Pandemic Preparedness

By Vicky Godley

In a time of turbulence and change, it is more true than ever that knowledge is power. John F Kennedy

G ai n P o w e r o v e r P ande mi c s b y E duc at i ng and P re p ari ng Y o urs e l v e s and Y o ur F ami l y !

Every winter the U.S. suffers a seasonal flu that kills approximately 36,000 Americans and hospitalizes more that 200,000. Terrible as that is, health experts are now warning about a far more lethal kind of flu--a pandemic flu that could kill over half a million Americans and hospitalize more than two million. Preparation is the key to minimizing the effects of pandemics.

Pandemics and Epidemics Have Occurred Throughout History

Typhoid Fever, Bubonic Plague, Cholera, Black Death, Spanish Flu, Asian Flu, Hong Kong Flu, SARS are all examples of pandemics that have occurred throughout earths history. The Spanish Influenza of 1918 was one of the worst in recent history. It killed over 50 million worldwide. Six months before the Spanish Flu became a pandemic; it was classified as an epidemic. The populations in Europe and the US were advised to start a Quarantine. Most city and state officials ignored the warnings, resulting in thousands of unneeded deaths. When the Spanish Flu reached the United States it only took two weeks for it to spread from border to border and this was before the days of being able to hop on a plane and fly from one end of the world to another in a matter of days. It is said that in todays world one sick person can cause the infections of over 250,000 people in a matter of weeks. Unlike the deadly pandemics of the past, we under-stand a whole lot more about what causes viruses and how we can minimize their effects on us and our families.

What is the difference between a Pandemic and an Epidemic?

An Epidemic is defined as a disease or viral strain that is localized to a region effecting a localized population. An influenza Pandemic occurs when a new Influenza A virus emerges and there is little or no immunity in humansthen spreads easily from person-to-person. It is found globally and effects global populations. It could be mild, moderate, or very severe even leading to death.

How does the World Health Organization decide when to declare a pandemic?

When we see a new virus coming from the animal kingdom or the bird kingdom, jumping to cause disease in human, and if this is a new virus that has not been seen in the past and it is causing disease in people, and most of the world's people don't have immunity to this new virus, and if the virus is spreading on a global scale, by definition, we can say that we have the epidemiological evidence to say that, maybe we are seeing an influenza pandemic.
DR. MARGARET CHAN, director-general, World Health Organization

In the Last 100 Years, the World has Experienced Five Pandemics
1918 SPANISH INFLUENZA Approximately 100 Million Deaths 1957-1958 ASIAN FLU 2 Million Deaths 1968-1969; 1970-1972 HONG KONG FLU 33,800 Deaths SWINE FLU 2009 Approx. 11,000 Deaths

Do you notice that through each pandemic the numbers of deaths have severely declined? This was in part because the last two hit during the holiday season when children and families were not at work and school where the disease could easily be spread. . It is also why we need to be prepared to shelter at home.

How Long Can a Pandemic Last?

PANDEMICS can last up to 2 years. COMMUNITIES could be infected by several waves lasting 6-8 weeks each. PREPARE for 3-4 months. (3 months supply could come in real handy)

Authorities estimate approximately 30-40 % of the world's population could be infected.

Infuenza Facts
What causes influenza? Viruses cause influenza. There are two basic types, A and B. Their genetic material differentiates them. Influenza A can cause moderate to severe illness in all age groups and infects humans and other animals. Influenza B causes milder disease and affects only humans, primarily children. Subtypes of the type A influenza virus are identified by two antigens (proteins involved in the immune reaction) on the surface of the virus. These antigens can change, or mutate, over time. When a "shift" (major change) or a "drift" (minor change) occurs, a new influenza virus is born and an epidemic is likely among the unprotected population. How does flu spread? Influenza is transmitted through the air from the respiratory tract of an infected person. The main way that influenza viruses are spread is from person to person in respiratory droplets of coughs and sneezes. (This is called "droplet spread.") This can happen when droplets from a cough or sneeze of an infected person are propelled (generally up to 3 feet) through the air and deposited on the mouth or nose of people nearby. Though much less frequent, the viruses also can be spread when a person touches respiratory droplets on another person or an object and then touches their own mouth or nose (or someone elses mouth or nose) before washing their hands. How long does it take to develop symptoms of influenza after being exposed? The incubation period of influenza is usually two days but can range from one to five days. When is a person with influenza contagious? A person is most likely to pass on the virus during the period beginning one to two days before the onset of symptoms and ending four to five days after the onset. Is there an alternative to vaccination in preventing influenza? Vaccination is the principal means of preventing influenza and its complications. Here are some steps that may help prevent the spread of respiratory illnesses like influenza:

Cover your nose and mouth with your sleeve or a tissue when you cough or sneeze-throw the tissue away after you use it. Wash your hands often with soap and water, especially after you cough or sneeze. If you are not near water, use an alcohol-based hand cleaner. Stay away as much as you can from people who are sick. If you get influenza, stay home from work or school. If you are sick, don't go near other people to avoid infecting them. Try not to touch your eyes, nose, or mouth. Germs often spread this way.

