Dem, Monotreme, et al …
Trying to be short-n-sweet with this suggestion/question but will elaborate if I’m not making myself clear.
If we, as the wiki, are attempting to create no just community awareness, but community action plans I have a suggestion to make.
There are populations in our communities that can’t, don’t, or won’t access information currently available on the internet. Broadcast news is only offering sound bites with few real constructive suggestions.
There are also people that, even if they do have access to the internet resources currently available will either be overwhelmed by or unable to understand the volume of medical information out there.
The various discussion threads on community awareness, community hotlines, postcards, etc. have brought to mind something that may be a truly practical aid during a pandemic situation where most care will have to be done in-home due to scarce resources, scarce skilled health care workers, and/or scarce hospital beds and equipment.
Would it be possible to put together a single page flyer that in simple language can provide practical in-home care protocols?
If possible, I think the best format would be in a concrete “if this symptom, then that treatment”.
This creator(s) of this flyer would need to keep in mind the likely vast differences in educational backgrounds of the user and play as much as possible to the low-end. The creator(s) would also need to recognize that most folks in in-home care situations would likely only have access to OTC medicinals and/or common household products and materials.
Also, by keeping the language and instructions simple, it would be easier for it to be translated into multiple languages.
Is this something someone already has in the works? Phone lines and online access can be clogged up and could also fall prey to technological failures (e.g., loss of power). A piece of paper that a family can tape to the kitchen cabinets will be available when all else fails.
Thanks, Kathy in FL.
Bumped for visibility.
Let’s collect a few links.
Anyone who wants to volunteer their time and draw up such leaflets can post them here for comments or improvement.
I’m interested in this also, and I think the real challenge will be to make it “short and sweet”. Just sanitation alone can get impossibly complex.
Let’s bootstrap - just create a page somewhere and we will cooperatively massage it into niceness.
I you’re unsure how to do that, start by creating an outline or two on this forum thread.
We can move onwards at our own speed.
Something that can be put into grocery bags would work well. Not everyone has internet acess. Everyone shops for food or has it done for them. This would be a terrific project.
Some links to get started or to borrow ideas from are woodson’s guide and the NDU posters.
lugon, i suggest this gets added to brainstorming.
Here is my take on it. It is a first very quick draft, put together by cut and paste from other sources together with a bit of my own glue. Feel free to change, add, and delete as you see fit.
Dear Neighbour,
I would like you to think about a few things that might be happening in our neighbourhood shortly. Something is happening out there in the world that might affect you, your children, your neighbours, in fact everyone, one way or another. This thing is called avian influenza or bird flu.
Avian influenza refers to a large group of different influenza viruses that primarily affect birds. On rare occasions, these bird viruses can infect other species, including pigs and humans. The vast majority of avian influenza viruses do not infect humans. The one we would like you to think about is a specific avian influenza virus called H5N1.
An influenza pandemic is a rare but recurrent event. Three pandemics occurred in the previous century: “Spanish influenza” in 1918, “Asian influenza” in 1957, and “Hong Kong influenza” in 1968. The 1918 pandemic killed an estimated 50–100 million people worldwide. That pandemic was exceptional, and is considered one of the deadliest disease events in human history. The other pandemics were much milder, with an estimated 2 million deaths in 1957 and 1 million deaths in 1968.
The H5N1 virus was first discovered in 1959 in Scotland when it killed a large number of poultry. It did not, at that stage, do any harm to humans, but like all viruses it had the ability to change. And changed it has. At the moment it is still primarily a virus that attacks and kills large number of birds, but it has also killed humans that have handled birds. If the virus changes a bit more and learns how to infect a human from another human, then we will have a big problem. We will probably get an influenza pandemic. An influenza pandemic happens when a new subtype, or strain, of the virus emerges that has not previously circulated in humans, and it starts spreading as easily as normal influenza – by coughing and sneezing. Because the virus is new, the human defence (immune) system will have no pre-existing immunity. This makes it likely that people who contract pandemic influenza will experience more serious disease than that caused by normal influenza.
For this reason, the avian H5N1 virus is a strain with pandemic potential, since it might ultimately adapt into a strain that is capable of infecting from human to human. Once that last change occurs, it will no longer be a bird virus, it will be a human influenza virus.
