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Missouri - Pandemic Action Council Plans for What Ifs

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  • Missouri - Pandemic Action Council Plans for What Ifs

    Pandemic Action Council plans for what ifs

    by TIM HARE Ledger Staff Writer
    Published: Thursday, April 10, 2008 12:50 PM CDT
    E-mail this story | Print this page


    <table class="clear" align="right" width="336"><tbody><tr><td align="center"></td></tr><tr><td align="center">The Audrain County Pandemic Action Council met Monday at Jansen Auditorium at Audrain Medical Center. The lunch-and-learn program, coordinated by Sarah Williams, Pandemic Planner for Audrain and Montgomery counties, was sponsored by the Audrain City-County Health Unit in Mexico. Participants included key players from Audrain, Callaway and Montgomery counties, including (from left) Kevin W. Lowrance, administrator, Audrain City-County Health; Karen Schutz, city of Vandalia; Steven B. Shaw, Disaster Preparedness Coordinator, Audrain Medical Center; Roger Young, Audrain County Eastern District Commissioner; Pat Farnen, Audrain County Coroner; Jim Eaton, Statewide Commander for Mass Fatality Response, NDMSR Region VII DMORT; David A. Neuendorf, CEO, Audrain Medical Center; Williams; and Andrew Brennecke, Planner, Montgomery, Osage, Gasconade, Audrain and Callaway counties.

    </td></tr></tbody></table> Logistics regarding an extreme emergency situation, particularly a pandemic, was the general topic of discussion at a lunch-and-learn event hosted earlier this week by the Audrain County Pandemic Action Council (ACPAC), and coordinated through the Audrain City-County Health Unit.

    "It's important to ... at least address the situation, talk about it, prior to something happening," stated Jim Eaton, the keynote speaker of Monday's presentation conducted in Jansen Auditorium at Audrain Medical Center in Mexico. "Sit down with your immediates, your contemporaries that are in your sphere of control, so to speak, and say, 'What if?' Have your disaster plan in place, ready to go, and like I say, it might not work. But at least you're talking about it, at least you're thinking about it, and that's the important thing."

    Eaton, CEO of Eaton Funeral Home in Sullivan, Missouri, serves as statewide commander for mass fatality response, and is also a trained member of Global-BMS Disaster Recovery Team, and the National Disaster Medical System Region VII DMORT Team. DMORT itself is an acronym for Disaster Mortuary Operational Response Team, comprised of a group of forensic specialists who respond to mass fatality events for the National Disaster Medical System. Accordingly, the principal focus of Eaton's hour-long presentation was mortuary affairs in a mass casualty situation.
    <table class="clear" align="right"><tbody><tr><td align="center"><!-- AdSys ad not found for news:middle -->
    </td></tr></tbody></table> "What we try and do, is each time we have such a meeting, we try and address a major topic," stated Sarah Williams, pandemic planner at ACCHU. "And our goal is not to solve the whole problem in one meeting, because ... that's impossible. But what it does is, it helps to create conversation and dialogue, and initiate some planning."

    She added that Eaton was specifically asked to deliver the presentation because of his "knowledge and experience that can help us at the local level create and facilitate our own self-sufficiency."

    Williams said ACPAC meetings themselves are administered via contract with the state's Department of Health and Senior Services, coordinated through the U.S. Department of Homeland Security. "These meetings help us prepare for a multitude of different disaster scenarios, but in particular, specifically, for an influenza pandemic," she said. "The reason for that is because earthquakes, tornadoes and such are terrible events, but they are generally more localized, as opposed to a pandemic, which will not be just nationwide, but it will be worldwide. So it's not like we can call St. Louis or Denver for help. We're going to have to be able to figure out how to take care of things the best we can on our own."
    <table class="clear" align="right" width=""><tbody><tr><td align="center">
    </td></tr><tr><td align="center">
    </td></tr></tbody></table> Eaton proceeded to detail various preparedness decisions, responsibilities and assignments vital for consideration by area leaders in advance of large-scale emergency. Among the broader concerns requiring effective assessment, he cited recordkeeping; availability of resources, such as body bags, identification tags, and cooler space for fatalities; procedures regarding release of decedents; access to information sources; release of information to the press and public; procedure for proper handling of fatalities with regard to societal expectations, while similarly factoring potential strain on resources and personnel; and ability to access state and federal resources.

