Comment on Post at Effect Measure
Hurrah, so glad to see this topic.
Revere, your idea is a terrific one but I wonder if people would be so selfless. If I am healthy, would I want to expose myself to ill strangers and perhaps bring the virus back to my family? I wonder. It would take a lot of courage.
Would love to see a discussion (as I mentioned in some other comment) also about preparing "communities" that are urban. In a large, faceless apartment building, will it be every apartment for itself? Or is there some way we can help each other?
Thanks.
An observer: It's not that hard to organize people in an apartment complex. In the 60s and 70s we did it all the time over rent control issues. You can call a meeting with a flyer and half a dozen of you can start it off. Some things are probably better done closer to the event, however. So if it looks like there is a pandemic developing, that's the time to do it.
Regarding selflessness, people are all different. But in general there is no shortage of people who are willing to help others, even with some risk to themselves. It happens all the time. So I'm not worried about that. But it happens much more readily if there is some knowledge and preparation ahead of time, as a barrier is uncertainty about risks.
Other things might need to be done much more ahead of time. I have some examples of those, too, but I'll let this thread go a awhile.
the CERT program (currently being used in FL to help clear debris, etc) is a citizen's group organized through local fired departmernts and FEMA to help:
What is CERT?
The Community Emergency Response Team (CERT) is a Federal Emergency Management Administration (FEMA) program which helps people prepare to respond to emergency situations in their communities. The CERT concept was originally developed and implemented by the Los Angeles Fire Department in 1985, after a series of earthquakes that left many victims without emergency services.
With a bit of training and recruitment, seems like a natural.
About organizing in an apartment complex: I guess my question was more like, does it help? I can see local communities where people know their neighbors and maybe could share child care duties, storing food in basements, etc. But if you live in a small apartment that's less possible, and if you don't know your neighbors (and none have kids) is there a reason to organize?
I'm thinking along the lines of maybe having a group of "responders" -- maybe one or two on each floor -- who people could turn to if they need help or fall ill. Would that be useful?
AO: My guess is that there will be various ways to do this, depending on the circumstances. Your idea seems like a good one and should be in the toolbox.
Yes indeed, the template emergency response plan that states are using and kicking down the road to the cities and towns is all about setting up centralized dispensing sites -- it's so transparently ridiculous it's hardly worth mocking. Any effective responses have to be decentralized, based on outreach strategies, organized at the neighborhood level, and based on very specific awareness of who lives where, it seems to me. An analogy is how the British organized for the blitz -- there were centralized shelters in London but most of the strategy depended on block captains to enforce blackouts and organize first response where the bombs dropped. My uncle, who was a local minister, had a parishioner who had a dud bomb land in her chicken coop. He led the evacuation of the family and the neighbors, to the church, and of course everybody brought them casseroles, and they called the UXB unit. That's how they got through it. But the people at the local level were informed, trained, and they had rehearsals. Not just the police and firefighters and army.
AHA, the reveres find some utility for faith communities!
Melanie: Of course we do. It would be nice if they had some use for us! (the godless)
For small isolated towns and villages, the local mailman knows his customers and if the mail builds up in their mailbox, often times he/she will go up to the house to ensure that they are OK, or looks for signs that they are on vacation, ( Car gone, etc...)
Would this work in major suburbs and cities? I don't know, but at least it should work in the rural areas.
.
Under Emergency Management Institute EIM and FEMA is a program called CERTS community emergency response teams...trained and organized locally to manage disasters until "professional help" arrives. Sounds like an idea-there are some best practice models at:http://training.fema.gov/EMIWeb/CERT/new_CERT/
index.htm
chuck: good thought. CDC also has an initiative in several places to use the postal service to distribute antivirals (if there are any to distribute).
Plans being drawn up for my Local Authority involves firstly doing door-to-door services as usual but without the direct contact, and secondly using Social Services dept personnel who have recovered from the disease to go out into the community. Organising local community groups will be a relatively easy option where community cohesion is strong; however, one problem I have in my area is a lack of cohesion which often has led in emergencies to an 'everyone for themselves' situation - we need to overcome this as soon as possible. Unfortunately, none of the senior people see this as easily achievable and won't promote any initiatives.
The institutional reluctance in UK local government to attempt to deal with these difficult issues because they are difficult and because they are hard and because you might not succeed has made sure that only initiative with an excellent chance of success are pursued. The measures which should be put in place apply to much more than just a flu pandemic; they are an excellent source of community resilience against all sorts of incidents.