Health experts have been monitoring the new and extremely severe influenza virus – the H5N1 strain – for over eight years. The H5N1 strain first infected humans in Hong Kong in 1997, causing 18 cases, including six deaths. Since mid-2003, this virus has caused the largest and most severe outbreaks in poultry on record. In December 2003, infections in people exposed to sick birds were identified.
Since then, over 175 human cases have been laboratory confirmed in several Asian countries (China, Cambodia, Indonesia, Irak, Thailand, Turkey, and Viet Nam), and more than half of these people have died. Most cases have occurred in previously healthy children and young adults. Fortunately, the virus does not jump easily from birds to humans or spread readily and sustainably among humans.
Once a fully human to human capable virus emerges, its global spread is nearly guaranteed. Countries might, through measures such as border closures and travel restrictions, delay the arrival of the virus, but they cannot stop it. The pandemics of the previous century encircled the globe in 6 to 9 months, even when most international travel was by ship. Given the speed and volume of international air travel today, the virus could spread more rapidly, possibly reaching all continents in less than 3 months.
Because people will have no immunity to the pandemic H5N1 virus, infection and illness rates are expected to be higher than during seasonal epidemics of normal influenza. Current estimates for the pandemic estimate that a large number of the world’s population will require some form of medical care. Few countries have the staff, facilities, equipment, and hospital beds needed to cope with all these people who suddenly fall ill. The hospitals expect to reach capacity within 1 day if an H5N1 virus with efficient human to human transmission of the virus reaches the population.
Supplies of vaccines and antiviral drugs, the two most important medical tools for reducing illness and deaths during a pandemic, will be not be there in any country at the start of a pandemic and for many months thereafter. It takes up to 6 months to develop a new vaccine. The lack of vaccines are of particular concern, as vaccines are considered the first line of defence for protecting populations.
Historically, the number of deaths during a pandemic has varied greatly. Death rates are largely determined by four factors: the number of people who become infected, how agressive the virus is, the underlying characteristics and vulnerability of affected populations, and the effectiveness of preventive measures. Accurate predictions of deadliness cannot be made before the pandemic virus emerges and begins to spread. Estimates have ranged from 2 million to over 1 billion dead. If the current death rate of the virus does not change (currently 65% as of March 2006) how and where will the dead be buried and/or cared for?
High rates of illness and worker staying at home are expected, and these will add to the social and economic disruption. Past pandemics have spread globally in two and sometimes three waves. Not all parts of the world or of a single country are expected to be severely affected at the same time. Social and economic disruptions could be temporary, but may be amplified in today’s tightly knit systems of trade and commerce. Social disruption may be greatest when no workers are there to do essential services, such as power, transportation, and communications.
In a world of just-in-time inventory management for material inputs, finished goods and labor, disruption at ports, airports, borders and rail lines would quickly lead to empty shelves in the shops. Health care services, vaccines and antibiotics, masks and other protective materials would be in short supply regardless of price. Every sector and every business in every country would be affected.
Health care would be strained beyond the breaking point. All public gathering places would close, as would mass transit and non-essential services. Front-line health care and nursing home workers would be essential, and judging from past experience, many of them would be subject to infection and quarantine despite our best efforts at isolation, immunisation and antibiotic protection.
Large cities with dense populations in residential, shopping and office space would be worst hit. People would stay away from high-rise office buildings because of virus attack. Stock piling of basic food, drug, water, energy and safety supplies would initially lead to shortages and then skyrocketing prices.
Governments will not hesitate to impose quarantining, including requiring people who may have had exposure to the virus to stay within their homes, denying landing rights to air planes and ships from countries where the disease is spreading, forcibly isolating people showing suspicious symptoms, and banning concerts and sporting events.
The bottom line is that a pandemic, even one less bad than the 1918 Influenza breakout, would have hugely disruptive effects. Depending on its length and severity, its economic impact could be comparable, at least for a short time, to the Great Depression of the 1930s.
