Disaster/Pandemic preparedness

indigo girl · Feb 28, 2007

I wanted to place this link in the preparedness thread. It refers to an article in the Journal of the American Osteopathic Association about a technique that was used in the 1918 pandemic that successfully lowered mortality. This article discusses the currently high fatality rate for avian flu victims, and the fact that our treatment options are limited. It is worth looking at what worked in the past.

I am very grateful to the poster at Flutracker that provided this link, and I am very pleased to find this information:

http://www.flutrackers.com/forum/showpost.php?p=68255&postcount=1

indigo girl · Mar 1, 2007

Preparing for Pandemic - A Family Checklist Video

The only thing that I would question about this info is suggestion to stockpile food for only 2 weeks. History tells us that the 1918 pandemic came in waves of about 12 weeks each. I believe that there were three waves in one year.

I would aim for 3 months supply of food as well as water for each family member and pet.

indigo girl · Mar 1, 2007

Health Care Worker Disconnect, an essay from FlaMedic at Avian Flu Diary

was written in December 2006. The topic is still relevant today:

http://afludiary.blogspot.com/2006/12/hcw-health-care-worker-disconnect-253.html

Lost in all of this debate, or lack of debate in too many cases, is the sobering reality that once a pandemic begins, it will be too late to prepare. The scramble for PPE’s and medicines will quickly outstrip the supply chain.

And this will put hundreds of thousands of Health Care Worker’s lives at risk. Mostly nurses, techs, nurse’s aids and orderlies: for these are the ones that will have the closest, and most prolonged contact with infectious patients.

indigo girl · Mar 2, 2007

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.

indigo girl · Mar 3, 2007

Critique of the CDC's Pandemic Planning Guide

http://www.cdcchatter.net/index.php?name=News&file=article&sid=397

Interesting article from the CDC employees. But, of course most nurses will not have the option of telecommuting.

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.

indigo girl · Mar 4, 2007

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/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."

indigo girl · Mar 7, 2007

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/2007/03/ramifications-effects-of-trucking.html

indigo girl · Mar 10, 2007

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/2007/03/wishing-on-czar.html

sanctuary, BSN, MSN, RN · Mar 11, 2007

Thanks again, indigo girl. Chilling but perhaps that's what it takes to get people thinking.

indigo girl · Mar 11, 2007

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/

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.

indigo girl · Mar 11, 2007

Michael T. Osterholm of CIDRAP, from Foreign Affairs, March/April 2007

http://www.curevents.com/vb/showpost.php?p=696423&postcount=1

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.

sanctuary, BSN, MSN, RN · Mar 12, 2007

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.