Disaster/Pandemic preparedness - page 10

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
    This is the Washington State, Dept of Health's Pandemic Influenza site.
    There is some very basic information here.

    The video is excellent! It will take 22 minutes of your time, and was produced
    in 2005 so the numbers of cases, countries involved and some info will not be
    up to date. Nevertheless, this doctor does a great presentation.

  2. by   indigo girl
    Seriously looking for the ants amongst all those grasshoppers


    Here's why the message can not be heard, and why no matter what information is being given, it will never make any difference to the outcome:

    Quote from Salon.com
    David Pollard's How to Save the World

    The Coming Pandemic: What the Experts Say
    July 12, 2007

    1. Most people cannot be expected to plan ahead or prepare for it: It is not in our nature to plan for eventualities until and unless we are convinced they are virtually certain and imminent. We can send out all the information we want on emergency preparedness and emergency kits. Most people will ignore it until it is too late.

    2. Public expectations of what government will do to prevent, mitigate and manage a pandemic are substantial, growing and largely unrealistic. This is another instance of the phenomenon of learned helplessness, and it's exacerbated by governments that are prone to overpromise things to assuage gullible voters. After Katrina, we should know better.
    But we still keep on trying...

    It's been an interesting journey. Thank you, Sophia Zoe for saying it so well.
    Amazingly, intelligence has little to do with doing what is necessary.
  3. by   indigo girl

    From Avian Flu Diary with permission from the author:

    Saturday, July 21, 2007
    Alabama Pandemic Drill


    # 998

    Pandemic drills are fairly common, and not terribly newsworthy. This small notice in the The Birmingham News today caught my eye for a couple of reasons.

    Drill will simulate flu pandemic

    Saturday, July 21, 2007

    The Alabama Department of Public Health has scheduled an exercise at Garrett Coliseum in Montgomery on Tuesday to simulate an outbreak of pandemic influenza. The one-day drill will simulate a situation in which large numbers of people become ill. Only the sickest patients will be sent to the hospital, and home care will be stressed. An alternative care site also will be set up to care for influenza patients who have no caregivers. Finally, the exercise will demonstrate the distribution of antiviral medications to priority groups.

    The Montgomery City-County Emergency Management Agency, Alabama Hospital Association, Alabama Department of Public Safety, local hospitals, American Red Cross, volunteers and health department staff from the Anniston, Mobile, Montgomery and Selma regions are participating.

    Readers of this blog are certainly acquainted with the idea that, during a pandemic, most people will never see the inside of a hospital. We have roughly 1 million hospital beds in the United States, 90% of which are occupied at any given time, and a pandemic could simultaneously sicken millions across the nation.

    Even if hospitals could maintain their current staffing levels, something highly unlikely during a pandemic, the surge capacity simply isn't there to handle millions of flu cases. We haven't the beds, or the personnel.

    At some point, even the sickest of the sick may be turned away from hospitals. Most people will have to ride out the flu at home, cared for by their loved ones or friends.

    This hospital crisis will affect those without the flu as well. Anyone who needs hospital care, whether it be for a heart attack, stroke, cancer, or trauma will find that the level and availability of care will be less than during normal times. Elective procedures may be canceled, and lets face it, going to a hospital filled with sick and infectious people might not be the healthiest thing someone could do.

    The second thing that caught my eye was the statement that antivirals would be handed out to `priority groups'.

    Exactly what that means is unclear. But given the limited amount of antivirals we will have available, it isn't terribly surprising. Whether antivirals are dispensed based on severity of symptoms, or some other criteria, there won't be enough to hand out indiscriminately.

    Some surprisingly blunt admissions are creeping into the reportage of late. The sort of things you'd only have read in a blog a year ago.

    I wonder if anyone is paying attention?

    posted by FLA_MEDIC @ 8

    Nope, Fla Medic, for the most part, they are not. Even if they read it,
    they will not do anything to help themselves.
  4. by   indigo girl
    AMA Launches New Disaster Journal:
    Disaster Medicine and Public Health Preparedness


    Quote from www.ama-assn.org/ama/pub/category/17711.html

    The new quarterly, peer-reviewed journal is the first comprehensive publication emphasizing public health preparedness and disaster response for all health care professionals.