If I Got the Flu Last Year, Will I Have Immunity to the Next Flu Virus?
In general, a person who is infected with an influenza virus one year will have some immunity to closely related viruses that may persist for one or more years. For example, if someone was infected with the A/New Caledonia/20/99-like strain of H1N1 that predominated during the 2006-07 season, they are likely to have some immunity that will protect them if they are exposed to that strain or a closely related strain again during the 2007-08 season. The degree of protection depends on the health of the person involved. Young and healthy people with normal immune systems will likely have good immunity against the same or closely related strains of virus from one year to the next. However, people with weakened immune systems are less likely to have immunity that carries over in other years. It's important to remember that influenza viruses are constantly changing so antibody made against one strain will become less effective against new strains as influenza strains evolve over time. In addition, there are different types of influenza viruses circulating and different variants within virus types, and the same type of flu virus does not necessarily circulate each year. For instance, during the 2006-07 flu season, influenza A (H1N1) viruses predominated; however, infection with an influenza A (H1N1) virus (and subsequent antibodies protecting against re-infection with the same virus) would not provide protection against influenza B or influenza A (H3N2) viruses ALL IT TAKES IS ONE INFECTED PERSON To get on a boat, a train, or an airplane

To go to school, or the workplace, or a place of worship

One sick person can infect 250,000 people

if you are otherwise healthy, it is recommended that you stay at home while you are ill. If you have pre-existing medical conditions, including asthma or other lung disease or immune disease, it would be appropriate to seek healthcare as early as possible, to try to avoid serious outcomes. It is also recommended that pregnant women and the very young also seek medical evaluation early. Inzune Hwang, Preparedness Medical Officer,CDC Before leaving your home when you are knowingly infectious, please take the following into consideration:

Although most healthy people recover from the flu without complications, some people, such as older people, young children, and people with certain health conditions (such as pregnant, asthma, diabetes, or heart disease), are at high risk for serious complications from the flu. CDC

To Vaccinate or Not To Vaccinate!

There are many differing opinions regarding vaccinations. Before you try to talk someone out of any vaccination please consider the following (and keep your opinion to yourself): 1) It is a person decision whether or not you and your family are vaccinated. 2) It is NOT for you do decide what another person should do. 3) For some, vaccines will save their lives. for [some] individuals, only vaccines (beside natural infection) can provide pandemic strain specific, prolonged individual protection. WHO How important is vaccination compared to other control activities such as use of antivirals, social distancing and infection control to stemming a flu pandemic? All of these actions are complementary and none replaces another action. If a pandemic vaccineis not available, then the other actions must be relied upon to protect people.

Where will the vaccine be available?

Vaccination clinics organized by local health departments Healthcare provider offices Schools Pharmacies Workplaces.
What is the difference between Seasonal Influenza, Pre-pandemic", and Pandemic Vaccines?

Seasonal influenza vaccines refer to vaccines that are updated yearly and that protect against currently circulating influenza viruses. Pre-pandemic vaccines", contain antigens that correspond to the current H5N1 influenza strains. Pandemic vaccines are used during a current pandemic in action Pandemic vaccine is a vaccine of the future with unknown antigenic composition. It will protect against the pandemic influenza strain but will only be available after the emerging virus of the next influenza pandemic has been isolated. Persons vaccinated may need a booster dose to be fully protected World Health Organization How long will it take to produce the first doses of pandemic influenza vaccine in the event of a pandemic? If production of a vaccine starts on the day a pandemic is declared, it is thought that at least four to six months will be necessary to produce the first doses of vaccine. WHO A fully licensed swine flu shot might not be available until the end of the year, a top official at the World Health Organization said Monday, in a report that could affect many countries' vaccination plans WHO 7/13/2009

On July 29, 2009, the Advisory Committee on Immunization Practices (ACIP) recommended that novel H1N1 flu vaccine be made available first to the following five groups first.

Pregnant women Health care workers and emergency medical responders People caring for infants under 6 months of age Children and young adults from 6 months to 24 years People 25-64 years old with underlying medical conditions (e.g. asthma, diabetes)

Antivirals
How They Work: Antiviral drugs are used to prevent the flu for people who have been close to someone with the flu, or for people that need protection from the flu but they either: Dont get protection after vaccination, The Vaccine is unavailable Or they cant get the vaccine because of allergies, for example Influenza antiviral drugs also can be used to prevent influenza when they are given to a person who is not ill, but who has been or may be near a person with influenza, such as a caretaker or family member. For treatment, influenza antiviral drugs should be started within 2 days after becoming sick. When used this way, these drugs can reduce flu symptoms and shorten the time you are sick by 1-2 days. There are four antiviral drugs approved for use in the US Tami flu ) is approved to both treat and prevent influenza A and B virus infection in people one year of age and older. Relenza (Zanamivir ) is approved to treat influenza A and B virus infection in people 7 years and older and to prevent influenza A and B virus infection in people 5 years and older Amantadine (Symmetrel, generic) is approved to treat and prevent only influenza A viruses in people older than 1 year. Rimantadine (Flumadine, generic) is approved to prevent only influenza A virus infection among people older than 1 year. It is approved to treat only influenza A virus infections in people 13 and older.

Economic And Social Disruption Will Be Great

Once a deadly pandemic hits, what will it be like in our community, our nation, the world? The need for antiviral drugs will likely be inadequate early in the pandemic, and you can plan on a shortage of hospital beds, ventilators, and necessary medical supplies. High rates of illness and worker absenteeism are expected, and these will contribute to social and economic disruption.

