From Flu Wiki 2

Forum: Meeting Tonight

24 October 2006

Birdie Kate – at 13:32

Our community forum is tonight and here are my questions I will be asking - depending on what questions they answer beforehand. I might just stick to the planning questions and not ask the questions about the committee.

1.Is this forum to allow community development of the regional plan as stated in the state Memorandum of Understanding? And will there be another town wide forum to educate the community of the contents of the plan.

2.Some experts are recommending individuals have 6 – 8 weeks worth of food, over the counter medicines, etc. when are your recommendations and when do you plan on having a broad based public awareness campaign to reach every resident of our town? Does your plan include distribution of fact sheets regarding social distancing, sheltering in place, isolation and quarantine, etc. and who will be in charge of developing these plans and the timely distribution to every member of the town?

3.Are there plans in place to set up hotlines for information and is our town planning on creating an informational website to address concerns of the towns residents?

4.How many licensed volunteers have volunteered to take care of residents who cannot take care of themselves? Have you done any recruiting of the 400+ licensed professionals we have on town?

5.Mike Leavitt, Sec of Health & human Services said at his May summit no pandemic will respect borders. You must prepare for an influx of individuals from border towns. There are currently 3000 plus gang members in surrounding towns. How do you plan on dealing with problems associated with the increase in crime and citizens?

6.Do you have an operational plan to implement various levels of movement restrictions within, to and from town? When will the public be informed of these restrictions?

7.What plans are in place to provide life saving maintenance medications to residents in town who are sheltering in place or quarantines?

8.Realistically speaking, bordering town has over 86,000 people; the hospitals in XXXX will not be able to take citizens from XXX as they will be overwhelmed. What plans are in place for XXX to care for its influenza patients and also for regular medical emergencies?

9.Experts agree there will be no vaccine available for at least 6 months and even then there will not be enough. Why is XXXX so focused on being a POD at this stage in the planning?

10.What plans are in place for mass fatality management including funerals, burials, and deaths at home? Do you have alternative sites for mass fatality besides XXXX Funeral Home?

11.It is estimated that there will be a 40% or more absenteeism rate among workers. What plans are in place if XXXX were to lose utilities due to the pandemic? Is XXXX ready to supply some type of shelter that would include heat and electricity? What about waste management?

12.The current strain of H5N1 has hit children the hardest, who will decide when to close the schools? School contingency plans for web based learning, ptv learning, etc?

13.The Memorandum of Understanding that all towns signed states that local communities are responsible under their own authority for responding to an outbreak and having comprehensive plans and measures in place to protect their citizens. Considering the unique challenges posed by an avian flu outbreak why is it that XXXX has no specific pandemic plan and only an adaptable All Hazards Plan?

14.Also, regarding the All Hazards Site Regional Coordinating Committee it asks for representatives from town, health, faith based, and also members of the public. Can you tell me who is on the committee from the public sector? What stakeholders are represented on the regional coordinating committee from business, faith based organizations, private schools, etc.?

I will keep you posted

Ruth – at 14:07

I can’t wait to hear how they answer all those questions. They are great questions that should be asked of all city and town officials. I suspect few know how to answer them.

Annoyed Max- Not mad yet – at 14:19

Oh don’t forget to ask them what plans the planners have in place for when THEY loose 40% of their workforce. And ask about armed closing of the local borders I got an interesting response when I asked this.

Average Concerned Mom – at 14:20

Annoyed Max — what was the reponse???

Annoyed Max- Not mad yet – at 14:23

Don’t let them pull this either…oh that question is addressed in the existing plan xxx. You have to be like where is this additional plan and what does it say. My locals pandemic plan was hollow leads to other plans that had not been written yet or had nothing to do with AF and would not adapt well.

Annoyed Max- Not mad yet – at 14:26

Lethal force, closing of all the county borders. When I asked who would be making these decisions all they would say was the govt even when I pressed exactly who in govt they would only say the govt. But they plan on using national guard and local police at least and who knows what else.

