Continued from here
prepmaniac – at 08:06
A burning human body is not something you want to look at or smell. It might seem like a good idea, but the reality is something that could give normal people flash backs that are triggered just by the oder of a hamburger. Please don’t try this. It won’t work any way.
crfullmoon – at 11:17
“people need to get their local officials talking about how communities can plan together now, to efficiently and respectfully handle their dead”
if they say they “think that won’t be necessary” hand ‘em the current cfr chart off the Wiki, and, some of the good stuff in the What is TLC thread, and the How many children will die in a 1918-like scenario thread…
(if this thread is getting too long maybe a mod can start a new one?) What’s before Texas in the alphabet? That is what state we’ll be looking at next, after I get some other things done first…
My best friend is an Assistant Sales Director at a large funeral home. They also have a large cemetery at her facility. I asked her yesterday how many burials a day max out her and her staff; she had had an extremely rough day at work so she was using me to vent on. She said seven. Just seven burials would max out her resources for the day. I asked her how her facility would react in a pandemic flu situation with the possibility of (I used a conservative number of 30 dead a day). She said her facility would have to shut down and that the state would have to step in. She said they only have four backhoes and a few other pieces of equipment to service the whole property. She said that given the low wages paid to cemetery workers that they would likely quit before working in that sort of pressure situation. The funeral industry is so highly regulated that trying to ask her questions about how mass casualties would be handled was so far into the theoretical that she couldn’t even speculate on how they could make it work without a suspension of their normal operating rules. And that suspension would have to come at the State level. She has almost three decades in the industry and if she doesn’t know… I’ve asked her to start talking to the big bosses about this. I’ll let you know what I hear.
Chillin, that is some bad news. I must admit that I know next to nothing about the funeral industry. I have not lost anyone close to me in my life so perhaps I should say I know nothing about it. Keeping my unenlightenment in mind, I can’t help but be surprised that seven bodies would be the maximum capable of being handled in a large funeral home. If it is a large funeral home I figure it might be in a large city, then whoa baby. If seven is all that can be handled in any, oh say, Chicabo funeral home, then we need to seriously reassess how they operate. I’d like to know more. Can you tell us which city this is in. I just want to get a clear picture of how much doo-doo we could be in and your article has a ring of truth to it.
Sadly, the backup plan is “hopefully there is enough fuel for bulldozers”. BTW Cabinlass, Nice chat about rap. Email if you like!
“the state would have to step in” it (ditto; feds) would have to step in for every single municipality and it (ditto; feds) has already given notice it cannot; local responsibility, get community talking about contingencies. Darn hard to do when most people do not know we’ve been in a pandmeic alert period for the past year, nor that a pandemic would be “like a 12-to 18-month blizzard” -nothing we’ve ever lived through and very hard to do without advance education and physical preparation.
CabinLass did you see the first two threads? Canada’s pandemic plan, and Ken West, had some practical thoughts that show why the local “plans” we have won’t work.
Big failing in your area? First Task listed: http://pandemicflu.gov/plan/states/statelocalchecklist.html
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.
We don’t have one, and we could have gotten started a long time ago but the decider decided back in 2005, first task was not to tell the public until pandemic was really happening.
The City is Baltimore. Her company is large and runs multiple facilities across several states. They may be thinking about this at the corporate level, but if so it hasn’t trickled down to the rank and file yet.
Tennessee; still has such low cfr, (0.2 to 2%cfr) let’s hope they prepared what to do with all the bodies… (where are the mortuary sections in this plan? ok: p 59) …
“8.a. ..Discuss mass fatality plans with state and local health officials. The state’s medical examiner has been tasked by the TEMA to develop a detailed mass casuality plan.” ( this late date, the plan is, they told an individual to make plans for the whole state? But, what’s the plan?)
b.”Work with officials to identify temporary morgue sites.” (do the communities agree with choice of sites; have you told them about a pandemic year and lack of vaccines and hospital care yet?)
c.”Determine the need for supplies (e.g. body bags)to handle an increased number of deceased.”
d. contact precautions…e.Autopsy (who is going to have time and staff and transport to do autopsies?) airborne and contact precautions (hope someone listed buying and pre-placing extra supplies like PPE; have to look for the medical examiner’s plan, later.)