While I'm leaving a comment for once, I just want to say thanks for providing an excellent source of information, which I share with many in emergency planning in the UK.
I offer up myself as videographer and maybe we could get this 1) on Google 2) on the Fluwiki 3) ... can we get this on regular TV?
Reveres, and all... find the best ideas.... I will shoot edit and try to keep it down to one minute... PSA.
I should blogwhore, because it's on topic. Click the homepage for info on a little test of local health department emergency response readiness done by the Rand Corporation. (Post titled " Is Pooster's Fork, Wyoming, ready for the big one?")
First, cercantes, I like the picture very much.
Second, I am appalled by responses but not surprised... isn't that terrible?
huddy: Thanks for the thoughts. Anyone out there want to venture some ideas for huddy's problem? Just because the local authority can't solve it, doesn't mean it isn't solvable.
This may not be the best answer however...In the worst of times.... sometimes, it takes just that, people rise to the occation. If there is an opportunity and a place to fill, just maybe, it will be filled. Some people are timid and would like to do things but can't see their role or feel they don't know enough or are worried they might do something wrong. Having 'open' positions ready might help ???
With respect to people being afraid to help out for fear of getting sick, why not enlist the recovered? (I saw this idea on flu clinic or fluwikie or somewhere.) I would think that after someone has recovered he/she would be much more likely to volunteer.
It also seems that a local communication plan would be important, both before and during a pandemic. You wouldn't necessarily want people congregating somewhere to get information, so what about designating a specific radio station for local updates?
Huddy, I used to be a community organizer back in the good old days. The best answer I can give you is that people come together around concrete, immediate concerns, not abstractions. If you organize a community to take on a project with tangible results, like a community cleanup day, planting a community garden, going down and protesting at the public works department about the potholes (that's the classic, actually), getting a street light put in where the old folks have to cross the street to get to the grocery -- that sort of thing -- then they'll join up, elect officers, come to meetings. Then you can train and prepare around contingencies such as an epidemic.
Starting off by talking about something far off that may never happen isn't going to get it done.
And Tardigrade -- the preznit's picture is in all the post offices, public schools, federal buildings, etc., so I figure, why not have him on my blog? Makes it seem kind of official.
Our neighborhood of 50 homes is very well organized and we are CERT trained. We have point persons and emergency staging areas designated, as well as an archive of data on each of us that may be needed in an emergency such as family emergency contacts, pets, locations of critical items within the house, meds each person needs, skills each may bring to bear, etc. I wrote a thoroughgoing article in our newsletter about bird flu last month and we are meeting to discuss this Sunday. One of our neighbors is a prominent physician at our local hospital, and past administrator. He is also well-connected with the mayor of our large city. He told me there is no contingency plan at the hospital and gave me the task of drawing a rough draft community plan up, which I have been doing. I've also been working on personal and family level plans which are considerably easier but important for folks to grasp the enormity of the task ahead.
Here is my very rough community level plan -- please give me useful feedback, for which I will be very grateful. It's long and very incomplete.
********************
COMMUNITY PLANS FOR H5N1 Pandemic
Preliminary considerations:
1. 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 a quarter to a half staffing everywhere for various durations
2. Virus is contagious before symptoms appear (which can be 3 - 6 to even 17 days) and after symptoms (21 days for children, 3-5 days for adults, longer for the immunocompromised)
3. Children and otherwise healthy adults are most at risk
4. All bodily excreta will be very dangerous, especially feces and sputum/mucus; virus begins in gut and diarrhea is often first symptom, preceding respiratory symptoms
5. We will probably need twice the beds and ICU facilities
6. Public services such as water, power, communications, and transportation will likely be seriously affected
7. Deliveries of food and other essential commodities may be disrupted
8. There may be civil disorder
9. There will be an exodus from the city, potentially carrying virus elsewhere
10. There will probably be mortality of at least an extra 50% beyond normal; at least 1/3 of these will likely be under 65 years old
11. Most patients should probably be treated in the home, or if more critical, in secondary ICU-like set ups in schools or other unused locations
City functions:
1. Close schools and other nonessential places where people congregate
2. Stockpile materials, medicines, face masks, gloves, antiseptic cleansers and wipes
3. Set up vaccination priorities (in conjunction with medical personnel) in a logical way that puts essential personnel first: medical, police, essential waterworks, power, communications, waste and morgue workers; then children and adults, preferably those latter who commit to serve as neighborhood or healthcare volunteers (if we should be so lucky to have any vaccine at all)
4. Policing will be needed to guard hospitals and pharmaceutical stockpiles
5. Establish lines of succession in critical positions
6. Develop plans to keep essential services operational; establish minimum staffing level requirements
7. Coordinate essential commodities deliveries and rationing
8. Include area for public information on website if not already present and arrange with local radio & TV for regular accurate official updates (assuming media is functioning); utilize ham radio
9. Insure that institutions where people live together such as nursing homes or prisons are prepared
10. Consider how to deal with the homeless, who will be particularly vulnerable
11. Establishing guidelines or rules for (voluntary?) quarantine: home isolation, isolation of contacts of known cases, restriction of movement, requirements for use of face masks
