really complex. I mean, even more so to a normal business or small business for a pharmacy. And I guess in terms of steps they can take to get more prepared today to be ready for tomorrow, whether it is their business processes or their staffing or their, you know, even getting the community ready. I mean, what have you seen anything that's, I guess some easy quick steps that they can take to get ready now or help the community, the broader community get ready now. 

Dr Libby McCourt (20:12) 

Yeah, in terms of quick, easy steps, I think even just starting to think about it, like I'm always surprised at the number of people who, whenever I say that my research is in disaster management, they're just like, what, wait, yeah, pharmacists wouldn't do stuff in disasters. And I'm like, yeah, I know. So it literally only takes a second for them to make the connection of why the hell are you doing that to, yeah, of course. So I think starting to even think about it, maybe put it on your team meeting, like once a month, once a quarter. 

just to be like, hey, what disasters might be coming up or what disruptions might be coming up for us over the next couple of months? Like, is it possible that we might have a blackout? Is it possible that our air conditioning might go off? How would we respond? And just sort of like throwing out some hypothetical scenarios, I think is a great place to start. The other thing that I think we really need to start doing, and we don't necessarily do enough, is talking to each other. You spoke about working in silos. And I think  working in pharmacy, we do often get to know the pharmacists around us or our GP colleagues, but having that conversation of how are going to respond in a disaster? What are you guys looking like? What does your response look like? How do we communicate with each other? And it doesn't need to be writing like a huge plan together, but having a rough idea of, well, that GP practice, everyone that works in that GP practice actually lives on the other side of the river. And if that river floods, no one's coming in. So it's shut down. 

does that affect us and what will we have to put into place to manage that? So I think just that sort of thing and then also having arrangements for how we can share resources. So I've talked to so many people who, like we published a paper a couple of years ago about people who are on opioid replacement therapy and how they were managed in the community and how it impacted the hospital and things like that. And there was two community pharmacies in that community and one of them had opioid replacement therapy medicines, but they were shut. And then the hospital was running out. They couldn't get access because roads were shut. 

And then the pharmacy that did have some, like they  were close so they couldn't share their medicine. So some sort of like resource sharing, because at the end of the day, we're all looking after the same community. So if I have stock, but I can't open my pharmacy, how can I share that with either the hospital or the other community pharmacy down the road, so the patients can get their care and can continue their care? Because opioid replacement therapy is another one of these things that is high risk. And it's high risk, especially in a disaster, because it's an extremely stressful time, high chance of want to make sure people are getting that therapy and if they have to go from one pharmacy to a hospital to another pharmacy  

 It’s not happening, especially in a very, very stressful time when they might be worried about again, house, family, their own health, etc, etc, etc. Are you really going to wait in an emergency department for hours on end who may themselves be experiencing all of these things too? We need to make it as accessible as possible for people. So I think having those conversations, making good relationships with GPs, pharmacies, hospitals around you so that you've got those relationships to begin with. Because if you're in the middle of a disaster and someone calls you up, hi, I'm Renae I'm from the community pharmacy down the road. I'll be like, why are you calling me? I've got 20 patients in front of me. I'm trying to do this, this and this. Like, leave me alone. But if I knew you before, I'd be like, God, Renae, isn't this a nightmare? Yes, it is. Okay, let's work together to solve this. 

Renae (23:45) 

Yeah. a hundred percent. And again, I mean, so much of what we're doing in the social capital space is about if you can build those connections before, you are so much further down. And I think there's two things again from I mean, there's so many things that my brain is just going, but I think two kind of things. I think, yeah, having those local connections and those, I guess, sector relevant connections. So you connected into, you know, the different other chem other pharmacists and the other hospitals, etc., in your community and region. 

But what I'm seeing here too is that I think in the systemic approach for disaster planning, how amazing would it be to do some scenarios whereby those who are creating the government plans or processes have to experience what you experience as well? Because I think there's so many, you know, scenario trainings for pandemics, et cetera, et cetera. And I know that, some of the national and state, cohorts are broadening participation, but it's still not. really considering, I guess, different consequences to the extent that it should be. So I reckon, you know, thinking about, one of the questions I was going to ask is what needs to change across government and emergency management and the health sector. So pharmacists are recognised and integrated as a core part of disaster preparedness. But I think communities need to lead that themselves a bit. But then also maybe the pharmaceutical sector needs to take more proactive step and say, we want to run some scenarios to educate you on what happens from our perspective as well, which is why you need to be considering us, because we're a major essential service, but also there are consequences, really big consequences. 

