How would you advise a pandemic planner?

Involve the business, charity and church communities in helping to get the word out. The more the public is inundated with information the less they can ignore it. If people see how concerned and involved big business is they may start to pay attention.

How to advise planners for business? I get this one a lot. Use the military thought on all things that didnt work out from the get go..Assume the worst, make contingencies for that and hope for the best. Sometimes no matter what you do, it wont be enough and acceptance that defeat of the plan and loss of troops is inevitable. Do what you cant to limit that with whatever resources you have. Its many times not about money, its about individual survival and that each person has to be responsible for themselves. Like our government, it cannot survive a nationwide Katrina if everyone pulls from different directions all at the same time. Ensure you have the basic supplies and assume that it WILL last for four months. If it only lasts for two and you have enough for four you will see it waning, give up your supplies to those who dont have them. Each person fits a role in our society and if there are no plumbers, you dont have water. If a single electrical worker dies, it impinges on the ability to produce power. That worker may or may not have prepared, but he has to keep the power on. If he is sick or is trying to feed his family he will not show up.

Get the churches, synagogues, fire houses, to start stocking up. It will cost about 800 dollars to feed a family of four for four months. If even one church with 1000 members committed 5 dollars each brought in canned food each Sunday and utilized a list system, two totally unprepared families would be saved a weekend. We have a lot of weekends between now and pandemic. Overstock on everything and as I tell my wife when she is heading to Costco and Sams.... Buy another case of something.

Businesses MUST return to service just as soon as the all clear happens. There was a short recession after 1918 flu and then the roaring 20's hit. Businesses closed and stayed closed for way too long out of fear. We will run thru the existing resources much more quickly as we are now a JIT (Just in Time) truck society pretty much all over the planet. If you see it starting to come, order what you know you will need to restart and then a months supply. Some businesses will eat it initially and then they will use their supplies and be waiting for new materials. Its this lag that will cause you major problems.

Cross train your workers. Fred Smit at Fedex used to say, "Let the decision be made at the lowest level possible" Drop requirements of 3 and 5 signatures in bigger businesses to get a check authorized for more than "X" number of dollars. Two Managers is enough. Get those people that never answer a phone to answer it. Set up social distancing and keep sanitizing spray available at every work station and keep those keyboards and phones sprayed off. Make everyone's work station off limits to others.

Have the building maintenance people set the air for complete circulation. Dont recycle air, pay the cost of having the air reheated or cooled so it just comes into the building and goes right out again.

There are so many simple things. Keep thinking on how not to allow the bug into yours or others presence or contact.

If you are prepped...but your neighbour and community are not...you are not prepped.

http://www.traveldailynews.com/new.asp?newid=32795&subcategory_id=96
Please read the above article, entitled Pandemic Risk Increases as Anti-viral Drugs for Avian Flu Loose Effectiveness
The article says: "Over dependence on (Anti-virals) can create a false sense of security."
"We know from surveillance studies and from hospital clinical studies that resistnce to the two primary anti-viral drugs, the Tamiflu and Amantadine drugs, have already occurred. The H5N1 strain of the virus does not sleep and always constitutes a danger."
And there is the issue of systemic influenza as opposed to respiratory influenza. UK doctors said some of the bird flu patients had diarrhea. Influenza can attack much more than the lungs. How effective will anti-virals be against systemic influenza of the H5N1 type? It is my understanding, and please correct me if I am wrong, that Tamiflu and Relenza are not very effective against systemic influenza. There are reported cases in Indonesia where the virus attacked the central nervous system first, and the patients showed no respiratory symptoms of influenza, and these patients had diarrhea. How will doctors be able to identify patients with systemic influenza during a pandemic when their time will be limited, and laboratories will probably reach gridlock, as they receive more samples than they can analyze? Will a laboratory during a pandemic still be open, especially if some of the staff is sick with H5N1? Will this produce a bottleneck in the hospital system, stopping all clinical analysis of bird flu patients, and causing the hospital systems to implode? During a pandemic how long will it take to get the lab results back on suspected systemic influenza patients? Will there still be any laboratories functioning if hospital laboratory supplies fail to reach the hospitals as the transportation system collapses. Will gas stations still have gasoline?
Even now it is more difficult for doctors to diagnose systemic influenza. So what happens to systemic influenza patients during a pandemic? By the way, the patients whose central nervous systems were attacked by H5N1 died rapidly.
H1N1, Spanish Flu attacked more than the lungs. It caused the internal organs to shut down. Many who survived were diabled for life due to heart damage, liver damage, etc. Will anti-virals stop a cytokine storm? I think not.
Some H1N1 patients commited suicide. Do we have enough psychiatrists to treat those with brain damage and psychosis resulting from H5N1 infection. Yes, some H1N1 patients went stark raving mad, and never recovered. Many H1N1 patients suffered severe depression, and some of these committed suicide.
I do not believe the anti-virals were designed to protect the entire body. They were designed to protect the lungs.
Anti-virals have never been used against a full scale pandemic. The conclusion they will protect us against a pandemic will not be proven until they are used massively, and given to millions simultaneously. Then doctors will have the clinical data to determine their effectiveness.
What happens if anti-virals completly fail to protect H5N1 patients? What do doctors do then? What about the masking effect, meaning people taking Tamiflu with H5N1 infection that is difficult to detect in standard tests?

