Prepared Citizens

Do unto others as you would have them do unto you.

  • Previous Posts

  • Michael Osterholm Quotes:

    “What we need to be doing now is the basic planning of how we get our communities through 12 to 18 months of a pandemic.”

    “Ninety-five out of 100 will live. But with the nation in crisis, will we have food and water? Are we going to have police and security? Will people come to work at all?”

    “It's the perfect setup. Then you put air travel in and it could be around the world overnight.”

    “We can predict now 12 to 18 months of stress of watching loved ones die, of wondering if you are going to have food on the table the next day. Those are all things that are going to mean that we are going to have to plan -- unlike any other crisis that we have had in literally the last 80-some years in this country.”

  • US Health and Human Services

    Secretary Michael Leavitt

    "If there is one message on pandemic preparedness that I could leave today that you would remember, it would be this:

    Any community that fails to prepare with the expectation that the federal government or for that matter the state government will be able to step forward and come to their rescue at the final hour will be tragically wrong,

    not because government will lack a will, not because we lack a collective wallet, but because there is no way that you can respond to every hometown in America at the same time."
  • Joseph C. Napoli, MD of Resiliency LLC

    "I think a new meaning is evolving for resiliency and resilience.

    In some contexts the words are being used to mean the strength to resist being impacted by an adverse event rather than either the “capacity to rebound” or “act of rebounding” from adversity.

    Therefore, resiliency and resilience appear to be assuming the meaning of fortitude, that is, “the strength or firmness of mind that enables a person to encounter danger with coolness and courage or to bear pain or adversity without despondency” as defined in the Webster’s Third New International Dictionary.

    If so, we are coming full circle with science accepting a religious moral virtue – fortitude – as written in the Bible’s Book of Wisdom"




  • Faith Based Resources

    John Piper
    Jonathan Edwards
    Reformation
    Pink-Saving Faith
    Pink-Christian Ethics

    "Examine yourselves, whether ye be in the faith; prove your own selves"
    (2 Corinthians 13:5).

    Why Faith Groups Must Care

    When the Darkness Will Not Lift by John Piper

    Stand

    Be Not Afraid
    Overcoming the fear of Death
    by Johann Christoph Arnold







    While I am not a professional journalist, I do embrace the code of ethics put forth by the Society of Professional Journalists and the statement of purpose by the Association of Health Care Journalists and above all else I strive to "do no harm".


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  • Definitions

    from Wikipedia



    Pandemic Influenza


    An influenza pandemic is an epidemic of the influenza virus that spreads on a worldwide scale and infects a large proportion of the human population.

    In contrast to the regular seasonal epidemics of influenza, these pandemics occur irregularly, with the 1918 Spanish flu the most serious pandemic in recent history.

    Pandemics can cause high levels of mortality, with the Spanish influenza being responsible for the deaths of over 50 million people.

    There have been about 3 influenza pandemics in each century for the last 300 years. The most recent ones were the Asian Flu in 1957 and the Hong Kong Flu in 1968.



    Seasonal Influenza


    Flu season is the portion of the year in which there is a regular outbreak in flu cases.

    It occurs during the cold half of the year in each hemisphere.

    Flu activity can sometimes be predicted and even tracked geographically. While the beginning of major flu activity in each season varies by location, in any specific location these minor epidemics usually take about 3 weeks to peak and another 3 weeks to significantly diminish.

    Individual cases of the flu however, usually only last a few days. In some countries such as Japan and China, infected persons sometimes wear a surgical mask out of respect for others.



    Avian (Bird) Flu
    Avian influenza,

    sometimes Avian flu, and commonly Bird flu refers to "influenza caused by viruses adapted to birds."


    "Bird flu" is a phrase similar to "Swine flu", "Dog flu", "Horse flu", or "Human flu" in that it refers to an illness caused by any of many different strains of influenza viruses that have adapted to a specific host.

    All known viruses that cause influenza in birds belong to the species: Influenza A virus.

    All subtypes (but not all strains of all subtypes) of Influenza A virus are adapted to birds, which is why for many purposes avian flu virus is the Influenza A virus (note that the "A" does not stand for "avian").
    Adaptation is non-exclusive.