Annoyed Max- Not mad yet – at 14:28

If they did try this it would cut off a huge part of travel through the NE. The interstate and 95 both run through the area not to mention local highways, rail, and air. I was lead to believe no one in and no one out.

crfullmoon – at 14:49

Go Birdie Kate, go!

Making copies of questions to hand media and others, if you only get to ask one question each, might be an idea for other people’s public pandemic meetings. I may rework your list before the Nov. public meeting here. (Going to need to be organized; so I don’t just have steam coming out of my ears.)

“the timely distribution” would be now; not wait until pandemic starts to rage and then pass out a lot of unfamiliar info, and say, So out of luck if you’re not ready for curfews, illness, out of town on vacation, ect.

senegal1 – at 15:32

Ok Here is what I think for what its worth.

I am never going to again ask “What are your plans?” Immediately these people talk about and/or pull out large reams of paper and say this is our plan. Frankly what I saw yesterday in the National Institutes of Health on Grassroots preparation and planning meeting was that people are using these plans like the have all the time in the world and the process of writing plans has become the response! Coming from a background of having dealt with real emergencies in real busted societies — I can not stress this enough.

The main point of having a plan is to 1) help people come to grips mentally that something like XXXX could happen; 2) to help you think through what resources you want to pre-stage; 3) to help you create the relationships that are the crucial points to help you get through an emergency. I would rephrase the questions above to point out that as one speaker said yesterday — its not a pandemic its a plandemic. Its sadly too true. Ask what is the timeline for having X in place? At what date will you have done X by? If you were to estimate today how long you might have before we are faced with a pandemic how long would you estimate? Are you aware that in the WHO`s latest preparedness document that they are saying “You must prepare NOW. A pandemic is imminent?” (That thread is on here — it was started last night. I thought the words were chilling.)

Another question: Is there an agreed upon ethics statement that all potential decision makers have signed and that we will expect decision makers to use when making the tough decisions? Kartine showed us that we need such a document. It is impossible to know all the difficult decisions that must be made in advance. However with a statement of ethics — really of what we expect our decision makers to do for us and to us — there will be an expectation that leaders and decision makers will be guided by fairness, justice, and open communication and voluntary compliance and this will engender more trust for enacting the difficult decisions that might have to be made. This should be a community known document with lots of imput in my view — such items as health workers and volunteers will never be compelled to work; distribution of any avaliable supplies will be equally done to all communities or we will seek to create the greatest good for the largest number of people or what ever the members of your community feel is fair. One of the speakers yesterday Judith Walzer Leavitt from the University of Wisconsin had the best presentation (after our own Anon 22!) showing the differences in two communities — one which the Director of Public Health used force to enforce laws and one where the Director of Public Health used open communication and cooperation to bring all parties in to enforce laws. Director A ended up creating riots and was ultimately removed from his position. Director B ended up with significant cooperation amoung all communities groups and was able to enforce some very difficult policies and had one of the lowest death rates for the epidemic of all major cities. This is one of the top things we need our leaders to realize.

Finally, we need to realize that we need to create a culture change. Most planners are speaking about educating the population and making them aware. This is useless. Most planners even knowning about how serious the situation is are not prepped. Most of the people in the room at the NIH yesterday — even the guy from John Hopkins had only a couple of gallons of water in his basement. Its about creating cultural change not just raising awareness. If you are half ashamed to ask your doctor about pandemic flu and your doctor writes you off — how seriously do you think anyone can take this? The stigma of talking about pandemic flu is almost worse than the intial stages of AIDs back in the 1970s. What is the community doing to get doctors to talk with their patients about pandemic flu and urge them to prepare?

Thats Just Ducky – at 15:40

Annoyed Max- Not mad yet – at 14:26

Were you able to find out what the triggering event for this action would be? When would they implement the travel restrictions?

Or does anyone else know?

Thats Just Ducky – at 15:55

Annoyed Max- Not mad yet – at 14:26

The DoD. Google “USNORTHCOM pandemic flu”. They just did a huge training excercise for the new unit to handle the pandemic flu earlier this month.

http://tinyurl.com/y33lnd “…While USNORTHCOM’s mission is to deter, prevent, and defeat aggression against the United States, its territories and interests, the command is also directed, upon request by the president or secretary of defense, to provide defense support assistance to civil authorities, which places it in the thick of preparedness planning for a pandemic flu….”

crfullmoon – at 16:07

“the process of writing plans has become the response! “ Bingo!

