Disaster/Pandemic preparedness - page 4

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
    Thanks to FlaMedic at Avian Flu Diary for posting this information from the
    Washington State Pandemic Flu website.
    http://www.doh.wa.gov/panflu/

    If you look at nothing else, it would be well worth 20 minutes of your time to see the video of Maxine Hayes, MD's presentation on why avian influenza is such a threat.
    She remarks on how the people of this country have so much belief in modern medicine that they can not imagine how their world could be changed by a severe pandemic. You might share that belief.
    http://www.doh.wa.gov/panflu/video.htm

    It is a good website, but I agree with FlaMedic that one week's worth of stored food will be inadequate. Please, aim for at least 3 months stored food and water for your family and pets.
    Last edit by indigo girl on Mar 2, '07
  2. by   indigo girl
    Critique of the CDC's Pandemic Planning Guide
    http://www.cdcchatter.net/index.php?...rticle&sid=397

    Interesting article from the CDC employees. But, of course most nurses will not have the option of telecommuting.
    Quote from www.cdcchatter.net/index.php?name=News&file=article&sid=397"
    The Survivalist sees three separate courses of action.

    1. Be a constituent.
    We all need to pressure policy-makers to start a crash vaccine program.

    2. Be a community citizen.
    The CDC plan is a decent start and a vast improvement on past government efforts. But effective pandemic response will require extensive what-if conversations at every level of society—in the workplace, at the PTA, at the water-filtration plant. Do your part by imagining what your practical role would be and discussing it with colleagues and neighbors.

    3. Be a survivalist.
    If you're as worried about a pandemic as I am (and as Julie Gerberding is), take nothing for granted. Carefully game out your own family response: Could you manage to telecommute for several months? To the extent possible, every family should be prepared for some level of isolation, with necessary food, health, and entertainment supplies. In a pandemic scenario, social distance can slow down the spread of the disease and buy valuable time for a vaccine.
    Last edit by indigo girl on Mar 12, '07
  3. by   indigo girl
    High hopes that the research of AIDs physician/scientist, Dr. Ho will lead to protection against many strains of H5N1 because that is what it will take, protection against many strains:
    http://www.flutrackers.com/forum/sho...72&postcount=1

    Quote from www.flutrackers.com/forum/showpost.php?p=69072&postcount=1"
    http://www.flutrackers.com/forum/showpost.php?p=69072&postcount=1]
    David Ho Da-yi... famous for his cocktail therapy for treating HIV... said his New York-based laboratory is analyzing all available H5N1 sequencing to track down a consensus sequence to formulate new vaccines via two different approaches, DNA and proteins, to offer cross immunity protection against various strains of H5.

    ...the approach is easy, cheap and fast to produce while requiring only one shot to achieve immunization.
    "If you know what strain is likely to cause the pandemic, you can just take that strain to make the vaccine. But if you guess it wrong, big trouble.
    "The H5N1 is so widespread right now, it has to be one of the viruses we're worrying about," he said.

    According to Ho, the new vaccine has the potential to be made in one week and it will be very cheap "for governments to buy for the entire population."

    "Once we have the results in experimental animals, it will take six to nine months to produce for human use, but it will take another several months for regulatory agencies to approve, such as FDA [Food and Drug Administration] in the United States, before running clinical trials on humans," Ho said.

    "It's not going to be very quick," he said, but stressed that "it's prudent to be prepared."

    He added: "I'd say the flu pandemic is going to come. We just don't know when."
  4. by   indigo girl
    The ramifications of our just in time delivery system being impacted by the shut down of the trucking industry due to emergency disruption/pandemic is a hugh problem. We are so dependent on that industry to function without delay. But, what if they can't or won't?

    This is why you want to have emergency food and water supplies for at least 3 months. You have to be able to feed your kids if the stores remain closed.
    Think about it. The govt says, you are on your own. They will not be able to help if every community in the nation is impacted. How could they?

    http://afludiary.blogspot.com/2007/0...-trucking.html
  5. by   indigo girl
    Across the nation, every state has been told to prepare for a pandemic.
    They all have plans, and they are all different. How will they ever implement these plans? There are hugh gaps in the planning that leave much to the imagination.

    I live in a state that seems to have one of the more concrete plans. Actually, I can see some of this planning working for us. But, I work in a state that has one of those more amorphous plans. It's frightening really, because there is so much inconsistency between these two states. RI tells us straight out, we will use refrigerated trucks and ice skating rinks to store the dead. Connecticut, no mention of any storage, in fact I do not think that the subject is discussed at all. There must be planning for this, I hope, but they are not sharing the details.

