Saturday, January 25, 2020

Not Too Soon To Be Thinking About Preparedness

5 day Epi Curve - Credit CSSE GIS Dashboard











#14,728



Over the past 5 days we've seen the number of confirmed novel coronavirus cases more than quadruple - mostly in Mainland China - but with cases also showing up increasingly outside of China.  Despite herculean (some would say draconian) efforts at quarantine by Chinese officials, the prospects for containment are rapidly dwindling.
What we don't know is the severity of this pathogen in humans (both healthy and with significant comorbidities or risk factors). 
The numbers we get are understandably incomplete, and possibly redacted by China, and so we can't say much about the CFR (Case Fatality Ratio), or the CAR (Case Attack Rate), at this time.  Some subset of those infected are affected severely enough to be hospitalized, and (for now at least) the number of deaths has surpassed the number of recoveries.

While the majority of hospitalized cases are reported as `stable', we aren't getting a very good picture of their clinical condition, or the kind of supportive care they require.  So far, most of them remain hospitalized - some apparently for a couple of weeks.
Unknown are how many mild, moderate, or even asymptomatic cases exist that are not sick enough to seek medical care, be tested, and get added to the case count  That number, while still not known, is likely to be significant. 
All of which means that we still don't really have a good handle on how big of a threat this novel coronavirus is likely to be. Even so, it is not too early to begin thinking about how you, your family, and your workplace are going to cope with it.

Long time readers know that pandemic preparedness has been a big part of this blog over the past 14 years, but I've picked up a number of new readers over the past week or so, and so below you'll find  excerpts from a much longer blog I wrote last September (see #NatlPrep: Personal Pandemic preparedness) that looked at advice from the CDC, FEMA.gov, and Ready.gov on what people should do before, and during, a pandemic.



Credit CDC


This  advice from Ready.gov.
Pandemic
Before a Pandemic
  • Store a two week supply of water and food.
  • 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. Get help accessing electronic help records.
  • 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.
The last item is one we've discussed often (see Yes, We Have No Pandemic . . . But Line Up A Flu Buddy Anyway). I first fleshed out the idea in a 2008 blog called Lifelines In A Pandemic.
A `Flu Buddy’ is simply someone you can call if you get sick, who will then check on you every day (by phone, social media, or in person), make sure you have the food and medicines you need (including fetching prescriptions if appropriate), help care for you if needed, and who can call for medical help if your condition deteriorates.
Those people who care for others, like single parents, also need to consider who will take care of their dependents if they are sick.
In 2017, the CDC released a 16-page Household Pandemic Planning guide, which emphasizes the use of NPIs - or Non-Pharmaceutical Interventions - during a pandemic.
Get Your Household Ready for Pandemic Flu [PDF – 16 pages]
The CDC’s Nonpharmaceutical Interventions (NPIs) web page defines NPIs as:
Nonpharmaceutical interventions (NPIs) are actions, apart from getting vaccinated and taking medicine, that people and communities can take to help slow the spread of illnesses like influenza (flu). NPIs are also known as community mitigation strategies. 
Measures like social distancing, hand hygiene, staying home when sick, avoiding crowds, wearing a mask if you are sick, even the closure of schools or other public venues are all potential NPIs.

Additionally, the CDC has prepared guidance for a number of other venues:
The good news is, much of what you need to do now to prepare for a pandemic would hold you in good stead for any prolonged emergency or disaster.

While nCoV2019 is definitely still in the `before a pandemic' stage - and it may never get there - now is the best time to make your plans and gather your supplies, because your options only get worse after a crisis is declared.
 
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