Disaster/Pandemic preparedness - page 23

I was looking the the other Disaster/Pandemic thread that Florida1 started. She mentioned that after the hurricanes, that they had problems getting basic supplies and food stores were often closed... Read More

  1. by   indigo girl
    Pregnant women would have special needs in flu pandemic

    http://tinyurl.com/26fj5g

    Quote from tinyurl.com/26fj5g


    Recognizing this group's vulnerability, the U.S. Centers for Disease Control is gathering experts with backgrounds varying from drug metabolism in pregnancy to baby delivery to come up with special pandemic guidelines for pregnant women.

    In the 1918 Spanish Flu pandemic, one study reported on 1,350 pregnant women who became infected; 27 per cent died from the flu. In the milder Asian Flu pandemic in 1957, half the women of reproductive age who died from flu in Minnesota were pregnant.

    "From the limited information that we have from previous pandemics, it looks like pregnant women are expected to be a vulnerable population for future pandemics," says Dr. Sonja Rasmussen of the CDC's National Center on Birth Defects and Developmental Disabilities..."
  2. by   indigo girl
    More on the concerns that pregnancy presents during a flu pandemic as reported in
    the Helen Branswell article, and the state of our healthcare system with permission from Effect Measure:

    Quote from scienceblogs.com/effectmeasure

    Flu preparedness and pregnancy

    One of the least talked about problems in pandemic preparedness planning is that even if there is flu all around us and the health care system is struggling (and almost certainly failing) to handle the resulting demand of patients, people will still be getting sick from the usual things (heart attacks, strokes, etc.), having accidents, and yes, getting pregnant.

    There is pretty good reason to think that getting the flu when pregnant is even worse than getting the flu otherwise. A pregnant woman's immune system reacts differently because of the special circumstance of accommodating the foreign antigens represented by the fetus. Evidence from past pandemics suggests that the risk is not only higher but very high for pregnant women during a pandemic. And this has CDC worried. Helen Branswell of Canadian Press sets it all out in a characteristically informative and well-informed piece:

    Women who are pregnant when the next flu pandemic strikes will find themselves with special needs, concerns and risks -- and very little science to help decide things like whether it's safe to take flu drugs or necessary to wear medical masks in public.
    Recognizing this group's vulnerability, the U.S. Centers for Disease Control is gathering experts with backgrounds varying from drug metabolism in pregnancy to baby delivery to come up with special pandemic guidelines for pregnant women.

    The nearly 70 experts convene in Atlanta on Thursday and Friday to go over what little data exists. In the process, they will try to figure out what to recommend on issues such as antiviral drug use in pregnant woman and how to try to ensure continuity of obstetrical care for mothers-to-be during what is expected to be a medical emergency.

    An expert from the University of British Columbia who will be attending the meeting acknowledges at least some of the recommendations will not be typical evidence-based guidance, but rather advice "couched in the language of ignorance."(Helen Branswell, Canadian Press)

    I want to pause for a minute and stand back and admire this reporting. The pull quote is the first 175 words of a 798 word article. Consider how much we learn in that short space. The craftsmanship here is really stunning, the more so because we are usually unaware of it.

    But back to the subject. The rest of Branswell's piece supplies details about some of the topics of concern: the effects of fever on pregnancy outcome, the unknown adverse effects of prophylactic antivirals and vaccines with novel adjuvants, the extent of increased risk and how to advise and handle pregnant women during a pandemic. The problem of pregnant women is a special concern for most people because if we weren't wired to worry about the next generation we probably wouldn't have survived as a species. But in a medical, rather than an evolutionary sense, it is part of a much bigger problem: what about all the non-flu related medical problems during a pandemic . . . heart attacks and strokes, acute appendicitis, kidney stones, auto accidents, etc. It's not just a triage question for flu patients (which flu patients will be treated first, who will get respirators, etc.) but a triage question for all urgent medical cases, many of which will not be flu, even in a pandemic. We can cancel elective medical procedures but the emergency room is full of non-elective medical demands.