In addition, with whole swaths of the population unable to work, either because of illness, care giving or quarantine. Schools and possibly nursing homes would close as young children and the elderly might well be particularly vulnerable to getting and spreading the disease. This would throw many able-bodied workers into care-giving status. Yet, if the experts are correct that this could be similar to the 1918 virus where those with the strongest immune systems are the most likely to die, then the bulk of the labour force in the 20-to-40 year old age range would be severely incapacitated.
Think about what you would do if you could not work for five or six months. In addition, assume you’d be trying to assure you would not be forced to sell your assets at a dramatically reduced price, for example your home or stocks you own. In other words putting yourself in a position where you could sustain yourself for those five or six months without selling assets. So you’d need alternative income sources, while at the same time reducing liabilities. This means paying off any debt as quickly as possible and avoiding any new debt. It all comes down to pulling in the purse strings, spending less than you earn. Hopefully, one would have a reasonable period of time to initiate all this.
Think about what you can do to be prepare for this pandemic. What would you need if you were forced to stay at home for up to 6 months or longer? How would you survive? What would you eat, drink, do during that period? There are answers to these questions, but you have to take some postitive to be prepared. You have to want to be prepared. Unfortunately you cannot depend on the government or local authorties. They will be overwhelmed and understaffed. So you will have to do it on your own, or with friends and neighbours.
I am aware that this virus might not mutate to human to human, but I am also aware that it is critically close. I am trying to create awareness so that our citizens can prepare themselves for the possibility.
Yours etc
The much simpler NDU posters have a “letter” size, and are translated, too.
Maybe we could add something on the back of something like that? (Is the suggested reading level and word count 8th grade, or 3rd grade?? something less than we’d like, probably, but, has to get read.)
Grocery stores might be more ok with handing stuff out if it was snips from our respective govt. websites, for the most part.
(how much do they want to get paid for adding a page to bags? Will they do it if we brought them? Time to call chain honchos and ask if they read the govt. business pandemic planning recommendations yet?)
Maybe the leaflet pays itself if we leave room for the business doing the photocopies to put their own advertising. We just have to write it with contagiousness in mind: it has to be acceptable for the business to spread it with the business’ name attached.
“Brought to you courtesy of Local Grocery - we too keep our hands clean!”
I know my local board of health said they weren’t willing to inform the public for months yet; wonder what they were planning on using?
I doubt Nabarro or Osterholm or Leavitt would mind if people beat their boards of health, or school boards, or pastors, or politicians to getting some of the govt pandemic tab info onto the public’s radar.
Pandemic is likely to occur at some point in time.
Right now there will not be enough medicine to give out to the public to prevent or treat pandemic influenza.
Handwashing, coughing or sneezing into your elbow, staying home when sick, letting employees stay home when sick, social distancing, closing schools, and quarantines, can be used to try to avoid infection.
A pandemic wave may last 3 to 5 months, and pandemics have had a few waves.
(Sigh. I need to go think of something else for a while, so I’m fresh to be an unwelcome messenger tomorrow.)
crfullmoon- “(how much do they want to get paid for adding a page to bags? Will they do it if we brought them? Time to call chain honchos and ask if they read the govt. business pandemic planning recommendations yet?)”
My husband and I own a grocery store (in Canada). I don’t know what the ‘rules’ would be everywhere, but here most grocery stores wouldn’t expect any payment for this unless you’re actually selling a product. Talk to the store owner or the manager if it’s a chain, many will be willing to do it gratis. Failing that, message bords at entrances of many grocery stores have spots for leaflets that anyone can leave information in. Or they could be handed out at other places in your area- schools, churches, daycares, libraries, sports clubs, recreation complexes(pools, gyms), etc. Talk to the people in your community and see who’s willing there. If money isn’t a problem for you (God, wouldn’t that be nice!), you can make up leaflets and pay the postal service to distribute them locally with the rest of the mail.
Here’s one that I wrote:
Dear Neighbor,
I’m writing this letter to you in the hopes of raising your awareness about the clear and present danger we are facing with the avian flu (bird flu). I am not an alarmist; I did not prepare for Y2K, nor was I overly concerned about SARS or West Nile virus.
