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The use of good judgement during the discussion of controversial issues would be greatly appreciated.

Vents, Community Preps and Flu Excercise

by: Bronco Bill

Fri Aug 22, 2008 at 15:44:04 PM EDT


I'll only leave this up on the Front Page for about a week. Comments are welcome.

In the afternoon of August 18, I had the opportunity to sit and talk for about an hour with the one person in my state who is probably more in tune with, and concerned about, Pandemic Influenza than anyone I've met off-line. I wish I could divulge his name and title, but he asked that I not do that, due to the politics involved here. But do rest assured that this person knows what he's talking about.
This coming November will be the 2nd live, all-state Pandemic Flu excercise. More on that in an upcoming Diary.

Bronco Bill :: Vents, Community Preps and Flu Excercise
The first thing we talked about was the importance of ventilators. This is the same person I spoke with last week about the number of vents available here in the state, as well as the US.
After hemming and hawwing, he looked straight at me and said "There is no way ventilators are going to keep anyone alive in a pandemic. Even Health Care Workers will be working in panic mode, scared that they may catch the bug, and there is a good possibility that mistakes will be made. Vents need to be attached and adjusted by a Respiratory Therapist, and there aren't enough RTs to go around. A large majority of HCWs are not going to want to put themselves at risk as they have to remove tubes and expose themselves to a deadly virus. The only option that we've seen is to put them in full bio-hazard suits, and we just don't have those available on a large-scale basis."
We spoke about the option of home-care, and the one thing mentioned most often was that most home-care will mainly consist of keeping the patient rested, hydrated, and calm.  The majority of the population doesn't know, and wouldn't be comfortable using, medical procedures without a trained HCW at hand.

Quarantines. They won't happen. Not in Virginia, anyway. The thinking is that, first, this is the US. Ever since WWII, we don't quarantine entire populations for any reason, and FEMA knows that. Second, to cut off a group of people, either for their own safety or the safety of others would be nearly impossible given the size of the areas that would be affected by such a quarantine.  There are some differences in what the local Emergency Planners are saying and what the state executives are saying, though. That will need to be looked into very closely, and some "adjustments" will have to be made.

School closures. This state, like Massachussetts, is a Commonwealth. The Department of Education has no say over individual school districts when it comes to closing schools. That decision is left entirely up to the districts.  It really bothers most of us, including my contact, but that's the way it is here. Nothing short of a major state vote is going to change that.

Community Preps. The Commonwealth has set aside their stockpile of anti-virals and emergency supplies to be used, not just for PanFlu, but for most major disasters. We were the first state to take part in the purchase of the Tamiflu stockpile, and the second state to have live PanFlu excercises that encompassed the majority of health districts in the state.  There have been at least 8 localities that have held seminars and neighborhood meetings, one of which I attended last year: Local Williamsburg PanFlu Prep Presentation.

PSAs The Commonwealth has several on-line pages ready for JIT broadcast in case of PanFlu, as well as a new draft of the state Influenza plan, dated June 2008, as well as the official state website here.
As for current PSAs, I haven't seen nor heard any broadcasts regarding PanFlu or prepping. We're in the middle of storm/hurricane season, and most of the prep focus is there. Apparently, the PanFlu plan is to notify the public as soon as a threat is realized. Unfortunately, the public prep announcements will mimic what is on pandemicflu.gov, which at this time is "up to two weeks" of food and water.

We spoke for about an hour, covering several areas along with the above. Basically, the state is prepared for just about any emergency and/or disaster. At least, as well prepared as local politics will allow at this time.

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excellent summary
sounds like most states. Some are more advanced, some not. Some have practiced communications, some have practiced surge (at least locally), some neither.

So it goes.

Good enough? No. Satisfactory? No.

Nonetheless, that's where we are at.


It's a very strong reality check IMO
What it tells me is that the government is completely unable and/or unwilling to enforce any of the measures that would truly mitigate a pandemic such as school closures, airport closures, restrictions of trade or travel, etc....forget about it.

It also says that anything resembling adequate health care interventions will not be forthcoming. From the way he describes the probable reaction of HCWs to treating flu victims, I have to wonder how much good the tamiflu stockpile will do if there is no one there to administer it?

