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Community Support Centers

sharon sanders

Editor-in-Chief & President
What ideas do people have for turning church/temple/mosque facilities into support centers under the constraint of social distancing?

For instance, if a religious group has a 5000 sq. ft. building that is not being used, how can that building be temporarily converted into a support center?

What needs to be there? clinic, commissary, counseling, food & water distribution, communications etc.

What should be stocked, and in what quanities, in the typical clinic for 0-200 persons, 200-500, 500-1000, 1000-5000? The same categories for all of the above services?

How far apart should each of the work stations be to follow social distancing guidelines?

How can personal homes be used for the above instead of the group facility? What ideas are there for this? I.E. Member 1 has water storage in their garage for fellow members. This garage is open 8-5 daily for distribution and everyone follows certain protocols to obtain and re-supply water here. Member 2 has the flour for the group.....etc...etc.

Can we "brain storm" this further?

The religious groups could have a significant impact on lessening morbidity and mortality in a pandemic if given logistical guidance.
 
Re: Community Support Centers

This sounds like some of our local discussions.

We decided it was best not to plan anything that would require people to gather in groups. It's best to deliver food, supplies, etc. to the homes.

Food distribution may best be handled by existing restaurants, etc.

I would think the best role for faith-based is for issues not addressed elsewhere by EMS personnel, restaurants, etc. Items like coordinating basic survival needs - medications, baby formula, etc.

Other issues - counseling, school supplies, & simply checking up on each family to see how they're doing - especially elderly/disabled.

Perhaps one thing they could work on NOW, is to set up neighborhood designations and communication chains details. This can be helpful in any emergency. During recent flooding here, nobody knew how many families actually lived down long sideroads beyond flooding bridges. Had something like a "telephone tree" been in existance, communication and hard data would have saved many folks from major inconveniences.

One disadvantage of good coordination might be that folks will think they don't need to prep, so it should be made clear that the appearance of organization should NOT be intepreted as any guarantee of supplies.

.
 
Re: Community Support Centers

This type of planning is best done with the local Emergency Operations Center (EOC). Also all participants should get at least the basic orientation to the National Incident Management System (NIMS). Some EOCs plan to limit mobility so that group gatherings (possibly even at supply shelters) are prohibited. Others have plans to strictly control traffic, so that you will not be allowed to deliver supplies unless you are authorized under the community plan to do so. In my opinion, issues like these illustrate why it is so critically important to get involved locally. The Governor, County Commissioners and Sheriff are the elected officials who have the authority to make life and death decisions for you (or appoint the people who make those decisions).

A community that has done a comprehensive pandemic exercise could give some examples of how these issues are addressed.

When we did the Pale Horse exercise (for smallpox) in San Antonio in 2002, we came up with the tabletop idea of using faith based and neighbor hood volunteers pick up supply bags at ad hoc neighborhood depots to be delivered or exchanged door ro door on the front yard or porch.

Tara O'Toole has written that in NYC after 9-11 in the Battery Park high rise apartments, the tenants' association officers went door to door to check on the elderly and disabled.
http://web.upmc-biosecurity.org/pages/events/peoplesrole/introduction.html

JT
 
Re: Community Support Centers

Great - this is a start. The intent of this thread to discuss the mobilization of the massive manpower offered by the religious communities for use in a pandemic.

Thank you Thornton - In the United States contact your local EOC for guidance/tips. These are usually in the Sheriff's office for each county in each state.

Also begin your education on this process:

FEMA Independent Study Program:
IS-800.A National Response Plan (NRP), An Introduction


http://www.training.fema.gov/emiweb/IS/is800a.asp
 
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Planning for Pandemic Flu - One Church's Example

Planning for Pandemic Flu - One Church's Example

<TABLE id=AutoNumber1 style="BORDER-COLLAPSE: collapse" borderColor=#111111 cellSpacing=0 cellPadding=0 width=549 border=0><TBODY><TR><TD vAlign=top align=left width=162></TD><TD vAlign=top align=left width=381></TD></TR><TR><TD width=6></TD><TD vAlign=top align=left width=162>
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</TD><TD vAlign=top align=left width=381>July 2006

Sisters and Brothers in Christ,

Although bird (avian) flu is currently limited to fowl and is only occasionally transmitted among those in close contact with infected birds, infectious disease experts indicate that this virus could adapt and could spread between people. If this occurs, the world may be faced with a flu pandemic.

The church has served a unique role historically when previous pandemics have impacted society, and may do so again. ELCA Domestic Disaster Response has produced several resources to guide the church through a discernment process regarding the pandemic flu.

