Here’s What a 7-Day Medication Go-Bag Actually Holds.

By Dr. Jamie Wilkey, PharmD — Director of Clinical Strategy, Jase
Edited and approved by Kristen Carpenter, PA-C — Clinical Advisory Board Member

The Atlantic hurricane season opened earlier this week and runs through November 30¹. Across every preparedness site in the country, the same advice has been republished: build a 7-day medication kit. Have a plan and the resources you need. The advice is fine. The execution rate is dismal.

I mean, how many of your patients living in a hurricane zone actually have a full 7+ day supply of every medication they need on hand right now?

Most families don’t get that far.

Not because they don’t want to.

The actual lift is just so much bigger than “grab a Ziploc bag, throw your meds in and label it.” The version that actually protects a family is two layers, not one. And providers sit upstream of both of them.

I’ve watched the failure end of this from a pharmacy counter. Patients showing up after a power outage with insulin that warmed in a dead fridge. A mom three states from home looking for an inhaler refill her insurance won’t authorize until next Tuesday. A dad asking what to do about a nail puncture his kid took stepping out of floodwater 2 days earlier.

And when patients don’t know the exact names of their medications and the pharmacy that fills them, well then trying to get a refill in another location is just made so much harder (and it happens all the time). The pharmacies that did stay open had lines pouring into the parking lot, staff working through the night to get patients medications they couldn’t get on their own.

You’ve watched the receiving end of this from the exam room or the shelter clinic. The patient who ran out two weeks ago, who can’t tell you the dose, who has no idea which pharmacy filled the original prescription. By the time the patient is in front of you, the front-end work the family didn’t do is now urgent clinical work for you.

Storms Don’t Just Close Pharmacies

They strip out every workaround a family relies on in the back of their mind. And this isn’t an anecdotal, one-off problem. It is a documented one.

After Hurricane Katrina, more than a third of evacuated children with pre-existing chronic conditions ran out of medication². After Sandy, 74% of community pharmacies in the worst-hit NYC neighborhoods sustained structural damage³. After Maria, the median Puerto Rican household waited 181 days for power restoration⁴, which is not a window any refrigerated medication survives. Refill timelines, pharmacy availability, and cold-chain integrity fail at the same time, on the same patient.

The fragility goes upstream too. Hurricane Helene’s flooding of Baxter International’s Marion, NC facility, which manufactures roughly 60% of the IV solutions used by US hospitals, triggered a national IV fluid shortage that lasted nearly a year and forced hospitals across the country to delay surgeries and ration supplies⁵. Local pharmacy disruption and national supply chain disruption can land on the same patient in the same week.

That falls hardest on the patients with the thinnest margins: chronic-disease patients, families who are displaced, and anyone whose refill ran out on a Friday. These are the patients sitting in front of you between now and peak season.

How This Actually Runs in Your Clinic

Before the checklists below, the part most preparedness articles skip.

If you just glanced ahead at “Provider checklist” and felt the lurch….when, exactly, am I supposed to do any of this….fair. You’re already running late. You barely have room for the reason the patient came in, let alone a preparedness conversation with an 82-year-old on nine medications. We know.

So the version of this that actually works in a real primary care schedule isn’t a provider conversation. It’s an MA workflow with handouts, built into rooming and post-visit tasking, that you sign off on but don’t carry. The article you’re reading is the handout. Screenshot the relevant sections, send them to whoever runs your rooming protocol, and the work happens around your visit instead of inside it.

Two Layers, Two Different Owners

• Layer One (patient-owned chronic medication readiness): MA work, almost entirely. Your only in-visit contribution is signing the 90-day Rx.
• Layer Two (clinician-prescribed contingency layer): your clinical judgment, or refer the patient to us and we’ll carry it for you.

Below, what each layer looks like in practice.

Layer One: Patient-Owned Chronic Medication Readiness

A 30-day minimum, ideally 90+ days, of every chronic medication a family member can’t go without. Plus a written list of every prescription: drug, dose, prescriber, pharmacy. A pharmacist three states over can act on that list to help. Without it, they don’t have enough information to do anything, and your patient is now on a long, arduous road of trying to figure out exactly what they take and which pharmacy to call. That means delays. The last thing your patients need in a disaster.

MA Workflow for Layer One

Screenshot this and hand it to whoever rooms your patients.

At rooming, for every patient in a coastal or flood-risk zone, the MA asks two questions:

1. Do you have a written list of every prescription you take?
2. Do you have 90 days of every chronic medication on hand right now?