Dr Libby McCourt (25:18) 

Yeah, and I think that's challenging as well to engage because at the end of the day, like a lot of our GPs and community pharmacies are private businesses too. So how do you involve them in disaster training scenarios? I work for government at the moment. And so if I went to a disaster training scenario as a pharmacist, like I would probably get paid for that day of work. Whereas if you are invited to community pharmacy, depending on the boss and who owns it and that sort of thing, they may or may not get paid to attend that and then are they going to take a day of no pay to attend that or if they have to pay to be there that's another challenge because and this is something I've come across a lot in my own work is that are you going to pay to be trained in something like diabetes that you're gonna see 80 times a day for the rest of your life or do you pay to be trained in a disaster which you may or may not experience in the next five years maybe. Like I think as people get along most people have experienced a disaster sometime in their career but like that sort of investment is challenging too and then for private businesses to take a hit for this thing that may or may not happen is always such a challenge and I feel like there needs to be some sort of local or state government pocket of money to uplift, encourage, allow people to attend these days because I know that running for government like we do have a lot of multi organisation training scenarios and they usually involve the health department, the ambulance, the police, the firees, but private business isn't necessarily in there. And so they'll do these mass casualty events, which is like very important. We need to get those people to hospital, we need to get them looked after. But there are people in mass casualty events that will just wander into a pharmacy that will just wander into a GP and like how do you deal with that influx of people? How do you know who to treat there and then or who can you help and who do you need to be like okay you need to be going to the hospital now because you've walked into the pharmacy but you're missing an arm. 

Renae (27:19) 

Can't quite help with that one, but yeah, Libby, you're so spot on and I think this is you know I'm a small business owner and I have been for a couple of decades and yeah I go to a conference or I go to a scenario, get invited to so many things. Renae, you always have great ideas, come along, but then yeah, I don't earn a cent from being there, and sometimes I have to pay to be there as well. I think it's a real gap in the systemic process because the small business owners, the pharmacists, etc., are absolutely crucial for community resilience and wellbeing. So I hundred percent agree with you that the system needs to change there to have a more inclusive and again, yeah, why should we turn up and everyone else who's from government or wherever else, they're getting paid their normal daily rate and we're actually losing money or not getting paid a hundred percent. So if you could change one misconception about pharmacists in disasters, what would it be? 

Dr Libby McCourt (28:09) 

golly. I think just that... They can be there and they can help. Like I think a lot of people, probably their biggest misconception is that they haven't even thought about it. So it's maybe not necessarily a misconception, but just you don't know what you don't know. So yeah, pharmacists can be there. They can help. They can work in evacuation centers, helping to get medication lists. They can work in pharmacies, treating minor injuries, getting people the medications they need, providing advice, even stuff like telling people how to store their medicines in a disaster, how to look after their health in a disaster. So there are a lot of impacts of disaster that don't mean you need to go to the emergency department, but they are very uncomfortable and can develop into something more serious like sore throat, sore eyes, shortness of breath from like inhaling smoke. Like how do you manage those things and then escalate them when appropriate? I think, just that pharmacists have a great role to play. And I think 

Renae (29:09) 

And really are an essential service. I mean, here's what I'm taking from this. 

Dr Libby McCourt (29:13) 

about our communities, you know, like there you'd be hard-pressed finding a pharmacist working in a community that doesn't love the community that they live in and providing the services that they do. at the end of the day, like you said, private business, is tough to balance. And often if pharmacists are opening after a disaster, it's usually at a loss to themselves and to their business because they can't charge people for the medicines that people are leaving with. They are often giving stuff away like, okay, you've been evacuated, you need toilet paper and a toothbrush because you didn't think to grab a toothbrush on your way out, understandably. Have a toothbrush, have toothpaste, have your warfarin as well that you need, off you go. So like, how do they do that and know they're contributing to the health of people while also being appropriately recognised by the government of, thank you, you've helped so many people, we don't want you to be in a financial black hole for this. 

Renae (30:09) 

Correct. That's sustainable yeah, resilience as well. my gosh, I could talk forever. But my last since I might have to do another one. my last question's always the same. So Libby, what are the two things you'd most like to see done differently in the disaster resilience space? 

Dr Libby McCourt (30:27) 

Oh, I know, I know. OK, I think I've already raised them, but I think that really collaboration across community and tertiary. I would love to see primary care, GPs, pharmacists, hospitals working together on a coordinated response. It doesn't make sense for the hospital to respond in one way and the community to respond in another. And it doesn't. 

Renae (30:29) 

If I know too, sorry. 

Dr Libby McCourt (30:55) 

They are so interdependent on each other. Something can be managed in community. It's going to hospital. If the hospital is too busy, people are running out of that ED and going straight to the community. So we really need to make sure they're preparing together, getting on the same page and sharing resources. I think that's probably like 80 wishes in one. So I might leave it at that. 

Renae (31:15) 

I think it's so, yeah, 100%. I mean, as you say, like the pharmacists are so, they're just so important to communities in good times, in you know, the well-being of communities. So I think they're really underrecognised as that essential service. But also, I talk about a lot of social businesses or social infrastructure places with the work of Professor Aldrich around them being the untapped golden nuggets. And I think the pharmacists are certainly that in our communities. If we could make sure their, business is viable and sustainable and that they are set up to be able to respond and recover with the community and set those preparedness and build those connections and they are trusted in the community. So if we're looking to build awareness in the communities, using the pharmacists as that kind of trusted point of contact as well is to me a no-brainer.  

So fingers crossed the work that we're doing with the ACT Pharmaceutical Society is a step forward. And I'm not going to talk about that because we'll probably have someone else on to chat as well. But it's really, it's really exciting and a really great cohort of advisors in that as well. So a big thank you to Dr. Libby McCourt for talking with me about pharmacists in disasters. We'll have the links to Libby and her work in our website. So thanks so much. And hopefully I'll talk to you again soon. 

Dr Libby McCourt (32:34) 

Thanks, Renae. A really lovely debate with you today.