One resource is entitled "Responding Faithfully in a Time of Pandemic Flu," a document created to prepare congregations to serve their community in the event of a pandemic incident. It refers directly to selections from past ELCA social statements on what it means to be a public church and the role of congregations.

A second resource is entitled "Congregational Planning for Flu Pandemic," and it includes specific information for the continuation of important congregational functions in the event of a pandemic.

Finally, we have provided a Top Ten list of ways that you can help to prepare your congregation for a pandemic event.

We hope that you will find these materials helpful and utilize them in preparing yourself and your congregation to serve your greater community. ELCA Domestic Disaster Response will continue to provide the church with updated and accurate information regarding pandemic flu, and the staff of DDR is always available to answer questions or concerns.




</TD></TR></TBODY></TABLE>http://www.elca.org/disaster/pandemic/default.asp
 
Re: Community Support Centers

In our area, we live on a major pipeline. The gas company comes door to door every couple of years. They asks how many adults and children live in the home. At this time they leave a contact number in case of an emergency. Church's could play a large role in disbursing contact numbers and knowing how many children and elderly are in each home. This may be essential in rural areas, where people have very little contact with their neighbors.
 
Re: Community Support Centers

Not everyone's community has done planning. When I contacted our officials, they are so "not interested" that it was obvious if we wait for their coordination, it's a trip to nowhere. Our (rural) EMTs have received no pandemic training whatsoever.

Our rural communities are usually ignored in a disaster and we're accustomed to taking care of our own problems. We, as individuals and communities/neighborhoods also have authority to make decisions regarding our own life or death. Trusting elected officials with that responsibility can be a fatal mistake. I refuse to abdicate my right to make decisions regarding the life and death of my family.

Thornton said:
This type of planning is best done with the local Emergency Operations Center (EOC). ........ The Governor, County Commissioners and Sheriff are the elected officials who have the authority to make life and death decisions for you (or appoint the people who make those decisions).

.......When we did the Pale Horse exercise (for smallpox) in San Antonio in 2002, we came up with the tabletop idea of using faith based and neighbor hood volunteers pick up supply bags at ad hoc neighborhood depots to be delivered or exchanged door ro door on the front yard or porch.

Tara O'Toole has written that in NYC after 9-11 in the Battery Park high rise apartments, the tenants' association officers went door to door to check on the elderly and disabled.
http://web.upmc-biosecurity.org/pages/events/peoplesrole/introduction.html

JT
 
Re: Community Support Centers

one possible community need I see is a place for workers willing to work thru waves, but not endanger their families. Medical folks, first responders of police, fire, and other essential services, utility workers, etc. They may be willing to take personal risk- but not the risk of bringing something home to their spouses and children.

For obvious reasons, a dormitory is not the best idea!

Unused hotels/motels seem about right for this. The ones with seperate entrances for each room might be the best bet.

If none are available, then perhaps portions of the large building you mentioned could be partitioned into individual cubicles for this? How about a barracks for healthcare workers? (again, large and partitioned).

Or, such a spot could be used for overflow clinics. Triage and treatment areas for the cases that dont need admission to the hosptial.

Supply distribution centers, storage for supplies, hopefully with a drive up consumer contact point.

Immunization/medication distribution sites, if and when that beomes available.

Expedient morgue.

Expedient barracks for troops.



One thing that most Emergency Planning has focused on since 9/11 has been unified, central command during emergencies. That puts the leaders of various services all in one place for command and control. 9/11 taught us that seperate but equal command leads to confusion and reduced effectiveness of response.

But in a pandemic or other situation, that might serve to bring all the leaders to one place - to be infected together. In a high attack rate situation, if that center has one person sheddding virus to those in that centralized area- it could devastate comman and control when half the command group becomes ill at or about the same time.

Perhaps one option to avoid that is to break C&C into teams, each practicing small group social isolation and careful infection control practices. Each team has a leadership representative from each consituency.

As long as all stay well, they could spell each other- say, each team takes responsibility for C&C for a day at a time, or twelve hour shifts. They report off to each other via phone, radio, etc as they turn over command to the next group for their designated time period.

They never physically intermingle or use the same rooms. Then if one team is exposed and illness runs through the group, the other(s) will likely be functional and able to maintain C&C.

Depending on the size of the building and other needs, part of a building like this could be used for that purpose.
 
Re: Community Support Centers

Sharon,I think the current wroking thing is people should avoid personal contact closer than three feet. That should reduce infection via airborne droplets. If the virus is an efficient spreader via aerosol, that wouldnt be enough.