We already know that without a series of active, regular and strong mass media warnings coming from the government, telling people to set aside 3 months worth of supplies, people won't. Some can't anyway. (And the very fact that this concerned government official you spoke with is unwilling to have his name and title divulged clearly demonstrates the political hot potato the subject is, and thus how unlikely that the government will pre-warn the public except in the weakest and most watered down, cya- only terms.)

Waiting until the pandemic is underway will lead to the panic buying that leaves many without any supplies at all, and for those who get to stores first maybe a week or two supply at best. It is possible some people will die from starvation if supply lines completely break down for months.

And with no warnings coming from tptb and/or the media regarding taking the threat of pan flu seriously,  we as individuals will continue to have a hard time convincing even our own family members to prep until it is too late.

So what can we do? We can prep enough for ourselves, then add enough for our immediate families (if they are near enough for it to help) and then if time and purse strings allow, set aside some for our neighbors as well.  We can save ourselves - if we are lucky - and maybe afew other people. And then we can pick up the pieces later.

Always have a plan B.


It was my worry all along that the independance of US states would prove a major barrier
In my ignorance, I assumed that once a plan had been set out by your government that it would only be a matter of time before it was adopted over the whole of the US. In fact, I was a little jealous that your plans were better than ours. I was wrong.

Dem, Susan and others have always assured me that important people KNOW that pandemics are one of the worst things we might face. However I'm not sure the message has filtered along the branches of power (in the UK too).


[ Parent ]
we have also said that
the real action is local.

it's not consistent. The CT Gov would close schools. She has the authority, but local districts can close without the Gov's permission.


[ Parent ]
It's the parents
who will make the difference. If they know not to send their children to school when the threat is near, then it won't matter what the schools do or don't do.

I think we should continually remind parents that they have a right (and responsibilty) to make that choice. Just because the school is open doesn't mean a child MUST attend.

If parents are empowered (and encouraged) to make their opwn choices about whether or not it is safe, by the time TPTB close the schools, there wont' be very many kids attending anyway.


[ Parent ]
I think it's both
There are a lot of very passive people who will not and cannot take action (by reason of their temperament, on top of ability to understand and access to resources) before being told or even pushed to do so.  Look at the people left in NO, and those who only left the last minute and got stranded for hours on the road.  Think of all the people who would not wear seat belts before they became mandatory under law.  Even today I still see occasionally parents letting their kids stand or play on the backseat rather than strap them in.

The point that I'm making is, we absolutely need to inform and empower parents to make those decisions, but pandemics involve complicated issues, and it will take a massive amount of public education and still the degree of awareness, sufficient for them to take action will still be small.

But if we can affect decision making at the local level, the story is vastly different.  You only need one or a few key people (like the governor of CT, bless her heart) being aware and persuaded about the need to act early to close schools, then you will have overcome all the complacency issues among parents.

The beauty of the early proactive school closure plan, is there are zero compliance involved, cos what are parents going to do, drop their kids off anyway?  The experience in the recent Hong Kong school closures tells us there will be a very small number of families who will initially still send their kids to school, whether because of ignorance or inability to get childcare.  Schools will need to keep their facilities open to look after these kids for the day, but I suspect pretty soon the knowledge and fear about infection plus pressure from staff (they don't want to get infected either, do they?) will deter all but the most recalcitrant.  

If parents are empowered (and encouraged) to make their opwn choices about whether or not it is safe, by the time TPTB close the schools, there wont' be very many kids attending anyway.

What I hope to see (and what I work on, slowly but steadily) is to have schools closed before most parents are even aware of the dangers.  Yes, we MUST inform the parents too, but we will get MUCH better results if we do both, I think/



All 'safety concerns' are hypothetical.  If not, they'd be called side effects...


[ Parent ]
BB's comment here is instructive
about his experience with earthquake preparedness in CA

http://www.newfluwiki2.com/sho...



All 'safety concerns' are hypothetical.  If not, they'd be called side effects...


[ Parent ]
I agree strongly with your comment
we absolutely need to inform and empower parents to make those decisions,

The biggest problem is that parents largely rely on schools as an unpaid child care center. Even for two parent families, in the majority both parents work, so if one must stay home it significantly affects their income. In single parent families there is even less choice.  Parents will be very reluctant to keep their children home if it means losing wages for extended periods. To cooperate with school closure, they must therefore be convinced that this is a life and death matter, that the choice is a paycheck versus the life of their child.  