    Being adapted towards a particular species does not preclude adaptations, or partial adaptations, towards infecting different species.

    In this way strains of influenza viruses are adapted to multiple species, though may be preferential towards a particular host.

    For example, viruses responsible for influenza pandemics are adapted to both humans and birds.

    Recent influenza research into the genes of the Spanish Flu virus shows it to have genes adapted to both birds and humans; with more of its genes from birds than less deadly later pandemic strains.

    H5N1 Strain


    Influenza A virus subtype H5N1, also known as A(H5N1) or simply H5N1, is a subtype of the Influenza A virus which can cause illness in humans and many other animal species.

    A bird-adapted strain of H5N1, called HPAI A(H5N1) for "highly pathogenic avian influenza virus of type A of subtype H5N1", is the causative agent of H5N1 flu, commonly known as "avian influenza" or "bird flu".

    It is enzootic in many bird populations, especially in Southeast Asia. One strain of HPAI A(H5N1) is spreading globally after first appearing in Asia.

    It is epizootic (an epidemic in nonhumans) and panzootic (affecting animals of many species, especially over a wide area), killing tens of millions of birds and spurring the culling of hundreds of millions of others to stem its spread.

    Most references to "bird flu" and H5N1 in the popular media refer to this strain.



    As of the July 25, 2008 FAO Avian Influenza Disease Emergency Situation Update, H5N1 pathogenicity is continuing to gradually rise in wild birds in endemic areas but the avian influenza disease situation in farmed birds is being held in check by vaccination.

    Eleven outbreaks of H5N1 were reported worldwide in June 2008 in five countries (China, Egypt, Indonesia, Pakistan and Vietnam) compared to 65 outbreaks in June 2006 and 55 in June 2007.

    The "global HPAI situation can be said to have improved markedly in the first half of 2008 [but] cases of HPAI are still underestimated and underreported in many countries because of limitations in country disease surveillance systems".





    Pandemic Severity Index


    The Pandemic Severity Index (PSI) is a proposed classification scale for reporting the severity of influenza pandemics in the United States.

    The PSI was accompanied by a set of guidelines intended to help communicate appropriate actions for communities to follow in potential pandemic situations. [1]

    Released by the United States Department of Health and Human Services (HHS) on February 1, 2007, the PSI was designed to resemble the Saffir-Simpson Hurricane Scale





    From the Massachusetts Health and Human Services



    Isolation


    refers to separating people who are ill from other people to prevent the spread of a communicable disease.



    Quarantine


    refers to separating and restricting the movement of people who have been exposed to a communicable disease and are not yet ill.
  • Additional Information

    Creative Commons License
    Prepared Citizens by Catherine "Jackie" Mitchell is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 United States License.
    Based on a work at http://www.preparedcitizens.org.




    The posts on this site are subject to change. Mostly due to errors in spelling or grammar. I never said I am a professional journalist. I have new appreciation for the job that they do. Also, not all comments made by others will make it onto this site. Comments that advertise a commercial product do not get posted most of the time.


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  • standingfirm

Non-Pharmaceutical Interventions – Part II

Posted by preparedcitizens on January 20, 2008

This is an update from the original post 12-14-2007 here

A report from the Council of Canadian Academies entitled:

“Influenza Transmission and the Role of Personal Protective Respiratory Equipment: An Assessment of the Evidence”

There is an interesting discussion that I want to attempt to highlight.
The discussion is that there are 2 major modes of influenza transmission. Inhalation transmission and Contact transmission being those two modes.

The

“influenza virus exits the respiratory tract of an infected person: (i) expulsion of the virus into the air through sneezing, coughing, speaking, breathing or through aerosol-generating medical procedures, or (ii) by direct transfer of respiratory secretions to another person or surface. The new host acquires the virus either by inhalation of the infectious particles from the air or by contact with infectious material directly or via self-inoculation through a contaminated hand.”

This is where the two primary transmission modes, inhalation and contact, come into the picture.

In inhalation transmission there are ballistic particles and inhalable particles. Ballistic particles are more effected by gravity and have an infectious range of under 3 feet with a particle size of 100 μm¹. These particles may remain in the air from seconds to days. These particles are deposited on the mucous membranes (eyelids, lips and nostrils, etc.) and not inhaled.

