While doing my prepping, I started wondering if hospitals were prepping. Afterall, we have already been warned. We are on our own. Let’s take water as an example. Most city water systems need two things,
If they lack either of there of these…. no water.
No water, no
The list is endless. Any other thoughts or ideas on this subject?
HR Alley RN: Check out this discussion- “Supplies Cache List for Rural County Level Government” at 18:33 anonymous wrote about this very subject. Good read.
I know that the hospital in Newport, RI was briefing staff on pandemic issues not too long ago. I have a friend who works there.
What was said at these briefings? Anything new?
On the fence but leaning Thanks for the reference. What can i say… A day late and a dollar short? Let’s just hope i’m late for my own funeral. gina
H A RN: You certainly have your priorities straight, IMO. But stepping back one from the hospitals to the greater setting of the city as a whole, of which it is a small part?
We must realise the biggest picture: If the city goes down, EVERYTHING goes down, immediately or soon. Therefore, I say critical services CANNOT be allowed to fail. At any price.
And I do not think they will fail entirely. Intermittently, lesser quality, yes. But by-and-large, they will be there.
Let us not disparage the basic intelligence of workers at, for an instance, electricity generating plants. The bleeding hearts lament they will insist on being home with their families at such a time. Home? Doing what? Lighting the candles?
The electricity supply threatened is the life power of the homes and families of these workers themselves. And if the water works, and others, are kept going, then the dangers of violent social disruption are at least diminished in that so many are not so dramatically driven to desperation.
If this is too much for AMERICANS, for example, I can only pray those nasty, nasty Russians and Chinese can and will ‘bite the bullet’ and carry world civilisation on….
Nik have you any contacts in Sydney hospitals that would know if they were prepping? any other Australians have medical contacts? and medical insights?
Some hospitals are, some aren’t, at about the same rate as the rest of our services. The outlook is not good. Don’t plan to count on your local ED.
Here’s what the American Hospital Association testified to before Congress in 3/16/06. The testimony covers a number of very real problems, such as-simply adding beds and assuming there will be a complimentary surge in staff is unrealistic, where will this surge of trained staff come from? They can’t even find them now… The testimony then gets to the crux of the matter:
“…A hospital’s ability to deliver optimal medical care in the setting of any disaster event, regardless of its cause, is in large part contingent upon an immediately available supply of key medical equipment, supplies and pharmaceuticals, as well as adequate staffing. However, due to financial pressures, hospitals have adopted just-in-time supply chains for their equipment and supplies. As a result, in a disaster hospitals would face an almost immediate shortage of critical supplies such as ventilators, personal protective equipment for staff, drugs and other supplies. In addition, most hospitals routinely operate at or near full capacity and have only limited ability to rapidly increase their workforce.
[SNIP]
…As a result, the ability to provide acute and extended health care delivery in the setting of a surge in demand remains significantly limited. Furthermore, planning and funding for medical surge capacity remain far behind the other elements of the nation’s tactical response to creating a secure homeland. And given the very real concerns regarding an impending influenza pandemic, communities must focus on priorities for building such capacity that goes beyond the purchasing of beds, a metric which is too simplistic, and of little use, in creating the sort of capacity that is truly needed.
The federal government must help protect the nation by providing greater resources to hospitals to meet the challenges of emergency readiness and ensuring that those resources are made available in a timely manner. In addition, given what Americans need from our nation’s hospitals, today is a time for investment, not cutbacks….”
They are quite aware of the situation they are in, and the full testimony has some good points representing their perspective. So…this is how hospitals see it. In my state, WA, they have already indicated it will have to be an outpt treatment approach, and I expect that it’s only a matter of time until the outpt clinical community says it’s too much for the Feds, the state and the hospitals, and us too, the office is closed! (and for good reason, they have even fewer resources for dealing with pandemics).
Ceredwin,
My medical friends tell me to count on “sufficient care” which won’t be either sufficient or care. As Mike Osterholm said, we are screwed if this pandemic happens in the next couple of years.
