Published
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 for weeks after the storm.
That concerns me. I wonder in case of disasters like hurricanes, earthquakes and pandemics if the nurses who work in the area have problems like that. I'd be worried about leaving my family if there was no heat or electric. After loosing electric in the ice storms in the Carolinas a few years back, my husband bought us a generator. I try to keep enough gas stored so that I could run that and maybe have an extra tank of gas for getting back and forth to work, if things were shut down. I never want to wait in the cold on those gas lines again; or have to risk driving around to find necessities!
What disasters have you been through? What lessons did you learn about what things would make life easier if it happens again to you? What can we learn from your experience, and how can we prepare for so we dont have to go through th esame problems you did?
Where there any sepcial tricks or issues that came up that helped you at work? Any special problems that nurses in disasters face?
I have a confession- my home first aid kit is pretty anemic right now :) DH burned his hand prety badly at work last week. I hadnt checked my kit in awhile, and was shocked to see how low I was on some stuff. I only had one roll banfage and had to make a run to WallyWorld the next day! If the stores were shut or the roads iced in or otherwise impassible that would have been an issue. Maybe not life threatening- but its a small example of how not being well prepared can be a problem.
I'd have been so embarrased to admit to hubby I couldnt take care of it, or come thru when he needed me to.
What do you do to prepare? I'm going to restock my kit, and get some more OTC stuff to keep on hand too. What else should I be thinking about?
Laura
Where do the presidential candidates stand on pandemic preparation?
http://www.dailykos.com/storyonly/2008/6/1/01420/75347
At least some of them have thought about it...
A reminder from Barack Obama:
If we're lucky, we'll have at least a year, or perhaps several years, to prepare for a flu pandemic. But we might not be so lucky. And regardless of whether it is this particular strain of avian flu, H5N1, or another deadly strain, the time to act is long overdue if we want to prevent unprecedented human suffering, death, and economic devastation.
HHS Seeking Public Comment On Pandemic Guidance Documents
http://afludiary.blogspot.com/2008/06/hhs-seeking-public-comment-on-pandemic.html
The HHS has just published 3 interim guidance documents on pandemic influenza and is asking for public comment on them between now and July 3rd, 2008.
SUMMARY: The Department of Health and Human Services (HHS) is seeking public comment on three draft guidances:
Interim Guidance on the Use and Purchase of Facemasks and Respirators by Individuals and Families for Pandemic Influenza Preparedness;
Proposed Guidance on Antiviral Drug Use during an Influenza Pandemic
Proposed Considerations for Antiviral Drug Stockpiling by Employers In Preparation for an Influenza Pandemic.
Hawaii to screen international travelers for flu-like illnesses
http://www.flutrackers.com/forum/showpost.php?p=161651&postcount=1
The Hawaii Department of Health announced Wednesday that the state will implement a voluntary checkpoint screening process for international visitors to detect flu-like illness at Honolulu International Airport.
The program will span a one-year period and was made possible through a cooperative agreement between the Hawaii Department of Health and the Centers for Disease Control and Prevention in the amount of $289,000, the department said.
The Department of Health will collaborate with U.S. Customs and Border Protection, CDC, the Hawaii Department of Transportation and Hawaiian Airlines, the health department said.
Prophylactic Antivirals For Health Care Workers
Commentary on two documents released by HHS last week follow.
Can you believe that they are recommending 12 weeks worth of
antivirals for us? Would our employers really do this?
It is the right thing to do, but seriously, there isn't enough Tamiflu
available. Read the link to see where most of the Tamiflu is going to be
used.
http://afludiary.blogspot.com/2008/06/prophylactic-antivirals-for-health-care.html
...the most striking change is the recommendation that private sector
employers consider stockpiling prophylactic antiviral medications, particularly
if their employees will be at high risk of exposure.
That means Hospitals, EMS units, Fire Departments, and Law Enforcement
Agencies, among others.
Outbreak prophylaxis of front-line healthcare and emergency services
workers (fire, law enforcement, and emergency medical services [EMS])
is recommended because of their important role in providing critical
healthcare services, preserving health and safety in communities, the lack of
surge capacity in these sectors and the importance of reducing absenteeism
when demands for services are likely to be increased.
A strong recommendation that hospitals and emergency services provide
12 weeks of prophylactic antivirals to all employees who will have
direct exposure to infected patients.