9. “Security” Additional security may be required… (ya think?) families may disagree - ( yes especially if they haven’t been part of the conversation and are just realizing their loved ones may have to die without vaccines, vents, or cures, and bodies be piled in temporary morgues somewhere)
p71 XV does have some interesting/useful (limited event) mass casualty links, but why didn’t they take from them and “flesh out” their plan already?
(Gotta go now - -these plans will work fine, if each state has about two dozen H5N1 patients. Guess I need some fresh air…)
Fiddler, that is one strange flu forum and Rap is queen bee.
This is a strange thread title but sadly,and even more so now with the release of the Sept 2006 WHO report that if H5N1 becomes pandemic by adaptation (mutation) rather than reassortment it is possible for it to keep its’ current lethality.[59% this date]
And this thread isn’t as depressing as the inevitable one will be on ‘Orphans’.
We live in scary times my friend.
This might be relevant:
Geez YYZ - the heading above yr mass fatalities article scared me to death!!! Mass evacuation to Rural Areas!!
gharris – at 01:25
Well, it should scare you more to know that I found this link from the Ontario pandemic planner October 2006 newsletter page 2:
Anon yyz All I can say is Have they lost there friggin minds. Are you going to be able ot see this web cast? If they make available a DVD let us know Id love to see it. this would be funny if it wernt true. Cant make this stuff up.
Anon yyz All I can say is Have they lost there friggin minds. Are you going to be able ot see this web cast? If they make available a DVD let us know Id love to see it. this would be funny if it wernt true. Cant make this stuff up.
Anon yyz All I can say is Have they lost there friggin minds. Are you going to be able ot see this web cast? If they make available a DVD let us know Id love to see it. this would be funny if it wasnt true. Cant make this stuff up.
janetn – at 01:42
Hm, I am not a Health Care Professional. I just noticed that the webcast counts towards Continuing Credits for Nurses.
May be some one on the forum attends and requests a download link?
That is the scarriest thing yet.
ow; I’m getting a tension headache; between seeing the online tension at the fluwiki and thinking about having to keep talking to local citizens and “emergency” planners who have the whole see-no/hear-no/speak-no-Pandemic thing going’ on.
Still; we need to find out what the TN Medical Examiner’s office (or coroners?) planned to do… Ow. can’t Google for it right now… Someone want to find the TN thread and ask a prepper what their hospital or health locals plan to do with bodies?
maybe I’ll go clean the garage and rake leaves today… think I will go take some ibuprophen and a hot shower, before I get sick.
Bulldozers and mass graves really are the only answer. Plans should be made to storehouse and guard diesel for the machines for this esssential task.
(Note to Cabinlass, Yes, indeed. The site is more like a cult. A very moneymaking cult.)
Fiddlerdave – at 08:45
re: “Bulldozers and mass graves really are the only answer. Plans should be made to storehouse and guard diesel for the machines for this esssential task.”
If we end up with a ‘significant’ CFR , then I agree with you-they are number 1 on a short list of answers.
gharris – at 01:25
re: “Mass evacuation to Rural Areas!!”
I believe that was developed after Katrina re: mass evacuations, but have no doubt it’s being looked at somewhere re: how to empty out a big city for any numner of reasons.
Also re “Mass evacuation to rural communities” look at this:
This program is co-sponsored for Military and Federal GETN subscribers by the School of Public Health, University at Albany, SUNY, The Center for Public Health Preparedness (CPHP) and Department of Defense Medical Interagency Satellite Network with the technical support of the Satellite Education Network (SEN) at Ft. Lee, VA.
http://www.dlnets.com/suny_09Nov06.htm
It’s due to run 11/9/06-anyone feel like auditing the class and reporting back to the rest of us?
