why people won’t prep and how to get round that problem
Continued from here
INFOMASS – at 21:47
Getting back to social distancing, it appears to have some positive impact, though it might break down if the infection and CFR are high. I have a question. Has there EVER been a pandemic with a 30%+ infection rate that had a CFR of over 50%? I know the black plague wiped out a third or so of Europe over many years, but that was when cities had little or no clean water and sanitation. While some people do not trust history as a guide, and it is always possible for something badly novel to appear, the odds of getting something worse than our worst previous pandemic are low, though not zero. Are there any pandemic historians out there? (I assume we are not dealing with terrorism/biowarfare -could be wrong.)
Average Concerned Mom---copying your last post here
Average Concerned Mom – at 22:09
I was wondering the same question, INFOMASS. I did a little reading lately of some of the plagues but it seems that they were of the kind spread by fleas. (Bubonic?) Such as the one written about in “Journal of a Plague Year” by Daniel Dafoe. Also, the Black Death in whenever that was — 1400s? — was spread by fleas, i.e. (I think) not contagious person to person? I presume that means it spread whn the rats carrying the fleas moved from house to house, or perhaps the fleas spread from person to person.
If all this is correct, it makes sense that a highly fatal disease could spread and kill so many people, becuase as people dies out, the disease vector remained.
But, has there ever been a highly fatal CFR 50%+, easily spreadable, INFLUENZA epidemic? It seems so unlikley — it seems eventually it would just have to die out for lack of people able to spread it.
Average Concerned Mom: You are right, I should have specified influenza epidemic. Also, I assume that existing malnutrition had a big role to play in previous episodes. For what it is worth, the US Navy reported 3–4% CFR and infection rates of 30% or so in 1918. That is, 1% of the Navy died. Of course, this next one could be MUCH worse, which is why ask about the worst influenza pandemic we know of.
ACM - 22:09
The Black Death was spread by 2 sources. One was the fleas thought to be the original source of infections. The 2nd source was the phlegm and mucus discharged by the plague victims themselves. Depending on your sources, the Black Death killed between 30–60% of the population.
Monotreme – at 17:32 quote “Basically, I agree with your scenario. Bridges and tunnels will be the restriction points.
Now might be a good time to get a backroads Atlas if you are planning on bugging out. However, I wouldn’t be surprised if there were lots of “informal” checkpoints and blockades.
Frankly, I wouldn’t bet much on anyone’s ability to bug out in time if there really are plans to restrict travel.” end quote
I don’t intend to bug out (I’m in the sticks already), but I still have two different state atlases showing backroads and cowtrails. My concern is the folks trying to cut through the woods.
Once the government identifies that a severe pandemic has started overseas, I expect it give the nation notice that they have a set period of time to get to their homes or final destinations (1 day, 3 days, a week…I don’t know). Once that time is up, the restriction points will close. I’m sure it will be a time of great confusion. If anyone is planning on bugging out of the cities, I think they should be prepared to do so at a moments notice.
It seems that there are several interpretations of the term ‘social distancing’ on this thread:
1. personal social distancing e.g. hand washing, masks, cover mouth when coughing, bleach disinfecting
2. closing of public places and events e.g. schools, theatres, sports games, work places
3. quarantine (suspected contact) and isolation (symptomatic suspected cases) of individuals
4. restriction of travel at boundaries of cities, states, countries
Some of these are public policy decisions (which affect individuals and therefore discussions drift to how individuals respond to such a policy, not how effective a policy is). Others are more individual decisions but taken collectively, may shape public policy.
Each of these categories may have its own efficacy, and each combination of more than one category may have a different efficacy. I notice there seems to be several conversations on these categories going on at the same time. There may be a view that one category is more effective than another, implicit in the chat.
I think we should also study the efficacy of PPE for HCW, perhaps a special thread as it has been so controversial, money being the biggest constraint.
Sorry to be so META. I sense that this thread is drifting because we are not looking at the same problem. Perhaps discussing one by one and then combining them will gets us to a clearer picture.
All of those things _are_ “social distancing”. What did you specifically want to talk about?
What’s “META”?
I don’t think that anyone should try to enforce the restriction of flight for Americans when they try to move. The social distance I want to enforce is at my front door. First, I have worked for the Dept of Health in my state doing infectious disease followup. I know some of the issues. In a pandemic IMHO it (restrictions on travel) does not work. It does buy some time. Given the context, what good will that short period of time do us if we can’t seem to muster the social will to take advantage of the time we have now? Will a riot at your local big box store over the last bag of rice be settled in a just fashion by the man with the gun over there? I think not. Do you want your brother shot by a national guardsman because he is trying to get home and got caught in the crush. Do you remember Kent State? I will defend my own home as necessary and I do want the police, fire, National Guard to keep order. I think of this as life boat ethics. Those that can’t/won’t prepare or insist on moving will have their own fate in their hands. I want to arrange for all people to stay put and feed them. Is that such a tough concept? Is that problem beyond us? I think not. Should we work? NO! Should critical infrastructure people work? YES! Should they get pay?…yes extra if I were in charge. Bill me later. Who pays their bills during a national pandemic emergency? Nobody! Bill me later.
I envision a bad job being done by locals at the bridge. Traffic jams, medical supplies halted, who can pass, who can’t. It may contribute to food shortages in their own community. Some say there is not enough food. How does the United States manage to feed itself every winter? There is enough food (for this rich nation), the problem for us will be it’s distribution. If the consensus is to find a solution to this problem while we are able, then let’s do that. To stop discussion of a topic by being dismissive is a way to avoid the hard issues, but it does not solve the root problem.
Oh, and you children (those who exhibit childish behavior), should remember that there are older adults (those that exhibit adult behavior) who would like to discuss the issues here without rants and name calling and fights. Please, do me (a regular here for a long time) a favor and stop your fight. I am not asking you to leave (only a mod considers that action)just cool down. I am really not interested in your opinions of others, but I am interested in your opinions of what is being discussed.
Thanks to those who gave me the links to a simple plan. I confess to being very tired from a long conference I just attended..sleep at 1:00am and up at 6:00am for 4 days straight….no wonder I could not find it.
