• Thinking through Pandemic Flu issues

    by  • December 16, 2007 • The Global Picture • 0 Comments

    (a summary of my thinking on more general pandemic flu issues, prior to me producing a simple introductory guide, to be dropped into the public domain in an editable format for better heads than mine, with more domain knowledge, to hack on.)


    Start with this link.

    So, I’m aiming for a five or a four page document, encapsulating three facts.

    1> Build a model of your town inside of your house.

    Basically a map of your town, showing little icons for the power station, the doctor, the pharmacy, the superstore, the school, the office, and all the other places that people go (the veterinarian.)

    Three classes of things on this map:

    A> Places you go and either drop things off or bring things home from. “Stuff moving.”
    B> Pipes and Wires (and waves) which deliver services – sewage plant, electricity, etc.
    C> People you go to see: friends, relatives, professionals like doctors, vets etc.

    Note that what we’re doing here is *integrating* the support systems around a simple concept:

    * think about all the places you go every week or every month, and the things you do there.
    * now you need to **bring those places inside your house** so that you go to your basement rather than the supermarket, to your medicine cabinet rather than the pharmacy, and so on.

    The *map* here is “each week, where do you go? what do you do there? now **bring those places inside your house.**

    This is a very different mental model. What we’re focussing on is the **image** of scaling down your town or your city so it fits into your house. We literally move the little icon for Supermarket and put it into your bedroom. We move the little icon for power plant and move it into your wind up charger that sits in the living room. We move the little icon for school and move it into your kitchen, where you have toys and games and books for your children.

    This idea of presenting the preparation process as “building a town’s worth of services in your own house” is key.

    Right now the preparedness game is about thinking about the whole thing collapsing and then what do you need to survive *now*. This puts people’s mental focus on a scenario they can’t cope with, and produces paralysis. Instead, I want to put people’s focus on their daily lives, and this idea of “copying the stuff which makes life normal into your house” so that you have the (notional) feeling that you’re preparing to continue a normal life, but inside your house.

    We’re breaking away from the apocalypse thinking because that’s useless and paralyses people. Instead, we’re thinking about bringing *more things into your house* so you don’t have to go outside to get them. It’s about “not going outside” not “surviving when everything has gone to hell.”

    Different mental frame. Build a model of your town inside of your house so that everything you would usually go outside to do you can do right at home.

    It also dissolves the barrier between food, utilities, medical and other planning. It’s a smoother map: you bring your town inside your house. You make your own mental map of town, of where you go, and then you start bringing things inside.

    So that’s Part One: a new preparedness map based around the clear mental model of replicating the services you get from outside your house inside your house. Keys here are that it focusses the mind on *traveling* as a key “index” – you have people think about where they *travel* and what they do there. Then you have them copy that stuff so they *travel* to their bedroom, not to the supermarket.

    I believe this will catch a lot of stuff for people with special needs that would get missed in more conventional apocalypse-preparedness thinking.

    *where do *you* go?*
    *what do *you* do there?*
    *what do you *pick up* or *drop off*?*

    The list of preparation steps then becomes about working with your normal activities, rather than working with your needs. Most people don’t have a strong mental picture of their own needs, they don’t understand “so much water, so many medicines.”

    What they have is “Well, every thursday I go to the clinic, and on sundays I bring dinner to Auntie Nelly because her caregiver only works six days a week. Oh… I wonder how that will work?”

    Different map. The focus is on the *routines of life* and *how to maintain the routines of life without going outside.*

    NOT on the apocalypse.

    2> Better and worse periods during the pandemic

    Again continuing the idea that the goal is to *maintain normality* (a **KEY** concept from, for example, the British experience in World War Two) we need to teach people the idea that the pandemic is going to come in waves if it comes at all. So we want to focus people on the idea of “a few weeks inside, followed by a time when you can go outside, go to the stores, stock up again on things like medicines, and hope that you’ve seen the last of the flu. And if it comes back, you go home and wait it out again.”

    Can’t stress this too strongly. The Name Of The Game is “maintain normality.” Not prepare to survive a crisis – people don’t like to think about that. We’re preparing people to Maintain Normality – much easier to think about!

    One of the keys is the idea that the goal is to reduce outside trips by 90%, not reduce them to zero. Yes, we know that reducing them to zero is ideal, but “I couldn’t stand to be cooped up like that all day” is a deal killer. So having people prepare to take 90% fewer trips outside for two weeks to six weeks is a reasonable goal, assuming limited resupply runs. Therefore we talk about things like masks and so on seriously: “on your few trips outside you should have the following things to keep you *and your family* safe: masks, gloves etc.” (goggles?)

