From Flu Wiki 2

Forum: Strategic National Stockpile Medication Dispensing Plan

07 September 2006

tjclaw1 – at 22:12

My husband received the following e-mail from a colleague today: (I’ve deleted names and identifying information)It was sent to all full-time college faculty.

“**** ****** Assistant Professor of English and Speech

  • ****** Community College

Hi everyone,

I have volunteered for this and participated in the training. It is a fascinating, massive undertaking that we all will want to function smoothly if the day ever comes that it needs to be mobilized. If you are a resident of Lee County, I urge you to consider volunteering. You do not have to be a health care professional. I would be glad to answer any questions you may have also. I’m sure Whiteside County Health Department would appreciate your call as well. All counties in the nation are required to have a plan ready to implement. The call for volunteers from Lee County is below.

VOLUNTEERS NEEDED!

The Lee County Health Department is recruiting volunteers for their Strategic National Stockpile Medication Dispensing Plan. In a public health emergency, numerous volunteers would be needed to assist with medication dispensing (health care professionals), assisting with form completion, on-site security and more. The list is extensive.

Training covers clinic flow, confidentiality and legal issues, photo identification badges and general volunteer information. During an actual event, trained volunteers will receive their medication or vaccine before the general public.

From more information or to express interest in becoming a volunteer, please contact Lora Fassler at the Lee County Health Department, 815–284–3371 ext. 128.

  • *****

Dean of Health and Sciences

  • ****** Community College”

WOW, this is the first I’ve heard of any planning in our little midwest community. I’m going to e-mail the person who sent my husband this message (know her well) and see how many people were in her training, and get more details.

09 September 2006

crfullmoon – at 12:13

(I’d like to see what the authorities have on hand this year to distribute, too. Sometimes, the signing up volunteers to dispense medication gives a community the incorrect reassurance that there is anything helpful to dispense if a severe influenza pandemic breaks out. First preparations should be to get the public ready for possible quarantines/supply disruptions. Volunteers don’t just need a plan on paper; they need supplies at home for themselves and their families, as does the public.)

Average Concerned Mom – at 13:36

crfullmoon —There’s a phone number there and a name for someone in the health dept….could you call her and ask how much vaccine they have for pandemic flu? (-: OK, well, how much Tamiflu?

BirdGuanoat 13:58

Well first you actually have to HAVE the drugs to dispense…

I’ve read extensively about the SNS-pharma.

There is a warehouse on a federal installation not too far from me that contains one of the west coast caches.

The most interesting thing I read, is that only a SMALL percentage of the cache is actually a physical cache stored in a warehouse.

The rest is a cache on paper. Specifically contracts to manufacture/deliver x number of x meds in x timeframe, and push them via military transport to where they are needed.

crfullmoon – at 14:26

ACM at 13:36 I won’t be calling. I know the faces I’ve gotten here from those who want you to be reassurred and go away, not be able to recognize that “the Emperor’s New Clothes in Dr. Caligari’s Cabinet” are about as useful as their current “Dispensing Plans” if pandemic breaks out.

EnoughAlreadyat 15:09

tjclaw1 – at 22:12

I’m with you--- this is WOW!! Maybe it’s just me, but it sounds like something is being activated. Is it just me?

anon_22 – at 18:33

Check out this paper on Getting Medicine to Millions: New Strategies for Mass Distribution from the University of Pittsburgh Center for Bio-security proposing how they can use retail stores to distribute medicine.

so related thread Questions For Dr Inglesby

10 September 2006

tjclaw1 – at 17:47

Turns out that I know the woman who is in charge of our county’s emergency preparedness. We both have 2- and 5- year-olds and have used the same daycare center for years. I’m going to try call her tomorrow or Tuesday to see what’s going on - I’ll likely run into her at daycare tomorrow morning.

I e-mailed the person who sent my husband the e-mail and this person said the county seems well-prepared (don’t know the specifics), but this person attended a one-day meeting on emergency preparedness where pandemic and general emergency preparation was discussed. She didn’t know of any plan involving public education, but encouraged me to get involved because “we need more people to be prepared.” Looks like I’m coming out of the closet….(or pantry).

My biggie is when they plan to close schools.

11 September 2006

tjclaw1 – at 09:10

I talked to the woman who is in charge of our county’s emergency preparedness at my daughter’s daycare this morning. She said they are having a hard time getting volunteers. She assured me that if I volunteered, in the event of a health emergency our family would get medication/vaccination first. I’m going to a meeting on Thursday night, so I’ll report back. She did say that they would be conducting triage at any mass distribution clinic looking for anyone with symptoms so that others wouldn’t get infected. She seemed to be concerned about other diseases such as smallpox, etc., as well. They are going to test their mass distribution plan at this year’s flu clinic on October 28.

