Personal Pandemic Preparedness

by eyeswideopen

Preliminary considerations:

  • There will most likely not be a targeted vaccine until about 6 months after pandemic has begun; any vaccine prepared ahead of the pandemic will likely confer only partial protection
  • There will most likely not be enough antivirals for treatment, let alone prophylactic use
  • Assume a quarter to a half of the public will become infected over a 3 month period (a flu wave, of which there usually are 3 — the worst being the 2nd — a few weeks or months apart) and 3/4 to a half staffing everywhere for various durations
  • Virus will be shed before symptoms appear (which can be 3 - 6, up to even 17 days) and after symptoms (21 days for children, 3–5 days for adults, longer for the immunocompromised)
  • Children and otherwise healthy young adults are disproportionately at risk
  • All bodily excreta will be very dangerous, especially feces and sputum/mucus; virus often multiplies in gut and diarrhea is often first symptom, preceding respiratory symptoms
  • We will probably need two or more times the hospital beds and ICU facilities
  • There will probably be mortality of at least an extra 50% beyond normal; a high percentage of these are likely to be under 65 years old, which comprise workers in essential services
  • Most patients should probably be treated in the home, or if more critical, in secondary ICU-like set ups in schools or other locations
  • Hospitals will need to continue their usual work and erect a firewall to protect vulnerable inmates from flu
  • Childcare and family nursing responsibilities will strain ability of healthcare workers and other essential infrastructure workers to provide services
  • Public services such as water, power, waste disposal, communications, and transportation will likely be intermittently interrupted
  • Deliveries of food and other essential commodities may be disrupted
  • There may be civil disorder due to shortages and desperation

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Personal Bird Flu Preparedness

  • Don’t panic.
  • Get into the habit of washing your hands 20 seconds hot water with soap or ethanol hand sanitizer; carry antiseptic wipes
  • Get into the habit of coughing/sneezing into the crook of your arm/sleeve or better yet, use tissue, not your hands; hands are a major means of spreading germs; virus lasts up to 48 hours on steel and plastic; 12 hours on cloth and paper.
  • Get a flu shot and if over 50 a pneumovax
  • Consider preparations to isolate yourself for about 3–6 months
  • Stock up on potable water and food with long shelf-life, water, medicines, basic household necessities (toilet paper, paper towels, plastic bags, tissues, plain bleach, soaps and detergents, batteries etc) masks, latex gloves, sugar, salt, multivitamins, and other staples
  • Accumulate vacation time
  • Make contingency arrangements with your workplace to be able to work from home if possible
  • Be prepared for essential services to be interrupted: see AlphaGeek’s 5 part series on emergency preparedness and the Red Cross’s Disaster planning booklets from the Pandemic Preparedness Guides page
  • Learn how to treat water to make it potable (or at least usable for washing) in case of interruptions of water supply link
  • If possible, start a vegetable garden and/or orchard
  • Learn basic cooking if necessary
  • Get a clothesline and clothespins or folding drying rack
  • Put together a basic set of handyman tools and learn how to use them
  • Have a mobile phone and an email address; get high-speed computer access
  • Get a passport or other photo ID and credit card if you don’t already have them; use electronic transactions preferentially
  • Save money; have cash on hand
  • Consider getting a good bicycle
  • Consider learning self-defense and acquire pepper spray and/or stun device
  • Ensure car(s) are in good working order, have good spare tires, maps, and keep car filled with fuel. Get a good fuel can for extra fuel
  • Remember that your car is a generator; all you need is a DC/AC inverter and cable (do not idle car in closed area where CO poisoning may occur)
  • Exercise regularly in order to strengthen your heart and lungs; taking care of your health now will benefit you later
  • If you smoke, stop now
  • Get a physical exam and get your medical history and records in order; include list of necessary medicines
  • Put medical and financial records onto a small flash data card (keep updated)
  • If you have high cholesterol, take statin drugs — they apparently reduce flu complications as a beneficial side effect
  • If you have gout, use probenecid, as it will double the half-life of Tamiflu in the body, thereby stretching supplies
  • Learn how to take blood pressure, pulse, temperature, respiration rate; learn basic first aid and nursing procedures
  • Stock your medicine cabinet: aspirin and other OTC pain relievers, codeine, phenergan, vallium, Tamiflu or Relenza (use Relenza only in those 7 years or older, without COPD or asthma) if possible
  • Obtain a stockpile of essential medicines; contact your doctor explaining why; watch expiration dates
  • Be sure you have a complete first aid kit
  • Prepare a living will and a regular will; arrange for organ donation (if you wish)
  • Network with your friends and family about plans with respect to pandemic
  • Think about how to isolate yourself and your family, minimizing contact with others, for 3 months
  • Learn as much as you can about bird flu
  • Consider how you can help during a pandemic (preferably if you are resistant to the virus through vaccination or survival); volunteer for training with local hospital, CERT or Red Cross
  • Expand alternate means of communication such as teleconferencing, cell phones, landlines, email, ham radio