“mass graves”: no, too traumatic; you need to id/death cert. and, keep track.
Collective burial: probably. http://tinyurl.com/yeo9yv (from the first MF plans thread) Please print or email this guide to “local stakeholders” and it shoudl be being discussed now in communities, but, it isn’t…
Ken West’s “PREPARING FOR THE PANDEMIC A guide for cemetery and crematorium managers” April 2006
The term collective burial is used where burials occur in a trench in rapid succession, each burial separate and identified.
It can be provided by relatively unskilled staff and does not rely on technology or external help.
It is not “mass” burial where the bodies are placed together and one on top of another.
It is recognised that collective burial is not likely to be seen as morally acceptable in a modern society.
Even temporarily, it could have a serious psychological impact on the bereaved in that the body will not be finally placed for some months and the grieving process will be interrupted.
Much as I feel we must avoid collective burial this is only assured if a massive amount of chilled body storage is provided. The high cost of this will not be borne by many authorities and it is unlikely the government will fund it.
Collective burial would be necessary where:
Firstly, the number of dead exceeds the capacity to store, inter or cremate them
Secondly, where the dead have to be temporarily interred because autopsy, registration or the Coroner’s service has collapsed.
Collective burial would involve excavating a trench 4’ 6” (1350mm) deep, 300’ (90000mm) long and 8’ (2400mm) wide which would accept 100 coffins laid side by side 3’ (900mm) apart.
One hectare would accept about 2,000 bodies.
A collective burial site could be used purely to put bodies into a sterile environment, as soil has an antiseptic quality, in order to hold backdecomposition. After the emergency the bodies could be exhumed for post mortem or reburial/cremation in the conventional way.”…
(that’s just an excerpt; they need to read the whole guide, and start talking about this, or the surviving public really will be outraged and traumatized with the results under current “planning” Don’t the officials want to remain “in good odor”? - maybe discussing mass fataltiy management, and, the current cfr, will get the public prepping. )
(or maybe I’ll just move to New Zealand, climb a tree, cut the soles off my shoes, and learn to play the flute…)
Maybe the “officials” are thinking that those of us that make it through any type of truly horrendous pandemic will be so grateful to be alive and preoccuppied with putting things back together that we won’t have time to blame them. Who the heck knows anymore.
(Note to Fidler-Is Rap an employee of his or his wife?)
Maybe that’s another reason I want to tell as many people as possible ahead of time; the public still has time now to check the warnings, see when their state summit was, read the various guideline assumptions, and, recent report warnings; still have time to ask better questions and hear the patronizing answers for themselves.
We won’t have time for a big investigative Commission” after - they might as well start investigating the catastrophic “planning” and “public risk communication” right now.
Officials know; they just don’t want the public to know. They should be held personally accountable.
CRFullmoon: “Officials know; they just don’t want the public to know. They should be held personally accountable.”
This is why the only orders and tasks from leaders for military and law enforcement will to protect these same leaders and all officials from the suicidal mobs of starving and dying people instead of doing something useful. If I have nothing better to do (because of lost preps, for instance), I probably will be in the lead of one of those mobs.
In large cities, it is a very short step in infrastructure breakdown to where dead bodies pile up real fast. Even if the infection rate is low, confusion and panic may reign. The top sheet of the pandemic plan should have tactics for bulldozing bodies into mass graves for avoiding the secondary disease issues. The plans involving coolers etc are never going to see a dime spent anyway. You have about 3 days before they get reaalllll smelly and dangerous, and a source of visual trauma to see that is much worse than not knowing which stack a relative is in.
(Note to Cabinlass - no - just an earnest useful follower/admirerer he lets be bad cop! I am being polite.)