    Here is a very good essay discussing our national lack of realistic planning.
    Seriously, plans do need to be realistic and based on what the threat actually is. Example, the case fatality rate for avian flu is currently over 60% so your numbers for planning should reflect this, shouldn't they?

    It sounds to me like we REALLY are on our own. That is what they told us, isn't it? Flu bloggers use the acronym, YOYO.

    http://afludiary.blogspot.com/2007/0...g-on-czar.html
  6. by   sanctuary
    Thanks again, indigo girl. Chilling but perhaps that's what it takes to get people thinking.
  7. by   indigo girl
    Of course, it is easier not to talk about what could happen. Nobody wants to discuss any frightening scenarios that could occur on our doorstep. I know that yet, do we not have a responsibility to our families, and to the people that we serve, to do the best that we can to plan interventions and mitigation strategies for an event that history tells us is inevitable? That a pandemic will occur is not an opinion. It is a certainty. We can not avoid this, and we do have an obligation to each other to face this, and help get our people ready. Nurses, we will be in the line of fire.

    What will it take to convince people? The belated announcement that H5N1 is already on this continent? It is, you know. The escalation of cases in another part of the world or the reality that human to human transmission is occurring, and has been since 2003? You just have to look at the dates of infection in all the clusters of the infected to know that this is true. I will post those cases on Pandemic News/Awareness so that it can be seen more easily. What about those adaptive changes that the virus has made that allow it to infect mammals more easily, the kind of changes that make it more like a human virus rather than a bird virus?

    We buy insurance for many eventualities, and most would argue that it is not a waste of money. It is called taking responsibility, and that is what is being called for, taking responsibility to lessen mortality. We have to, because there is no avoiding this. This will hit all of us where we live.

    http://afludiary.blogspot.com/

    Quote from afludiary.blogspot.com/"
    We can no longer hold onto the old idea that we are somehow protected by oceans, or distance, from these emerging infectious diseases. They are but an airplane ride away from anywhere in the world. A failure to stop them at the source all but guarantees that someday, we will be dealing with them on our doorstep.
    Last edit by indigo girl on Mar 11, '07
  8. by   indigo girl
    Michael T. Osterholm of CIDRAP, from Foreign Affairs, March/April 2007

    http://www.curevents.com/vb/showpost...23&postcount=1

    Quote from http://www.cidrap.umn.edu/cidrap/files/67/foraffosterholm0307.pdf
    The interconnectedness of the global economy today could make the next influenza pandemic more devastating than the ones before it. Even the slightest disruption in the availability of workers, electricity, water, petroleum-based products, and other products or parts could bring many aspects of contemporary life to a halt. The global economy has required wringing excess costs out of the production, transport, and sale of products. Inventories are kept to a minimum. Virtually no production surge capacity exists. As a consequence, most of the developed world depends on the last-minute delivery of many critical products (such as pharmaceuticals, medical supplies, food, and equipment parts) and services (such as communications support). In the United States, approximately 80 percent of all prescription drugs come from offshore and are delivered to pharmacies just hours before they are dispensed. An increasing number of U.S. hospitals now receive three rounds of deliveries of drugs and supplies a day to meet their needs. With such long and thin supply chains, a pandemic that closed borders, caused worker attrition, and suspended travel or the transport of commercial goods would seriously disrupt the delivery of everyday essentials.

    Yet the consideration of such disturbances has been largely absent from preparedness planning. This oversight is partly due to past experience with disasters, such as earthquakes or hurricanes, for which relief supplies from nonimpacted areas were quickly available for impacted ones. Such disasters are limited in time, meaning that rescue and recovery can begin in short order. A pandemic, on the other hand, would affect the whole world for months, and relief efforts would put a strain on resources everywhere. Unfortunately, there are no easy answers to solve the supply-chain problem; it may simply be too big. None of the published models estimating the macroeconomic consequences of pandemic influenza fully account for it, reflecting a lack of imagination on the part of both the private and the public sectors.
  9. by   sanctuary
    There is the worrisome secondary or domino effects, like: no plans for large numbers of dead bodies, bodies left in homes, weeks or months of ongoing cleanup, major need for decontamination, or matresses dragged out into the streets, no ability to haul them away, more infections, possibly of staph and e. coli, etc. Sounds like a (bad) science fiction book.
    Maybe this is Guia, shrugging.
  10. by   indigo girl
    This is a very powerful piece that offers much to think about. It is unfortunate that this type of planning is actually necessary. This was written in December of 2005. Obviously, the federal govt recognized the threat even back then. It is more urgent now with the changes that H5N1 has made, IMO.
    (hat tip PFIF/Retired Paramedic MI)