    The fact that the medical care system is already broken should be alarming, but apparently we have gotten used to it, sort of like having a stone in our shoe. We keep limping along, ignoring the nagging pain. But if we have a pandemic we will be asked to run for our lives, not just from flu but from all the other routine things, too. Flu prepping won't protect us from those. Only an adequate health care system can do that.

    By all means let's each of us do what we can individually to be ready for a pandemic. But to be really ready we are going to have to get together and invest in a public health and social service system. I don't see a lot of evidence we are doing that. At all.
    The Editors of Effect Measure are senior public health scientists and practitioners. Paul Revere was a member of the first local Board of Health in the United States (Boston, 1799). The Editors sign their posts "Revere" to recognize the public service of a professional forerunner better known for other things.
  3. by   indigo girl
    Protecting the Healthcare Workforce in Pandemic Influenza

    http://www.youtube.com/watch?v=rGk-E...eature=related
    (hat tip flutrackers/florida1

    The University of California at Berkeley produced this excellent video.
    They have put some thought into what problems healthcare workers
    would be facing including caring for their families at home during a
    pandemic situation.

    With H5N1 now endemic in wild bird populations on the three continents
    of Africa, Asia, and Europe, it is smart to look ahead and plan for the
    possibility of the appearance of the virus on this continent. There is much
    that we can do in advance. UC, Berkeley is at the forefront of pandemic
    planning in healthcare.
  4. by   indigo girl
    Closing Schools As a Mitigation Strategy During a Pandemic

    It is controversial but makes so much sense when you look at the stats.
    Pandemic viruses prefer the young. What other choice could we make?

    http://afludiary.blogspot.com/2008/0...f-full-or.html

    Quote from news.yahoo.com


    U.S. cities that quickly closed schools and discouraged public gatherings during the great flu pandemic of 1918 -- which killed tens of millions of people globally -- had as many as 50 percent fewer deaths than cities that took less decisive measures, according to a recent study.
  5. by   indigo girl
    Recent Pandemic Flu Drill in Bethel, Connecticut

    http://www.flutrackers.com/forum/showthread.php?t=62779

    The link takes you to a thread with articles and some commentary by folks
    who participated in this drill. There were nursing students, EMT students, the
    National Guard, docs, nurses, PAs, public health, hospital and nursing home
    staff, and folks volunteering to be patients. This was very impressive.
    We sure could use more like it across the country.

    It sounds like it was a great learning exercise. I was very moved by
    the comments of one of the participants, Pixie, who as a moderator at
    Plan for Pandemic, one of the panflu forums was a keen observer.

    http://www.flutrackers.com/forum/sho...39&postcount=2

    Quote from www.flutrackers.com

    Seeing the National Guard go operational in one's own neighborhood is always a jarring thing. The National Guard members working this exercise, along with the nurses previously mentioned, took their responsiblity very seriously and remained "in character" throughout. I was very impressed by that. At one small white satellite tent, I noticed a very serious young woman Guardsman in khaki's and surgical mask, standing firmly in parade rest in the middle of the entrance door. Behind her, in neat rows on chairs, were seated a group of student nurses, in their yellow disposable PPE gowns and surgial masks, watching a video shown on a screen in front of them very attentively. Something about that scene was the most poignant of the day. No mention was made, as far as I know, about the fact that these troops and these nurses are very much in the demographic that is affected by the H5N1 virus (realistically, the virus that has brought us to the point of exercising surge response and vax distribution). Something about the scene with the attentive seated nurses, and their very professional guard, made my throat catch a bit. I suppose they'll all go very courageously into this battle.
  6. by   indigo girl
    From the Connecticut Department of Public Health:

    A Personal and Family Guide

    http://www.newfluwiki2.com/upload/ctgov.JPG

    Everything you need for your family for 2 weeks is what they are advising.
    It's a start, but I think 3 months would be better. Do a little each time
    you shop. The fondue pot with sterno is a very good idea. Everyone
    could do that.
  7. by   indigo girl
    Student Pandemic Flu Prep Site

    http://www.studentsprepamerica.org/
    (hat tip Avian Flu Diary)

    For the students on this forum, does your school have a plan?
    Do you have one?