PROPHYLACTIC USE OF TAMIFLU BAD IDEA, LEADING VIROLOGIST SAYS
Forget the prophylactic Tamiflu seems to be the message from this article
in Homeland Security Today. It's better to take Tamiflu 6 hours or
so after symptom onset, and hope it works.
http://hstoday.us/content/view/3741/150/
The US government's new proposal to use drugs like Tamiflu and Relenza as
a prophylaxis to prevent infection by a pandemic strain of influenza is
wrongheaded, says Dr. Graeme Laver, a former professor of biochemistry
and molecular biology at the John Curtin School of Medical Research at the
Australian National University in Canberra.
Laver, who played a key role in the development of both drugs, has been
studying influenza viruses for nearly 40 years. He and Dr. Robert Webster
(another world-renowned virologist at St. Jude Children's Research Hospital)
are credited with having first found the link between human flu and bird flu.
... it is "much better to use Tamiflu only for early treatment. If people
with flu symptoms take Tamiflu immediately, say within six or so hours after
symptom onset, the infection should be rapidly terminated, the person
should recover, and then, and this is important, should then be immune to
reinfection for the rest of the pandemic. Much better than any vaccine.
This has been called 'Aborted-infection Immunization,' and to use Tamiflu in
this way would allow many health care workers and so on to go about their
business without fear of reinfection."
(hat tip croftsblog)
http://afludiary.blogspot.com/2008/06/virologist-disagrees-with-hhs-proposed.html
Insightful commentary, as always from Avian Flu Diary on prophylactic use
of Tamiflu. He is right, of course about very few early recoveries. Most
of those that have survived infection with H5N1 were in the hospital for quite
some time. They were the lucky ones. Do you feel lucky? I don't...
I don't feel very trusting either when it comes to believing that the govt
can get that antiviral into our hands within 6 to 8 hours of symptom
onset.
...we haven't seen very many `quick recoveries' thus far.
One could argue that up until now most bird flu patients haven't received
the drug early enough - and that might well be true - but we don't have a
lot of evidence that Tamiflu administered early will be a panacea for
pandemic influenza.
Health Care workers, particularly those with families, are going to have a
difficult choice deciding whether to work during a pandemic.
Baxter's Cell Cultured Vaccine
http://afludiary.blogspot.com/2008/06/nejm-baxter-cell-cultured-vaccine.html
It appears that the future of vaccine technology is in using cell based
cultured vaccines rather than egg based. I am glad for the research
but feel uncomfortable with the use of monkey cells for this vaccine.
Let's hope that we do not need these vaccines soon because we
are not going to have them quickly, and there still will not be enough
for the global population.
Commentary from Avian Flu Diary on the two New England Journal of
Medicine articles on Baxter International's cell-cultured vaccine:
...a targeted vaccine cannot be produced until a pandemic strain is
identified, and using our current egg-based technology, it can take
another 20-28 weeks to produce the first batches of vaccine.
Second, our global capacity for creating vaccines using this egg-based
technology is limited. No one knows exactly how much we could produce
in a year, but estimates are that only enough vaccine could be produced
to inoculate 10%-15% of the world's population.
Public Health Planners Continue to See Problems With Fed Pandemic Plans
http://www.flutrackers.com/forum/showpost.php?p=164382&postcount=1
Flutrackers.com has posted this original article from Homeland Security
Today. In the event that the original article at HST is no longer available,
the information will be preserved at flutrackers.
There are tremendous problems addressed here. I can not imagine how
they can plan for all of these but I am thankful that they are acknowledging
that these critical issues must be tackled.
Public health planners who work on seeing the big picture of preparedness
for a catastrophic event like a global pandemic say the government still
hasn’t gotten a handle on things like coping with continuity and security for
multiple critical resources supply chains and quarantine issues.
One seasoned public health planner said, “I think the reasoning may be
flawed in certain areas, particularly the lack of attention to critical
infrastructure, and lack of notation that poor/ethnic minorities may need
particular support from law enforcement, as their communities may be
most vulnerable to social disorder."
This authority also believes, as do others HSToday.us has heard from, that
the matter of quarantining hasn’t been adequately debated.
But “the largest issue,” the veteran planner said, “is we have yet to describe
the common operating picture we need during a global catastrophic event.