Always have a plan B.


[ Parent ]
Yes, the issue clearly is informed choice
Parents need to be assisted to make the right decisions in order to prepare, and that can only happen by widespread education.  It's something that needs to happen as part of government policies, in every country.  Personally, the issue became clearer and clearer to me over time, starting from when we first tried to articulate our 'mission' at the first APHA convention, in our very first flyer http://www.newfluwiki2.com/sho... to when I challenged tptb at the NBSB meetingm, that it's not acceptable that parents are not at the table for such an important decision that directly impacts them and their families.  http://www.newfluwiki2.com/sho...

The WHO is drafting the next version of guidance for pandemic preparedness planning, which had this statement that caught my eye:

In mid-September, the current draft document will be posted on the web for additional comment and then final revisions will be made.

The documents being drafted include "Handbook for the public".  I'm looking forward to seeing whether the contents meet this universal need, of empowering citizens at all levels of society and in all countries.  The battle of ideas is important, because whatever WHO puts out, whether we agree or not, countries and governments are going to use that as both their guidance and their 'get-out-of-jail-free' card.  It will not be enough, but precisely because of that, we need to do our best to make sure the lowest common denominator is set high enough to overcome the current pervasive inertia and denial.  I also hope that those of us who have views will be able to send in robust responses.



All 'safety concerns' are hypothetical.  If not, they'd be called side effects...


[ Parent ]
not to be morbid
but if people are dying, the call gets clearer to make.

[ Parent ]
except people will not be prepared
but still, that as i said is one big reason why I think school closure will play a significant role in saving lives, cos once they're shut, they are shut!  And transmission is likely to slow right down, buying everyone time.  As shown in the recent Hong Kong experience:





All 'safety concerns' are hypothetical.  If not, they'd be called side effects...


[ Parent ]
Yes, Dem, but.....
If TPTB (either state or local) wait until people are dying in large numbers, then it's already too late.  The fact that schools get closed after we start seeing dozens of young previously healthy people dead in local hospitals won't help the thousands who are infected at that point; the spread might be somewhat reduced but not enough.

Schools need to close sooner rather than later.


KEEP THE GRID UP!
Prudent People Prepare Properly

"better to have it and not need it than need it and not have it!"


[ Parent ]
React before people start dying
DemFromCt,

 When virus breaks out in school people keep their kids home so I hope parents do this.

 Like SusanC said - some will not be prepared.

 Kids may go to daycare which I see as just as densly populated with more person to person interaction and person to surface interaction.

 Staying home with young kids is a no brainer for most parents. Staying home with 17 year old, 16 year old, 15 year old, 14 year old .. that is not as clear a call.

 I hear a difference in parents between letting a 15 year old girl stay home alone and a 15 year old boy stay home alone.

Kobie


[ Parent ]
keeping children home after many are sick-
does little to nothing to limit the spread of the disease, since they are already infected.  Keeping them home means they will infect the rest of their family.  The latency period is one of the things that people 'don't get'.

KEEP THE GRID UP!
Prudent People Prepare Properly

"better to have it and not need it than need it and not have it!"


[ Parent ]
Sickness latency
LmWatBullRun,

 Yea, unlike SARS, theory says people can shed the virus before theys start to show symptoms.

 You are right - once a person is sick it is too late.

 However the pandemic plan calls for teating alot of folks at home. Here they may not get better and could make alot of folks sick unless precautions are taken.

 I have not read what palliative care will be recommended or if palliative care will be done at home.

 If palliative care is done in the home then people will need re-supply of palliative matterials?

Kobie

 


[ Parent ]
Palliative care will be a luxury
The things palliative care can do are relieve pain and/or anxiety.  Palliative care is intended to relieve symptoms.  

In the event of a high CFR pandemic, I expect no medical care to be available to the majority of people.  This would mean that I do not expect morphine or its derivatives to be available to most of those who would be dying in agony without benefit of those medicines.

It won't be a matter of what would be recommended treatment of choice, but a matter of availability.  I don't think that what would be needed would be available.  I don't think "re-supply" will be an issue, because I don't believe there will be sufficient initial supply.  (You can't "re-supply" what was never supplied in the first place.)