Z – at 23:29
Metadata is data about the format of the data. In my post, I was discussing what’s the better way of carrying out the discussion, hence my post was a META-comment :-)
From wikipedia.org
“Meta (Greek: ìåôÜ = “after”, “about,” “beyond”), is a common English prefix, used to indicate a concept which is an abstraction from another concept, used to analyze the latter. “
I think all of them are important, but I think they should be discussed sequentially or separately, and then combined, so we won’t end up in a debate which one is better when we haven’t quite reached a near consensus as to how effective each one is. What I posted was a suggestion. I have no preference what to discuss first. They are all important. I just felt that if we all understand this meta-point, then the discussion will be easier.
What do you think?
Well, when I started the thread I anticipated there will be differences of opinion, which is fine. I also anticipated there will be people who have a sort-of blanket approach and think it’s all futile or nothing is going to work. My response to that is, yes, there are a lot of challenges which means chances are a lot of things won’t work. But precisely because of that, we have to really put our intelligence to work to figure out opportunities for more effective interventions where they exist.
We will probably have to have plans A, B, C, D, and E and maybe more, and depending on how it pans out, if you have multiple alternatives, and fully understand the pros and cons of each alternative and when they might work best and when not, then you are more likely to be able to come up with the right one at the right time.
But the time to do figure these out is NOW, not when all hell breaks loose.
I always learn a lot when I write up stuff to post here. And the most important insight from writing this thread yesterday was this, and I will repeat the following excerpt from my previous pose:
Reducing the Impact of the Next Influenza Pandemic Using Household-Based Public Health Interventions
Wherever in the world the novel strain evolves, with modern news services and electronic communication, there will be a period of time during which the disease is not present in some large populations but is known to be spreading in other more remote locations. This presents a window of opportunity for implementing interventions to reduce R0 prior to the introduction of the pandemic strain from those remote populations.
How we use that time is going to be the most important determining factor of how each community will fare. And because that time may be quite short (in the context of policy making and implementation), probably not more than a couple of weeks (even if you have the first cases within a country, 99.9% of communities would still not be exposed yet), those plans need to be made in great detail now.
To put it in another way, communities need to set plans for different stages:
The policies that will make the most difference to eventual mortality and the sustainability of society will be those rolled out at #2.
Absolutely, positively 100 percent correct.
NOTHING else really matters until re-building.
THAT is where policy decisions should be affected by the electorate.
“THAT is where policy decisions should be affected by the electorate.”
THAT is where policy decisions should be affected by the informed electorate.
aka Fluwikians
We have a lot more learning to do.
anon_22: Completely agree. My deepest fears and frustrations abound because I have no trusted leader to guide me. I have lived a sheltered life in a small southern town. My experience does not include triage, feeding masses of starving people, rebuilding a society.
I’ve read numerous books about England during the WWII years and I know that many of the policies which were established to protect the British population required heartbreaking sacrifices which would be unthinkable to the average person today: Imagine our governments today making statements on CNN which decree that all children under the age of 10 are to be placed on busses and trains and be shipped to a secure facility (without their parents, and under the supervision of unknown volunteers, nannies or boy scout leaders, etc.) …..a new policy designed to ensure the survival of the nation’s children. Or another example; all homeowners in the states of Texas, Louisiana, Mississippi, Alabama will provide room and board for a minimum of 2 persons from identified megacities, for the duration of the pandemic.
Many policies just like these were put into effect, and they succeeded, but the British leadership imposed these policies on citizens who’d suffered years of hardships, extreme food and materials rationing, terrible fear, tremendous losses of military men and these circumstances allowed them to lead the population to accept the need for sacrifices of this magnitude.
If a pandemic flu sweeps around the globe in the next year or two, what leaders will we trust to devise policies that we can live with? How many dead will have to be counted before an average citizen will allow someone to walk off with his child, never knowing if that child would return home.
I am afraid that no one will have the courage to step up and say, “I am your leader and this is what we must do”.
Swann,
Read my latest posts on the ‘worst case scenario thread’.
Okieman – at 22:55 — “Once the government identifies that a severe pandemic has started overseas, I expect it give the nation notice that they have a set period of time to get to their homes or final destinations (1 day, 3 days, a week…I don’t know). Once that time is up, the restriction points will close.” — You made my spine crawl… How did you come to that conclusion? Did you see published guidelines somewhere or is it just common sense? (See my post in the first rumour thread, 11 August 2006, “A Duck Orange Mercurey for this post – at 11:50, point 5 reads: Borders will be closed very fast when TSHTF (2nd time also I hear this from different sources, although it is mentioned in the Ministry of Defense Plan). I am given to understand that border workers will be given 24 hours to go back home to hole in.)
Anon_22 at 01:56 — The French Govt plan deals, in some respects, exactly with that (not that I think much of it), I’ll try to answer your points one by one in translating excerpts from it, bear with me, it’s a long haul job (and it’s Sunday and I’m taking my little old lady out this afternoon)!
Also in NZ, there are official plans to limit social gatherings and close schools. The areas impacted depend on the incursion of the pandemic into the country.
Step one of social distancing is at an individual level, which includes avoiding crowded areas - public transport, shops, busy elevators etc. and ensuring people who feel unwell stay at home. It is the last one that is a problem because for years people treat the flu like a cold and ‘soldier on’. I have noticed this ‘season’ though that people are being more ‘aware’ of the impact of bringing flu and similar bugs into the workplace and we are seeing people choosing to take time out when sick.
Anon_22 at 01:56 — …communities need to set plans for different stages:
Before even dealing with the prepandemic stage, the French Govt paper has a general introduction on the role of the Govt. Some sentences are worth noting: General strategy:
Then are presented the different international levels of alert, which essentially reproduce that of WHO (6 levels with subdivisions), with two additional paragraphs:
Of note in this introduction:
Dadada on antiviral medications/vaccines. Dadada on the role of each ministry.