REDUCTION IN ROUTINE SERVICES UNAVAILABLE

Groceries Toiletries Pharmaceuticals Gasoline

Utilities

ATM Machines

Hospitals

Public Safety

Items We Take For Granted Will Become Nearly Or Completely Unavailable

Transportation

Cell Phones

Television

Schools

Emergency Medical System Will Be Over Whelmed

INSUFFICIENT Medical Staff Skilled Facilities Beds Emergency Care Ventilators Medication Medical Supplies

Any community [or family] that fails to prepare and expects the federal government to come to the rescue is tragically wrong. Michael O. Leavitt, Secretary of Health and Human Services, 2006-09

How Do We Prepare?
STAY HEALTHYPlan Ahead Get your yearly flu vaccine: The current vaccine wont protect you, but if it is a mixed strain containing components of the seasonal flu, this may help your body fight the virus better. (high risk group) Get a pneumonia vaccine: Many succumbed to secondary pneumonia in the 1918 pandemic. This vaccine covers multiple bacterial forms of pneumonia and could improve your chances of survival. (high risk group) Get elective medical procedures done now: Healthcare practitioners may not be available in a pandemic. Get dental work done now: Tooth and mouth infections are urgent medical issues. These may get into the bloodstream and cause serious illness.

Learn and Get into the Habit of Preventing and Spreading of Germs

Personal Hygiene
The Facts About Handwashing When Done Correctly, handwashing Is the Single Most Effective Way to Prevent the Spread of Communicable Diseases. Good handwashing Technique Is Easy to Learn and Can Significantly Reduce the Spread of Infectious Diseases Among Both Children and Adults. Hands should be washed with clean water and soap:

When they are dirty After using the restroom Before and after preparing meals After cutting and handling raw meat Before eating After cleaning the house

After caring for someone who is ill After changing an infants diaper After cleaning up blood/body fluids
After handling dirty bed linen clothes

Before and after flossing teeth After you cough or sneeze in them

HANDWASHING and COUGHING TECHNIQUES

Hand Sanitizers
Carry them with you Use them often when youre out in public When shopping, take baby wipes and wipe off the handle of your grocery basket your grocery basket

Pointers when going out in public:

Its OK to wear masks and gloves during a severe outbreak. A lot of others will look at you and wish they had done the same. When you have to go to the Dr or other office, take your own pen for writing your name and your own magazines and other reading material. Use your hand sanitizer often. If there are no places to sit for semi-isolation in an office, ask tell the receptionist you will wait in your car and they can call you right before your turn. If an isle is too crowded for your wellness, wait until it empties.

Think Distance and Sanitation

Shelter in Place while the virus is circulating Self-Isolate Be fully prepared in all aspects of daily life! At the very least, minimize the times that you do leave your home.

Exercise Social Distancing Avoid exposure to infected people, especially large groups. OSHA recommends a 6 foot separation from others in the workplace.

Gather and organize Self-Reliance and Preparedness supplies now. Many of the items that you will need during a pandemic will be hard to get during those times so make your vital purchases now while they are readily available.

How would the Brethren have us Prepare

All is Safely Gathered In (www.providentliving.org)

3 month food supply of foods your family eats regularly. Long-term Basics: Basic Recommendation Per Person: Grains 400 lbs, Legumes 60 lbs, Sugar /Honey 60 lbs, Powder Milk 16 lbs, Cooking Oil 10 qts, Salt 8 lbs. Gradually ADD to this list for more satisfying meals.

Water: Minimum of 14 gallons per person or enough water to drink and wash with if there were no other water available, if possible a way to purify water.

Financial Reserve: Set aside some money to carry us through if money from the banks were not available for a period of time. Include small bills.

Prescription Medications: 1-3 month supply of prescription medications (ask Dr. to help w/ this)

STOCKPILE SUPPLIES NOWWhile the Shelves are Full

This would supplies for: Sanitation: toilets, washing clothes, bodies and dishes also trash and waste disposal; personal hygiene supplies: soaps, toothbrush, hair, etc; cooking without electricity; Lighting, heating and fuel and ways to communicate. Details about these can be found in the following handouts: Earthquakes Part 2 and 3, Radio ReadyCommunicating for Emergencies; and No Power Cookers.

Pandemic Preparedness and the workplace

Incorporate Pandemic Planning into the Organizations Business Continuity Plan Develop a disaster plan that includes pandemic preparedness (see www.pandemicflu.gov/plan/businesschecklist.html. Make sure that your business continuity plan protects and supports your employees, customers, and the general public. Informed employees who feel safe at work are less likely to be absent. Prepare and plan for operations with a reduced workforce. Identify business-essential positions and the skills required to sustain essential business functions and operations. Be sure to cross-train three or more employees so they can function appropriately in these positions. Plan for downsizing services but also anticipate any scenario, that may require a surge in your services if they are critical in a pandemic situation. Organize and identify a central team of people or focal point to serve as a communication source so that your employees and customers can have accurate information during the crisis. Work with your suppliers to ensure that you can continue to operate and provide services. Evaluate Personnel Risks and Concerns Identify possible exposure and health risks to employees. Will employees potentially be in contact with people with influenza? Are employees expected to have much contact with the general public or each other? Minimize exposure to fellow employees or the public. For example, can more employees work from home? This may require enhancement of technology and communications equipment. Develop a sick leave policy that does not penalize sick employees, thereby encouraging employees who have influenza-related symptoms (such as, fever, headache, cough, sore throat, runny or stuffy nose, muscle aches, or upset stomach) to stay home so that they do not infect other employees. Recognize that employees with ill family members may need to stay home to care for them. Recognize that, in the course of normal daily life, all employees will have nonoccupational risk factors at home and in community settings that should be reduced to the extent possible. Some employees will also have individual risk factors that should be considered by employers as they plan how the organization will respond to a potential pandemic (for

example, immuno-compromised individuals and pregnant women).

