This is an Exercise. It Is Not Real.
If pandemic flu was rampant in southeast Asia for real, everyone in the U.S. would be going to the banks for cash and going to the grocery stores for groceries. Soon, cash and groceries would not be available. Therefore, waiting until you hear news about pandemic flu being declared somewhere in the world is not an effective plan. You must plan ahead of time so you don’t get caught in the rush of the masses who did not prepare. Of course, we would prefer that everyone is prepared ahead of time and that there is no “rush of the masses.”
The worst case scenario for pandemic flu planning says:
– 2% of the people who get sick will die from pandemic influenza.
– Absenteeism rates at work should be expected to be between 40% – 60% overall. This includes the people who are actually sick, the people taking care of the sick, and the people who are staying home because they don’t want to be exposed to sick people.
The Expected Symptoms of Pandemic Flu:
– From CDC: People infected with the current strand of the avian virus (H5N1) have shown everything from typical human influenza-like symptoms (fever, cough, sore throat, and muscle aches) to pneumonia, severe respiratory diseases, and other life-threatening complications. Symptoms of avian influenza may depend on which specific virus subtype and strain caused the infection.
Preparing for a Pandemic – Where to Start
It is predicted that the influenza pandemic illness attack rate will be 30-40%, which will disrupt services, overburden community resources, and severely impact the economy. According to the World Health Organization, “Given the high level of global traffic, the pandemic virus may spread rapidly, leaving little or no time to prepare,” therefore, the time to prepare is now.
Pandemic Flu Planning Checklist for Individuals and Families
At Home:
- Store water, food, and other essentials. Prepare to get by for at least a week on what you have at home. Remember to include your pets and livestock when storing supplies.
- Store medical and health supplies. Ask your healthcare provider for a prescription for an extra supply of your regular drugs. Keep health supplies and non prescription drugs on hand.
- Make household emergency plans.
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- Prepare for possible changes in healthcare. For example, medical advice and healthcare may be more difficult to obtain during a severe pandemic. There may not be enough medical supplies, healthcare providers, and hospital beds for all persons who are ill.
- Difficult decisions about who receives medical care and how much treatment can be administered will be necessary. Talk about these possibilities with your family and loved ones.
- In a severe pandemic, you may be advised to stay away from others and from public places as much as possible. Plan to limit the number of trips you take to run errands.
- Think about how you would care for people in your family who have disabilities if support services are not available.
- Decide who will take care of children if schools are closed.
At Work:
- Prepare to stay at home. Staying at home from work when you are sick is the most important thing you can do to protect others. You may also have to care for your children if your child’s school/daycare is closed or if you have to care for your loved ones that are sick.
- Know policies. Ask your employer or union about sick leave and policies about absences, time off, and telecommuting.
- Encourage planning. Every business, organization and agency should have a plan for making sure essential work can get done if large numbers of employees are absent over many months. You may be asked to perform duties that are not typically part of your job.
- Explore other ways to get your work done. Find ways to reduce personal contact, such as increased use of emails or phone conferences. Plan to work from home whenever possible.
- Employers should consider stockpiling medications. See http://hstoday.us/content/view/4053/149/ for more information.
In Your Community:
- Know your neighbors. Talk with family, friends, and neighbors to make sure everyone is prepared. Be ready to help neighbors who are elderly or have special needs if services they depend on are not available.
- Know school policies. Know policies about illness and being absent. Be prepared for school closures.
- Volunteer with community groups. Assist with planning for emergency response to disasters and pandemic influenza.
For additional information go to www.ready.gov or www.pandemicflu.gov.
SDHD PanFlu BlogEx 
Good points.
“2% who get sick will die? ”
According to the WHO of the 385 confirmed cases, 243 have been fatal or 68% death rate. Source: http://www.who.int/csr/disease/avian_influenza/country/cases_table_2008_06_19/en/index.html
Do notice from the chart the wide variation outcome. Though 2% may be ooptomistic on a large scale like the US, it is still the goal and theoreticaly possible.
2% is not a ceiling – just as high as resonable experiance guides us. Much like CAT-4 hurricane was king untill we had a CAT-5 hurricane.
When planing to stay at home with kids – plan to have activites and school work to keep them busy. Phones, TV, internet may be distrupted by planned rolling blackouts.
BTW at a Fred Friendly meeting the VP of CitiBank said “We had COOP for CIO, CFO and managers but no COOP for tellers, security guards and people to replenish ATM machines.” It was an eye opener for him.
One thing I did not see was MOA and mutual assistance. Power companies, fire fighters, etc often send their folks to other places. During the pandemic that may not be possible. However business can form agreements of support.