Then there’s a whole chapter on Information, training and communication, in which I note, in its third paragraph and in bold characters:
My next instalment: Anon_22′s first point: Prepandemic stage (to be continued)
Anon_22s first point: Prepandemic stage
Community’s plans (social distancing) for a prepandemic stage [I will highlight in bold those measures that are strictly concerned with social distancing]:
Have to go now, will finish tonight or tomorrow. It’s been a terrible experience to actually read throuh line by line to translate (even though I’d already read it). That plan is completely inappropriate. I didn’t think much of it at first, but I do even less now. I’d hoped to answer Anon-22′s questions, but it’s obvious there is nothing in detail with regard to social distancing preparedness at community level, apart from those measures to retrict population movements, or to move populations, or to quarantine them. Anyway I’ll continue it, because there are more “juicy” bits before the end.
when the virus goes effecient H2H, I suspect it will board a jet quickly for a worldwide sight seeing tour. It will possibly be in every major city before anyone realized the threat exists. The WHO will send a team to check the “large” cluster of illness that developed over 2–4 weeks. By the time they figured it out, we will most likely have virus everywhere. We of course will be freaking out… with noone else listening “oh there he goes again with the bird flu…..”
Soon after, oil will stop being delivered to local gas stations due to production line and delivery links beginning to fall apart, restricting most movement by car making the “bugging out” concept almost non existant. Then the food shortages. Then the water treatment plants.
Those who SIP early and have been practicing social distancing and lots of handwashing will most likely not get infected.
I highly suggest we all behave as if the virus is already circulating and be very careful what you touch. Practice makes perfect.
anon_22 at 1:59: What leader in any democracy in the world today would have the political capital to roll out “martial law” at your point #2? Because that is what would be needed to get the job done (as much as could be done).
Even some of the informed here at fluwiki would blanch at the prospect, even if several hundred had already died in Indonesia from a confirmed efficient strain. And if all of the world’s democracies were on the same page in this respect, most would swear it was a conspiracy to steal power from the people. How much cooperation would they get? How much infighting (while the panflu flew to their environs)?
If we had responsible governments they would be saying LOUDLY that this is what we must do, if that above event should occur.
FrenchieGirl – at 05:02
I came to my conclusions by placing myself in the shoes of the folks that have to make these decisions in the real world, ie- while trying to devise contingency plans for pandemic flu. To me, the scenario I have described makes sense if implemented during the early stages of a severe pandemic. It makes sense to me to break the country up into blocks bounded by geographic features and attempt to restrict the movement of people within those blocks. No shooting of people, but rather road blocks stopping people from traveling. This would help conserve precious fuel reserves also.
This sort of thing probably should not be tried in areas of the country where there is city next to city next to city. That is not where a restriction point should or would be placed. But rather out in the countryside in logical restriction points where the geographical features of the land would help stop the movement of vehicles and people. Yea, someone could hoof it on foot cross country, but how many folks are able and willing to do that over say 20 miles of woods or desert to the next town. Some, but not a lot. Again, this is to slow the movement of people, not stop it completely, because that is not possible without lethal force.
I’m not saying that people would accept all of this quietly. The howling over this would be tremendous, especially in the early stages, and especially by some people that would think or want to promote the idea for political purposes that President Bush was trying to take over the country. (If any of you here on the FluWiki think this way, then all I have to say is…well…your nuts:-) I say that with a smile because I can’t imagine that anyone in their right mind would seriously think that way. This is a pandemic we are talking about, and normal procedures of doing business must be set aside for a while if we are going to slow the movement of the virus and buy ourselves some additional time.
Okieman: Given the (lack of) response to Katrina and the 2% of population stockpiles of Tamiflu, expecting the federal government to act efficiently sounds like a hope rather than a reasonable expectation. I do not think this administration wants to “take over” even though they have grabbed excessively to widen executive power in my opinion. But neither do I think they are capable of governing seriously at any time, and especially not in a pandemic. I do expact a lot of fragmentary and futile steps that are as likely to aggravate as ameliorate the situation. Local and family organization are our hope.
INFOMASS – at 10:07 “Local and family organization are our hope.”
I agree whole heartedly, and the government has told us as much. We will be on our own, and we should prepare accordingly.
Infomass - You asked if there were any pandemic historians out there. Pandemic History is not my area of specialization, but I did find some information in “A History of England,” authors David Harris Willson and Stuart E. Prall (Holt, Rhinehart & Winston, 1984): p. 136 - “In August, 1348 the bubonic plague, or Black Death, suddenly appeared in England. Its germs were carried by the fleas on black rats that came into the country on ships from abroad. The first outbreak of the plague was of immense ferocity, for the people had no immunity and persons living close to the margin of subsistence fell victims to the disease.” The plague returned in 1361, 1368, 1675 and remained in England for more than 300 years. p. 128 - “This dread disease, which greatly reduced the population, created an atmosphere of alarm and a sense of crisis. Social and economic conflict arose as a reduced labor force demanded better wages and freedom of the bonds of serfdom. Commerce and industry appeared to suffer less than agriculture, for it was during this period that England ceased to be merely a producer of raw wool and became a manufacturer of woolen cloth.” p. 132 - “Conditions in France were miserable. The Black Death raged without mercy, the government was disrupted by the absence of the King, great stretches of the countryside lay waste, the wretched peasants rose in revolt, free companies of English soldiers roamed about the country plundering as they went.” p. 140 - “On the whole, the wealthy classes (England) held their own more successfully in the towns than in the country because commerce was less affected than was agriculture by the Black Death.” I hope this helps give some perspective. It seems to me that some conclusions that can be drawn are one, there will be a reduction in the population despite our best efforts; two, there will be a period of civil unrest; and three, civilization will survive, because people are a very resilient species who most often crave stability, peace and prosperity.
I’m sorry. I’m the one who posted the above.
Continuation
Phase 6
THAT’S IT!
What have I learned with respect to communities social distancing planning? Whatever is planned is not in the Government Plan above. It may well be done — if it is — by means of internal directives. I am going to have to get more info on this.
To respond to Okieman – at 09:55. I agree with you in theory. In practice though, I have seen the “zoning” they did in France this spring when they installed a protection perimeter around the poultry farm that was affected, and I was able to go three times inside the area without being stopped, nor did I see any police/military on those roads. You say “no shooting of people”. How about if one tried to force through a police road block? I’m certain as can be that French policemen (military too) would shoot. They carry arms, and some of these youngsters are just hoping for some opportunity to use those (dixit my - older - policemen hubbie and brother). Whether you can force people into quarantine (by town, by region, by district, by area, etc.) would much depend on the mentality of the people in the place concerned. In Switzerland, very law abiding citizens, I’m sure you could. In France, unless towards the Easter borders, I don’t think you could. As for moving entire populations, as the French Governments envisages, I don’t think it would be feasible; the memories of the hell convoys is still too strong; if the French Government were to try this, or even talk about it (I mean talk about it on TV, radio, not just in a White Paper), that Government would be dead after the first words, no politician is going to risk his career to try and force population movements. It’s bad enough when they have to evacuate a neighbourhood to remove some old-lost forgotten WWII bomb.