Updated April 30, 2009 Pandemic Planning Workplace Preparedness, page 3 of 5 2007 by Intellectual Reserve, Inc. All rights reserved. Printed in the USA. English approval: 04/07. 36838

Assist employees in managing additional stressors related to the pandemic. These are likely to include distress related to personal or family illness; life disruption; grief related to loss of family, friends, or coworkers; loss of routine support systems; and other similar challenges. Assuring timely and accurate communication will also be important throughout the duration of the pandemic in decreasing fear or worry. Employers should provide opportunities for support, counseling, and mental health assessment and referral should these be necessary. If present, Employee Assistance Programs can offer training and provide resources and other guidance on mental health and resiliency before and during a pandemic. Work with DMBA and Risk Management as well as state and local health agencies to provide information to employees and customers about medical care in the event of a pandemic. Employee Hygiene Develop policies and practices that distance employees from each other, customers, and the public (see the Pandemic PlanningSocial Distancing fact sheet for more information). Consider practices to minimize face-to-face contact between employees such as e-mail, Web sites, and teleconferences. Policies and practices that allow employees to work from home or to stagger their work shifts may be important as absenteeism rises. Consider stockpiling items such as soap, tissue, hand sanitizer, cleaning supplies, and recommended PPE. When stockpiling items, be aware of each product's shelf life and storage conditions (avoid areas that are damp or have temperature extremes) and incorporate product rotation (consume oldest supplies first) into your stockpile management program. Encourage employees to wash their hands frequently with soap and water or with hand sanitizer if there is no soap or water available. Also, encourage your employees to avoid touching their noses, mouths, and eyes. Encourage employees to cover their coughs and sneezes with a tissue or to cough and sneeze into their upper sleeves if tissues are not available. All employees should wash their hands or use a hand sanitizer after they cough, sneeze, or blow their noses. See the Pandemic PlanningPersonal Hygiene fact sheet for more information. Provide employees and customers in the workplace with easy access to infection control supplies, such as soap, hand sanitizers, PPE (such as gloves or surgical masks), tissues, and office cleaning supplies. Provide training, education and informational material about business-essential job functions and employee health and safety, including proper hygiene practices and the use of any PPE to be used in the workplace. Be sure that informational material is available in a usable format for individuals with sensory disabilities or limited English proficiency. Refer to fact sheets on hygiene, home preparedness, social distancing, and PPE for more information. Periodically disinfect work surfaces, telephones, computer equipment, and other frequently touched surfaces and office equipment. Discourage employees from using other employees' phones, desks, offices, or other work tools and equipment.
Updated April 30, 2009 Pandemic Planning Workplace Preparedness, page 4 of 5 2007 by Intellectual Reserve, Inc. All rights reserved. Printed in the USA. English approval: 04/07. 36838

Encourage employees to obtain a seasonal influenza vaccine (this helps to prevent illness from seasonal influenza strains that may continue to circulate). Protecting Employees and Customers Educate and train employees in proper hand hygiene, cough etiquette, and social distancing

techniques. Resource documents are available through Risk Management. Understand and develop work practice and engineering controls that can provide additional protection to employees and customers, such as drive-through service windows; clear plastic sneeze barriers; ventilation; and the proper selection, use, and disposal of PPE. Evaluate the types of measures that may be used to protect employees and customers (listed from most effective to least effective): engineering controls, administrative controls, work practices, and PPE. Employees should avoid close contact with their coworkers and customers (maintain a separation of at least 6 feet). They should avoid shaking hands and always wash their hands after contact with others. Even when employees wear gloves, they should wash their hands upon removal of the gloves in case their hands become contaminated during the removal process. Minimize situations where groups of people are crowded together, such as in a meeting. Use e-mail, phones, and text messages to communicate with each other. When meetings are necessary, avoid close contact by keeping a separation of at least 6 feet, where possible, and assure that there is proper ventilation in the meeting room. Reduce or eliminate unnecessary social interactions. This can be very effective in controlling the spread of infectious diseases. Reconsider all situations that permit or require employees, customers, and visitors (including family members) to enter the workplace. Promote healthy lifestyles, including good nutrition and exercise. A person's overall health impacts their body's immune system and can affect their ability to fight off or recover from an infectious disease. Concerns When Living, Working, or Traveling Internationally Employees living abroad and international business travelers should note that other geographic areas have different influenza seasons and will likely be affected by a pandemic at different times. The U.S. Department of State emphasizes that, in the event of a pandemic, its ability to assist Americans traveling and residing abroad may be severely limited by restrictions on local and international movement imposed for public health reasons, either by foreign governments and/or the United States. Furthermore, American citizens should take note that the Department of State cannot provide Americans traveling or living abroad with medications or supplies even in the event of a pandemic. These conditions will be similar to those found in most other countries. Each individual should contact their own countrys Department of State for information specific to their countrys policies and regulations.
Updated April 30, 2009 Pandemic Planning Workplace Preparedness, page 5 of 5

How Do I Keep My Family Safe During a Pandemic

Shelter in Place While the Virus is Circulating Quarantine your Family Be fully prepared in all aspects of daily life! At the very least, minimize the times that you do leave your home. Exercise Social Distancing Avoid exposure to infected people, especially large groups. OSHA recommends a 6 foot separation from others in the workplace.

