THIS IS AN EXERCISE. IT IS NOT REAL.
The shortage of workers caused by sickness and absenteeism has created significant disruption of supply chains and availability of utilities.
The below sickness numbers contribute to the disruptions.
| July 25 | Population | Absenteeism Rate | Attack Rate | Number of people who have presented to the hospital with flu-like symptoms | Fatalities past 24 hours |
| Bannock | 75,565 | 35.00% | 27.00% | 748 | 13 |
| Bear Lake | 6,411 | 35.00% | 27.00% | 63 | 1 |
| Bingham | 41,735 | 35.00% | 27.00% | 413 | 7 |
| Butte | 2,899 | 35.00% | 27.00% | 29 | 1 |
| Caribou | 7,304 | 35.00% | 27.00% | 72 | 1 |
| Franklin | 11,329 | 35.00% | 27.00% | 112 | 2 |
| Ft Hall | 3500 | 35.00% | 27.00% | 35 | 1 |
| Oneida | 4,125 | 35.00% | 27.00% | 41 | 1 |
| Power | 7,538 | 35.00% | 27.00% | 75 | 1 |
Workers are not available to drive trucks or repair trucks, so supplies are not getting to their needed locations. Gas tanks are empty. Grocery stores are empty. Repair parts are not available. Mail is not being delivered on a daily basis. ATMs are empty of cash.
Workers are not available to operate and maintain the country’s infrastructure. Some areas may not have not had electricity for several days because a wind storm knocked down power lines, and there is nobody available to fix the lines. Pump stations on natural gas lines may need repair to continue pumping gas to homes and business. Sewers could be backing up with very few people to alleviate the problems. Telephone lines may have been knocked down but not repaired in the same windstorm that knocked down the power lines. Internet services dependent on central servers may need maintenance that is not available, so internet access is limited.
The above scenario is a possibility during pandemic flu. However, with proper planning on the part of Critical Resources and Key Infrastructure, the percentage of probability can be reduced. The Department of Homeland Security has published national guidelines for Critical Infrastructure and Key Resources (CI/KR). If you are in the utility business or provide key resources such as gasoline or groceries, this document should be considered a “must read.”
Continuity Of Operations Planning (COOP) provides the foundation for continuing your business or services during times of emergency or disaster. This applies to government angencies and all businesses. How do you plan to protect your employees and respond to the above scenario so that your company does not go out of business because of pandemic flu?
Here are some basic tips for COOP:
Plan:
- Review the “Pandemic Influenza Guide For Critical Infrastructure and Key Resources” to get the big picture about COOP and how it fits your government agency or business.
- Complete the planning checklists at http://www.pandemicflu.gov/plan/workplaceplanning/index.html
- Begin reviewing pandemic flu plans and options at corporate meetings. Be sure to include Facility/Maintenance and Human Resources departments in the planning effort.
- Review your supply chain for critical paths that could disrupt operations. Address issues with your suppliers.
- Plan for alternate electricity and heat/cooling in your facility.
- Partner with your local health district for planning assistance.
- Cross-train staff to perform additional functions when needed.
- Review Human Resources policies to ensure they address extended sick times caused by employee sickness and the employee taking care of sick family members.
- Other workplace policies to review include daycare in the workplace and possibly providing food for employees who can make it to work.
Protect:
- Provide hand sanitizer stations near doors, in dining facilities, and in restrooms.
- Consider telecommuting as a viable work option to minimize physical interactions during pandemic flu.
- Exercise your pandemic flu plan during an emergency drill at your facility, using back-up personnel in key positions.
- Consider partnerships with other companies who can provide staffing for your business.
Respond:
- Put your pandemic flu into action.
- Keep a close eye on your supply chain and be “ahead of the curve.”
- If your employees are sick, send them home so they don’t infect other employees.
Links and Other Good Stuff:
- COOP for Critical Resources and Key Infrastructure: http://www.pandemicflu.gov/plan/pdf/cikrpandemicinfluenzaguide.pdf
Government personnel should consider: Staffing and task prioritization. Alternate electricity, heating/cooling, and communications.
Business personnel should consider: Staffing and task prioritization. Alternate electricity, heating/cooling, and communications.