 


[ Parent ]
agreed,
which is why schools need to close sooner rather than later.

KEEP THE GRID UP!
Prudent People Prepare Properly

"better to have it and not need it than need it and not have it!"


[ Parent ]
No palliative re-supply ??
Clawdia,

 Hi. Hmm, my big worry was the logistics or re-supply of at morphine and other substances so it was not taken or misused by family and friends. There are some sick folks out there who will take medicine from kids and the elderly.

 Vents are not an option - H5N1 does more damage than the body can repair in most (60%) of the cases.

 Palliative care in the hospital is not an option - there
are not enough free vents.

 Palliative care in mass situation may not be an option (space, trained folks, supplies)

 Palliative care in home is not an option because as far as we know there is not enough supplies?

 Let me know if you think any of these are right or wrong.

Kobie


[ Parent ]
Well . . .
Vent therapy is not palliative care.  It is wrong to say that palliative care in hospital is not an option because there are not enough "free vents".    The issue is not that there are not enough ventilators free or otherwise, the issue is that vents would not save lives because people would be too ill to recover even if they had access to vent therapy.

Palliative care in home, as defined as optimal relief of symptoms with sufficient quantities of morphine and derivatives, will not be available because there will be insufficient quantities of the needed medicines.  Not enough drugs to go around, and no way to distribute those that do exist.

The way I look at it is if one becomes ill quite early in the first wave of a pandemic, then one might be able to obtain needed drugs and some level of medical care.  But once a number of people are ill, there simply will not be enough drugs, not enough care givers, and the list goes on . . .In the event of pandemic flu, initially I would expect attempts at treatment.  When that becomes an impossibility, I would expect limited availability of palliative care measures.  Finally, after a short period of pandemic influenza in the community, I would expect no care of any kind to be available to the average person.

All this is why SIP options are so important - the ability to isolate from the community, to prevent illness by way of that isolation, is the best chance to survive a pandemic.
It is why I think travel restrictions and closing borders would be so vital, and why immediate measures will be necessary - in order to limit the spread of the virus as much as possible.  It is why so much focus has been put on closing schools - it is another form of isolation, and right now, isolation is the intervention most likely to do the most amount of good for the most people.  

People need to stockpile water, food, fuel, medicine, etc.
Having those things when you need them, and being able to survive while remaining isolated from those who may be ill, are what many of us see as the best chance at increasing the possibility of personal survival.

As things stand now, we are not going to be able to treat and/or cure victims of pandemic flu.  What we would be able to do, if isolation/quarantine measures are instituted rapidly enough, would be to slow the spread of the virus while a mad scramble ensues in an attempt to create, manufacture, and distribute a vaccine.

I think that may be the point you're having difficulty grasping . . . that we will NOT be able to treat and/or cure victims of pandemic flu in a high CFR pandemic - and right now, I do not think we could adequately care for even the victims of a pandemic no more severe than that of 1918.   The entire medical system would be totally overwhelmed, well past the point of efficacy.
It is sad, but I believe it to be true.

You're grasping at straws that do not exist, I'm afraid.  The problem with doing that is that all the time and money and energy spent on measures that would fail - such as ventilator therapy - is time, money, and energy that could be better spent otherwise.  Every minute spent on vent care is a minute wasted, in my mind - just for an example.



[ Parent ]
"Do not go quietly into that good night"
Clawdia,

 Hi. Yes vents are not palliative - just re-stating the facts.

 Sigh. There is no solution for a pandemic just mitigation. Perhaps the next generation or two will find a solution "to save succeding generations from the scourge of" of pandemics.

 Still - "to rage against the dying of the light" and do your best whith what is.

 Its going to be terrible to watch someone slowly suffocate due to H5N1. Worse to experiance alert and sober.

 Dr. Kevorkian and I are still disagree on the resolution of hopless care. I still do not see the pandemic as hopeless. IMO the untested solutions still outweigh the unknown problems.

 I'm just looking for the facts.

Kobie


[ Parent ]
You are Correct
I have already told my employer that I will be asking for a leave of absence and taking my child out of school as soon as I see the BF going global.

I work in a school and they all know when I leave they need to start looking at going too.  

You have the right to take you child out of school and homeschool.  I live in Colorado and it is legal to homeschool.  Everyone needs to check into their state to see what the law states.  