Death and illness will not themselves describe the impact. [We haven’t
adequately addressed] the ability to keep oil flowing from the North Slope [to]
ensure the west coast has gas, potassium from Guam ensures we have
fertilizers, commercial flights from Asia ensure there are critical parts for
Internet servers.The complexity of supply chains is far beyond the
imagination of the public health planners, we almost need a futures market
for information.”
New here but thought i would put my 2 cents in. I am not only in hurricane ally i was in katrina's path. I worked during katrina. I was not worried about my family. (they evacuted up north) I was not worried about my safety.
I spoke with my husband that morning. My house was flooded. Once the stoem hit, power went out, (generators died on day 2), WE had 7 vented adults, and 7 vented nicu pts. and 7 RTs on duty!!! The windows started to blow. pts were stranded in their rooms. the pressure from wind blew doors shut. we couldnt open them. it was awful! Then when the winds slowed, the locals started walking in. barefooted, naked. They were swept out of their houses and clothes. covered in mud and debri. Each person had a story. A sad, scarey story. It was one of the most horrible things I have ever been through. The whole time knowing my own house was destroyed.
things I wish could have happened:::
*hosp keeping us informed
*hosp not being full of pts
*evacuate pts from rooms with windows before storm starts.
*large O2 cylinders being placed on each floor before elevators stop working!! 5 stories of stairs!!!!!!
*Our dept head finding us a place to shower before storm
As far as being prepared. My suggestion is what ever you get ready put it in the top of the closet!! In a water proof container!! And, just incase your house gets washed away...write your name and address on container!! LOL! I always thought I was prepared. boy was I wrong!
Water, baby wipes, hand sanitizer, bleach,extra clothes, shoes (not crocs)zip loc bags, dog food,
the list is so long. I dont think you can ever be prepared enough.
AMA Now Supports Personal Rx Stockpiling For Disasters
http://afludiary.blogspot.com/2008/06/ama-now-supports-personal-rx.html
Personal medication supply in times of disaster: Earthquakes, hurricanes
and floods have headlined recent news reports. This new policy supports
allowing all patients with chronic medical conditions to maintain an
emergency reserve of prescription medications. It also encourages patients
to carry a list of current medications and the prescribing physician's contact
information with them to ensure continuity of care in the event of a disaster
or other emergency.
"There are more than 125 million Americans living with chronic illnesses who
rely on medication," said AMA Board Member Steven Stack, MD. "Disasters
can happen at any time, and ensuring that patients with chronic conditions
have access to needed medications may help minimize the uncertainty,
confusion and health risks following a disaster."
Example of Citizen Education for Disaster/Pandemic Preparation
http://afludiary.blogspot.com/2008/06/net-gain-for-your-community.html
Nez Perce County in Idaho has developed the type of program that is
urgently needed across the country. Using citizen volunteers from the
community to check on neighbors and offer education and assistance in
advance of any disaster makes sense. Everyone gets educated as to
what the risks are and how to minimize them with regards to a pandemic
situation as well. This is an excellent all hazards approach that any
community could use with success.
Produced by the Lewiston - Nez Perce County Office of Emergency
Management, and the Idaho North Central District Health Department -
this 34 page PDF file provides an excellent template for any community to
begin creating their own neighborhood disaster response.
NET, or Neighborhood Emergency Teams, are designed for an `all threats'
response. Prime among those, however, is the threat of a pandemic or
other communicable disease.
The ability of every community to mount a daily, door-to-door check of its
citizens during a prolonged disaster such as a pandemic will be paramount
if the maximum number of lives are to be saved. For most communities,
volunteers will be needed.
indigo girl
5,173 Posts
Hong Kong experiments with anti-H5N1 cocktails
http://crofsblogs.typepad.com/h5n1/2008/06/hong-kong-exper.html
They used Relenza, Celebrex, and NSAIDs. It improved the survival rate, at
least in mice. Treatment was not started until after 48 hours. At this time,
survival in humans indicates that treatment with Tamiflu must occur during the
first 48 hours. Also, Relenza is an inhalent drug unless they have found some
new way to deliver it. I wonder how they gave it to the mice...
This is an interesting article and the treatment looks promising. There has
not been much to offer victims of H5N1 except Tamiflu, and already, there
have been some cases of Tamiflu resistance. Research into alternative drugs
is desperately needed.