Continued from here
Lots of folks in Massachussets prepping!
crfullmoon – at 10:15
(BB, when does this need a new thread?)
Found and added this page titled Pandemic Preparation in the Commonwealth Regional Conference Update from 6/12/06.
Silly, we’re already prepped! ;^)
(Oh?? Well, maybe we can see how many new-to-FluWiki MA people we can get in here, then.)
From the above Commonwealth Conference page, “ Regional Conference Update6/12/06
Our Goal
When the pandemic has passed, and the impact of the wave recedes, we will be able to look back and know:
That the Commonwealth of Massachusetts did everything it could; and That by having the right plans in place, and the capability to respond effectively and efficiently, we were able to come together to meet the challenges.
Our Goal
We will be able to say that:
We maintained essential services,
We preserved life and minimized discomfort,
We created a supportive caring network for our most vulnerable,
We minimized the suffering of ALL our residents, and
We protected our families and first responders.
What must we prepare for?
Surge capacity within the health care system (personnel and hospital capacity).
Assure the health and safety of the most vulnerable citizens.
Assure the continuity of society.
Surveillance / real time identification capability regarding flu outbreaks.
Timely, effective communications.”…
(Now, what is exactly being done to be able to say that; tangible preps and taken actions - inquiring minds want to know. Wouldn’t knowing help the public?)
i’d like to say, since i’m working on ph emergency preparedness efforts this summer (and possibly for the upcoming year) in MA that i know how close we are to meeting the above goals, but…i’m just learning as well, and am working with a largely underfunded region of western ma. compared to the scope some of those i work with have on the overall scene, i really don’t know much.
there are teams organized for mass antibiotic distribution, tho i’m not sure if this would be something that manifested following a wave of pandemic, or whether just in the cases of bioterrorism, but there are plans for that. (something i’ve been meaning to ask about.)
plans also apparently exist to seize ice trucks in the event, unbeknownst thus far to the owners of said vehicles. there are plans to utilize an area skating rink, of course. expectations that bodies may have to be interred, then exumed later for proper burial. i’ve been told electric utilities are expected to be maintained during such an event (w/40% absentee rate), but not necessarily in the case of a storm bringing down lines during that time. there’s been some mention recently as to whether or not public schools could be utilized for surge capacity, and if they should, given that the building’d have to be burned later.
we’re trying to plan for those living with special challenges (disAbilities) which is the main portion of the project i will be running with this summer and perhaps beyond. my heart breaks when i think of those with disabilities being less able to prep for situations like this, but….then there might be alot of heartbreak involved on all fronts regardless.
the materials that have been donated to us, and which we’re hoping to mail to all households re pandemic (provided we receive funding perhaps from Homeland Security, which would be nice), recommend stockpiling food, water, and any possible medications for two weeks. and upon inquiring why only two weeks, i was informed that “we don’t wanna overwhelm people as most can’t even put food on the shelves for the next week, let alone several months.” in a way, i’m really just glad the, that any, information’s going out at all in a widespread kinda way.
there is this emphasis on the need to educate the public as much as possible so they might go thru certain ‘freak-out’ stages ahead of time, tho i’m not sure just how much public education’s actually been taking place. personally, i would love for nothing more than to be offering these public info sessions myself, and if this all doesn’t break before i complete my MPH next spring, and perhaps even before, that may be what i find myself doing.
much of what i’m learning now tho besides certain useful ph career skills -and am asking as many questions as possible without being entirely obnoxious- involves prospective dispension sites, volunteer recruitment, how unprepared we are overall, in addition to alot of what i’ve learned already from this site and current events.
public health is very drastically underfunded. we’d benefit from placing greater emphasis on prevention in general, as most of us here value doing w/re to potential pandemic.
i’m not quite sure how i could possibly inform here other than little bits and pieces like those above however, as i’m still learning as well.
go Mass preppers!!
Thanks for posting, Posie.
…”there is this emphasis on the need to educate the public as much as possible so they might go thru certain ‘freak-out’ stages ahead of time, tho i’m not sure just how much public education’s actually been taking place”…
Also, there is the ability for people, agencies, essential workers, to stock deeper pantries *now*, so, they should be being told “at least 2 months”, (and I do think more could afford to, if they thought it was a life and death priority, given that they federal government and the state government have said last year do not expect them to be able to meet your individual needs).
(Maybe their Prepare For List needs to include Prepare For Adjustment Reactions by the Public Before Pandemic, and Prepare For Bereavement Reactions by the Public Post-pandemic?
Local officials have been reluctant to openly talk about it and put it openly in the local budget requests for this past year. I hope they are soon far enough along in their own adjustment reactions that they can deal with educating the public as to worst-case, and lead to get ready.
…”Transparency, by itself, cannot ensure trust.The public must see that competent decisions are being made. But in general, greater transparency results in greater trust.”… p8. WHO Outbreak Communication Guidelines.
(I still think we’ve had dumb luck that any of the past human-to-human cases haven’t been in a position to be an airline traveller. Let’s use the time now to get the public in the know; it may take more time than they think.)
Dear Colleagues:
Over the past several months, the Commonwealth of Massachusetts has been engaged in numerous activities designed to prepare individuals and organizations in Massachusetts for an influenza pandemic. Many of you have been involved in summits, regional conferences and trainings, exercises, and other forums as you consider the planning efforts that are relevant for you and your organizations. I applaud your involvement to date, and hope that you will continue your preparedness efforts.
During May and June, The Massachusetts Department of Public Health (MDPH) hosted regional conferences for several distinct audiences:
The report of findings from these conferences is now posted on the MDPH website at www.mass.gov/dph/flu. Click on “Massachusetts Pandemic Flu Planning” in the featured links to reach the report and other valuable pandemic resources, including:
MDPH is working with the Massachusetts Emergency Management Agency (MEMA) and other partners to organize exercises and drills for the fall of 2006. Please watch for developments in your region to participate in these pandemic exercises. Thank you for your continued involvement in this important planning initiative.
Sincerely,
Paul J. Cote, Jr. Assistant Secretary of Health Commissioner of Public Health
Dear colleagues,
The Massachusetts Public Health Association will be holding its annual meeting on Thursday, October 5, in Marlborough. Please see the attached brochure.
Alfred W. Crosby, the keynote speaker, is the author of America’s Forgotten Pandemic: The Influenza of 1918, the definitive account of the 1918 influenza pandemic in the U.S. He combines medical, political and social history to provide a vivid account of this cataclysmic event.
In addition to Dr. Crosby address response panel, there will be a brief business meeting to elect the board of directors and town meeting, students’ poster session, exhibit tables and a light buffet lunch.
A networking reception and book signing will follow the meeting.
To register, please the attached brochure, or go to www.mphaweb.org <http://www.mphaweb.org/> to register on-line. Attendance is free for MPHA members.
Please join us on October 5 as we learn form the past to better prepare for the future.
Donna Lazorik, RN, MS
Adult Immunization Coordinator
Massachusetts Department of Public Health
617–983–6821
MDPH Flu Website: www.mass.gov/dph/flu <http://www.mass.gov/dph/flu>
CommunityDispatch.com Release Date: August 15, 2006
…” In the first meeting of its kind, Homeland Security’s Federal Emergency Management Agency (FEMA) will host a meeting of all six New England Adjutant Generals to discuss the regions emergency preparedness and plans for all-hazards response.
In addition to the Adjutant Generals, The U.S. Coast Guard (USCG), 5th Army, and NOAA will be represented and discuss their roles and activities regarding emergency management.”…
…”The meeting will take place Wednesday, August 16 at the Federal Regional Center in Maynard, MA. Some of the topics to be discussed include FEMA’s, USCG’s and 5th Army’s response to an event,
the 1938 Hurricane and the impact a hurricane would have on New England in 2006, evacuations,
mass care and sheltering and a health and medical strategy when responding to an incident.”…
I’d encourage all Massachusetts voters to contact campaigns and ask about the pandemic preparedness issue:
if enough people are asking, perhaps they will think they have to come up with public stated positions. (Steering them to the main Flu Wiki site might help their big picture, too.)
Also, any chance which questions candidates will be asked in public can include the “P” word? Journalists, where are you? League of Women Voters? Local meet-and greet opportunities?…
Massachusetts Department of Public Health Massachusetts State/Local Pandemic Planning Committee September 13, 2006 Western Regional Health Office, Northampton Minutes
Facilitator: Donna Lazorik, MDPH. Present: Patricia Abbott, Northampton HD; Mary Ellen Ahearn, Franklin Medical Center; Lois Bissette; Pittsfield HD; Dan Bresnah; Holyoke HD; , David Dlugose; Jackie Duda, Foothills Health; Bill Elliott, Shutesbury BOH; Julie Federman; Amherst HD; Mike Goyda, OSHA; Bettye Anderson Frederic, Springfield HD; Charlie Ishikawa, Cambridge Health Alliance; Vanessa Kenealy, MMS; Darrin Lillie, Canyon Ranch; Nina Martin-Anzuoni, MA Public Health Coalition; Paul Medrek, Bay State Health System; Margaret O’Clair; Liz Pujolas, MedImmune; Jacob Pyra, Canyon Ranch; Gerald Stadnicki; Wendy Tryon; Lee VNA; David Urso, Veterans Administration; Jody Wax, Granby School Dept.; Gail Bienvenue-Mailhott, MDPH; Stephanie Bozigian-Merrick, MDPH; Mary Conant, MDPH; Barbara Coughlin, MDPH; Barbara Mackey, MDPH; Marija Popstefanija, MDPH; Helen Crean-Taugher, MDPH
Influenza Vaccine Supply: The Centers for Communicable Disease Control and Prevention (CDC) expects that more than 100 million doses of influenza vaccine will be available for the 2006 – 2007 influenza season, more than were ever available in one season before, and 19 million more doses than were available last flu season. As in previous seasons, delivery of vaccine will occur in multiple shipments from September into November and perhaps December. MDPH has ordered 680,100 doses of influenza vaccine, including a limited number of doses of thimerosal-free vaccine for children < 3 years of age and pregnant women. State-supplied influenza vaccine is targeted children < 18 years of age; residents of long-term care facilities and adults in high-risk groups who are vaccinated in public settings, such community health centers and local health departments. For recommendations on timing of influenza vaccination and other information, see the MDPH Recommendations of the Prevention and Control of Influenza, 2006 – 2007 at www.mass.gov/dph/flu, click on Seasonal Flu, click on Information for Providers.
Pneumococcal Vaccine: MDPH provides pneumococcal vaccine at no cost for all Massachusetts residents at risk for pneumococcal disease, including children < 5 years of age; everyone > 65 years of age; and others with chronic medical conditions.
Avian Flu Update: Since December 2003, a total of 244 human cases of H5N1 have been reported to WHO from 10 countries (Azerbaijan, Cambodia, China, Djibouti, Egypt, Indonesia, Iraq, Thailand, Turkey and Vietnam); 143 (59%) have died. H5N1 is widespread in wild birds and domestic poultry in Asia, and parts of Europe, Africa, and the Middle East. Updated information on avian influenza can be found at the CDC website: www.cdc.gov/flu/avian. An MDPH fact sheet, Influenza: Birds, Pandemics and Protecting Yourself, can be found in English, Spanish and Portuguese, at www.mass.gov/dph/cdc/epii/flu/avian_public.htm.
Pandemic Public Education Campaign: MDPH will be launching an educational campaign on pandemic preparedness for the public this fall. The campaign consists of the general message that all flu is serious and that there are some basics steps the individuals and families can take to protect themselves: wash your hands, cover your cough, get an annual flu vaccine, make a family emergency plan, and volunteer in your community. The campaign will consist of tear-off sheets at pharmacies, transit placards, radio and TV PSAs, and a half-hour video for distribution to cable stations and other venues.
Pandemic Preparedness in Shrewsbury: Bill Elliott from the Shutesbury Board of Health and vice-president, MA Association of Health Boards, provided an overview of emergency preparedness activities in Shutesbury. With the help of an MDPH-supported intern from UMass Amherst, Shutesbury is planning to survey all town residents to identify residents with special needs. They are also developing a plan to reach all residents in their homes with medications and/or vaccines, if necessary. To get a copy of the survey developed by the town of Shutesbury, please contact Bill Elliott at boardhealth@shutesbury.org.
Home Care of People with the Flu: MDPH, with local public health input, is developing a educational program on caring for people with influenza-like illness at home. The goal of the program is to provide families with the knowledge and confidence they need to care for family members at home during seasonal flu and during a pandemic. This has the potential to lessen the impact of influenza on the health care system by enabling families to become the first line of triage. The program will cover care for fever and other symptoms, basic infection control in the home, and indicators of need for medical assistance. The program will consist of a train the trainer presentation to spread the information into communities and a video that can be shown on cable stations and other venues, such as community meetings.
EDS Exercises: Local health departments that are planning to use this year’s flu clinics to exercise elements of the their emergency dispensing site (EDS) plans are encouraged to notify Joe Cahill at the Massachusetts Department of Public Health at (617) 624–5711 or at joseph.cahill@state.ma.us.
2006 State/Local Pandemic Planning Committee meetings: Wednesday, December 6, 2006, 10:00 – 11:30, State Lab, Jamaica Plain
Directions: www.mass.gov/dph/bls/dir/dirmain.htm
2007 State/Local Pandemic Planning Committee meetings: Wednesday, March 14, 2007, 10:00 – 11:30, location TBA Wednesday, June 13, 2007, 10:00 – 11:30, State Laboratory Institute, Jamaica Plain Wednesday, September12, 2007, 10:00 – 11:30, Western Regional Health Office, Northampton Wednesday, December 5, 2007, 10:00 – 11:30, State Laboratory Institute, Jamaica Plain
Up coming events: Oct 3, 2006 MIAP Conference. Keynote speaker: Bill Atkinson, MD, CDC. For information, call 617–983–6800. Oct 5, 2006 Annual meeting of the Massachusetts Public Health Association Keynote speaker: Alfred Crosby, America’s Forgotten Pandemic: The Influenza of 1918. For more information or to register, go to www.mphaweb.org. May 1, 2007 MA Adult Immunization Conference, Worcester
Thanks, Posie.