12. Restrictions on airports and international and national travel
13. Curfew should there be unrest
14. Ports and shipping (?)
15. Establishing emergency fuel supplies (?)
16. Set up temporary morgues; body recovery teams with prepared vans that completely isolate corpse and protect drivers; body disposal in least potentially infective way, cremation encouraged
17. Videotape school classes to put on TV or the internet so education can continue at home
18. Can we set up our own lab to manufacture antivirals or vaccines? Gilead, the company that created Tamiflu but licensed it to Roche (and is suing to get it back), is based in California: appeal to them to make it invoking compulsory license? (OK, maybe this is nuts)
Hospital functions:
1. Set up mobile nursing units (part of firewall) with portable antiviral air filters for using in sick rooms (to protect the worker) as well as traditional protection
2. Stockpile supplies, vaccines, antibiotics, and antivirals, IV kits, O2 devices
3. Provide public education materials (in conjunction with City)
4. Volunteer vetting and training: vaccination, administering meds, nursing assistance, testing for H5N1, errands, etc.
5. Establish minimum staffing levels; identify essential personnel; establish lines of succession
6. Oversee secondary location set up and personnel (part of firewall)
7. Suspend elective surgeries
8. Ensure critical functions such as waste disposal, backup power, supplemental water purification, laundry, sterilization, etc., with contingency plans for personnel shortages and service outages
9. Set up public information web pages and blog for Q&A
10. Transport seriously ill patients to secondary locations (EMT? City?)
11. Documentation and data collection for analysis
12. Should air conditioning or forced air heating be modified to eliminate viruses (UV, ozone, high filtration) in secondary facilities? Or replaced with radiant heat in winter and ice in summer?
Neighborhood functions:
1. Set up communications node (if communications are still up and running) or point persons
2. Keep track of all cases; transport afflicted when necessary
3. Stockpile goods and move resources to where needed such that there is no waste
4. Immunized (via vaccination or flu survival) persons hopefully volunteer to run errands and help with nursing
5. Consolidate errands to minimize contact in public places
6. Neighborhood education and news updates via newsletter, websites, email or phone trees
Public Education:
1. Hygiene considerations: hand washing, cough technique, awareness of infectivity on surfaces and cleaning techniques; special effort to train children
2. Importance of flu shots and pneumovax
3. Stay home when ill
4. Material preparations such as stockpiling food, water, household basics, etc
5. Advance planning such as how to educate children pulled from school and working from home
6. Teach basic nursing skills such as taking blood pressure, pulse, temperature, respiration rate
7. Teach public how to identify H5N1 and specific nursing measures for home care; videotape classes for broadcast on TV and web for the public
I know what you mean by the "don't worry, be happy" crowd. I just sent an angry letter to The Nation because of an article they posted online, "Scare Scenario" by Dr. Marc Siegel--a doctor, no less-- who tries to paint people like you as Chicken Littles. I bet he has his secret cache of Tamiflu ready, but he covers up the truth in favor of a pablum of misinformation for the unwashed masses.
See: http://www.thenation.com/doc/200.../
bird_flu_scare
Even a stash of Tamiflu administered early will not necessarily save a person... about 20% die anyway, I understand.