On medicating Bird Flu:

I would like to see health insurers, pharmaceutical suppliers, pharmacists, and MD associations to work together to have simple to follow, widely available, medication packages to dispense. Insurers provide the financial blessing, MDs standardize prescriptions, suppliers manufacture in volume, and pharmacies, confident of being paid, purchase large quantities. As you say, Revere, it just takes planning.
...And I'm not talking about Tamiflu, necessarily, but meds to moderate inflammation in the airways, pain relievers, and so on, as well as well written booklets that describe good palliative care at home.

Once the anti-virals fail, and people are dying in mass, as they did in 1918, I recommend using the treatment offered by doctors in 1918. First, open all the windows in your house, even in winter, to get plenty of fresh air. Then take laxatives to clean the bug out of your system. And shoot all the stray dogs, like they did in Arizona.
If that does not work, carry a lucky charm or a rabbit's food with you at all times.
And for the nation of Iran I have special advice. Your citizens will have a special problem starting about October 27, 2006. Not only will you have to deal with bird flu, but also with radiation sickness. Are anti-virals effective against H5N1 in bird flu patients that also have radiation sickness?
The US Navy is sending a massive armada, including nuclear powered aircraft carriers, to the coast of Iran.
This armada will arrive about October 27. See The Nation magazine for the deatails.
It is possible Dick Cheney may have had something to do with this, since he is our vice president, and he is very smart. He is also a good shot with a rifle.
The B60-111 tactical nuclear bomb, about 30 of them, will be the cause of the radiation sickness.

Get non-hysterical, but truthful, emphatic information to social service organizations, fire, police, businesses, religious organizations, schools. Maybe it won't be H5N1, but we will be hit with something at some point. And, repeat, repeat, repeat.
"Bird Flu? Isn't that just a scare tactic? I don't believe in that stuff." I have tried, but people get tired of hearing from me--someone authoritative (perhaps skipping the executive branch....) needs to quietly, firmly scare people into action and preparation. I sure would like to know that "we" have been thinking, planning and stocking up. It may not be needed today, but tomorrow is still out there.

willliam: What exactly is the point of your posts? Most people here know about drug resistance and its dangers. I am not averse to political commentary, but yours is pretty much the same thing no matter what the topic. Please keep your posts on topic, as disciplined as you can make them and constructive, not just rants. An occasional rant is OK, but continual ranting is extremely tiresome and you are losing your audience and worse, clogging up the thread. You don't seem to hear what people are saying to you. You are not listening. And we are not llistening to you as a result.

"Involve the public - be honest and open"

Could have publicized the WHO's
"Ten things you need to know about pandemic influenza",
a year ago, since
they thought "you" needed to know it a year ago...

Better late than never;
tell the public there is no top-down, business-as-usual emergency response to a deadly pandemic year,

get communities and households brainstormming.
Don't worry about the short-term economic effects; a depopulating event that blindsides the public worldwide will not be good for anybody, either, longer-term.

Don't call "adjustment reactions" "panic".

It's not the "panic" now; you have no idea what panic in an H5N1 pandemic might look like, say, next month,
it's the Outrage during and afterwards
the TPTB should fear, because they are being disingenuous, at best, with other peoples' lives.