Just stumbled across an old summary report from a Pandemic Influenza “Public Discussion” Sponsored by: Middlesex Community College, Lowell Health Department, Massachusetts Department of Public Health, back in April 2006. [snips follow]
…”The following issues were mentioned by participants as the major challenges: Language barriers, Transportation for individuals with disabilities and special needs, The impact of quarantine measures and triage on elderly individuals who may nothave the resources to care for themselves in the home if they became ill and there was no room to hospitalize them, Dissemination of information, Stockpiling of perishables (particularly space for storage and resources for purchasing necessary supplies), Worries about charges for emergency supplies for those who cannot afford to purchase them, Need for security at triage sites where people are waiting for treatment, Need for individuals in the community with basic training on health and safety to provide services, Sanitation concerns, Access to medication and vaccine”
…”Participants reported the following key recommendations: Develop a local cable television program to educate the public on pandemic influenza and the pandemic planning efforts that are going on now, Consider using old unused buildings for storage of food, medication, and other emergency supplies as well as for health care triage sites, Stockpile medical supplies at home and at health care institutions for people with underlying conditions and basic first aid supplies for trauma cases, Ensure more involvement from communities of color in the pandemic planning process, Develop public information in a wide range of different languages, Conduct planning now to involve mass transit in assisting people that do not havetransportation as well as to provide sufficient services to ease traffic congestion to and from health care facilities during a pandemic”…
…Concerns were expressed about how the increased burden on mortuary services would behandled. A suggestion was made to use the ice rink at the Tsongas Arena as a temporary morgue or considering the use of cremation if cultural and religious concerns would not bar this option. Another comment stressed the need for emotional support for the grieving. Other mortality related concerns were raised such as how to care for orphans if parents should die during the pandemic. Similar logistical concerns as were raised in the previous section were discussed”…
…”However, based on the knowledge questions on the survey, it appears that more detailed public information about pandemic influenza is needed. For instance, 98% of respondents correctly identified that human cases of avian influenza had been reported in Asia. However, 43% of respondents incorrectly indicated that there were human cases of avian influenza in Africa, 59% reported that there were human cases of avian influenza in Europe, 12% thought that there were human cases of avian influenza in Canada, and 10% indicated that there were human cases of avian influenza in the United States. As of April 18, 2006, of these options, only Asia (sic)had reported human cases on avian influenza.” …
And as for this fall, if it was Oct 2005, I’d think it would be enough, but if the …”Pandemic Public Education Campaign: MDPH will be launching an educational campaign on pandemic preparedness for the public this fall. The campaign consists of the general message that all flu is serious and that there are some basics steps the individuals and families can take to protect themselves: wash your hands, cover your cough, get an annual flu vaccine, make a family emergency plan, and volunteer in your community.” I’d have to say this is too little, maybe too late, and at the very least, disingenous.
Have not seen too much activity here on our Mass. thread. Seems like I have been posting on every one but this lately! Has anyone heard from BelarusMama? Think she is from my town and have not seen a post from her the last couple of months. Maybe like me she has been lurking on this thread but not saying much. Hope you are ok out there.
FWIW- ebay has an antique Wringer Washing Machine for $9.99. YOu have to pick it up yourself. It’s in Mass. Only 9 h left. I have nothing to do with this… just saw it on ebay…. & live way too far to “pick it up”… or I’d bid on it.
Does anyone know if anything is happening in or around Haverhill? I have a sister that lives there!
Well, none of the candidates for Governor have said anything public about Pandemic Preparedness.
Even if they said it in the same breath as “Homeland Security” or “anti-terrorism” measures, it’d be an improvement.
No harm in telling the public the federal pandemicflu.gov site will be a year old in October, and ask, Have they done their checklist yet?…
(Really, candidates could say, the WHO “Ten” things you need to know about pandemic influenza site will be 1 year old as well, and discuss how local governments have spent the past lucky twelve months…So, mentioning the US fed site sounds easier than that, right?)
Printing out the pandemic awareness week cards might be a good idea; plenty of places to hand them out.
I’m-workin’-on-it, I’d have to say the MA public, local authorities, and essential workers/first responders are not aware and not prepared. Certainly not for what we know the possible timeframe, consequences, and impacts may be.
Car insurance, home insurance, fire insurance, flood insurance (even health insurance is going to become mandatory, rather than go directly to single-payer health care!); let’s start telling the public “Pandemic Insurance” is a deep pantry so they can get their needs met during illness or quarantine or prudent sheltering-in-place to avoid getting sick if there is no treatment available and no cure. (And possible supply chain/utility disruptions.)
A little short-term sacrifice used to “build character” right? Leadership could get people taking some helpful actions now, rather than waiting and trying to give reactive orders during a pandemic.
NauticalMan,
All A-OK by me…just been a-lurking for some time. I really got annoyed at the whole Niman thing so I stopped activly participating, but I still have my ear to the latest news. Thanks for thinking of me.
i’ve noticed in the few hours per week i work as an intern at a local emergency preparedness office, that much planning taking place there does so in the absence of specific reference to ‘pandemic’. for reasons of funding, i believe, many programs, such as ‘debris mngmnt’, medical reserve, etc. orient their planning around general type disasters, when everyone involved clearly understands potential pandemic as *the* most likely next candidate for these program efforts.
for instance, debris mngmnt, while planning for removal of downed trees and houses from a hurricane or tornado, also must have plans for where to inter large numbers of corpses in the event of a major disaster. so at meetings, you’ve got people discussing things in terms of, “when this happens….IF it happens…”. with everyone well aware the person means pandemic.
this being just what i’ve gathered as a small fly on the wall, for the most part. point being tho, that often there are plans being put into place that do not always specifically mention pandemic.
just a thought.
NauticalMan - I check in here because I have much family in Essex county Mass, and dearest friend in Athol. Thought I’d say Hi and wish you well. Truly sounds as though there exists a lot of motivated and productive activity from you folks. Just wish I saw some of my family here. It would be good to have affirmation that they are being proactive. Take care everybody.
glad to live in mass. Thanks Posie, CRFullmoon, etc for you informative posts. Checked out mass flu site, again no specific calls in the plan for individual prep..they talk about the “sectors of business, hospitals, education” and status of how each is prepped and where to go forward, but no mention of the “sector” of the individual or familly…I would like to know what the MA plan is to tell us how much to prep. I can’t believe in their meetings they don’t mention how to get us to personally prepare, it is so strange.
I hope your flyer (the one going to households, funding dependant) comes out before the winter Poisie. Then maybe my friends will prep.
I ran into a friend a couple weeks ago who works at MDPH. I didn’t pry into what he may have done on a personal level, but he did seem worried. He’s on the “morbidity” side of the planning. There are concerns about those areas where the need is obvious but MDPH and the hospitals have no control. For instance, an increase in medical waste is anticipated without the means to handle it since it is private sector (mostly Stericycle) and some substantial part of the waste ends up out-of-state. The inability to prod the business community into action also concerned him (I have yet to see anything at my company). $3,000,000 has been tagged for panflu, including 500 more beds, but he did not know over what timeframe the money would be spent so unclear when the state is gambling on panflu arriving.
Just checking in as Nautical Man reminded me I haven’t posted here in ages. Been away for 2 weeks and have lots to catch up on. On my trip down in VA, I saw lots of bill-boards foo the Red Cross about preparing ‘for the unthinkable’- It’s a start. Can report though, that my company- a large supermarket chain that operstes in all the NE states has a decent plan made up.
I am from a Western MA small regional response area. To be honest, I am pretty fed up with the lack of response. I have been attempting to notify people of this problem for 3 years. I knew that we would need that much time to prepare a response because of the lack of funding that trickles down to our area. Basically, all I have seen is tons of denial. I hear things like “we have a vaccine fridge and no where to plug it in”. I have volunteered, emailed the selectman, called and stopped by the town offices. I have even mentioned the pandemic to my friend in charge of the Council on Aging. I am just now beginning to see a bit of preparation for the regions response but no actual warning being sounded to the towns residents who are mostly blue collar pay check to pay check workers. They will need time to prepare and I don’t think that this is going to happen. So now a friend and I have prepared a brochure for people and if I have to I will spend the next few weekends standing outside the local grocery store and church services on Sunday and hand them out. Sorry if I sound bitter but this really is frustrating. How difficult would it have been to send out a brochure with the tax bill or water/sewer bill?
Belarusmama, glad to see you are still out there, yeah, I was a little miffed over Niman and all that, as he always seemed to have the inside info in places we were concerned about, like Karo. I tend to overlook most peoples faults as I sure as hell have them myself. Don’t let that stop you from participating. Come back Henry!!
Lisa in Southern Maine, hello to you and all the good folks down Maine! Hard to read all the threads all the time, but us retired folks do pretty well I think. Hmmm, that reminds me, maybe frozen lobster meat for my preps?Not a cheap item, but sure would be a treat after months of beans, rice, and pasta… The old honorary Maine citizen up to Boston.
Cinda, welcome back to the MA thread, have noticed your posts elsewhere. Just voted in the Primary, if any of you have not, there is still time… Although my town supposedly has some kind of plan, no one seems to know what or where it is. Not posted on town website. Sent Goju’s post on his NYC conference and his thoughts on upcoming meeting with officials from his town to my Town Manager, but no response.
Hi folks, I am a life long resident. I will take a few days to get up to date with this thread. I have to think about how to get involved in all of this. I have ideas and resources. Let me think about how to use the time and effort effectively.
standingfirm – at 16:22, I hear ya!
Dude, love to hear your ideas.
(I think it is a bit late for politicians to make vagues promisises about “filing more legislation” - for goodness’sake; get the info from the WHO “10 things you need to know about pandemic influenza” (9, sir!) and the message HHS Leavitt told eveyone (even at the under-attended and under-reported MA summit in Feb.)…”
“Any community that fails to prepare, with the expectation that the federal government or, for that matter, the state government will be able to step forward and come to their rescue at the final hour, will be tragically wrong, not because the government will lack a will, not because we will lack a collective wallet, but because there is no way that you can respond to every hometown in America at the same time.”
Local level planning is not happening; if all the households are unaware and unprepared for a pandemic year, the number of beds or burial spots is totally irrelevant.
The unprepared households are the problem; tell them how to prepare for months of disruption.
Car insurance, house insurance, health insurance- well- a deep pantry and lots of information is Pandemic Insurance for a family.
Welcome, any new lookers from MA… New readers and new preppers…
I work in Mass but reside out of state. My employer is not concerned too much. I feel I will just take my sick time and be gone for a while.
You would be very surprised as to the lack of planning at my job considering I work for one of the largest employers in the commonwealth. Sorry that is all you will ge out of me LOL
bump
did I read the mass state plan correctly in it does not address INDIVIDUAL prepping or recommend any particular family stockpiling (even a week, three days etc) AT ALL?
MA will be coming up soon in the “states pandemic plan” thread. Don’t want to post wrong. I wish they’d make recommendations like FL.
hear your pain in Western MA, about the vulnerable unprepped out there (I live in Boston which could have it’s own different nightmares like civil unrest). People on the ground in my actual part of the city, even healthcare people in clinics, seem clueless here.
Someone said somewhere that they need to not only do pandemic plans but IMPLEMENT them now…it starts now. Maybe thats the probllem, its all on paper still doesn’t help them plug in the vaccine frig.
As an aside, My local health center affiliated with major teaching hospital was storing vaccine in a frig, with thermometer, that was ten degrees above temp causing expiration date to be irrelevant. Wonder if my MMR booster that I got a few months ago was effected.
Since there aren’t any vaccines now, telling the public to get excited about keeping “deeper” pantries at home would sure help
if pandemic flies in next month, or next year, or however many more years until Leavitt said we’d have any capacity to make vaccine in public quantities…
Dr.Nabarro was begging officials to stop planning and *act* on action items, (and I think that was last year!).
We’re wasting “God-given time” (The phrase he used Sept 6 for our present pre-pandemic state) to prepare.
Nothing’s been fixed yet, but I may be giving a public talk in the western MA area. How many of you are out there?
Or ‘out there’? LOL
Depending on when and where it is, it might be worth a drive…
or at least, call some people in western MA and “talk up” your talk; tell them they shouldn’t pass it up.
I am in Western Mass Anon_22. It would be something to actually meet someone from this site. Email me at muse if your time allows. I can’t wait to ask you some tough questions! Can you tell me any you questions you can’t answer? Just a hint…..
I hope it does become fixed.
Hi Posie, I am working in public health emergency preparedness here in the eastern part of the state, and am interested in contacting you directly. Were you at the MHOA quarterly meeting last week? I am just starting a ‘special pops’ emergency plan, following MDPH FY ‘06 deliverables guidelines.
I attended, and the Region 1 rep gave an interesting update on ‘best practices’ (I’m assuming you’re in Region 1 out of Northampton). Could you email one of the fluwiki administrators: demfromct@earthlink.net as he has my contact info.
Thanks everyone for letting me post this notice. I/we will certainly share any pertinent info with everyone.
MassMPH, I will do that (contact Demfromct). I did not unfortunately, have the opportunity to attend the recent meeting in Northampton. Let’s talk.
Standingfirm, hi. We may have met briefly on another site. Great to see you on this thread!
Anon_22, I would be very interested in attending any talk you might offer in W.MA. Given notice, I’m sure there would be quite a bit of interest in the PH Dept here at UMass as well, in addition to much of the surrounding area. There was a conference at the University in May, though it wasn’t made available to the general public, and another conference I had the opportunity to attend at Westfield State around that time.
As somewhat of an aside, there is a man in Holyoke desperately searching now for (unpaid) help to assist with developing pandemic prep plans there. I’m not sure what else I can take on at this point though I could provide contact info to anyone who might be interested in such an endeavor. As I’m sure all in W.MA are aware, Holyoke could really use the help.
There is a definite need for information out here. I’d enjoy connecting with anyone in the western MA region interested in doing so. Perhaps I can leave my contact info with Demfromct.
Cheers, all.
Posie, I can give you an email box on muse if you like. just post here that you want one…do you understnd how I work it?
ED.gov broadcast needs more places in MA to see it; only 3 listed so far -not that I know what information the content is going to give.
Is “Man in Holyoke” using the Flu Wiki, and/or the large file communication project? If he tells the stores and the public they need to stock up for a long pandemic, that’s a good place to start… What place was handing flyers out at grocery stores; they started with the 3 flu definitions (seasonal, avian, and pandemic)- and some other store is now selling 8-day emergency food packs, right?
I keep wondering about underwriting on NPR stations… what could be said?
Dude, you can hook me up with muse, if you like. that might things easier? (i don’t understand yet what it is exactly, but…) an email sent to demfromct was returned to me, so let’s do that.
Cheers.
www.doe.mass.edu/pandemic/news06/0925planning.html
“Update: Use of School Facilities as Hospital Influenza Specialty Care Units….”
crfullmoon,
When I first saw your article you posted I was hoping they would be saying we can’t use the schools but….
while I am not in Mass here is a NH law that talks about destroying facilities that have had public health issues. now we have all heard the virus can stay on surfaces for quite some time. I also read that ambulances will be useless once you transport one avian flu patient because ambulance cannot be fully steralized. I am not sure Mass has this law but can look into it later. So we use schools and when it is over we close them? If we use a school for the first wave, we might as well leave it be until at least the second wave is over. Not that my kid will be in school, but if there is school between waves then we coudl be sending kids into a death trap. I am shaking my head. Are these people who “run” things stupid or what?
TITLE X PUBLIC HEALTH CHAPTER 141-C COMMUNICABLE DISEASE Section 141-C:16-a 141-C:16-a Decontamination. – The commissioner may close, direct and compel the evacuation of or decontamination of any facility where there is reasonable cause to believe that there is a danger to the public health. The commissioner may also decontaminate, or cause to be decontaminated, or destroy any material of which there is reasonable cause to believe may present imminent danger to the public health. Destruction of any material under this chapter shall be considered a taking of private property and shall be subject to the compensation provisions of RSA 4:46. Source. 2002, 258:22, eff. July 1, 2002 at 12:01 a.m.