The public has been warned, for a long time, by many sectors,(there’d be a handy timeline!) to prepare because they are on their own; how are we telling our community to prepare for a pandemic influenza year?

What can we do next week, and every week, to improve their awareness and preparations?

How many of our first responders live in town? What can we do to change that?

Are there still people who feel, if pandemic occurs, “there is nothing we can do anyway”, or that, “the public can’t handle the truth” that are still being allowed authority?

(Goes off to keep temper from boiling over) (Do I have a facial tic yet?? Rrrr.) I’ll have to “channel” one of you calmer folks when we have our town’s little pandemic awareness presentation.

Annoyed Max- Not mad yet – at 16:11

They would not elaborate on when, and I think I caught the person off guard with my questions or they flat out didn’t know any more. I would guess it would be on the CDC or WHO to change the pandemic number of some other event that we can quantify that would initiate road blocks. It was clear that they had not examined this decision in any detail. Ill say this, God help anyone that points a weapon at me or gets in my way during a pandemic, it will not be greeted with a friendly smile. And to the people in charge that happen upon this, I guarantee this will be the response of everyone else. My response might be calculated but theirs will be out of terror and desperation.

senegal1 – at 16:27

Annoyed Max — Just so the problem!

Fiddlerdave – at 16:29

All these plans would be much more useful if they were on a paper stock that made them be better toilet paper.

crfullmoon – at 17:40

Firelighters, Fiddlerdave; a magnifying glass and a little sunlight.

-no wait; we’ll need some left for evidence/history…

Leo7 – at 18:22

Birdie Kate:

I’m afraid with that many questions they will tell you you’re hijacking the meeting and move on. Condense your list, is what I recommend. You want answers not attitude. Number four would be intersting to know because it would show someone had a heart to cover the problem. Good Luck!

crfullmoon – at 18:50

Devil is in the details if you ask #10. (Expedited/deputized prouncement/death cert/ burial? Are staffs’ households prepped, how long will fuel hold out for transport/digging - then, when that’s disrupted, what is the plan? )

Leo7, some good professionals may not volunteer if current planning makes it look like they will be stuck on site with no PPE, all run out of supplies/meds, no power, in two weeks or less, (if they’ve not gotten sick themselves by then). I also don’t want to lose all the trained health care workers; they are essential during recovery and beyond, too. (People also might be willing to help on their own terms, not under some botched local FEMA-type bureaucratic nightmare. Some have family commitments that have to come first, too; especially when feds and state say, we’re on our own, and, lack of local preparation still means even hcw’s families would be So Out of Luck.)

Birdie Kate – at 22:00

I am back….

meeting was good. only 5 members of the public attended. It was live on tv. the Dr spoke about pamdemics and the flu. The Emergency Manager spoke and said they are working on a plan. They will never be done the plan it will always be a plan in progress. They don’t have enough resources or manpower to do it all. He stressed heavily on volunteers. (I was screaming pick me, pick me on the inside). I didn’t ask all my questions and I did pare them down. SO here they are. I didn’t really learn anything that I didn’t know. It would have been better if there were more people there and they asked questions - i was the only one who asked questions and I was nervous as heck. I asked if we would have see the final plan and he said it would always be a work in progress.

Some of my questions were answered in what they said in their presentation and some answers I got from someone else who was there but not on the panel.

1. Is this forum to allow community development of the regional plan as stated in the state Memorandum of Understanding? And will there be another town wide forum to educate the community of the contents of the plan. ---------Didn’t get a clear answer.

2.Some experts are recommending individuals have 6 – 8 weeks worth of food, over the counter medicines, etc. when are your recommendations and when do you plan on having a broad based public awareness campaign to reach every resident of our town?. Does your plan include distribution of fact sheets regarding social distancing, sheltering in place, isolation and quarantine, etc. and who will be in charge of developing these plans and the timely distribution to every member of the town?


