Will the Bush administration lock you up in a pandemic?

"HHS spokesman Bill Hall said the government plan stressed community and individual involvement."

And all five or six of us who know about that plan are busy implementing it.

> History makes clear that a heavy-handed,
> coercive approach to pandemics that treats the
> sick as potential enemies is not only an
> unnecessary violation of civil liberties but
> is also ineffective from a public health
> standpoint and will leave more Americans stranded,
> sick and untreated." (Reuters)

I don't know what they refer to here with "History".
SARS had clearly shown the opposite.
Also CDC-study, military-report from 1918,
papers about NPIs.

But see this thread with a poll, on how reluctant
people are against this.
http://www.singtomeohmuse.com/viewtopic.php?t=21

It would have been helpful if this report had presented more actual excerpts from federal planning documents. As it is, the few excerpts they present are from documents that have been discarded (what's the point of citing those?) or from versions that have not been published (as in the purported May 2007 revision of the HHS Pandemic Influenza Plan excerpted on p. 20).

But their recommendations are well taken, including the indirect recommendation that judges and court staff be included among those who will get early access to vaccines and antivirals. (They didn't go so far as to include lawyers in general!)

I feel much better about the govt. plan now that the ACLU opposes it, as the ACLU is wrong 99+ percent of the time.

Saw that article today and though oh, Revere will post about it.

Why should US citizens trust the para-military?

How can health ppl coordinate with military personnel? A serious question, and in principle, in abstracto, no obstacles exist?

Katrina. Gitmo. The war on drugs (oops, not top of the pops right now.) The US industrial-prison system. No doubt many would not agree to that grouping and wish to argue differences.

To mention just a few scraps of confetti floatin- down.

DHS looks more and more like a vicious repressive system that f***s up under the radar.

The DHS rules and actions are justified by: bad planning, clashes between different entities etc. no guide lines, these are our procedures, etc. etc. People die. (meaning they need not have.)

Of course the ACLU (imho) has no real role to play here, it is obfuscation. No doubt they think they do their best, yet they serve to muddy the issues.

I saw this last night and was going to send to you Revere but I knew you would pick it up anyway.

So here's the deal. We start into a pandemic. People are dropping like flies, in homes, at the hospitals and on the freeways. Its assumed that its highly pathogenic, Then for no other reason than to slow it they implement isolation. The laws are already there to allow for this in every state and we will say that the outbreak happened in Atlanta. This is still a states issue at this time. Suddenly it breaks out in Los Angeles having climbed onto a plane just 8 hours earlier and arriving there having flown the 4.5 hours made it into the terminal. The person makes it home and is unknowingly infecting all of Los Angeles. Obviously the situation in LA and Atlanta have to be contained. So to get the PTB into place the City Mayors declare a state of emergency, then the states and finally, the USGovernment as it spreads beyond control. People moving about would be infecting others so the order is given. No movement of any kind. If you do, you will be subject to arrest. That arrest will put you into a jail cell with likely infected people. You also might be infecting them. So the ACLU's position is what? Violating the law that they say is so dear to their hearts. You got rights? No, because this is in every civics class in the tenth grade. It is in the Constitution for the declarations of emergency and martial law.

I understand your feelings regarding the beefing up of infrastructure but this begs the question? What infrastructure? The hospital central supplies only keep a week to ten worth of the normally used stuff. Bigger hospitals 30 days. Add in what they have in the just in time warehouses they push it out to another 30. But, its based on normal use. The estimate was that the entire system would crash pretty much at the 30 day mark for the hospitals, and somewhere between 15 and 30 for the smaller ones if not earlier. I noted from the study that the guys were biased against the law and order and wanted to go to a more medically centered approach. But the suggestion is that there is something they could do. What?

If we exclude cost of doing it, what could they do except to put them onto a ventilator? A few drugs, a lot of morphine and atavan, maybe a couple of antivirals that so far havent generated definite good outcomes and thats about it.
There arent enough ventilators, there arent enough beds to consider it. The 5% number generated enough people to fill those in the first two days of a pandemic of H5N1 in every state. Thats a state and CDC projection and thats after they boot the ortho's and observation only heart patients. Talk about rights? Who is going to be responsible for those people that by a percentage will get an infection and/or have their second or third heart attack while they get triaged out the door? Liabilties will be huge and who will be responsible? Hey, I got rights? I dont think that one is going to hold up in a civil action after this.

