# 2434
We are told, almost on a daily basis, that another pandemic is `inevitable'. That it could come this year, next year, or perhaps five years from now.
Pandemics come, on average, every 30 to 40 years. Humanity has seen at least 10 pandemics, along with many lesser pseudopandemics, over the past 300 years.
It is, quite frankly, just a matter of time before the next one hits.
And when it hits, we are going to have to find ways to live and work in a pandemic environment.
An idea that many people hold is that if a pandemic comes, they will simply lock themselves in their homes until it is over. While this might sound like an attractive strategy, for most people it is an unrealistic goal.
Pandemics are not short-term events. They have been known to go on for months, sometimes for years.
Few people would be able, financially, to remain sequestered in their homes for months on end. Fewer still could stockpile enough supplies to tide them over for that length of time.
The presumption is that a pandemic would come in waves, possibly several of them over a period of a year or two, with each lasting weeks or even months in every community.
Schools could be closed for up to 12 weeks at a time.
Some businesses, particularly those that involve public gatherings of people, could find themselves temporarily shuttered by order of the public health department.
Many businesses that remain open may find employee absenteeism seriously compromising their operations.
Some people will be sick, others will be taking care of sick loved ones, while others may simply be afraid to come to work out of fear of exposure to the virus.
While nobody knows just how bad this absenteeism will be, estimates of up to 40% have been mentioned by pandemic planners.
That could be low, or it could be high. We won't know until the next pandemic is over.
Absenteeism could, of course, lead to supply chain problems. Remove 40% of a company's employees, even for a short period of time, and production or deliveries of goods is likely to suffer.
Businesses that depend on goods and services provided by other businesses could find their own operations jeopardized. The fear is that a cascade effect could be felt throughout the entire global supply chain, and that serious shortages of food and medicines could occur.
There could even be interruptions in the power and water supplies, due to absenteeism and fuel delivery problems.
Lest you think the above is simply the ravings of a mad blogger, the HHS on their pandemicflu.gov site warns that:
Social Disruption May Be Widespread
- Plan for the possibility that usual services may be disrupted. These could include services provided by hospitals and other health care facilities, banks, stores, restaurants, government offices, and post offices.
Being Able to Work May Be Difficult or Impossible
- Find out if you can work from home.
- Ask your employer about how business will continue during a pandemic.
Schools May Be Closed for an Extended Period of Time
- Help schools plan for pandemic influenza. Talk to the school nurse or the health center. Talk to your teachers, administrators, and parent-teacher organizations.
- Plan home learning activities and exercises. Have materials, such as books, on hand. Also plan recreational activities that your children can do at home.
Transportation Services May Be Disrupted
- Think about how you can rely less on public transportation during a pandemic. For example, store food and other essential supplies so you can make fewer trips to the store.
- Prepare backup plans for taking care of loved ones who are far away.
Stock a supply of water and food. During a pandemic you may not be able to get to a store. Even if you can get to a store, it may be out of supplies. Public waterworks services may also be interrupted. Stocking supplies can be useful in other types of emergencies, such as power outages and disasters. Store foods that:
- are nonperishable (will keep for a long time) and don't require refrigeration
- are easy to prepare in case you are unable to cook
- require little or no water, so you can conserve water for drinking
Much , of course, will depend on the ultimate CFR (case fatality ratio) of the next pandemic, and its attack rate.
A mild pandemic would not be expected to produce such calamitous effects.
The attack rate is the percentage of people that become sick from the virus. In 1918, that was limited to only 30%.
In other words, 70% of the world's population, while exposed, never fell ill.
The factors that may have led to 70% of the population not coming down with the Spanish Flu are not well understood, nor are they guaranteed to be repeated in the next pandemic.
The CFR, or percent of those who are sickened that die, varied widely in 1918. Here in the United States, and in many parts of Europe, roughly 1 in 50 died.
In some nations, like India, the number was probably closer to 1 in 10. And among some aboriginal tribes in New Zealand, the number was 1 in 3.
We've seen milder pandemics, of course. 1957 and 1968 were far less deadly. But 1918 isn't necessarily the worst-possible-case, either.
And as we saw in 1918, the first wave was mild, only to be followed a few months later by a far more lethal second wave. Things can change quickly in a pandemic.
As you can see, a pandemic is a complex, changing, living thing.
And we'd better be focusing on how we will meet and adapt to one, if we expect to get through it.
I. The first step is individual preparedness.
Not to hunker down for 3 months, or six, or perhaps a year or longer. But to take the burden off of relief agencies who will have their hands full trying to help people who were unable to prepare for themselves.
As the HHS pandemic site warns: Even if you can get to a store, it may be out of supplies.
Being prepared, with a reasonable stockpile of food, water, medicines, and essential items means you can pick and choose when you go out to try to resupply.
If a pandemic is raging in your community, you probably don't want to have to stand in line for hours with hundreds of potentially contagious people, waiting to buy food or medicine.
Having anywhere from 2 weeks to 3 months worth of supplies already in your pantry gives you a lot of options. The same principal applies to things like prescription medications, water, and other essential supplies.
One of the best resources on the web for learning how to prepare for a pandemic, or any other disaster, is GetPandemicReady.Org.
Secretary of Health and Human Services Michael Leavitt put it this way earlier this week:
`We need to continue to use every opportunity to talk about individual preparedness. Yes the government needs to play a role, at the state, federal and local level . . . but people have a responsibility and it is the aggregate of their actions that will ultimately determine whether we are prepared or not. " - Michael Leavitt Oct 29th, 2008
By being prepared, we not only remove a burden from society to help us during a crisis, we free ourselves up to help our friends, our families, and our neighbors.
And ultimately, that is what it is going to take to get through a pandemic. Neighbor helping neighbor. Friend helping friend.