I'd be more concerned about ventilation. IMHO Ventilation patterns should all be up and out of the building, from all points. Actively moving upward air may be safer. ie, No ventilation patterns that allow for horizontal airflow that stays in the lower eight to ten feet. I dont have a reference for that, or scientific proof of any efficacy, just my own speculations. But if it is reasonable, that means looking at air conditioning and ventilation, and a way to adjust it if needed, and a way to power it if munincipal power is not avialable for even short periods of time.

Another concern of mine in such a situation is fomite and hard surface transmission. Without individual bathrooms and cooking facilities, such a facility would need scrupuous, continuous attention to cleanliness in all common areas- but especially in those areas. So large amounts of hand sanitizers, surface cleaners, disposable wipes and cleaning supplies would be a big need. Educating all "residents" on how to do that would be paramount.

I think there are guidelines on stocking such a facility thru red cross and other disaster response organizations. They would be a good planning startfor food and supply storage. They may have historical data on whats been needed to suppport disaster resonse teams after such incidents as Andrew and Katrina. Salvation Army, one of the Baptist church organizations and perhaps others who kept teams at disaster response sites for a long periods after those incidents might be a resource for that info.

We'd could look at them as a basic start, instead of "re-inventing the wheel". They may have learned things that would prevent error or make life easier in future responses, especially long term ones. Then decide the length of time that such a facility would need to run (months, one wave, or years!) , and adjust storage to match and preferably exceed that (a fudge factor is a good thing)!

But current support center guidelines for staging areas would not likely take those needs for increased disinfection into account. I think that would need to be taken into account and adjusted upward, at least by one order of magnitude. Unless someone has a better way to estimate that? This may all be laid out somewhere, maybe military planning?
 
Re: Community Support Centers

I continue to learn and learn and learn. IMO, two major needs that need to be addressed in the "pre-pandemic Phase" are centralized information and resources for the disabled. In talking with my County Emergency Preparedness liasion yesterday, she shared work has taken place within her department. There are areas, she continued, they simply have not been able to address yet. At this time, that includes non-profits, shelters, residential programs. (and others) And that does not mean the county coming up with a plan for these areas. Rather, it has been difficult to even have beginning conversations so those agencies can begin in earnest their preparation. When the pandemic hits the US, people will want information. To decrease the panic/ chaos that information must be reliable, be timely, and be accurate based on fact. Those networks for passing and receiving iinformation must be set up now. A plan of care for the disabled, the elderly must be set up now. There are people in the community willing and able to meet these needs- it just means networking/ connecting. NOW that is a a job. :)
 
Re: Community Support Centers

You are on target Colormyguilt. According to the Federal Pandemic Guidelines these plans should be in place and exercised while we are Phase 3. Florida has excellent specifications for special needs shelters in hurricanes. I have not seen any good plans nor heard of planning committees that address the special needs shelters in a pandemic. This week I will participate in meetings to address the plans for existing specialized long term care institutions.

AD you are right that rural areas have different needs and options. All of us need to have plans and to exercise those plans. 10 years ago I lived in a rural community and I would have more confidence of survival in place for my neighbors in that setting. In urban areas, we know from individuals with panic disorder that it is quite possible to live years in an apartment without having direct contact with anyone. I do not know of urban areas that the entire population survives months without contact. Even in war zones there are some trickle of supply lines. In a complex democratic society, setting expectations of elected officials is a significant responsiblity and on a very real level our lives depend on those expectations.
JT
 
Re: Community Support Centers

given the information provided recently on aerosol transmission of Influenza A, i'd recommend caution in setting up large enclosed spaces in which folks may gather. having droplet nuclei airborne for several hours combined with the problem of infected patients being contagious yet asymptomatic for the first 48 hrs, would seem to make many of the shelter environments considered appropriate for other disasters little more than a nicer place to go to get infected.

the review CDC did is elsewhere on this site, but i bookmarked the cdc link..
http://www.cdc.gov/ncidod/EID/vol12no11/06-0426.htm
 
Re: Community Support Centers

c3jmp said:
given the information provided recently on aerosol transmission of Influenza A, i'd recommend caution in setting up large enclosed spaces in which folks may gather. having droplet nuclei airborne for several hours combined with the problem of infected patients being contagious yet asymptomatic for the first 48 hrs, would seem to make many of the shelter environments considered appropriate for other disasters little more than a nicer place to go to get infected.

the review CDC did is elsewhere on this site, but i bookmarked the cdc link..
http://www.cdc.gov/ncidod/EID/vol12no11/06-0426.htm

I was thinking an alternative could be a progressive arrangement with members' homes that have a separate entrance.