I have heard that Emerson Hospital in Concord is talking with the town to use a nearby Middle School in the event of an emergency. No doubt it would save lives if there were enough health care workers to staff it and if they had adequate medicines. Disinfecting the place would be a significant but not impossible undertaking? Turn up the heat and spray and wait two weeks?
Ok Here are the Mass laws, Chapteer 111, section 92 DANGEROUS DISEASES . I can’t find anything like the NH law but maybe someone else can
anon_22: Hope you had a good trip to Washington DC area. I wonder if IV high-dose Vitamin C is one way to deal with these issues? I imagine the standards of care will slip a lot, but rather than just give whiskey and lemon juice like in 1918, maybe there are common meds (statins too, as you say) that might actually help or reduce damage? I share Tom DVD’s concern that the US (and Canadian?) system is not set up to stockpile these medicines, so that they will not be available. Your point about training is excellent, but maybe somebody should make a low-quality video (internet/cheap DVD’s) of a 5 evening course and make it available for free or at cost? I just do not think that we will get organized enough and why not use technology?
(Get the college students looking at Flu WIki before their campuses get used for regional tabletop excercises? Maybe they can think of something?)
All that money poured into local schools, and they may have to burn them down after pandemic? (Do that wrong, and it spreads virus too.)
Not telling the parents about pandemic after the WHO, federal, and state warnings is inexcusable.
It was left off our Town Meeting, it is excluded from the locals “getting the memo” what a Pandemic Influenza Year means, (like 1918 but worse as we are no longer so self-sufficient as a society) at every opportunity by those “in charge”.
We don’t have every level and sector integrated before pandemic starts; cross-training, stockpiling, “stakeholder meetings” nothing public, or that will tell the public it can’t be stopped and there is no vaccine and not enough medical care to go around unless prompt SIP of non-essentials reduces the attack rate. The public that has not changed priorities and stockpiled needs, because they weren’t warned pandemics can last months, and supply chains will be disrupted.
Who can swallow this ---- ?
…”Update: Use of School Facilities as Hospital Influenza Specialty Care Units
The unique challenges of pandemic flu and the potential for widespread illness require us to build response capacity in the healthcare system that is unprecedented. A flu pandemic will stress the healthcare sector well beyond its existing potential to provide care to the sick.
Therefore, all Massachusetts acute care hospitals have been directed by the Massachusetts Department of Public Health to evaluate potential sites in their area where they could, with the assistance of the state and local preparedness partners, provide inpatient care to flu patients.
These Influenza Specialty Care Units (ISCUs) will be licensed as satellite facilities of the hospital,
and will be utilized for approximately 2–4 weeks, if needed,
to provide screening of outpatients, and for the care of flu patients that do not meet the criteria for hospital admission, but who are too sick to be cared for at home. In the event of activation, staff and equipment will be provided.
Because school buildings meet many of the criteria for such a facility (eg food preparation and dining facilities, adequate restrooms, and large open rooms that can hold a number of patients in a single space), you may be contacted by your local hospital to discuss the feasibility of identifying buildings in your district, in an emergency, as an ISCU.
If you are contacted by a local hospital regarding possible use of school facilities in your district for this purpose, we urge you to cooperate in the planning to the extent feasible It is important that you bear in mind that if the impact of a pandemic is such that we need to provide hospital level care in school buildings or other such facilities, there will be a declaration of a public health emergency and appropriate guidance from the state.
If a school building in your district is designated as an ISCU, it will be important to have a plan for temporary re-assignment of the students and staff in that facility to another building or alternate educational site in the event that the ISCU is activated.
If you have any questions about ISCUs being designated in your area, you may contact your local hospital’s emergency planning coordinator or Dr. Lisa Stone, Hospital Preparedness Coordinator at the Massachusetts Department of Public Health, (617) 624–5282 (office), (617) 908- 9001 (NEXTEL) or at Lisa.Stone@state.ma.us.”…
“Update: Regional Exercises of Continuity of Operations Plans
In order to further strengthen the Commonwealth’s ability to respond effectively to a pandemic flu event, the Massachusetts Department of Public Health (DPH), in collaboration with the Massachusetts Emergency Management Agency (MEMA), the Executive Office of Public Safety (EOPS), and the Harvard School of Public Health (HSPH), is planning a series of “tabletop” (Dr.Nabarro, last month, said It is too late for tabletop excercises; take action!) “exercises to practice implementation of our Continuity of Operations Plans (COOPs) at the local level across the state.
DPH and MEMA will be hosting approximately 26 regional tabletop exercises across the Commonwealth to enhance and integrate state and local pandemic plans during October and early November. Community and state college campuses are being considered as potential locations for these exercises. HSPH has designed the master exercise scenario and is creating a web-based course that will provide municipalities and other local stakeholders with a baseline of pre-requisite information in advance of the tabletops.
Each event will have between 100–200 participants, and invitations to participate in these exercises will be coordinated jointly by MEMA, DPH, and our municipal boards of health.”…
crfullmoon,
do you have any idea or a list of when these tabletop exercises are being held? I would love to attend one. Maybe find out when they close the Mass border coming into NH :)
Is it this? Updated 8/12/06 “The HHS/CDC Crisis & Emergency Risk Communication (CERC): Pandemic Influenza course is a 1½ day training that offers a combination of influenza communication tabletop exercises and informative group discussions”…
“We can expect the following:
Susceptibility to the pandemic influenza virus will be universal.
Of those who become ill with influenza, 50% will seek outpatient medical care.
The number of hospitalizations and deaths will depend on the virulence of the pandemic virus, with severe pandemic influenza causing nearly 2 million deaths in the United States.
In an affected community, a pandemic outbreak will last about 6 to 8 weeks.
Multiple waves (periods during which community outbreaks occur across the country) of illness could occur with each wave lasting 2–3 months.
The need for fast, accurate, and credible information to be vast.
Communicating to concerned members of the community will be a paramount responsibility and the right message delivered at the right time by the right person could save lives. The HHS/CDC CERC: Pandemic Influenza course will give leaders and communication professionals the best approaches and tools to exercise quality communication before, during, and after a pandemic.”…
“Region I, CT, ME, MA, NH, RI, VT; Boston…Oct. 3–4, 2006″
oops
Does the MA Flu Wiki page need an edit, to put new events at the top, as they pass on the calendar?
About to drop dinner in the keyboard;see y’all around.
…”9. What kind of care will be provided in an ISCU?
ISCUs will provide supportive flu care only. Due to financial and logistical constraints, staffing concerns, and supply chain issues, there will be no mechanical ventilation supplied in ISCUs.
The use of room air oxygen concentrators will provide low flow oxygen in addition to intravenous fluids,antibiotics and other supportive care.
Patients admitted to an ISCU that develop the need for more critical care will be transported to the ISCU’s acute care hospital. The provision of a specified level of care for a single diagnosis will permit the pre-stockpiling of equipment, supplies and pharmaceuticals, as well as training of volunteers.”…
(Where are the collective burial sites, or how can the dead get processed so well that those aren’t needed??)
hey folks, received this today:
Dear colleagues,
Today, Massachusetts launched a public pandemic education campaign, “Flu Facts: What You Need to Know”. Local boards of health and more than 60 other organizations are participating in this campaign, including media outlets, healthcare providers, business and industry, schools, colleges, and community-based organizations statewide.
The main theme of the campaign is that any flu is serious and there are simple steps to prepare yourself and your family. The campaign includes TV and radio spots in English and Spanish, hand cards, posters, transit cards and a “Stay Healthy” coloring book for children, as well as a half-hour educational video that is being distributed to local cable access stations.
For more information on the Flu Facts campaign, or to order print materials, visit the campaign website: www.mass.gov/dph/flu <http://www.mass.gov/dph/flu> (www.mass.gov/dph/cdc/epii/flu/flufacts_campaign.htm) or call 1–877-MASS FLU (1–877–627–7358) or TTY: 617–536–5872.
Donna Lazorik, RN, MS
Adult Immunization Coordinator
Massachusetts Department of Public Health
617–983–6821
MDPH Flu Website: www.mass.gov/dph/flu <http://www.mass.gov/dph/flu>
it might also be a good idea to keep an eye on the calendar of events here: http://www.masslocalinstitute.org
as i’ve learned there’s going to be a 4hr risk communications/pandemic seminar taking place w/speakers from DPH and MEMA re mainly pandemic and communicating w/the public/media. largely an experiential/exercise type training of which there have already been several. this will be located in Shrewsbury tho the date has yet to be set.
(Dude, is it still possible to get that muse situation goin on?)
cheers, all.
Problem is, “they” still don’t think the public “Needs to Know” very much.
They passed up the Ten things the WHO thought you needed to know about pandemic influenza -the ones they thought we needed to know back in Oct. of 2005. Public should be stocking up, and discussing how to deal with something none of us have had to deal with in our lives.
10.19.06 Somervill MA “Planning for Disaster: Emergency Preparedness for Vulnerable Populations” ….” Focus communities for this forum include Winthrop, Revere, Chelsea, Everett, and Somerville. However, everyone is welcome.”… This event is free, but advance registration is required. Register online at http://www.mphaweb.org or click here for a registration form. For more information please contact Eric Weltman at the MPHA at 617–524–6696, ext. 111 or eweltman@mphaweb.org.”
Training Level for above event is rated “Awareness”.
Do their local Chamber of Commerces, and faith communities hear about events like this?
Repeating my post from another thread, but, check the date on this draft; no excuses for not preparing the public!
December 24, 2003…”Infectious disease outbreaks of various sizes occur frequently in Massachusetts and affect people of all ages, race, gender and health status. They can range from a single case of hepatitis A in a food handler or a few cases of meningitis in high school students to thousands of people potentially infected as a result of an influenza pandemic or bioterrorist event. The initial response to the health and social consequences of an infectious disease emergency will be initiated at the local level with assistance from the state. Therefore, state and local agencies must have a practical plan in place to respond. The Infectious Disease Emergency Plan (IDEP) provides a framework for a coordinated response to such events.”…
“Assumptions: Influenza Pandemic” (this is a December 24, 2003 draft, mind)
An influenza pandemic is inevitable. There may be very little warning. Most experts believe that we will have between one and six months between the time that a novel influenza strain is identified and the time that outbreaks begin to occur in the United States. Outbreaks may occur simultaneously throughout much of the United States, preventing shifts in human and material resources that normally occur with other natural localized or regional disasters. The effect of an influenza pandemic on individual communities will be relatively prolonged — weeks to months. The impact of the next pandemic could have a devastating effect on the health and well being of the American public.
MDPH estimates that in Massachusetts alone, during a 2 – 3 month period -
Up to 4 million persons will be infected
Up to 2 million persons will become clinically ill
Up to 1 million persons will require outpatient care
Up to 24,000 persons will be hospitalized
Up to 6,000 persons will die “…
Nothing about Pandmeic in our Town meeting, ads on tv this morning telling the public
“what they need to know” about “flu”
-which they have no idea is code for Pandemic Influenza Year
Evidently the public “needs to know” wash your hands and stay away from people who are sick. Argh.
They thought the Big Dig fiasco is a problem; the public doesn’t even see the iceberg coming… And the politicians refuse to talk about it in public.
What is wrong with the journalists in this country? They were supposed find facts and inform the people, not be managed by corporate-politico machines. How about contact university journalism students? Anyone have contacts? Anyone have college kids?
Everyone enjoying the television ad campaign? Wash your hands, don’t touch your face, put together an emergency plan in case of a major outbreak… [insert rolleyes icon here]
Get word out to people you meet what all the “code phrases” to avoid saying “A Pandemic Influenza Year” are…
Thanks for all the hard wiki work that went into the Awareness Cards; I think they help, better than just us writing down a link.
Welcome any new readers/posters from MA. What’s going on in your community?
I will be giving a talk on “Who Will Tell the People? Preparing for the next Influenza Pandemic” at Simon’s Rock College of Bard, Great Barrington, MA on 19 October, 5pm at the Lecture Hall. All are welcome. Apologies for such short notice as the date was not fixed till now.
BTW, I plan on repeatedly using “Who Will Tell the People?” as the first half of any of my pandemic flu talks for the forseeable future. Pushing the point, you know :-)
(they need to add it to their Calendar of Events page?)
I will tell a few people out that way.
I know, its a very small college and this is very last minute. :-)
Town prepares for a flu pandemic Seeks volunteers in case of outbreak Medfield, Oct 15, 2006
… “public health forum will be held from 7:30 to 9 p.m. on Wednesday on the second floor of Chenery Hall, 459 Main St”
…”Health officials from across the region will follow up on Oct. 30 with an exercise simulating a pandemic at Framingham State College, Rheaume said.”…
(I put most of the article up in the Misinformation Hall of Shame thread. No full disclosing before joining medical reserve corps, and no mention in the article of stocking up. And, this doozy, “Fifteen million people died worldwide during the flu pandemic of 1918, Rheaume said.`We don’t expect that same scenario should there be another pandemic,” she said. `It’s a very different world in 2006 compared to 1918″…) (Let’s see; now have at least 3x the population, no longer 50% of the population farmers, more like 2% now, people now kept alive by fragile supply chains and imported meds and medical proceedures, and, a much higher virus fatality rate today…I don’t expect the same scenario; I expect worse than 1918.)
Seems like similar, year-behind, “What (little) You Need to Know” forums are popping up other places, too, this fall.
Why isn’t Pandemic Preparedness a campaign debate issue?? Don’t we have any journalists?
:-/
How did your talk go in Great Barrington, anon 22?
Can anyone attend this event in Springfield on Thursday the 26th? I would like to hear what they have to say. The event is free, but you have to call in a reservation.
Maybe call and ask how long they will tell the public to stock up, as you cannot attend?
(Bits worth printing out, to hand officials?) From “Findings from the Forum on Pandemic Flu, sponsored by the Massachusetts Health Policy Forum, June 2006″ “The Pandemic Threat: Is Massachusetts Prepared?” http://tinyurl.com/yldvka
…”In Massachusetts, the state’s pandemic preparedness plan is intended to ensure that essential services are maintained, there is minimal discomfort and loss of life, the most vulnerable are cared for and that individuals, families and first responders are protected. The goal, as relayed by Commissioner Cote, is to look back and to know that Massachusetts did everything it could do in the face of a pandemic.
The plan takes into account hospital and health care facility surge capacity and staffing issues, surveillance and identification of influenza, the health and safety of vulnerable populations, timely and effective communication, and societal continuity of government and essential services during a crisis.”…
“Businesses, schools, colleges and universities, providers and municipal governments all should be preparing “continuity of operations plans” (COOPs) in order to ensure that operations continue and contingencies be made in the event of a pandemic.