…that’s actually. But things would change when panflu pictures from Asia with deaths,masks,quarantine,crowded hospitals come in every day…
bump
I didn’t have time till now to continue this series. Thanks to FrenchieGirl for letting us know what the French government is planning.
If we go back to the notion that social distancing policy measures will make a difference to the eventual outcome only if started early, then the next logical question is how do we make this come about.
The most important prepandemic policy to adopt is to tell people to stockpile essential items.
Social distancing may happen by government directive, started early before the disease takes hold, or it will happen spontaneously when people are alarmed enough to start self-quarantine themselves. Either way, the need for provisions will be severe and acute.
If a significant percentage of the population has enough food, water, essential medicines, etc to SIP for at least a few weeks, it will give the government some breathing space at a time when major decisions are needed and services are stretched.
Getting people to stockpile essential items is the only logical policy decision that governments can arrive at from the various studies on social distancing measures.
I’m going to jump back to much earlier on this page
Swann – at 03:18 “anon_22: Completely agree. My deepest fears and frustrations abound because I have no trusted leader to guide me.”
Well, maybe you have to quit thinking that, and think how you can be the leader.
We need to start getting used to the idea that there’s no cavalry out there, not just after the pandemic started, but even now.
We are it, folks.
Each one of us can get started reaching out, advocating, however we can. We push TPTB so they eventually will have to answer our questions.
So I repeat what I said in my last post,
Getting people to stockpile essential items is the only logical policy decision that governments can arrive at from the various studies on social distancing measures.
I can’t speak for others but I am asking for a completely reasonable and proportionate (ie NOT worst case) response based on science.
Let’s go sell this wherever we can.
anon-22: “I can’t speak for others but I am asking for a completely reasonable and proportionate (ie NOT worst case) response based on science.”
Could you elaborate more as to what you feel this is? I have tremendous respect for your opinion. And I tend to worst-case us back to the Stone Age.
Thanks
I have often wondered if the time duration of the next pandemic will not last as long as it would if everyone prepped.
If every single person were prepped to SIP for 2 years, and did so, wouldnt the flu germ just hang around outside our houses? Then when we finally do have to come out it would be just as lethal?
On the other side of the coin, look at what we actually have (0.1% of population prepped). Once critical infrastructure goes down, most suburban people will have to leave their homes, in search of something to drink, within 1 week. Most city people will have to venture out within 2 to 3 days. Given a choice of certain death through dehydration or possible death through flu, folks will take their chances with catching flu. At that point the masses will be out in the street fighting for what water they can find and the flu will rapidly spread and get whoever it’s going to get.
So I think given a certain virus, the pandemic will be over and done with much quicker with a society that is not prepped than with a society that is prepped. The pandemic will be vastly more severe, but will be over much quicker. IMHO.
What say you?
I fear you are right, JJF… I have always felt that the social turmoil will be so severe, that if one can survive the first month of collapse then one has a reasonably good chance of long-term survival. It’s surviving the short term, high danger time that’ll be the hard part.
anon_22 – at 13:28
I can’t speak for others but I am asking for a completely reasonable and proportionate (ie NOT worst case) response based on science.
I’m with you on pushing for prepping at the individual and community level and I salute your attempt to wake up TPTB, but I don’t understand the quote above. To me, the available data suggests that the worst case scenario is the most likely one. That doesn’t mean it will happen, of course. However, there is no scientific evidence that an H5N1 pandemic will be mild or moderate that I can see; quite the contrary.
What is your current thinking on this?
JJF,
A pandemic virus will live in people, it won’t be lurking outside your door unless there is an infected person lurking outside the door.
Even if everyone in the First World SIP’d place for 2 years, an unlikely proposition, the other 5 billion people will not be able to SIP. Which means that the virus will still infect large numbers of people. Once it has done that and comes by for subsequent passes, it will encounter hosts with antibodies. To evade their immune systems, certain mutations will come under selection. These mutations are expected to result in less lethal strains. Certainly this was true of past pandemic strains. Eventually, this process is expected to result in a strain no more lethal than “regular” flu.
In American Samoa, there was a complete quarantine during the 1918 pandemic. No-one died of it there. No-one.
In Australia, there was an attempt to keep it out. Ultimately this failed, but they delayed long enough that the virus was much weaker. They had reduced mortality as a result.
Jumping Jack Flash:
“If every single person were prepped to SIP for 2 years, and did so, wouldnt the flu germ just hang around outside our houses? Then when we finally do have to come out it would be just as lethal?”
If every single person did that, then yes, perhaps. What is most is significant is precisely that not every single person can or will. They’ll be out and about, contracting the virus, and either recovering, or not. Those who recover will be immune to the virus until it evolves away from that immunity enough to return as just another strain of seasonal flu. Those who survived the virus in its pandemic form will have partial immunity to the returning virus which the SIP’ers emerging from their bunkers will lack. But because the survivors will be partially immune, less of them will become ill during subsequent seasons; attack rates for seasonal flu are typically 5% to 15%, compared with 35% or higher for a pandemic (the high attack rate is part of the definition of a pandemic, actually). This will reduce the SIP’ers’ chances of catching the bug, though not necessarily the severity of the illness for them if they do catch it. Additionally, there is always the hope that an effective vaccine will become widely available, or that the pandemic strain will evolve to a less lethal form.
“So I think given a certain virus, the pandemic will be over and done with much quicker with a society that is not prepped than with a society that is prepped. The pandemic will be vastly more severe, but will be over much quicker.”
I think a lot depends on whether you take into account the effects of social disruption. Considering only those directly affected by the virus, the pandemic which runs its course more quickly would probably infect fewer numbers in the long run, and therefore look “less severe”. But more people ill at the same time means much greater potential for social disruption. If critical systems fail, the effects of that have the potential to cause more deaths than the virus, and be much longer lasting.
