Thursday, April 30, 2009

The Stockpiling Dilemma



# 3102



Roughly a year ago, when the pandemic threat seemed distant to all but public health officials and a few disease geeks blogging on the subject, the CDC began to recommend that Americans consider stockpiling a small quantity of facemasks and respirators in the event they might be needed during an outbreak.



In an  Interim guidance on the use and purchase of facemasks and respirators by individuals and families for pandemic influenza preparedness  the American public was given a much stronger recommendation for the home stockpiling, and use, of facemasks and respirators than we'd seen before. 


Some excerpts from this guidance:


Although not all households will have someone who becomes ill with influenza during a pandemic, because one cannot predict in which households an infection will occur, it would be reasonable for each household to stockpile some respirators that can be used, if needed, when caring for an ill family member.


With proper precautions, a single caregiver can use the same respirator several times over a day for brief care visits with the same ill person in the household,[2] so a stockpile of 20 respirators per household would be reasonable.




Pandemic outbreaks in communities may last 6 to 12 weeks.[3]  Persons who cannot avoid commuting on public transit may choose to purchase 100 facemasks for use when going to and from work.


An additional supply of facemasks also could be purchased for other times when exposure in a crowded setting is unavoidable or for use by an ill person in the home when they come in close contact with others.[4]



Ideally, that is when you want to encourage people to stock up; before a crisis begins.


The same was true for encouraging Americans to stockpile at least 2-weeks of food in their pantry.  Something that has been part of the family planning advice for nearly 3 years.



Before a crisis, authorities knew that too few people would heed that advice to make much of an impact on the supply chain.


AFTER a crisis has become high profile for a large segment of society, urging people to go out and stockpile masks or food can cause huge runs on the just-in-time inventory kept by most stores.


And that poses a genuine dilemma for governments and emergency planners.   


A public call to `stock up’ now, would probably result in a mad rush to the stores by millions of people.   Those who were slow to act, or who didn’t have the financial resources to stock up, could find that the shelves would be bare for them and their families.


If you doubt the impact of such a statement, consider the infamous Toilet Paper Shortage of 1973.


In December of 1973, the United States was suffering through the first of the oil shocks, and gas prices had tripled. Americans were understandably nervous.


Johnny Carson, the King of Late nite TV made an offhand joke, a week before Christmas that the next shortage congress was worried about was of Toilet Paper. It got a small laugh.


The next morning, millions of Tonight Show fans ran out and cleaned the shelves of all of the available toilet paper. Some people bought shopping cart's full. By noon, there wasn't a roll to be had in most major cities. The supplies were, err, wiped out, so to speak.


That night, Johnny Carson went on the air to explain, and apologize. There was no shortage, it was all a joke. Only one problem: Now there was a shortage. As soon as new supplies were delivered and put on the shelves, they were snapped up by worried buyers. People were hoarding toilet paper out of fear, and the shortage continued.


Even though the supply chain was unbroken, it took 3 weeks before normalcy returned. And all of this took place back when stores actually had stockrooms, and didn't rely on just-in-time inventory restocking.



Multiply this scenario a hundred times, and you'd have some idea of what would happen now if the President, or some other high profile official suggested everyone lay in a 2-week supply of food, medicine, and  . . .you guessed it . .. toilet paper.



The supply of facemasks and respirators is finite, and quite frankly, we need as many of those to go to Health Care Workers (HCWs)  and first responders as possible.   


They are going to be most at risk for exposure to the virus. And without protective gear (PPE’s) many will probably elect not to work.  



If you were smart, and listened to the sage advice of the HHS, FEMA, and, and have laid in a reasonable amount of supplies. 




You are ahead of the curve, and will be in a better position to care for your family, and hopefully help your friends and neighbors.  


There still exists a window of opportunity for people to make reasonable and modest additions to their preparedness level.  To acquire a small stockpile of basic foods, medicines, and emergency supplies.


But don’t expect many public officials to stress these actions, now that a pandemic alert has been issued.  Doing so could cause panic buying, and immediate shortages.


And that could make matters worse for everyone.



This advice remains on the HHS site:


Be Prepared

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

See a checklist of items to have on hand for an extended stay at home.


To plan for 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.
  • 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.



These recommendations are sensible ones to prepare for any disaster, not just a pandemic.  


Each year we see floods and hurricanes, and tornadoes. Some regions are prone to earthquakes.  Disasters happen.


Being prepared can not only ensure that you and your family have the resources you need to deal with an emergency, it can free up public resources to help those who were less prepared.