    "Disasters are unplanned, but the response shouldn't be," said Ron M. Davis, MD, AMA President-Elect. "Whether disasters are natural or man-made, infectious disease pandemics or terrorist attacks, physicians, health care professionals and public health workers must be prepared to respond to emergencies and aide in the recovery efforts that follow. We can't predict when a disaster will strike, but as first responders, we can better prepare ourselves and others to protect the health and safety of our patients and citizens."
    Last edit by indigo girl on Sep 15, '07
  5. by   indigo girl

    Quote from afludiary.blogspot.com/2007/07/fairfax-county-virginia-gets-it.html

    Fairfax County, just outside of Washington D.C., is heavily tied to the Federal government. It is a largely upscale bedroom community for the Nation's capitol. Many of the residents either work for the Federal government, or for government contractors.

    This week, county officials are doing a mass mailing to 440,000 households in the county of a 17 page pandemic home care booklet. As you can see from this article, they aren't mincing words.

    Home care will be essential

    Hospitals won't be able to cope

    There is a `high possibility' a pandemic could occur

    People need to prepare.

    Quote from http://www.timescommunity.com/site/tab5.cfm?newsid=18621617&BRD=2553&PAG=461&dept_id= 506096&rfi=6

    Local health professionals expect a staff decrease of about 40 percent during a pandemic, Hanfling said.

    The problem is exacerbated by a worldwide shortage of health care professionals, Addo-Ayensu said.

    The answer is teaching people to care for themselves at home as much as possible, especially during less severe phases of a flu, Hanfling said.

    The 17-page pamphlet, called "Caring for Yourself and Others: Seasonal and Pandemic Influenza," was mailed with grant money the health department received from the Centers for Disease Control and Prevention.

    It outlines ways for people to protect themselves, both during the annual flu or something bigger, with information on self care, when to seek medical attention and emergency information.

    "Caring is preparing," Hanfling said.
    Last edit by indigo girl on Sep 15, '07
  6. by   indigo girl
    Here is the Fairfax Country pamphlet that was mailed out to the public:


    Kudos to the public health officials of that county for giving out this information, and enabling their citizens to prepare.

    This is what the people need to know. No beating around the bush with this
    info. The only advice that many of us would change is the suggestion to store
    2 weeks worth of goods. It is not in alignment with the projection of pandemic waves occurring over periods of weeks, and the possibility of more than one wave of infection.

    But, it's a start.

    Quote from www.fairfaxcounty.gov/emergency/pandemicflu/county_influenza_guide_july_2007.pdf

    Planning for pandemic flu is not just a government issue. Residents have a
    responsibility to prepare themselves and their family
    . This reference guide will
    help you understand influenza; learn how to protect yourself and others from
    catching the flu and how to limit its spread; find out how to manage illness in
    yourself and others; determine when to seek medical care; and know what to do
    to prepare yourself and family for a pandemic or other emergencies that might
    disrupt our community for an extended time.
  7. by   indigo girl
    It is worth looking back at the CDC Mitigation Strategy. This link is to an earlier
    discussion about the CDC Press Conference giving their plan to use what worked
    in 1918 against the Spanish Flu. With no vaccine and limited amounts of antivirals
    we are going to have to do this. Notice the hurricane model being used to indicate
    the severity levels of influenza outbreaks:

  8. by   indigo girl
    Fear of Fear:

    The Role of Fear in Preparedness...
    And Why It Terrifies Officials

    by Peter M. Sandman and Jody Lanard

    (hat tip : writangl at effect measure)

    The authors are risk communicators. This is not a new document, but it is
    still pertinent.

    I am reminded of this document every time someone makes a comment about
    scaring the public, or says that the pandemic influenza information is all about fear.
    And I am thinking, well yeah...
  9. by   indigo girl
    From Effect Measure with permission of the editors:

    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.

    Pandemic planners and the wisdom of crowds

    Category: Bird flu * Pandemic preparedness * Public health preparedness
    Posted on: July 29, 2007 3:13 PM, by revere

    There is an apocryphal story of a politician during the Revolution of 1848 desperately running after a crowd in Paris's Jardin du Luxembourg. "I'm their leader," he cried. "I must follow them!" A couple of years ago most national pandemic planners were occupied with procuring stockpiles of antivirals, worrying about the lack of a vaccine and reassuring people that they had the matter under control if a pandemic were to strike. No one believed them and they knew they were whistling past the graveyard, but the poverty of vision was amazing. There has been much progress since then. Now there is open talk about the need and potential efficacy of non pharmaceutical interventions, or as the jargon has it now, "community mitigation guidelines." Whatever you call it, the objective is to reduce contact through measures of social distancing (closing schools, theaters, etc.). So the planners are getting there. Now a just published survey in CDC's journal, Emerging Infectious Diseases, shows the public was there long before the planners.