Hi JJF, Monotreme…and Racter…good to see your post.
H1N1 is still circulating as aftershocks or ripples from the 1918 pandemic. There may be a few pockets of persons who have not encountered H1N1 but by now they would be few and far between.
The bottom line immunologically is that there will be no latent or passive immunity to H5N1…this means every person will have to be in effect infected in the future..as with H1N1.
There is going to be 1–3 initial waves of infection from strains that one would rather not be infected with…if it is possible to in effect choose when we are infected then we can wait until H5N1 starts to lose its bite and then get sick…
…this is probably more easily said then done.
I personally couldn’t count on one hand the individuals I have met in my life that I know would be capable of sustained and effective SIP for any length of time…and most of them are trained professionals.
Tom — I could not agree with you more. The thought of an extended stay at home with my beloved family (and ONLY my beloved family) is giving me nightmares.
What is it you see as the biggest problems to a “SIP” for most people and what do you mean by the term SIP (Shleter in Place)? As some people use it, they mean stay in their house and do not go out for any reason (as in a chemical attack) whereas for others it appears to be shorthand for something else — no outings, perhaps, no social events, or school; but walks around the block, working in the yard, and so on would be fine as long as you stayed away from too many other people.
Do you see the biggest problems to SIPping to be logistical, or psychological?
Oh, and finally — what professions prepared one to stay at home with only a few others for along period of time? Astronaut? Submarinier? (-:
Monotreme,
You and I have had this conversation so many times, but I still find it hard to really explain what I am trying to say. So be patient and let me have another go.
I believe that a pandemic happening in the near future with H5N1 is likely to be catastrophic. It has a high chance of being a partial population-depletion event. The CFR can be anything from 2% (miraculously) to the current 50 or 60%. It’s hard to say what is the likely CFR of course.
But what does a CFR 2% or 20% or 50% mean?
Let me quote you a line from an official of an unnamed country, “All the scenarios that we’ve been working on, even the best case scenario, involves picking up dead bodies on the streets.”
That’s what I’m looking at. People dying, with no help. Dead. At home, or dumped on streets by frightened families. Bodies rotting, flies, smells. People abandoning loved ones because they are sick. (Anybody who doesn’t think that should go read ‘The Plague’ by Albert Camus). Everything else, hospitals, infrastructure, you can extrapolate.
So this is one piece, the worse or worst scenario(s). Let’s just put that on one side for the moment.
Now I’m going to switch gear and look at what is currently happening. How many of us have tried to talk to people, friends who trust you, and tried to convince them of the necessity to pay attention to this pandemic issue, and failed?
I just had dinner with a couple who have been our friends for more than 20 years, the kind of friendship where we could appoint each other as guardians of our kids in our wills if we die. Wonderful intelligent people. Medics, both of them. They understand everything that I say, they have lived through SARS (as HCWs, remember), they have the money to prep, they are responsible parents, they make sure their kids got a good education, took their vitamins, teeth straightened out by expensive orthodontics, got told the facts of life, everything, the works.
But I’ve been telling them about this for at least 6 months, and they have done nothing.
Why is that?
This is by no means a unique experience. I can say most of my friends, mostly medical folks, are not doing anything about it. They don’t need me to explain ARDS, they see it in hospitals. They know the CFR for those in their kids’ age range. But they do nothing.
They would make sure everybody wear seatbelts, they buy insurance for everything you can think of. But they don’t buy preps as insurance against a pandemic.
I have thought long and hard about this, and I have a theory.
Imagine you are a man from Mars, and you’ve never seen or tasted a lemon before. What is it that I can say or how is it that I can describe the experience of sucking on a lemon for you to really get it? Some of you may have just experienced some actual sensations in your mouth when you read about ‘sucking on a lemon’. Even if you didn’t, you can imagine what the sensation would be like. In fact, you can make youself feel it. It is possible to turn on that special sensation, to ‘light it up’, so to speak.
But if you’ve never ever experienced anything like it, whatever I say, it is going to be very hard to get that sensation.
This ‘lighting up’, is the key. It is a biological, a neurological phenomenon. It is not anything abstract or ethereal.
If something is close enough to someone’s experience, even if they have never experienced it, like losing a loved one in a car crash, they are still able to imagine what it might be like for that to happen. But if it is something so extraordinary, something that is so far removed from their experience, then no matter how much they understand it rationally, it can get very hard for them to get ‘lit up’ about it. This ability to imagine, to try on, the unimaginable, does not come easily to everyone. Some of us have it, most people don’t.
This ability to get ‘lit up’, is also a biological, neurological event. The advent of functional MRI scans have in recent years revealed that our thoughts, aspirations, phobias, motivations, are not just abstract psychological phenomena. They are also measurable biological events!
What’s more, our biology is not static. It is affected by our history and our life experiences. For example, patients of depression may show specific changes on the scans. People who have normal scans, then experience traumatic life events that cause them to go into (secondary) depression, may then develop the same abnormal patterns that they didn’t have before, and these patterns may disappear over time as the person gets better. But if they experience repeated trauma, the depression can persist beyond the trauma and become permanent . When this happens, scans may correspondingly show persistent abnormality. (best reference: ‘Shadow syndromes’ by John Ratey) Our life experiences are literally imprinted in our neurology.
People get worried about losing someone in a car crash because they have experienced enough of life to know what it might be like to lose someone, and they’ve got the neurological ‘experience’ imprinted, even if it is second hand, sufficiently so that if they think about it, they will get ‘lit up’ sufficiently which kicks them into taking action, eg buying a safer car.
But if they’ve never ever had that imprinting, of the scenarios that we are talking about, it gets very hard for the lighting up to happen sufficiently for them to take action.
Now let me bring the two ends of this discussion together, and ask, what does it take for people to get off the butt? Some people might think if we make it horrible enough, they will take action.
My hypothesis is that we might need to make it just horrible enough (ie within the range of their life experiences so that their neurology can get lit up) for them to take action, but not so horrible that there is nothing in their life experiences to give that prior imprinting necessary for the lighting up to occur.
So if I were to say, it’s going to be dead bodies everywhere, they won’t know how to fill in the blanks, to create the kind of representation in their heads that lead to rational action. So they just blank out and do nothing.
