Sunday, September 18, 2016

#NatlPrep: Biodefense & Pandemic Preparedness

Pandemic Severity - Credit HHS


Note: This is day 18 of National Preparedness Month . Follow this year’s campaign on Twitter by searching for the #NatlPrep hash tag.
This month, as part of NPM16, I’ll be rerunning some edited and updated older preparedness essays, along with some new ones.

Given the myriad other daily threats this world faces, worrying about a pandemic may seem a bit quaint and oh-so 2005, but as a Blue Ribbon Study Panel on Biodefense concluded a little less than a year ago, the threat is very real.

Worse, they believe we aren't near ready to deal with it, when it comes.

You’ll find the 2-page Executive Summary available HERE, while the full 84-page report can be downloaded HERE, which lays out 33 recommendations for the U.S. government to improve their biothreat preparedness.

The study focuses not only on naturally occurring pandemics, but the growing threat of an intentionally released bio-engineered pathogen, along with accidental lab releases

While a bio-attack might sound the stuff of fiction, the tools and knowledge required to create enhanced or synthetic life forms becomes more affordable and accessible every year.  What once might only have been possible in a multi-million dollar lab can now be accomplished on a limited budget in a modest lab.

But even if you discount a deliberate attack, we’ve seen a rash of  lab accidents involving  `select agents’ – like Anthrax, Ebola, H5N1, and even Smallpox – over the past couple of years.

While none resulted in a serious bio-release, many scientists believe the return of H1N1 in 1977 after an absence of 20 years was due to a laboratory accident either in Russia or China. 

Of course, Nature's laboratory is also open 24/7, brewing all kinds of new nasties, without regard for their impact on you or I.

We are currently watching a long (and growing) list of novel swine and avian flu strains with some pandemic potential. Earlier this week we looked at their ranking by the CDC: IRAT Evaluation Of Novel Avian & Swine Flu Risks.

Given the ability for influenza viruses to reassort and `reinvent' themselves, the odds are this list will only grow longer in the years ahead.

A new study out this week also offers cautionary evidence of the mutability of coronaviruses as well.

Coronavirus Spike Protein and Tropism Changes
R.J.G. Hulswit, C.A.M. de Haan, , B.-J. Bosch
Coronaviruses (CoVs) have a remarkable potential to change tropism. This is particularly illustrated over the last 15 years by the emergence of two zoonotic CoVs, the severe acute respiratory syndrome (SARS)- and Middle East respiratory syndrome (MERS)-CoV.
Due to their inherent genetic variability, it is inevitable that new cross-species transmission events of these enveloped, positive-stranded RNA viruses will occur.
(Continue . . . )

But the list of potential pandemic viruses doesn't stop there.  Ebola showed that it can be a formidable foe in 2014, and this year we are dealing with the spread of a particularly insidious arbovirus.   One few had even heard of a year ago.

Others on the `short list' include:
  • Hendra Virus
  • Nipah Virus
  • Monkey Pox
  • Bubonic Plague
  • Lassa fever
  • Rift Valley fever
  • Marburg virus

I would add in Virus X, the one we don't know about . . . yet.

In short, we live in a threat-rich environment.  And as the world's population increases, and we live closer together in urban settings, the threat of a major pandemic only increases.

A dozen years ago  - when the H5N1 bird flu virus first threatened - we saw a massive global push for pandemic preparedness. Many groups selected a CPO; a Chief Pandemic Officer.  Someone in their business, organization, or family - whose job it was to coordinate their pandemic plan  (see Quick! Who's Your CPO?)..
Unfortunately, since the 2009 H1N1 pandemic was perceived by many as being mild and the next event thought years away, many corporate, organizational, or agency pandemic plans haven’t been updated – or in some cases even looked at – in years.
While a pandemic may not strike with the suddenness of an earthquake or a Hurricane, a pandemic virus can still spread around the globe in a matter of days or weeks, leaving precious little time to prepare.

