• Pandemic Flu / Swine Flu Orientation and Action Guide

    by  • April 25, 2009 • Personal • 9 Comments

    Swine Flu 2009 on Wikipedia.

    Here’s the skinny.

    1> The Mexican Cluster has (as of Saturday April 25 AM) about 1000 cases and about 70 people have died so far. This gives us two pieces of data. It’s not likely to be more than about 7% fatal, which is bad, but basically within the planning envelope of many governments. It’s also spreading person-to-person rather than just pig-to-person or bird-to-person which is doctor speak for “we are totally screwed.”

    2> There are reported cases in the US and containment of the bug is unlikely. The “SARS II” scenario is that the virus is contained and does not become a civilization-level threat. If we are not in this scenario, and the virus is indeed loose, international travel will stop, and there may be massive internal quarantine issues and health emergencies. In a city like London, an outbreak could kill a hundred thousand people. We could hear of cases as soon as right now if somebody was sick on a plane from Mexico.

    3> Right now, there are four things you should do.

    A> Prepare to stay at home for a month while a wave of flu passes by. This keeps you out of the way of the germs. Things to consider are medications, food and toilet paper. You should get and fill a three month prescription for anything you need now in case of quarantine / supply chain problems later. On short notice you can assume (hope) that water supply and electricity supply will continue, although if the flu wave is extremely severe that may not be the case.

    Here is an absolutely minimalist food shopping plan. You should probably buy more different stuff, but I wanted to illustrate just how little is required. Here is a somewhat more comprehensive and gadget-oriented shopping list.

    Readymoms have considerably more sane and comprehensive resource guides available. You should read their stuff.

    B> Prepare psychologically for an extremely difficult period. This means doing things like visiting your parents, figuring out your relationships if they are in ambiguous states, making sure that you are not your job, your car, your house or any other such thing, but are yourself. The key to resilience is wanting to survive, putting yourself in the driver’s seat of the situation, and being clear about your goals. The psychological shock of a hundred million people dying of flu in the next year (a reasonable estimate: CAR20/CFR7) cannot be over-estimated. But the immediate challenge is not going into Ostrich-mode and putting your head in the sand: rather, remain alert to threats and act appropriately.

    C> Understand what pandemic flu is and is not. Do some reading, not just the news, but the “flubie” sites – there are a number. You’ll see opinions from “end of civilization” through to “keep calm and carry on.” Prediction is difficult, especially of the future, but understanding the range of options and contingencies is critical at this time. You are an individual and community actor in a situation which is as threatening to your life as a car crash or an aeroplan crash in many ways. The fact that the threat is large and distant does not change that it is real. Your brain is poorly evolved to act rationally around large, remote threats but you can compensate by reading, thinking and acting.

    D> Go out, today, and buy four things. Surgical or N95 masks, hand sanitizer, a gallon of bleach, and a week’s worth of groceries. You need these things not just to protect you, but to protect the people around you if you get sick. The surgical mask stops you breathing in infectious particles, but it’s even more effective at stopping you infecting other people. Hand sanitizer should be used immediately on returning home or arriving at the office: if everybody does this is really helps protect these spaces. Bleach is a contingency measure in case of things like water supply problems or a need to disinfect an area. The groceries trip is practice for social distancing by reducing your number of trips out, and gives you a little buffer. Social distancing is about avoiding unnecessary contact with crowds and public places to reduce infection risks. If you are in an area at risk, make one trip, not five. Pretty soon everywhere may be at risk at least some of the time.

    All of these measures have two effects. The first is that they protect you. The second is that by protecting you, they protect the people around you, and if enough of us do these things, we all protect each other.

    Right now, London has no reported cases. If you are reading this in Mexico, however, you should implement immediately. And if cases show up in London, we are on a war footing immediately: everybody does these things to protect everybody else, period.

    UPDATE: The Flu Code is a set of rules we should all adopt if we find ourselves in a pandemic situation. If enough people do these things it will create “herd immunity” where we deprive the virus of hosts and all protect each other. Please pass it on. The short URL for the Flu Code is http://bit.ly/flucode

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


    9 Responses to Pandemic Flu / Swine Flu Orientation and Action Guide

    1. A student of history
      April 25, 2009 at 1:36 pm

      I’d like to point out that even a worst-case scenario is not likely to outdo the Spanish flu much, which despite being extremely serious did not cause civilisation to come to a grinding halt. And that pandemic had a very unusual mortality pattern – does that also hold for this one?

      And just to be horribly, horribly cynical: A large population cull (on the 1918 model) would make the financial rubbish easier to handle, what with the reduced number of able-bodied people competing for jobs.

    2. April 25, 2009 at 7:13 pm

      This is excellent.

      Further suggestions, for those who want to prepare for loss of utilities: a camping stove (google “Penny Stove” for directions), fuel for it (e.g. gasoline or Heet), and two gallons of water per person per day (say, for a week) might also be worthwhile. You can use the bleach to keep the water from going bad; Google is your friend here.

      In the 1918 flu, according to the InSTEDD Pandemic Influenza Citizen’s Guide, the communities that were able to implement social distancing measures were able to maintain lower levels of infection. So if it goes pandemic, you won’t just be saving yourself by staying home — you’ll be saving your city!

    3. Alex
      April 25, 2009 at 10:14 pm

      Thanks for taking the effort to help with prep.

      “Student of history”, the idea that reducing the population will reduce competition for jobs is silly, as the number of jobs in existence is dependent on the population and its ability to spend cash, both of which would be reduced in a flu situation

    4. Jason
      April 26, 2009 at 12:15 am

      Real time SF resources


    5. April 26, 2009 at 12:41 am

      Unlike Vinay, I don’t have any expertise in this area. But two thoughts on the historical perspective.

      (1) In 1918, the world was far less interconnected, international travel was slower and less widespread. Not only are a significant proportion of the world’s population now accustomed to jumping on a plane, but the trade networks on which (for example) our food supply depends rely on this new level of interconnection.

      (2) Even in western countries, background levels of mortality from infectious diseases – including infant mortality – were far higher in the first quarter of the 20th century. (Not to mention the normalisation to large-scale death of young healthy men in Europe after five years of bloody war.)

      Both of these factors suggest that a 1918-style outbreak today would have far greater social and cultural knock-on effects.

      Are there other factors which counterbalance these? Better background levels of public health may have reduced vulnerability – though this effect would be invisible, since mortality rates for the current outbreak would already take this into account. Increases in knowledge, both in medicine and in strategies for coping with a pandemic. (Again, this is just amateur speculation, though – I’d be interested in others’ thoughts on this stuff.)

    6. Kathy Frederick Lov
      April 26, 2009 at 4:01 pm

      Thank you, Vinay, for taking the time to put together a comprehensive and thoughtful summary of critical information that is now reaching across the globe faster than the virus! Your kind gift will undoubtedly save lives.
      Nurse Kathy
      San Diego

    7. picklesandmilk
      May 1, 2009 at 1:31 am

      Its nice to actually see someone else is taking this seriously. It seems like most people here in the US is in total denial that this could turn into a really bad situation before it gets better. People actually laughed at me when I told them I bought face masks. Well anyway, I appreciate the tips and think they will be really helpful.

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