Same here in Oz. But, oh my, TWO YEARS is a long, long time. And I, as others apparently, am worried about this autumn, October-November! And the coming (Northern Hemisphere) winter!
Of course, with ten times the medical facilities, staff, and supplies, it will be largely in vain if the water goes off, and the electricity, phones, etc…
I would like to be able to afford a generator and a huge tank of fuel, as so many wikians are, BUT if utilities fail and social order breaks down, what does it profit a man?
Prepper Australia — 03:43
Have you noticed the thread “Australia and New Zealand” also?
Not Paranoid But at 02:38
For what it’s worth, and I know that it’s not the topic of this particular thread, but I have medico friends in Adelaide (a gp and a specialist) who know someone on the Australian government’s pandemic advisory board and that person has told them that a flu pandemic is imminent and that they should start preparing.
P Australis:
“For what it’s worth” is worth a great deal indeed to us folk Downunder….
NPB and I and others of our ilk check the “Austr…NZ” page regularly. If you care to expand on that, or other ‘local’ news we would all be enormously interested and grateful.
Cheers.
Yep i am with Nikolai - the more info the better my investigation was to the Funeral directors assoc and they say they have been in loads of talks with the govt main issue - how to bury the dead when their staff numbers are down… yep real stuff and not pretty.
Prep Aus share and share - and probe your friends partic those in govt, medical professional areas. My interest area is media so I am very interested in the media communication strategy of each country (re crisis communications) Australia seems to be lacking compared to other countries.
Guess we need to move this to our own Aus thread!
Nikolai and Not Paranoid But,
Sorry for the delay, I thought my reply would be more relevant posted on the A&NZ 8 thread, where its just been posted. Regards P.A.
My son’s best friend(who practically lives with us) his mom is the head of radiology at the hospital in a neighboring town. She refuses to believe anything about the bird flu. I figured that because she is the head of the department she would be included in preparing for it. She says the hospital is doing nothing and never will because it is a non issue.
She’s an idiot then
Sorry for the above. I guess its all just starting to wear me down a bit. This militant ignorance we all seem to strike so often is the worst of all.
I can tell you that in the Texas Medical Center - the answer is yes, they are preparing. I work in one of the hospitals there and we were given new policies about 2 weeks ago. Our faculty are no longer allowed to travel to Southeast Asia and China for the forseeable future. More countries will be added to the “no travel” if/when it becomes necessary.
The plan is to “lock down” my hospital at the first hint of bird flu. Our patients are fragile. My hospital is what is called a “defend in place” institution. Therefore, patients and visitors are always screened for communicable diseases.
We are also on a major hand washing campaign right now. As you may recall, the Texas Medical Center as a whole was caught with its pants down during the flooding of Tropical Storm Allison. Lots of lessons were learned and, hopefully, new attitudes were developed with emergency planning.
Finally! Things are beginning to move at my hospital. I just spoke with one or our security guys and the planning has started. Plans are being made to stock MREs and training has begun for riot control for our security. Even trainging for a rifleman on the roof. The message has finally sunk in!
as melanie says, different hospitals are in different phases of planning. It’s planning not plans… plans are never done and always insufficient.
The wiki has a hospital and local page for planning, btw. please post there if you have specific plans to post.
BTW, in CT the hospitals are purchasing PPE and makeshift gas-powered ventilators as stopgap while the state tends to the tamiflu issue. They are making checklists as per pandemicflu.gov. they are planning screens for sick visitors and staff (you can’t get in with fever). But personnel are the sticking point, as outlined elsewhere (see Ceredwin – at 02:52). Changing the mindset from ‘work at all costs’ to ‘stay home if you’re ill’ takes both time and leadership.
Finally, true planning means working with the city or town to identify alternate care facilities and stay-home teaching. None of this is a surprise to fluwikians, but all of this is in different stages and phases in different locales.
We can and should create or steal an outline for this. Something simple to get them going. At the very least a list of workable links. An “Eccles’ guide for hospitals”, sort of. As a wikiproper page, of course.