What Are the Basics of Social Distancing

Social distancing may be a viable alternative for the general public to avoid the pandemic influenza infection until a vaccine becomes available. Below, in order of potential effectiveness, are various aspects of SD suggestions: 1. Limit exposure to other people within 6 feet. 2. Minimize exposure to enclosed spaces containing crowds, such as movie theatres, grocery stores, gas stations, schools, malls, and so forth. 3. Use personal protective equipment, such as N95 masks (see Pandemic Planning Personal Protective Equipment fact sheet), if you must get within 6 feet of anyone outside your immediate family (or other individuals where you have intimate knowledge of their health conditions) or if you must go into an enclosed space containing crowds. It should be noted that there is limited information on the use of surgical masks for the control of a pandemic in settings where there is no identified source of infection. 4. Wash hands after touching any item that may have been touched by others or use disposable gloves (see Pandemic PlanningPersonal Hygiene fact sheet for more details). Contaminated surfaces can transmit influenza for 24 hours. Its OK to go outside. Just make sure there is more than a 6+ft distance between you and your neighbor

What do I do during a Pandemic and were have to be quarantined?

If Kids Cant Go to School and Parents Cant Go to Work DO Work on Family History Write a Story; As a Family or Individually. Make Sure You Have a Decent Sized Religious Library and Learn the More About the Scriptures. Have a Set of Encyclopedias (Not Internet That May Not Be Available) Learn Tons of New Information. Make a List of Interest of Each Family Member and Have the Supplies Needed Each Person Also, staying on some sort of a schedule is best when isolated from society

If the Pandemic Influenza Comes to Your home

Dont wait until someone in your home gets sick. Look at how your home is set up Where can you put the patient to keep them isolated best from the rest of the family? Who will be the primary caretaker(s)? Choice A, Choice B, Choice C
If there are other cases of avian flu in your neighborhood, it would be safest to keep your children in your yard or home away from others who may be infected. Plan in advance what will need to be done or who you can call upon if you are either alone, ill and incapacitated, or if the adults in the household become ill and incapacitated. Talk with family members and loved ones about how they would be cared for if they got sick, or what will be needed to care for them in your home. Schools and day care facilities will likely close. Plan your child care in advance and how you might function by working at home for example, or how college-age family members can assist in younger child care during the time their schools are closed. Having multiple younger children from several households in one home for day care is less than optimal due to the high risk of spreading the disease.

Whats the Difference Between Isolation and Quarantine?

Quarantine Is a public health strategy intended to stop the spread of very contagious disease Refers to people who, while not yet ill, have been exposed to a very contagious disease and could be able to spread it to others Is effective in protecting the public from very contagious diseases Is usually decided by state health departments and state leaders, though you can self-quarantine if you feel the need to do so Isolation Separates people who have a specific very contagious disease from those who are healthy Restricts the movement of people who have a contagious disease to stop the spread of their illness
If there are other cases of avian flu in your neighborhood, it would be safest to keep your children in your yard or home away from others who may be infected. Plan in advance what will need to be done or who you can call upon if you are either alone, ill and incapacitated, or if the adults in the household become ill and incapacitated. Talk with family members and loved ones about how they would be cared for if they got sick, or what will be needed to care for them in your home.

Schools and day care facilities will likely close. Plan your child care in advance and how you might be taken care of in the event the you and/or your spouse gets sick. The following diagram shows how to set up an area in your home in case a family member gets sick. Ideally, setting up the sick room next to a bathroom is best. However, if your house is small and you have only one bathroom, consider having the well family members use a portable commode. If this isnt convenient, be sure and sanitize the bathroom, often, especially after using it to clean up after a sick family member or one in quarantine.

Area 2 Sick Room Bucket with disinfectant The items that will be located in the sickroom are: Thermometer with alcohol Water. for disinfecting the thermometer Biohazard waste bin. Vaporizer and/or Humidifier Hand Sanitizer Blood pressure monitor Stethoscope This is the area where ALL Soda straws for helping to administer fluids p.p.e. is removed Biohazard wastebasket Disinfecting wipes for all surfaces. Use these on a continual basis for keeping Area 1 contamination Table with all sick room needs down. Fresh gowns, masks, gloves, Disinfect the doorknobs and light switches, hair covers, etc shoe covers. Also, when leaving the room. extra medications, Hand sanitizer. Use this occasionally on gloved hands and when ready eating utensils, extra bedding, tissues to leave the room. Et c . Curtain

//////////////////////

Make sure there are no heating/air conditioning vents are in the sickroom area. If there are any vents in this area, cover them well. The ideal area for the sick room would be one with an attached bathroom. If this in not available, you can supply the sick room with a portable toilet. Make sure all surfaces in the home and especially around the sick room bath room are disinfected continually. Clorox wipes and Lysol spray are two good choices. You can open a window for fresh air, just keep children away from the area when playing outside.

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Main area of house
Curtains between Main Area of house and again between area 1 &2 can be plastic shower curtains hung with an extension rod. Make sure each curtain is closed immediately upon entering and exiting.