There will not be enough coffins for even a fraction of the bodies to be preserved for collective burial with the intent of future removal for permanent burial. My friend who was 11 in 1918 said her father had to build coffins for her next door neighbors. Neighbors and family members had to take care of the sick, dying , and dead. She and her father did not get sick at all. Her mother got sick, but recovered. Her mothers sister and BIL died and left 2 young girls. Her mother nursed her sister and BIL, but had to take in te orphaned girls who never got sick. This family lived in a regular neighborhood in a mid size city. I think it might be the same where I live. I don’t think I can wait for help to bury my family. Even back then, help from gov. was too slow to really help. The gov. workers are people too. They are dealing with their own losses and sick family and friends. In 1918 neighbors had to help each other. It could take weeks to have a body picked up by someone else. I think I could build a coffin out of interior doors. People who are going to be handed the task of buring thousands of bodies that they don’t know are probably just going to want to get the job done. I think you should make your own plans and not worry about what the gov. will do with the masses. We will be on our own. We have been told that.
I am very concerned about mass evacuation. I hope that it is a plan that never is attempted. What a disaster that would be. Perhaps we should all write a letter. Or alert the newspaper to the plans when we find out the details.
Newspapers perhaps have been told the “don’t Panic the public/ it’s a “national securty issue” - We have plans and we’ll tell the public when we think it best.
“Manage the media” has more space than “telling the public to make local contingency preparations”; check the state plans.
:-( Mass evacuation; besides plain old “no necessities” motivating mobs, I most fear urban firestorms.
“for avoiding the secondary disease issues” - I still am of the mind these are secondary to the psychological issues; live people spread more disease, unless dead people or animals are in your water sources… Keep in mind we will be seeing deaths of all kinds, not just H5N1, and probably have to use the same contact/airborne precautions against the living to keep from getting sick.
Scientists say mass burials are not necessary after natural disasters, and live humans spread influenza much more efficiently than dead ones.
http://www.paho.org/English/DD/PED/FAQcadavers.htm Frequently Asked Questions on the Management of Cadavers
“Given the widespread interest in the topic of management of dead bodies, PAHO/WHO, the ICRC and a broad group of global experts have collaborated to produce practical decision-making guidelines on this delicate and difficult task. These frequently-asked questions are an example of the kind of information contained in a new publication on the subject, which should be ready by April 2006. Watch this web site for more news.
Information for the Public
1. Do dead bodies cause epidemics?
Dead bodies from natural disasters do not cause epidemics. This is because victims of natural disasters die from trauma, drowning or fire. They do not have epidemic causing diseases such as cholera, typhoid, malaria or plague when they die.
2. What are the health risks for the public?
The risk to the general public is negligible. They do not touch or handle dead bodies. However, there is a small risk of diarrhoea from drinking water contaminated by faecal material from dead bodies. Routine disinfection of drinking water is sufficient to prevent water borne diseases.
3. Can dead bodies contaminate water?
Potentially – yes. Dead bodies often leak faeces, which may contaminate rivers or other water sources with diarrhoeal diseases. However, people will generally avoid drinking water from any source they think has had dead bodies in it.
4. Is spraying bodies with disinfectant or lime powder effective?
No, it is not effective. It does not increase decomposition or reduce the risk of disease.
5. Local officials and journalists say there is a risk of disease from dead bodies. Are they correct?
No. The risk from dead bodies after natural disasters is misunderstood by many professionals or the media. Even local or expatriate health workers are often misinformed and contribute to the spread of rumours.
Information for Workers
6. Is there a risk for those handling the dead bodies?
For people handling the bodies (rescue workers, mortuary workers, etc.), there is a small risk from tuberculosis, hepatitis B and C, HIV and diarrhoeal diseases. However, these diseases do not last more than two days in a dead body (except for HIV that may survive up to six days).
These risks can be reduced by wearing rubber boots and gloves and practicing basic hygiene (washing hands).