And I agree with DemFromCT: planning means getting in touch with one another and creating a language to describe situations. That in itself has value. When there’s human links, a few words will suffice to trigger sensible action.
Just like when the novel writer sent the editor a small note which just contained this: “?”. The editor replied just as concisely: “!”.
Which of course meant that the book was selling well.
I used to think of the hospitals as the primary battleground. No longer. They become breached and useless (or shut off and impotent) by day two or three. Nikolai is right. It is the Utilities and Transportation where this war will be won or lost.
I work at an Ivy League West Philadelphia hopsital that is part of a huge health system (>1,000 beds total). Despite multiple emails to the infectious disease doctor who is in charge of creating the pandemic plan (since Feb 2006), I have heard nothing. I create and send out emails to my department with bird flu updates, education etc about once a week-and no one emails me back with a question or a comment.
The 60 bed local community hospital 15 miles from my house is better prepared, but only becasue their emergency management person is a RN who is extremely educated and informed on bird flu (she calls it her personal nightmare) as well as all other emergency topics.
The IC RN in our hospital has no illusions about how we will fare in a pandemic even with a CFR of 2–3 %. The extra masks,disaster planning, stocking MREs have to be done because we have to do something. To many in our community our little hospital is not just a job. Many have been here a long time. To let it go down w/o trying is like giving up on a family member. I will work until it becomes too dangerous to continue to do so. In the meantime, we are working with the county( who told us to prepare for the worst) and hopefully the city gov. Kelly
The American Association for Respiratory Care is circulating a draft of recommendations and my workgroup has circulated our final recommendations to a relatively small, but growing number of planning agencies/authorities. They’re mostly clinical, but one point we wanted to get out was that the disposable, pneumatic ventilators that have been purchased over the last few years for other disaster contingencies will be useless. Both the AARC and my group strongly recommend consulting us (either) before you make purchases. I have had difficulty finding places to post my report and have been sending it to one individual (over 100 now) at a time. It has been well received (actually better) by the Canadian Society for Respiratory Care, as they have committed to widespread distribution. We are already prepped for hurricaines and most hospitals are quite happy to change the name of whatever current disaster plan they have to Panflu Plan. NO ONE wants to spend money on it now, as we are heading into the slow summer season. We are going to have a bake sale to buy extra masks, (J/K)
rrteacher — how about posting a link to your draft recommendations here so that we can email or deliver a hardcopy to our doctors? The chance that the report will end up in the right local hands is low, but certainly is greater than 0%.
any time you are ready, we can host it here.
It will be interesting to see how hospitals, both local and national groups, respond when the Federal plan comes out, supposedly tomorrow.
It sounds like the industry is very conflicted on trying to be there for their patients or keeping them out (no fever allowed,rooftop gunmen)So what is Joe Publics best bet if tshtf?Take sonny/granny to the hospital?Hope to be okay at home?
malachi – at 14:35 --- no fever allowed,rooftop gunmen
I just can’t picture rooftop gunmen, but if TSHTF, you could very well see armed security around the entrances to medical facilities to enforce the rules. This could also cause problems, because in some areas, people may become so desperate after being turned away, that they may very well return fully armed, demanding to be seen by a doctor.
And this thread also brings up another question: will the government suddenly decide to pass a law (if social distancing is mandated) stating that it will be a federal offense to intentionally sneeze on somebody? 3 times and off to jail you go?
I know it sounds crazy, but people have been known to do some crazy things…
Just a crazy question, but OTOH, we have some crazy laws here…
Bluebonnet, Np1, rrteacher-can you send me copies of your institutions/departments policies? send to: puub@comcast.net. I’ll forward them to TPTB.
Re: bluebonnet’s comment” Our faculty are no longer allowed to travel to Southeast Asia and China for the forseeable future”
That is not a level 3 travel restriction per WHO recommendations; I wonder…does the Texas Medical Center think we’ve moved levels?
There is no point in having guards, National Guard or otherwise, at the hospitals after the first few days, when there nothing to treat arrivals with.