You are the only one who cares about YOUR CHILD be pro-active.  DO NOT WAIT FOR YOUR SCHOOL DISTRICT!


[ Parent ]
I believe the problem is,
we are preaching to the choir here.  I doubt that we will find many flubies who will not take their kids out of school asap.

The question is, is it enough, us saying to each other, "do not wait for your school district"?

I have nightmares about the 99.99% of children who will not have parents clued up enough to take action.  



All 'safety concerns' are hypothetical.  If not, they'd be called side effects...


[ Parent ]
But...
how do you get parents to take this seriously? Locally, there is hardly any interest from parents.

Plus, I feel they will listen to the PTB and if TPTB don't tell them, then they feel they need not be concerned.


[ Parent ]
which is why we need to work with those
who work with parents.  As well as directly working with parents or parent groups.



All 'safety concerns' are hypothetical.  If not, they'd be called side effects...


[ Parent ]
"only be a matter of time"
If you think back, it was the US government that told the individual states to come up with their own plans, that the Feds would offer guidelines but not do all the planning for everyone.

(Being snarky here:) Important people DO know that pandemics are one of the worst things we might face. However, most of the really important people aren't in any position to force the gov't's hand.


[ Parent ]
well, there is knowledge and awareness
Dem, Susan and others have always assured me that important people KNOW that pandemics are one of the worst things we might face. However I'm not sure the message has filtered along the branches of power (in the UK too).

and then there are political calculations (including betting on a pandemic not happening on someone's watch), backroom horse-trading (you support me on this and I'll support you on that), interest groups, and lobbyists.  Government is always a messy process, a lot of compromise and consensus seeking, and never optimal solutions.  Just my 2 cents.



All 'safety concerns' are hypothetical.  If not, they'd be called side effects...


[ Parent ]
Sorry to be a broken record, but
You folks keep ignoring the Iron Law.

Right now, the perception of most of those who control what our bureaucracies are doing is that 'bird flu' is a tempest in a teapot that threatens their organization.  I mean, the Indonesian Government and the Chinese Government have obviously determined that it is in their best interest to cover things up. They are not stupid people; they are doing the things they think will ensure their continued control of the government and their survival. (survival of their people is not a primary concern.)

Most of the numerous governmental organizations here in the US have the same motivators-
1)Maintain the status quo;
2)ensure they get adequate funding;
3) don't take any controversial positions that would threaten their jobs;
4)Have a backup plan if something does go wrong; find a credible way to blame someone else. (right now the current evisceration of the WHO panflu alert is a perfect excuse for these types...)

I'll say it once again-

THE IRON LAW TELLS US THAT THE PRIMARY MOTIVATOR FOR EVERY BUREAUCRATIC ORGANIZATION IS TO ENSURE THE SURVIVAL OF THE ORGANIZATION, NOT TO FULFILL IT'S STATED GOALS.  Period.

KEEP THE GRID UP!
Prudent People Prepare Properly

"better to have it and not need it than need it and not have it!"


[ Parent ]
see comment below to UK - Bird
The CT Gov would close schools. She has the authority, but local districts can close without the Gov's permission. And yes, the action is local.

So, I don't agree entirely with

What it tells me is that the government is completely unable and/or unwilling to enforce any of the measures that would truly mitigate a pandemic such as school closures, airport closures, restrictions of trade or travel, etc....forget about it.
it will be hard to do early, but that does not mean it will not be done. How effective these measures are is another story entirely, especially if there's hesitation.

[ Parent ]
Sorry..I meant the federal government.
My fear is that if it is only state to state and local to local, the discoordination of such will do little to prevent the spread of the pandemic nationwide and world wide. Pockets of protected areas are pretty much what occured in 1918, and that seems to be all we can count on here. Hopefully you and I (those reading this) are in these pockets.

Also, without funding and back up from the federal government, I'm not sure how many states are willing and able to set up truly effective plans.

Always have a plan B.


[ Parent ]
VA DOH Monthly Activity Report
One thing that the Virginia Department of Health puts out is a monthly Pandemic Influenza Monthly Activity Report.  I don't know if there is a link for these reports on the DOH website (I couldn't find one) but I find them by a Google search.

Virginians can read through and see what activities have happened at the state and local levels.

Here's the one for August 4 2008:

http://www.vdh.virginia.gov/Pa...