Note: the many concert halls, movie theaters, resteraunts, schools, etc that will close during a pandemic provide a ready sorce of free hands and able bodies. Use them wisely. Some community centers are planning to renovate during a pandemic if they are able.
Kobie
Kobie: we’re using the 2% death rate for the scenario because it’s the primary planning number from CDC. We have to start somewhere that is reasonable. And your point that it is not a ceiling is a very important note!
What is a Fred Friendly meeting? Is that where anyone can meet with the CEO? In any case, it’s important that businesses realize that every function in their businesses, whether in-house or outsourced, needs to be addressed in COOP in terms of staffing, supplies, and maintenance.
In our health district, we have discussed the ability to have workers from closed businesses or agencies work for the critical infrastructure and key resources. For example, if schools are closed, the teachers and staff could work somewhere else in a similar or quickly trainable job.
The expected 2% Case Fatality Rate (CFR) is an important indicator of future impacts and present actions to mitigate these. This CFR would drive full activation of the Emergency Operations Center. We expect the non-medical impacts of a 2% CFR to be as critical as the medical/health impacts (examples in Homeland Security’s “National Strategy for Pandemic Influenza”, May 2006).
An important change from ‘traditional’ natural disasters, is that public health is in the “operations cell” (along with fire, EMS, law enforcement and public works) for a pandemic, vs. the “support cell.” This recognizes their operational role, puts them with the right partners, and provides immediate access to the “executive cell” (chief elected officials, attorneys, PIO). Perhaps most important, this structure is the organizational vehicle to facilitate considering medical and non-medical aspects of pandemic flu together.
The benefit of advance local government employee personal preparation becomes evident. They (or their families) are not in the lines at stores. They are better able to concentrate on their public service function.
Finally, the benefit of previous exercises (and this one) becomes evident.
My first response and question is: what do I really need to make it 1 week without leaving the house? I know there are lists out there, but most of them are quite long and purchasing all of the supplies is expensive. So, what are the priorities? How much water do I need per person? If I buy it now, can I just store it until I need it or do I need to replace it after a certain amount of time? What are the best foods to keep for a long time? I’m assuming canned foods and things like rice and beans, but I’m not sure. Also, does it really make sense to have enough supplies for only a week? Won’t the outbreak last longer than that and I should really be able to make it 3 or 4 weeks?
Tera,
There are some very good emergency preparedness sites with lists of exactly what you are asking for. Also, http://www.lds.org/providentliving has lists and resources for food storage and emergency preparedness.
Tera Letzring,
Hi. One week can be easy. Those in training have found:
1) Buying in bulk helps reduce food bill and gas usage.
2) It takes a lot of room.
3) Rotating stock and writing the exp date is important.
4) Many packages do not have an expiration date but a MFG code.
5) Friends, family and neighbors look at the pantry funny. Toilet paper takes up a lot of room and kinda stands out.
6) Powdered milk and powdered eggs are not easy to find.
7) MREs and some dehydrated food is expensive.
8) It is convenient – people stop over and you just happen to have extra!
Your point about 3-4 weeks is well taken. There will also be two (2) or more waves. yes it could last longer than 4 weeks as school closures could be up to 12 weeks or ninety (90) days or three (3) months. Source – warning it is very detailed from March 2008 :http://www.cdc.gov/eid/content/14/3/pdfs/07-0673.pdf
Easier to read 2006 Pandemic Planning for Educatiors saying 3 months
Click to access planning-guide.pdf
Some are going three (3) week, some for several months. There are some ethical questions about “I have food but my friends and neighbors do not – what do I do? Do I feed them?” This harks back to the 1950’s “If I have a bomb shelter do I let my neighbors in?”
Here mutual support in small groups may help. One woman from the UK has pushed the famalies of three. This is for support, baby sitting and rounding out skill sets while following social distancing rules. Yes they should be neighbors. Yes since most people do not talk of pandemics nor preparation it may be hard. Yes it can be done – people do come around.
Good luck.
Kobie
“I am not a great man but have such vision for I stand on the shoulders of giants” – T. A. Edison, inventor.
ShdTraining
Hi. I agree 2% is a starting point, is resonable and does not sound like hysteria nor “the sky is falling”
It was Joseph Petro, Executive Vice President and Managing Director of CitiGroup who made the comments. Very honest.
Also Rajeev Venkayya was there before he leaft the Bush Administration. Interesting comments. I think Mr Venkayya is working for the Gates foundation now. Source:http://healthyamericans.org/newsroom/releases/release061207.pdf
Class room guide to Fred Freindly is here.