7. Should workers wear a mask?
The smell from decaying bodies is unpleasant, but it is NOT a health risk in well ventilated spaces/areas and wearing a mask is not required on health grounds. However, workers may feel better psychologically if they are using masks. The public should not be actively encouraged to wear masks.
Information for Authorities
8. How urgent is the collection of dead bodies?
Body collection is NOT the most urgent task after a natural disaster. The priority is to care for survivors. There is no significant public health risk associated with the presence of dead bodies. Nevertheless, bodies should be collected as soon as possible and taken away for identification.
9. Should mass graves be used to quickly dispose of the bodies?
NO. Rapid mass burial of victims is not justified on public health grounds. Rushing to dispose of bodies without proper identification does more harm than good. Mass and commingled burials (pit burials) traumatize families and communities and may have serious legal consequences (i.e., inability to recover and identify remains).”
(I would add, unable to prove death for inheriting assets, adopting orphans, remarriage, all sorts of things.)
“10. What should the authorities do with the bodies?” (This is for local natural disasters with outside aid only, but has relevant points)
“Bodies should be collected and stored, either using refrigerated containers, dry ice or temporary burial. Identification should be attempted for all human remains. Photographs should be taken and descriptive information recorded for each body. Remains should be stored (i.e. using refrigeration) or buried temporarily to allow the possibility of an expert forensic investigation in the future.
11. What is are the potential mental health issues?
The overwhelming desire of relatives (from all religions and cultures) is to identify their loved ones. All efforts to identify human remains will help. Grieving and traditional individual burial are important factors for the personal and communal recovery or healing process.
12. How should bodies of foreigners be managed?
Families of visitors killed in a disaster are more likely to insist on the identification and repatriation of the bodies. Proper identification has serious economic and diplomatic implications. Bodies must be kept for identification. Foreign consulates and embassies should be informed and INTERPOL contacted for assistance.
Information for Responders
13. I am a volunteer, how can I help?
To be helpful you should advocate for the proper recovery and management of bodies and assist in recording necessary information. You might also assist with the recovery and disposal of the dead, under direction and responsibility of a recognised coordinating authority. However, you would first need to be briefed, advised, equipped and supported for this difficult task.
14. I am a NGO, how can I help?
Providing support for families and collection of information in collaboration with the coordinating authority will best help the surviving relatives. You may also advocate for proper identification and treatment of the dead. NGOs should not be asked to carry out the identification of dead bodies, unless they are highly specialized for this task and work for and under direct supervision and responsibility of a legal authority.
15. I am a health professional, how can I help?
The survivors need you more than the dead do, but any professional help in fighting the myth of epidemics caused by dead bodies which may lead to their hasty disposal will be appreciated. Talk about this to your colleagues and any members of the mass media who may be misinformed.
16. I am a journalist, how can I help?
Your help is most critical. If you hear comments or statements regarding the need for mass burial or incineration of bodies to avoid epidemics, challenge them. Consult WHO locally. Quote this and other publications. Please do not jump on the band wagon of alarmist rumours. Be professional.”
Canada Pandemic planning for Mass Fatalities (also in earlier MFP thread, this one is a html link) See Planning for Possible Solutions/Expediting Steps and Death Registration
I think, previously, I found what vaccinations mortuary staff would need after something involving bodies left outside in water sort of situations; not going to have time right now to go look in the threads.
What do Dr.s here think about vaxes recommended for travellers to countries where typhoid, cholera, hepatitis, ect, occur and medical help is not available? Should people who plan to volunteer collecting unattended deaths, bury corpses, ect, try now to get up-to-date vaxes?
Will local communities see the need for this and use money so they have slightly protected volunteers ready to assist? They also need to buy and pre-postiton PPE, and the death certificate forms, and make legislation to expedite legal record-keeping during an influenza pandemic, by greatly expanding who is allowed to fill out the paperwork.
