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  • Officials play out pandemic scenarios

    Officials play out pandemic scenarios
    Thursday, November 9, 2006

    The event was to gauge the county's readiness for the arrival of an airborne disease like avian flu. By TJ GREANEY Southeast Missourian Asking "what if" can be fun, but when contagious disease is the topic, the implications are deadly serious. Approximately 65 area officials, medical professionals, first responders and others met Wednesday at the Osage Community Centre for a "table top" exercise. ...


    The event was to gauge the county's readiness for the arrival of an airborne disease like avian flu.
    By TJ GREANEY

    Southeast Missourian

    Asking "what if" can be fun, but when contagious disease is the topic, the implications are deadly serious.

    Approximately 65 area officials, medical professionals, first responders and others met Wednesday at the Osage Community Centre for a "table top" exercise. The event was to gauge the county's readiness for the arrival of an airborne disease like avian flu.

    The theme of the meeting was that no matter how well officials plan, maintaining order will be difficult once panic takes hold of the community.

    "We can sit around here and plan for different situations, but when people start dying, that's when you start doing things differently," said Cape Girardeau County Emergency Operations Center director Dave Hitt.

    Cape Girardeau Area Magnet executive director Mitch Robinson agreed. He said even if public places and schools remain open, fear could cause people to quarantine themselves.

    "I'm not going to be sending my kids to an environment that's already a breeding ground for all sorts of germs," he said of the schools. "It's getting scarier and scarier as we talk today."

    Cape Girardeau County has an estimated 460 law enforcement and fire personnel and 425 doctors at its two hospitals. A low projection of the impact of avian flu estimates 28,292 infected people in the county alone.

    One hospital representative said anything greater than 100 new patients per day would likely exceed the facility's resources.

    At the meeting, moderators presented the group with three hypothetical scenarios.

    In the first, a respiratory illness struck Asia with those officials struggling to quarantine the sick. In the second, the virus came to Southeast Missouri and made 10 percent of people sick. In the third, an epidemic hit the area with an infection rate of roughly 50 percent and left 6,000 dead in three weeks.

    Charlotte Craig, director of the Cape Girardeau County Public Health Center, said the recent illnesses and evacuation of the Mississippi Queen riverboat opened her eyes to the difficulty of quarantine.

    "We're not going to be able to enforce it," she said.

    Municipalities in the area each passed an ordinance earlier this year ceding quarantine power to the health center in the event of a pandemic.

    Craig also said she was surprised to find the largest retailer in the area, Wal-Mart, has no plan in place to make goods available in the event of a catastrophe.

    Retired nurse and Cape Girardeau City Councilwoman Marcia Ritter took the opportunity to advertise the local chapter of the Medical Reserve Corps. The organization is essentially a group of health professionals who are no longer employed but can help in the event of an emergency.

    Ritter also suggested using drivers and vehicles from the Cape Girardeau County Transit Authority to help move the sick.

    John Russell, medical director of the Cape Girardeau Pediatric Rural Health Clinic, said even if there are enough responders, they may have to make difficult decisions in determining which patients go to hospitals and which remain in isolation.

    "They need to ask themselves, does this patient need to go anywhere or should we contact some other community resource and have that patient stay home," he said.

    tgreaney@semissourian

  • #2
    Re: Officials play out pandemic scenarios

    as we see time and time again, local resources are not prepared to handle even a 2-5% CFR.

    Comment


    • #3
      Re: Officials play out pandemic scenarios

      At a recent pandemic planning meeting I attended with the County Public Health, their representative related the County had been charged with this scenario: 1) a biochemical medical emergency has just occurred; 2) everyone within the county must receive medication within 48 hours; 3) there are 750,000 individuals within the entire county (city/ suburbs/ rural).

      We were presented with a map: 40 PODs have been designated/ county has been divided into sections/ each section to have minimum 1 POD/ minimum of 50 staff at each POD/ so that staff from each POD can service 20,000 people in the 48 hours/ hospitals have their own PODs/ training to be set for non-medical volunteers to assist in dispensing and/or re-packaging meds as they arrive.

      This is the type of communication that can make it "real" to the general public- so that people can begin planning NOW. My message: PLAN NOW

      Comment


      • #4
        Re: Officials play out pandemic scenarios

        Not to be difficult, but even if they have the structure in place to do a 48 hour distribution, where are they going to get or stockpile 750,000 doses of medication?

        I think it is a mistake to mislead the public into thinking that there will be a vaccine or sufficient antivirals to treat everyone once a pandemic starts.
        http://novel-infectious-diseases.blogspot.com/

        Comment


        • #5
          Re: Officials play out pandemic scenarios

          Medication is not being equated to vaccines/ antivirals. Instructions related to us at the meeting is that the county public health department had to develop a plan whereby the county public health department would be able to put into every resident's hands medication within 48 hours. Anthrax and/or biochemical medical threat were verbalized/ pandemic flu was presented but minimized.
          For those at the meeting, it was stated vaccines are not/ will not be available. Specific questions had to be asked, however, to obtain this information. Tamiflu will be used only for treatment within 48 hours. - not as a prophylactic. There is very limited amount in our regional stockpile. What is available will be used on a priortized basis.
          This was a planning meeting for those county agencies with residential services. When I asked how many were tracking the pandemic, the answer was zero. (Except for the public health liasion.) When I asked how many had begun developing plans for their agencies, the answer was zero.
          In my own agency's planning meetings, I presented with the CFR in Indonesia at 76%; overall at greater than 59%. I was directed this info will scare people and should not be presented. What is scary is, when I look to the right and the left of me, 3 out of 4 of us will not live if the CFR remains at 76%.