And even before that, also to be noted, guards are people too, how many do you think are going to stand in front of dozens or more sick, angry and maybe armed people?
Military options are poor substitutes for REAL planning and preparation that can actually be effective. Such as telling people NOW what they need to to and for HOW LONG! And thus avoid these desperate scenaros.
Grace RN - Check your e-mail.
How can I post Word or PDFs here?
bluebonnet-thanks.
I work in a hospital in Eastern Ontario. We recently had a seminar outlining our hospital’s preparation. They are stocking tami flu pills, masks, gloves, food etc. They stated that they had to rent storage space to store their extra supplies above their usual three weeks supplies. They also informed staff that holidays would be cancelled during the event of a pandemic. They informed us that a pndemic may come and go in waves,each of which can last for months at a time My personal feeling is that I would work during a pandemic if they would provide accomodation for me. I don’t wish to work in nursing and risk the possibility of bringing the flu to my husband, sons, or grandchildren. Athough of course if any of them became it my first priority would be to stay home with them. We will also given Pandemic Planning Guides for Individuals and Families from our employer.
I work in a hospital in Eastern Ontario. We recently had a seminar outlining our hospital’s preparation. They are stocking tami flu pills, masks, gloves, food etc. They stated that they had to rent storage space to store their extra supplies above their usual three weeks supplies. They also informed staff that holidays would be cancelled during the event of a pandemic. They informed us that a pndemic may come and go in waves,each of which can last for months at a time My personal feeling is that I would work during a pandemic if they would provide accomodation for me. I don’t wish to work in nursing and risk the possibility of bringing the flu to my husband, sons, or grandchildren. Athough of course if any of them became it my first priority would be to stay home with them. We will also given Pandemic Planning Guides for Individuals and Families from our employer.
Remember hearing awhile back about the drive up doctor service? you don’t even get of your car. I know in cental Florida it was printed in the paper a few months ago that they have a triage of doctors put into play and they would be become the doctors who you go to see with the flu. I think it was 22. They would have the hazard suits on etc..
Our community hospital is involved in planning on 5 fronts: - vaccine disbursement - community triage sites (keep them off the hospital grounds!) - alternative care sites (local motels are great: one bathroom per bedroom) - law enforcement aspects (hospital will be panflu ICU only, and all other patients sent to alternative care sites, like it or not, and disgruntled rejectees can get violent) - supplies and staffing: already run VERY lean (storage for 2 days worth of food, max) Pretty grim framework to use for planning
Sorry for the blank message above. It was my experience working in a small San Diego hospital that we were in now way ready for any type of disaster. Central Supply (which is the storehouse of medical supplies) in the hospital I worked in did not have much in the way of medical supplies because of their expense and rapid expiration dates. We would have been unable to treat any more than 300 emergency patients. The oil for power outage back up was limited to 48–72 hours. After that, if oil was not re-supplied, the hospital would be in the dark with zero power.
An increase in 30% of patients would be devastating. No beds, no monitors, no staff, no meds. Nurses, already overworked would never report to work and expose their families. After my experience of staffing nurses in all units for 5 years would find it hard to believe that most nurses would put society before their own health and families. I would not expect them to.
If it takes 4 hours to get through the emergency room at children’s hospital with any childhood ailment in a non-crisis time, imagine what it would be like in a Pandemic.
Don’t rely on Hospitals to prepare for the Pandemic. It is just too costly to prep with massive amounts of supplies that will expire.
SoCalGal- re: “Don’t rely on Hospitals to prepare for the Pandemic.” You are so right, but sadly, too many people, for many reasons some not of their making, rely on ER’s instead of a family doctor, or even an assessment by an adult at home. The American hospital system is in a state of imminent collapse, but few outside of the healthcare system know that, or believe it.
Helping primary care practioners to keep working/keep their offices open, or provide somewhere to see patients will be crucial, but as far as I know, not included in emergency planning that I’ve seen. PCP’s are near collapse too from HMO’s, they routinely send patients to ER’s as they’re overwhelmed with work.