House 1 - water
House 2 - canned food
House 3 - rice and beans

etc. etc.

Religious groups that are small can join others.
 
Re: Community Support Centers

sounds good. my concern was that the disaster shelters that work for hurricanes, tornados, earthquakes, etc. might not be appropriate in a pandemic; sheltering from the elements vs sheltering from each other. and not just each other, since someone can cough in a room, leave it, and someone else may enter the room, and get infected (when they breathe the droplet nuclei suspended in the air)..
 
Re: Community Support Centers

c3jmp - Absolutely correct. In the absence of adequate official plans, we have to try to provide some of the background work for them here.

We need more options. What we see most commonly discussed are 2 extremes: a) survival in isolation, virtual work environments, or less commonly b) alternate treatment sites.

We need plans on how we can work on site among people and still maintain a degree of safety. In those plans we must include support for people the authorities have advised to remain isolated or quarantined.

First we have to get people's attention with the seriousness of potential impact of pandemic. At the same time we must educate people that preparedness mitigates the adverse impact. Second, the health impact of the pandemic will be variable in location and time. We need a means to establish credible information for communities to understand the level of risk at any given time. Just because a devastating outbreak is occurring in one part of a state does not mean we have to shut down the whole country by closing schools and businesses. Third, we need to foster communications and trust between local authorities, health officials and the community. A strong pre-pandemic relationship is needed to withstand the pressures of the crisis.

Now the hard part. What specifically do we suggest local communities do to support vunerable persons (easily over 80% of a community) when the community is is in the midst of an outbreak that has increased demand for local hospital beds by 50% or more (for starters). What do we recommend to maintain operations to a city 100 miles away that has not yet seen a case?

Some local plans address these issues: New York City, and in California San Diego County and San Mateo County. That may be good place to see where they need augmentation or adaptation for our areas. For example, have the faith based and neighbor hood groups been fully utilized in these plans. If not, what would it take to get them included and involved?
JT
 
Re: Community Support Centers

yes.... that would be the problem.. and finding solutions that don't rely on the energy sources we're likely to lose at a consumer level - petroleum and electricity. and getting the larger masses to take responsibility for their own survival. take away petroleum, and most of our ems, fire, and law enforcement will be on foot.

take away electricity, and the communications capabilities we depend upon will evaporate. certainly there are alternatives - nothing prevents people from setting up arrays of solar cells to charge deep cycle batteries, and achieve some level of self sufficiency; but that requires taking responsibility, and having the initiative to take it before the disaster happens, rather than waiting until after and wondering what happened.

that will be a radical change in mindset for most. people can get FRS radios that will charge from 12VDC sources, and have a limited communication capability within a neighborhood. the question is, will they? the problem with expectation is that for most, it's expectation of what someone else will do for them.
 
Re: Community Support Centers

I live in upstate New York. When TV10 states a blizzard is coming in, many flock to Wegman's. In a short space of time, shelves are depleted. People take their groceries/ take extra water/ fill up the tank/ grab an extra load of wood/ a few movies/ etc. and go home to "settle in." Maybe, just maybe, we may get one or two snow days. Even in upstate New York, this scenario is not as common as it used to be twenty years ago. However, when the warning goes out, people get going. This pandemic, however, is outside the experience of many people in the developed countries. Just as in the US as in Katrina. Just as in 9/11. The major task in having people willing to prepare may be in being able to get information out that can address just this. Add to this that people process information in different ways. The relationships that are developed, as Thornton states above, in the passing of this pre-pandemic information will be crucial as the pandemic comes into our communities.
 
Re: Community Support Centers

i agree. i'm not as worried about rural areas - i grew up in one, and people are more self-reliant and prepared simply because they have to be. when i was a kid, we were snowed in for a month - and there were no problems. it's the more densely populated areas i worry about - that ship all their goods in, where people depend much more heavily on county/city utilities.

the supply chain problems for cities are fixable, as well the dependencies on energy resources that may go away. the time to fix it is now - before the resources disappear, or become unavailable. i wish the govt would declare a state of emergency now - so we could get visbility to the issues, and get the problems fixed before it costs millions of lives. haven't the CDC, WHO, and several leading scientists established that we have credible information of an imminent threat - why aren't we addressing it as such? because it's a virus, not a terrorist?
 
Re: Community Support Centers

now - having said that.. i'm prepped out to 18 months.. i live in a rural area, and supporting my family is my responsibility. but i have options that people in the cities don't.
 
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