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Should Birds in the US Become Infected:

  • Wash eggs to remove fecal traces and cook all poultry products thoroughly (use food thermometer — cook to 158 degrees F.) if you continue to consume them; eggs should not be runny; avoid raw egg products such as mayonnaise, some ice creams, etc.
  • Avoid contaminating other foods with raw poultry juices
  • Wash hands before and after handling food
  • Sanitize cutting boards, knife, and counter tops with hot soapy water or a bleach solution 1 tsp bleach to 1 qt water)
  • Avoid sick or dead birds, especially wild birds
  • If you keep birds, prevent any contact with wild birds or the excreta thereof; keep them under cover
  • Report suspicious instances of sick or dead birds
  • Keep pet cats away from dead birds; A(H5N1) can infect cats. Although A(H5N1) has not been seen in dogs, it would be wise to keep pet dogs away, too
  • Put enhanced hygiene measures into high gear

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Should a pandemic occur:

  • Put enhanced hygiene measures into highest gear
  • Avoid close contact and shaking hands, restrict visitors, avoid mass transit and gatherings of people. Infective radius around someone with flu is about 3 feet, so adjust your social distance
  • Avoid touching eyes, nose and mouth
  • Wear glasses instead of contact lenses so you minimize touching your eyes
  • Don’t share eating utensils, glasses, etc.
  • Avoid directly touching water taps and doorknobs
  • Wash or sanitize hands after touching anything that others may have touched
  • Disinfect surfaces (door knobs, keyboards, phones, money, taps etc.) with 1:50 bleach (1 cup bleach to 5 gallons water) or 70% alcohol solution: leave on surface for 2 minutes; surfaces contaminated with body fluids should sit 10–15 minutes in a 1:10 (1 cup bleach to 1 gallon water) bleach solution
  • Wear disposable surgical masks in public
  • Pull your kids out of school; home school (hopefully using internet resources to be made available)
  • Work from home if possible
  • Organize your neighborhood so you can share goods and take care of each other; survivors will be more resistant and thus able to run essential errands for others, if they have fully recovered
  • Learn how to identify bird flu symptoms and learn effective nursing specific to the disease (classes may be offered at your local hospital)
  • Designate a sick room area that is treated with an increased hygienic sensibility, make it easy to clean; perhaps use an antiviral air filter
  • Laundry should be done in hot water, with bleach to sterilize
  • If you can afford it, get an oxygen concentrator and needed tubes
  • Download a copy of Dr. Woodson’s Personal Preparedness Guide for Avian Flu
  • Keep your plumbing in good working order via preventive measures; should someone in your household become ill, feces are full of virus and thus are very dangerous; it may become very difficult to find a plumber (copper sulfate for tree roots in pipes, bleach gel for clearing pipes (never use bleach with ammonia), or use commercial treatments)
  • Keep yourself informed with updates
  • Handle incoming mail with caution
  • Sterilization of appropriate items can be done in a microwave (3 minutes on high)
  • Get a trash can with a foot-activated lid to use as a bag-lined biohazard waste bin for used masks, gloves, etc.
  • Utilize electronic and internet transactions preferentially; delivery systems should be less vulnerable due to limited interactions with people, although driver and fuel shortages could hinder
  • Consider removing facial hair to improve fit of filtering masks
  • Learn how to properly fit filtering masks to avoid leaks

