Forum: Meeting Report from Western NC

Yesterday (Sept. 14) there was a talk given on pandemic preparedness in Columbus, North Carolina. It was only a small gathering of concerned citizens, nonetheless a powerful and effective session. The presenter was Dr. Martha Salyers, who is the Director of the Public Health Regional Surveillance Team covering 19 western NC counties (region 6). Her position coordinates local public health disaster response with the state level, and she is giving talks to groups of doctors and business people in addition to citizens. Yesterday, Dr. Salyers was speaking to a fairly well-informed group of citizens. We judged her information accurate and up-to-date, and she was a concise and friendly speaker, but did not sugar-coat what is happening. Frankly, we were grateful for that. Because the group was small, we had more than usual interaction with her. She began by covering the basic science of the virus and current events, which need not be covered here. From my notes, these were her primary points.

• She talked about availability of hospital beds. Citing a 30% infection rate of 300 million Americans, that gives 90 million infections. Maybe not all will need hospital care, depending on what the virus is doing at that time. But, there are only about 1 million hospital beds in the U.S., and they are kept as full as possible in normal times.
• Given this ratio of infections to hospital beds, North Carolina is planning alternate care locations, and possible portable facilities for treatment of ill persons. They foresee no private hospital rooms being available, there will be 2–3 people per room and people in hallways if necessary. There may be areas of hospitals dedicated to influenza patients only.
• There simply will not be enough ventilators. The companies that sell or lease these machines will probably be sending them to hospitals that they get easiest and fastest payment from. The federal government may also commandeer essential medical supplies to assure better delivery to places they feel need to receive supplies the most.
• One thing everybody should do, is to get all of your essential documents copied and keep them in a handy place.
• About stocking up on your usual meds, some meds cannot be prescribed for more than 30 days, and sometimes there are problems with insurance companies paying for longer than a 30 day supply of some meds. If you want to stock up, you may need to pay for some of these items out-of-pocket.
• There was implication that localized quarantines could be ordered.
• It is generally accepted that amantadine and rimantadine is not working on normal seasonal flu, and they have no expectation that it will work on H5N1. They are expecting a black market on tamiflu.
• I asked if hospitals etc. are setting aside extra antibiotics (for secondary bacterial infections) or immune suppressant drugs. She said very good point, but no they aren’t doing that yet.
• She was very clear that there will need to be rationing of medical care and supplies - and that process will be very, very difficult. Some rationing decisions will be made on a federal level, others on a state or local level.
• She gave an example of one ventilator being available for 2 patients. What characteristics or general status of each patient will most allow for survival? They might look at past medical history, smoking, etc.
• There could be problems with burial of the dead. A nurse from the local hospital attended the meeting, and she bluntly said, we might have to bury our own.
• Ways to lower risk of exposure: 1) masks, even surgical masks to keep out droplets; 2) social distancing (she meant, don’t get in close proximity to other people, even at home); 3) frequent hand washing; 4) use of gloves, especially if you have to go out (masks are assumed, of course). There was mention of a big necessity getting children and adults better trained on how to cough, importance of hand washing, etc.
• Perhaps the most important item I took out of this meeting was this. Prepare, prepare, prepare. At family level. Then small groups, then at local level. She said, no matter what the plans are at any governmental or business level, it all boils down to - you have to be prepared at home. And, “we don’t know if the right people will be making the right decisions when the time comes”.
• She recommended a minimum of two weeks of preps, but acknowledged that three months would be wise, and that any one wave of influenza could last even longer. And yes she is prepping.
• She also stressed that given the large nature of this beast, government agencies are having difficulty dealing with the immensity of the potential problem. So again, prepare, prepare, prepare at the family level.

I hope this report will help a few more people decide what they need to do.

beehiver, thanks for the information. I am happy to see that some public officials are clued in and are trying to be honest with the public.

Thank you for the information. Again, it makes me more anxious each time I read this stuff, but it reminds me that I am not overreacting or crazy.

beehiver — I’m just wondering — any explanation as to why should we get our essential documents copied and in a handy place?

That recommendation seems like fine advice, for anyone, as you never know when there may be a house fire, earthquake, or some other reason you will need to suddenly leave your domicile — but why in the context of an infectious illness? Or was this advice just part of general preparedness advice? Thanks

Having key documents are important in case someone cannot speak for themselves, or have to provide proof of identity, or become ill and need a medical history, wills, power of attonery paperwork, passports or other identification (to include SSN cards), birth certificates, next of kin/emergency notification information, insurance paperwork, pre-arrangements for funerals and burials/cremations, all of it can be important and useful.

bluesky — gotcha — in the event of severe illness or… death. )-: I think I understand now. “Have your affairs in order”.

beehiver

“I asked if hospitals etc. are setting aside extra antibiotics (for secondary bacterial infections) or immune suppressant drugs. She said very good point, but no they aren’t doing that yet.”

Thank you, thank you, thank you, thank you, thank you…etc.etc.etc.

/:0)

beehiver, great job!

It’s encouraging that some people who are in postions of influence are well-informed.

I think it’s great that Fluwikians are going to these conferences. This is a fantastic community prep.

My thanks too, beehiver. I included your notes in an email to all my loved ones this afternoon.

wonderful report! thank you for taking the time to go, pay attention, take notes and post them for all to see.

The one thing she didn’t mention, is HCW. If hospital beds are fully occupied in normal times, and presumably you only have enough HCW to care for patients in those beds, how are you going to care for MORE patients in alternate locations when you have far FEWER than your normal number of HCWs?

Some are advocating maybe it is unwise to consider alternate locations without sufficient care, as those locations will become the foci of further infectious waves.

Something to think about.

Hi everyone, you’re all very welcome! It seemed like from the first moments this meeting got started, we knew this lady was for real. About the documents, you all covered it pretty well. Just in case there were a lot of cases (and I do hope that will never be true), if there is confusion it would be good to have papers ready. Boy, it was kind of hard to think about some of this stuff, and like some of you I have been following this for a year or more, but it was good to talk some things out.

I also have a tape from the meeting in Conover, NC at which Osterholm spoke two days ago. If the tape turned out okay, I will post about that…but give me a few days, I am getting way behind on some work here!

Beehiver, thanks for the update. It makes me glad to know the folks back home are taking this seriously and telling it like it is likely to be. No one can say they haven’t been warned after this type of presentation. Now, if Eastern NC has the same type of coverage, maybe they will have a fighting chance to survive this intact.

What about Europe?

Europe will blame the U.S. and then cry for help!

Not true. Various people are working on it. Just cos its not visible here doesn’t mean things are not being done.

beehiver Thanks. The little voice in my head that keeps repeating “…You not crazy,are you?”…You not crazy, are you?”…You not crazy, are you?…”, can finally take rest. $;0)-←<

lugon - EU has a macroeconomic report -but - started by basing in on the low-ball/Enron-ed attack and mortality rate assumptions the US CBO report did ! …”The results are compared with those obtained in similar studies. Our basic conclusion is that, although a pandemic would take a huge toll in human suffering, it would most likely not be a severe threat to the European macroeconomy.” Good Stuff!

(rofl; lugon, please bring me an empty paper bag. Tell me again what the Dali Lama said, something about, Banging one’s head on the wall does not stop human beings’ “handbasket” journey.?)

beehiver, thanks for the report, (and may your county be free of varroa mites).

Thanks also to Dr. Martha Salyers. “we don’t know if the right people will be making the right decisions when the time comes”.

(But, we have a pretty good i-de-a; mm-hm hm-mm! )

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