Mark: I see Siegel's crap all over the place now. He's a medical Wendy Orent. Interestingly, I knew him slightly 20 years ago when we were both working on something at the Hastings Institute (a bioethics think tank). Didn't know him well then and he is infuriating now.
cervantes:
I know we can overcome the problems and I also know that even the most fractious communities can come together during extraordinary times - but, and here's the but: We need the public to follow clear instructions as part of an overall disease control strategy, not acting on their own.
A more general comment:
Local and Regional government (at the moment in the UK) are pretty ineffective at planning for (what are widely perceived as) non-imminant incident scenarios.
My situation for example which is incredibly frustrating is that my superior lived through the '67 pandemic and doesn't remember a thing and so is convinced that any future pandemic won't affect him.
I can't imagine he's on his own feeling like this - generatinig momentum in government through awareness raising is my current priority.
In the UK many of our relevant large scale contingency plans (mass fatalities/mass casualties etc) are sound.
What I, UK needs are:
1 - Business continuity plans as a statutory obligation to be assessed by external auditors
2 - Central direction and instruction on key issues:
i - School Closures
ii - drug distribution
iii - use of emergency powers
iv - Mass garthering cancellations
If i had these answers - thresholds/etc for the above - my contingency plans (for central london) would be much better and could be exercised now. As it is, i'm struggling to have my superiours approve the time I'm dedicating to this.
Mods - How about moving these comments to a wiki page? It's getting a little hard to read the longer comments (some of which I'm to blame for) in this tiny window?
Eyeswideopen: your draft is simply great. Could we please copy it over to the fluwikie? Please do share next versions too.
Re Da Challenge:
- It's great that you (Revere) have put a specific challenge forward. I haven't had a chance to do serious thinking on it. I intend to reserve some time tomorrow night.
My hunch is that if we pinpoint and address maybe 20-40 such "focal points" we will have "solved" the main problems (the first 90%, so there's only the remaining 90% left to do).
Software developers call this "bug reporting" and "bug squashing". Hey, they even have "bug squash parties" where they eat pizza and drink refreshments. (Some may want to use lateral thinking, up to you.)
- I intend to "harvest" the ideas that have been put forward so far. The usual stuff of summarizing, looking at areas that have been covered, areas that are still not covered, etc. Of course I wouldn't mind if someone else jumps in before i do it ;)
Eyeswideopen - An excellent post.
Just one thing missing though, is the issue of home working. If you can do some or all of your job from home rather than have to travel to work, you should try to do so.
Utilities and telecomms I dont think will be too severely affected perhaps more in the US than the UK promoting this among employers and the work force could be potentially quite useful.
If you can be at home caring for family/friends etc and yet still productive, then some of the social and economic impacts can be off set, particularly if this can be taken up more widely.
There was a related idea that might or might not work: there are cybercafes (for playing games and chatting with other teenagers) and these could perhaps be turned into cyberoffices (with appropriate security and perhaps custom linux "live-CD" systems and pendrives - I'm sure people at slashdot, linuxtoday and similar sites would love to lend a hand).
Perhaps we could have voluntary "neighborhood isolation", with only certain "knowledgeable" people going to buy and sell stuff outside? If it's not full isolation, at least we diminish the number of contacts - the "slow it down" strategy.
If schools are shut down or people don't go to schools out of precaution, we must learn how to organise teenagers on the streets - and smaller kids in the home. Or provide them with tips on self-organization. Walkie-talkies, flags, anything will do. A role-playing war-game of sorts. They will go into this with their own brain-content anyway.
The Potomac Institute has an information packed a poster entitled "Bird Flu and You", which you can order from their website - I think it's free.
When my order arrives, I plan to ask local merchants, physicians and dentists to post one of them in their workplaces.
I'm starting from scratch, since the public health department in my town told me that they are relying on FEMA for their emergency plans, silly girls.
I copied Dr. Grattan Woodson's manual "Preparing for the Coming Influenza Pandemic" from Fluwiki for my own doctor. I hope he has put it in his waiting room, as suggested.
Gotta start somewhere. It's so helpful and impressive) to hear from others who are much farther along in this process. Thanks
huddy: Yes, this definitely belongs on a wiki page. I'm not sure you can't trust the public, 'tho. Maybe it's the local authority that needs the clear directions.
Revere:
To use a quote
"There's no such thing as society, only individuals". The 'public' is a mass of individuals and communities - all of which act and respond to the same situations and information in different ways. The trick will be to make sure that a good public information campaign is undertaken.