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If you get sick:

  • Stay home if you become ill or if you feel you might have been exposed to the virus; see below, last entry
  • If you are concerned that you have been exposed and possibly infected, immediately contact healthcare professionals
  • If you get sick, immediately get Tamiflu or Relenza and take it — it must be taken within 36 hours of onset; do not take it as a preventative as it only protects for the duration you take it. You are vulnerable thereafter. Tamiflu: 2 x 75 mg caps for 7 days
  • If you get very sick, contact healthcare professionals or go to designated medical facility for A(H5N1)
  • Wear a mask as much as possible when others are around

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If you are nursing a sick patient:

  • Wear N95 mask (ensure proper fit), gown, hair covering and goggles
  • Wash up thoroughly after every contact
  • The most important thing is to keep patient hydrated to avoid dehydration; diarrhea, vomiting, and high fever make this all the more critical
  • You will need to make a fluid replacement fluid using clean water (1 qt.), sugar (3 Tbsp.), and salt (1/4 tsp.) (see Dr. Woodson’s guide for directions); you will have to force fluids, drop by drop if necessary
  • You will need Tamiflu or Relenza, hydrocodone, phenergan, and vallium as well as antipyretics such as aspirin, acetaminophen, ibuprofen
  • Give patient a bell or other means of signaling you
  • You may need an oxygen concentrator to deliver oxygen to the patient: there are services renting these but they will probably be in short supply
  • Lower a very high fever to about 101 degrees F, the optimum temperature to fight the virus; use antipyretics like acetaminophen or ibuprofen or (in adults) aspirin and a lukewarm moist compress
  • Patient may have diarrhea early on; feces contain virus; you may need a bed pan or bedside commode; be very cautious in emptying; sterilize with bleach solution
  • Consider rigging a make-shift curtain around the patient if possible
  • Be exceedingly careful in handling all materials in contact with the patient such as laundry and utensils; disinfect using bleach
  • Burn all used kleenexes used by flu patient; they are hazardous waste
  • Use trash bag-lined biohazard trash bin (foot activated lid)
  • All contacts of A(H5N1) victim should monitor their own temperature and symptoms; self-quarantine for 1 week and check daily for 14 days after last exposure for signs of fever, influenza-like symptoms, and gastrointestinal symptoms; possible postexposure chemoprophylaxis with 75 mg Tamiflu 1x day for 7–10 days, ask healthcare professional (it is doubtful there will be sufficient Tamiflu for this sort of usage except in very serious situations)
  • Isolate the patient from CDC and WHO “Infection Control for Viral Haemorrhagic Fevers”
  • Planning and setting up the isolation area from CDC and WHO “Infection Control for Viral Haemorrhagic Fevers”

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WHEN SERVICES FAIL:

Electricity:

  • all else flows from electricity: heat, food preparation, communications, lighting, computing, entertainment
  • DC to AC inverter to use car as generator (not in a closed space: CO poisoning) as long as there is gasoline; have a self-contained jumpstarter on hand in case you run down your car battery
  • 5 gallon (bright red) fuel can full, stabilized with Sta-Bil (a double dose keeps it fresh 2 years), stored carefully, protected, away from the house; date it
  • Consider a backup solar system with battery array

Lighting:

  • Battery-operated LED lanterns for ambient light
  • Solar battery charger (solar and LED gear: http://store.sundancesolar.com)
  • If you use candles or candle lantern, be careful as they are a fire hazard
  • Hand-crank or shake flashlights
  • LED lightbulbs (standard base) 2 or 4 watt, if you have limited backup electricity like solar/wind/batteries