Lets take this a bit further. There is no way that any state or the federal government can respond to this kind of disaster. They didnt in 1918 and they wont now. It costs too much. But thats relative. The people who would be dying would be saying that government didnt do enough. If you take the storage of "enough" whatever that "enough" might be or is would be incredible. "Enough" , food alone would have to be stockpiled and maintained to astronomical levels. The 1950's Civil Defense used a first kill rate of about 1/3rd of the population, then another 1/3rd in the first six months from radiation, sickness and other causes. Then they stockpiled food in the CD shelters for the remainder. 1/3rd....... We would be left with about 2/3rds right now, an infrastructure in shambles and food production would be ? Medical IMO might be the initial hit, everything afterwards would be more major than that.

I agree that more could be done but I would put that 5% number into a frame and mount it on a wall. 83% for the running two year rate is what we are seeing. 1/2 of that would be say 40% but thats likely too high because the message would get out and people would stop moving around and infecting each other. So I would guess and its as good as anyone elses...30% from primary cause flu. The other stuff would come to pass without a doubt inside of four months. Hospitals lasting maybe the first month then gone and the secondaries causes start kicking in as the first wave is peaking. But thats just my opinion. It might be far less or worse.

But back to the streets. You have heard me post that from a food standpoint alone that it would take 30-40 flights a day or 630,000 lbs of food to feed the people in a tri-county area here in Memphis. This to me will be the thing that tips the balance. Hungry people will do crazy things. There is at any given time on the shelves by an estimate maybe a two-three day supply of primary food items, with another weeks at the local warehouse, then another two at the manufacturers. Under normal consumption and delivery schedules. Picture some food truck showing up in a Mogadishu scenario. Yep, if its a four month event you would see your neighbors doing this. I can only think of what would happen and hope that there would be more to go around but there simply isnt. Federal supplies would be on the way but they might be able to go another week to ten. By my count give or take we are going to see a two months without food scene at a minimum. Maybe three.

We have been warned and have been for about pushing on two to three years. The message? If this comes its going to be the states problem and every man for himself. They have eliminated the ACLU with a single document and via notifications by paper, news, and internet and that is the NPFP. You have as Americans been advised of an impending threat and told to take action immediately to secure self and family. They also state that chaos at the least would ensue, anarchy perhaps. All of this is covered in the NPFP and its based upon the 5% suggestion.

The article makes a very valid point about rights. Your rights will be impugned by about 1/2 at the first declaration...the state of emergency. The local officials will have sweeping powers to maintain order. We have been there many times in the riots of the 60's and at other times. If a declaration of martial law is made you have to fully understand what the powers of local, state and federal officials are and at that time they are infinite. You get caught stealing from a Zales, then you can be shot on sight. If you are stealing food (if there is any) from a store then you'll likely not have a problem. Dont rob a bank and call it hungry as they were so wont to do in New Orleans. You rights during a declaration of martial law? ZERO! Order will be maintained at all times and small towns will be dealing very harshly with their dissidents and I use that term because its the assertion above. The ACLU knows fully well what a persons rights are during this time and they also know they are zero. They are setting this up for the inevitable Katrina type lawsuits and they will say they were disenfranchised, they didnt get due process and the three guys that did the study will be saying that government didnt do enough. They will point to this study and say that the government should have......and insert their answer here. That should have will be a point of contention for years. I rank it right along with the New Orleans seawalls. If it had been ten feet higher, it wouldnt have breached. But eventually something would have caused it. Couldnt possibly be a hurricane that government has no control over. And thats what its about....control. We try to control things and central government is the catch all. We never take personal responsibility.

There is no physical way to counter H5N1 in a highly pathogenic manner. Thats from just about everyone. Revere would say that bolstering the infrastructure would generate better outcomes....There is no poof of that yet. Off antigen vax, more hospital supplies, beds, doctors and even more ventilators and people to operate them have all been used so far on a smaller scale in the countries that have had BF. No one can point to any thing or a grouping of things and say, "Yes, that allowed _________ to live." You can insert the dollar figure here ___________for what it cost for them to be dead, and here ________ to be alive. The alives will cost huge amounts of money.

The one Chinese guy that had everything available to him and was in one of their best hospitals cost around 50,000 USD to produce one outcome. If we used Tennessee and the 5%= 56,0000 dead and they all went to the hospital only to die, then took it at even 1/2 of the 50K Chinese cost it would totally devastate the system. UHC, private or state care would cost 1,400,000,000 and thats just to produce dead people. Would cost more than that to produce one outcome that would likely not be able to work or stand upright for nearly a month. Understand that I think we could do more but I dont know what more is. If more is to put money into supplies for hospitals I would say to what end? If its into research you are danged skippy if it produces a vaccine. If its to beef up the police forces and their ability to operate in a bio-hazardous environment, yes that too. I havent seen anything from the above that indicates to me that what they suggest will have any answers for rights, or more so the ability to survive. Its just not there and no one can point to anything from a medical standpoint that would make their statement bear water. Rights in a pandemic zone are the same as they are in a combat zone....You have the right to try to survive, most likely someone you know will be dead and it might be you.

