Disaster/Pandemic preparedness - page 28

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
    When It Comes to Preparedness, the Ball Is in Our Court

    Excellent analysis from Avian Flu Diary. There is so much worth
    reading in this one piece.

    I pulled out only the one section on the suggestion that families
    should stockpile their own Tamiflu.


    Quote from afludiary.blogspot.com

    ...the working group has determined that the number of courses of
    antivirals the United States needs on hand for a pandemic would be
    at least 195 million.

    Roughly 2.4 times more than the government intends to purchase.

    They urge that the private sector, mostly businesses - but `families and
    individuals as appropriate' - stockpile the rest.

    This would provide:

    6M doses for deployment overseas to try to stop an outbreak
    79M treatment courses for the infected here in the United States
    103M courses to provide prophylaxis for healthcare and emergency
    service workers
    5M courses for outbreak control in Nursing homes, prisons, and other
    closed settings
    2M courses for people who are severely immuno-compromised

    With an anticipated Federal and State Stockpile (currently lagging behind
    the goal) of 81 million courses, this means that the private sector would
    have to make up the 114 million course shortfall.
  2. by   Ayrman
    The ball is indeed, as they say, in our court. My wife suffers from an innumo-compromised condition that has the past few months caused her health problems. Looking ahead to what may lay in the future we've begun to stockpile her medications in earnest, including Tamiflu. An interruption in the supply system would open the door for opportunistic infection, and we have already seen what that means in her case.

    No thank you, I will not sit idly by and wait for the lines to form and prices to react to increased demand along with shortages caused as much by the inability to move the supplies to the areas of highest demand as any actual production shortfalls.

  3. by   Laidback Al
    indigo girl posted the following link to a home care toolkit from cidrap in january of this year.

    Quote from indigo girl in january 2008
    important information from cidrap:

    promising practices for pandemic planning

    toolkit provides guidance on home care for the sick


    this portal, promising practices-pandemic preparedness tools, has been updated since then and there are a variety of links and sources relevant to health care workers.



    this project aims to enhance public health preparedness for an influenza pandemic and conserve resources by sharing promising practices.
    cidrap and the pew center on the states (pcs) launched this initiative to collect and peer-review practices that can be adapted or adopted by public health stakeholders. the project was conceived and funded by the pew charitable trusts.
    this collection of more than 150 practices represents a yearlong effort. our advisory committee, composed of state and local public health experts in pandemic influenza preparedness nationwide, selected the categories and topics at left.
    pandemic planners and others submitted materials, chiefly via surveys. the practices in this project come from 25 us states and 37 counties & cities. if your agency isn't included (click on the map to check) you can still submit practices.
  4. by   indigo girl
    A Quick Response to a Flu Pandemic


    Why not make it easier for Americans to get Tamiflu for their families,
    this Professor of Pharmacy Administration asks? It sure isn't easy now.

    Quote from online.wsj.com

    Why not simply have the Food and Drug Administration waive the
    requirement of a physician's prescription for the drug? That way every
    American can make his or her own decision about purchasing a
    medication that could save their lives and those of their families in the
    event of a true public health emergency.

    A new behind-the-counter (BTC) class of drugs available through
    pharmacies that is currently being considered by the FDA would seem
    to be a viable mechanism for optimizing consumer access while ensuring
    an appropriate degree of distributive control...
  5. by   indigo girl
    HHS Webcast Next Week - home healthcare delivery during a pandemic


    This is scheduled for after the long weekend. The national pandemic
    plan calls for most people to be treated at home, not in the hospital
    perhaps making this one of the most essential topics for families.
    That this topic would even need to be discussed, points to the concern
    about the ability of the healthcare system to cope with large numbers
    of flu victims.

    If you missed any of these webcasts, they will be archived for later

    Quote from afludiary.blogspot.com

    Key topics:

    Assumptions that need to be considered when assigning a care-giving
    role to home care agencies during a pandemic

    Operational, ethical and legal challenges pandemic planners will face

    Strategies home health care agencies can employ to overcome these
  6. by   big-chicken
    A MA hospital is sending letters to all employees regarding an emergency preparedness grant that the Hospital recieved from the Dept of Homeland Security. In order to be prepared for an outbreak of contagious disease, they are requiring all emplyees to complete a questionaire. They are required to list the names of all persons living in their house-holds and any persons they have close contact with. In the event that an infectious disease is brought into the hospital, the employees and their families would be required to be screened and placed on antibiotics.