I suggest that anyone who wants to be first in line to get medication/vaccines call your county health department and see if they need volunteers. I don’t have tamiflu or any other meds that I cannot legally purchase, so this is the only viable option for my family.

BirdGuanoat 09:13

tjclaw1 – at 09:10

I talked to the woman who is in charge of our county’s emergency preparedness at my daughter’s daycare this morning. She said they are having a hard time getting volunteers. She assured me that if I volunteered, in the event of a health emergency our family would get medication/vaccination first.

---

Sure you will.

And you believed her ?

Clawdia – at 09:55

tjclaw1 - I hate to say it, but the way I see it, you still do not have a viable option to obtain meds.

No way is anyone going to send you to the head of the line because you do volunteer work.

That’s not the way to protect your children.

Np1 – at 10:10

BirdGuano – at 09:13: You are such a cynic. You probility don’t believe in the tooth fairy either. Kelly

Average Concerned Mom – at 10:34

I’m not getting something (as usual).

I thought the problem was, there won’t be any medicine or vaccines to distribute.

If (or rather, when) there finally is some to distribute to the masses, why woulcn’t a volunteer be able to get some first?

(I’m assuming that this mass distribution in a community would be occurring after the distribution to health care workers and essential personnel. Who presumably would have their own volunteers….)

cactus – at 10:38
  Standing in a long line to get meds would be scary enough.

  What with this monster having a 48 lag between infection and any sign of illness, that seems like a very risky business.

  And, being someone actually providing the shots or the pills, scarier yet.  No thanks, I think I would stay in my little place, thank you.
Average Concerned Mom – at 10:42

I would get a vaccine if available between waves.

I would stand in line to get medicine if a family member needed it. Better yet, I would drive my car to a drive thru pharmacy. If there were any gas.

I probably wouldn’t volunteer to distribute medicine person to person during a pandemic; maybe through a plastic partition like they use at banks.

Clawdia – at 10:59

AC Mom - you’re right - the biggest part of the distribution problem remains that there might well be absolutely nothing to distribute.

On the other hand, if and when a vaccine or anti-virals are available, they will be distributed according to already drawn up priorities . . . and nowhere have I seen local volunteers listed as priority recipients of scarce resources, much less volunteers and their families.

Annoyed Max- Not mad yet – at 12:21

I picture the gov’t giving small pox blankets to the native Americans. “We are the gov’t and we are here to help.”

BirdGuanoat 13:08

Clawdia – at 10:59

On the other hand, if and when a vaccine or anti-virals are available, they will be distributed according to already drawn up priorities . . . and nowhere have I seen local volunteers listed as priority recipients of scarce resources, much less volunteers and their families.

---

BINGO, we have a winner.

Volunteer priority is in NONE of the pandemic response plans I have read.

NONE.

Let me repeat that.

NONE.

Talk is cheap. Especially from someone who may have no authority to change priorities.

Yes I’m a cynic. I fully admit it. It comes from 30 years of working within the system.

LauraBat 13:50

tjclaw1: Don’t be too discouraged by comments. If you want to volunteer to help BECAUSE you want to volunteer to help, then defiitely do so. All communities will need as much help as possible. We’ll all need help to get through it.

However, if your main motivation is to get medications and/or vaccines, then you need to seriously consider the fact that 1) there may not ever be any meds/vaccines to give out 2) volunteers may or may not have any higher priority than anyone else. You could potentially put yourself and your family at risk for something that may not be there. And it wouldn’t be fair to organizers to plan on your being there, only to have you bail out later. Voluteers need to be dedicated to the task. The planning committee should not be making promises to potential volunteers that they may not be able to fulfill. Once they say “oops” half the people will leave.

Clawdia – at 16:08

LauraB - 2) volunteers may or may not have any higher priority than anyone else.

One more time . . . volunteers are not on any priority lists. BirdGuano said it exactly. It’s what I thought, and he confirmed it. That kind of does away with the “may or may not”, in my mind. I don’t believe in giving anyone false hope, especially someone who has already been given false information.

Clawdia – at 16:15

As an aside, BirdGuano may think he’s a cynic, but I think we’re both realists.

anon_22 – at 16:38

Even if they don’t have vaccines and antivirals, they still need people to distribute even tylenol.

If there are NO plans and NO mechanisms for distribution, they will have riots sooner, IIMO.

anonymous – at 17:16

I have a feeling that this is a hoax. Can anyone confirm if its true or not?

LauraBat 17:29

anon22 - I agree that we will need lots of volunteers and various plans for distributing even the most basic of meds (and food). I just think volunteers should come forward because it is something they want to do, not because they think it will help save their a$$e$$. While it would be a great motivator to get people to help, once they find out the meds aren’t coming, they’ll be gone. Any person or organization promising anything more should be drummed out of town.