Oh and Revere, one other thing. It wont be just a Bush Administration that would lock you up. It will be your state and local officials as this is directly and by federal mandate a states problem. You'll be lucky if they dont shoot people on sight once the order is given for martial law for moving about. Strictly enforced. With this floating around, I might take the bullet rather than be locked up with people that might give it to me.

There is a plan for getting meds out to the public. The Strategic National Stockpile. http://www.remm.nlm.gov/sns.htm
I have been to classes on it and think it should work in a outbreak

Its a bio-shield approach to something there is no vaccine for? So they have to disperse off antigen vax that likely will not work. Thats also Pandemic Level 3.1 stuff in the US.

John,
I'm a local public health official and the SNS is still at the federal level. It has not trickled down to a large majority of local health departments yet. Also, with limited vaccines, or antivirals, we won't be using a public point-of-distribution network. The site will be secret and secure.

Please refer to the president's Pandemic Plan statement in reference to containment and action to be taken in the event of an outbreak or Pandemic. Being aware of the actual course of action planned and what will occur should clear this question up rather quickly.

There is a plan for getting meds out to the public. The Strategic National Stockpile. http://www.remm.nlm.gov/sns.htm
I have been to classes on it and think it should work in a outbreak

Posted by: John | January 15, 2008 1:08 PM
That's great news! Thanks John. On the civil right thing it seems to me that no matter what plan is ready there are going to be literally millions of people who don't like it. Especially if you are on of the one adversely affected by the "new" rules!
Dave Briggs :~)

"Understand that I think we could do more but I dont know what more is. "

More is educating the public to prepare for it, so they have a fighting chance of surviving through the worst of it. More is following through on pandemic phases and calling a spade a spade. If it's level 4, put it at level 4 so certain plans can fall into place. Buying ventilators is a waste of time and money. Buy, instead, a media plan to get people prepared, get them to own the situation, to find a way to survive through, to not put the blame on someone else or some obscure health agency, or governmental power-that-be.

Kelly-I agree. It might be a little hard to take but I cant find anything that indicates that drugs, machines or even prayer helps. Luck of the draw to get past it.

Just in, Indon 16 year old has died. Bengal has been asked to close its border with Bangladesh, Nepal. India is culling 1/2 million birds as we speak.

Interesting. I wonder what happens if we are in a pandemic in late October early November this year? Say, right around election time.

Shannon-As a very experienced poll watcher for the elections not to take place there would have to be a declaration of a national emergency and that would be looked upon as a takeover if thats what you suggest. Could we see it popping in about that time? Sure, but if I were a Republican and I wanted to ensure a power grab I would ensure that the two candidates wouldnt be there on the other side. Why upset our apple cart for two people?

But to answer the question. A single state with BF would still have the elections. 1/2 dozen? No. Social distancing methods, wipe down of the machines and we would have the election.That is inherent in democracy. Could they postpone them? Yep and Congress would likely approve the extension of the Presidents term as NYC did for Giuliani during the WTC's event.

But there would be too many people around with weapons for them to extend it more than the wave time (four months) to not change power.

I am vehement about that kind of stuff. I do and I dont give one big rats butt about who wins, just as long as its fair, legally done and you dont have dangling chads in Palm Beach County. As in stuff the machine with 3 ballots. First one punches, second one dangles and the third dimples. And its really cool when you find the ballots in the boxes neatly stacked when they are opened up. Even better when you have more votes in the boxes than a 100% turnout of the voters in that same county and two others... all for Gore ...... How very strange.

It may be that the best thing to do with an influenza pandemic is to let it run it's course. Hiding from it may help you avoid it for a season or two, but the virus won't disappear. Sooner or later, everyone who is susceptible to the pandemic influenza will get it, this season or next, some will die, others will survive. Those who survive will have immunity, and then 30 years later comes another pandemic flu.

Also, the 1918 pandemic showed the 1st stage that hit in the spring was much less deadly or transmittable than the 2nd stage in the fall. So avoiding it in the spring was like jumping from the firepan into the fire so to speak.

Even then, the fatality rate was 5% for those who actually got it, and many of those who died, were killed by a secondary pneuomonia from bacteria, which would be easily handled todsay with antibiotics. The key will be getting antibiotics to people in a pandemic flu outbreak to eliminate deaths from secondary infections.

Government today rules by fear. Terrorists, Disease, WMD, etc. Just ways to get you to give them more power over you.