All these comments are based on one-time “natural disaster” considerations, from the look of them. Pandemic issues will run differently. You need to bury the dead TODAY because tomorrow, you will have more dead and less resources and people to bury them for a period of time measured in months. Coffins are expensive and very time consuming, and even a simple wrapping like a sheet are going to be dearly valuable (you are going to have millions of people in bed, seriously ill, doing what people do to the sheets in those situations). I guess what I don’t see factored in to many calulations is the time and effort of the healthy what will go into the basic care for millions of long term sick people. Many of those ill with H5N1 are seriously sick for longer than a month! Take away their labor, take away the labor of at least one person to care for that person, and there will be such a shortage of people to keep things going. These 2% CFR’s are a joke when you consider that many will get NO care and just die of thirst or starvation compared to now, where there are plenty of well people for caretaking. This is going to be a problem even with infrastructure intact! Wherever power is lost, all modern conveniences are lost (washing machines!) Caretakers washing sheets by hand! And hauling the water etc..
I would like to see an evaluation of the danger of dead bodies whose deaths are caused by H5N1, not regular influenza! The virus is shown to live a long time under more adverse conditions much worse than a body. If not denied access to the bodies, many animals, birds, cats, dogs, insects, other animal scavengers and human scavengers (seeking gold teeth, for instance) will be at work, and we do know many animals are infected by and may well act as vectors for H5N1. This may not matter, I guess, if the virus is very prevalent, you either are susceptible or your aren’t. But who is going to volunteer to handle them on an individual basis? Where will their gloves, masks, gowns come from (which rational or not, people will demand)? We know there will not be enough for the sick care. One person from a distance can bury 1000′s of bodies with machinery. More WILL die because of the efforts for “decent” burial in a widespread disease or ongoing disaster, is it the right prioritization of human and material resources we have AT THE TIME?(too bad we won’t expend resources in advance to avoid these choices while we can afford it. People trying to deal with these issues AT THE TIME would benefit from support for the very probable resource triage considerations.
Hey, Fiddlerdave, you’re welcome to have at my local (and MA) officials - too many of them still act like pandemic can’t even really happen, or, they can just “drop the ball” and fed DMORT teams or the calvary or the cemetery fairy will deal with the bodies, since the cfr is going to stay so low anyway, and people will be able to go shop in the stores after their two weeks of food runs out, and hopefully we will have a vaccine already before pandemic ever happens, they’re certain telling the public now would have “bad outcomes”, ect, ect.
too bad we won’t expend resources in advance to avoid these choices while we can afford it but -there first and last thought is The Public Can’t Handle the Truth, so they just want to let the Consequences play out. Sure would like community plans, (we could have started Oct. 2005) so we can mitigate deaths from all causes, but, the foresight, ethics, and leadership to do so, are not to be found.
If anyone can get press, politicians, parents, or funeral home directors to read these MFP threads, and, the current cfr and Case for Closing Schools kind of threads… I can’t think what else will do any good now except full community disclosure, (and maybe I’m wrong!)
Yes, I want the community preparing how they will care for people, and find, id, make paperwork for and go bury the dead, daily! Once pandemic starts, it will be so much harder, or impossible, to do so; must be discussing and preparing now.
Like they said, Their priority is gong to be the living. Meanwhile, your teenager is wrapped in a dirty sheet for 3 weeks, decomposing while you are trying to protect her body from rats, dogs, insects. Just bury her with a private family ceremony. You can make preparations now. Then you won’t have to be psycologically damaged by her being put in a mass grave. We are preparing for our kids in case they survive a pandemic. We need to prepare in case they don’t.
Ground isn’t frozen yet; maybe I can convince the cemetery trustees to be the first in the county to dig collective burial trenches, now… (They’re just starting to think like I wish they had been 12 months ago; Hey, what are we going to do if there’s a pandemic?) (And I guess no one is scoffing at the one who says that in a meeting, this year.)
(Imagine; “What will we tell the public; we can’t dig trenches before we are sure we need them, they’ll panic!”)(Wish me patience, before I want to give up and emigrate to NZ. At least I could remember the townsfolk and their children like they are now; blissfully/willfully ignorant, but, alive.)
