Tuesday, February 5, 2008

Chapter Two

During the coming months Scott and Sissy begin to see that at least some people in the government, as well as in the private sector, are beginning to take a panflu event more seriously. This is seen primarily at the Federal level. There is the Pandemic Flu Leadership Blog sponsored by the Department of Health and Human Services. There is commitment of funds to help other countries control the spread of avian influenza and other potential pandemic viruses and diseases. There are panels and committees formed to look into how to inform the public. There is a lot of talking about doing more talking, but it is better than what is occurring at the more local levels of government.

At the state level, guidance and public transparency starts breaking down. While every state in the union develops a pandemic plan, not many of them address any but the mildest scenario. Only a few states actually advertise their plans to the public. Some large corporations are planning for business continuity and employee protection, but most of the small businessmen still seem oblivious to the threat. Even the banking industry participates in a three week long dry run of their continuity plans. While there are some notable exceptions, the local level governments rarely have pandemic plans preferring to cite their state plan as enough even though this is about as unrealistic as can be.

Unfortunately for Scott and Sissy, they do not see any effort in their own local government to take serious responsibility for pandemic preparedness. Nor can they communicate their concern to the majority of their family, friends, and neighbors. They did manage to get Sissy’s parents to do a little more canning and to stock a few long-term staple items but their limited income kept them from doing much beyond that. Too often though people laugh off their efforts. They feel like the proverbial ant trying to warn the grasshopper of the coming winter. The effort by those in government is too little to offer much legitimacy to the topic of pandemic preparation. There isn’t enough talk about personal responsibility and personal accountability. Certainly the consequences of a pandemic occurring in our modern age of just-in-time delivery isn’t widely discussed. The mainstream media outlets appear to chose to completely ignore the issue altogether in favor of celebutante gossip, the politics of the fashionable, and the troubled economy.

Scott and Sissy lose their illusions about being able to directly and immediately cause their family and friends to prep. Too many times they have gotten the rolling-eyes look in response, or are politely ignored. Still, they persist in trying to get the information out there in as many venues as they can. Their efforts aren’t anything like Paul Revere riding up and down the street crying "The flu is coming, the flu is coming," but they at least feel that they are reaching a few individuals.

As part of their effort to stay informed, Sissy participates in online communities called forums that have been specifically set up to discuss influenza issues related to the possibility of a pandemic. On these forums she meets a lot of people who are also concerned about informing their communities about the dangers posed by a pandemic. Sometimes the discussions are about a pandemic similar to the 1918 Spanish Influenza. Sometimes the pandemic is hypothesized to be milder like 1957 (Asian) and 1968 (Hong Kong). More often the discussions consider a pandemic rivaling the scope of the Black Plague of the Middle Ages but which plays out in the modern era. This is primarily because the CFR of the most likely viral candidate isn’t coming down, but has actually risen over the last couple of years. Right now, if a patient is diagnosed with that strain of avian influenza, they have only a 30% chance of survival and their long-term prognosis isn’t good. Some patients even have their brain functions compromised so that even if they do survive, they will suffer for the remainder of their lives with the consequences of the original infection.

People from all walks of life, every socio-economic level, and wide-ranging political beliefs come together on these forums and to create tools to educate others.

>Excel inventory spreadsheets
>Guidelines for treatment of pandemic influenza at home
>Catalogs of alternative cooking methods
>Plans and diagrams for off-grid energy sources
>Detailed explanations of treating and storing water
>Checklists for community readiness status
>Flyers, slides, brochures, and other handouts that can be used at health and safety expos or academic presentations
>A two-week grocery list and menu for families who are financially challenged, but prepping inclined
>Recipes for using basic staple and long term storage food items
>Back-to-basics instructions for independent living
>News gathered and translated from many foreign news sources

The speed of bureaucratic assistance is barely creaking along but some mitigation legislation makes it through to the state level. This is supposed to force how the county and city governments will respond to a panflu event. One major piece of mitigation is that once efficient human-to-human-to-human (H2H2H) transmission occurs within the country, the state governments will begin to ready their mandates for school closure. Once efficient H2H2H transmission occurs within any state, schools will close for a minimum of 4 to 12 weeks, depending upon the attack rate and CFR. Another piece of the mitigation plan prohibits all public gatherings that involve children; such as Little League, scouting, etc. There is some talk of getting the United Way involved to force compliance of this last point. For those community service groups that receive funding from the United Way – a significant number – non-compliance would mean the loss of funding.

There is an initial hue and cry by parent, business, and community groups when these community mitigation plans are made public. They quickly fall silent however when national and state planners release enough information about how the mitigation techniques will lower the mortality rate for children thereby lowering their ability to infect adults; this in turn would lower potential healthcare costs and lost wages. Silence is not necessarily golden however, as compliance is still an open-ended question since many mitigation plans have no legal teeth to them. And, the issues of disbelief and apathy are ever-present dangers to the ultimate usefulness and success of mitigation plans. Worst of all for these efforts is that some quasi-scientific groups within the medical-political arenas propose that mitigation is a waste of effort and money because it isn’t ultimately efficacious in stopping pandemic infections and would be bad for the economy.

Some states are having serious discussions about pandemic issues. New York raises the issue of having enough ventilators as well as the trained staff to use them. Nez Perce County in Idaho actually reached out to the public for assistance in designing their pandemic plans. Louisiana sends out brochures on pandemic prepping, though most people on the flu forums consider the state’s plan a direct opposite of the national mitigation recommendations. Some states place multi-page inserts in local newspapers.

But despite these plans being made at state and county levels, the information does not appear to be reaching the general public on a large scale. In fact, in some areas pandemic plans are marked confidential and require a freedom of information request before they can be viewed. Its enough to make someone wonder if the plans really deserve to be Top Secret, or do they realize just how poor their plan is?

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