But if I were to say, there’s going to be a pandemic. A lot of people might die. But scientists are telling us that if we all co-operate and keep away from people as much as possible, then there is a chance of reducing the deathrate and the impact. To do that, the government might decide to tell everyone to stay home for a while, at least until they get things under control, and shops might close. So you need to have enough food and essentials at home so you can stay in if necessary. It’s just the same as preparing for a hurricane, except maybe for a little bit longer.
Now you might say, why not then tell them to prep for 3 months? Why 2 weeks? Surely that’s not enough.
Yes, 2 weeks is not enough. But, again going back to the neurology, 2 weeks is just about the limit of what most people’s shopping experiences go. How many of us have found it really hard to figure out what 3 months’ of food mean?
Plus 2 weeks is do-able. If you give a large group of people a task that is too difficult, you will lose a large percentage right off the bat. Any book on goal setting will tell you that a goal that is too difficult to achieve is a goal that is too big. You need to break it down into smaller ones. That’s what most people need.
But, and here’s another key, the act of going out to shop for 2 weeks’ worth of food etc, will be a new neurological experience. It will start another process of imprinting. The mind starts getting used to the idea. Then getting people to do more preps becomes easier.
And getting them to ask the right questions also becomes easier. This is another important point, when someone is asking the question, they are lit up. They are on the right page. That is when your message is most likely to be effective. The best time to sell someone an idea is when they are asking, NOT when you are pushing.
Tom:
“I personally couldn’t count on one hand the individuals I have met in my life that I know would be capable of sustained and effective SIP for any length of time”
I like to think in probabilistic terms, rather than all-or-nothing. If going out means N opportunities to get infected, and D represents the number of days on which one ventures forth, then one’s chances of getting infected during any given time period are N times D. Even if you can’t keep D at zero, you can still reduce N without getting real fancy — just try to keep a little distance from others, and pay attention to what your hands are doing. The same could roughly apply to another risk most of us are willing to accept on a regular basis: driving a car.
Average Concerned Mom:
“what professions prepared one to stay at home with only a few others for along period of time? Astronaut? Submarinier?”
Video game tester. They refer to the outdoors as “the big room with the blue ceiling”.
BTW, what I am advocating, that governments all over the world publicly tell every family to prep for 2 weeks, is what the US government is already doing. So kudos to them.
BUT, they have been whispering it.
They need to step up and say it loudly and clearly.
And of course every other country should do that too.
It will focus everyone’s mind.
anon_22 – at 00:01,
Well it looks like we still agree on the worst case scenario, unfortunately. I thought maybe you had new information that made you more hopeful. Oh well.
As regards the psychology of adjustment, I have to say I have not had the same experience you have where I live. I have convinced numerous people to start very serious preps. I gave a talk at my institution and did not pull punches. To my great surprise, it was very well received. As I was walking to my car people asked me where was the best place to buy rice, in bulk. Many people here are prepping to various degrees. Some people aren’t, of course. Some are too busy with other problems. Some think it’s a low probability event etc. However, the local PTB are definitely taking it seriously and are prepping. Preppers are not regarded as weird or alarmist. In fact, the local PTB regard pandemic preparations as a civic and company responsibility.
In New York City, OTOH, no-one takes the possibility of a severe pandemic seriously. Any discussion of prepping is regarded as loony.
The difference is the signal from the local PTB, IMO. In my city, prepping is encouraged at many levels and considered normal behaviour. Although they are working on the assumption that a 2% CFR is the worst case scenario, which I disagree with, they think there is a signficant chance that this will occur. In NYC, OTOH, almost all media stories portray prepping as nutty and underplay the risk. None of NYC PTB are making realistic plans or communicating to key players that they should take pandemic preparations seriously.
So, IMO, if TPTB in your city were to start putting inserts in Newspapers saying that a severe pandemic was a very serious possibility and the preps at the personal, community and company level were necessary and strongly encouraged, I think your friends would take your concerns much more seriously.
Finally, I have used CIDRAP and Michael Osterholm to convince a number of people to prep. One reason I am so grateful to the guy.
Anon 22 at 00.01:
Excellent, precise and may I add persuasive? You are right about the “lit up” connection.
As many have commented here, once a person makes a commitment to act-as in buy food and water for two weeks, another level of evaluation kicks in. It’s that first commitment that’s important.
Monotreme,
Each country, and even different communities in the same country, need different things. But what I am specifically saying is for governments to publicly and visibly put this out. THAT is what will make the biggest difference.
The current political climate in the US and the UK is such that anything just this side of unbelievable will get trashed as government fearmongering to divert attention from their foreign policy failings. What I would like to see is not a divisive society, but one in which mature people can put aside differences and talk to each other.
anon_22 – at 00:01
If you need a means to help people understand what is coming, remind them that 80% of the people of New Orleans evacuated the city before the storm hit. Only 20% of the people remained to go to the super dome and convention center or stayed in the city. They were in a fact very very lucky. Help did come, the government was able to rescue them.
Now put the other 80% back into the city with the same disaster, only no one will be coming to help because you have the same problem in over a 100 other cities. That is what the worst case Pandemic would look like. No power, no food, no water, no medicine. The hospitals so over crowded that doctors and nurses have to decide who will live or die and everyone, demanding that they receive treatment.
Truly I do not fear the disease, I fear the effects that a pandemic will cause that is why I prep.
The only reason why the Bush administration is ‘lit up’ is because of Katrina. Including seeing those bodies floating in the water, some not retrieved for many days. Remember how people said “I couldn’t believe this is happening to Americans?”
They have watched enough world news to accept these things happening in the Third world, but when it happens to Americans, it triggered an entirely new neurological experience.
And the reason why they are only whispering about prep is because they have cried wolf one time too many, so that gets imprinted as well, the experience of being called liars.
Anon_451,
It is not about the logic of the argument. It is about the psychology of the argument, IMHO.