(and what about XDR TB?? why can't we be proactive, instead of reactive? Humans; what a species.)

"A medical conference in the UK last week was told that the Government's faith in antivirals as the key to combatting a pandemic is misplaced."

Just because everyone has finally realized Tamiflu is dodgy all the antivirals are suspect? So some wanker commitee comes up with a list of "Ten Tips on Pandemic Flu Planning" I'm sorry but the warm and fuzzy feeling everyone got at the medical conference from the list isn't going to equate to even one life saved.

What about Sankyo's LANI? I'd be fast(er) tracking developement and stockpiling.

If you haven't heard of LANI then you've no reason to be commenting, unless it's to add your bleating to the pseudo-informed drivel coming from the rest of the sheep.

And I'd be lining up the GSK management for an ass kicking( to death) for dropping the developement of IV Relenza for a decade.

Just because Roche bought the WHO with free Tamiflu we haven't seen other neuraminidase antivirals tested in the field. What a joke.

Focus planning from the bottom up. Community planning is key. Help turn ordinary citizens into stakeholders by giving them a say in the planning. This will instill good faith efforts and credibility at the local level.

Plan an attack. This may not be very in line with the usual aims of this site but you have a system business, healthcare or whatever. Put your self in the place of someone trying to disrupt your system, where are you most vulnerable? Military strategists look for the little common everyday things with the biggest knock on effects - fuel supply lines, ball bearing plant, Gaza power plant etc. In your system what would cause havoc if it stopped working and how are you going to mitigate its effects? No one keeps adequate spare parts anymore, why bother when DHL will have one next day, its the gaskets and O rings of this world that that are going to catch us out.

I would put us Miso at a good five years behind the curve on this one. We are going to take casualties because its hard to study something that changes its face every week. I agree about Tamiflu. Something strange is happening with that stuff and while it might have been the fire blanket before its looking pretty weak right now.

How to survive this? The only true thing that I have seen so far is from the military manuals on this kind of stuff. It IS a bioweapon from nature, not man and its got to be treated like it is. The costs are staggering just to make someone comfortable, much less cure them. I think Revere would agree that cure isnt in the future for quite some time nor is a fully prophylactic vaccine.

My business is now loaded with full bio-warfare equipment so my people can work. We are training every other week in it and the God forsaken full face plate masks. This includes the washdowns with phenolic, and or bleach. Full shower decontaminations. It takes an hour to suit up, you can work for four or five and then you spend two getting out of the thing. How do I get them to do it? My offer is simple. Either learn how to use it or dont plan to work. If you work there will be one large box of money waiting on you if you do. I am told that outside of the military and 360 degrees and 600 miles I am the only one that is prepared. Buy the equipment for your people. Aclimate them to it once a week and then hope that it doesnt come. Need training? Call your local NG or ANG base and ask for the Chemical/Bioweapons NCO. He cant talk about it other than to say he would have to call you off the govts. clock but once at home he could set you up a program.

All sorts of things you can do. Every one of them that you do complete puts H5N1 or its cousins farther and farther away from you. A different kind of social distancing.

William, I dont launch personal attacks against anyone on Revere's blog but man, you need to lay off the caffeine for a while. Step back and read what you are writing old son. Its getting ragged and sounds like someone heading to Columbine High. I get a lot of crap about wipe 'em off the face of the planet myself but be advised that carrier battle group has been scheduled for deployment for three months. Dont worry about the B-60's either, those are bunker busters and designed to have limited radiation poofs.

Besides all of the carrier groups and cruisers already on station carry nukes. Enough to do all of the Middle East and have enough left over for a few other bad actors out there. Several carry the neutron weapon and if they were going to do them, thats what they will use. Its just too damned close to the border with Russia and the air flow patterns will take radiation to China and S. Russia. Thats a BIG BITCHIN' STEP you are talking about and they wont use nukes until they are sure they can get in there or cant as the case may be. That one I dont have intel on.

There are 700 Hawk anti-aircraft batteries that were upgraded by the French and they can now detect stealth bombers to a limited degree if they do it right. But seriously, no nukes man. Take a break and sit back and watch for a while.

Revere is a patient man but he has his limits.