People in town have wheelbarrows and sleds; something could be worked out. Family members will think it a priority to not leave the dead unburied, if they are able, and some in the neighborhood may feel called to volunteer to assist those who are still caring for others or too weak themselves to move bodies. Many neighborhoods are near one or other of the cemeteries. (I still miss the old thread title, Bring Out Your Dead…)
time for another Mass-fatality-plans-or-lack-thereof:
South Dakota …”Mortality Surveillance” “Pediatric influenza-associated deaths are reportable events. Adult influenza deaths are identified by death certificare review.”…
(SD does not have a BSL-3 lab :-( )
…”Pandemic Phase 6″ Surveillance; they assume they’ll be using the South Dakota Electronic Death Registry”… (feel free to quip here)…
(hopeful plandemic pages about vaccine and antiviral distribution, read, read…)(State assumptions; “Basic necessities, ie; shelter, food, medical, phone, are provided to persons under movement restrictions” - I must have missed reading where the supplies to do that got bought and community gets organized) Encourages all health care facilities of any kind to “discuss” during the updating of their “All-Hazards” plans issues including -listed after vaccine and antiviral distribution- “ 10) Surge capacity, and 11) mortuary issues”…
…”Potential collaborators” -“who either have contributed or will be asked to contribute to the plan” (I hope they’ve contacted them by now!) do include ones like State Association of Funeral Directors, Board of Funeral Services, (Don’t see mass fatality management mentioned by name in their EOP responsibility matrix. I must need new Rx trifocals.)
“Authority of Govenor”…yikes, p 49, ok…”(8) May provide for the examination and safe disposal of any dead body as may be reasonable and necessary to respond …” State Dept of Health has authoritiy over (2)location of cemeteries and removal and burial of the dead…
But I’d say, 67 pages with no real addressing of dealing with practicalities of extended mass fatality surges at all, (odd since there is no real mention of pro-actively telling the public so they can prepare to cope before vaccine is made), and it is ridiculous in 2006 to still use those low CDC numbers, without even putting in the higher attack and fatality rates HHS is using, let alone what H5N1 is doing now.
(Pandemic is just another excuse for time-wasting meetings and rules for more paperwork? Think of new bureaucratic ways to make authority flow charts and count how many get sick and how many hours into a pandemic it takes to max out bed capacity, tell others to update their plans and consider issues but- ? And then what? The public suffers through months and years of system failure consequences? What a “blizzard”…)
Did I mention I think the dark side of the Medical Reserve Corps is that it may be more of a hospice gig? Sure looks like it; if pandemic ends up causing ARDS in young/healthy people.
If they don’t have a Mortuary Reserve Corps, they need one; feel free to draft local officials who refused to be honest and warn the public. I hear none of our cemetery workers can afford to live in the municipality they work for, so, I’d start looking for volunteers within walking distance of the cemeteries, to cross-train now, too…
Do the local overflow, influenza special care units or whatever yours are called, and state of emergency laws, have provisions for front-line people to pronounce death, id, and make death certificates, and some way to get the bodies seen by the family (or photographed) and sent for same-day burial? (Will they dig up the school playgrounds for plague pits? How much PPE do they have today? How many body bags, are they pre-positioned? Ask; it makes you so popular…not.)
Be tactful; people like this end of the pandemic planning issue even less than normal, if that’s possible. But, this needs to get prepared for ahead of when needed.
South Carolina pdf …”p 39. …5.”South Carolina’s health care workers, emergency response workers, medical examiners, funeral directors, and morticians will face a sudden and massive demand for services, and a possible 40% attrition of essential personnel.”…
“11. The number of hospital beds and level of mortuary services able to manage the consequences of an influenza pandemic will be inadequate.”…
(Pollyanna write some of those other -see pdf link- assumptions? She obviously doesn’t read Flu Wiki. And, she must have got cash bonuses for every time the words “vaccines” or “vaccinations” appeared in print.)