    Some 3500 subjects in Europe and Asia were asked which of the following responses would be most likely in the event of a pandemic:

    Avoid public transportation
    Avoid going out for entertainment
    Limit shopping to the essentials
    Take leave from work
    Keep children out of school, even if it remains open
    Limit physical contact with friends and family
    Avoid seeing doctors, even when sick from something unrelated to flu
    Stay indoors at all times
    CIDRAP has an excellent summary of the study. Here's some of it:

    A recently published survey of Europeans and Asians showed that, when faced with an influenza pandemic, most would avoid mass transit and limit shopping to essentials, and many would avoid other public places, including restaurants, theaters, and the workplace.

    The study, published online Jul 20 in Emerging Infectious Diseases, found that "avoidance of public transportation was consistently reported across the region as the most likely precautionary behavior," with about 75% of respondents choosing that option.

    Reactions to other risk-avoidance measures varied by region. For example, 79% of Europeans would likely avoid places of entertainment such as cinemas, restaurants, and theaters, while only 33% of Asians said they would. And 52% of Asians said they would stay home from work, compared with 35% of Europeans. (CIDRAP News)

    The responses didn't seem to be conditioned on whether the pandemic was mild or severe. And the survey was done in late 2005, before the time when planners were seriously discussing these kinds of social distancing policies. People were already someplace it would take planners another year to get to.

    I am not inclined to give much weight to the specific differences or levels for the various responses. This is a hypothetical question and not quantitatively transferable to what would happen in a real event. What it does show, however, is that a substantial proportion of people have a good idea of what they might do in the way of spontaneously altering their behavior. While political leaders and planners wring their hands over what the criteria will be for closing schools (a Draconian measure with huge economic and social implications for most communities), the decision will most likely be made by people without reference to what the planners think. The governor or prime minister or provincial leader will officially close the schools when students and teachers stop showing up.

    This isn't an argument for not thinking about what should trigger a school closure. But it is an argument for shifting the major effort away from trying to figure out what the trigger will be to planning to manage the consequences. Similarly for the effects on trade, commerce and travel.

    People will vote with their feet. And the leaders will follow the crowd. Both should think ahead about what this will mean.
  10. by   indigo girl
    Banking/Finance/Insurance Industries to Conduct Pandemic Drill

    This sounds voluntary, and is being promoted by Dept of Homeland Security.
    They are very interested in critical infrastructure protection.

    (hat tip monotreme/PFI)
  11. by   indigo girl
    York, Pa officials Urge 90 Days of Pandemic Preparation


    Quote from afludiary.blogspot.com/2007/08/york-pa-officials-urge-90-day-pandemic.html

    Government officials have been urging people to prepare for a pandemic for more than a year. The `standard' advice has been to have a 2-week supply of food and water in every household. Many, including myself, have expressed the opinion that 2-weeks simply won't be enough in a severe pandemic.

    Some local health departments have broken ranks with the Federal government, and have advocated more than 2-weeks. There is a move afoot at the federal level to try to change the recommendation to `at least 2-weeks', and I suspect we may see that subtle, but important change soon.

    Quote from http://www.yorkdispatch.com/local/ci_6525819

    "It isn't just pandemic influenza that people should think about being prepared for," said Dr. David Hawk, director of the York City Bureau of Health. "There's always threat of a terrorist attack, a nuclear event, power outage or blizzard."

    In the 1918 influenza pandemic and again in 1957 and 1968, the people most likely to get sick were not the very young and very old, but those of working age -- those who would normally keep electric plants and water treatment facilities operating. Planners believe that pattern could happen again and possibly disrupt services that are usually taken for granted.

    The mantra: Prepare now to save lives later.

    Smith volunteers for Hampton-based Community Awareness and Preparation, which attempts to help residents prepare for pandemic and other disasters.

    Canned goods, powdered milk and stacks of bottled water -- three gallons a day per person is recommended for drinking, washing and cooking -- also should be included in one's emergency stockpile if possible. Smith said access to food, electricity, water and gasoline could be limited.

    Look at 90 days: She demonstrated a makeshift cooking device comprising a cookie-cooling rack, four votive candles and a 4-inch tall square frame. It would work in a pinch should residents become housebound. She and other health officials recommend preparation for a 90-day span, which would cover the first wave of flu.