          The public in general has little concept; I had little understanding myself of "this beast" until I committed myself to tracking/ learning. At the beginning of my "education" I could not understand self-imposed quarantine.

          I believe getting this information to the general health can help greatly- past the initial "panic." People need to understand they really are going to be on their own. There will not be stockpiles of medicines. There will be no stockpiles of food except what they have gathered for themselves/ their families. Pharmacies will be extremely limited, if available. In re: antivirals, most of general public will not have access to such- due to the priortization lists developed/ being developed. People need this information so they truly can begin to understand, if they want to keep themselves and their families safe and healthy, they will be on their own to do so.
          One group member stated- the American Red Cross will be there. No, the Red Cross has been very clear re: individual responsibility (explicit/ non-explicit). Our county schools will be closed for 12 weeks; no child care. Major HR issues for employers/ employees.

          I agree with you. The ethics issues are enormous. This is a difficult task for the world. Thank heavens for so many committed people.

          Comment


          • #6
            Re: Officials play out pandemic scenarios

            pandemic flu was presented but minimized.
            The public in general has little concept
            You don't suppose these are related in any meaningful way do you?
            21st Century Omega Man

            Comment


            • #7
              Re: Officials play out pandemic scenarios

              Originally posted by colormyquilt
              At a recent pandemic planning meeting I attended with the County Public Health, their representative related the County had been charged with this scenario: 1) a biochemical medical emergency has just occurred; 2) everyone within the county must receive medication within 48 hours; 3) there are 750,000 individuals within the entire county (city/ suburbs/ rural). ....


              Medication is not being equated to vaccines/ antivirals. Instructions related to us at the meeting is that the county public health department had to develop a plan whereby the county public health department would be able to put into every resident's hands medication within 48 hours. Anthrax and/or biochemical medical threat were verbalized/ pandemic flu was presented but minimized.
              For those at the meeting, it was stated vaccines are not/ will not be available. Specific questions had to be asked, however, to obtain this information. Tamiflu will be used only for treatment within 48 hours. - not as a prophylactic.
              Well, I think I have it all figured out now.
              The most popular medication for flu now is Tamiflu ... but it won't be available.
              The most popular medication in 1918 was whiskey.

              So in lieu of Tamiflu, I figure they plan on handing out 750,000 bottles of whiskey.

              Comment


              • #8
                Re: Officials play out pandemic scenarios

                the problem is, that they can't speak about without having to be afraid that it's bad for their image.
                Suppose they come to the conclusion that shooting at people
                is reasonable to enforce the quarantine, would they ever
                dare to talk about it now ?
                I'm interested in expert panflu damage estimates
                my current links: http://bit.ly/hFI7H ILI-charts: http://bit.ly/CcRgT

                Comment


                • #9
                  Re: Officials play out pandemic scenarios

                  Never thought about the whiskey.

                  For many people in the developed countries, there can be a very limited understanding of "being without." One does not have to live in poverty to live by the concept of entitlement. There can be the pervasive belief that "someone will be there." (Look at Katrina.) Which is a major step away from survival by independent/ self-sufficiency. Most of our grandparents in the US did this- it is how they survived the great depression and the longevity of WWII.

                  IMOO, it is not that most people can't prep. It's that they need fair and factual information. They need to be able to trust what they are hearing. They also don't always know what questions to ask. Regarding this pandemic, there is alot for people not to know. If I am wanting people to hear my message: PLAN NOW, I may have to meet them where they are.
                  And until the CFR shows evidence of approaching 2%, it is imperative ethically that they be provided the information CFR 76% means 3 out of every four will die.

                  I take email addresses to forward basic preps/ shelf life lists. I send people to the WEB. I also send them to flutrackers- Get information, get information. Buy water. Buy water. It is either getting a little easier for people to listen or my skin is toughening up alittle. I have felt a heightened sense of urgency- even moreso with babies now dying in Indonesia.

                  I truly wish that people in position/ with the power to spread the word- because they have the information- would do so. It did not happen in 1918.
                  For so many different reasons. I am not sure those reasons are any different today. So, that may mean the responsibility is delegated to those who are committed to getting good information to as many as possible to do exactly that.

                  Comment


                  • #10
                    Re: Officials play out pandemic scenarios

                    Originally posted by colormyquilt
                    .....
                    IMOO, it is not that most people can't prep. It's that they need fair and factual information. They need to be able to trust what they are hearing.
                    ....
                    I truly wish that people in position/ with the power to spread the word- because they have the information- would do so.....
                    People no longer know who to trust, e.g. talking heads on TV programs, elected officials, FluTracker posters, etc. There are always points and balanced counter points. To survive we have become a global society of skeptics, mostly relying on our own personal opinions and limited experiences to make choices. Since a pandemic with a CFR of 75% is out of the realm of personal experience and understanding, people will not act upon this information, no matter who is presenting it to them.

                    The key, or the trick, is to find a visible, recognizable, and respected spokesperson that people will listen to and who can carry the pandemic message to the masses. I am just not sure who that might be.
                    http://novel-infectious-diseases.blogspot.com/

                    Comment


                    • #11
                      Re: Officials play out pandemic scenarios

                      I agree, Laidback Al.

                      Until that time, IMO, we have to do the best we can with what we have/ where we are and where we see those we are communicating with are.

                      I do not entertain "sugarcoating"- that speaks to my credibility. I do believe it requires taking the time to reach people with what information I have at the level they are at. Due to a general lack of trust and the "need not to believe." This is a beast we are talking about- the virus itself, the pandemic, the lack of a vaccine, the extremely limited supply of antivirals, the limited food supply.

                      On the other hand, there are alot of good people who are committed to doing what they can where they are. I am glad to know there are others around the world "who really see" and keep chipping away at this task.
                      Each one who contributes helps.

                      Comment

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