Individuals and families are also encouraged to make emergency plans and to stockpile a supply of food, non-perishables and medications to last for about one month.” …
…”Commissioner Cote agreed with Dr. Gerberding that timely and effective communication is critical in planning for a pandemic “…
…”For hospitals and other healthcare facilities, a one-month supply of food, water and needed medications should be stockpiled”
…”public information campaigns will begin. In the meantime, Cote encourages individuals to take action by making emergency plans, stockpiling a 30-day supply of food, water, non-perishables and medications…”
…” according to federal, state and local officials there is a long way to go”…
…” This is not an exercise for public health departments and first responders, but rather an opportunity for individuals to become involved and plan for themselves, their families and their communities. It is likely that another pandemic will occur and there is no reason to think otherwise”…
Will there ever be enough people online we can break into counties? (Wish every municipality had a Flu Wiki going by now)
(Welcome any new Massachusetts lookers…)
Dan in MA,
I did attend this event in Sprgfld: http://tinyurl.com/y2awc7 and will share with you a somewhat edited version of the letter I sent to a friend re my observations:
>>
First off, the strength of the presentation was in its emphasis on an all hazards approach to emergency preparedness at the family/personal/community level. A moderately detailed exploration in that regard. Kudos. There were also suggestions regarding the importance of planning for those with special needs and a brief exploration into those individuals qualifying as such.
Materials/hand-outs were available in english and spanish.
Participants received sample emergency kits.
There was a film re the all hazards approach to preparedness. Quite honestly, it was largely inaccessible and of little interest to the general audience. (I am fascinated with this entire field and anything related and yet I could barely maintain interest.) The film largely discussed what’s being done at a systemic level to co-ordinate emergency response/communications/connectivity. It contained little or no practical information applicable to a general public. This was unfortunate as there was much interest demonstrated among the participants in general.
The next portion of the presentation regarding the PEACE approch, an acronym for
People preparing Emergency Kit Arrange for care of others Contact numbers Exercise your family disaster plan
Which all sounded great. **** began speaking and the woman, *******, accompanying him promptly assumed the mike a short way into this. My overall impression was a lack of empathy among presenters for different challenges represented by the relatively depressed population of Springfield. There was little direct information re Pandemic specifically, which was what the audience had been lead to believe would be the case. (I attended a talk given by this presenting group before and was not impressed with the degree of knowledge re pandemic exhibited by them. There was mention of…”after the two or three weeks of disorder, essential services should come back on”, and appeared to be confusion between seasonal flu and pandemic.)
A certain degree of frustration and lack of trust among many audience members became increasingly palpable as the presentation progressed. One woman asked how it was that low-income people on food stamps and Medicare/caid could be expected to put-aside necessary prescription medications in efforts of preparedness. Everyone began to nod and stir in agreement anticipating the answer, tho the response to this question was so weak I can barely recall it. The woman mentioned how some folks might be tempted, out of fear of impending disaster, to pill-pinch, not taking their prescribed medications as scheduled, in hopes of creating a better just-in-case personal stockpile. (Horror of horrors! We need to be addressing this issue for sure!)
One head of a local organization for seniors spoke-up and said that this was his second forum of the sort in which he’d participated. He wanted to know what “the plan” actually IS. “Is there a plan? Where can I get a hold of it? I need REAL information here.”
The response to this was, if I may say so, entirely rude. He was dealt with almost as though he were acting disorderly at a public function or bar-room. His question/concern was neither validated nor answered in any sufficient sense. This man was told that they didn’t need to be wasting time on issues like this and that he could come outside right now to discuss it with him personally if he’d like. (Let’s take it outside, buddy.)
Things began to quickly degrade with the room buzzing and my own frustration growing due to my feeling this man’s question to be entirely valid and the lack of validation I was witnessing taking place among those whose responsibility I felt it was to validate it. Even if the response had to be, “I don’t know”, it was a valid question on the part of an individual that we should be concerned with informing.
But no one seemed to be able to either answer his question or validate it. It became obvious to me the audience was losing trust in those intending to inform. This became increasingly the case as *** began to discuss why it was we couldn’t provide him with any type of plan…because, as in the case of a terrorist attack, “there are bad people who would like to do bad things to us and we can’t let them know our plans beforehand as that makes us more vulnerable to attack.” <not a direct quote but pretty damned close>
Later in the day several people raised this same question this individual’d raised earlier, “Ever since he asked that question I’ve been thinking, what *is* the plan for our community?!”
Another individual inquired as to PVTA and public transportation in the event of an emergency. Would there be plans to evacuate people during a disaster? How would this be done? The answer to this was entirely unsatissfactory and uninformative, imvho. Also, he wanted to know how people would be able to continue to feed their children when schools closed and the free lunch programs they depend upon are no longer an option. (Key.)
The presentation continued, tho with varying degrees of full attention being afforded by the audience. I have worked with and taught classes throughout Springfield. There is a general underlying mistrust among the public regarding those seen in positions of authority (and perhaps with good reason). One can’t expect to speak to a population like this as though they are simple children and be openly received. I had the impression these folks were being spoken to as though they were not educated enough to understand real answers. It’s a common assumption that minorities, the economically-challenged, and opportunity-deprived, just because they may not be highly educated, lack the intelligence to understand information being presented to them, whatever the subject matter may be. So no matter how these folks seemed to be expressing their degree of survival intelligence, of which they expressed a great deal, they were in no way being acknowledged/validated for the fact. One woman began to speak of her experience during the 1918 pandemic and was very concerned with how a situation like that would be handled in this day and age. She was barely acknowledged in her comments.
And perhaps all presenters had entirely positive intentions. Certainly. I’m just not sure the style of presentation was appropriate for the audience.
The message, though substantial, was being presented in an overly complicated manner. Participants were looking for and satissfied with practical information that could be applied to their circumstance, as well as the circumstances of those they serve. The message needed to be presented in an accessible and clear-cut fashion, in absence of information irrelevant to their specific needs/interest, and yet empathically, relationally, while validating their concerns, and yet not in a condescending manner. People know when they are being spoken down to.
So these are the main points I’d like to emphasize in my observations of today’s presentation. And I realize it was their first. The organizer of this event looked immensely concerned at certain points, and overly-exhausted. I felt like I wanted to get him a big glass of water and an easy chair. He is just too sweet.
The table-top activity was interesting. Our group was small. When we returned to the larger table-top group however, I began to once again feel frustration seething beneath the surface of those in attendance. There was one woman, a participant, (I’ve seen her before but am not sure where,) who seemed to be taking the reins in a relatively unaggressive sort of way and was conveying some very useful information to those in the group. (Sanity at last!) People were genuinely giving her their attention. She looked a little strained though, given the group dynamics.
As a side note, kind of funny, when **** was mentioning how ******* typically gets to work at home alot (they kept getting off track with this irrelevant stuff), she laughed and said, “See! I had to take a shower today to come here!” and one little tough black lady yelled, “Well, it didn’t work!!!!” and everyone snickered until someone said, “Be nice!” and it was all quickly glossed-over tho I could tell ******* was a little hurt. That made me feel bad for her but…Springfield can be a tough crowd (but they’re also generally pretty fantastic). For people struggling with some very basic level survival stuff already on an ongoing basis, hearing some nice white girl gets to work in her pajamas at home everyday isn’t gonna go over all that well.
My friend who attended with me was visibly disturbed by some of what went on at the event and wrote a scathing critique on the evaluation form. I tried to keep comments constructive.
The main issues with this presentation imo seemed to be:
-much of the information presented not entirely pertinent to audience
-disconnect between educators/informants and audience
-issues of mistrust and specific concerns remaining unaddressed/invalidated
-information overly complex for demographic. audience seeking practical and concrete information/plans in absence of any remote trace of condescension.
-lack of answers to many questions raised (special needs, meds, long-term care, senior homes, homeless shelters, low income, substance abusers, childcare in the event schools are closed, etc)
-insufficient information provided (alot of info regarded some areas but not other key related areas)
-all hazards approach overly broad and general (as to make suggestions of duct tape and plastic for windows irrelevant if we’re going to fail to discuss how very small amounts of bleach can be used to safely purify drinking water, for instance.)
point being, if we’re going to begin to offer info-meetings to the general public, we’d better make sure we’ve got answers, or at least admit that we don’t have answers to the questions being asked, because it destroys some level of trust and receptivity when we don’t.
This was the first meeting I’ve attended which held the goal of informing the general public re potential pandemic and general emergency preparedness as its primary goal. I hope there’ll be alot more events like it though we seriously need to be taking into consideration special needs populations when we’re addressing “general” populations as…what…15% of the population presently falls into the special needs category!?!
I know everyone’s trying to do the best job they can with what they know. I don’t mean to insult the hard work of any of those involved with hosting/presenting an event like this. It requires a great deal of effort to throw something like this together. These folks are not coming from an academic environment where socio-economic class sensitivity is in emphasis. Everyone worked very hard today to fulfill what they’d intended to accomplish. I’m sure they’ll learn from the experience and hopefully we can learn alot from their….experience, as well. >>
The event was videotaped and I’m sure would be available through MPHA.
This is the first event of its kind, that I’m aware of, in this region, which has attempted to bring the message out into the general community, to the public who so very much needs to hear it. There is a very strong interest. I hope to be a part of facilitating/presenting at forums like this….only much much better… sometime in the relatively near future.
MDPH document on ISCUs:
1. What is an ISCU? An Influenza Specialty Care Unit (ISCU) is an alternate care site to provide additional capacity for hospital level care for flu patients. Every Massachusetts acute care hospital is required to plan for an ISCU for their cluster population. 2. What is a hospital cluster? Every community in Massachusetts is being assigned to an acute care hospital for purposes of pandemic planning. The communities, with their hospital, are referred to as a cluster. 3. Why do we need ISCUs? Based on our planning assumptions, we expect that 30% of the residents of MA will become ill with the flu. Of those, half are expected to need evaluation and some level of care delivered by the health care sector. We anticipate that 80,000 will need hospital level care over the course of the first wave of the pandemic (estimated to last 8 weeks or longer), and 11,569 patients will need hospital level care during the peak week of the epidemic curve. While hospitals will use a variety of strategies to accommodate the surge of flu patients, it is unlikely they will be able to provide care to all those that will need it. It will be important for hospitals to still be able to admit and care for those non-flu patients that will still require hospitalization. Therefore, we expect that hospitals will admit only those flu patients that require critical care – those needing mechanical ventilation or management of other acute co-morbidities. Unless hospitals identify additional capacity, and develop a plan to bring it online, the number of acute care inpatient beds will fall far short of the need, and many patients that need hospital level care will be unable to access it. 4. What kinds of places can serve as ISCUs? In order to provide safe care to sick patients with relatively few staff, ISCUs need to be able to accommodate a large number of patients in a single room. That allows adequate supervision by fewer staff. Hospitals have been provided a matrix to help identify the best sites in their ISCU community, schools, colleges, armories, hotels (meeting rooms/conference areas) and other buildings that meet the general guidelines can be used. Among the factors the hospitals need to consider are facility ingress and egress, ability to secure the site, the public’s familiarity and access to the site, existing infrastructure such as phone lines and internet access, and adequate restrooms and food storage/preparation areas. 5. What are Emergency Dispensing Sites? Emergency Dispensing Sites (EDS) are part of the CDC National Strategic Stockpile program. Under this program, every community in the United States has been asked to develop the capability to provide immunization or prophylaxis to their entire community within three days of a bioterrorist event. In order to fulfill this requirement, local health departments have evaluated potential EDS sites and have created staffing and other operational plans for these sites. As this program pre-dates the ISCU planning program, most communities have already identified their EDS sites. 1 6. What if the ISCU site has already been identified as an EDS site? While it is highly unlikely that an EDS will be needed during the peak of the pandemic, it is a possibility we must plan for. It is important to remember that while there are multiple communities per hospital’s ISCU cluster, and only one community will host the ISCU, there is at least one EDS site identified in each community. Therefore, if a site identified as an EDS serves as the ISCU, the population served by that EDS site can be re-directed to another site in that community, if available, or to an EDS in a neighboring community. The provision of hospital level care to sick patients requires that hospitals conduct a search for the best possible ISCU site. This process should be done in close collaboration with the local health department. In the end, the decision of whether to allow an EDS to also serve as an ISCU will be a local decision. 7. Why do we need to create these ISCU clusters? Once concern about a pandemic is perceived as a real threat, we can expect that residents will begin to seek evaluation and information. In order to protect the hospital emergency rooms and provider offices and clinics from becoming overwhelmed by people seeking flu care, we must have pre-identified sites that people can be directed to go to instead of their hospital or physician office. Identifying and planning for these sites in advance will allow local communities and local health departments to inform their residents about how to access care. In addition, the clusters provide the demographic and population data on which state planners generate impact projections. 8. How will people know which ISCU to go to? Once the clusters have been defined and the ISCU sites identified, the local communities and hospitals can begin to develop their public education campaigns to ensure clear and accurate public education materials to direct residents to the most appropriate site of care. 9. What kind of care will be provided in an ISCU? ISCUs will provide supportive flu care only. Due to financial and logistical constraints, staffing concerns, and supply chain issues, there will be no mechanical ventilation or oxygen supplied in ISCUs. The use of room air concentrators will provide low flow oxygen in addition to intravenous antibiotics and other supportive care as needed. Patients admitted to an ISCU that develop the need for more critical care will be transported to the ISCU’s acute care hospital. The provision of a specified level of care for a single diagnosis will permit the pre-stockpiling of equipment, supplies and pharmaceuticals, as well as training of volunteers. 10. How will patients arrive at the ISCU? Each ISCU will have a triage/evaluation area associated with it. Patients will arrive at the evaluation center where they will be screened and triaged. Most patients will be cared for at home. Some may receive short term treatment, such as a few hours of intravenous treatment. Patients arriving at the ISCU evaluation center that need critical care will be transported from the ISCU directly to the hospital as long as hospital capacity exists. Those that are too sick to go home and those for whom home care is not possible, but who are not sick enough to require an acute care hospital bed, will be admitted directly into the ISCU. In addition, ambulances will be permitted under a special waiver to transport a patient directly to an ISCU rather than the hospital. 