    Now, are resupply runs plausible? Well, given that we know most people won’t prepare to a two weeks of indoors time standard, and we also know that mass starvation in the home is not an option, yes, people are going to go outside to find food. Or governments will have to deliver it.

    Again, what we’re looking at is a much more limited preparedness model: reducing your trips, and preparing to cruise by the worst periods with nearly no trips outside is a very different model from “go inside and stay there for six weeks.”

    Very few people are going to do enough advanced work to go home and stay there for two months. Almost nobody. Of the current flubie community, who are the most prepared for this, what percentage have six weeks of at-home time currently? 20%? 5%? Certainly I would be surprised if it was 1/3 of the people on the forums, even among regular posters.

    So what we’re looking at here is a model about half way between http://ready.gov and http://weareallgoingtodie.com – something which focusses on reasonable risk reduction, while making it clear to more prepared readers that they could extend this strategy all the way to risk *elimination.*

    This is the crux. Pandemic flu is an experience that people are going to live through. People are going to be living *with* the pandemic for years, in all probability, from the news reports from other parts of the world, through to peaks of activity in the part of the country they live in, with school and office closures and so on. Then things calm down, and people go outside again. In most countries, only a few tens of thousands of people, not counting the LDS (mormons,) have the capability to go home and stay there for a year, and that is not going to change in the immediate future.

    So we’re looking at a 90% reduction in trips, with repeated but brief periods of complete quarantine.

    It’s possible it could be changed with real government money, but we don’t have that yet. There’s still no 1-800-send-food number where you can order a one-family-for-one-year kit off the shelf, as designed by people who know what they are doing, bill it to the Government, and pay off the loan they gave you to buy it over the next five years.

    Which is really what we need but we’re not going to get it.

    3> Supplies for staying home

    This would be the bulk of the document, including things like stove instructions and so on.

    I’m not going to do the detail here – I don’t have all of it straight yet.

    This is where we get into Standard Kit territory. As far as possible, we should be aiming towards something that can be provided **BY RETAILERS** – the individual doing preparedness work is the wrong market here. We want to teach retailers what the kits should look like, which products they should stock, as a public service, and as a legitimate pre-crisis business opportunity.

    Your standard models are probably about as good as they’re going to get:

    * masks
    * gloves
    * something to cook on
    * a source of light
    * food

    We all know that model in general outline. Drilling down to get optimal details is going to take more time, possibly more time than we have. But the crux of this message is that we have to get away from the “kit” model of preparation, and into the “systems” model of preparation.

    The kits will come. They’re a lot less hard than they look for the most part (has anybody tried kitty litter for human beings? how much is a 50 lbs / 25kg bag anyway?)

    But right now my primary concern is building a stronger model for the preparation process, to enable more people to think about this stuff rationally, by moving the model from “survive the disaster” to “maintain normality *through* the hard period* and by moving away from “pack your house with survival gear!” to “reduce your trips outside by moving essential things inside.”

    That change in language and mindset, if it’s close enough to right to motivate change, might let a lot more people (who often can’t handle the Flupocalypse model) get involved in the preparedness process.

    We still need brilliant technical fixes for a number of basic problems, but if only 0.001% of the population applies those technical fixes, we have no progress. The first step is increasing the base of people preparing and doing the thinking and testing about these models.


    (more from a previous piece follows)

    This is a rather long email containing three insights into pandemic flu preparedness in an American context. It’s very much a continuation of the “Hexayurt” approach – use of materials already in the supply chain with appropriate use of basic science and corporate resources.

    I’ve come up with three interesting things so far and I think there’s room for a good deal more improvisation.

    The assumption I’m making is that “social distancing” / shelter-in-place is the key response that will be recommended in a crisis. Every time two people meet there’s a chance of transmission, and keeping people at home with their families minimizes the number of contacts, and the number of possible transmissions.

    In that scenario, we may also have to contend with infrastructure failures related to lights, water, gas, toilets and so on. It gets daunting quickly, although I think there are well-understood preparation approaches to many of these challenges.

    Anyway, leaving aside that whole thing, here’s the insights I have so far. There are three points:

    1> Improvised ethanol stoves for widespread deployment (E85 and paint cans.)
    2> Using cordless electric drills as cranks to power electrical devices (yes, I’m serious.)
    3> Food distribution networks.

    Improvised Ethanol Stoves for Stay-at-home cooking
    For cooking and possibly heating, I think the key is a simple stove which burns a widely available fuel. Gasoline is far too dangerous. Wood is impractical for cooking in many places, and is no-go for indoor use which could be a critical factor in urban environments. My suggestion is E85 – ethanol with 15% gasoline. Straight ethanol would be better but quantities and supply chains are questionable, I believe.