That being said, there will be countless acts of favoritism, etc. on local basis. Maybe not so much with un-available meds, but with other supplies, assistance , etc. I’ll scratch your back….Like I always said in business, never burn your bridges because you’ll never know when you might have to cross back over them again.

Bird Guano – at 17:33

The above is the primary reason the Red Cross is having a tough time finding any volunteers to train for a pandemic.

Nobody trusts what is being said.

Networking is always key to getting anyting done in a time of crisis, and those with a prior relationship will always get more favorable treatment.

Just ask any quartermaster in any war in the last 100 years.

:-)

Leo7 – at 17:43

Folks! You need to wake up! As the drugs—whatever they turn out to be—filter down—local people will decide how they’re given out. National guidelines will be changed to fit the local need. Ergo…anyone who volunteers to risk their life to help others for long stints of 12–18 hours—will get the—drugs—whatever they are—so they can prevent the hospitals being overwhelmed and riots. Th whole thing runs on essential workers and volunteers—not people who SIP!

Clawdia – at 18:42

Some of you are assuming that there will be things that filter down to the local level. I’m not inclined to think that there will be much of anything to distribute. I hope I’m wrong.

tjclaw1 – at 19:31

anonymous – at 17:16 “I have a feeling that this is a hoax. Can anyone confirm if its true or not?”

I guarantee it is NOT a hoax. Here’s what I found out today, and I’m trying not to focus too narrowly on a “public health emergency.” It could include other diseases than Avian Influenza, such as small pox, as one that was mentioned to me. I was told they need a lot of volunteers so that they can work in shifts. Yes, I think they are assuming that they will have something to distribute in case of a pandemic and, yes, you are right, there might not be anything. If we have enough time before a pandemic hits, and that’s a big IF, maybe there will be a vaccine for mass dispensing that provides some protection. But rather than hope, I want to help plan in case it is available. No, I’m not willing to expose my family to a disease for which there is no vaccine and I will make that perfectly clear.

I have confirmation from both a person on the Health Dept. Board of Directors and the person in charge of our county emergency preparedness that we will receive our medication or vaccine before the general public. I know both persons well and believe them. The person in charge of emergency preparedness provided me with 160 fliers to be distributed to the parents of my daughter’s grade school that read as follows:

VOLUNTEERS ARE NEEDED! The Lee County Health Department is recruiting volunteers for their Strategic National Stockpile Medication Dispensing Plan. In a public health emergency, numerous volunteers would be needed to assist with the medication dispensing, form distribution and completion, on-site security and more. During an actual event, trained volunteers will receive their medication or vaccine before the general public. For more information or to express interest in becoming a volunteer, please contact Lora Fassler at 284–3371 ext. 128.”

Lora told me that they have taken out two half-page adds in our local newspaper and are starting public service anouncements on our local radio station beginning this afternoon. I’ve known her for years and I think she is really trying to do the right thing. I’ll ask if counties can have different priorities than the national/state plan and how they are doing it.

The principal at my daughter’s grade school said she would encourage her staff to volunteer. She said that a couple of years ago they had to close the school when two kindergartners got meningitis and then they had to have a mass-vaccination clinic at the school.

I’m trying not to be short-sited and realize that there are other public health emergencies where my training and volunteering could be just as important. I’m attending the training Thursday evening at our local community college and will report back. If anyone has any questions they want me to ask, please let me know.

Now that I have my own preps complete, I feel a responsibility to try and help my community prepare, so long as it doesn’t endanger my children.

12 September 2006

Clawdia – at 01:34

BirdGuano said this, “Volunteer priority is in NONE of the pandemic response plans I have read.

NONE.

Let me repeat that.

NONE.

Talk is cheap. Especially from someone who may have no authority to change priorities.”

If BirdGuano said it, I believe it. There will be no vaccine until after H5N1 goes pandemic, if it does. After there is a vaccine, probably six months to a year after the pandemic strain appears, it will go to military and government and essential personnel, and because of the lack of vaccine manufacturing capacity, there simply will not be enough to go around for a very long time.

Leo7 – at 01:43

TJClaw1:

I would go to meeting and check it out. Attendance at a meeting isn’t signing your life away in blood. In my city the police organize to give out ice during hurricane downtown. They have it down to an art form. Fema workers stand around and watch them. Anyway, it takes a lot of people to move it. People pull up open trunk, food water ice thrown in by police—drive away. Food and water on one side of the trunk ice on the other. You can keep the 6 feet distance. The risk is giving injections. So you have to think about what you’re doing and how it relates to when you go home. The local community will decide what the volunteers get—whether its antibiotics, MRE’s etc.