GetPandemicReady.org - non commerical website with practical ways for families to prepare.


ACM--this is cool!
...now I can go back and talk to my contact with specific questions and requests. Thanks.

[ Parent ]
Wow, 13 pages of activities happened this month!
Looks like a lot of people are awake to this issue.  :-)

"The truth does not change according to our ability to stomach it."  Flannery O'Connor

[ Parent ]
594 page plan
 While I am glad to see a June 2008 date on the 594 page state plan, the assumptions on page five (5) and six (6) bother me.

 "B) A pandemic disease outbreak may precipitate infection rates exceeding 25 percent in an affected population, with projected mortality rates as high as 2 percent among those infected.
 C) Workforce absenteeism may rise as high as 40 percent at the height of a given pandemic wave for periods of about two weeks."

 I hope that as a draft the next version acknoledges a higher CFR, absenteeism rate and longer duration.

 On page nine (9) - no way to make cities comply: "While no mandate exists requiring localities to complete a COOP plan, VDEM developed a COOP Toolkit for local governments to address the growing number of questions being raised and to assist localities in the areas that make COOP planning"

  I was worried that cities might fail because the business that support them would close for the duration. I guess the state corporation commision or licensure board can not make COOP part of business model.

 I'm still reading the document.

 Sorry that all I have posted is negative. I'm trying to help not just bash.

 BTW - if you go to the VDEM web site and look under threats and emergencies pandemic is not listed with other emergencies (Blackouts,Chemical Emergencies,Drought, Floods, Geologic Events, Hazmat Incidents,Heat-Related, Emergencies, Hurricanes, Lightning, Radiological Events, Terrorism, Thunderstorms, Tornadoes, Wildfires, Winter Weather )

 If you see the section public health on the left hand side bar and click on public health then pandemic shows up.
Source: http://www.vaemergency.com/thr...

 If people go looking for pandmeic or ai, well it is not all that easy to find.

Kobie


I think the reason for 2%
Is that there really isn't any historical record that shows a higher CFR. The current CFR overseas is high, but it's not at a pandemic stage.

It's unknown whether the virus, if and when it mutates to H2H form, will retain its current virulence, or become less deadly.

Also, the Feds are looking at 2%, as well as WHO and CDC.


[ Parent ]
2%, common ground and accepted figure.
BroncoBill,

  Agreed that 2% is the accepted figure.

  It bothers me that the connection seems flawed. 1918 was caused by H1N1 (source http://en.wikipedia.org/wiki/S... not H5N2. The current mortality rate is 60% or higher.

 Yet if one cries "it won't be twice as bad, four times as bad or ten times as bad as 2%, it will be 30 times worse" they loos all credibility and are dismissed.

Kobie


[ Parent ]
well
locally in Bethel, we gamed for 7%, CDC did~12-14%, State DPH in CT ran a communications tabletop with 20%, HHS did the same with ~30%.

[ Parent ]
30%...
so what happened in the exercise?



All 'safety concerns' are hypothetical.  If not, they'd be called side effects...


[ Parent ]
it's here...
http://www.newfluwiki2.com/sho...

it was an almost full day communications exercise that didn't progress beyond the point where the realization of how bad things might get started to sink in, and included variations of cfr only at the very end (i.e the process and lead-up, not the cfr, was stressed). I said at the time the actual numbers were not that important regarding what we were doing (which is true).


[ Parent ]
oh yeah, I forgot about that one ;-) n/t




All 'safety concerns' are hypothetical.  If not, they'd be called side effects...


[ Parent ]
Risk important.
DemFromCt,

 I'm glad things set in. Risk is important - IMO.

 Many medical procedure list death as a possible outcome - but what difference does it make?

 Roller coaster has a small element of injury - so waht.

 Young males (15 to 25) often seek things that are dangerous. Its ok, there is someone who knows how to relocate a shoulder or get them to the doc can for stitches.

 My fear is people will get over the shock and aw of 2% CFR and then when it rises to 8% TPTB will shut down. Why? "This is not suppose to be happening"  Then it rises to 20% and TPTB many not want to even show up.    

  Things get alot more attention when they remove any safety net.

Kobie


[ Parent ]
A confirmation
I think that the posts above all confirm the need for folks to try and do something similar to what Richard did within their own school system.