This flu is something different and we need to be prepared for it. Currently the situation is not dire. The flu has not yet mutated to be easily transmittable between humans. The 150 people who died from it have had direct contact with infected birds. But scientists are watching the flu carefully and anticipating that it will soon mutate to be easily transmittable between humans, like the regular seasonal flu. The way this will probably happen is that a person afflicted with the regular flu will also contract the avian flu. The genes of the two flus will recombine within that person’s body - creating a new flu with the lethal attributes of the avian flu and the easy transmission of the seasonal flu. It’s thought that this flu could come as early as this year or next. Currently, 50% of people who have contracted this flu have died and strangely the age group most affected is healthy people between the ages of 20–40.
People in the know (scientists and health professionals) are very worried. They have been raising the alarm but not enough people are listening. There is now an official website put up by the US government (Department of Health and Human Services) and that site is instructing individuals and families to stock up and be prepared. The important thing to realize is that there may be no services available to you and your family. If the flu becomes pandemic, unlike with New Orleans, ALL communities will be affected and the rest of the country will not be rushing in to help us. Hospitals will be overwhelmed. Law enforcement will be hampered by loss of personnel. Municipal services (electricity, gas, water and garbage removal) may be disrupted. Grocery stores may shut down or not receive supplies.
The following is an extract from the government’s web page: Social Disruption May Be Widespread “ Plan for the possibility that usual services may be disrupted. These could include services provided by hospitals and other health care facilities, banks, stores, restaurants, government offices, and post offices. “ Prepare backup plans in case public gatherings, such as volunteer meetings and worship services, are canceled. “ Consider how to care for people with special needs in case the services they rely on are not available Another spot on the government’s site itemizes things that each person should stock up on:
1. Items to have on hand for an extended stay at home: Examples of food and non-perishables Examples of medical, health, and emergency supplies o Ready-to-eat canned meats, fruits, vegetables, and soups o Protein or fruit bars o Dry cereal or granola o Peanut butter or nuts o Dried fruit o Crackers o Canned juices o Bottled water o Canned or jarred baby food and formula o Pet food o Prescribed medical supplies such as glucose and blood-pressure monitoring equipment o Soap and water, or alcohol-based hand wash o Medicines for fever, such as acetaminophen or ibuprofen o Thermometer o Anti-diarrheal medication o Vitamins o Fluids with electrolytes o Cleansing agent/soap o Flashlight o Batteries o Portable radio o Manual can opener o Garbage bags o Tissues, toilet paper, disposable diapers
Please check this out for yourself. Here are a few good websites to go to:
www.pandemicflu.gov This is the government’s official web site www.who.int This is the site for the World Health Organization www.fluwikie.com This is a very useful site on the avian flu
Thank you for taking the time to read this. Planning for this impending threat has to be at the individual level. Assume there will no assistance available. To protect ourselves and our community, we need to take personal responsibility and stock up now. When the time comes, you will not be able to stock up at the last moment - there will be panic and shortages.
Please act now. The avian flu could be very soon.
Your concerned neighbor
So, we have “letters” and we have “leaflets”.
I’m not clear about the content of the leaflets we’d produce, but at least … here, I’ve just created Brainstorming.Leaflets?.
Nice work. I still wouldn’t say “Avian Flu” because it doesn’t sound like a big deal to the public, and when H5N1 gets here in birds and mammals they may think that’s what all the fuss was about. “Pandemic may start at any time, but you need to be prepared before you know it’s happening.” might be more how I’d put it.
(ABC News just ran a headline about preparing for an “Epidemic”. Arg! Stock up for 7 days! What does it take to get through to people correctly?? “Beam me up Scotty, there’s no sign of intelligent life!”)
Felicia, that sounds very readable and informative. I would pass it around without qualms. I agree with crfullmoon though, there has to be a way to get people to see the difference between bird flu and bird/people flu.
Pandemic flu or panflu. Explanation should be included re the different terms. No one uses avian flu, it’s bird flu.
Just a thought - do you think it would be a good idea to suggest that people donate a few items to their local food bank while stocking up?
(I went to Kmart on December 23rd, and overheard a conversation in line. The people behind me were last minute Christmas shopping - not because they were procrastinators, but because they had to wait for that last paycheck . I think lots of folks are in that position - even seemingly middle class people. I worry about these folks.)
amt – at 10:44
wonderful suggestion.
