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Bedford County Emergency Management Director Scott Johnson and Avian Influenza Planning Project Manager Dr. Carl Bailey have been examining what difficulties the county will likely face in the event of an Avian Flu pandemic.
The pair stressed they do not want to frighten the public about what an outbreak of the deadly virus could mean, but encourage preparedness for everyone -- no matter if they are involved in government, business, civic groups or just protecting their families.
Social isolation
A pandemic is an epidemic that covers a wide geographic area and affects a large portion of the population, like the 1918 Spanish flu outbreak.
The 1918 flu pandemic, commonly referred to as the Spanish flu, was first found in the United States, appeared in Sierra Leone and France, and then spread to nearly every part of the world, according to Wikipedia.
It was caused by an unusually severe and deadly influenza strain. Many of its victims were healthy young adults, in contrast to most influenza outbreaks, which predominantly affect juvenile, elderly, or otherwise weakened patients.
The Spanish flu lasted from March 1918 to June 1920. It is estimated that anywhere from 20 to 100 million people were killed worldwide
When that occurred, America was still mostly an agricultural society, and travel was comparatively limited.
Today, people interact with each other socially a great deal more, Johnson said. Because of this, officials say "social isolation," or staying at home, is one of the best ways to stop the spread of the virus.
In such an event, the county would close schools and any kind of excessive public gatherings to keep people apart.
"When you get within that magic 36-inch distance (from another person), you transmit it," Bailey said.
Bailey corrected the assumption that the reason so many people died in 1918 was the quality of medical care.
"The medical ... is no better or worse than it was ... but we do have many more things in place to alert the public," he said, adding that by the time people were aware there was a pandemic in 1918, it was already well underway.
Johnson said that typically when flu or virus outbreaks occur, administrators would shut down schools for just a few days to let the bug die out.
But the time frame for a pandemic is much longer, Bailey explained. According to the Centers for Disease Control, local planners should prepare for three waves of the virus, each lasting from eight to 16 weeks.
Economic damage
Bailey said the single biggest issue right now is working with industry in the county. When meeting with the heads of these companies, Bailey asks what would happen if they came in on a Monday morning and 15 percent of their workforce was gone.
"By Tuesday, it's 20 percent and by Thursday it's 35 percent ... gone. You've got no people to produce wages," Bailey said. He also referred to a recent economic study that looked at how long businesses could survive without cash flow. Only large businesses would be able to cope for 12 days without cash flow, Bailey said.
However, the small businesses would have to close their doors and could possibly never reopen.
"The economic damage to this county, if we really don't get it together, would be far and away the worst damage we would suffer," the doctor said. "The death, the grief, the loss will happen. That we will get through ... our 130 pastors will be tasked to the limit."
But it could take years to recover from the economic impact. Bailey said he's "ruined many a chicken dinner meeting with community groups" by relating these painful facts.
"I try to wake these people up, but I also tell them that there is light at the end of the tunnel," Bailey said. "Just don't get near anyone and you won't transmit it."
Mobility means danger
Bailey says because of the change of our mode of living, with much more mobility, things are considerably different than during the 1918 pandemic.
"Medicine has not changed that much -- there was no vaccine then and there is none now," Bailey said, but people are less than six hours away from an international airport and access to any part of the world.
"There's an enormous number of issues that federal and state agencies are working with regarding what to do if a pandemic hits somewhere," Bailey said, giving an example of someone flying into Nashville from an overseas outbreak and then driving to Shelbyville an hour later.
"You begin to think about all those situations," Bailey said, calling it a "Pandora's box." Just one example to ponder is the number of 18-wheelers that move through Shelbyville each day.
"How many trucks have to arrive here on a daily basis to feed us? What would happen if trucks didn't show up for three days? All of our stores would have no food on the shelves. It's a horror story."