Private Citizens should consider: Emergency Kit Supplies. Alternate electricity, heating/cooling, and communications.
All readers are encouraged to leave a comment about the how this exercise scenario might impact your lives.
THIS IS AN EXERCISE. IT IS NOT REAL.
July 25, 2008 at 8:41 am |
Interesting how the number of those reporting to the hospital was only about 50, considerable drop of the first couple of days. Do you suppose this is d/t education of the public by the media on staying home. Time will now tell how rapidly this first wave will go.
Or, for the sake of the exercise has this time frame just been sped up? I see our death rate maybe going up as those that have already been hospitalized may worsen but as stated the number being hospitalized has reduced. Perhaps this is a learning curve for the providers, there is no longer any place to admit to and further we have learned that there isn’t much we can do to stop the course thus sending them home for care is the best that can be done for them. No vaccine, no more Tamiflu thus nothing more to do. No more ventilators, those available all in use. For some death inevitable and dying at home might be a more comfortable environment. Socially, the U.S. will finally have to face what third world countries have always accepted-no heroics for those that will die anyway. For me that is where I would rather be-home and die in a comfortable environment with my family rather than in a noisy hospital and being poked and prodded all day, feeling bad that already overworked staff are having to take care of me when there really isn’t much to do.
If power is lost, morgues and other storage areas for bodies will become an issue with decay and then the mass grave idea may become an issue.
More questions, more for us to ponder. This will be the ultimate reality show.
July 25, 2008 at 9:00 am |
Mike Doyle: concerning the sickness numbers this morning, this is to simulate a short plateau in growth caused by immediate reaction (social distancing, cover your cough)to news released on Monday that ultimately goes away after a day or two. There is no scientific proof about this, just something I think will happen.
July 25, 2008 at 9:15 am |
Sigh,
This is where it turns from a burden and starts to get bad.
The scenario is good and descriptive. SDHDTraining might add that some lost food in bad refridgerators. Dry ice production is down. Rolling blackouts have started.
I feel the disruption will happen *before* H5N1 hits the US. There was a Wall street Journal article about Bejing idling factories to clean up the air and how that effect was being mitigated.
One thing I fear is not getting to trained people. Once a business close down how do you contanct the electricians, welders, plumbers, and IT folks who are able to work?
It would be good for each city and town to have a list of who is who and what jobs they can do. Privacy is an issue.
Mike – love your comment about “ultimate reality show” About the power loss another blog had serveral nurses blog on how hard it is to bag a patient for more than an hour. From personal experiance Hospital generators run the ER, OR, NICU, etc but not the AC or some elevators.
Three thigs to check are (yes its another list)
1) How much of the hospital the genny will cover
2) When was the genny last tested – this can be a hard one for people are scared to switch over to the genny and find out something is wrong. The would rather waite for a disaster to find out.
3) How long can the genny run at 80% power. How much fuel is there. Is it diesel or natural gas driven ?
4) Can the hospital be segmented to shed power requirements incase the fuel supply is low.
Good posts.
Regards,
Kobie
“”As dusk fell through the city lights, none shown brighter than a lonely candle keeping vigial till dawn” – kobie
July 25, 2008 at 9:43 am |
It is good to see infrastructure degradation in this exercise, and important to discuss the impacts. The DHS “Guide for Critical Infrastructure/Key Resources” is a good document to initiate local planning.
The responsibility and control of gas and electric utilities is spread among a variety of organizations and jurisdictions, including local and state agencies, and private businesses such as energy suppliers and distributors. Consequently, the role of local government is more of coordination than direction.
Electricity is critical. Losing it impacts other systems and can result in:
1. communications loss/degradation
2. inoperative traffic signals leading to further transportation problems
3. loss/degradation of water treatment and distribution capability
4. loss/degradation of wastewater treatment capability
The utilities I’ve dealt with are concerned about public safety and interested in actively working with local officials to jointly work on local power allocation. You can develop a prioritized system which keeps critical facilities (hospitals, 9-1-1 centers, etc) powered.
In this scenario, the operations cell in our Emergency Operations Center is reviewing the inventory of generators and fuel. Evolving generator needs will likely exceed supply. The operations cell would develop recommendations to chief elected officials to allocate these scarce resources.