Re: notes to neighbors- I’d suggest using no words with more than 3 syllables. The average reading skill of adults in the US is 5th grade. (This is true, and not meant to be condascending.) Forgive any misspelled words, no spellchecker!
(That explains too much… Along with the anti-science, anti-intellectual culture “we’ve really gotta problem here”)
Would half— or quarter-letter-size, with something about what a pandemic is, how long possible and Leavitt’s messages about no vaccine or antivirals nor federal or state aid; community sectors are supposed to be planning how to cope, ( …”Have a plan that isn’t just a piece of paper,” Leavitt said…) the pandemicflu.gov address, and on the back side, a list of some kinds of food/meidcal/cleaning items, with addresses where to get more prep/medical suggestions?
(Ha! I just remembered I’d dreamed about the
You’re on Your Own/We Warned You pandemic quotes from the feds, printed on slips of pink paper…
Hand out “pink slips” - hm, maybe to our local elected officials or municipal employees, with how long to stock up for, and websites, on the reverse.)
I think that some of the problem relate to the terms we use, like pandemic, bird-flu, avian flu, H5N1 etc. They do not sound bad or dangerous in themselves. It would be better if we constantly used “Monster Flu”, “Killer Flu”, or something similar, for the pandemic version of bird flu. Try to see it in relation to the Black Death and Spanish Flu. Very simple terms that now have a black-lined overtone of something sinister. The fact is that we have to use “Hollywood” inspired terms for something that is so bad we have problems visualising how bad it could be. The language have unfortunately been flattened to such an extent that hard terms are needed before most people will understand what you are talking about.
The flyer I was suggesting needs to be very practical. Not too wordy, not graphic intensive, and short enough that you can use a font size that is legible after the “copy effect” (making a copy of a copy, etc.)
Perhaps something along the lines of “In the event that your household becomes affected by the flu pandemic, the following are suggestions for dealing with some of the symptoms associated with influenza.”
This is a very tentative flyer that I cobbled together. Maybe someone can use it and add to it to make it more constructive and practical.
INFLUENZA IN YOUR HOME
At the time of the printing of this flyer, there is not a vaccine for the pandemic strain of the flu currently affecting many communities. This may be a stressful time and there is a possibility of a shortage of health care resources. As a result, many people will be forced to care for family members at home. In the event that your household becomes affected by the flu pandemic, the following are suggestions for dealing with some of the symptoms associated with influenza.
Good home treatment for influenza can help to relieve symptoms. Good hygiene will help to prevent the spread of the virus. Both may also help lower your risk of developing complications.
1. Bed rest can help you feel better. It will also help avoid spreading the virus to others. Infected family members should be kept apart from the main living areas.
2. Drink plenty of fluids to replace those lost from fever. Fluids also ease a scratchy throat and keep nasal mucus thin. Hot tea with lemon, water, fruit juice, and soup are all good choices. A person with a fever should not eat heavy meals. Clear fluids and broths will be better on their stomach. If the flu sufferer becomes dehydrated the body cannot fight off the virus.
(include a short statement and recipe here for a common ORS)
3. If fever is uncomfortable, take acetaminophen or ibuprofen to lower it. You may also sponge the body with lukewarm water to reduce fever. Do not use cold water or ice. Lowering the fever will not make symptoms go away faster, but it may make the flu sufferer more comfortable.
4. To relieve body aches and headache, take aspirin, acetaminophen, or ibuprofen. Do not take aspirin if flu sufferer is younger than 20 unless a doctor tells you to do so. Also, aspirin and ibuprofen can upset the stomach, while acetaminophen does not. (Include a short statement on the danger of Reyes Syndrome)
5. Try a decongestant or nasal spray if for a stuffy nose. Look for a single-ingredient decongestant that contains phenylephrine. If nasal drainage is thick, a decongestant that contains guaifenesin may help keep it thin and drain. Do not use medicated nasal sprays or drops more often than directed.