Click to access program1.pdf
FLA-MEDIC, another flu blogger, has a good write up at
http://afludiary.blogspot.com/2007/06/pandemic-seminar-video.html
Yes it is a 2hr show, but it goes by so fast.
In closing I’m glad teachers can find a place to work. Many will have much to learn. Also, pay for those forced out of work by H5N1 is still an issue.
Regards,
Kobie
“We have a long way to go and short time to get there and do what they say can’t be done.” – country song
ShdTraining
Hi. I agree 2% is a starting point, is reasonable and does not sound like hysteria nor “the sky is falling”
It was Joseph Petro, Executive Vice President and Managing Director of CitiGroup who made the comments. Very honest.
Also Rajeev Venkayya was there before he left the Bush Administration. Interesting comments. I think Mr Venkayya is working for the Gates foundation now. Source:http://healthyamericans.org/newsroom/releases/release061207.pdf
Class room guide to Fred Friendly is here.
Click to access program1.pdf
FLA-MEDIC, another flu blogger, has a good write up at
http://afludiary.blogspot.com/2007/06/pandemic-seminar-video.html
Yes it is a 2hr show, but it goes by so fast.
In closing I’m glad teachers can find a place to work. Many will have much to learn. Also, pay for those forced out of work by H5N1 is still an issue.
Regards,
Kobie
“We have a long way to go and short time to get there and do what they say can’t be done.” – country song
Hello Tera,
An example of a two-week food supply is on the http://www.getpandemicready.org website. On the left colum of the homepage, click “downloads.” Then select “#5. Small Spaces, Small Budgets.” The author lists (about page 8, I think) supplies for a family of four for two weeks. Of course this would be modified for your dietary preferences. This all fits in two tote boxes. Last November it cost about $130.00, but has no doubt gone up since.
Also nice – it includes recipes for using those supplies.
Emergency Operations Center: initial status briefing
1. Public health presents. Health/medical aspects, including:
a. (information in scenario thus far)
b. projected impact on local population and healthcare facilities
2. Emergency management presents. Projected non-medical impacts/limiting factors, including:
a. electrical supply: uncertain. Power plant workers are vulnerable to infection like everyone else. Fortunately, most of the power here is hydro-generated, so fuel delivery concerns are minimal. It is not known how much of this power will be sent to other parts of the grid, where power generation is more uncertain.
b. transportation/supply chain: uncertain. The supply chain is vulnerable. It depends on petroleum, electricity, natural gas, several types of transportation (needing healthy drivers and healthy refinery workers), materials, and people keep things going. This complex process requires a near-perfect infrastructure. A further limiting factor is the the “just-in-time” business model adopted universally over the last decades. Supplies are not kept on-site, but rather ordered “just-in-time” from regional warehouses. If transportation degrades, we can expect shortages to cascade down through every system that we use everyday. Especially critical would be shortages of food and medications.
3. Public Works presents. Water supply and wastewater treatment. For water, the limiting factor for the surface water components of the system will eventually be chlorine availability. Local industry uses large amounts of chlorine. Activation of MOUs would be considered as a contingency. Wastewater treatment will eventually be limited by chlorine availability.
4. Fire/EMS presents. As outlined in the Pandemic COOP plan, several options are available to maintain essential services. These include:
a. Staffing the 9-1-1 dispatch center with a paramedic to provide a higher level of screening for emergency responses, and information on home treatment of flu.
b. Cancelling non-emergency ambulance transfers out of the area
c. Activate full staffing of reserve firefighters
d. Cancelling routine fire inspections
5. Law enforcement presents. As outlined in the Pandemic COOP plan, several options are available to maintain essential services. These include:
a. Prioritizing response
b. Transfering some records functions to non-patrol staff
c. Activating reserves
A weeks worth of supplies to SIP (shelter in place) shouldn’t even be considered as a starting point. Most people could survive – after a fashion – on what they have in the house for a week, but after that a large and very hungry population would be forced to leave their homes – and risk infection – to seek food. The problem is that a high CFR will undoubtedly disrupt or even stop shipments of essential supplies (such as food, meds, fuel, etc) and will not go away in a week. Do you want to be one of the millions going from empty store to empty store trying to find something to take home to your starving family? What if you unwittingly take the virus back with you? Get up to speed on “prepping” and begin to stock foods that will keep long term (ie canned and properly stored dry foods, such as rice, beans, etc), and evaluate your situation with regards to heat, light and water if you couldn’t rely on those being provided for you. Could you cook with no power? It sounds alarmist, but a major pandemic would knock us back to a lifestyle akin to the early 1800’s for a lot longer than a week. “It’ll never happen”, you say? It did in 1918. Spanish flu took 18 months to circle the globe three times and wiped out 80-100 million, most of them during the second wave. A similar pandemic event could potentially kill well over 300 million in a world with a population of 6.6 billion. Use the time you have wisely and prepare. And if the experts are wrong and it doesn’t happen any time soon, you’ve bought food that you can use in the future at today’s prices and saved a lot of money. Best insurance policy I can think of.