11. Will all non-critical flu patients in the cluster be directed to the ISCU? While we are planning on only one ISCU per hospital cluster, we anticipate that there will be a need for additional clinical evaluation and flu information centers. Many residents who are only mildly ill, or are not ill themselves, may need a place to get support, information, advice, or behavioral health assistance in coping with the impact of the pandemic and the associated fear and anxiety. Therefore, the numbers of 2 persons seeking help is likely to be greater than the ISCU evaluation center can handle. Therefore, we will be working with communities to identify sites and staffing for additional triage/evaluation centers. However, all flu patients that require hospital level care will still be admitted to either the acute care hospital if critical, or the ISCU if non-critical. 12. Where will the staffing come from? Staffing is the greatest challenge we face in providing access to care for all patients, flu and non-flu, during the pandemic. While we anticipate that health care workers and non-clinical support volunteers will respond to the need, we know that they may also be facing illness themselves or have sick family members or other responsibilities that will lead to a reduced workforce at the time of the surge in flu patients. We are working now to increase the number and competencies of Medical Reserve Corps in communities throughout the Commonwealth. We have created a new program, MSAR, to pre-identify and pre-credential volunteer health professionals so they can become part of the response to any surge event, pandemic or other. Included in the outreach for that program, and for the Medical Reserve Corps, will be retirees, students, and inactive health care workers. Finally, we are working with all sectors to ensure that call down lists are kept up to date, and that all employees, clinical and non-clinical, know that their help will be needed, and that there will be a role for everyone to assist. 13. Where will the beds and the equipment come from? At this time, the state is requesting funding to resource 5,000 level 4 beds. Level 4 beds are extra beds and supplies that the hospital can use in overflow areas, such as hospital lobbies or cafeterias, or in an ISCU. These beds will be stored with all the supplies and equipment necessary to provide supportive flu care. The equipment, including oxygen concentrators, will be provided if the state receives the funding. 2,000 transport style ventilators are also included in the funding request, but will be used in acute care hospitals only, not in ISCUs. Level 4 beds and the associated supplies may be pre-positioned within hospitals at the hospitals request, and may be used for any surge event. 14. How many ISCU beds should hospitals plan for? MDPH hospital coordinators are working with the hospital disaster coordinators to identify the projected number of hospital level flu patients anticipated based on the hospital cluster population. The hospitals will then compare the projected impact with the ability of the hospitals to surge internally, including the use of overflow (Level 4) beds in areas such as meeting rooms and cafeterias. The total surge projection, minus the number the hospitals can accommodate, will provide the number of ISCU beds to plan for. 15. What are the hospitals’ responsibilities? Hospitals have been given four required steps in ISCU planning: site identification, collaborative planning with area health directors, a data update form, and a completed application for licensing. In addition to the planning aspects, the hospital is expected to provide and supervise the key roles of Director of Medical Operations and Administrator on Call. The hospital will also appoint a staffing coordinator who may or may not be from the hospital itself. For example, a health department from one of the cluster communities, or an MRC member, may be able to serve as the staffing coordinator. The staffing coordinator will work with the MRC points of contact, and other local entities to identify local staffing resources. If the local communities and health care entities are unable to recruit sufficient staff to activate the ISCU, MSAR volunteers may be requested from the state. 16. Who will pay the ISCU staff? Many personnel are expected to work as volunteers. Those personnel employed by the hospital assigned to work in the ISCU, as well as contractors providing services, such as linen and food service, should be paid by the hospital. MDPH is working with the payors to determine payment options for other ISCU staff. 3 17. How will hospitals be reimbursed for care delivered? Hospitals should be reimbursed for the care of the ISCU patients provided that they follow normal registration and billing procedures outlined in the hospital’s credit and collection policies. However, as some patients will be receiving care “out of network”, or in a different setting (ISCU), MDPH is currently working with the health plans in Massachusetts, as well as CMS, to structure the reimbursement for pandemic related care. Please note that there may be additional opportunities for reimbursement from public or private entities (e.g., from either a specific federal or state law authorizing the coverage for such costs or from other private entities like the American Red Cross). MDPH will notify hospitals of such additional reimbursement mechanisms should they become available. 18. What about pediatrics, people with pre-existing conditions, or other special populations? A special working group has been created to ensure that the needs of all special populations are integrated into the planning. 19. How will the Department of Public Health inform hospitals about regulatory changes to support an altered standard of care if one is needed? MDPH is working with CMS, the health plans, ethicists, lawyers, members of the public, and others to anticipate waivers of EMTALA and other changes in regulations that may be required under an extreme pandemic scenario. This information would be communicated directly to all hospitals through our multiple communications systems, as well as posted on our website. 20. Will hospital employees working in the ISCU be protected from malpractice liability? What about doctors who normally work in the hospital but are not technically employees? With respect to hospital employees, the hospital should consult with its insurance carrier to find out whether current policies cover employees in an ISCU, or if it is necessary to add a rider to protect employees who are working at a different site from the hospital itself. Health care providers who are not employees should similarly check with their insurance carriers to determine whether they need additional coverage. 21. Are Workers’ Compensation benefits available to hospital employees who work in the ISCU? Again, the hospital would need to check with its insurance carrier to determine coverage of benefits within the ISCU. Note that the employee would need to be working within an ISCU operating under the authority of the employer hospital’s license as approved by the state, the hospital employee must be acting as a hospital employee, and the injury must arise out of and in the course of employment in the hospital employer’s ISCU. 22. Will volunteers have any liability protection for work they perform in an ISCU? Although there is no clear protection under state law, volunteers will have some protection from negligence under the Federal Volunteer Protection Act (FVPA) if certain conditions are met. The hospital must be a non-profit organization, and the volunteer must be unpaid and must act within the scope of her responsibilities in the ISCU. Furthermore, the volunteer must be properly licensed, certified, or authorized to act. (The state may issue waivers of state law, for example to allow certain health professionals to act outside their scopes of practice.) As a practical matter, these requirements mean that 4 the hospital must have a mechanism to officially sign the volunteers in, verify their credentials and give them clear work assignments. 23. Will volunteers get any protection under the Good Samaritan laws? Possibly. The Good Samaritan laws protect various categories of health care workers (listed below) who in good faith and without receiving a fee “render emergency care or treatment other than in the ordinary course of practice.” Coverage under these laws depends on there being an emergency. Although the emergency does not have to be officially declared, it is not clear whether the concept of emergency, and thus coverage under these laws, extends beyond an immediate, urgent need (such as an auto accident). Categories protected from liability for negligence are: • Physicians, nurses, and physician assistants licensed in Massachusetts, another state, or Canada • Respiratory therapists licensed in Massachusetts • People trained in CPR, AEDs, or basic cardiac life support Two other Good Samaritan laws provide protection that does not require the care to be other then in the ordinary course of practice, or to be provided free. These laws protect the following from liability for negligence: • Physicians, dentists, and hospitals in Massachusetts for failure to obtain consent from a parent of a child, or the spouse of a patient, when delay will endanger the life, limb, or mental well-being of the patient • EMS personnel who “in the performance of their duties” render first aid, CPR, transportation or other emergency medical services 24. Are Workers’ Compensation benefits available to volunteers who are hurt or made ill through their work in the ISCU? No. At this time, there is no law mandating Workers’ Compensation coverage for volunteers by either the state or the hospital operating the ISCU. 25. Should the hospital require volunteers to sign a statement acknowledging that they are not being provided with liability protection or Worker’s Compensation coverage by the hospital? Yes, this is advisable. 26. May the Hospital be sued because of the actions of a volunteer? This would depend on whether the state or federal government enacts a special law authorizing liability protection for health care providers (hospitals, clinics, and other). Absent these protections, the hospital may be liable for the volunteer’s negligent misconduct that is related to actions directed and controlled by the hospital as part of the ICSU operations. In Massachusetts, the “charitable cap” on damages provides that monetary recovery against non-profit organizations may not exceed $20,000, if the activity giving rise to the harm was done to accomplish directly the charitable purposes of the organization (as opposed to commercial purposes). 27. If someone falls and gets hurt at an ISCU site, whose insurance will cover it? In situations where the hospital is contracting to use a building or space owned by another entity, it will depend on what is listed in the MOU or agreement with the site related to control of the site. Generally, the site itself will be liable for slips, falls, and injuries caused by the physical set up of the property, unless the site can show that the slip and fall arose from caring for the patient and the hospital staff was negligent in some standard of care that caused the accident. 5 Both the hospital and the site in which the ISCU is established should check with their insurance carriers to see whether the policy is written to cover events that are the fault of the hospital, but occur at a remote site that is under the control of the hospital. 28. If a volunteer gets sick and dies in an ISCU, can his estate recover damages from the hospital? An injury and potential legal remedies available to a volunteer in an ISCU should not be any different from such remedies that are available as the result of an injury that occurs in any other setting. Both Hospitals and the sites providing the ISCU should check with their insurance carriers to make sure that normal volunteer activities will be covered during the operation of an ISCU. 29. What does it mean that an ISCU may operate under an altered standard of care? An ISCU will not have all the equipment, resources, and appropriate clinical staff normally available in a hospital Emergency Department or other clinical setting. MDPH is working with a group composed of ethicists, attorneys, health care representatives, and others that is analyzing legal and other issues involving altered standards, and that will develop a process for implementing them. 30. Will health care workers in an ISCU be asked to work outside their scopes of practice or supervise individuals working outside their scope of practice? I If so, how will they be protected from liability, or discipline by their respective Board of Registration? Working outside one’s scope of practice is an aspect of altered standards of care, and may occur during the operation of the ISCU. As noted above, MDPH is developing a process and a set of guidelines that could be used by health care entities and practitioners to modify scopes of practice during such a crisis, should that become necessary. The process would most likely include legal orders issued by either the Governor or the Commissioner of Public Health that would waive certain restrictions and set forth what activities would be allowed. 31. How can I get more information? Please contact your regional hospital preparedness coordinator for more information, or to address specific issues related to your ISCU planning. You may also contact Lisa Stone, Hospital Preparedness Coordinator, at 617 624–5282 or Lisa.Stone@state.ma.us. October 2006
oops. a little squishy. : D
APHA Annual Meeting Nov 4–8, 2006 in Boston: http://www.apha.org/meetings/index.htm
some relevant sessions:
Status Day Start Time End Time Show Locations Session # Paper # Title Notes Monday 8:30 AM 10:00 AM 3020 KATRINA, RESPONDING TO A PUBLIC HEALTH EMERGENCY: THE EVENT AND THE AFTERMATH Note
Monday 10:30 AM 12:00 PM 3106 EMERGENCY RESPONSE TOOLS FOR COMMUNITY PLANNERS Note
Monday 12:30 PM 1:30 PM 3158 ENSURING FOOD SAFETY, EMERGENCY PREPAREDNESS AND DISEASE PREVENTION Note
Monday 2:30 PM 4:00 PM 3310 PLANNING FOR PANDEMIC INFLUENZA: LOCAL, STATE, TRIBAL AND FEDERAL PERSPECTIVES Note
Monday 4:30 PM 6:00 PM 3395 ASSESSING AND TRAINING THE WORKFORCE FOR EPIDEMICS, DISASTERS AND BIOTERRORISM Note
Tuesday 8:30 AM 10:00 AM 4039 EMERGENCY AND DISATER PREPAREDNESS I Note
Tuesday 12:30 PM 1:30 PM 4087 DEVELOPING PUBLIC HEALTH INFRASTRUCTURE TO ADDRESS ACTS OF BIOTERRORISM AND/OR PANDEMICS Note
Tuesday 12:30 PM 2:00 PM 4118 DISASTER PREPAREDNESS AND RESPONSE: A HEALTH PLANNING APPROACH Note
Tuesday 12:30 PM 2:00 PM 4129 QUARANTINE, ISOLATION AND OTHER HUMAN RIGHTS ISSUES IN DISEASE CONTROL AND PREVENTION Note
Tuesday 2:30 PM 4:00 PM 4227 PUBLIC HEALTH EMERGENCIES AND HUMAN RIGHTS Note
Tuesday 4:30 PM 6:00 PM 4300 EVALUATING PREPAREDNESS FOR EMERGENCY RESPONSES AND POST KATRINA LESSONS Note
Wednesday 8:30 AM 10:00 AM 5055 EMERGENCY AND DISASTER PREPAREDNESS II Note
Wednesday 2:30 PM 4:00 PM 5171 EMERGENCY PREPAREDNESS AT THE LOCAL OR STATE LEVEL Note
3310.0: Monday, November 6, 2006: 2:30 PM-4:00 PM Oral
Planning For Pandemic Influenza: Local, State, Tribal and Federal Perspectives
Continued outbreaks of avian influenza in an ever-growing number of countries raise the concern that an H5N1 influenza virus will evolve into a virus spreading efficiently from person to person and resulting in an influenza pandemic. Planning for such a pandemic poses many challenges at the federal, state, local and tribal levels, some of the key ones being the number of unknowns (epidemiology, availability of countermeasures, effectiveness of social distancing measures), the need to plan for response with local resources given the widespread nature of the event, the impact on the healthcare system, and possibly on other critical infrastructure, and the coordination of the large number of entities involved in planning and in response. Much of the response to pandemic influenza will unfold at the local level, so it is important that all communities engage in planning. The requirement for states to submit plans as part of CDC’s preparedness cooperative agreement in June 2005, the recent allocation of funds through that cooperative agreement, and the heightened level of attention to the potential for an influenza pandemic at the highest levels of government have resulted in substantial focus on planning for pandemic influenza at the state and local level. This session proposes to provide a federal, state, local and tribal perspective on selected current issues and activities. Learning Objectives: At the end of the session the participant will be able to: 1) Describe an approach to community engagement around prioritization of scarce resources, 2) Describe the role of local health departments in contrast to state health departments in pandemic response, 3) Describe the unique aspect of tribal planning 4) Describe current availability of vaccine and antiviral drugs Moderator(s): James A. Gaudino, MD, MS, MPH 2:30 PM Introductory Remarks
2:35 PM Planning for Pandemic Influenza: Federal Perspective Pascale Wortley, MD, MPH 2:50 PM Planning for Pandemic Influenza: State Perspective Susan M. Allan, MD, JD, MPH 3:10 PM Planning for Pandemic Influenza: Local Perspective Paul Etkind, DrPH, MPH 3:30 PM Planning for Pandemic Influenza: A Tribal Perspective Jim Roberts 3:50 PM Discussion
See individual abstracts for presenting author’s disclosure statement and author’s information. Organized by: Epidemiology Endorsed by: Academic Public Health Caucus; Community Health Planning and Policy Development; Maternal and Child Health CE Credits: CME, Health Education (CHES), Nursing
The Massachusetts Departments of Mental Health and Public Health and Boston University’s Center for Multicultural Mental Health would like to invite you and your volunteers to attend a “The Behavioral Health Response to Major Disasters”. This two-day basic training is designed to introduce participants to the principals of Psychological First Aid (PSA) and acute emergency emotional support response. At the end of the two day training participants will have the opportunity to join the roster of the state’s volunteer disaster counselors.
Please see the attached brochures for dates and locations of upcoming sessions.
Participants do not need to be clinically licensed or have a background in psychology or counseling to attend.
Tuition is free but registration IS required.
For more information about the program and registration, please see the attached fliers (note: the November training is listed on the first flier, the January and March training sessions on listed on the second).
Please feel free to distribute this information among your co workers and to contact me with any further questions or comments.
Yours,
Liam Seward
Emergency Management Coordinator-CO
Department of Mental Health-Central Office
25 Staniford Street
Boston, MA 02114
Office #: 617–626–8170 Fax #: 617–626–8077
email: liam.seward@dmh.state.ma.us
( participants better stock up their households for a pandemic year and get their communites doing likewise.)