    I understand the hospital's need to be prepared for this sort of thing, however I do see some problems that could result from having to provide all this info to the hospital.

    Has anyone experienced this?

  7. by   indigo girl
    Quote from big-chicken
    A MA hospital is sending letters to all employees regarding an emergency preparedness grant that the Hospital recieved from the Dept of Homeland Security. In order to be prepared for an outbreak of contagious disease, they are requiring all emplyees to complete a questionaire. They are required to list the names of all persons living in their house-holds and any persons they have close contact with. In the event that an infectious disease is brought into the hospital, the employees and their families would be required to be screened and placed on antibiotics.

    I understand the hospital's need to be prepared for this sort of thing, however I do see some problems that could result from having to provide all this info to the hospital.

    Has anyone experienced this?

    Interesting, but I have heard nothing about this.
  8. by   indigo girl
    Fort Detrick unit to track diseases that affect U.S.


    Bird flu is just one of many possible problems that they are tracking.

    Quote from www.baltimoresun.com

    Even before yesterday's name change, the center had begun to focus
    more broadly on epidemics that could enter the United States,
    endangering civilians as well as government personnel, he said.

    For several years, it has written "predictive reports" on avian flu, a
    strain of influenza spread by birds that has also killed more than
    220 people, most of them in Southeast Asia and Indonesia.
  9. by   indigo girl
    Pandemic Impact vs Duration


    The choices that CDC, HHS, and other involved govt agencies have made
    for the national pandemic plan are based in part on our past history of
    what worked and what didn't in 1918. Then as now, there is no vaccine.
    We do have Tamiflu, but not nearly enough.

    Quote from afludiary.blogspot.com

    One of the less frequently mentioned aspects of a pandemic is that the
    better job we do of lessening it's impact and slowing it down, the longer
    a pandemic wave is expected to last.

    With insufficient antivirals, and no prospects of a targeted vaccine during
    the first pandemic wave, our national strategy is to slow down the virus
    through the use of NPI's
    , or Non-Pharmaceutical Interventions.
  10. by   indigo girl
    An Aussie vet heads for Vietnam


    This story is a great example of what needs to be done to prepare
    globally for the next pandemic. Send help where it is needed now.
    The hot zone countries gain by having the expertise of vets trained
    in public health measures. The non infected countries gain by
    having scientists gain first hand experience dealing with avian influenza.
    Mutual assistance and cooperation wins out over censorship any day.

    Quote from crofsblogs.typepad.com

    The Waverton resident left for Vietnam this week to work on public health
    measures to control bird flu and other animal-to-human transmissible

    She will be working with a World Health Organisation (WHO) team to try to
    influence government policy on the avian influenza strain that has ravaged
    poultry flocks in Europe, Africa and Asia.

    She said the disease had already caused widespread culling of chickens and
    ducks, affecting the livelihood and food sources of Asian families.

    What an opportunity! But all countries should be shipping their vets and
    public-health experts into the hot-zone countries, to listen, learn, and lend
    a hand. Their experience would be invaluable for all concerned.
  11. by   indigo girl
    Pandemic Issues For Home Health Providers - Pt 1

    There are many communities that have very little home health
    coverage at this present time. For example, in eastern Connecticut
    there is so little home health care available currently that most folks
    recovering from total knee replacements who could have done fine
    at home, had to go to nursing homes with skilled rehab for their care.
    If they had lived in Philadelphia, they might have received home care

    Expectations for home health agencies during a pandemic do not
    include caring for flu victims unless they are already home care patients.
    That is not a possibility. There are not enough agencies and staff
    providing care now, and there will be even fewer staff providing care
    during a pandemic.

    So what will be the role for home health during a pandemic?
    Optimistically, it looks like the govt might be expecting them to fill
    in the gaps, caring for people being discharged home from the hospital
    early in order to free up beds. If anyone would take the time to read
    your state's pandemic plan, you might see that this anticipated role
    has been the plan all along. The real question that needs to be
    answered is, how will they do more with less? If that question can
    not be answered, than the plan is useless and can not be implemented.
    No matter how you look at it, those discharged patients are not likely
    to get much care.