On our own
Johnson said in a normal disaster response, the event is extremely localized. But in the occurrence of a pandemic, "everything you read from the federal government, to the state, city and county is 'don't expect any help' from the federal government or the state because everybody is going to be in the same boat."
When there is a large local disaster, such as a tornado or other event, counties can rely on mutual aid from neighboring areas, but in the case of a pandemic, everyone will have their hands full.
"We have to be prepared to be on our own," Johnson said. "Federal officials have been real good saying that since Katrina." Counties in Tennessee are in various stages of planning, with some counties "not doing anything," Johnson mentioned.
"You know you're never going to be totally ready," he said.
Bailey said he's been working in emergency management for decades and has always heard from the federal government that if people can hold out for 72 hours in a given situation, help will be on the way.
"This is the first time we have heard in repeated meetings and briefings that there will be no help available. You will truly be on your own," Bailey stressed.
As a result, many civic and faith-based groups would be turned to for help during a pandemic. A plan is being worked out with assigned duties for each organization. But no matter how proactive they are with their planning, Bailey admits they will not be able to save everyone.
Bailey has contacted all the churches in the county, which will then recruit people from their congregations to become the workforce for emergency management, from very minimal-risk tasks such as telephone work to a high-risk job such as delivering food to an infected family.
"The most important thing we can do is prepare as much as we can," Bailey said.
It's sad when we're told that our medical situation hasn't improved in 90 years.
We have more medical personnel and more equipment and pallative (if not curative or preventative) treatment but how much of it can reach the stricken if the caregivers become ill?
How will our crops and animals fare?
There may have been more people die of the pandemic's side effects than of the disease itself.
(That's not even counting the economic impact.)
We can physically isolate ourselves,grow a good deal of our own food,store water and other necessities,get medical care and supplies from people in Hazmat gear and do our learning,fellowshipping,etc.online or via other technology.
We can stay in touch without getting physically near one another.
Much of the damage that occurred earlier came from panic and lack of preparation.
The result was like something out of a doomday novel by Michael Crichton or Stephen King.
In addition to the civil defense type efforts,we need to get ready to survive independently.
We need to prevent our dying because we can't reach a glass of water or put on an extra blanket or leave a burning or flooded building.
The flu can mutate to more benign forms in order to have hosts healthy enough to further its spread.
If we can't stop it before it starts,we need to be able to wait it out.
The preparations we make to lessen our helplessness and help us come back from our shut-down will serve us well even without a pandemic.
We have the past to learn from.
Remember,the generation that lost its youths to war and pestilence had just survived Reconstruction and went on to overcome drought and Depression.
They created a generation that would rise from the ashes of a second World War to claim the title of "The Great Generation."
We can choose to beat this disease and any other calamities by being realistic about their dangers-and our own resourcefullness and resilience.
Spread of avian flu by drinking water:
Proved awareness to ecology and transmission is necessary to understand the spread of avian flu. For this it is insufficient exclusive to test samples from wild birds, poultry and humans for avian flu viruses. Samples from the known abiotic vehicles also have to be analysed. There are plain links between the cold, rainy seasons as well as floods and the spread of avian flu. That is just why abiotic vehicles have to be analysed. The direct biotic transmission from birds, poultry or humans to humans can not depend on the cold, rainy seasons or floods. Water is a very efficient abiotic vehicle for the spread of viruses - in particular of fecal as well as by mouth, nose and eyes excreted viruses.
Infected birds and poultry can everywhere contaminate the drinking water. All humans have very intensive contact to drinking water. Spread of avian flu by drinking water can explain small clusters in households too. Proving viruses in water is difficult because of dilution. If you find no viruses you can not be sure that there are not any. On the other hand in water viruses remain viable for a long time. Water has to be tested for influenza viruses by cell culture and in particular by the more sensitive molecular biology method PCR.