    Quote from www.studentsprepamerica.org

    Perhaps the most threatening aspect of a flu pandemic is worker absenteeism. Studies predict high levels of worker outages worldwide for the duration of a pandemic(7). The global economic system based on just-in-time delivery of all goods will be significantly jeopardized under these conditions, experiencing shortages in every sector as illustrated in this manual (PDF). Additionally, critical infrastructure will suffer from supply and worker shortages, affecting our police, firemen, medical personnel, electrical workers, truck drivers, etc. When all the implications of a severe flu pandemic come to light, the disastrous implications are endless.

    Some organizations have begun to prepare and can serve as examples for future actions from communities and industries across the nation. One example is our very own Columbia University, who this summer released a plan to cope with the next severe flu pandemic, as well as an FAQ designed to educate students and faculty(10). Some towns, like New Canaan in Connecticut, have begun to inform their citizens and urge community and individual preparation(11). And every day, more people are learning about the potential H5N1 pandemic. Many are stockpiling in their homes for their families. Some are taking action to prepare their neighbors, businesses, and local communities. As students, we cannot sit idly waiting for our parents and leaders to take notice and prepare. We will inherit the future. Our lives are most threatened by this virus. We have the power to have our voices heard. We must take action now to prepare our families, our communities and our nation.

  8. by   indigo girl
    Japan - Testing Pre-Pandemic Vaccine

    http://afludiary.blogspot.com/2008/0...-pandemic.html

    Quote from afludiary.blogspot.com


    Japan is among a handful of nations (including the United States, Denmark,
    Taiwan, and Switzerland) that have invested in a pre-pandemic bird flu vaccine.
    These vaccines are based on an earlier clade of the H5N1 virus, and no one
    knows how effective they will be against a mutated virus.

    Japan Considering Pre-Pandemic Bird Flu Vaccine for Their Citizens

    http://afludiary.blogspot.com/2008/0...ns.<br /> html

    Quote from afludiary.blogspot.com

    Under the ministry's current plan, the vaccinations for 10 million people
    engaged in occupations maintaining social functions,
    such as police officers
    and those working for water and electric utilities, will start in fiscal 2009.

    Hoping to eliminate concern over a possible epidemic, the ministry also will
    discuss whether to include the general public in the vaccination plan.

  9. by   indigo girl
    Alabama : Pandemic Education

    The exercises that are taking place in various locations across the country
    are a wonderful start but, for us as HCW to take the possibility of such a
    high impact event as very real, ongoing education needs to be implemented.


    Ideally, every state will offer pandemic seminars for HCW, and law
    enforcement monthly, and for no longer than an hour at a time.
    This kind of information is difficult enough for people to take in, but if
    exposed to it routinely in small amounts, it makes the possibility of
    pandemic more belivable, and not so unlikely to occur. After all we are
    asking people to understand that pandemics are naturally occurring events
    because they actually are, and that they occur about three times per century.


    These events can have a high impact on our lives and that of our loved
    ones. There absolutely will be another pandemic, but the severity of the
    occurrence can vary. The last devastating pandemic took place in 1918, and
    lasted for over one year. It is very difficult for many people to believe that
    such an event could happen again because of our absolute belief in the
    superiority of modern medicine and technology. That faith in our current
    medical system will be the achilles heel for many including HCW. An ongoing
    education on the impact of pandemic issues on the public health system
    presented in hourly increments would help to get the message across that we
    are overdue for the next pandemic, and that we all have a role to play for
    the best possible outcome for everyone. Most can not handle this type of
    information for more than an hour at a time, and talking at us is not as
    effective as participation in exercises that force us to respond to some of the
    many problems that can be anticipated as if we are performing a practice
    code situation. This needs to happen soon, occur routinely, and become
    part of mandatory continuing education because it is that important.


    We are the first society in history that has had advance warning of the
    possibility of a severe pandemic occurrance with our current information on
    H5N1, a bird flu virus. The 1918 pandemic was also the result of a severe bird
    flu virus, and the parallels are obvious. Secretary Leavitt of HHS has reminded us
    that we have been granted some God given time to prepare. We do not know
    how much time we have, but we should use it wisely.


    http://afludiary.blogspot.com/2008/0...education.html

    Quote from www.al.com

    "It's not a matter of if, it's a matter of when," was the echo of some of the speakers at the state agency's flu pandemic emergency preparedness meeting this week in Mobile. The daylong seminar, held on the Brookley Complex alongside Mobile Bay, is part of a series of 11 conferences across the state aimed at providing instructions for pandemic readiness and continuing education courses for nurses, social workers, paramedics, and law enforcement.