The CDC, and FEMA continue to urge pandemic preparedness, as from this from


You can prepare for an influenza pandemic now. You should know both the magnitude of what can happen during a pandemic outbreak and what actions you can take to help lessen the impact of an influenza pandemic on you and your family. This checklist will help you gather the information and resources you may need in case of a flu pandemic.

This section is Expanded. Click to CollapseBefore a Pandemic

  • Store a two week supply of water and food. During a pandemic, if you cannot get to a store, or if stores are out of supplies, it will be important for you to have extra supplies on hand. This can be useful in other types of emergencies, such as power outages and disasters.
  • Periodically check your regular prescription drugs to ensure a continuous supply in your home.
  • Have any nonprescription drugs and other health supplies on hand, including pain relievers, stomach remedies, cough and cold medicines, fluids with electrolytes, and vitamins.
  • Get copies and maintain electronic versions of health records from doctors, hospitals, pharmacies and other sources and store them, for personal reference. HHS provides an online tool intended to help people locate and access their electronic health records from a variety of sources.
  • Talk with family members and loved ones about how they would be cared for if they got sick, or what will be needed to care for them in your home.
  • Volunteer with local groups to prepare and assist with emergency response.
  • Get involved in your community as it works to prepare for an influenza pandemic.

This section is Expanded. Click to CollapseDuring a Pandemic

Limit the Spread of Germs and Prevent Infection

  • Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.
  • If possible, stay home from work, school, and errands when you are sick. You will help prevent others from catching your illness.
  • Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick.
  • Washing your hands often will help protect you from germs.
  • Avoid touching your eyes, nose or mouth. Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.
  • Practice other good health habits. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.

And this, from

Community Planning

Seasonal Flu  

It takes all of us to help keep communities healthy during flu season. Through education and planning, you can help protect your community from the seasonal flu.

Seasonal Influenza (Flu): A Guide for Community & Faith-based Organizations & Leaders (PDF – 718 KB)
Preparing for the Flu: A Communication Toolkit for Community and Faith-based Organizations (PDF – 3.94 MB) (Centers for Disease Control and Prevention)

Pandemic Flu  

The federal government cannot prepare for or respond to the challenge of a flu pandemic alone. Your community can develop strategies that reduce the impact and spread of pandemic flu.

Faith-Based & Community Organizations Pandemic Influenza Preparedness Checklist (PDF – 68.91 KB)
Lista de Preparacion para una Pandemia de Gripe Tanto para Organizaciones Comunitarias como Religiosas (PDF – 268 KB)
Community Strategy for Pandemic Influenza Mitigation (PDF – 10.3 MB)
Plan Now to Be Ready for the Next Flu Pandemic (PDF – 213.55 KB)
The Next Flu Pandemic: What to Expect (PDF – 226.83 KB)

If you are an employer, you should know that OSHA considers it your responsibility to provide a safe workplace – even during a pandemic - and has produced specific guidance on preparing workplaces for an Influenza Pandemic  along with Guidance for Protecting Employees Against Avian Flu

And for business owners - if you only have time to follow one link from this blog post - I’d highly recommend the 20 minute video produced by Public Health - Seattle & King County -  called Business Not As Usual .

We could easily go years, or even decades, before the next severe pandemic strikes.  Or, it could begin somewhere in the world tomorrow. Like earthquakes along fault lines, and tornadoes in Tornado Alley, pandemics are inevitable. The timing is really the only question.

For a family or an individual - if you are well prepared for a flood, or a blizzard, or a hurricane - you are probably in pretty good shape to deal with a pandemic.  Unfortunately, fewer than half of all American households are so prepared.

Businesses, healthcare facilities, and government agencies will find that their disaster plans will need to consider pandemics a bit more specifically.  For more information on how to prepare, you may want to revisit:

Pandemic Planning For Business
NPM13: Pandemic Planning Assumptions
The Pandemic Preparedness Messaging Dilemma

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