Preparing the Sick Room

This should be done at the onset of a serious risk in your community. Any family member exposed to the flu should stay in this room, away from family members, until all danger is pasted ; that is 7-10 days from exposure

The more you remove, the less cleaning and disinfecting youll have to do later

Considering the number of germs incubating in a sick room, it would be best to empty the room of all fabrics: Clothing in closets and dressers Shoes in closets Fabric Covered Furniture Take Down curtains or drapes ( the window can be covered with aluminum foil for privacy and keeping light out).

Cover carpets with thick plastic.

Cover mattress with plastic. To prevent patient from getting too hot from the plastic, perhaps a blanket over the plastic will be comfortable.

Pillows can be easily replaced, so leave them as is.

When the sick room is no longer needed, Wash walls , floors and furniture with disinfectant.

Influenza Home Treatment Supplies

Bedding: Extra Sheets & Disposable Pads Blood Pressure Cuff Bleach: unscented to purify water & decontaminate surfaces Gargle & Nasal Wash Humidifier for Respiratory Treatment or Tea Kettle for steam therapy Kleenex for runny noses or sneezing Personal Protective Equipment: Surgical masks, N95s, goggles, gloves, gown, shoe coverings Thermometer w/ Alcohol for cleaning Medicines: Caffeine Tea For Respiratory Treatment Diphenhydramine 25 mg: allergy, sleep-aid, cough suppressant

Loperamide 2 mg: slows or stops diarrhea Meclizine 25 mg: Nausea & Vomiting Pain Reliever: Ibuprofen, Tylenol, Aspirin (Adults only) fever, aches & pain Tussen - EXPECTORANT ONLY: Helps loosen congestion in your chest and throat, making it easier to cough out through your mouth. Medicine Syringe & dosing spoon for medication Oral Rehydration Solution (See below) Pen & Paper: to record care given Portable toilet or Bedpan Soap for Washing Hands Squeeze bottles, and straws for hydration of the severely ill Homemade Oral Rehydration Solution 1 t. salt 8 t. sugar 5 c. clean drinking or boiled water and then cooled To taste: Crystal Light or "sugar-free Kool-Aid" (NO regular Kool-Aid-bad for diarrhea) Stir the mixture till the salt and sugar dissolve.

Alternative Rehydration Recipe 1/2 -1 cup precooked baby rice cereal 2 c. of water 1/2 tsp. salt Mix well the rice cereal (or sugar), water, and salt together until the mixture thickens but is not too thick to drink. Give the mixture often by spoon and offer the child as much as he or she will accept (every minute if the child will take it). Continue giving the mixture with the goal of replacing the fluid lost: one cup lost, give a cup. Even if the child is vomiting, the mixture can be offered in small amounts (2-1 tsp.) every few minutes or so. Hint: Banana or other non-sweetened mashed fruit can help provide potassium. A Word about Other Drinks and Foods Appropriate drinks to administer during the home-prepared stage include official ORS solutions, salted rice water, salted yogurt-based drinks, and vegetable or chicken soup with salt. Clean water should always be used when preparing a solution. Drinks to be avoided include soft drinks, sweetened fruit drinks, sweetened tea, coffee, and medical tea infusions with diuretic effects due to high sugar content and/or caffeine. In addition, drinks with a high concentration of sugar can worsen diarrhea. Continue feeding children when they are sick, if they will eat Continue breastfeeding if the child is being breastfed Regarding Homeopathic Remedies Learn the proper method when using homeopathies, essential oils and old wives tales recipes, as the wrong way can be a bad way. When used properly they can offer pain relief and healing.

P. P. E . Personal Protection Equipment

What is PPE?
Protective equipment, including personal protective equipment for eyes, face, head, and extremities, protective clothing, respiratory devices, and protective shields and barriers.

This You Tube video shows a nurse demonstrating the donning and removing of the ppe. Watch it carefully; she explains what to do and why. http://www.youtube.com/watch?v=3Khm3_upwKc&feature=related

Instructions (ehow.com) 1. Donning PPE o 1 Don your gown first by securing the ties at the neck and waist.
o

2 Put on a mask or particulate respirator. If using a mask, place it over your nose, mouth and chin, securing it with the attached cloth or elastic strings to fit and pinching the metal clamp, if applicable, over the bridge of your nose. You don particulate respirators much the same way as a mask, except you should have a professional fit-test a respirator prior to use.

3 Don goggles or a face shield. Goggles with standard earpieces work just like regular glasses; tighten those with an additional, or standalone, headband so the goggles do not slide off your nose. If using a face shield, place the top portion on your brow and affix the headband so it fits comfortably.

4 Slip on gloves by inserting each of your hands into a single glove, which are typically ambidextrous, and adjusting them to fit. Place the cuffs of your gown under each glove to eliminate any gaps between your gloves and your gown. If you'd like, place another glove on your hands to achieve the extra protection of "double gloving."

2.
o

Removing PPE 1 Remove your gloves by peeling one of the gloves away from your wrist with the other gloved hand, turning the glove inside out in the process. Slide a finger from the now bare hand under the remaining glove and peel it off from your wrist, again, turning the glove inside out in the process,

2 Take off your goggles or face shield by grasping the portions nearest your ears and pulling up and away from your face.

3 Remove your gown by unfastening the straps in the back and pulling away it away from your neck and shoulders.

4 Remove your mask or respirator by untying or lifting the straps up and over from the back of your head and away from your face.