Consider backpack stoves as a way to cook your food – they are lightweight, don’t take up much room, and you can buy Coleman fuel to keep on hand. The right stoves work great and are very efficient.
Emergency Operations Center – recommendations to Chief elected officials
The following are likely recommendations to the Chief Elected Officials from the “Operations Cell” of the EOC:
1. Issue a water restriction order (sacrificing lawns to reduce the amount of chlorine used)
2. Activate MOUs with wholesale fuel distributors (reserves for emergency response vehicles)
3. Activate “Neighborhood Emergency Teams” (NET Teams) – more on this tomorrow.
4. Schedule media conference. Joint Information Center is formed. Leading the media conference will be Commissioners/Mayor, followed by Public Health, followed by Public Works.
By reading the blog site I find it comforting to know that so many in our area are pandemic knowledgable. I am only beginning to learn about something that I’ve never given much thought to before.
Just 24 hrs. ago I didn’t know what a pandemic was. In the last 24 hrs. I’ve learned a great deal. I’ve studied http://www.getpandemicready.org and pandemicflu.gov, begun purchasing some food and medicine supplies and my husband said he would take care of our water needs.
I went to Mallory House, an assisted living center in I.F., and was happy to learn that they have an Emergency Guide Book. Michelle M.A. and Lonny the new administrator took time to answer all my questions. They have a plan for their water and food supplies, medications, emergency power supply, evacution plan, activities to calm residents and much more. I’m relieved to know my mother will be cared for in the event of an emergency.
I’ll keep learning.
Congratulations Deborah F. and best wishes to you and your family as you continue preparing. From my experience, each preparing ACTION you take (however small) is important, and helps build confidence that yes, we can deal with this threat, just as our ancestors did in earlier pandemics.
Very good news about Mallory house also. It sounds like the staff is caring and professional.
EdM – excellent recommendation. I have several single and double burner Coleman dual fuel stoves for emergencies. While the Coleman fuel is great, it’s expensive. Even at todays prices, regular unleaded gas is much cheaper and the stoves are designed to run on either. The same applies to dual fuel lanterns, which make great emergency lights. You can pick both up at garage sales and online much cheaper than new. Stock up now (and don’t forget mantles).
A few notes from the exercise moderator:
1. We learned what Fred Friendly is. Thanks.
2. Deborah F.: One of our goals is to educate private citizens. The fact that you’ve taken action with that information is even better. Please pass the word. And thank you for participating.
3. Concerning Backpacking stoves gas: Have you done any tests to determine which gas has more time or meals per dollar to compare operating costs versus initial investment?
4. I haven’t watched the FLA-MEDIC video but will put it on the to-do list after the exercise.
5. Mel Johnson: great county EOC briefing templates. Can we pass to our county EOCs?
6. Jacksdad: your philosophy of a food supply as a hedge against flu, disasters, and inflation as insurance. is a great selling point.
Thanks to all for participating and adding some great discussion!
Darin
The LDS distribution folks have a neat long term storage starter kit. It should last approximately 30 years…. I really like that because I don’t have to worry about rotating that much.
also, preparedness.com has some good ideas for water, including putting gallons of water in the freezer to prolong shelf life, and help keep frozen items frozen during and emergency (if your freezer is large enough)
I’ve done lots of research but haven’t starting stocking up yet!
(Oh, and another really nifty idea – solar cooking. Solar ovens are more common in Kenya, they can cook on cloudy days, in freezing weather, etc. I’m thinking of purchasing one of those – some people use them when camping here in the states. Its a real neat idea. The documentary channel had a show about them last week.)
Chris W,
Great post – solar ovens. Tin foil ovens are good as well.
Please, these things come in handy *before* any possible pandemic. Tornados, hurricanes, power outages, job loss, etc. They are just good skills one needs in a pinch.
There is a ROI (return on investment). Look at what is in our cars: spare tire, cell phone, a snack or water, etc. Some even cary road flairs, first aide kit and jumper cables. These things do not get used all the time but they pay back either with peace of mind or in not having to call for help.