Yes we need volunteers. We have approached some town organizations. The health officer is in charge of handling this. We don’t really have a lot of resources or people to do this.

3.Are there plans in place to set up hotlines for information and is our town planning on creating an informational website to address concerns of the towns residents? Website and flyers --------We are working on that. We will post stuff on a website and have flyers available for the public.

4.How many licensed volunteers have volunteered to take care of residents who cannot take care of themselves? ------ don’t have that information on me. Have you done any recruiting of the 400+ licensed professionals we have on town? ----we have an application for volunteers that can be filled out.

5.Mike Leavitt, Sec of Health & human Services said at his May summit no pandemic will respect borders. You must prepare for an influx of individuals from border towns. There are currently 3000 plus gang members in surrounding towns. How do you plan on dealing with problems associated with the increase in crime and citizens? ----didn’t ask – although volunteers were needed when they talked about security issues.

6.Do you have an operational plan to implement various levels of movement restrictions within, to and from town? When will the public be informed of these restrictions? ---working on that will take direction from the state

7.What plans are in place to provide life saving maintenance medications to residents in town who are sheltering in place or quarantines? ----volunteers will deliver

8.Realistically speaking, bordering town has over 86,000 people; the hospitals in XXXX will not be able to take citizens from XXX as they will be overwhelmed. What plans are in place for XXX to care for its influenza patients and also for regular medical emergencies? ------ have requested money for that and have asked local businesses if their property can be used – heard this before the meeting

9.Experts agree there will be no vaccine available for at least 6 months and even then there will not be enough. Why is XXXX so focused on being a POD at this stage in the planning? – didn’t ask

10.What plans are in place for mass fatality management including funerals, burials, and deaths at home? Do you have alternative sites for mass fatality besides XXXX Funeral Home? -----looking at out of town ice rink – didn’t ask during meeting

11.It is estimated that there will be a 40% or more absenteeism rate among workers. What plans are in place if XXXX were to lose utilities due to the pandemic? - yes this is a concern as well as fuel, etc. working on this

Is XXXX ready to supply some type of shelter that would include heat and electricity? What about waste management? ----didn’t ask

12.The current strain of H5N1 has hit children the hardest, who will decide when to close the schools? School contingency plans for web based learning, ptv learning, etc? didn’t ask

13.The Memorandum of Understanding that all towns signed states that local communities are responsible under their own authority for responding to an outbreak and having comprehensive plans and measures in place to protect their citizens. Considering the unique challenges posed by an avian flu outbreak why is it that XXXX has no specific pandemic plan and only an adaptable All Hazards Plan? – didn’t ask

14.Also, regarding the All Hazards Site Regional Coordinating Committee it asks for representatives from town, health, faith based, and also members of the public. Can you tell me who is on the committee from the public sector? What stakeholders are represented on the regional coordinating committee from business, faith based organizations, private schools, etc.? ------ have talked to organizations but have not set up a committee

geez looks like i didn’t ask a ton.

FloridaGirlat 22:28

Birdie Kate – at 22:00

I do not know what state you are in… (so it may be different…)

Here, the public Health Department takes control of deciding whether schools are closed, sports events, or other gatherings take place when there is a health issue. This does not even have to be a pandemic for this to happen. Any type of outbreak that is communicable and is present in the community will trigger these actions. The Public Health Departments report diseases within the community and the CDC keeps track of the bigger picture. They then can advise the individual health department.

I thought I read something above about ethics. There are many studies and guidelines that talk about the ethics of tough decisions. There are guidelines on how to make decisions for scarce supplies, vents, meds, etc. that keep it fair and unbiased. These will probably guide most plans of this type…

Hope that helps a little…

25 October 2006

anonymous – at 00:26

Good job! It takes some big ones to get up there and start firing off questions. Keep up the good work, I wish more people would go to these kind of meetings and ask questions.

crfullmoon – at 07:41

“only 5 members of the public attended” -gee, they tried real hard to make sure people knew about that meeting, and that it was no vac ines, no fed/state/mutual aid, life-or-death pandemic year they were discussing didn’t they?