(Who was that man wandering with a lamp? Diogenes? “I’m looking for the honest pandemic fatality management plans…”)
p63 …”P. South Carolina Coroners Association, 1. Assist with coordination of temporary morgue operations and final disposition of deseased persons” (left out those devilish details again) “2. Assist with documentation and recordkeeping relevant to pandemic influenza related mortality.” (what about annual mortality? What about collateral deaths during pandemic? Where is all the pre-printed forms prepositioned? How do the bodies get buried??)
“Q. South Carolina Funeral Directors Association, 1. Assist in coordination of next-of-kin notification operations. 2. Assist with coordination of temporary morgue operations and final disposition of deseased persons. 3. Assist with documentation and recordkeeping relevant to pandemic influenza related mortality.” (So much writing, so little useful said.)
(Now, p. 65, it’s back to smallpox; most of the beginning of this pdf is all about all-hazard, man-made, localized incident response. Oy.)
Rhode Island pdf Surprised how detailed this gets; historical background as to Medical Examiner’s office, projected cost of gloves per pandemic wave, all sorts of detail as to who takes what steps, but, still not sure what good it does. Going to call it a night; if anyone wants to look through the pdf and post the relevant bits, I’m going look at this again in a day or so. Starts to all look like the same old, too-low attack and cfr%s; just, truck the bodies to the nearest ice rink and process’em by-the-current-book with the current staff (perhaps minus 50% staff overall…) (Z-z-z-z-z)
http://www.health.state.ri.us/osme/massfatality.php
“The Medical Examiner will assume jurisdiction over the types of deaths described below based upon the Code of RI.
Deaths due to or suspected of being due to:
Infectious disease or suspected infectious diseases that may represent a bio-terrorism event or emerging infection.
Natural, nuclear, biological, chemical or other mass casualty event.
Homicidal, suicidal, accidental or undetermined causes related to the mass casualty.
The Medical Examiners Office will work in conjunction with the investigating agencies, federal agencies (DMORT) and other ancillary personnel, and the family assistance center to recover and identify the decedents, determine the cause of death, and notify and support the families. “
Wonder who to ask for the details and how the staff is preparing to do these things? (Doesn’t an “emerging infection” sound better than “a pandemic influenza year”?)
“ICFA Approves Emergency Licensing Policy Statement in Preparation for Potential Mass Fatalities
July 18, 2006 — ICFA President Thomas G. Roberts, CCE, announced that the association has approved a policy statement to encourage the enactment of state laws for the emergency licensing of funeral directors, embalmers, and crematory operators who are validly licensed in other states. Currently, a few states have enacted such laws but most have not. The policy statement anticipates a critical shortage of licensed funeral professionals due to natural disasters, terrorist attacks, war, or widespread disease such as the potential for a pandemic avian flu attack.
The ICFA Government and Legal Affairs Committee reviewed the draft policy and recommended its approval to the Executive Committee. Subsequently, the Executive Committee, which is chaired by President Roberts, approved the statement on behalf of the association. The Executive Committee is authorized to act in lieu of the Board of Directors in between board meetings and, due to the relative urgency of the issue, prompt action was taken.
Similar “Emergency Licensing” statements are also being considered by other national trade associations and it is hoped that a joint statement might eventually be issued on behalf of all of the associations that are members of FAMIC, the Funeral and Memorial Information Council, which functions as an umbrella group for many of the national associations representing the funeral services professions.”…
http://www.icfa.org/icfanews.htm#policy
(I think pandemic will be so rapidly widespread places will not be able to shift staff and resources much; they will be need everywhere, right? But, for the next hurricane, flood, or airplane disaster, ect, allowing out-of-state licenses to be honored would be useful) (“a pandemic avian flu attack”? let’s start a list sometime of all the different phrases in use…)
new contribution
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