If either answer is no, before you walk into the room:

• MA hands the patient a printed medication-list template. A patient-portal export works; a printed sheet works better. The sheet is the kit half the time. On that sheet, the patient writes which pharmacy currently fills each medication, especially if they use multiple pharmacies or the same chain at different locations.
• MA flags the chart for a 90-day Rx where the medication and patient qualify.

The only piece that requires your time in the room is the signature on the 90-day Rx. If insurance pushback is likely, the MA can message the pharmacy directly and flag the request as preparedness-related so the pharmacy team can advocate.

After the visit, still MA-driven:

• For patients on refrigerated medications (insulin, GLP-1s, biologics, refrigerated antibiotics), the MA hands a cold-chain handout: cooler storage, ice packs, temperature-out-of-range window per manufacturer guidance.
• Confirm tetanus booster status. Schedule if due. Inexpensive, durable, and exactly the kind of thing that gets missed when the storm is already on the radar.

Build this loop into your hurricane-season rooming workflow once and it carries itself the rest of the season.

Discount Cards Are Your Patient’s BFF

(Put this on the handout.)

Most insurance companies won’t cover a 90-day refill ahead of schedule. So when patients try to be proactive while the sun is still shining and they get an insurance rejection, this is the wall where most patients quit. The workaround is simple if it isn’t a controlled substance and the patient has refills on file: ask for a 90-count and pay cash or use a discount card. The out-of-pocket price with discount cards (think GoodRx) for generic medications often lands inside their copay.

Put this on the MA’s handout, second item after the medication-list template. The patient doesn’t need to hear it from you in the room. They need it to be the line they read on the way to the parking lot.

A Note on State Emergency Refill Rules

Under a declared state of disaster, pharmacies have more wiggle room to give additional quantities of already-prescribed medications. Statutory ceilings vary brutally state to state: 90 days in North Carolina (the only one), 30 days in a handful of southern and western states (AZ, FL, KY, LA, OK, OR, TX), 7 to 15 days in some, a 72-hour baseline in others, and 16 states with no emergency refill authority at all⁸. Schedule II controlled substances are excluded almost everywhere. The patient who waits for the governor’s declaration is already inside whatever ceiling their state happens to set. And those timelines are short, viewed through the lens of how long disaster response actually takes.

The takeaway for your patients: don’t plan around the emergency refill. Plan around having the 90 days before the emergency.

Layer Two: The Contingency Layer for Predictable Post-Landfall Problems

Short-course antibiotics for floodwater wounds, where CDC guidance is explicit that early empirical antibiotic therapy improves survival and clinicians should not wait for laboratory confirmation⁶. Antibiotics for waterborne GI illness. An antifungal for the mold that begins growing in saturated drywall within 24 to 48 hours per CDC guidance⁷. Allergy and respiratory rescue when air quality drops. Rehydration, anti-diarrheals, basic wound care.

This is where it really starts feeling overwhelming, both for patients and for the providers they ask. Most prescribers were trained to write antibiotics for active infection, not for a bag on a shelf. I know, I know. You’re saying, “No way! No way! I’m not writing antibiotics for a bag on a shelf before I’ve seen the patient.” That impulse comes from years of stewardship training, and stewardship was right to push us there. Writing for a bag on a shelf feels like using a different muscle entirely. It is….and the patient asking us isn’t asking for the wrong thing. The healthcare system simply hasn’t caught up to why the question is being asked.

You have two execution paths for Layer Two. Pick the one that fits your practice.

Path A: Prescribe Layer Two Yourself

The indication-level checklist below is what we’d cover in a JaseCase. Use it as a starting formulary for your own patient population, or adapt as needed. Unlike Layer One, this is your clinical judgment, not your MA’s. But it is still front-loaded preparation work, not in-visit work, and a single template note can carry most of the dosing instructions.

Path B: Refer the Patient to Us

If proactive prescribing for the contingency layer is outside your scope, comfort zone, or available time, hand the patient our information at the same visit the MA hands them the medication-list template. Jase’s clinical team (pharmacists, physicians, and physician assistants) runs Layer Two at the highest clinical standards, with evidence-based regimens screened against each patient’s history. We carry the prescribing, the patient education, and the written use-only-if instructions. You keep the primary care relationship. The patient doesn’t leave your visit without an answer.

Indication-Level Checklist for Path A

Screenshot for your reference.