Thanks for trying.

(Ice rink is a no go.) (Have you told the ice rink owners yet? Bet they haven’t.) (Send ‘em to the Mass Fatality Management Plans threads)

Birdie Kate – at 09:56

They did say there would be no vaccine for 6 months and that we are on our own.

A lot of people I spoke with said they were not aware of the meeting. The meeting organizer said that they did put out press releases, flyers, etc. I told them I didn’t see any flyers and saw the press release in small print in the newspaper. I will look at the mass fatality plans. Thanks crfllmoon

I guess people just don’t care, want to know, or are too busy.

I woudl have asked more questions but was stumbling over the ones I asked. I was nervous. No one else asked anything so I was self concensius.

Anyways it worked out well, I did it and got some answers. Not all but some. Of course I am planning on staying on top of things as best I can.

Science Teacher – at 10:28

Birdie, congratulations for having the guts to stand up and ask questions. Sounds like you did a great job!

I’ve attended a few local events and have learned that the folks attending as well as the speakers, get more information from the questions then from the material presented. Questions that are unanswered get people’s attention and through the natural process of curiousity, they will look for answers. You may have provided the incentive for your town members to begin thinking outside the box. Those 5 folks that attended will tell others about your questions and lack of realistic answers provided by your town.

The only thing I would recommend in addition to what you have done would be to bring the downloadable Pandemic Awareness cards with the Fluwikie web address and hand them out to everyone there including the speakers.

You did good!

Birdie Kate – at 10:54

crfullmoon

anywhere specific in Mass Fatality Management Plans?

Thanks

crfullmoon – at 12:42

Canada had some words of wisdom, as did Ken West in the UK - let me see if I can go snag ‘em out. (Basically; why the current “we’ll let the bodies pile up in refrig trucks and ice rinks until one person processes ‘em all”, or, “well, when we can’t cope, we can just ask for a DMORT team to come” aren’t workable options.)

crfullmoon – at 13:30

Canada 2004 pdf Really worth a read, goes through all the normal steps now: forum page Snips from that here, (my bold): …”Within any locality, the total number of fatalities (including influenza and all other causes) occurring during a 6 - to 8-week pandemic wave is estimated to be similar to that which typically occurs over six months in the inter-pandemic period”

A number of issues have been identified,which should be reviewed with coroners/medical examiners, local authorities, funeral directors, and religious groups/authorities

“it is important to examine each step in the management of a corpse under normal circumstances and then to identify what the limiting factors will be when the number of corpses increase over a short period of time.” …

…”Existing disaster plans may include provisions for mass fatalities but should be reviewed and tested regularly, to determine if these plans are appropriate for the relatively long period of increased demand which may occur in a pandemic, as compared to the shorter response period required for most disaster plans.

There are currently no plans to recommend mass burials or mass cremations.

This would only be considered in the most extreme circumstances.

Since it is expected that most fatal influenza cases will seek medical services prior to death, hospitals, nursing homes and other institutions (including non-traditional sites) must plan for more rapid processing of corpses.

These institutions should work with the pandemic planners and the FSAC and coroner office to ensure that they have access to the additional supplies(e.g., body bags) and can expedite the steps, including the completion of required documents, necessary for efficient corpse management during a pandemic.”…

“Some religious groups maintain facilities including small morgues, crematoria and other facilities that are generally operated by volunteers.

Access to these resources should be discussed with these groups as part of the planning process during the interpandemic period.

In the event that local funeral directors are unable to handle the increased numbers of corpses and funerals, it will be the responsibility of municipalities to make appropriate arrangements. “…

…”To reduce any liability for business losses, municipalities should avoid using trucks with markings of a supermarket chain or other companies, as the use of such trucks for the storage of corpses may result in negative implications for business.”

…”Using local businesses for the storage of human remains is not recommended and should only be considered as a last resort.