"The media loves disasters - can be good as well as bad

True. But not very useful."

I disagree, Revere. Planners need to be very aware that media hysteria in a disaster like this takes on a life of its own -- it can drown out the planners' own message, undo much of their careful planning and whip up the public in ways that are unhelpful to all. But officials can also capitalize on that intense interest and use it to great adavantage if they truly understand what to expect and plan for it.

Managing the media will be like running a stampeding herd--scary but doable and very important to get it right.

The social upheaval scenarios are sort of related. I don't see this as inevitable, like some do, but if we continue sending the current message to the public that Tamiflu is our only hope & magic bullet, the inevitable need to ration it will certainly encourage that kind of disorder at some point.

Getting back to topic - Advice to business planners. (I are one.) Many businesses that are taking the pandemic issue seriously are engaging in workplace prep, meaning sanitation measures, social distancing, sometimes remote locations (or work from home), etc. All good, all needed. Strategic business planning for pandemic involves close examination of your supply chains ? and preplanning alternatives; forethought and understanding about rapid changes in consumer /customer demands over a protracted timeline; a willingness and ability to change your business rapidly in response to changing external conditions; and development of a post-pandemic plan.

Counting on ingenuity to deal with the complexity we will likely face is far more effective with advance strategic thought and preparation. A restaurant chain might realize that the dining business will be minimal during a pandemic period. To keep the business alive they might shift to catering to local first-responder organizations. Good plan, but if they didn?t preplan it ? get the catering equipment needed, train staff and provide for their safety ? before the pandemic begins, that ingenious thought will die on the vine, useless. But with forethought and preparation, they will aid their communities during a pandemic, and survive to rebuild their business base post-pandemic.

In anything more than a mild (1968-type) pandemic, those businesses that will not plan for rapidly changing market conditions will either fail or be severely weakened. Those that plan for flexibility, resilience and responsiveness (for all kinds of disasters), will not only survive, but provide social stability, enhancing the conditions in their local communities and the global economy. Many businesses are counting on the assumed resiliency of the global economy without accepting the role they each play in that resiliency.

The mayor of my town asked me roughly the same thing about two months ago. I still need to get back with him about it. I guess now is as good a time as any to start the process, so here is what I came up with over lunch today.