July 25, 2008 at 10:02 am |
Electricity is critical (again)
No electricity for an extended period, and maintaining the social order comes into question.
For us, the continued use of “Neighborhood Emergency Teams” (NET Teams) is critical, and helps drive the direction towards stability. Activated early on (WHO Stage 5) the NET teams are familiar to the neighborhoods. This link to local government is established. Should power (and communication) be lost in the community, current information still gets out, and needs are still brought to the attention of local authorities.
July 25, 2008 at 10:17 am |
Both trash disposal and sewage could evolve into health issues.
Practical solutions for families are in http://www.getpandemicready.org in the center section. The topic is “Waste,” in the hygiene section.
If a household does not have (or runs out of) plastic bags, perhaps public health could send instructions on proper/safe construction and use of outdoor pit latrines during this emergency condition. The big concern is ground water contamination – we don’t want to solve one problem and create another. This is where the NET Teams are again valuable. They would know which households needed to do this. Using guidance from public health, NET Teams could show residents eligible locations (100 feet away from a water source, for example) to construct a pit latrine.
July 25, 2008 at 11:25 am |
I have been reading this blog-ex every day for the past several weeks. And finally felt compelled to write. I am in a unique situation, I work in a hospital lab so am exposed to patients and body fluids everyday. I am also the single mother of a 4 year old with a congenital heart defect which makes him more susceptible to flu complications. I understand that my position is important and that if I am well and my coworkers are not, I should work to the best of my abilities. However, my family comes first and I am prepared to shelter at home for up to 10 weeks. And I am willing to do so.
I should work if I can, I know. But my closeness with the sick public combined with my son’s weakness simply won’t let me. I can’t justify putting him at risk.
July 25, 2008 at 11:33 am |
SDHDTraining,
Hi. Over lunch one thing came to mind – care for care givers. After a few days of being overwhelmed and with many more weeks to come is there anything in the plans to help “decompress” or care for those giving care.
After the 2005 electricution at the Boy Scout Jamboree, several pastors wrote about their coping stratagies. It was hard for many and hard for those giving aide and care.
One other thought – people are on ventilators – power goes out – generator does not kick in does not work, is out of fuel, battery is dead, engine is broke, the transfer switch failes or they do not have a generator to begin with. Lots of reasons to be in the dark.
My question is: Do you let people bring in portable generators from home?
If yes – where do you put them and run them.
If no – how do you tell the parents sorry. You have what we need but your child will not make it?
Regards,
Kobie
“Tact is making a point without making an enemy”
July 25, 2008 at 11:43 am |
Kobie: concerning the portable generators at home. I think our hospitals would allow someone providing a generator but it wouldn’t get them access to a ventilator or other resource outside of normal triage processes. Our health district has no authority with hospitals, so I can’t really speak for the hospitals. The rural nature of our area has many positive aspects to it, namely an agricultural culture where many homes have equipment that will be useful.
Someone previously mentioned communities having an inventory of skills of its residents. Some of the counties in our district have done just that. That’s another great aspect of rural communities. In a county of more than 5,000 people, an inventory like that would become very difficult to create, not to mention the nightmare of maintaining it.
July 25, 2008 at 2:33 pm |
SDHDTrainins,
Hi. Thank you for the info. I assumed PH would not have powers over private companies, hospitals included. Generators are an issue in a couple of disasters but a bigger issue during a pandemic power outage. The ventilators are so expensive and are for life support.
Yes I mentioned the skills inventory by city / town so cities know who to call on. The skills list would be another un-funded requirement. Maintaining it would be easier if people signed up themselves. More cities are setting up e-Gov email alerts and notifications that citizens sign up for. To this website a skill set list could be added. The benifit to the citizen is that they are more likely to be asked to do something they like or are qualified for than “unskilled labor” catagory.
BTW – here is a news article from today about “More than half of nursing homes lack plan for pandemic flu” Source: http://www.webwire.com/ViewPressRel.asp?aId=70930
Seeing the number of dead for today’s scenario which is capped at 2% I want to multiply the numbers by 30.