It's the beginning of the school year and PTO/PTAs are going to be looking for presentations. Do you have a school nurse that you are friendly with, if you are helping out at your school? Can you find a way to broach the subject?

I hope that some more consider giving it a shot with in their schools. RMA will help you pull together information. I'm sure others who have already done similar pesentatons will also.  

www.EmergencyHomePreparation.org -- A 'card-catalog' style of prepping information.   -


Some research on how the public might ( or might not) respond...
I recently read 'The Unthinkable: Who Survives When Disaster Strikes - and Why' by Amanda Ripley (2008).  The book is a well researched, and compelling.  For me, it's been helpful in thinking about possible public reactions to a pandemic, as well as other disaster scenarios.

http://tinyurl.com/68a6gx

"Ripley, an award-winning writer on homeland security for Time, offers a compelling look at instinct and disaster response as she explores the psychology of fear and how it can save or destroy us. Surprisingly, she reports, mass panic is rare, and an understanding of the dynamics of crowds can help prevent a stampede, while a well-trained crew can get passengers quickly but calmly off a crashed plane."

(I usually just a lurker, but I think you all would appreciate this book. I am not associated with the author or publisher.)


Amt264 - thanks
Amt264,

 Thanks. The facts are always best to have.

 It goes along with what happened on 9/11 as well as Flight 92 (I think it was flight 92)

 The stewadess called in saying they where being hijacked and the people in charge could not believe how calm she was. It freaked them out.

 In the movies everyone always goes screamming - right? Maybe that is just in the movies.

 The author: http://www.amandaripley.com/

 The book: ISBN: 978-0-307-35289-7 (0-307-35289-7)

Kobie


[ Parent ]
thank you!!!
I have argued that same point with some very high ranking officials. UPMC and others have documented how 9/11 in NYC (no panic, thank you NYC) is more the norm.

[ Parent ]
Let's say, just for the sake of argument, that tptb are as well read
and well informed as you and some of the others here are...or if not, that they have people on their payroll to do the research and keep them up to speed on all aspects of people handling and human nature, such as described that book.

This means they already know that "mass panic" is highly unusual behavior, and that public response to the news of a potentially highly lethal pandemic would bring out a calm and measured survival response rather than a running- around-in-circles-screaming-and-passing-urine response.

Thus one has to ask this question, and I mean it in all seriousness: Why do they continue to use the excuse of the necessity to avoid public panic to justify their continued refusal to inform the public of this very real and growing threat in sufficient time for the public to prepare?

The most logical reason - barring the alternate possibility that the world leaders are actually alien reptiles seeking to take over our planet - is that tptb fear it would cause an economic downturn for some businesses. People would spend money on practical things such as food, water containers, solar power, etc instead of on big ticket items. In a "survival mode" they would tend to put less on credit cards and try to keep more cash on hand.  

So, if this logic holds up, that means tptb are willing to sacrifice a billion souls for the sake of their own (and their bankrollers) profit margin. Sick

Always have a plan B.


[ Parent ]
Economic downturn?
MaryInHawaii,

 You could be right that TPTB see that as a knee jerk reaction.

 However Y2K did not cause mass panic, we all got new PCs, it spurred econmic spike in several sectors. This goes for Hurricans as well.

 Since TPTB are saying YOYO upfront, there does not seem to be a liability issue unless they remain quiet. Ok, skip the liability issue. The mayor of NewOrleans was seen more as victum of Katrina than a participant of the disaster. Heck he even got re-elected.

 Hmm, if most pandemic items do not come from China but are localy made then .... nawww that could not be it. Skip it.

 I'm at a loss.

 Any one have any ideas?

Kobie


[ Parent ]
their biggest stated concern
is that people don';t listen no matter what you say.

What their bosses think, in POTUS and VPOTUS offices, I cannot bear witness to.


[ Parent ]
Interesting

  Hmmmm..... Interesting.