Governmental Issues to Address
1.Do not depend on the federal or state governments for assistance during a pandemic. They likely will be so busy with even worse emergencies than the ones you have, that their resources will be spread to the breaking point. If they are able to help, consider it a wonderful surprise, but dont depend on it.
2.Tell people the truth. Contrary to popular wisdom, panic does not occur when people are given bad news (even very bad news), but occurs when people either do not have enough information to make a valid judgment for themselves, or believe they cannot trust the information they have.
3.Engineers deal with issues using three response parameters, specifically: reactive, proactive, and interactive. Government should do the same.
Reactive is where you respond to something that has happened. Perhaps that something was not planned for, perhaps it was. But you are reacting to an event or a situation that has occurred and requires a response.
Proactive is where you anticipate situations and events ahead of time and seek to stop them or to mitigate their effects through planning, stockpiling supplies, performing additional maintenance on infrastructure, etc.
Interactive is where you manage an event or situation as it occurs. Use of training, planning, resources, etc. allow one to handle what is happening as it happens, thus preventing or mitigating negative effects.
4.Make sure that the necessary laws are in place to handle the crises associated with a pandemic.
Specifically, ensure that the government in your area can issue and enforce a quarantine. While quarantines are ineffective as a long-term strategy, they can be effective during the first two or three weeks a disease is in a area to slow down its advance. Even if you dont use it, making sure the law is in place is important. REMEMBER, however, that if you quarantine someone, you are then responsible for taking care of them. That means getting them the food, water, medicine, etc. they need in order to survive.
Make sure the government in your area can commandeer resources (with compensation to the owners, of course). If there are shortages of food, water, equipment, etc., the government may need to step in to secure these resources and see to their equitable distribution. This may be important to ensure that people with more money dont hoard food, etc., while less fortunate people starve, die for lack of medicines, etc.
5.Plan, Plan, Plan, but make sure of two things. First, make sure that your entire staff knows that all the plans in the world are useless when the stuff hits the fan. At that point, its entirely about what they have learned and how they handle the situation interactively, as discussed above. Second, make sure that your plans do not depend too heavily on factors that are out of your control, such as anti-viral drugs that come from the state or the feds.
6.Stockpile materials needed for a long siege against the virus. Especially basic items, such as food and bottled water, medical supplies, preventative supplies (such as N95 and N100 masks), batteries, etc.
The masks may be particularly important for your police and medical personnel. If the research is true and most influenza is spread by virus suspended in aerosol contacting the lungs, then your police and medical people need that protection, especially when responding to situations with sick and/or dead people.
They also need to know how to wear them properly and what not to do in them (like exposing them to oils). Remember that masks do not fit everyone. If necessary, your people should use duct tape to create a seal. Yes, I know, it sounds funny, and probably looks even funnier, but it works and may give them the protection they need.
Also, stockpile cleaning supplies. While they may not do a lot to stop influenza, they will help reduce a lot of other infections, that could cause complications for someone who is just recovering from a pandemic infection.
7.In terms of food, Meals Ready to Eat (MREs) are good to have on hand, if you can get them. They store well, and can be used both by your people and distributed to sick and needy people, if necessary.
8.Engage your people (your staff) at all levels. Hold brainstorming sessions and encourage them to take part in the planning process. They will certainly think of things you cant, because they are in the trenches every day.
9.Engage the businesses in your area. Get them to commit to the idea that if and when a pandemic shows up in your general area, they will greatly increase their back-stock of products. Modern companies work on the idea of just-in-time supply chains, so that they do not have excess stocks in their warehouses. Thats great in normal times, but could be very problematic during a pandemic, if supply chains break because of the disease. Get them to understand this and work with you to ensure that you and your citizens have enough of what they need. Engage their corporate headquarters if necessary, to get approval for such a move.
10.Work with governmental agencies above and below your level to coordinate responsibilities and tasks, and to make sure that you are all working on the same page. However, dont depend on any other government agency for what it takes to survive.
11.Identify the critical services that your governmental group provides, and plan to maintain these during the pandemic, to the best of your collective abilities.
12.Within each critical department, divide your staff into at least three teams. Make plans so that, once a pandemic arrives in your general area, the teams will be sequestered from each other, and ideally, from the community at large as well.
This may necessitate providing a certain amount of support for their families during this time, and making sure that they and their families can communicate via telephone, etc.
Non-critical staff may be able to provide some of this support.
The purpose of sequestering the teams is to ensure that if the disease infects one critical employee, not everyone on the staff is endangered. At most, everyone on the team is endangered. Ideally, the sick employee is quarantined as soon as possible and many people on the team escape infection as well.
13.Identify community members who have training, skills, and resources that may be useful during a pandemic crisis.
Engage these people and let them know that they may called upon to assist in a crisis.
Document who they are, their skill, training, resource, etc. that makes them valuable to the community, and how to reach them.
This is one of those cases where you should make sure the laws are in place to accomplish this. Most cities in Georgia have an outdated 19th-century clause in their charters that allows the city to require citizens to perform services for the city for two weeks. If your city, county, etc. does not have such a clause or law, you might want to establish one.

Community Issues
1.Encourage the communities in your area (neighborhoods, churches, clubs, and other organizations), to work together to begin planning to help each other during a pandemic.
2.Encourage businesses in your community to work with you to develop plans by which they can continue operating, while minimizing the danger both to their workers and to their customers.

Individual Issues
1.Create parameters for individual health plans that people in your communities can use to create their own.
2.Make sure everyone in your area knows that they need to have an individual health plan for use during a pandemic. Make sure that they understand what should be in that health plan
3.Make sure that everyone with underage children know that they need to make an individual health plan for each child and (if the child is old enough to understand) make sure that each he or she understands their part in it.

Revere,
If you do not like what I say on your blog site, and you want censorship like our fascist government, then pull the plug on me and get me off your site. I have a right to say whatever I want to say, just as you have to right to say whatever you want to say. I stop the BS about what I say is not liked by some of your readers, and that I am tiresome. That is a personal attack agaist me.
So please pull the plug it you have to. I do not care.