Communities working together.
II. We need to be prepared to care for ourselves, or our loved ones, at home during a pandemic.
The odds that you, or a loved one, will receive treatment at a hospital during a pandemic are probably less than 1 in 20.
Most pandemic plans anticipate that only 5% of those stricken will receive hospital care. While they talk of admitting only the `sickest of the sick', the truth is, a great many very sick individuals could find themselves turned away from hospitals.
Hospital staffs will likely see high attrition rates due to their constant exposure to the a pandemic virus. Absentee rates of 40% or more are expected.
The ability of hospitals to care for patients will be dramatically reduced.
And it won't just be people with pandemic influenza who will be impacted. Anyone with medical needs is likely to find the system's ability to deliver timely and effective treatment will be compromised.
That means heart attacks, strokes, trauma victims, women in labor, dialysis patients, and a whole range of other patients may find serious challenges in getting care during a pandemic.
The AMA now recommends that people maintain a `Personal medication supply in times of disaster'.
This new policy supports allowing all patients with chronic medical conditions to maintain an emergency reserve of prescription medications. It also encourages patients to carry a list of current medications and the prescribing physician's contact information with them to ensure continuity of care in the event of a disaster or other emergency.
The HHS also recommends you have basic medications and supplies to treat flu victims, such as:
- Prescribed medical supplies such as glucose and blood-pressure monitoring equipment
- Soap and water, or alcohol-based (60-95%) hand wash
- Medicines for fever, such as acetaminophen or ibuprofen
- Thermometer
- Anti-diarrheal medication
- Vitamins
- Fluids with electrolytes
- Cleansing agent/soap
Another good resource is Dr. Grattan Woodson's free booklet, available on his website. Knowing how to deal with pandemic (or even seasonal) influenza in advance, and having the supplies you will need, can be life-saving.
Good Home Treatment of Influenza
The value of taking a first aid, or even an EMT course, cannot be overstated.
And of course, every home should have a well stocked first aid kit!
III. Businesses and their Employees need to plan on how they can continue to function during a pandemic.
We are all interconnected in more ways today than ever before. Even small businesses that might think of themselves as less than essential, can be important cogs in the functioning of the economy.
While some businesses will undoubtedly have to shut down, or alter their modes of operation, it is imperative that we keep as much of the economy functioning as possible during a pandemic.
And no, this isn't about profits.
This is about sustainability.
The guy who sits behind the counter at the auto parts store might not think of himself as `essential', but if he (or she) isn't on the job then a critical replacement set of brake linings might not be available for an ambulance or a police car.
If the corner gas station is closed, the delivery driver can't get fuel. And if the delivery driver can't get fuel, pharmacies, clinics, and hospitals won't get resupplied.
The clerk who processes orders for delivery is every bit as important as the driver who delivers them. The same can be said for the IT specialist who works in accounts payable, or payroll, or inventory for a corporation. Take away those functions, and the business grinds to a halt.
Millions of people who do vital yet unglamorous jobs keep the economy running.
And because of that the power stays on, potable water flows through city water systems, ambulances respond, the Internet stays up, and pharmacies are able to dispense medicines.
Take out enough of these cogs, and the economic machine fails.
And the true costs of that would be measured in lives, not dollars.
Businesses need to be preparing now for the next pandemic, and they need to do so as if their survival depends on it. For it surely does.
Few companies could withstand weeks or months of closure.
The key is to make workplaces safer during a pandemic, so businesses can continue to operate.
No, you can't make any business 100% safe during an infectious disease outbreak, but there are things you can do to reduce the chances of infection.
And it not only will protect employees and customers, it may keep you out of court as well.
There is an expectation by employees that their employers will provide them a safe workplace. This covenant, in many countries, is enforced by both civil and criminal law.
In fact, here in the United States, OSHA (Occupational Safety & Health Administration) created the following statement of worker's rights nearly 40 years ago.
WORKER RIGHTS UNDER THE OCCUPATIONAL SAFETY AND HEALTH ACT OF 1970
YOU HAVE THE RIGHT TO A SAFE WORKPLACE. OSHA REQUIRES EMPLOYERS TO PROVIDE A WORKPLACE THAT IS FREE OF SERIOUS RECOGNIZED HAZARDS AND IN COMPLIANCE WITH OSHA STANDARDS.
Employers take note. If you haven't spoken to an attorney about your responsibilities and liabilities during a pandemic, it might be prudent to do so.
To help employers know how to prepare, the Federal government has prepared a number of documents to help employers prepare their workplaces for a pandemic. These include:
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Guidance on Preparing Workplaces for an Influenza Pandemic (PDF - 313 KB) (Occupational Safety and Health Administration)
-
Pandemic Influenza Preparedness and Response Guidance for Healthcare Workers and Healthcare Employers (PDF - 405 KB) (Occupational Safety and Health Administration)
- Proposed Guidance on Stockpiling of Respirators and Facemasks in Occupational Settings (Occupational Safety and Health Administration)
- Federal Register Notice on Proposed Guidance on Stockpiling of Respirators and Facemasks in Occupational Settings
Employers may need to work out ways to institute social distancing, work from home solutions, and even provide prophylactic antivirals to high risk employees.
The number of potential solutions is only exceeded by the number of likely problems.
A severe pandemic, when it comes, will present challenges beyond anything that we have ever faced as a society. We won't have the luxury of hiding away, and waiting for it to pass.
As daunting as it may seem, a pandemic is survivable.
Some businesses -the ones that are prepared - may even find ways to thrive in a pandemic.
The choices we make now, before a pandemic strikes, will determine how well we do during a crisis.
But we must make these choices now.
Because once a pandemic has started, our ability and the time we have to prepare, will be severely limited.
