Swine Flu Fright: A Personal Report from a Pharmacy Near Ground Zero of the Outbreak

Joseph Benari is a practicing pharmacist at a large pharmacy chain in Queens, New York. A graduate of St. John University, Benari also lectures on a variety of topics including pharmaceutical ethics and theology to college students and medical professionals. He also is very involved in his community and volunteers time to work with college students as an advisor in their college careers and in their personal development.

Spray...spray...spray...wipe...wipe...wipe was the name of the game that day almost 24 hours after pigs were put back on the map. Let me start from the beginning. My pharmacy in Queens, New York, a branch of a national chain, is only 5 blocks from St. Francis Prep School, where in late April more than 40 students came down with swine flu symptoms. Most had just returned from a spring break in Mexico, with little to concern them, other than possibly thoughts of final exams, not too far away.

Within 2 or 3 days that pleasant picture changed drastically, as terrified parents and friends heard the ominous news reports describing dozens of confirmed swine flu deaths in Mexico--all this coupled with the outbreak of similar symptoms in their children. The immediate result: a stampede of calls and visits to doctors, hospitals, and pharmacies (and not always in that order).

Needless to say, my pharmacy was swamped--prescriptions to be filled and serious questions to be answered. Will my children die? Will it affect me? Will the medicine work? And, do you have enough? To the credit of the management, there was enough. At 10 am, we received a delivery of 10 boxes of Tamiflu (osteltamivir phosphate) 75 mg, #10, and the next morning there was a larger delivery of >400 boxes.

Despite the overwhelming influx of patients, nearly everyone entering the store during this period required and indeed got carefully thought-out, personalized answers. Virtually everyone truly needed patient counseling. Young and old alike were scared and wanted to take immediate action. An 87-year-old woman, for example, pleaded with me to phone her doctor for a prophylactic script for herself and her husband. Another patient showed up with a fistful of prescriptions because her physician was going to "throw the book" at her symptoms. Besides the obvious Tamiflu prescription, she also filled 2 antibiotics (in case it was bacterial), Phenergan (promethazine) with codeine for the cough, Allegra-D (fexofenadine hydrochloride and pseudoephedrine hydrochloride)--hey it's allergy season--a Medrol (methylprednisolone) dose pack, and Flonase (fluticasone) for good measure.

One woman described how 2 hospitals had turned down her request for flu testing for her daughter. It was her belief that the last thing they needed was the possibility of a flu virus spreading through their facility. She eventually did get her daughter tested by a doctor who confirmed influenza and told me that "we can't test for the specific subtype, but if they are from that school and they test positive for influenza, I'm giving them an Rx for Tamiflu. It's obvious to me that they all have it."

Omitted so far in all this discussion is the reaction of the pharmacist. We are all well aware of the possibility that we too can contract the disease. I recall a young mother, standing not even 5 feet away, handing me a prescription, asking questions, one after another, and coughing all the time.

Spray...spray...spray...wipe...wipe...wipe. Spraying the telephone cord, wiping the countertops, and running one more coating of alcohol on that phone receiver. All with my own triple combination therapy of Purell, Clorox, and Lysol. Will all this work, or should I make a clean break for aisle 17, the most tempting aisle in the store where blue face masks were flying off the shelves? Such precautionary questions were going through my head all day.

There also is the constantly nagging question of why am I working today--exposing myself to all this? Am I altruistic? Dedicated? I wouldn't mind if the rest of the world thought so. But to me, personally, I believe my fate rests in the hands of our Creator. It doesn't mean that I would deliberately take chances. (He still would want me to spray and wipe, of course.) But neither am I a coward. Someone has to be here. Right now it's me.