The post-pandemic implications of storing human remains at these sites can be very serious, and may result in negative impacts on business with ensuing liabilities.” …

“It is the responsibility of the Medical Officers of Health to place restrictions on the type and size of public gatherings if this seems necessary to reduce the spread of disease. This may apply to funerals and religious services.

Medical Officers of Health should plan in advance for how such restrictions would be enacted, and enforced, and for consistency and equitability of the application of any bans”…

“Individual municipalities should work with local funeral directors to plan for alternate arrangements. Planning should also include a review of death documentation requirements and regulatory requirements that may affect the timely management of corpses.”…

(If pandemic is declared, have extra categories of people already identified as having authority to pronounce death, make death cert. -preposition the paperwork- ect. Now; ahead of the need for new rules, to prevent piling bodies up!) (Am I hijacking your thread? Or just answering with too much info, as I tend to do?)

“PREPARING FOR THE PANDEMIC A guide for cemetery and crematorium managers” (From a paper by Ken West, MBE, presented at the ICCM Corporate Seminar in April 2006.) pdf Forum page Snips: ““The disposal of the dead is not a statutory service for local authorities, neither has central government any control of burial and cremation facilities. No government minister has responsibility for the component elements of the death industry. This includes the NHS, coroners and registrar’s service, cemeteries and crematoria, many of these latter two being operated by the private sector. Funeral directing, cremator and coffin manufacturers are entirely private and independent bodies. integration of all these disparate elements into a pandemic contingency plan is difficult and probably impossible ” …

…”UK cemeteries seemed to have maintained business continuity in 1918 possibly due to the following reasons:

• They had ample new grave space • They had perhaps six times as many gravedigging and gardening staff to fall back upon, all working longer hours over 6 days. • Shoring was simpler, if used at all. • All disposals were by burial and based on manual work. • They were used to high death rates in winter from flu, excess cold, etc. • They were used to high death rates in summer from cholera, typhus, etc. • They were not reliant on gas, electricity and road fuel. • They had highly efficient manual booking processes. • Medical certification was more simplistic and post mortem numbers were much lower.• They could hire additional staff immediately and a large pool of manual employees existed.

It is important to note that the huge pandemic in 1918 was not anticipated nor observed until after it had killed high numbers. It is suggested that 20% – 40% of the world population were infected. It affected many army units and in view of the war no contingency preparations were made. “…

…”In the 2nd World War contingency arrangements were considered but they did not always prove effective. For instance, government demanded that civilian deaths use shrouds (to save the use of wood in coffins), be interred in mass graves (to save resources) and be interred where they die (to save bodies being repatriated around the country). Both public authorities and people completely ignored this demand and continued to hold conventional funerals. Government was shown to be entirely out of touch with the situation on that occasion.

The danger is that little or no investment in contingency arrangements will occur and a stand-off between public authorities and government could develop over who funds what. If this happens then we are likely to lurch into an emergency and be forced to concentrate on the practical issue of body disposal and leave very little resource to handle the psychological aspects with the necessary sensitivity.

The management of this large number of deaths cannot be resolved by technology and a huge amount of manual labour is going to be necessary in order to move and handle the bodies up to the final disposal. “…

…” The death process now relies on technology and the loss of fuel for computers, cremators and excavators increases the risk of failure. The use of such equipment has also made it more difficult to introduce new staff, all of whom usually need a period of skills training.

Success in coping with the pandemic will be entirely reliant on the availability of trained staff to keep the operation going. Hospital capacity will also suffer like ours and many of our staff will have to stay at home to care for the ill. “…

This is a frightening number of deaths on a week-by-week basis so how do we respond? 4.0 MANAGING A HIGH NUMBER OF DEATHS”…

…”8.0 PREPARING FOR COLLECTIVE BURIAL The term collective burial is used where burials occur in a trench in rapid succession, each burial separate and identified. It can be provided by relatively unskilled staff and does not rely on technology or external help. It is not “mass” burial where the bodies are placed together and one on top of another.

It is recognised that collective burial is not likely to be seen as morally acceptable in a modern society. Even temporarily, it could have a serious psychological impact on the bereaved in that the body will not be finally placed for some months and the grieving process will be interrupted.