• Floodwater wound coverage: empirical regimen with Vibrio and Aeromonas coverage (typically doxycycline plus a fluoroquinolone for outpatient use in non-pregnant, non-pediatric adults) per CDC HAN-00497⁶ and current IDSA skin and soft tissue infection guidance. Use only if there is a wound exposed to floodwater and developing erythema, warmth, or pain.
• Waterborne GI illness: short-course azithromycin or ciprofloxacin per current outpatient guidelines, with loperamide for symptom control where not contraindicated.
• Uncomplicated UTI: nitrofurantoin or trimethoprim-sulfamethoxazole per current IDSA guidance, dosing-appropriate.
• Mucosal candidiasis or post-flood tinea: oral fluconazole or topical antifungal as indicated.
• Allergy and respiratory rescue: albuterol MDI plus oral antihistamine for patients with documented asthma or allergic rhinitis; consider short oral corticosteroid course for patients with a prior documented asthma exacerbation pattern.
• Rehydration: oral rehydration salts. Volume goals weight-based for pediatric patients.

For all of these: dosing-appropriate short course only, screened against the patient’s chart for contraindications and allergies, with written “use only if [specific indication]” instructions. This is condition-matched preparation, not standing antibiotic supply for whatever feels like an infection.

Appropriate Medical Preparation

The category is narrow on purpose: well-defined conditions, predictable presentations, evidence-based regimens, dosing-appropriate for short-course treatment in adults with no contraindicating comorbidities. Standing supplies for the same conditions a telehealth provider would prescribe for in real time, with the clinical work simply done earlier. This is in no way a replacement for primary care. Complex diagnoses, chronic disease management, and ongoing provider relationships belong in the exam room. In the past, appropriate medical preparation has not been available.

Jase was built for the providers we just described: the burned-out PCP running 20 minutes behind on a Tuesday afternoon, who knows their patient needs a Layer Two conversation and doesn’t have a way to give it inside a 15-minute visit. Refer them, or point them at us. We are not asking you to write prescriptions you don’t feel confident writing. We are not asking you to add a single line item to your visit. We are asking you not to leave the patient without an answer in an emergency.

The patients best positioned to weather a storm have the boring stuff handled: chronic meds in hand with a documented list any pharmacist can act on, and an appropriately scoped contingency kit on the shelf. The work is unglamorous, almost entirely front-loaded, and mostly delegable. It is also the difference between a family who weathers landfall as an inconvenience and a family who weathers it as a medical emergency.

That difference gets built weeks before landfall, in exam rooms exactly like yours. Mostly by your MA. By peak season, your patients will already know which family they are.

Sources

1. NOAA National Hurricane Center. Atlantic hurricane season runs June 1 through November 30; historical peak activity mid-August through October.
2. Bayard et al., “Disaster-Driven Evacuation and Medication Loss: A Systematic Literature Review,” PLOS Currents Disasters, 2014. Pediatric medication disruption and shelter refill-need data drawn from Hurricane Katrina cohorts referenced in the review.
3. Arangua et al., post-Hurricane Sandy community pharmacy survey of severely affected New York City neighborhoods (74% sustained structural damage).
4. The Washington Post, “After Hurricane Maria, Puerto Rico was in the dark for 181 days, 6 hours and 45 minutes” (analysis of median household power restoration time, 2017–2018).
5. American Hospital Association reporting and NPR coverage of Baxter International’s Marion, NC facility, which produces approximately 60% (≈1.5 million bags) of IV solutions used by US hospitals. FDA declared the resulting saline shortage resolved in August 2025.
6. CDC Health Alert Network, HAN-00497, “Severe Vibrio vulnificus Infections in the United States Associated with Warming Coastal Waters.” Recommends initiating empirical antibiotic therapy without waiting for laboratory confirmation. Outpatient empirical regimen guidance per current IDSA skin and soft tissue infection guidelines.
7. CDC MMWR Recommendations and Reports, rr5508, “Mold Prevention Strategies and Possible Health Effects in the Aftermath of Hurricanes and Major Floods.” 24 to 48 hour mold growth window after flooding.
8. Healthcare Ready, “A Review of State Emergency Prescription Refill Protocols.” Statutory ceilings under declared disaster range from 90 days (NC) to 30 days (AZ, FL, KY, LA, OK, OR, TX) to 7–15 days to a 72-hour baseline; 16 states have no emergency refill authority. Schedule II controlled substances excluded almost everywhere.