The only good thing that could come out a pandemic would be the chance to completely revamp the American healthcare delivery system. There won’t be a recognizable one after a pandemic.
Grace is right. Unrecognizable. The healthcare system is constrained by factors that are not mostly related to treating disease. Economics and politics. WTSHTF, many of these constraints will come off or be ripped off. The lunatics will be running the asylum. That’s us. We may be constrained by a lack of resources, but we will not be limiting care because some suit at HMO HQ says so.
Dem-Thanks for posting our work here. Dr. Mike is taking it to Stewart and Stuart at OPHEP this Friday. These guys do listen now. We are making progress.
Richard
I’m at a major midwest university hospital where they are doing BF vaccine research, and NOTHING has come down the pike from hospital administrators re: BF planning. We are already pretty much at capacity with day-to-day operations and the resources are stretched thin - and nobody is paying any attention to BF. I shudder to think what this place will be like when people start getting sick.
I’m doing what I can to get my church, family and close friends prepared - but beyond that until things start to really heat up, people don’t want to hear about it. Especially the hospital administrators, it seems.
I am chair of the infection control at my tiny hospital, so guess what I’ll be presenting at the next meeting? It will be a few weeks until then. I’ll let y’all know how it goes!
RuralMD. Good Luck! By all means keep us posted. You may very well give us ammunition to us in our areas. Just a currios thought. Are drug companies/ rep’s keep doctors supplied with enough samples to help them if pharmacies shut down? Afterall, people will still get sick due to other causes. gins
We are getting NO samples of any antivirals (except the anti-HSV, such as Famvir). In the past few weeks, we have had samples of only two antibiotics. Everyone is cutting back on the samples.
I just sent an internal e-mail to senior management at my hospital asking what they are doing now that the President’s plan has been published. By that I mean other than forbidding travel to the Far East.
Will let you know something as soon as I hear. These folks are very good at disaster planning, but (that word again) I have heard nothing from my lower level management about this. In fact my manager looked at us like we were crazy yesterday when several folks asked about telecommuting.
I spoke with our Infection Control RN today. She is really on top of things! She attended a state meeting (didn’t know if Mike Leavitt was there, though) and brought back a large packet of info, including scenarios, checklists and pre-made plans. We will meet next week to go over these things and our Infection Control meeting is the next week. By the way, last year we had a “bioterrorism drill” at our hospital, and the scenario was using an infectious disease. Everything came off fairly well. We had HAM radio backup that networked all over the state (in this scenario, other networks were down), and decontamination procedures. Overall I feel that our little hospital is ahead of things in a lot of ways!
kmc RN – at 08:17 - Is that in Iowa City? I hear they are doing vaccine “booster” research.
I know a HCW in that hospital and they knew nothing about BF, or said they didn’t.
FYI - Today I took a relative with no insurance to the county hospital in Las Vegas, UMC, and stepped into outpatient admitting. People were lined up from the admitting desk to the door, and several were lying on the filthy floor, with their bare heads lying on the tile.
And this is the NORMAL situation, with no flu, etc. I was told ALL county patients have to get all their prescriptions at this one hospital’s pharmacy - all the other county pharmacies were closed due to lack of funding. It took only 14 hours from social services to doctor visit to pharmacy to get several vital prescriptions filled. And this is without bird flu. Anybody wonder why these faciities don’t have extra resources for bird flu? What extra resources?
Time to refresh this thread. Responsiblity? Accountability?? Front line staff have to be asking questions and they are not. Until they start putting the pressure on, it will continue to be a few monthly meetings and many more questions than answers or action
Supplies won’t all expire; can hospitals stock up and use the oldest stuff first -just hold more in inventory that usual? (If they have the political will, for-profit pressures, ok…nevermind.)
Our national health infrastructure is part of having a secure “homeland”. So is having healthy citizens. Get a few calls in to elected officials, too, so they know we are aware of H5N1 and the gap between “plans on paper” and “harsh reality”.
meanwhile, back to hospital prep…
spam removed.
spam removed.