    Don't Rely on Feds to Fight Bird Flu

    http://firechief.com/mag/firefighting_dont_rely_feds/
    Quote from firechief.com/mag/firefighting_dont_rely_feds/"
    http://firechief.com/mag/firefighting_dont_rely_feds/
    In a worst-case scenario, dealing with the dead could place a strain on resources. Some predications indicate that fatality rates could increase beyond the ability for local coroners and morticians to handle. Contingency plans for cold storage and body removal need to be discussed among chief officers. One trigger for panic or unrest will be the inability to remove a deceased family member from a home. If this process takes days, the spread of other disease and the psychological impact could increase the toll of the flu, creating unrest. It's generally not the role of the fire service to place a victim in a body bag. However, securing the body in a sealed bag could reduce the effects of having a decaying body in the home. This should be discussed with the local coroner or medical examiner to develop a contingency plan and supply the fire service with body bags.

    We can only hope that we will be spared the bird flu pandemic. The key is for the fire and EMS chief to sit down, make plans, brainstorm and build contingencies for worst-case scenarios. This scenario will not play out like other disasters and will create logistical challenges. Local municipalities may be on their own to operate without federal assistance. If federal help does arrive, expect significant delays and shortages until the Department of Health and Human Services receives full funding to prepare the country.
    Last edit by indigo girl on Mar 15, '07
  11. by   indigo girl
    Which mask would you feel safer in? Surgical masks are less costly and there are more available. They are also easier to wear. But, will they protect you when in close contact with an avian flu infected patient?

    Personally, I think demanding more protection is the better way to go.
    It would be nice to know exactly how influenza is spread, but we can not wait around for consensus.

    http://www.flutrackers.com/forum/sho...05&postcount=1

    Quote from www.flutrackers.com/forum/showpost.php?p=70805&postcount=1"
    The masks-versus-respirators issue is one of the most sensitive in pandemic planning. N-95 respirators are hard to wear correctly, especially for long periods of time, and respirator manufacturers have conceded that global demand in a pandemic would outstrip their production capacity. Acknowledging those difficulties, the US, Canadian, and British pandemic flu plans all initially recommended surgical masks for health care workers in almost all situations.

    But in Canada--where the airborne disease SARS (severe acute respiratory syndrome) shut down the city of Toronto for several weeks in 2003--the Ontario Nurses Association has threatened work stoppages if its members do not receive N-95 respirators during a pandemic. And in the United States, the Centers for Disease Control and Prevention expanded its guidance on respirator use last October under pressure from the healthcare industry, and now says using a respirator is "prudent" for any healthcare worker in contact with a known or potentially infected patient.
  12. by   indigo girl
    Kiwis Forming Neighborhood Support Groups - Croftsblogs
    http://crofsblogs.typepad.com/h5n1/2...forming_n.html

    Quote from crofsblogs.typepad.com/h5n1/2007/03/kiwis_forming_n.
    The threat of a deadly flu pandemic is a key factor driving the largest increase in neighbourhood support groups seen in Christchurch.

    About 170 new groups were set up last year, taking the total to over 1900 in Christchurch and Banks Peninsula. Neighbourhood Support coordinator Patrick Creasey said the increase was partly due to concern about crime, civil defence emergencies, and bird flu.

    Canterbury University associate history professor Geoffrey Rice said his research into the 1918 flu pandemic in New Zealand showed communities which organised themselves early had the lowest death rates.

    Sick people, especially those who lived alone, could have their lives saved by their neighbours, he said.
    Never think that the problem is too big to be handled. There is plenty that we can do to prepare for the next pandemic. We should not just wait for this to happen.

    First, take a look at what your beliefs are about the possibility of pandemic. Are your beliefs based on facts or opinion? Have you done any research about this?

    For more information, you could go here. Feel free to ask if there is anything that you do not understand.
    http://allnurses.com/forums/f195/pan...ii-184877.html
  13. by   indigo girl
    I am putting this link in the preparedness thread because we need to think about this scenario, and the solution for it. I do not have the solution.
    The essay addresses some possibilities.

    It is not a pretty picture so no one is going to want to deal with this, but we have to, unless we have completely given up. I do not think that we have given up. I also think that most feel this would never happen. Yes, it could.

    I do not like to post anything that looks at worst case scenarios without providing solutions. The best that I can come up with, is to tell you to start thinking about this, and address this at work. When they laugh at you for asking, ask them in return, "is your opinion based on fact or on the latest research, and what the govt is saying we have to do?" We have a moral obligation to our communities to make sure that they are, in fact preparing.
    Think about it. Enough of us could make a difference in saving more lives.
    Isn't that what we are supposed to be doing?

    Start asking about how many masks have they stockpiled. Are they N95?

    Here is the link.

    http://afludiary.blogspot.com/2007/0...report-in.html

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