    Quote from afludiary.blogspot.com

    ...this report identifies two primary receivers of home health care
    during a pandemic.

    Those medical and surgical patients, not hospitalized because of the
    pandemic, who are well enough to be discharged early from hospitals to
    free up hospital beds for more severely ill patients.

    Patients who become or already are dependent on home health care
    services (predominantly elderly persons with chronic disease) and will
    continue to need in-home care during the influenza pandemic whether
    or not they become infected with the influenza virus.

    Accordingly, the home health care industry will be asked to handle their
    current patient load, plus the addition of surgical and medical patients
    discharged early in order to free up hospital beds during a crisis.

    This at a time when their own ranks may be severely depleted due
    to absenteeism.
    Last edit by indigo girl on Jul 13, '08
  12. by   indigo girl
    pandemic issues for home health providers - pt 2


    who will pay for all of this in advance of an actual event?

    i can see these agencies becoming leased by the govt or commandeered
    during an event in progress as that may is the only way they will stay
    afloat and provide at least some of the care envisioned in this report.
    it is probably the only way that they will be supplied also.

    Quote from afludiary.blogspot.com

    `.... supplies specifically needed for surge patients
    and supplies for surge and existing patients that are not usually
    provided, such as food, water, or medications.'

    finally, agencies need to ensure that their workforce has the essential
    protective equipment needed to safely care for patients, including
    niosh-certified n-95 filtering face-pieces or higher rated respirators
    as feasible.

    the assumption that during a pandemic, supply lines will continue as
    normal, is seriously in dispute
    . there are good reasons to believe we
    could see prolonged shortages of many goods, including disposable ppe's
    such as masks, gloves, and gowns.
    pandemic issues for home health providers - pt 3


    Quote from afludiary.blogspot.com

    surveys indicate that a significant number of health care workers may
    be unwilling to report to work during an infectious disease-related

    the new york city survey cited above indicated that less than half (48
    percent) of the workers would be willing to report to work during an
    infectious disease outbreak...

    the most commonly cited reasons that workers gave for not being willing
    to respond to an emergency included fear and concern for their own and
    their families' health and well-being
    (31.1 percent and 47.1 percent
  13. by   indigo girl
    Booster vaccination may help with possible future avian influenza pandemic


    Quote from www.eurekalert.org

    New evidence suggests that a booster vaccination against H5N1 avian
    influenza given years after initial vaccination with a different strain
    may prove useful in controlling a potential future pandemic. The study
    is published in the August 1 issue of The Journal of Infectious Diseases, now
    available online.

    ...as the virus continues to mutate into genetically distinct lineages, or clades,
    the problem arises as to whether vaccines based on an older clade will be
    effective against newer versions. The new study is the first to report that
    giving one dose of a newer-clade vaccine to those who were vaccinated
    previously with older versions is more effective than giving only doses of the
    newer vaccine to unvaccinated subjects.

    The results not only support the booster technique, but also show that even
    though the virus had mutated since the initial vaccination, using it to boost
    an earlier vaccine is more effective than simply vaccinating subjects with the
    most current vaccine. These findings are important given the fact that
    influenza viruses are mutating constantly.

    "These results suggest that one strategy for pandemic control could
    involve prevaccination of some segments of the population prior to the
    emergence of a pandemic so that effective protection could be achieved
    with a single dose schedule if and when a pandemic emerges," the
    authors wrote.

    In an accompanying editorial, Gregory A. Poland, MD, of the Mayo Clinic
    College of Medicine, noted that some are already looking to begin such
    prevaccination primers against H5N1 influenza. For example, Japan is
    planning to immunize health care workers starting in 2009, and the U.S.
    Department of Defense is offering a vaccine to those in high risk

    "determining who should receive these vaccines, when, and in what
    order and under what circumstances deserves widespread debate,

    As of mid-June, 60 percent of the more than 380 human cases have
    been fatal, and half a billion birds have died or been culled to prevent the
    spread of the disease.

    (hat tip flutrackers/ironorehopper)