    In terms of devices to burn the ethanol, there is a lot of room for improvised stoves with an alcohol base. Ultralight hikers have a wide range of technologies for this purpose. However, for mass deployment, I believe that filling a clean paint can most of the way with fiberglass or paper towels, then filling it part way with E85 or ethanol, then covering the exposed fiberglass with tin foil (preferably the heavy gauge stuff from the bottom of, say, a disposable turkey roasting pan) with a hole for the “wick.” If knocked over, even lit, the fiberglass will prevent a dangerous fuel spill. Alcohol stoves tend not to produce much carbon monoxide, and reports online indicate that E85 burns relatively cleanly, without much smoke. It’s possible the ethanol will corrode the paint can over time – this is something which requires some research. Approaches include using more tin foil inside of the can as a liner, or use of an enamel layer (such as grill paint.) U-shaped “sausages” of tin foil would be used to keep the pot sitting on top of the paint can from smothering the flame.

    http://afdcmap2.nrel.gov/Website/Stations/viewer.htm has a map of E85 filling stations (green) which shows strong availability in the mid west, some availability on the east coast, and nothing to speak of on the west coast. In areas where ethanol is available, in the event of a “stay-at-home” scenario, hardware stores would prepare stove kits, or assemble the stoves completely and fill them with ethanol for customers.

    In terms of availability, I believe the supply chain characteristics for all the required components for these stoves is strong, and the cost (perhaps $5 per stove) is extremely attractive. Testing is required, but the basic design is well understood.

    Drill Dynamos
    In terms of improvised power generation, there are few good solutions. I’d like to see a lot more small renewable power devices in circulation, but realistically in a pandemic scenario where the grid may be unstable, sourcing additional power resources is likely to be impossible. One possible solution is cordless electric drills. Initial research indicates that the drills can be used as generators – put a handle in the chuck, turn the handle, and it turns from a motor (consuming electricity) to a dynamo (generating it.) Having a range of gearings is extremely helpful, because the force required to turn the drill can be adjusted to suit the length of handle and other factors.

    The trick is then getting the power out of the drill. Different models may have different characteristics in this regard – a diode to prevent back-flow to the battery, for example, would make it hard to get power back from the drill without modifications.

    However, it’s quite possible that some or even many drills could be simply modified to recharge their batteries when you spin the drill chuck by hand. If this is the case what we have is a massive installed base of ready-to-go crank-powered electrical devices. It might require a dollar or two of additional components in some cases.

    This is an area where we would need the help of the drill manufacturers to understand their systems better. The demos I have seen on the Internet look convincing, however. I think that it’s possible that manufacturers could be encouraged to provide a plug-in for their existing battery-and-drill standards which would enable the drill to be used as a charger, and then provide USB-format power to recharge cell phones, or power AA battery chargers in turn.

    http://www.zetatalk.com/energy/tengy05p.htm has a few details. I will note that this appears to be a profoundly weird web site, however the technology is sound. I’m also fairly sure that the modifications being made to the drill in this case are excessive because the drill is being modified so it can remain connected to a battery when not in use without discharging it, rather than simply winding to charge and then disconnecting.

    Stay-at-home boxes – emergency food distribution without incurring additional human contact
    Simply put, the biggest challenge to getting people to stay at home is food and other necessities. One approach would be to work with the supermarket chains on developing a standard “stay-at-home box” – a grocery box focussed on long-life, low-or-no cook materials, which families could pre-purchase now. Additional items like N95 masks could be included.

    This box could also be made available during a crisis through protected supply chains, and distributed in a no-contact format as follows.

    Boxes would be packed by grocery store workers wearing masks and gloves. They would then be left for 72 hours – the lifespan of an exposed flu virus. The virus can survive much longer if it is sneezed on to a surface, which is why the masks are important. They are then placed into the back of a distribution truck by people wearing proper respirators, and the truck delivers the packages to the street. Once it is safely gone, people can come out individually and collect their packages.

    This approach could make it possible for people to shelter in place for a long time, as may be optimal in highly infected areas in catastrophic pandemic flu scenarios. It also requires relatively little person-to-person contact to maintain. I believe that a similar approach could be operated down the supply chain, using the 72 hour or less lifespan of the viruses on exposed surfaces as a “firebreak” which would allow food and other essential supplies to travel, without taking along unwanted passengers.

    These basic hygiene practices, rigorously applied to the food distribution networks, could save lives.

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    Vinay Gupta is a consultant on disaster relief and risk management.


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