Kelly, hi and welcome. Your situation is unique but you are not alone. Your concerns have come up again and again. No one wants to take H5N1 home. Oddly those who get H5N1 and recover are the most likely to since they would not show any signs and may be more cavalier in their actions.
Also your feelings of being compelled to work are valid. You got into the health care industry to help people – right? That is what you like doing.
Please post your feelings and questions.
Regards,
Kobie
“According to my calculations the problem does not exsist” – some humor
July 25, 2008 at 3:56 pm |
Mel: Clicked on the web you listed-comes up no data.
Kobie: Gens, vents-reality show
Our community, Lava, several years ago went through and made a list of skills folks have, folks who would volunteer their wells for water, there is even a medical clinic(unfortunately none of the providers live in town-they live 35 miles away in Poky. There are however, 2 PA’s who live in the community but they work at ISU, we have multiple EMT’s and a few nurses,-medically I suspect we could be OK, though I feel my primary place to be is work at ISU in Student Health.
Pit latrines good idea but lime would be a nice addition-rural areas might find this easier to do than urban. Good camping etiquette could teach folks about distance from water etc.
Food spoilage is going to be another issue in freezers etc once power down. Gens fine until out of fuel. Gens adequate enough to run even the minimum of appliances expensive. Pumping water by hand from a well feasible but best if shallow and not 300 feet deep. Deep well hand pumps available but cost approximately $1200. Then one thinks wind power-great idea-initial outlay expensive-same for solar.
Just think though, everyone fills there vehicles-saves the fuel in them-ride horses, buggies and bikes-the greenies would love you. Families might even become more nuclear-get to know one another, society becomes simpler, bartering becomes more important than money-life harder but simpler. Guns might be important for food but unfortunately for protection against those who feel that taking others belongings is easier than doing it on their own. Then you will need town law-basic simple-like intended in the Constitution-speedy trial and swift judgment-no appeals. This could be dangerous. Oh, so many questions. There was a show on TV called Jericho-didn’t last long but was about what happened after a series of nuclear bombs went off in major cities and the chaos and corruption that took place afterwards and those trying to protect their own families and their towns. That started me thinking about possibilities even if not nuclear-just “all hazards” any disaster. This has been fun. Comments have been great-keeps the wheels churning looking for solutions.
Have a great weekend folks. Wouldn’t it be nice if in a real disaster we could take the weekends off-call a time out. HA!
July 26, 2008 at 3:24 pm |
forget the wells i power goes out…
get a well bucket.
check this doc of what happens when we lose power…
http://www.empcommission.org/docs/A2473-EMP_Commission-7MB.pdf
its over.
July 26, 2008 at 6:53 pm |
Mel,
Hi. Yes there is some pandemic prep traction with the “Go green” and “Live off the grid” folks. It becomes part of resiliancy. To take a licking and keep on ticking.
It also goes against what many see as a trend that “the government”, not the people, will come and save you.
How did your skill list go?
Because of criminal history, child abuse or sexual assault not everyone can work in all locations. This will limit who can work where – even during a pandemic. Background checks may be a problem when courts shut down and police are overwhelmed.
Goju,
Wow that report is fresh – April 2008. It read like Shakespear. It helps define what can happen. NY and California have experianced blackouts. The relays for HV transmission lines and oil filled switches are not the same as local switches. Black outs at this lelve take all hands to repair quickly. The fewer the people, the longer it will take.
Oddly I see training forlks for the medical field being easier than for High voltage or power distrubution. It is my *opinion*, just an opinion.
The diagram on page 12 is good.
This becomes a public health issue due to spoiled food, loss of power to medical facilities and people who rely on medical equipment.
Its is not all “Doom and Gloom’ but look for the weakness, recognize problems and have a workable plan ‘B’ and a workable plan ‘C’ for when the do fail.
Things fail from time to time. If it it could be real bad then prepare. Before hand you have a choice of either being safe with supplies or waiting for rescue and hoping for the best. Remeber, afterward you do not have a choice.
Regards,
Kobie
“Be Prepared” – Sir Baden Powell, founder of souting.
“Keep the grid up” – Goju
July 2, 2009 at 11:46 am |
great post(why i keep getting an error when i try to subscribe to your feed)?thanks