Could my local health dept have kept the public and first responders more behind the times and unprepared? I doubt it, they seem to have been trying diligently on a state and local level to keep the public from panicking/preparing.
November 16, 2006 Natick, AISNE Fall Business Conference
…“Avian Flu Pandemic” Attorney Connie Burton of Ropes & Gray LLP will discuss the implications of a school closing as a result of the avian flu on an independent school’s contractual obligations to teachers and parents. Connie will also discuss the resources available to schools in developing a “to do” list should an Avian Flu Pandemic occur.
Please email questions to Carol Peterson at AISNE at carolataisne@charter.net so Connie can address your specific concerns “
for one thing, a to-do list should have been being acted on months ago… maybe they’d like to see the TLC slides…
bump
bump
btw, at 20:54, he may answer his own phone during business hours.
When Fort Devens was Ground Zero of Flu Pandemic
…”In early 1918, Fort Devens was one of the main centers of the U.S. war effort. On Sept. 1, its barracks were jammed with 45,000 soldiers waiting to be shipped to France. By the end of that month, Fort Devens was a charnel house filled with the dead and dying.
Bodies were being carted away like cordwood. More than 8,000 sick and dying men clogged its hospital, which had a capacity of 2,000. The extra bodies, living and dead, were stashed in halls, corridors and outlying buildings. Doctors were baffled. They had never seen anything like it.
Alarmed by the reports from Massachusetts, U.S. Surgeon General William Gorgas sent four prominent physicians to visit the base and tell him what was going on. They reported their horrified amazement at the sight of “hundreds of stalwart young men coming into the hospital in groups of 10 or more. Their faces soon wear a bluish cast; a distressing cough brings up blood-stained sputum. In the morning the dead bodies are stacked about the morgue like cordwood.”…
…”From Fort Devens the plague spread quickly to Worcester County. By the middle of September, newspapers were reporting its ravages. Leicester reported 125 cases. Eight died in Millbury on one day. Westboro and Holden closed their schools. The Leominster hospital had to turn away people who were dying.
On Sept. 15, Worcester Mayor Pehr Holmes ordered fires lighted in all public school furnaces, in an effort to stem the disease. It had little effect.
At the end of September, the Worcester Board of Health essentially shut the city down.
“All public, private and parochial schools, all theaters, motion picture houses, all places of amusement, all dance halls and public halls” were to close their doors until Oct. 7. That included the saloons. The churches were already closed after a ruling from the state. The board appealed for extra nurses at City Hospital, which was stretched to the limit and beyond. New graduate nurses were offered $4 a day, experienced nurses $60 a month, doctors $150 a month. At the behest of Mr. Holmes, City Hospital trustees voted to convert the Agricultural Society building in Greendale into an emergency hospital. It was ready within 10 days.
Public schoolteachers, their classrooms closed, volunteered as nurse assistants. They made beds, changed linens and helped out in various ways.
Mrs. Samuel Colton opened her Elm Street mansion to any emergency workers who needed a bed and a bath. Various organizations pitched in. The Catholic Women’s Club, the Blessed Sacrament Red Cross Auxiliary, the Zionist Organization of Worcester and several others did what they could during those grim days in October 1918.
A home on Harvard Street was hastily opened to offer help to children made orphans by the plague. The Worcester Telegram reported that “immeasurable good” was done in placing bereft tots in the homes of relatives and friends.
When the wave of deaths began to wane, Worcester quickly recovered. Perhaps 1,000 to 2,000 people died in Worcester County, but that was not nearly the toll experienced by other localities. “…
Tellingly-named, “Bird flu and you” forum (and, attempt to get Medical Reserve Corps volunteers who don’t know what an H5N1 pandemic currently entails)- announced on a website, but, not the health dept’s or the town’s, and, surprise - held long after many have already left town for the long holiday weekend.
Will take notes, and try and calmly get some current info out to the public if anyone besides the health dept. presenter shows up. (Hope the public will start looking up facts for themselves, and stop trusting local govt that has chosen to keep the public as ignorant as possible for as long as possible.)
Well, I don’t really know what to say; did take notes, (will look at them later -after the headache pills kick in, and, some sleep). There were more people than I expected (about 20) the speakers did seem to want to talk more about other small local emergencies they knew what they’d do about than stay on topic of pandemic. The presentation did start with very what What is influenza, avian flu, pandemic, but did go on a lot about vaccine distribution, the role of volunteers, that volunteers would have preference in getting meds and vaccine (until the audience checked that he didn’t mean within the first 72 hours from pandemic, but, what an audience member said Leavitt had pointed out; 6 to 8 months into pandemic they’d be doing the town vaccine distribution. The health dept head said he didn’t think it would take that long to have vaccine available I didn’t jump on that remark, but I’m sure if Leavitt had better news he had given it to us by now. Where are the vax plants in MA? Volunteers that needed childcare might bring their kids to the Emergency Distribution Site. People had asked how the distribution volunteers would keep from getting sick; ridiculous attempt at saying they’d have “protection like in hospitals”, and “they’d screen people” and know who was sick. (I wasn’t the only one asking questions. Retired people, and, people with schoolkids asked questions.)
Health dept should be ashamed than anyone in town doesn’t know we’re in a pandemic alert period and should be stocked up and ready at home at any time; 13 months after the federal website went up. The public doesn’t know they are expected to know if their neighbors need help and to go “care for them if they’re ill or cook for them” or “tell us so we can get them help”. Townsfolk aren’t ready to care for themselves, and making it sound like the SNS was just brimful of whatever we’d need for the duration was incredible. (I didn’t get a chance to ask how many days supplies are in the SNS; it is for limited events.) (One person said afterwards, if that had been they first they’d heard of it they’d think pandemic could be serious but wasn’t soon, and, didn’t hear anything from the presenter about anybody dying.)Did mention school closure, (but school families haven’t been told to stock up, and says the state has to give permission to close schools).
Only mentioned birds; omitted H5N1 in mammals (did he even ever talk about “H5N1”? said bird flu or said “pandemic”); slide was incorrect about only human-to-human (hasn’t it gone h-h-h?), sign up to volunteer; that volunteers now had to fill out CORI forms first, oh yeah; bad impression of how slowly’ pandemic would “ramp up; over in Asia, then over in Europe, just like bird flu so far”. Implying warning after pandmeic starts and, that then they’d tell the public what else to do, (and implying they’d have time to do it). Say they’re already doing things like telling the public and working with stakeholders, though the audience may have noticed otherwise. Some people afterwards stayed and talked; one asked if we knew any doctors or nurses who mentioned pandemic, because the ones she knew were not going to go near a hospital come pandemic. Did get some numbers out to the audience by asking questions, did give some cards out afterwards. Could have done better, but… (The post-event headache isn’t as bad as it could be, either.)
Hi anon, Did you attend an MRC recruiting event? (Held by regional MRC coordinator — a position funded by MDPH region) or did you go to an Avian Flu informational forum, with some MRC recruiting thrown in? Sounds like a regional MRC effort, it it wasn’t hosted by an actual town. Any talk of MSARS recruiting (medical professionals) by area hospitals, or ISCU organization (Influenza Specialty Care Unit)?
It was hosted by the town’s health dept official (who stated to me a year ago, telling the public to look at the pandemicflu.gov would have “bad outcomes” There was also no public/local elected official awareness of the Feb. state flu summit. And, I am afraid this person does hold a regional position of responsibility of some sort.) -not held in the town hall so it was never listed on the town calender, never posted on the calendar in the town libary lobby for town hall events that need that library space. About the only thing the public would notice on the health dept website has been the suggestion to volunteer as citizens or as medical professionals “in case of emergency”. (this page would not win prizes for risk communication). This meeting only mentioned EDS, (but I know ISCU sites have already had to have been chosen). (Planning to use school buildings and having not warned school families we are in a pandemic alert period is unacceptable and the outrage if people lose their children, and, the loss of govt trust may be unrepairable.) The retired people who were at least half of the audience, made comments that they did not want to give up personal information into a database to volunteer, and also had concerns about how the volunteers were going to be kept from catching pandemic. The mother with schoolage kids also had concerns, (and I think the breezy suggestion that childcare could be onsite at the EDS was a “no sell”) -I would have liked to hear the details about “sheltering families” of first responders, but it was more that a certain message was supposed to get out, not that we were supposed to question everything said. Misleading to go on about chains of command, and vaccine distribution and wanting to give priority to volunteers, ect (they had it figured out down to how many people would have to pass through the EDS per minute - guess that was calculated on pre-pandemic population, not what’s going to be left after 6 to 8 months on an uneducated, unprepped populace.) Don’t have the exact numbers around, (and still have the headache -ow) but town proabably has at least 40% households with children, and we still have elderly population, who may be getting priced out. It was a “what you need to know” about “bird flu” and consider volunteering for MRC as it ran in the couple of places it was announced. (I know at least one doctor who when they got mailed the invite to sign up ages ago, spouse said, if the “emergency” is pandemic, don’t go. I said we’ll need hcw after a pandemic too; we can’t lose you all.) Oh and they missed a teachable moment when people asked about bird H5N1 and birdfeeders; he hadn’t told about mammals, so couldn’t give advice now from the FAO about dogs and cats, carniverous mammals; that needs to be public, so panic actions aren’t taken if the LPAI mutates to HPAI; even if the public doesn’t want to keep cats indoors, ect, they need the facts so they’ve been warned. Didn’t even suggest contact precautions at feeders; since he falsely stated no bird flu has been found in the US yet; he wants to wait until it is and then tell people what to do -for too many issues.
If Massachusetts really want to say they did everything possible, the new govenor (or the outgoing Mormon gov, just say it; federal and state put preparedness down to local level. Get Cote to do a “pandemic influenza year” PSA; something!) better start coming clean with the public before they get blindsided.
anon for this one – at 22:32: bad impression of how slowly’ pandemic would “ramp up; over in Asia, then over in Europe, just like bird flu so far”…
I think we can work with this objection, which we see frequently (the biotech man in Goju’s WTNH TV piece last night said basically the same thing - plenty of time to get ready once it goes pandemic).
We need some slides that show just how rapidly H5N1 has spread in birds. Now, I’m one who really would like to see the entire bird flu / pandemic flu separated in people’s minds, but let’s work with what we have. We need slides that say “this is how fast, fast, fast, the H5N1 that is easily transmissible in birds has raced through the world’s bird population.” (And that is in spite of and WITH the use of avian vaccines). We need to explain that that is an “epizoic” and that that kind of rapid spread and the now stubborn endemic nature of H5N1 in many areas is what happens when a flu virus is easily transmissible among birds.
Then, we need to show slides of the 1918 pandemic, and explain that this is what happens when a flu virus becomes easily transmissible in people. That, we need to stress, is exactly what we mean by a “pandemic.”
An epizoic, then, is transmission of a flu virus between birds that is fast, fast, fast.
A pandmeic, then, is transmission of a flu virus between people that is fast, fast, fast.
We need to emphasize that speed is one of the outstanding features of both epizoics and pandemics. Showing the speed of the spread we’ve seen in birds, and the speed we saw in the 1918 human pandemic might help bring that point home.
If you were an official that wanted the public to understand - (and, you also would have held the slide show at a special town meeting after the state summit, and, brought in all local stakeholders as their fed checklists came out…)
I know the simulations (weren’t they military? I hadn’t brought the ref.) showed airline hubs spreading it, and I did have plenty of other govt. assumptions that said, assume impacts simultaneously, little or no warning, ect. I did mention the recent IOM conf, that influenza cases double every 2 to 3 days so there would be little time to act to close schools, and getting ready has to be proactive, not reactive. I will try and get the information in front of the public other ways, now.
Massachusetts Department of Public Health Division of Epidemiology and Immunization
Influenza Advisory #8 November 8, 2006
Update on Influenza Vaccine Supply in Massachusetts The Massachusetts Department of Public Health (MDPH) has just received an additional 318,000 doses of influenza vaccine, the bulk of MDPH’s remaining order. This will allow MDPH to distribute the majority of the outstanding state-supplied vaccine allocations to most providers. Providers of state-supplied flu vaccine will be contacted by their local vaccine distributor in the next several days regarding the distribution of these additional doses. To date, MDPH has received 624,260 doses of vaccine or 92% of the total order. According to the Center for Disease Control and Prevention (CDC), close to 1.1 million doses of influenza vaccine had been distributed in Massachusetts as of October 27. This includes both privately purchased and state purchased vaccine. Inclusive of the latest shipment just received by MDPH, at least 1.4 million doses of influenza vaccine have now arrived in Massachusetts as of November 8.
Influenza Vaccine Available for Purchase Live, attenuated influenza vaccine (LAIV) available for purchase: LAIV (FluMist), licensed for non-pregnant healthy people 5 – 49 years of age, is available for purchase. FluMist is a good alternative for health care workers and other contacts of people at risk for complications from influenza, including families and caregivers of infants younger than 6 months of age who are too young to be vaccinated themselves. Flumist is also appropriate for non-pregnant healthy people who are seeking preservative-free influenza vaccine. To purchase FluMist, call MedImmune at 877-FluMist (877–358–6478). Inactivated influenza vaccine available for purchase: Limited supplies of inactivated influenza vaccine remain available for purchase from several vaccine distributors and manufacturers. A list of influenza vaccine distributors is maintained by the Health Industry Distributors Association (HIDA) and is available at http://www.hida.org/document.asp?document_id=10082.
Questions Regarding Safety of Thimerosal-Containing Influenza Vaccine MDPH has received a number of questions regarding the safety of thimerosal-containing influenza vaccine, especially for children and pregnant women. The following is extracted from a CDC website Questions & Answers: Thimerosal-Containing Influenza Vaccine. For additional information, visit the website at http://www.cdc.gov/flu/about/qa/thimerosal.htm. Children: No scientifically conclusive evidence exists of harm caused by the small amount of thimerosal in vaccines, except for minor effects like swelling and redness at the injection site. On the other hand, recent research suggests that healthy children <2 years of age are more likely than older children and as likely as people >65 years of age to be hospitalized with flu complications. Therefore, children, including those that are 6–23 months of age, should be vaccinated with influenza vaccine with or without thimerosal depending on availability. Pregnant women: A study of influenza vaccination examining over 2,000 pregnant women demonstrated no adverse fetal effects associated with influenza vaccine. Case reports and limited studies indicate that pregnancy can increase the risk for serious medical complications of influenza. Because pregnant women are at increased risk for influenza-related complications and because a substantial safety margin has been incorporated into the health guidance values for organic mercury exposure, the benefits of influenza vaccine with reduced or standard thimerosal content outweighs the theoretical risk, if any, of thimerosal.