MRK,
Why in the hell are two massive strike forces headed for the coast of Iran as we speak? These are the early stages of a war with Iran.
You can personally critize me all you like, and tell me to stop, but I have just a much right as you do to express my opinions.
If you do like what I say, that is your problem, not mine.

Lenn,
4. Make sure that the necessary laws are in place to handle the crises associated with a pandemic.
Specifically, ensure that the government in your area can issue and enforce a quarantine. While quarantines are ineffective as a long-term strategy, they can be effective during the first two or three weeks a disease is in a area to slow down its advance. Even if you dont use it, making sure the law is in place is important. REMEMBER, however, that if you quarantine someone, you are then responsible for taking care of them. That means getting them the food, water, medicine, etc. they need in order to survive.
Lenn, you will not have long to wait for your desire to see a quarantine, but you may not like what you see. The Posse Comitatus Act of 1878, which prohibits the National Guard and the US military from involvement in local law enforcement will be abolished just as soon as a pandemic hits the US.
Then Bush, with the encouragement of Cheney, will use Executive Order 13010 to declare Martial Law. Bush, in a news conference in March 2006 specifically stated it may be necessary to quarantine the cities. All he has to do under Executive Order 13010 is notify the Congress before he declares Martial Law. Once declared, the Congress and Judicial Branch stop functioning.
Recently Congress passed a law authorizing the construction of detention centers, costing $385 million.
Anyone that resists through violence the imposition of Martial Law and quarantine of the cities will be placed in these detention centers.
And last Friday, the new anti-terrorist law, which negates US citizens any rights granted under the US Constitution, and authorizes the use of torture; will be used by Bush upon the arrival of a pandemic. All he has to do under the new law is delcare a US citizen an enemy combatant. At the moment he delcares you an enemy combatant, he can arrest you while you sleep, at 3 in the morning, take you to a detention center, and leave you there for life. Or he can have you executed. You will not like the type of quarantine Bush has planned for you.

Revere,
The second paragraph of that HD article you cite mentions, "if a pandemic were to strike within three years as predicted."

Have you ever heard of such a prediction? Or know what this is based on? Everything else I've seen says the pandemic timing is unknown and unknowable.

Teach the children and they will take it home to their parents. Kids are great conduits of information.

Take a walk in your neighborhood. Knock on doors. Say you are trying to organize disaster preparedness group in the neighborhood. Would you like to join me in planning for earthquakes, fires, pandemics and other disasters? You will be suprised at the positive responses you get.

Press releases written thoughtfully and truthfully, but with emphasis on protecting your family, business and community.

Find a celebrity spokesperson.

Big effort to get people vaccinated for "regular" flu. Tell how to find a flu clinic near you.

Hospitals, health care providers, home health agencies and the like need to start teaching staff about the pandemic to come. (I work in a prestigious hospital and have not received any education about avian flu.)

If anyone wants to look at the The Norwegian National Influenza Pandemic Preparedness Plan, in English, it can be found here.

I no longer understand emergency planner's instructions to store batteries. That's crazy. They don't keep. They wear out. I got crank flashlights from Costco. The new version has an alarm and a radio too; about $20 for 2 of them. Need a couple more for work & the car.

Most of the lit road signs and roadside phones have solar panels now. Didn't cell phones quit working during the East Coast power outage a few years ago because the cell phone towers didn't have power? NOW would be a good time for some cell phone company to distinguish itself from the competition, upgrade, and advertise reliability even when TSHTF.

Hospital power worries me. Yes, they have generators, but those require fuel, which needs a functioning supply line, refineries, etc. I wonder how much power could be generated by covering the roofs and parking lots with solar cells and feeding it into the emergency power system? Or wind turbines. Geothermal. Whatever works for the location. Diversity isn't just for 401K's.

Has anyone invented a solar powered refrigerated backpack for insulin yet? If not, dibs on the patent!

Then there's water companies. I hope they're already using water driven turbines to generate some of their power requirements. But I also read a paper describing chemical attachment of chlorine to plastic, which could be used to make filters and pipes for treating and delivering water *with no need for additional chlorine* because it isn't lost in the process! Thought I saved a copy, but now I can't find it. Very frustrating!