Read more: How to Don and Remove PPE | eHow.com http://www.ehow.com/how_6605120_don-remove-ppe.html#ixzz1PGcCi4jP

Caring for the Sick

Call your Doctor as soon as you suspect someone in your house has been exposed to a pandemic virus or anyone is showing the symptoms of a flu or cold. Use antiviral medications within 24-48 hrs of the onset of symptoms Encourage fluids to prevent dehydration. Treat Symptoms as they appear with over-the-counter medications or alternative measures, paying special attention to fever reduction, diarrhea control, hydration, and rest.

Isolate to Reduce Transmission

Isolate from the family Provide separate toilet Limit items in room Disinfect home daily
cup bleach to 1 gal of water (replace it every 12 hrs) Lysol Disinfectant Germicides that guarantee to kill flu virus

Use disposable dishes

Warning Signs an Adult Should be Taken to the Emergency Room or Designated Care Facility
Difficulty breathing or shortness of breath Pain or pressure in chest or abdomen Sudden dizziness Confusion Severe or persistent vomiting

Warning Signs a Child Should be Taken to the Emergency Room or Designated Care Facility
Fast or difficult breathing Bluish skin color Lethargy Irritability Cough Fever with a rash Dehydration Symptoms Sunken eyes Decreased Urination Sunken soft spot of top of head No tears when crying Dry or sticky mucus membranes inside mouth Watch for secondary infection once flu symptoms have diminished

You can download and print the booklet Good Home Treatment of Influenza via this website: http://www.birdflumanual.com/resources/Home_Influenza_Treatment/files/Good%20Home%20Treat ment%20of%20Influenza%2010pt.pdf

If There is a Death in the Home

Ideal situation, but not California law.
Police department should be called. Coroner: If no physician was in attendance, the coroner may be called to determine the cause of death. Death certificate is required for benefits, insurance, and other purposes. Wear protective covering when handling the body. Wear protective covering when handling the body. Cleaning supplies used for cleanup of the body must be placed in a plastic bag and tied securely. Wrapping the body in plastic is necessary Graves for mass fatalities during such an emergency. (If possible, fingerprint the body in the event bodies are exhumed for identification or proper burial

Dont be alarmed if: (Californias plan)

National Guard, Army, and Marines will be called in to maintain order and make sure quarantines are being obeyed They will be giving the families in your area instructions pertaining to: Quarantine, Isolating the Sick, and Death Procedures Youll be given instructions as to how notify authorities, (i,.e, the command in your area) as to the condition of your household, All Well, Illness in Home, Death in Household. They will instruct you as to what to do when someone dies. Most likely you will be told not to touch the body, leave it where it is, and someone will come within 24-48 hours to collect it.

Information needed for death certificate:

Documents/information needed in the first five days
You'll need to gather together the following documents and information as soon as possible - to enable registration of the death and to start funeral arrangements.

Documents
Medical certificate of the cause of death (signed by a doctor) and if available:
Birth certificte Marriage/civil partnership certificates NHS Number/NHS Medical Card

Information
The persons full name at the time of death Any names previously used, including maiden name The deceased date and place of birth The last known address Their current occupation or occupation before retirement Dates of marriages or civil partnerships The full name of survivng spouse or civil union partner Any state or occupational benefits the deceased was receiving at the time of death. Religion Organ Donor informatin In the event your state will be burying the dead in temporary graves (remember, the time will come when everyone will have immunity, so dead bodies wont pose as much as a threat) make sure you have sources of DNA so your family member can be property identified. You may have a chance to eventually bury them in a dedicated grave you have previously purchased or can purchase later.

In conclusion
We are given this insight in Doctrine and Covenants 90:24 [D&C 90:24]: Search diligently, pray always, and be believing, and all things shall work together for your good, if ye walk uprightly. This stunning promise from the Lord that all things shall work together for our good is repeated many times in the scriptures, particularly to people or prophets who are suffering through the trials of their own life stories. I sense that this promise comes from a tender, caring Father who desires to bless us and give us reason to hope through our earthly journey. Knowing that eventually all things will work together for our good will help us endure affliction like the faithful people from the scriptures who knew of His promises and trusted in them, having seen them afar off, and were persuaded of them, and embraced them (Heb. 11:13). We too can embrace this promise. Susan Tanner

Sources
Pandemic Preparedness (2008) Vicky Godley Preparing for a Pandemic Shanna L. Christ, RN, & Nurit R. Bassett, RN A Citizens Guide: getpandemicready.org Utah: pandemicflu.utah.gov Health and Human Services: pandemicflu.gov Centers for Disease Control: cdc.gov/flu/avian World Health Organization: who.int/csr/disease/avian_influenza/en/ National Institute of Health: niaid.nih.gov/dmid/influenza/pandemic.hm Good Home Treatment of Influenza by Grattan Woodson, MD Church of Jesus Christ of Latter-day Saints Wikipedia Fluwiki.com

EMERGENCY CARE STORAGE BINS

shannafincherchrist@yahoo.com The following is a list of items that can be obtained and stored/organized into bins for emergency and pandemic preparedness 1-2: ACTIVITY BOXES Scriptures and Hymnal for Adults Scripture Stories & Song Book for Children Game Book & Easy Craft Book for Children Adult Paint sets: Pastels, Water Color, Oils Beads Kit & Book, Scissors, Ruler Magnetic Story Book Board Markers, Crayons, Pens, Pencils & Sharpener Construction Paper, Lined Paper, Index Cards Googly Eyes, Pipe Cleaners, Popsicle Sticks Paints & Brushes: Poster, Acrylic, Water Color Glue, Tape, Paper Clips, Stapler & Staples Games, Story Books, Modeling Clay, Cards