Much as I feel we must avoid collective burial this is only assured if a massive amount of chilled body storage is provided. The high cost of this will not be borne by many authorities and it is unlikely the government will fund it.

Collective burial would be necessary where: Firstly, the number of dead exceeds the capacity to store, inter or cremate them Secondly, where the dead have to be temporarily interred because autopsy, registration or the Coroner’s service has collapsed.

Collective burial would involve excavating a trench 4’ 6” (1350mm) deep, 300’ (90000mm) long and 8’ (2400mm) wide which would accept 100 coffins laid side by side 3’ (900mm) apart. One hectare would accept about 2,000 bodies. A collective burial site could be used purely to put bodies into a sterile environment, as soil has an antiseptic quality, in order to hold back decomposition. After the emergency the bodies could be exhumed for post mortem or reburial/cremation in the conventional way.

9.0 BACK-UP STAFFING NEEDS Having run through the implications of the plan we can now consider the back-up staffing requirement. In Croydon, assuming a sickness rate of 25%, they will need 53 back-up staff, twice their current full-time compliment. This does not include staff employed on collective graves. There are many other back-up needs, not least generators and stocks.”…

…”11.0 POTENTIAL BOTTLENECKS OR PINCHPOINTS Apart from our own potential to fail we also need to consider:

• Failure of the registration service• Failure to obtain Forms B & C from NHS/Hospice/nursing homes • Failure of the Coroners service or mortuary service• Failure of Funeral Directors to deliver funerals • Failure of national road fuel supplies

12.0 ACTIONS Some of the actions we need to consider include: • Approaching cremator manufacturers about maintaining the operation of the cremators, and avoiding heat induced failures • Funding the expensive training and organising an exercise and simulation prior to next winter • Whether the pandemic could cause great hardship to some and particularly the disadvantaged. A response could include reducing the fees charged for burial and cremation. • How much the NHS will do on the psychosocial care of survivors bearing in mind current resources for such care are very poor. • How to ensure the psychosocial care of our own front line teams. “…

…”the extent of emergency powers. They are likely to highlight the need for equitable provision between authorities as the media will immediately focus on inconsistent standards and the impact this will have on psychological and grieving needs.

They may accept that it is not feasible to store the pandemic bodies at mortuaries, crematoria or funeral directors.

Neither is the use of refrigerated trucks for storage feasible in view of engine noise and pollution, and that moving bodies into and around these trucks is labour intensive, lacks decorum and requires a large discreet and secure parking area.

A further concern is that so many authorities will be in the same dilemma that an assumption that refrigerated trucks could readily be hired is erroneous.

The only solution is for each council to provide expensive temporary storage such as a chilled warehouse in order to avoid collective burial.

It seems likely the Home Office will accept that this is unrealistic and unaffordable. The Home Office may recognise that the disposal of a large number of bodies relies upon too many uncontrollable factors “…

…”The possibility of the service breaking down is extremely high and if bodies begin accumulating, the situation could quickly become serious.”…

(So, 6 months work in 6 weeks does not mean the pandemic year will be over by then, either. And I’m not sure what the attack/fatality/and collaeral mortality rates will be. But, everyplace thinking they can just drop the ball and have outside help come in, or, public won’t be outraged if they have to have mass graves, is just planning to fail the public.)

Cremation Association of North America Pandemic White Paper pdf from a “PI” USNORTHCOM event March 2006, Virginia.

…”Number to those estimated “to perish” during another PI (pandemic influenza) event in the US “between 5% and 7% of the infected population” (est 25% infected) (numbers provided by JTF-CS) (and also manage the 2.4 million deaths annually in the US)”…

…” Many of our JTF-CS committee members believe the single most important message that must be relayed to our senior leaders at the local state and federal levels is the need to develop a mass fatality/mortuary affair Emergency Support Function (ESF). …

Additionally, mass fatality/mortuary operations must move to the forefront of disaster planning rather than continue as a topic no one wants to address for all levels of government

Birdie Kate – at 14:35

Thanks! I will pass this on.

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