6. Breathe moist air from a hot shower or from a sink filled with hot water to help clear a stuffy nose. Avoid antihistamines. They do not treat flu symptoms and may make nasal drainage thicker
7. If the skin around the nose and lips becomes sore from repeated rubbing with tissues, apply a bit of petroleum jelly to the area
8. Use cough drops or plain, hard candy to help ease coughing. Take a nonprescription cough medicine that contains dextromethorphan if a dry, hacking cough develops. Some products contain a high percentage of alcohol. Use them with caution. Children should not be given any medication with alcohol in it at any time.
9. Elevate the head with an extra pillow if coughing keeps prevents rest. The may also help with general chest congestion.
10. Avoid smoking and breathing secondhand smoke. This is good advice any time, but it is especially important when there is a respiratory infection or the flu
11. In some instances people develop bowel complaints with influenza. If the flu sufferer develops diarrhea, it is even more important to make sure they have plenty of fluids. (see #2)
During recovery:
If a flu sufferer has not had any food for longer than 72 hours or has had a persistent fever accompanied by vomiting and/or diarrhea, it is extremely important that you introduce solid food back into their diet slowly. You should start with water and clear fluids (give a better explanation here).
It is very important to take any influenza infections seriously. Possible complications of flu include:
Pneumonia, which is an inflammation of the lungs. Some people are at increased risk for developing a specific type of pneumonia.
Primary influenza viral pneumonia, which occurs most often in people who have heart disease. It develops soon (24 to 36 hours) after flu symptoms start and does not get better with antibiotics. It rarely causes death in young, healthy people, but it can often be life-threatening in older adults, people who have other diseases, and pregnant women.
Secondary bacterial pneumonia, which occurs most often in older adults and people who have lung disease, heart problems, and other diseases. Secondary bacterial pneumonia most often develops after a period of improvement following classic flu. People with this type of pneumonia usually get better with antibiotics.
Bronchiolitis, which is an inflammation of the small air passages (bronchioles). Bronchiolitis usually affects children younger than 2 years of age and is the leading cause of serious lower respiratory illness in infants.
Sinusitis, which is an infection or inflammation of the mucous membranes that line the inside of the nose and facial sinuses. Facial sinuses are hollow spaces, or cavities, located around the eyes, cheeks, and nose.
Croup, which is a swelling or obstruction in the windpipe (trachea). It causes a distinctive hoarseness and a barking cough, a high-pitched sound (stridor) heard when breathing in, and difficulty breathing.
Worsening of chronic obstructive pulmonary disease (COPD).
Inflammation of the heart muscle (myocarditis), inflammation of muscles (myositis), or inflammation of the sac around the heart (pericarditis).
Fatigue and a lack of energy that persist after flu symptoms are gone. People may take several weeks to fully recover, although no cause for the symptoms has been identified.
Items that should also be include in the flyer somewhere:
The following is child-specific flu treatment for children.
Flu symptoms may last more than a week. Caregivers can relieve and soothe children’s aches and pains with basic home care.
Rest in bed.
Allow the child to drink lots of fluids of the child’s choice.
Treat fever with acetaminophen (Children’s Tylenol, Infant’s Feverall, Junior Strength Panadol) or ibuprofen (Children’s Advil, Children’s Motrin) taken according to package instructions or consult the child’s doctor (do not give aspirin because it poses a risk of causing Reye syndrome).
Use a humidifier in the child’s room to make dry air easier to breathe.
Children may need more careful attention for these symptoms.
Runny nose: Younger infants usually breathe through their nose and cannot breathe through the mouth. Even older children have difficulty breathing through the mouth and sucking on something at the same time. Therefore, it is very important that the child’s nose should be clean before feeding and before putting the child to sleep.
Suctioning is the method to clean the nose. For younger infants, use a rubber suction bulb to remove the secretions gently. Older children can blow their noses, but forceful blowing can push the secretions into the ear tubes or sinuses. Encourage the use of tissues and gentle nose blowing.
Dry or stuffy nose: It is important to remember that most stuffy noses are blocked by dry mucus. Blowing or sniffling alone cannot remove dry mucus. Use of saline nosedrops is helpful in loosening the mucus. These nosedrops are available at most drug stores. One minute after using the nosedrops, use a soft rubber suction bulb to gently suck out the loosened mucus.
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