Most Local Authorities are so weighed down with other issues that Business Continuity Plans, let alone anything approaching a pandemic plan - are just things on a to-do-list.
Local Authorities do need information I'll certainly be the first to agree, but we ain't getting it.
It could be that "the public" is a mesh of networks. We're hoping to produce a good set of "preventive, cooperative, effective memes" that will travel faster than the virus.
So we'll need to focus on "creating the memes" and also in "transmitting them through the mesh".
The "mesh" is an active surface - it doesn't just transfer "the message", but rather it changes it, mixes it with previous beliefs, amplifies or minimizes or shuts it down ...
Ok, this does not help. We all know it and it's not practical. One issue at a time.
huddy, lugon and others: We have different conceptions of the public. Neither are the only possibilities. A stimulating review of some cutting edge work in this area is in Philip Ball's book, Critical Mass (winner of best science book of the year award last year in the UK).
Clearly it is not a solution to depend on volunteerism. Planning has to depend on public employees who are trained and assigned to play specific roles. The key is that the response be distributed, that it involve neighborhood level communication and action. Outreach to the general public, including provision of information about the nature of a possible emergency, what to do in the event, and what the response plan consists of particularly as it affects them directly, needs to happen in advance of course. Community meetings, including recruitment of potential volunteers, can certainly be a part of it. You can't always count on people who volunteer, unfortunately, and that can't be emphasized too much.
The main point to me is that current "plans" depend on highly centralized locations -- emergency dispensing sites, temporary infirmaries, etc. That won't work and doesn't address 90% of the problem even if it could.
Huddy, Lugon, everyone:
Thank you so much for responding to my half-baked plans! I am so grateful to everyone who read and commented on it -- I will use everyone's ideas to attempt to improve it. I did address the work-from-home issue in my personal preparedness plan (also unfinished; I'll post it below and when I figure out how to wiki, I'll put it on flu wiki. I love the idea of a wiki here!), out of fear that business wouldn't take kindly to directives from the community, but I think I'll try to move into a more "common good" approach that has become so alien in our sad USA. Yes, I think the City should issue directives to further and facilitate telecommuting. It should not be left up to workers to negotiate their health from their employers.
Anyway, here's the other set of plans for individuals and family. I'm going to try to expand each section with respect to each type of service interruption. Aplogies for the length!
************************
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 use tissue, not your hands; hands are a major means of spreading germs
Get a flu shot and if over 50 a pneumovax
Stock up on food with long shelf-life, water, medicines, basic household necessities (toilet paper, paper towels, plastic bags, tissues, bleach, soaps and detergents, batteries etc) masks, latex gloves, sugar, salt, multivitamins
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 linked to at: http://www.fluwikie.com/
index.ph...parednessGuides
Learn how to treat water to make it potable in case of interruptions of water supply: http://athagan.members.atlantic....ntFAQ-
v2.2.html
If possible, start a vegetable garden and/or orchard
Learn basic cooking if necessary
Get a clothesline and clothespins
Put together a basic set of handyman tools and learn how to use them
Have a mobile phone and an email address
Consider getting a good bicycle
Learn self-defense and acquire pepper spray
Save money; have cash on hand
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
Get a passport or other photo ID and credit card if you don't already have them
Exercise regularly in order to strengthen your heart and lungs
If you smoke, stop now
Get a physical exam and get your medical history and records in order
If you have high cholesterol, take statin drugs -- they apparently reduce flu complications as a beneficial side effect
Learn how to take blood pressure, pulse, temperature, respiration rate; learn basic first aid and nursing procedures
Stock your medicine cabinet: aspirin or 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
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
Learn as much as you can about the bird flu
Consider how you can help during a pandemic; volunteer for training with local hospital
Expand alternate means of communication such as teleconferencing, cell phones, landlines, email, ham radio
Should Birds in the US Become Infected:
Avoid sick or dead birds, especially wild birds
Wash eggs to remove fecal traces and cook all poultry products thoroughly if you continue to consume them
If you keep birds, prevent any contact with wild birds or the excreta thereof; keep them under cover
Keep pet cats away from dead birds; H5N1 can infect cats. Although H5N1 has not been seen in dogs, it would be wise to keep pet dogs away, too
Put enhanced hygiene measures into high gear
Should 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
Be prepared to isolate yourself for 3-6 months
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
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 or at least white vinegar (2 cups per load) 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 at: http://www.fluwikie.com/
index.ph...parednessGuides
If you get sick:
Stay home if you become ill or if you feel you might have been exposed to the virus
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.