Influenza Disease Activity From October 22 through October 28, 2006, a low level of influenza activity was reported in the U.S. The proportion of patient visits to sentinel providers for influenza-like illness (ILI) and the proportion of deaths attributed to pneumonia and influenza were below baseline levels. Two states reported local influenza activity; 10 states reported sporadic activity; and 36 states reported no activity (two states did not report). For the 2006–2007 influenza season through October 28, WHO and NREVSS laboratories have tested 5,715 specimens for influenza, 49 of which were positive (70% type A, 30% type B). As of October 28, one culture specimen has tested positive at the State Laboratory Institute for influenza type B and MDPH has received reports of 10 positive rapid influenza tests. Influenza-like illness (ILI) reported by sentinel surveillance sites in Massachusetts remains below baseline and no clusters of ILI have been reported thus far this season. For more information on influenza surveillance, visit the MDPH Flu Website at www.mass.gov/dph/flu and click on Seasonal Influenza, Information for Providers, Influenza Surveillance.
i hope this conference is better than the Springfield version was. i was not at all impressed the presenters at that event (10/26).
From: Gustavo Acosta To: Holyoke Planners Network ; Holyoke Youth Task Force ; HCC Community Cc: AJ Juarez Sent: Thursday, November 09, 2006 10:40 AM Subject: [all] Invitation
The Massachusetts Public Health Association Invites You to Connecting the dots for vulnerable populations.
SURVIVING THE FLU PANDEMIC
December 7, 2006
10:00 A.M. to 3:00 PM
US Fish And Wild Life
300 Westgate Center Drive
Hadley, MA
Threats of natural disaster, pandemic flu, and acts of terrorism are sad realities of our world. Everyone is at risk, but there are populations, including immigrants, the elderly, children, and the disabled, that face greater challenges if disaster strikes.
Join MPHA, in a discussion of pandemic flu and all hazards emergency preparedness and do your part to identify the best way we can help each other in case of a community wide disaster.
Note: This event is scheduled at a federal facility. Please RSVP and bring a picture ID.
Lunch will be provided
RSVP Required to AJ Juarez, @ 413, 750–2060 or at
ajjuarez@verizon.net
RSVP and bring photo id? Ooh that will affect turnout…
So, about those hospital surge plans…
“Few doctors at Boston’s teaching hospitals accepting new patients November 12, 2006
BOSTON —A majority of primary care physicians at Boston’s top-tier teaching hospitals no longer accept new patients, putting them in the uncomfortable position of turning away people and leaving members of the public frustrated.
Massachusetts General Hospital’s physician referral line says all, or almost all, of the hospital’s 178 primary care physicians are not accepting new patients. The 42 internists at Boston Medical Center have had full patients lists for four months, and 108 of Brigham and Women’s Hospital’s 120 primary care doctors have closed their practices to new patients.
“There is a huge crisis in primary care right now,” said Dr. Sherry Haydock, the medical director of Internal Medicine Associates, a primary care practice at Massachusetts General.
Doctors cite a variety of reasons for the lack of access, including a national primary care physician shortage, the number of internists — especially women — cutting hours for more personal time, the aging population and the growing complexity of medicine that increases the time and services required for each patient.
Doctors have warned of a shortage of primary care physicians since early in the decade, when the number of medical students deciding to practice general internal medicine began declining. Twenty percent chose general internal medicine last year, down from 55 percent in 1998, according to Dr. Thomas Bodenheimer of the University of California at San Francisco…”
(Planning to draft/lockdown/lose people during pandemic is going to cut quite a swath, too…)
Doesn’t hospital surge have more to do with ER and bed capacity? (Yes, I can see without a primary you might be more likely to make an inappropriate visit to the ER…)
crfullmoon:
We need to start moving onto a parallel path in these NE towns. The towns do not have antivirals, vaccines, even masks. At this point, it is really necessary to question what they can add to the fight, what positive contribution they can make. If we think about it, I don’t think that there is much that they can offer. They had a chance to give their citizens a heads up early. Instead, they have backtracked and become even more cautious and conservative in their offerings to their constituents on the subject of emergency preparedness. Pandemic flu, as a separate topic worthy of attention, has been entirely abandoned. DHHS did not figure on this when it embarked on those state pandemic summits.
We are going to have to create citizens’ pandemic planning bodies. You know it, I know it, Goju knows it. We have, I figure, till Jan. when the PSA’s start running to get our ducks in a row. I have some ideas. Let’s all work together and not recreate the wheel. I think we can create stuff that can be easily replicable for various communities, in our stubborn NE area and when shared here at FW, stuff that may be able to be used more widely too. pixietheflutracker at yahoo dot com
Will tptb publically squash attempts for citizens’ pandemic planning bodies?
They love to tell people “nothing to worry about; we’ve been having plans -and why don’t you volunteer to distribute vaccine?” And the public loves to hear things are ok… it’s a real slow start to get them informed, and I tend to overload people, (because we should have started 13 months ago), some of whom don’t like to read, or have no grasp of the topic, or, just default to denial. Some don’t want to take that step; believing that with all the official hype about other “urgent threats”, the Titanic passengers aren’t being told about that biiig iceberg’s been headin’ our way…
(Guess I’m pretty crispy around the edges.) (I also need to make some sort of new email account I feel ok giving out…)
What can we do; get federal/and fluwiki (and HHS pandemic assumptions) info to all the organizations in town, all the PTOs, all the unions?
ask the town volunteer committee to call for a real PPCC? (that would cause a clash with the health dept;, I imagine vol.committee might not, for that reason). Ask the state to run interference, since stuff didn’t get passed down - or was it some sort of nod and wink arrangement to not pass it down?? State could be getting messages out and it’s not. If they’re wrong that they have time to deal tiny, managed, messages to the public, we all lose. I’d love to inform my fellow citizens; they just are only tuned to msm and govt/life as normal; too easy to discount me as messenger and not go check the message…(and possibly “get” scary news and have to go through a psychological adjustment, and, go prep).
Might as well try to get real pandemic planning going soon, as you say, Pixie. I am going to need a relocation, anyway. (And, am afraid time is running out for one of those.)
crfullmoon - at 10:41:
The only thing left to do, like the Nike commercial says, is “just do it.”
Authority is one thing that the towns could have lent to the fight. They did not. I believe the time is right for citizens’ action now (whereas it would not have been in June) because shortly we will be backed up by the Feds, and by PSA’s to the public. That’s why I think we need to get this geared up for Jan., since that is when the federal action will begin. Their overall message will confirm what we have to say. That is important.
The fed’s information, however, may be confusing and contradictory. That new pandemic plan update should give us some indication as to how confused and contradictory their communications may be. There will be a need for clear communication.
Any final “authority” to speak and organize will be given, sad to say, by the virus.
We need a few things that are easily replicable:
Will TPTB try to squash news of a locally oriented pandemic website? Maybe. Maybe they’ll tear down the flyers announcing the new site’s URL from the delis, the libraries, the train stations. Maybe they’ll object vocally to citizen-led meetings. Maybe. Maybe they’ll just be happy to wash their hands of the entire subject. I am begnining to think that the latter is very possible. And the more I think about it, the more I realize that they really do not, now that it is this late, have much they can bring to the game anyway.
The authority will be leant by the feds, who, if they are smart, will overtly encourage local citizen organizing and planning. Any remaining authority will come from the virus, which I think will have make any local efforts to inform welcome by “early 2007,” as our recent pandemic plan update said.
As for the public health officers, if any of them show up at a meeting saying that “there is nothing to worry about,” we can just hand them a copy of that brutal testimony which one of their fellow public health professionals gave in 1918, the piece from New Haven that GraceRN came up with. (Talk about someone reaching through the centuries and grabbing you by the collar).
crfullmoon and pixie,
I have a website, brochures etc. email me at pelhamresiliance@yahoo.com and I can send you them of you like for reference or use.
“model town website (to be replicated, with Woodson’s home nursing info, etc”
Use some of what is on the Flu Wiki already? (And, what about some sort of model poster presentation, for libraries to have? We sure have a reading list, too.) And, some of the pandemic assumptions from NACCHO, and doctrine from HHS In advance of an influenza pandemic, HHS will encourage all Americans to be active partners in preparing their states, local communities, workplaces, and homes for pandemic influenza and will emphasize that a pandemic will require Americans to make difficult choices. An informed and responsive public is essential to minimizing the health effects of a pandemic and the resulting consequences to society ?
“local citizen pandemic planning committees (authorized and urged by our U.S. Pandemic Plan itself” Establish a Pandemic Preparedness Coordinating Committee that represents all relevant stakeholders in the jurisdiction (including governmental, public health, healthcare, emergency response, agriculture, education, business, communication, community based, and faith-based sectors, as well as private citizens) and that is accountable for articulating strategic priorities and overseeing the development and execution of the jurisdiction’s operational pandemic plan http://pandemicflu.gov/plan/states/statelocalchecklist.html
What about some hard copy stuff (the home nursing info, and -?) for people who don’t have internet access, (or later, electricity?) and, we need it in a bunch of languages…
If it was just a matter of giving people a head’s-up, the town would have reached some sort of snowball effect by now… (I’d sure like some real live people around here willing to brainstorm.)
Do we have enough readers here, or lurkers, to have separate threads, well, for counties, or, for the numbered and lettered regions the state has made for planning? (Doesn’t seem like it)
Same “anon for this one” – as at 22:32
If you could imagine anything worse than that forum; you’d have to say it was the “article” written about it in the paper. I have no idea; it is a toss-up between stupidity and cover-up, but I’d hazard a guess the “reporter” didn’t even attend the meeting. Clueless reassurrances; verging on criminal negligance…
I don’t have much hope that when the new federal “managed messages” ever come out they will be telling the public what they need to hear to prepare anyway. For all I know, they will take so long, pandemic will break out first. This is so infuriating.
Birdie Kate -
I have been trying to email you at the address you gave above, but it’s not working.
crfullmoon -
Do you have any stories to share of your local public health officials being less than interested, less than helpful, or perhaps obstructionist, with regard to pan flu planning and preparedness? I am putting something together for the feds who are not aware of our problems in this regard (and they do want to help). If you have any stories, can you write them here or at the new forum, or email me at pixietheflutracker@yahoo.com ? Thanks crfullmoon!
Washington really thinks that at the local level we could not possibly be receiving resistance from official parties because they believe that their own message has been quite clear. I am trying to illustrate that the message has not been translated into action at the local level, and in many cases is met at the local level by us who are attempting to move the process forward with official resistance. Any stories you may have would be great.
“Washington really thinks that at the local level we could not possibly be receiving resistance from official parties because they believe that their own message has been quite clear.”
That loud clunk was my jaw dropping… I’ll find it, among the dust bunnies, and get back to trying to phone people - you have any interested parties you could point me towards? Not the ones who say, “ This dept can’t tell the health dept. how to do their job”, Well, we already did our bit; you have to put pressure on your local guys, (which does nothing, because I don’t cut their paychecks. (And guess who the public chooses to believe; their own government, who isn’t putting the word out these nine months since the MA summit? or me? (Guess who has the nicer message they wish was true.)
Looks like there are some stories in this thread already, yours, and at 22:32. Washington doesn’t look at local town websites, nor newspaper articles online??
They’d see not enough is filtering down, or how skewed and “nothing to see here; we have vax distribution plans” the headlines and stories are, if any mentioned at all.
Public was not told how long officials assumptions say pandemic lasts, nor Dr.Osterholm’s points about JIT failures and collateral damage.
‘’‘Most places don’t even have a PPCC; that is easily checked; they have an “emergency” committee with an “all-hazards” approach -no special weight possible to pandemic, and, no non-municipal committee members,(only emergency, health, school, fire dept representatives, ect) no faith or community or vulnerable population groups, no funeral home directors, and, no reports to the public. (And those committee members, who are in positions of public trust, and whose salaries come from our taxes, won’t step out of the party line and tell the public what they know; must “prevent panic” Baa!)
The local officials won’t swerve from “We can’t tell the public; they can’t handle the truth” (or, We don’t want to hear their adjustment reactions?) -they don’t care what I think. They pretend they took the CDC “for illustrative purposes only/not what H5N1 may do” spreadsheet numbers literally for planning purposes. This is easily checked in what the public sees ; the purported numbers of sick, beds needed, low death rates, only mentioning a short length of a wave as if that is the total pandemic, saying health depts have signed mutual aid agreements like fire depts have, as if that would have anything to do with making the populace in better shape for a pandemic influenza year, nothing beyond wash your hands to prevent “flu” to school parents; they do not know about the US dept of Ed. pandemic webcast; tell schools their federal funding is cut off if they don’t get this webcast out to parents now.
Or, can the federal govt make the tv channels braodcast the DOEd pandemic preparedness webcast? And the state pandemic summits? Important public service; national security issue, tax write off, whatever…break into their schedules; before it is too late to prep.
Trying to sign up volunteers, who have no idea pandemic is any more likely than any other sort of hazard, nor that it is currently probably fatal under overwhelmed, surge, conditions, not mentioning the current ages most affected, saying volunteers should get priority for meds and vaxes I know we don’t currently have… Volunteers that would get surprise duty tending patients triaged out to die. We don’t even have workable mass fatality management plans. For shame.
Just saw something on tv claiming the average money spent on the upcoming holidays will be $790. per person, plus $100. on themselves. How much money do movies make when they open? How much is spent on lottery tickets, alcohol, cigarettes (corporate advertising, political elections?) each month? Sure, Americans can’t afford more than two weeks of food in their homes to save their own and their children’s lives sure, that’s why they’re not being told 12 weeks prep would be a start, and influenza pandemic will impact us for over a year…
Government credibility is gone in my book; the lack of balance of powers, growing list of impeachable offenses, ect, hasn’t helped either. Many federal and state politicians are remaining silent of lack of pandemic preparedness, and it is not true “there’s nothing they could do anyway so don’t tell them”. Where’s the ethical leadership? Treat the public like adults and tell them; maybe they’ll surprise you and rise to the occaision, if you show some leadership. What is the economic recovery going to look like post-pandemic if you don’t, and it goes pandemic next month with the current fatality rate, and the attack rate seen in North America when Europeans first brought their animals and diseases to an unexposed populace? Even if it just goes pandemic next month and people don’t have two weeks food in their homes because it sounds like after two weeks it would be back to normal, or, they’d get enough help?
If the govt thinks people are expendable; let it blow through an unwarned, unprepared nation first, they may find key people skills die too, and for want of a horseshoe nail their kingdom may be lost. Trust in government will be gone, seems sure.
Thanks crfullmoon - excellent points all. I don’t think govt thinks people are expendable. I think they have no idea what to do. (Add your own colorful pejoratives to that last sentence to make it more accurate).
There seem to be two settings: One - go with the 2% scenario and manage the population through it. Two - high CFR and it just blows through like Katrina, and you pick up the pieces later. They are having a really hard time finding a middle ground here.
Crfullmoon, at this point I have the attention of one of the higher ups. The question has gone through my mind what to ask for now that I have his attention. Because of the late date, and all the problems you list, I am basically at this point pretty convinced that all we can ask of anybody with authority is that they tell the lower level guys to NOT be obstacles. To get the heck out of the way of any of us who ARE trying to do anything. That, at least, would be an improvement. I find it completely unacceptable that the people who are supposed to be tasked with the health and safety of our local citizens are the naysayers, the ones who are the most obstructionist, to those of us actually trying to move pandemic planning and preparation ahead locally. So, being that all you have said is true, my request basically is that they help us by getting these guys out of our way.