15 September 2006

tjclaw1 – at 13:22

UPDATE on Strategic National Stockpile (SNS) Medication Dispensing Plan meeting/training held last night. This is part of the NACCHO (National Association of County and City Health Officials).

This meeting was relatively well-attended for our small community (27 volunteers). It began with taking our photos for security badges and we were fed well during the 1/2 hour powerpoint presentation. A complete copy of the powerpoint presentation, along with SNS literature, a citizens’ emergency handbook, and other handouts were given to us. After the powerpoint presentation, the medication dispensing plan was explained to us and then we broke out into each of our volunteer groups for discussion with the person in charge of our unit. I knew a lot of the people “running the show,” as well as many of the volunteers. I was very impressed at how organized they are. I’ll highlight some of the information we received:

First of all, they really stressed having our family prepared (suggested 2 weeks). Further, they recognize that “[a] mass dispensing site will work best if volunteers are protected against disease, and if they know their families are safe as well. Volunteers, along with their household members, will be given the medication or vaccine as early as possible.”

The SNS supplies are stored at 10 strategic sites in the country, packed and ready to be delivered to any location in the U.S. within 12 hours of request. The inventory includes antibiotics, vaccines, chemical antidotes, and medical and surgical equipment. (I assume they will also have antiviral meds.) We were told that our hospital gets its own delivery, and the prison, nursing homes, etc., will get theirs from the health dept.

They have an excellent system for patient flow, triage, screening, security and crowd control, but still are working on adequate staffing. Interestingly, the hospital will have heated tents set up at the site to treat people exhibiting symptoms, and a team of ambulances. The plan also includes pharmacist/medical questions, as well as crisis counseling, separate worker/volunteer parking, a break room, showers, and lockers. They will provide us with PPE. The local horseman’s association has entered into an agreement to help with directing parking traffic, as well as local golf courses providing rides for people to and from the parking lot, and State and county police directing traffic.

Every problem I posed, they had an excellent answer/solution already in place. They recognize that half of the volunteers could be sick themselves or caring for ill family members, so they are really pushing for hundreds of volunteers. People working different jobs (support, nursing, security, etc.), all will wear a different colored uniform so everyone will know what everyone’s job is.

We were given very detailed instructions on qualifications for each position, check in, job duties, check out, etc.

Obviously, the purpose of this is more than just pandemic flu, but I am glad they are considering other possibilities. We are using the annual flu clinic as a trial run, although it will be much smaller than an actual mass dispensing (1,600 v. 36,000).

I know that it is unlikely we will be using this for antivirals (unless the area is placed under a Tamiflu blanket) or vaccine until the second or 3rd wave, but it makes me feel better to know that we have competent people working on this and enables me to “keep my ear to the ground” with my contacts.

I plan to gradually talk to the emergency preparedness coordinator about other plans (water, hospital overflow, massive deaths, food supply, etc.) little by little.

I encourage everyone to contact your local health department and inquire about the SNS Mass Dispensing Plan.

23 September 2006

crfullmoon – at 20:15

NACCHO 60 p pdf Local Health Department Guide to Pandemic Influenza Planning (Is this on the main Wiki somewhere yet?)Might want to print this one out, to show skeptics.

See their Planning Assumptions:

…”2. Localities will not be able to rely on timely or effective mutual aid resources, State or Federal assistance to support local response efforts.

3. An influenza pandemic may occur in waves, and last for 12 to 24 months.”

(too tiring to type from reading pdf -see link for full text) 4. -residents need information and tools to take responsibilty for meeting their basic needs… 5. “extremely short supply” of antivirals …

“6. A vaccine for the pandemic influenza strain will likely not be available for 6 to 8 months following the emergence of a novel virus.”

7 …”the normal ammount and level of hospital care will not be available” …

7.h. The number of fatalities will overwhelm the resources of the Medical Examioner’s Office, morgues and funeral homes.” …

8. … likely be significant disruption of … critical infrastructure”…

“Public Health Goals” never say Tell the public to do what they can to prepare for the above current assumptions. (and still uses the WHO Phases!)

p27 “Public/Partner Education & RiskCommunication”… “citizens must be encouraged to be as self-sufficient as possible during the outbreak, before it hits.

Such messaging may include how to best contain the disease by lessons like “cover your cough” or stress that in a pandemic, home health care of loved ones may be the more healthy choice”

(!)

Then on p28 they do say to “educate” during phases 1–3 but we know from speaking to pharmacies, ER workers, first responders, businesses, faith based/community organizations, ect, they haven’t really been approached yet.

Not telling the public to stock up now for supply-chain disruptions is going to cause unnecessary suffering, and preventable deaths. Promising possibility of vaccines and meds to volunteers without telling them what the current death rate of untreated H5N1 is, is unethical as well.

30 September 2006

DemFromCT - close thread – at 15:07
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