Basically, anything vital that can be detached from the grid and can run by itself should be. That includes spinach. It looks lovely in a window box. ;^}

Come on William. One submarine could do a nuke job on Iran without so much as a flutter in the bilge on the thing. Thats what they were designed to do. The two task forces are just replacing whats been on station for two years. Them tubs get tired after a while and they have to stay on station.

Look its simple as this. No one wants you to go. Revere has just asked for you to make your point and get on with it. No one is attacking you for your position. Sheyit, they attack me for mine all the time. But without getting too far off the subject, post something up about how to get thru this as Revere has suggested man. He isnt in your ass about it, just trying to keep the blog productive. I only go after them when I think they are wrong, or I have a position to posture that is generally 45 degrees all the way to 180 out from what most say here. On many occasions I defend the right of everyone to post up. No suppression of thoughts is Revere's bent but dont hijack the damned thing when the subject is how to prepare. Thats all he is saying. Stay on topic bubba.

Bests.

One of the things we are almost certain to see is lines or mobs of people, whether outdoors or inside unventillated rooms, coughing energetically on each other.

If authorities cannot bring themselves to train people to avoid crowds, they ought at least to be planning how to provide emergency services in ways which strongly discourage lines and crowds.

Someone ought to be talking to church groups who plan to host soup kitchens in their basements. (Yeah, I have tried. Not having the proper paper, I have been rolled over by "what else can we do".)

We should also be saying out loud that some actors will be promoting business as usual and efficiency, regardless the consequences for others. "we" as in everybody, because "we" as in a few will be pushed aside.

Yo Name-The media were actual conduits of H5N1 from their reporting in Palestine when it broke out there. They found it on their shoes. There is another thing, they wont be able to report from the scene because once they go in, they wont be let out.

ipmat-depending on where you live (US) you can order the equivalent of a light bulb worth of power panels for 29 bucks from Harbor Freight. They are 110 volt type. They ARE enough to power a battery charger which in turn could be used to separate hydrogen from water. I have a diagram you could use and it would produce a clean but invisible heat source. Little potatssium in the pipe would color it so you could either cook or heat up bricks. My Granny used to do that in the woods in the late 1800's in East Tennesse. They would use either bricks or big chunks of granite heat them up in the fireplace and put them into steel cans in the rooms.

Also your point about fuel is well taken about hospitals and electricity. The grid will likely snap in California, New York, and the Northeast. TVA has a lot of dam capacity (no pun) and even if the nukes go offline there is enough hydro to take care of the needs-sort of. There are weak links in the transmission and I dont think that they will be able to handle anything past Kentucky on the National Power Grid but they are discussing it. Frist is working on getting at least a 90 day supply of coal to those types of plants but if we get one trip in the NE anywhere, then its going to be a while before it comes back on. Valero operates a refinery here and has three banks of HUGE transformers that come down off of 660 transmission lines. If the power isnt there then gasoline is going to be gone. Phones by the way if you are residential in the US have battery backups that only last for three days. May see rolling blackouts and I know you saw the post about the surge thats needed just to get something back up on line.

Good list Lenn. My EMA director here wasnt aware that bird flu had risen up on anyones radar as the Health Dept. director is parroting Ms. Gerberding.

"No plan survives first contact"--General Helmut von Moltke. Recognize that one Randy? Your plans have to be flexible, ladies and gentlemen. That means if they don't work, or H5N1 changes its plans, we change ours.

Emphasize hygiene, then again, and again. It (both the training and the virus) starts in the schools (as noted above) and goes EVERYWHERE. The anti-virals most likely won't work if a second wave materializes (darwinian pressures will cause the virus to adapt) so the hygiene route is going to prove especially important to protect ourselves, and slow the virus down.

I like the idea of churches stocking up like that, probably more helpful than a lot of the Top Ten list. Food banks will also be crying for supplies-if you normally give to these charities, plan a little extra to toss into their kitties only when the pandemic is imminent. Trust me, they will appreciate it like no other gift. Surviving the virus is definitely going to be tough-the aftermath very well could be a lot tougher...

Have a plan that is set up in a "step" phase... with definite "trigger" points.

A few cases... you do this.... More cases.. this happens... and so on.

Make your plan flexible. A plan does no good if you do not allow yourself (or your committee) to step back, assess, and move forward.