    Further elaborating, Eaton presented a list of specific bullet points, rhetorically asking "What if?" of numerous concerns, including:


    Funeral homes experiencing 12-month caseload in a few months or less. <table class="clear" align="right" width=""><tbody><tr><td align="center">
    </td></tr><tr><td align="center">
    </td></tr></tbody></table> 30 to 40 percent of the workforce potentially incapacitated, ill or dead.

    Casket deliveries slowed or stopped.

    Vault deliveries slowed or stopped. <table class="clear" align="right" width=""><tbody><tr><td align="center">
    </td></tr><tr><td align="center">
    </td></tr></tbody></table> Limited service capability among medical, law enforcement, and firefighting personnel.

    Disruption to, and minimization of, transport of goods.

    Incapacitation among corresponding legal authorities or representatives. <table class="clear" align="right" width=""><tbody><tr><td align="center">
    </td></tr><tr><td align="center">
    </td></tr></tbody></table> Providing local context, County Coroner Pat Farnen stated: "Let's say that you come up with a number of 1,200 deaths in one month's time. To put that in perspective ... (East Lawn) Memorial Park right now does 100 interments in a year's time. Elmwood does 50 to 70 (in a year's time). So you're talking about a number of deaths that are going to occur in one month's time that would be equal to about six years of deaths."

    The framework for Monday's discussion revolved specifically around response to a pandemic, largely because of its catastrophic potential, and because many health experts believe such an event is inevitable. In recent years, considerable attention has especially been focused on the H5N1 avian influenza virus, commonly referred to as "bird flu." The virus - which has appeared in parts of Asia, Africa and Europe - primarily affects birds. However, there is concern the virus could mutate and spread from person-to-person, resulting in a worldwide influenza epidemic (hence the term "pandemic").

    Underscoring immediacy of the concern was the recent announcement by the World Health Organization that the first-ever case of human-to-human infection with the H5N1 virus had occurred in November. The incident involved a 25-year-old male from Pakistan who succumbed to the illness.
    <table class="clear" align="right" width=""><tbody><tr><td align="center">
    </td></tr><tr><td align="center">
    </td></tr></tbody></table> Authorities from the WHO have since conducted a preliminary risk assessment of the case, and found no evidence of sustained or community human-to-human transmission. Still, history is replete with deadly viral strains which have mutated and spread beyond local contagion, including the 1918 Spanish pandemic. Estimates indicate that 20 to 40 percent of the world's population became sick during the resultant outbreak, leading to approximately 675,000 deaths in the United States between September 1918 and April 1919.

    Williams noted Audrain County likewise was impacted by that pandemic. Utilizing historical figures for comparative analysis, she stated: "According to the U.S. Census, in 1910, the population of Audrain County was 23,171. That is compared to census of 2000, when Audrain County had 25,853. So, let's look at the city of Mexico: In 1910, according to the census, there were 6,013 residents in city of Mexico, compared to our 11,320. We take those numbers and do a little bit of math, and the (local) attack rate of the 1918 Spanish flu was 5.8 percent. If we move that forward to the 2000 census, 5.8 percent of population of Mexico, 11,320, is 656 people. So all of us would be affected by that, especially the medical people with that kind of a surge. And that is just in one wave."

    In summation, regarding advance planning, Eaton stated: "You want to make a flexible plan, and you want to train your staff. You can't train enough. Identify your needs, identify your resources, communicate your plan with other agencies in your area. Have your memos of understanding in place. Train other agencies utilizing your plan. Take your plan, take it to your fire protection district, take it to your ambulance district. Take it to your funeral homes and your coroners and your medical examiners. Make sure everybody is on the same page. Make sure that they at least know the plan is in place, and where to access this plan."
    <table class="clear" align="right" width=""><tbody><tr><td align="center">
    </td></tr><tr><td align="center">
    </td></tr></tbody></table> He added: "And every well-made plan may not succeed. What looks good on paper might not work in real life. Unfortunately not everyone will survive. The person you are working alongside today might not be there tomorrow. And there is still a lot of work after someone dies. There's the burial, there's the paperwork, do we have public funerals, or are they going to be suspended? What are your local resources for opening graves? Are you going to be able to open the grave at your local cemetery on your family plot? Or are you going to be so overwhelmed with mass fatalities that you're going to have to have a mass burial. That should be your last resort, is a mass grave. And everyone needs to be responsible for the deceased. Yes, some of you ... are going to be concerned with the living. But how we handle the deceased affects how we handle the living. They want to know that Mom or Dad have been taken care of in a dignified and respectful manner in the event that they die. That will ease their tensions and their fears."


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