    ...Security will need to be provided for mass burial sites, hospitals and pharmacies as fear and chaos could take hold of the community, McClellan said.

    Elmer Sellers, the assistant administrator for University of South Alabama Medical Center, said in the event of the pandemic barricades will go up at the facility's entrances to keep people who don't need to be there from entering the hospital and exposing themselves to germs.

    A triage center will be set up outside complete with x-ray machines, so health workers can assess whether patients need to be hospitalized.

    The hospital has one refrigerator truck ready to keep bodies once the morgue fills up, he said. "We are going to have a lot of fatalities," Sellers said.
  10. by   indigo girl
    Vietnam Begins 2nd Human Trial Of Bird Flu Vaccine

    http://afludiary.blogspot.com/2008/0...l-of-bird.html

    This is another trial of a prepandemic vaccine. As noted in the post above
    on 4/16/08, Japan is also doing trials. I hope that they are successful in
    protecting their populations. I hope so for them and for us as well.

    Quote from www.thanhniennews.com

    An official from the ministry said 30 volunteers from the Military Medical Academy in Ha Tay Province near Hanoi were injected with a one millimeter dose of the vaccine.
  11. by   indigo girl
    Commentary on Japan's Prepandemic Vaccine Plans

    SophiaZoe' does not write often, but when she does, it is always worth reading.
    Her analysis is from the perspective of a former law enforcement officer.

    http://birdflujourney.typepad.com/a_...and-pre-p.html

    http://birdflujourney.typepad.com/a_...-japans-p.html

    Quote from birdflujourney.typepad.com


    I have been a proponent of pre-pandemic vaccination of as many Health Care Providers, First Responders, and critical infrastructure personnel as possible for about as long as the concept has been floating around. I do always caveat that support though with the stipulation that the vaccine not contain any adjuvant, as I believe they are an unnecessarily dangerous inclusion for healthy younger adult, a wild card that even I am not willing to gamble on.



    By protecting the Front Line we protect the maximum number of those who will need them to be on post should the pandemic happen. The currently unanswerable question is just how much protection will be afforded to those who receive the pre-pandemic strain of vaccine...
  12. by   indigo girl
    Webcast Series on Pandemic Influenza

    http://www.pandemicflu.gov/news/panflu_webinar.html
    [hat tip PFI/Soundhound 1]

    April 30, 2008 at 2 pm, is the final webcast on the State planning and assessment process. The Department of Education will be featured and will address issues relating to the dismissal of students during a pandemic. More details will be available on www.pandemicflu.gov

    The first webinar on the State planning and assessment process, which aired on March 13, can be viewed at http://www.pandemicflu.gov/news/panflu_webinar1.html

    The pandemic influenza planning webcasts are brought to you by the U.S. Department of Health and Human Services.
  13. by   sharona97
    Quote from indigo girl
    Recent Pandemic Flu Drill in Bethel, Connecticut

    http://www.flutrackers.com/forum/showthread.php?t=62779

    The link takes you to a thread with articles and some commentary by folks
    who participated in this drill. There were nursing students, EMT students, the
    National Guard, docs, nurses, PAs, public health, hospital and nursing home
    staff, and folks volunteering to be patients. This was very impressive.
    We sure could use more like it across the country.

    It sounds like it was a great learning exercise. I was very moved by
    the comments of one of the participants, Pixie, who as a moderator at
    Plan for Pandemic, one of the panflu forums was a keen observer.

    http://www.flutrackers.com/forum/sho...39&postcount=2
    IG: You and i discussed this how long ago? Nurses will be needed to show up and how impressive to hear "in good form", which IMO means taking this ride seriously. I know I wll be volunteering if not on the payroll, doesn't matter. Our Parish is on top of following this forum. S.

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