Allow the plan to be developed by ALL stakeholders... This means the healthcare system, the public health department, businesses, police, EMS, Longtermcare facilities, Groceries, pharmacies, .... yes, and govt. Sometimes they have a role also.

Make sure the key players are a big part of the plan: i.e. Physicians to work with the community to develop criteria for patients to be admitted to Hospitals, alternative care site, or sent home for homecare; Nursing for "buy-in" on staffing issues, and altered standards of care; Police for their take on securing facilities; Govt. to commincate with the dtate for any available resources; public health for their sureveillence, monitoring of contacts, organizations of services, etc. (There is more)

And plan for certain things:
Social Isolation..... A must to slow the spread.....
Phone banks; manned with persons knowlegeable, led by nurses and physcians.. to provide support for those who have been sent home to care for their family member.

I can think of lots more..... (The never ending plan.)
:)

Miso: If you would like to provide a link about LANI, since you believe it's so crucial, rather than just calling other commenters sheep, that would be helpful. I don't really see why one can't have things of value to add about pandemic planning if one knows not one whit about a single anti-viral, but that's just me.

William: I have the right to go to a party and start talking in a loud voice about how I don't like the hosts or the food. But that doesn't mean I should, even if it's true. Others who try to get me to lower my voice or change topic aren't trying to violate my rights. They're trying to stop me making a horse's patoot of myself.

To everyone who's actually responded to the content of this post thoughtfully: thank you.

We had a huge wind storm here in Southwesternn France this week that knocked out electricity for 100,000 homes, including mine, for over 2 days.

No news, no email, no oven, no lights... I thought about the bird flu chatter of last year.

It was great to have friendly neighbors who, after a day came by with a generator to save the summer's harvest in the freezer. They then went all around the village doing the same. For free. You are right - people can be very nnice and rise to all kinds of kindness and solidarity in times of trouble. This should be emphasized in any leaflets about preparedness - "What can we do for each other" is a good question, but how do we do it without passing on the disease? Due to long evenings with no TV, computer, how great to have a plain old Monopoly set with candles and neighbors.

I loved the idea that someone gave above about wind-up flashlights - will get some.

We have a big water recuperator attached to the roof drainpipe and all of that water is great for flushing toilets etc. (No electricity means the pumping stations go down)

Days like those make one very pensive about how much we have and how much we waste and empathatic for the billions of people in the Third World who do not have access to clean water etc. Third World, am I nuts? Just think of New Orleans... the 9th Ward still doesn't have it!

Reveres: There are thousands of people who access your blog every day, as I do, and are aware of fluwiki and other bird flu information sources. They are planning, prepping, studying, and cajolling their families to do the same. But all this preparation is under the radar of most public health agencies, Red Cross, Homeland Security, etc.

I'm sure if you ask these agencies "how many citizens in the US are preparing for a pandemic?" the answers would vary widely, because they really have no reliable way of determining that statistic. Note that when any public figure encourages "preparedness" they refer to the standard 72-hour plan. A solid bird flu plan goes way beyond 72 hours.

The biggest challenge to public agencies during a pandemic will be to FIND individuals who have gone through the planning process, who have prepared, and convince them to reveal themselves to enlist their aid.

During power outages we neighbors help each other and check on each other. It's not a formally organized process, we just do it. But during a pandemic when casual contact may endanger my household? I don't know. I haven't thought about that part seriously enough. In that sense I am still not prepared.

I guess it's time to organize the neighborhood.
Love,
Library Lady

O'Leary and Library Lady: I couldn't agree more with both of you about this. You probably get tired of hearing me say the same things over and over, but I'll do it anyway. This is a task in community mobilization.

What you say about the lack of personal prepping is correct but I am not so concerned about some of it. The observation that nothing concentrates one's thoughts like the prospect of a hanging in the morning will also hold true. If it becomes clear that something is happening a half a world away and may reach us in 2 weeks or 3 weeks, people will get busy. But some things must be done ahead of time, as when that event occurs it will be too late to do some things, like get enough ventilators for your community's hospitals, and, this is the point here, having done some preliminary community work so that the response will not be panic but the immediate desire to organize one's neighbors for mutual support.

You don't have to convince everyone ahead of time or even most people. Just some people and also to have laid the groundwork for promulgating the idea we will most likely get through this intact if we are ready t help each other.