Jacksdad – good points as dual fuel may give one more options. Practice, be safe, train the family and have mantels and spare glass covers. Some are looking at corn oil stoves. They are being developed in developing countries that don not have petrol or gas.
Deborah F.
Hi. We are not alone. Personally for me leaving papers out at church, work and the library is non confrontational way. My boss “did not want me to create a hostile work environment.” Yes there are alot of people in denial. I can not change that. But now, they can not come back to me and say “Why didn’t you tell me.” We did our part. “You can lead a horse to water but you can not make him drink.”
For the municipal folks – prepared citizens put less of a strain on city services than un-prepared ones. Encourage preparation, in my opinion.
Regards,
Kobie
“Remember: the Stone Age didn’t end because the cavemen ran out of stone” British stock broker.
For Darin…please feel free to use/modify anything I’ve posted. I will try to get the City Pandemic COOP plan on the server tomorrow, if anyone could use an example template.
A view from the top – preparing for and responding to a severe pandemic
Our jurisdiction’s philosophy: During a flu pandemic, people will need a combination of personal/family preparedness, community sustainability, and effective government. Shamelessly extracting from “The Need to Prepare” in http://www.getpandemicready.org :
“Effective governments lead the way. Local and State governments must lead the way by informing the public of the threat, educating citizens about the possibilities, and encouraging them to prepare in their own way. Governments prepare citizens and institutions for the early use of community mitigation measures to reduce spread of disease when medicines and vaccines are unavailable. They maintain civil order, ensure essential services are operating, and that drugs and vaccines, when available, are distributed fairly.
Governments will NOT have the means to stockpile food and supplies for their populations, however, and it has been made clear that they will not be doing this.
Communities need to be resilient. Communities and businesses within them must be prepared to function in an environment of uncertain supplies, staffing and utilities. Essential workers need to be able to come to work in environments where chance of infection is minimized and necessary provisions have been stockpiled.
Individuals and families must be prepared. Having food, water, medicines and personal protective supplies is an excellent way to prepare for the potential disruption of a pandemic. Also important is mental preparation and resourcefulness. Every single family that has prepared on its own will reduce the demand on strained and insufficient community resources.”
These are keystones of a “culture of preparedness” described in the National Strategy for Homeland Security, Oct. 2007. Success or failure rests on local implementation.
Hence the importance of a comment from Laqueta a few days ago … “Neighborhood groups – a must to get involved early for accounting vulnerable persons, early organization of community leadership for community block containment.”
In a severe pandemic, as the critical infrastructure degrades, we anticipate that neighborhood groups will form. Local governments can assist in this process, and help maximize public health and safety.
Implementation.
In this exercise, we are at WHO level 5. Flu coverage is all over the news media, and people are becoming aware and concerned. How can local government help build resilient neighborhoods, even in advance of pandemic onset?
Our approach is “Neighborhood Emergency Teams” (NET Teams). These are two-person teams who visit residents in a pre-designated area to address basic needs. For our teams, we pair a city/county employee with a volunteer. Example volunteer sources are Community Emergency Response Teams (CERT) and Medical Reserve Corps (MRC).
A WHO level 5 alert would be a good time to use the NET teams to bring health information to each house, and encourage at least minimal preparations, even if only a supply of water from the tap.
After severe pandemic onset, the use of NET teams is increasingly important. Initially, they can help neighborhoods organize themselves to become more resilient. As the infrastructure degrades, the NET teams are increasingly the vital link between the citizens and local government that is trying to address their health and safety needs.
OK…down to business. NET teams represent local government. When they visit/call houses, they use the “NET Guidebook.” This was written by Nez Perce County Emergency Management, and North Central District Health, with contributions from very pandemic flu-knowledgeable citizens.
The guidebook is at:
http://www.co.nezperce.id.us/emergencymanagement/Commissioners/EmergencyManagement/tabid/564/Default.aspx (click on ‘NET Guidebook’)
Also at this address is the “Stay at Home Toolkit for Influenza,” adapted from Montgomery County, MD by our health district. For this exercise, this ‘toolkit’ would be an ideal handout for NET teams to leave with each house. (click on ‘Flu Toolkit’)
The NET Guidebook is a FREE document, with the only restriction in the copyright being that it cannot be used for commercial ventures – as in selling it to jurisdictions/organizations. A MS Word 2007 version is available if you desire to modify for your organization (content, logos, contact numbers, etc). For the MS Word 2007 version, please email melvinjohnson@co.nezperce.id.us