Communications:

  • passive:
  • Radio: hand cranked or battery-powered, solar battery charger; XM satellite radio has a 24/7 emergency channel, consider getting a receiver
  • TV: small portable TV with multiple power options (assuming TV stations are up and running)

  • active: phones, internet, loud whistle
  • Roll of quarters, prepaid phone card for pay phones (locate them in your area)
  • Have at least one old-style low-power telephone (not cordless) that can function without electricity
  • Prepare and carry a laminated card with all important contact information
  • Obtain a cellphone if you don’t already have one; learn how to send/receive text messages on your cellphone; familiarize yourself with wireless data capabilities of phone
  • Manual cell phone charger like Sidewinder
  • For internet when there is no electricity: use battery-powered laptop; recharge via car/DC-AC inverter or portable solar panel

Entertainment:

  • Books, games, musical instruments
  • Battery-operated DVD and CD players

Natural gas:

  • Warmth:
  • Close off unused areas of house; seal off with plastic and duct tape; cover walls and floors with rugs and blankets;
  • Fireplace with reflector or wood stove; fleece clothing
  • Emergency heating: Coleman Catalytic Heater and lots of 1 lb propane canisters (3/day)

  • Cooking and hot water:
  • Barbecue with briquettes or coal (must be used with proper ventilation)
  • Jetboil or other camp stove such as Coleman, plus fuel cartridges
  • Solar cooker and solar water heater (Super solar shower, 4 gal capacity)
  • Grate for cooking on fireplace fire

Water:

  • Store about 50 gallons of potable water; consider obtaining a food grade 55 gallon water storage barrel, keep it fresh
  • Learn how to purify water (rolling boil for 10 minutes, use AquaPak solar sterilizer, filtration. chemical, etc) link
  • Obtain water purifier such as Exstream Orinoco or Exstream Mackenzie water bottle for small amounts; First Need Deluxe Portable water purifier/filter for groups (get spare cartridges)
  • Use swimming pool water for non-drinking uses such as washing
  • If water pressure drops, indicating failure, shut off master valve to avoid contamination to water in your system; then, water in hot water heater tanks can still be used

Food:

  • Dried and canned foods, rice and beans, food bars, trail mix, candy bars, etc
  • Staples such as sugar, flour, salt, pepper, spices, Parmalat or dried or canned milk
  • Plant fruit trees, vegetable garden
  • Food preservation: 5 day super-insulated coolers with wheels; unload the contents of your freezer into them as soon as power goes out; keep in cool place; consider getting a small car-sized 12 volt DC mini cooler if you have medicines requiring refrigeration

Transportation:

  • mobility may be restricted, mass transit could be hazardous, and fuel shortages are likely
  • Consider getting a bicycle
  • Safely store extra fuel (see above, under electricity)
  • Get car with highest MPG

Hygiene:

  • Laundry, dish washing, hand washing all need hot water (see above, under natural gas)
  • Human waste: porta-potty, bucket with lid, or use strong trash bags duct-taped into drained (shut off water to it and then flush until empty) toilet, seal completely and dispose of after use; there are digesting enzymes and deodorants for toilet bags; use bleach solution to sterilize
  • Trash: compost pile for non-meat organic waste; paper can be burned if trash and recycling pickups are interrupted
  • Baking soda and white vinegar can serve as cleaners and deodorizers for many purposes if you run out of detergents
  • Moist baby wipes (unscented), Purell waterless hand sanitizer (use one with ethanol), rubber gloves

The above “When Services Fail” section is a very brief outline largely based on pertinent aspects of AlphaGeek’s excellent and highly recommended 5 part guide on Disaster Preparedness (scroll down to links) or at Daily Kos

Page last modified on December 13, 2005, at 06:19 AM by cassandra