    Hawk reiterated that pandemic is a matter of when, not if. He cited the Spanish flu pandemic of 1918, which claimed between 20 million and 100 million people, according to estimates from the Centers for Disease Control and Prevention. That pandemic is now recognized as the worst in history, especially when compared to pandemics in 1957 and 1968 that killed 1 million each.

    That's why Hawk and numerous others urge those who are able to prepare to do so now to help reduce stress on a system that will be unable to assist everyone.

    "People live day to day and paycheck to paycheck," Hawk said. "They can stock up incrementally, spend $10 a week until they have an adequate supply."
  12. by   indigo girl
    Study: Quarantines Work Against Pandemics

    To put it very simply, this is our official US policy for dealing with a pandemic influenza situation in the 21st century. Our situation is not much different than in 1918. We have very little antiviral medication, and an extremely limited amount of an untried vaccine of which most of us will never see.

    Please understand that this is it. This is all that we've got for protection for
    our entire population.

    There is no other national plan, hence the need for individual families to prepare by stockpiling food, water and medicine for at least a three month period. Three months is considered to be the length of time for each pandemic wave to hit a community with two or even three waves expected in approximately one year of time.

    These mitigation strategies are based on the following study being published in JAMA.


    Quote from http://www.time.com/time/health/article/0,8599,1650634,00.html?xid=rss-topstories

    The new report, published in the Aug. 8 issue of the Journal of the American Medical Association, analyzed the public-health measures taken by 43 U.S. cities, all with populations greater than 100,000, during the six months between Sept. 1918 and Feb. 1919. Markel found that cities that early on adopted "old-fashioned," non-pharmaceutical interventions — such as school closures, social-distancing in the community and workplace and quarantine — and "layered" multiple interventions at once for a long period of time fared better than other cities, with slower rates of infection and lower rates of death.

    ... "This study gives us real reason for optimism, that even reaching back to a time where there were no antiviral medications and no well-matched vaccines to fight a pandemic, the things communities did in terms of traditional public health tools — isolation, quarantine, social-distancing, canceling schools — made a big difference and have a lot of potential to mitigate the severity of a lethal disease pandemic."

    That's good news, considering that the U.S. has purchased only 26 million doses of the newly licensed H5N1 flu vaccines, enough to cover 13 million people...

    Researchers compare layering interventions to layering Swiss cheese: if the holes are vulnerabilities, with enough layering you'll end up with a solid block of prevention.

    Though Markel's study has just been published, it has already been rolled into policy. The Department of Health and Human Services and CDC finished their analysis of the study's data last December before incorporating it into the Community Strategy for Pandemic Influenza Mitigation, a collection of guidelines for use by individuals and communities issued by the agencies in February. The guide offers help in coordinating and implementing a strategy to protect communities from the front end of an epidemic and to keep them afloat until the appropriate pandemic-strain vaccine can be delivered to them — which officials estimate will be four to six months after the first case is identified

    Last edit by indigo girl on Sep 15, '07
  13. by   indigo girl
    Physicians Practice for Pandemic

    Many patients will be seen by their private physicians rather than the ER. It
    makes sense for these docs to prepare for this:

    (hat tip fluwiki)

    Quote from www.greeleytrib.com/article/20070808/NEWS/108080103

    To deal with pandemic flu, the office changed its operations entirely. First, they had to run with 30 percent fewer staff members, who would presumably stay at home with flu-stricken family members, children who were unable to attend closed schools or who were sick themselves. Those who came to work were screened for symptoms every day.

    Several other measures were implemented to keep the disease from spreading. Upon driving up to the clinic, a triage nurse stopped patients at the parking lot entrance and questioned them about symptoms. Those obviously suffering from the flu were sent to another health center. Those with questionable symptoms were given a mask and a number and told to drive around the back and wait in their cars for a nurse, who was fully clad in protective gear, to take them to an isolation room.

    Budensiek and his staff worked closely with Jon Surbeck, director of public health preparedness for Weld. Surbeck is well aware of the myriad variables that come with pandemics and said that's what made the exercises imperative in the planning process.

    Through their preparations, Budensiek recognized that a pandemic would affect more than just office operations, though. The staff saw that under the stress of the Asian avian flu, they may not meet insurance company timelines for billing and reimbursement. In that case, the office's cash flow would be impacted. Budensiek already has applied to his bank for an emergency credit line in real life, to be prepared for just such an incident.