3: BEDDING KIT Sets of Sheets & Pillow Cases 20 Absorbent Bed Pads Bedpan, Male & Female Urinals 4: BIRTHING KIT Instructions for the Non Medical Person Plastic tubs, Nasal/Mouth Syringes Clamps for Umbilical Cord, Scissors Pampers, Safety Pins, Diapers, Plastic Pants Blankets for Babies, Clothing for Babies Knit Hats and Gloves, Hand Warmers Light Robes for Mother, Nursing Pads & Cream Absorbent Pads for Bed (From Bedding Kit) Peri Bottles & Peri-Care Pads to Reduce Swelling How to perform emergency childbirth http://www.thefarm.org/charities/i4at/surv/ebirth.htm 5: DISH WASHING KIT Tubs, Dawn Detergent Sponges/Scrubbies Bottle Brushes Dish Cloths & Towels Steel Brush for Grill Wire Scrubs & Brillo Pads 6: DISPOSABLE DISHWARE KIT Knives, Spoons, Forks Bowls, Cups, Plates, Tablecloth & Napkins Ziploc Bags of all sizes 7: FABRIC & SEWING KIT Various types of fabric Small Tackle Box with Sewing Needles, Threads, Bobbins, String, Seam Cutter, Machine Oil, Scissors, Crochet Hooks, Yarn 8: FIRST AID KIT First Aid Flip Chart + Soldier First Aid Poison Control Instructions, Varied Sizes of Bandaids, Gauze & Tape Antibacterial Soaps (With Essential Oils) Saline Wipes, Alcohol Wipes, Disinfectants Slings Made from Sheet Material Ties Made from Sheet Material Ace wraps + Stretchable Fabric Splints with Stiff Placemats, Cardboard, Foam Finger splints + Popsicle Sticks & Tongue Suppressors with Coban Bandage Wrap

Heavy Bleeding: Kotex Pads & Sterile Pads Peroxide, Rubbing Alcohol Antibiotic Ointments, Burn Relief, Itch Relief & Pain Relievers (Essential Oils) 9: HYGIENE KIT Wash Rags, Hand towels, Tooth Brushes Toothpaste/ Essential Oil Curlers, Soap with Dispensers Manicure Set, Fingernail Scrub Brushes Tampax, Kotex, Panti Liners, Q-Tips Hair Spray, Lotion, Shampoo, Conditioner, Powder, Deodorant, Combs, Brushes Peri Bottles, Shoe Pads, Mirror Shaving Cream, Razors 10: INFLUENZA PANDEMIC TREATMENT KIT Book: Good Home Treatment for Influenza Book: Essential Oils Reference Guide Surgical Masks & Goggles, Gloves, Shoe Covering, Gowns, Body Bags (See Med Kit) 11: KITCHEN ACCESSORY KIT & RECIPE BOOKS 12: KITCHEN BOWELS & CUTTING BOARD KIT 13: KITCHEN DISHWARE KIT 14: KITCHEN POTS & PANS KIT 15: MEDICINE & WELLNESS KIT Home Treatment & Alternative Care Books, Reflexology & Essential Oils Guide Pen and Tablet for Patient Care Record Pill Cutter, Dosing Syringes & Spoon Thermometers (2) Blood Pressure Cuff & Stethoscope Humidifer, Diffuser, Tea Pot OVER-THE-COUNTER MEDICINES: Tylenol ,Ibuprofen, Meclizine 25 mg Loperamide 2mg (i.e. Imodium), Diphenhydramine 25 mg (i.e. Benadryl), Dextropmethorphan (i.e. Robitussin DM), ESSENTIAL OILS (i.e. from dTERRA) : Basil, Cypress, Ginger, Lavender, Lemon, Oregano, Peppermint, Thyme, Wild Orange, Breathe, DigestZen, Elevation, On Guard, + VITAMINS, MINERALS + Vitamins & Supplements, Gold-Silver Celectrolyte Solution, HYDRATION SUPPLIES Salt/Sea Salt, Baking Soda, Sugar/Agave, Flavorings/Citrus Oils, Straws, Squeeze Bottles, Baby Bottles

16: LIGHTS & COMMUNICATIONS KIT Lanterns, 100 Hour Candles Flashlights (battery, solar, wind-up) Shortwave radio (solar) C Crane Radio- LED light-Cell Phone Adapters (wind-up) AM, FM, Weather Multiple sized Batteries 17: LAUNDRY KIT RECIPE for Stain Remover RECIPE for Laundry Detergent Clothes Lines, Clothespins, Clothespin Holder Baking Soda, Borax, Fels Naptha Bars of Soaps Ammonia, Ivory Soap, Spray Bottles Large tubs for washing clothes Plungers to agitate clothes Hand Wringer 18: SANITATION KIT 2 Portable Toilets with Lids Toilet Paper, Paper Towels, Hand Wipes Small, 13 gallon& 33 gallon Trash Bags Spray Bottles, Sanitizers (Essential Oils) Flannel Squares for Toilet Paper Borax, Super Sorb, Peroxide, Vinegar Lime, Shovel, Masks 19: SHOE, BOOT, RAIN GEAR KIT 20: UTILITY & TOOL KIT Tool Box, Duct Tape, Tape Measure 21-24: WINTER CLOTHING KIT