Kobie


[ Parent ]
amt264-
Glad to see you out of the 'lurking closet'! Dealing with the public reactions is always an intriguing issue in the promotion of panflu awareness. -k

www.EmergencyHomePreparation.org -- A 'card-catalog' style of prepping information.   -

[ Parent ]
Vents, Community Preps and Flu Exercise
A pretty good take on the situation in my opinion.  Preparing for the Avian Flu has been a personal interest since I started tracking new cases around the world.  Watching, watching..has it/had it jumped from birds to mammals?  Watching, always watching.  Looking at maps for seasonal migration routes.  Watching, watching and trying to estimate when it WILL hit the U.S.  Antivirals haven't done squat in any flu season that I have treated patients, so I am not putting great faith in them for bird flu.  A person doesn't really die of the bird flu, they die because their lungs fill up with fluid....pneumonia.  A better choice might be to get pnemonia vax.  Another point.  There aren't enough vents to go around for every patient who will need a vent.  Agree, that RTs should be the ones to adjust the settings but there are a few internists and pulmonary specialists who can do it in a pinch.  I agree quarantines are not going to be a  solution - they would be labor and resource intensive to set up and maintain.  What I think will help along with school closings is self-quarantine prior to coming into contact with a flu carrier.  I am talking about locking oneself into one's own home to ride out the storm of viral infection.  Look to the Great Influenza of 1918....it lasted many months as it swept across the U.S.  We have to empower people to make choices for themselves and their families.  Parents have to be able to look at news reports and keep their kids at home.  Being able to make this decision with confidence means having prepared now for the basics of life to weather out the length of this viral storm.  

Just imagine being at work and getting the message to come pick up your children because the school is closed because of impending bird flu.  Can you feel the panic?  How are you going to get out of your office at the same time every other parent is doing just the same thing?  Can you see the panic on the roads and highways?  Can you feel your mind ticking off your home grocery list - thinking about the risk of going to get extra food?  

Now think about everything else you have come to rely on.  Will there be anyone at the water pumping stations?  What about sewage, gas stations, other utilities, and what about law enforcement?  Will there be anyone to perform those responsibilities on which you have become so dependent?  Will they be sick and can't come to work, or will they even show at work - they have families that need protection too.

Wow, I know I probably come off as a crazy crack pot.  But that was great to vent upon a topic about which I am very passionate.  


No, not a "crack pot" at all . . .
Not around here, anyway.

Nice to hear a new voice as it were.  You'll see lots of mention made here of people planning what you suggest, called "SIP" or
"Shelter in Place".  I'm sure more than one person here is prepared for self-imposed isolation measured not in days or weeks but rather in months and yes - for a some, even years.  

Many here expect the health care system would be almost instantaneously overwhelmed to the point that the average person won't have medical care available.  Many here at FW are quite concerned about the power grid and all the problems that would follow in the event the grid cannot be kept up.

So - see?  You certainly don't sound like a crack pot. :)


[ Parent ]
Everything you said bolsters the argument for early school dismissal.
First responders, utility workers, and food suppliers would be helped to continue working if pandemic spread could be slowed down drastically.  Keeping kids at home, not at school or in the mall, would slow the spread everywhere.  All we have to do is push the authorities to get the message.  :-)    To keep society running, it isn't enough to have a few families in every town keeping their kids home.  ALL kids have to be isolated early enough to slow the spread.  A wide-spread understanding of this idea would help in places where the vax laboratories and vax plants are, too.  If we're lucky, cell production of vaccines will be possible by the time a pandemic starts, but they still need workers and shippers and shot-givers (and needles and swabs etc.).

"The truth does not change according to our ability to stomach it."  Flannery O'Connor

[ Parent ]
Home for some
PreparedWarrior,

 Hi and welcome to either the looney bin or those with foresight.

 Staying at home or SIP will do well for many who have prepared to "ride the storm out." We have food, water, education and games for the kids and support structures.

 For many the loss of job and paycheck for a month or so will be much harder. Those working in hollywood, movie theaters, concerts, resteraunts, malls, skate parks, theme parks, convention centers, schools, universities, bars, strip clubs, rec centers, soprts (Football/ NASCAR/ Soccer / Baseball), manufacturing, buss terminals, airports could be laid off for a while.

 Personaly I would like to see these people trained in the medical field to help with the surge but so far just getting people to listen and plan is hard.

  Sadly alomst 2/3 of our economy is driven by spending. People not spending will be bad.

  BTW - I finaly understand that vents are a "non issue" That H5N1 does more damage than the body can repair so vents just prolong the enivitable.

 You said antivirals do not do much?

Kobie


[ Parent ]
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