“The inhalable particles can be classified into three size categories that have different deposition behaviour. Nasopharyngeal-sized particles range from approximately 20 to 100 μm in diametre and tend to travel no further than the upper respiratory tract. Tracheobronchial-sized particles have a diametre ranging approximately from 10 to 20 μm and are capable of depositing as far down as the tracheobronchial region. Alveolar-sized particles are less than approximately 10 μm in diametre. They are the only particles capable of reaching the alveolar region but can be deposited anywhere in the respiratory tract.”

The article goes on to state that there is evidence that the recommendation from the CDC described as the “three-foot-rule” is now practiced to be at around seven feet. There is thought that even long range inhalation transmission of influenza viruses is possible, how long that distance is is not clear to me but the article states that there is evidence that influenza is transmitted primarily at short range.

Contact transmission relies on transfer of the virus through direct contact with an infected individual through kissing or by touching a contaminated surface.

“The panel concluded that No evidence has been found that hand hygiene or other interventions that might prevent contact transmission (e.g., glove use in healthcare facilities) prevent the transmission of influenza.”

So, off with the gloves? Not necessarily. The last line of defense may be the only line of defense that the average citizen has.

In the absence of vaccines and antivirals the measures that we can take are temperature and humidity control (warm, humid environments inhibit viruses), quarantine and isolation methods, hand hygiene, respiratory etiquette, school closures and discouraging public gatherings.

The recommendation from the article:

Personal protective equipment (PPE) — e.g., goggles, gloves, gowns, surgical masks and respirators — is considered the “last line of defense” against exposure and supplements engineering and administrative controls. Personal protective respiratory equipment (PPRE) is a sub-category of PPE designed to block inhalation of hazardous airborne contaminants.

One point that is brought up in this article is the proper use and disposal of personal protective equipment. Masks must be fitted on the face correctly or they will not be useful.

From the CDC site:

Wearing a Facemask or a Respirator
Very little is known about the benefits of wearing facemasks and respirators to help control the spread of pandemic flu. In the absence of clear science, the steps below offer a “best estimate” to help guide decisions. They will be revised as new information becomes available.

Consider wearing a facemask if:

• You are sick with the flu and think you might have close contact with other people.

• You live with someone who has the flu (you therefore might be in the early stages of infection) and need to be in a crowded place. Limit the amount of time you spend in these crowded places and wear a facemask while you are there.

• You are well and do not expect to be in close contact with a sick person but need to be in a crowded place. Limit the amount of time you spend in these crowded places and wear a facemask while you are there.

Consider wearing a respirator if:

• You are well and you expect to be in close contact with people who are known or thought to be sick with pandemic flu. Limit the amount of time you are in close contact with these people and wear a respirator during this time. These recommendations apply if you must take care of a sick person at home.

Surgical masks on the patient and careful respirator use of the caregiver may have some benefit.

What is a facemask?

Facemasks are loose-fitting, disposable masks that cover the nose and mouth. These include products labeled as surgical, dental, medical procedure, isolation, and laser masks.

Facemasks help stop droplets from being spread by the person wearing them. They also keep splashes or sprays from reaching the mouth and nose of the person wearing the facemask. They are not designed to protect you against breathing in very small particles. Facemasks should be used once and then thrown away in the trash.

What is a respirator?
A respirator (for example, an N95 or higher filtering facepiece respirator) is designed to protect you from breathing in very small particles, which might contain viruses. These types of respirators fit tightly to the face so that most air is inhaled through the filter material. To work the best way, N95 respirators must be specially fitted for each person who wears one (this is called “fit-testing” and is usually done in a workplace where respirators are used). Most of the time, N95 respirators are used in construction and other jobs that involve dust and small particles. Some healthcare workers, such as nurses and doctors, use these types of respirators when taking care of patients with diseases that can be spread through the air.

If you have a heart or lung disease or other health condition, you may have trouble breathing through respirators and you should talk with your doctor before using a respirator.

From the Minnesota Department of Health:

Like surgical masks, N95 respirators should be worn only once and then thrown away in the trash.

N95 Fit Testing

PPE Placement

PPE Removal

 To PPE or not to PPE, that is the question only you can answer for yourself.

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