I also see them light up and able to comprehend two weeks. But I take them further as they are able. I love sending folks first to http://tinyurl.com/ojxvy which is Deloitte 18 month blizzard site. I tell them to click listen. Deloitte is a name they recognize. Golly gee, if they’re talking about it…. Then I send them to fluwikie and suggest reading CanadaSue. I also ask the question, if you follow the govt’s recommendation of 3 days or two weeks, who is delivering food to your door the next day? Will they have food at the store then and can you go if you are supposed to stay home for 6 to 8 weeks? They think about these things. Then we talk. One friend I mentioned BF to went to the govt site and prepped as they directed. She was proud. So was I. Then I asked her, on day 15…? Her brain then kicked in - she even figured out that the CFR might be a bit higher than some say, choked, and kept going on her thought process. If this, then that. Ohhhhh. So what now? People didn’t hear me six months ago. I’m more insistent with those I care about now. I feel there’s not much time left to get ready.
anon_22 – at 01:09,
Each country, and even different communities in the same country, need different things.
Hard for me to understand how NYC will need… nothing.
IMO, the CDC and the WHO are the ones who should be providing realistic assessments of danger we are in. From various recent threads, I have come to the conclusion that the people who control the message at these institutions are clueless. Therefore, I think we need more outside scientists to step forward and point out that the CDC and the WHO are understating the risk and that serious preps are necessary. Michael Osterholm has accomplished an enormous amount, but he’s just one person. We need other scientific and medical heavyweights to step forward and share some of the burden.
If the warnings come from scientists and public health professionals, politicians will have political cover for allocating resources.
anon_22 – at 01:14
And the reason why they are only whispering about prep is because they have cried wolf one time too many, so that gets imprinted as well, the experience of being called liars.
When you say and do anything to win elections it often comes back to haunt you.
The terrorise threat is real, however; when you use the threat for political gain and control of the masses, you have the boy who cried wolf effect. No one is willing to beleive you when the threat is ready to bite you in the back side.
Beside’s that is a Bird Flu not a human one and it is on the other side of the world. No need to be worried, it will never happen here.
Monotreme,
“If the warnings come from scientists and public health professionals, politicians will have political cover for allocating resources.”
In the US, there is enough scientific information and official acceptance of issues for ordinary folks to just go directly to their officials and say “why are we not doing this and this and this…”
It’s not going to be enough to satisfy you, Mono. But it is enough to get a lot more done than is happening now.
The key is to jump start things.
My message to Fluwikians in the US is this: you don’t need to wait for more scientific data. There is enough official recognition from the top (even if whispered) for you to go harass your community leaders to take action. Like right now.
annon 22 01:30.
anon 22, I know your intentions are honourable but many of us have been doing just that for years and have been met with distant stares and sighs and avoidance.
In other words, I’m afraid it is not going to work. We have to come up with another alternative and I don’t know what that would be.
I like Anon451′s post at 1:11 - Is even more effective if you put numbers to the NOLA analogy - I think the population of NO was around 450,000 before Katrina (?? pls correct if I am wrong - I live in Canada) 20% or roughly 90,000 stayed behind - final death toll probably around 3000 (?? is this correct) or (math impaired at this time of night!!) what percent is that .3%?? Now add back in the 80% and imagine no help arriving at all!!! That is a terrifying scenario to me!!
annon 22.
Could it be that if they begin to prep then they will have to finally admit their worse fears are about to come true. By not prepping, you remain in blissfull denial…
…speaking for others and not myself of course. /:0)
Racter. good one on the profession…another chuckle another notch on the humour gun…I assume the only gun you will be protecting yourself with.
Average Concerned Mom.
SIP, whatever it means, is utopian and cannot happen. The intricate planning that would allow total isolation for months is certainly beyond my capabilities and most others as well. What do you do when you run out of x supply and what if it is essential to your survival…well, you break your isolation.
Healthcare and medications are one of the bottlenecks and breaking points. Doctors are presently not allowing people to stockpile needed antibiotics etc. so what if you get sick and need medications if not treatment…well you then break SIP.
Survivalist training (army) or sterile technique training gives some of the discipline requirements necessary to survive for long periods in SIP.
My biggest complaint about SIP is that it gives a false sense of security because 99 % of those in SIP will have to come out of the burrow…then what do you do.
It is my strong belief that rather than concentrating on SIP as a panacea, we must concentrate on how to live with the virus in our environment and not become infected.
This involves the training of sterile technique used by surgeons, which is achievable but difficult to learn…
…I don’t mean we all walk around in gowns and gloves but what I do mean is to stockpile N95 masks, and prepare ourselves and our children to, for example, not to touch our eyes, nose or mouth until we return home and wash our hands (regular soap works well…don’t fall for the snake oil salesmen).
This is achievable…so is making our public environments more pathogen resistant…automatic disenfection of escalator handles…doors on public washrooms removed. etc.
I think it is wise to plan for short-term SIP…less than a month…beyond that it is impractical and impossible.
TOM - You wouldnt break your SIP for needed supplies because you would know that there wont be any on the shelves - and your family doctor will not be keeping office hours to examine you and give you a script, that’s for sure!!! That’s why it is SO important that we prep with ALL the supplies we can think of - to last as long a period as we can afford!! p.s. Do you notice that YYZ, you and I are staying up later and later at night to keep track of Fluwiki??!! Is it because our PPF is rising?? We shd try to get some sleep!!
g. I was going to say the same thing to you…about sleeping.
I don’t have a family doctor…not a good thing at the moment.
I expect that I will be prepping soon and I think I promised that I would tell everyone when I started…I’m still in that blissful denial hoping I will be wrong.
and thanks for the kind advice. Catch up with ANON YYZ and give it to him/her as well /:0)
Tom DVM – at 02:00
“anon 22, I know your intentions are honourable but many of us have been doing just that for years and have been met with distant stares and sighs and avoidance.”
It’s all about timing. The awareness and readiness change from month to month. What didn’t work before may work a lot better at a different time.
Secondly, there is a motto from somewhere that I don’t remember, “If at first you don’t succeed, try again. And again. And again….
It would be useful, of course, to refine and modify our techniques based on our failures. I have this wonderful quote “Try again, fail again, fail better.” Samuel Beckett, Worstward Ho, 1983. Hat tip to Fedson.
“In other words, I’m afraid it is not going to work. We have to come up with another alternative and I don’t know what that would be.”
If you don’t know what the alternative is, you don’t have an alternative. :-)
Keep trying. I know you’ve got it in you.
No, YOU know you’ve got it in you…
anon_22 – at 01:14
re: “…because of Katrina. Including seeing those bodies floating in the water, some not retrieved for many days. Remember how people said “I couldn’t believe this is happening to Americans?”