In terms of offering authority, your point that the local citizens would rather hear the message from those “in authority” is a good one. I think, in fact, that “authority” is ALL the local public health guys have left. They’ve got no other tools in their toolkit, so we need them for nothing else. I think they know they’ve got nothing else too. We should be helped with the “authority” issue when the fed PSA’s start running (assuming they are not watered down drivel). At that point, if any publich health official (who’s by then been given a year’s notice as you point out) has NOT created a PPC, then I think we will really have the authority to point that out, and the message will hopefully be reinforced by the PSA’s and the other fed education programs that will hopefully have started to roll out. I have no problem at this time gathering up all the stakeholders that you mention and taking a strong stance about the local leaders who have not done their jobs. Think of it as kind of an alternate political party almost, grassroots, with an issue. A year on, I don’t have a lot of sympathy left for them.
Thanks for your list of things I definitely would have forgotten, like the Dept. of Ed. broadcast and yes, I think they should be broadcasting the state pandemic summits too (and it frustrated me to no end that they did not do so at the time they were held). But you are right, and there is no time like the present. I wonder if we could at least get copies of the summits to help with PPC organization? It might be very educational for stakeholders to see and hear what should have been going on, vs. what has gone on. I’ll make the specific request that those tapes be made available. crfullmoon - great ideas all.
I expect watered-down drivel to continue to dribble in; that’s what we’ve been seeing so far. Nature doesn’t respect their drip-by-drip info release timetable.
There is a lot of information that could have been handed out frankly; how about “Better late than never”?
(Don’t want the first 9 of the WHO’s “things you need to know about pandemic influenza” on urban billboards? Webster’s or Nabarro’s quotes about, pandemic with current fatality rate possible? MadTv’s got “Sesame Street Bird Flu” running on “the internets”: Ok, do the federal checklists look so bad now?? Where’s are the PSA’s; people and churches and organizations, and school families and business employees, mortuary workers, ect, weren’t told these checklists exist. Change the prep ammmounts to include at least 12 weeks or more)
I don’t think the local health honcho here -nor the nursing honcho - ect- (we need hellllp!) is/are going to publically eat crow; can someone step in and “help” get the word out, or help get municipalities to form the PPCCs? (Is the only thing local authorities understand a threat to yank state funding or something??)
Sure wish I could know you were sitting down with the incoming govenor… somebody FluWiki-ish sure should be! (Please tell me I don’t know more than his “experts” that are “advising” him, Pixie - but- don’t lie to me…) and I wish he’d speak up before pandemic breaks out…. What’s wrong with being reliliant and informed and more self-reliant? Americans used to take more pride in that sort of thing, didn’t they? Or, they just had to be that way because life was not this easy…
No, I’m not sitting down with your incoming governor but I’m pretty sure that you know more than he does. Sorry. After seeing my state’s new pandemic website, I don’t even want to talk about my governor.
(you need a fluwikian email crull..)
(Well, maybe he knows what a crull is… I don’t.)
(I added the bolding.And comments.Sigh.)Milford daily news, Nov 10 …”scenario was devised by the Harvard School of Public Health for a series of tabletop exercises the DPH is holding to prepare local officials for an influenza pandemic that would cause illness and death throughout the world.
The latest exercise was held yesterday at Framingham State College and involved FSC officials, health departments, firefighters, police and hospitals from area towns including Norwood, Westwood, Wellesley, Watertown, Needham, Hull, Newton and Cohasset. The DPH will host another session at the college on Dec. 11.
The goals yesterday were to form connections with officials in other towns; think about orders of succession for when key executives are sick; discuss what non-essential services can be suspended during a pandemic; talk about when to cancel all public gatherings; plan to lead public health efforts with a work force reduced in size by illness; and prepare for communicating with the public in a way that provides useful information without causing panic.” [They forgot to tell the public what we would think useful now, pre-pandemic; stock up and get educated.]
“Naturally, the talk turned morbid at times.
“At some point, we have to start paying attention to the body pile,” said John Ciccotelli, public health director in Canton. Funeral homes will fill up quickly during a pandemic, he said.” [At some point; about day 3. And then what?? We need to talk.]
Officials at some funeral homes may refuse to accept bodies because they will be afraid of being infected, said Lynn Schoeff, who facilitated yesterday’s exercise and oversees emergency preparedness at Cambridge Health Alliance and the Cambridge Public Health Department.
While state officials stressed the importance of towns working together, one local fire official thinks mutual aid programs that normally run smoothly would fall apart during a pandemic because each town will have to deal with its own problems.
“Nobody is going to be offering mutual aid in a situation like this,” said William Morrison, a Norwood firefighter who coordinates the department’s emergency medical services.
The Harvard scenario predicts absenteeism rates of 30 percent throughout most of the state’s work force, causing a host of problems. Hospitals will have trouble feeding patients, pharmacies may not be able to fill prescriptions, and grocery stores could have empty shelves. To limit the spread of pandemic influenza, cities and towns will be closing schools and canceling public gatherings.
Believe it or not, this scenario may be optimistic. The Department of Public Health’s pandemic planning documents predict as many as 1.6 million doctor visits in the state over a period of months, and between 3,600 and 10,000 deaths.
The possibility of an influenza pandemic has captured the attention of public health officials and news media worldwide because of a strain of bird flu that has the potential to become easily transmissible among humans.
Some officials in attendance yesterday worried the public may grow weary of pandemic warnings and conclude there is no real threat.”… [I would say you haven’t given the public any H5N1 demographic/cfr, Pandemic Influenza Year warnings yet, hello?!]
That’s actually a pretty good story / turn of events crFullmoon! It sounds like the officials quoted are having their own “adjustment reactions” at the moment.
At least they are talking about body counts and the consequent problems. That is an area that they MUST deal with and specialize in as it is not an area private citizens can walk into and take up themselves. I think it is interesting that the article said “naturally, the talk turned morbid at times.” I think it does not turn morbid enough - in fact it does so rarely.
But as that fire official said (can we elect him to something??) the usual aid and cooperation will be otherwise out the window during a pandemic. As you have pointed out, crfullmoon, the public is far from growing weary of this message as they haven’t given it yet. Good excuse, though, dontcha think? And they can never decide if the message will give either:
or
So that gives them the excuse to do nothing?
I’m giving in to the “they will panic” option. I’m just going to ask my audiences whether they think people will panic. I’m sure hands will go up. Ok, fine. So I’m making a slide that will ask: would you rather have your citizens panic now or later? If that’s what they firmly think the outcome of communicating with the public will be, then they should be forced to pick between now and later as those are the only choices left to them in their scenario. (Or, is the potential of “panic” just really another excuse for inaction?).
You know, they always list the horrors: no school, lack of prescription meds, not enough hospital beds, no large gatherings, empty supermarket shelves, etc. ad nauseum. But they never stop to take a breath and consider that thorough preparation and SIP would ameliorate many of those inevitable woes. Where’s the lack of connection???
The big question - WHY are they only now talking about “preparing” to communicate with the public about a pandemic???
If people can ever imagine a 3rd option/reaction/scenario is possible
they can usually realize there is a 4th, 5th, one, ect, too.
(heard that said better, a couple of decades ago)
The mislabel “panic” if they count people asking questions in alarmed tones of voice, people taking any actions at all they were not told to take yet, people questioning points in the plan that sound illogical, ect.
Worry more about Outrage when the public finds out governments had warnings for years and we could have been acting sooner, Outrage if the current ages dying is what the unwarned, unprepped public gets slammed with: “You didn’t tell us that’s why you were mentioning “prepare for emergencies” “all-hazards planning” “flu” “stay home if you’re sick” (as if anyone with pandemic could get up and work!) - if officials don’t tell the public anything about a deadly pandemic influenza year (that Drs. Webster, Osterholm and Nabarro have made so plain)…
“WHY are they only now talking about “preparing” to communicate” ?
They want to keep the status quo for as long as possible, because tptb panicked when they heard, and decided to keep it from the public. That decision was their panic (= illogical/harmful) reaction.
Because they don’t want to be the bearer of bad news. Telling the public makes it part of everyone’s reality and then, economics and politics, and everything is going to change in ways we can’t exactly imagine, so, they’d rather pretend they had no idea it would be this bad, hope the public still had no idea either, and say it isn’t time for fingerpointing.
Let Nature change economies and politics the way plagues always have in the past, still in ways we cannot imagine exactly how it will end. (But, we here have a pretty good idea!)
:-(
Massachusetts State/Local Pandemic Planning Committee December 6, 2006 State Laboratory Institute, Northampton Tentative Agenda
• Introductions • Announcements • Flu season update • Late season flu vaccination • Update on avian influenza • Flu campaign • Home care of flu patients • State/Local Pandemic Planning Committee: Future Direction
2006 State/Local Pandemic planning Committee meetings: Wednesday, March 14, 2007, 10:00 – 11:30, Beverly Senior Center, Beverly Wednesday, June 13, 2007, 10:00 – 11:30, State Laboratory Institute, Jamaica Plain Wednesday, September 26, 2007, 10:00 – 11:30, Western Regional Health Office, Northampton Wednesday, December 5, 2007, 10:00 – 11:30, State Laboratory Institute, Jamaica Plain
Upcoming events: March 15, 2007 Flu Season Debriefing, 2:30 – 4:00 PM, Masspro, Waltham May 1, 2007 MA Adult Immunization Conference, Worcester
Anyone involved in the current Massachusetts initiative to operate seasonal flu vaccine clinics using EDS (Emergency Dispensing Sites) plans? This is supposedly a type of ‘trial run’ to test a community’s EDS plan, and MDPH (Mass Dept Public Health) was offering grants for $3000 per community (our town didn’t bite) to participate. Depending on the completeness of the community’s EDS plan (patient flow, intake, etc.), this can be an interesting exercise evaluation tool. What concerns me is the repeated reliance on ‘medical volunteers’ in these plans, even in support staff positions (greeter, registrar, supply chief). Will these volunteers understand the infection risks of being exposed to possibly contagious individuals? Even with double gowns, gloves, masks, eye protection and perhaps powered air supplies? That’s alot to ask of a volunteer!
I don’t know; I do not think any volunteers here were told anything we’ve heard Nabarro, Webster (nor Osterholm) saying. Full disclosure and consent are not within the locals’ “keep the public calm and ignorant” mission. The schools that are EDS were not used in any flu shot clinics that I heard of so far.
What the public is supposed to do, to cope without outside aid for months until there is vaccine to dispense, would be a good idea to be discussing.
Perhaps the MDPH could be offering grants for places that make Pandemic Preparedness Coordinating Committees as defined by HHS; private and public, all relevant stakeholders and existing community organizations discussing those difficult ethical and practical problems now, while we still can. If not allowed to help oversight and shape the plan, what the heads of municipal departments have been planning in secret may not be very useful about a week into a worse-than-seasonal flu pandemic…
Good day my fellow MA fluwikians. Have started a MA diary on our new forum. Much as we may love this one, note there are fewer and fewer posts, so would be happy to see you at our new location of the future!
I have just attended a two-day panflu forum sponsored by Harvard and held at the American Academy of Arts and Sciences in Cambridge. They had people from several nations and docs, scientists, economists, anthropologists, vets, historians, etc. and tried to get an overall picture of the problems. The papers will not be on the web because they will be printed in a special edition of the Journal of Infectous Diseases, but I will try to summarize some of the papers over the next few days. One thing of interest: while “regular” flu shots are of doubtful efficacy, there is a lot of new stuff coming in the near future which looks better - without adjuvants. Also a lot on animal health as a way to break the disease cycle. Will try to post in both places, though I prefer this one.
can you post it in a new thread? it’ll have general interest.
I have posted the speakers and some information about the Harvard avian flu workshop in the INFOMASS diary in the new FW. I will try to summarize some of the papers — too many to cover myself though.
yes, that’s quite a list…3 days worth…
Just went and read your list. Sounds like it was a great conference. Hope you have learned alot, and will share.
Although I am now a desert rat,I started out in Gloucester, so I am a Yankee gal by birth.Love my desert,but still miss the ocean.But not the Nor`easters.
how do you live without lobster and steamers? I didn’t know it could be done.
Yeah, that`s hard. But, no real Mexican food, Hatch green chilis, or real tamales back your way,either. Being transplanted at age 11 makes a difference,I guess.
LOL. You are absolutely right. ;−0
i wouldn’t trade, but having spent a summer in CA and traveled to/eaten in Texas on business trips, i don’t discount what you’ve listed.
Pixie,
sorry I just saw you message.
pelhamresilience@yahoo.com
must have mixed up my vowels LOL
Kate
Contact the Patrick/Murray transition team
“Our working groups want to hear from you. If you have a policy suggestion or perhaps something Deval and Tim should know about the current government, then leave it below. We welcome and need all of your input” Comment
No Pandemic Influenza Year Impact Mitigation working group yet.
FYI, the departing-back-to-Utah gov.spent 214 days out of MA in 2006.
…”Romney’s ever-present State Police security detail accompanies him out of state;…In June, the Globe reported that the cost of travel, lodging, and meals for the troopers had increased more than 60 percent over the previous year, to $103,000 over 11 months. Since then, however, the number of Romney excursions has increased dramatically.
In October, for example, he spent only six full days and four partial days in the Bay State, his schedules show. Starting Nov. 28, he was gone for 19 of 20 days.”…
We get the governments we deserve, I guess.
http://www.boston.com/news/local/articles/2006/12/12/patricks_volunteers_sign_confidentiality_pact/|Patrick’s volunteers sign confidentiality pact]] By Andrea Estes, Globe Staff December 12, 2006
Dozens of volunteers named to transition “working groups” by Governor-elect Deval Patrick were required to sign unusual confidentiality agreements intended to prevent them from leaking sensitive information to the press and the public”…
…”several working group members said in interviews yesterday that they were confused by the agreement, though most said they signed it nonetheless’…
…”James Alan Fox, a Northeastern University professor who sits on the Public Safety and Security working group, said he signed the agreement, but did not read it closely.”…
…”Some working group members said they never signed the agreement, though they didn’t openly object”…
…”Crosby, dean of the McCormick Graduate School of Policy Studies at the University of Massachusetts at Boston.
“I never got any sense of negative feedback from anybody,” he added. “There were many rather senior people sitting in the room when they passed [them] around. The fact that nobody made a peep is indicative of the fact that nobody took it wrong.”…
(sounds like his opinion that no one “took it wrong” -and reads as if there was either a glaring typo in what people signed, or, no one wanted to be the one to object publically.
Happy New Year!
Snip from MMS letter to transition team …”Among the Society’s budget priorities are the following:” … “Full funding of pandemic preparedness initiatives.”…
(Do they mean the -place orders for Tamiflu, vaxes, and a few more unstaffable ventilators, that don’t save many cases now, and won’t run if the grid goes out- initiatives?)
Links to transition team reports on some issues.