If you get very sick, contact mobile nurse network or go to designated medical facility for H5N1
Wear a mask as much as possible when others are around
If you are nursing a sick patient:
Wear N95 mask, 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 Tamiflu or Relenza, hydrocodone, phenergan, and vallium as well as antipyretics such as aspirin, acetaminophen, ibuprofen
You will need to make a fluid replacement fluid using clean water, sugar, and salt (see Dr. Woodson's guide for directions); you will have to force fluids, drop by drop if necessary
You may need oxygen for the patient; use oxygen concentrator
Give patient a bell or other means of signaling you
You may need an oxygen concentrator: hopefully, there will be 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 will probably have diarrhea early on; you may need a bed pan or bedside commode
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
"why not enlist the recovered?
...
Clearly it is not a solution to depend on volunteerism."
Thinking outside the box, and commenting anonymously so my head doesn't get bitten off as a result, shouldn't a competent U.S. health agency be locating existing bird flu survivors in Asia, and offering them (and their families) generous inducements (both money and citizenship) to learn basic nursing skills and come to the U.S. to work here? These people may turn out to be worth their weight in gold.
Ima: We don't bite off heads here (at least I hope we don't). The idea of registering the recovered has come up a few times. If there is an outbreak most people will recover so we don't have to go outside the country for that. I'd oppose that idea personally because it takes a resource from somewhere else when they need it. It is an "immune drain," so to speak. But there is no barrier to having a system in place in this country (or your country, wherever you are writing from; we have a global commenting community here) to do the kind of training you are suggesting. But it would have to be set up ahead of time.
eyeswideopen -- your list is an excellent resource. Will you be posting this somewhere on the web soon? Thank you.
Problem: older citizens who live alone and depend on their children (often in their fifties or sixties themselves) to get them groceries, pick up their prescriptions and make sure they are OK. What if these caregivers get sick?
What if they take care of themselves?
Of course, there are things they cannot do. But, are there things they can do? Can they chat over the phone? Can they take care of children (above a certain age)? Can they provide room at home, or knowledge in whatever they have experience with, or just company?
Right now, they may be a powerful force in countries where there are many people in the same situation. Could they make their voice heard somehow? Perhaps some journalists can contact a few of them and just ask them?
What's good about being old and fragile? Are there 'types of elderly people'? Could it be that at least some of them have something to give?
This may deserve some exploration. Anyone got some statistics regarding this specific part of humanity?
What simple tools would they need if they just want help from *anyone* who passes by? Walkie-talkies? A bell they can ring asking for help?
What would be some sort of extra motivation to help them? Maybe there could be some sort of currency they and they only can sign - so it's in the best interest of food suppliers to go to their homes?
Ok, this is best carried forward as a conversation with people who have some information.
revere wrote:
>Other things might need to be done much more ahead of time. I have some examples of those, too, but I'll let this thread go a awhile.
Please share.
Of course, there could be plans routed through usual "command and control" networks, but using an entirely different approach. What I try to say is that the military might receive instruction on how to organize civilians.
Anyone might use that instruction, of course.
Again, open instructions. Carried out by anyone who is healthy to do it.
huddy (10.25.05 - 1247 pm) asks for ideas on How to foster community where there's not much community to start with (my wording).
I don't think there's Instant Community Magic Powder, or is there? What happened when Katrina hit? Would could we learn so we could have the same human thing happening, only faster and more effectively?
Do we need some storytelling to help us?
Tardigrade wrote
>Having 'open' positions ready might help ???
Looks like it would help. In fact, many normal positions should be opened: if people who deal with waste are ill, it would be good to have how-to documents so that others can take their job temporarily.
So it looks like what we want to do is:
1) Set up plans that will be used only when the time comes. These plans should be ready to be copied and used in no time, by anyone wishing to help their community.
2) See what needs to be done in advance. Things that need organizing, buying things, setting up contact lists, etc.
3) Start building stories of prevention, courage, thoughtfulness, solidarity, and all the other values communities would/will need. Not after the facts like journalists are forced to do, but beforehand, like fiction writers do.
Are there other elements for community preparedness? How do we move forward?
http://www.changemakers.net/jour...journal/300510/
Commenting by HaloScan