Trust me, most Americans couldn’t believe it was happening to Americans- except perhaps for the Afro-American population. Every black person I spoke to was really not too shocked and I could understand their point-if there were white Americans trapped at the Super Dome in N.O., I suspect limos would have gotten in there quickly to evacuate.
Back on topic-despite the warnings from govt, despite what we saw with our own eyes in N.O. 1 year ago and now, people are so deep in-denial? overwhelming fear? can’t-happen-to-me syndrome? that those who prep for themselvers, for loved ones and yes, for strangers will IMHO, actually dramatically increase the likehood of survival of any disaster-not only panflu.
Push come to shove, we have to accept that a significant population of people-intelligent people, people with the means to prep, will not do so even when given the information. Why? I’m sure sociologists have some idea, but I personally consider it the same driving force behind non-compliance with current health care problems-couldn’t care less to too busy to a defeatist attitude.
In earthquake-prone regions people are encouraged to have food, water etc for a minimum of 3 days and most cope with that idea - for their own homes. Now try to get them to prepare to be confined to their workspace for 3 days and to prep there as well - forget it - they get the theory but do nothing in practise. Most assume they can just wander off home and even when they accept that they might not be able to achieve that immediately, they still do nothing. So, even when they seem to get the message, they don’t get all of the message.
In the 1918 flu in NZ, in some areas, pubs were kept open for a few hours each day as TPTB thought that keeping up morale was the best way to keep people healthy!
I have just checked our health emergency management plan and there are quite specific statements about closing education facilities, restricting public gatherings and restricting movement to/from infected areas. These are all covered by quite specific emergency acts - they are part of our law of the land.
We need some lateral thinking, don’t we? Or some other alternative :-)
AnnieB – at 05:57 --- Now try to get them to prepare to be confined to their workspace for 3 days and to prep there as well - forget it - they get the theory but do nothing in practise. Most assume they can just wander off home
Another issue with that is the fact that many employers will not allow a person to stash 3 days of food and water at their desks, and certainly won’t provide personal secure storage space for those items.
Even if a person “could” hide that in, maybe, his/her desk, add to that this scenario: Employee “A” has his 3-day stash of preps in his desk. The essential personnel are required to SIP in the office for 3 days. Let’s say in an office of 1000 people, 150 are considered “essential”. A few others have stashed food, but not many. What’s going to happen on the second day, when some hungry employee walks past employee “A”’s desk, and sees him eating and drinking? There will be a food run on that desk by whoever is nearby, and then every desk in the office will be turned inside out by folks looking for food.
Not all companies will provide food and water when they require essential personnel to SIP at the office…they won’t want the liability if someone may be allergic to some foodstuff they provided. And they’ll be hard-pressed to get any food brought in from the outside…
Welcome back lugon. Check out the Community Preps for a Worst Case Scenario series if you get a chance. Your input is always helpful.
Bronco Bill: Don’t companies provide expense money for meals and sometimes advance it? Or they could offer a variety of foods. The legal system is not likely to be in overdrive if we have a pandemic anyway. If the company is taking the operations continuity seriously, they will be thinking about food, masks, gloves, Tamiflu and even provisions for families. The main problem is that without federal leadership, the web of companies will break down because some critical ones will not be prepared. It is not just “just in time” but also that we are so interdependent. Our system is efficient when it is working well but is fragile when hit by unexpected (?!) shocks. An important unresolved question is how bad things have to get for a total breakdown as distinct from spot shortages. I do think social distancing would help prevent or slow the “total breakdown” scenario. If we learn how to treat with the disease, a slower spread would be a big help.
Bronco Bill: Don’t companies provide expense money for meals and sometimes advance it? Or they could offer a variety of foods. The legal system is not likely to be in overdrive if we have a pandemic anyway. If the company is taking the operations continuity seriously, they will be thinking about food, masks, gloves, Tamiflu and even provisions for families. The main problem is that without federal leadership, the web of companies will break down because some critical ones will not be prepared. It is not just “just in time” but also that we are so interdependent. Our system is efficient when it is working well but is fragile when hit by unexpected (?!) shocks. An important unresolved question is how bad things have to get for a total breakdown as distinct from spot shortages. I do think social distancing would help prevent or slow the “total breakdown” scenario. If we learn how to deal with the disease, a slower spread would be a big help.
As I read the postings on social distancing, which I understand, believe, ect. I see myself becoming more amd more aware of door handles, washing hands, touching face and working to retrain myself in these behaviors.
However, I am finding myself shaking hands, hugging and casually touching people more than I have done in the past. I wonder if knowing of the coming BF and what it will take to survive…I am trying to “stock up” on human contact also.
Ya’ll are talking about the personality that it would take to SIP and whether you know anyone that is capable of maintaining isolation. What choice do we have? If we don’t stay in how can we survive? It is a strange world we are envisioning. Sci Fi couldn’t get any better.
INFOMASS – at 21:25 --- Most companies that I’m aware of nowadays only give a daily stipend that will cover 1 meal. Of course, that could be stretched out for personal preps. Where I work, they REQUIRE a person that travels to have a corporate credit card, and then turn in receipts after the fact. No cash up front. Many companies are doing that now so they don’t have to have cash on hand for travelers. The credit card company does the direct billing to the company, the company pays the bill, and in turn simply deducts it from the paycheck. Insurance companies, such as the one I currently work at, are highly unlikely to shut down right away. They’ll have customers calling from all corners of the globe asking questions about their health benefits…
I am one of those who could not work from home. Working with PC hardware all day, I have to be onsite to repair any desktop or server problems that may arise. The company has promised that they would supply a modest stash of rubber gloves, and I’ve checked that out. What they’re planning is purchasing a large amount of Playtex dishwashing gloves, instead of disposable gloves. That way, we’re “not as likely to throw them away after each use”. Antivirals? Only for the executives. Food on-site? No place to put it. Masks or provisions for families? Fuggedaboutit. We’re on a cost-cutting binge right now that has managers telling employees to cancel any continuing education that they may have signed up for if the company is paying for it.
I’m sorry, but I use a pair of gloves once on an employees keyboard or desktop items? Those gloves go in the trash as soon as I walk away.
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