In Ta*wan, the majority party will lose power in the coming Presidential elections. The government had suggested not long ago that they might impose martial law and postpone elections in the event of bird flu. If the bird flu was in Ch*na only, it was suggested they might impose a travel ban on anyone coming from Ch*na, and they may have to suspend elections since many citizens live in Ch*na and would not be able to come back and vote.

So America has another export product, besides debt, jobs and weapons, we now export fear and ideas to governments in how to stay in power through undemocratic means. Madness.

There is no physical way to counter H5N1 in a highly pathogenic manner.

Three hundred million moon suits would do it for the residents of the States. Assuming continued distribution of batteries, filters and external disinfectants.

It might be cheap at the price.

More seriously, I would ask the question: in order to keep some semblance of an economy and social structure up and running, in the face of a high-efficiency, high-lethality pandemic, how many key people must we protect?

A pretty significant portion of the population, those who have no important functional work, could be told, go home and STAY home. Watching infected people die in living color on the television news would help get the point across. So would watching disobedient people get shot in streetcorner drumhead courts-martial.

Assume that we have to supply those housebound millions with survival minima of food rations via something like curbside or doorstep delivery. And we have to keep up the grid power, and keep the water and sewers working, and the Internet moving packets.

Who do we have to have out and about, working, to do that?

Whose jobs are functionally critical to national survival?

And how best to quickly and affordably protect them?

I've spoken about the idea of large, dumb, simplified, standardized designs for PAPR hoods. (That would be Powered Air Purifying Respirator, not "paper".)

If you get away from the idea of fitting something closely to the face, you can get a lot closer to the idea of a one-size-fits-all design. Simple snap rings inside to fit the heads of smaller people. Wide Velcro belts to close the thing up tightly at the waist. Fabricate it out of thick butyl rubber so that it can be repeatedly sprayed down with a cheap, potent liquid disinfectant like isopropanol (or, hell, ethanol -- might as well get *some* use out of all those new ethanol plants in the Corn Belt).

Make the donning, doffing and maintenance simple enough to be depicted with graphics on one 8.5x11 photocopy. It doesn't have to be foolproof. It just has to keep 90% of the fools alive.

Here's the 3M version. Design types, take a look at this and ask three questions. How can we make this cheaper? How can we make it simpler? How can we improve viral protection?

There is endless fuss with fitting face respirators. Head size, head shape, face size, face shape, do they wear glasses, do they have a long nose, do they have a beard or mustache? Hoods route neatly around all of that bother. Gee whillikers, Mr. Wizard! We may be on to something.

Lengthen the thing below the neck with an integral circumferential cape that hangs to the midsection. Tighten and seal it there with a wide Velcro belt. At the shoulder level, integrate sealed sleeves and heavy gloves. If someone has really delicate work to do, they can be moved to a safe decon area first. The hood/glove/cape is for out and about grunt labor like delivering supplies.

This isn't rocket science. It doesn't have to be. If people don't get sick they remain alive and functional. If they don't get exposed to virii they won't get sick. This is a brute force, no-frills way to greatly reduce exposures.

Trying to develop vaccines is a horribly expensive high-tech shot in the dark. A stockpile of hoods would instead be a simple, stupid, low-tech tool, guaranteed to at least partly work, that will not break when you need it most.

--

Oh, here's a thought. Those 3M hoods have a battery-powered belt pack to blow filtered air inside. Expensive. Complicated. Requires logistic resources to distribute. Requires scarce juice to charge.

A cost-minded designer could simply substitute a passive filter mount and an internal hose to a mouthpiece. Wearers of facial respirators pull filtered air by diaphragmatic lung power. A simplified hood to be made by the millions could certainly do the same.

Some critical workers may need the battery version because they have to speak while working, or because they have a nonflu respiratory problem. Throw a few of the deluxe hoods into the mix for those folks.

--

Hey PFT..... No one is exporting anything like that to Taiwan or China. A power grab in the US even by my party would be met with an extreme response. No, not going to be any takeovers on my shift. If its necessary to declare martial law then it will have a time limit and I think that the courts have ruled before that it shall only be allowed in 60 or 90 day increments, cant remember which.

It would be an incredibly stupid move. One that would fail. And believe me unlike many other countries the people that would try it would go the route of Benito Mussolini.

But you are right about the first wave. Look up "herald waves" and you get a full description of what you are talking about. My grandmother(s) left letters from 1918-20 when it was rolling around in the US. Here in Memphis there are driveway entrances that go nowhere in the old sections of town. They used to lead to houses, flu houses. After the pandemic, no one would live there so the city had to have them demolished.

Marquer-Right about that. A certain large air freight company in Memphis bought 5000 PAPR's to use on the ramp and when their safety guys showed them to me... I said where do you plug them in? They looked at me and said, "They need electricity?"

Going to get that a lot.