There is a widespread link between avian flu and water, e.g. in Egypt to the Nile delta or Indonesia to residential districts of less prosperous humans with backyard flocks and without central water supply as in Vietnam: http://www.cdc.gov/ncidod/EID/vol12no12/.... See also the WHO web side: http://www.who.int/water_sanitation_heal... .
Transmission of avian flu by direct contact to infected poultry is an unproved assumption from the WHO. There is no evidence that influenza primarily is transmitted by saliva droplets: "Transmission of influenza A in human beings" http://www.thelancet.com/journals/laninf... .
Avian flu infections may increase in consequence to increase of virus circulation. In hot climates/the tropics flood-related influenza is typical after extreme weather and floods. Virulence of influenza viruses depends on temperature and time. Special in cases of local water supplies with "young" and fresh H5N1 contaminated water from low local wells, cisterns, tanks, rain barrels, ponds, rivers or rice paddies this pathway can explain small clusters in households. At 24°C e.g. in the tropics the virulence of influenza viruses in water amount to 2 days. In temperate climates for "older" water from central water supplies cold water is decisive to virulence of viruses. At 7°C the virulence of influenza viruses in water amount to 14 days.
Human to human and contact transmission of influenza occur - but are overvalued immense. In the course of influenza epidemics in Germany, recognized clusters are rare, accounting for just 9 percent of cases e.g. in the 2005 season. In temperate climates the lethal H5N1 virus will be transferred to humans via cold drinking water, as with the birds in February and March 2006, strong seasonal at the time when drinking water has its temperature minimum.
The performance to eliminate viruses from the drinking water processing plants regularly does not meet the requirements of the WHO and the USA/USEPA. Conventional disinfection procedures are poor, because microorganisms in the water are not in suspension, but embedded in particles. Even ground water used for drinking water is not free from viruses.
http://www.un.org/apps/news/story.asp?Ne...
Ducks and rice [paddies = flooded by water] major factors in bird flu outbreaks, says UN agency
Ducks and rice fields may be a critical factor in spreading H5N1
26 March 2008 -- Ducks, rice [fields, paddies = flooded by water! Farmers on work drink the water from rice paddies!] and people -- and not chickens -- have emerged as the most significant factors in the spread of avian influenza in Thailand and Viet Nam, according to a study carried out by a group of experts from the United Nations Food and Agriculture Organization (FAO) and associated research centres.
"Mapping H5N1 highly pathogenic avian influenza risk in Southeast Asia: ducks, rice and people" also finds that these factors are probably behind persistent outbreaks in other countries such as Cambodia and Laos.
The study, which examined a series of waves of H5N1 highly pathogenic avian influenza in Thailand and Viet Nam between early 2004 and late 2005, was initiated and coordinated by FAO senior veterinary officer Jan Slingenbergh and just published in the latest issue of the Proceedings of the National Academy of Sciences of the United States.
Through the use of satellite mapping, researchers looked at a number of different factors, including the numbers of ducks, geese and chickens, human population size, rice cultivation and geography, and found a strong link between duck grazing patterns and rice cropping intensity.
In Thailand, for example, the proportion of young ducks in flocks was found to peak in September-October; these rapidly growing young ducks can therefore benefit from the peak of the rice harvest in November-December [at the beginning of the cold: Thailand, Viet Nam, Cambodia, Laos are situated -- different from Indonesia -- in the northern hemisphere].
"These peaks in congregation of ducks indicate periods in which there is an increase in the chances for virus release and exposure, and rice paddies often become a temporary habitat for wild bird species," the agency said in a news release.
"We now know much better where and when to expect H5N1 flare-ups, and this helps to target prevention and control," said Mr. Slingenbergh. "In addition, with virus persistence becoming increasingly confined to areas with intensive rice-duck agriculture in eastern and south-eastern Asia, evolution of the H5N1 virus may become easier to predict."
He said the findings can help better target control efforts and replace indiscriminate mass vaccination.
FAO estimates that approximately 90 per cent of the world's more than 1 billion domestic ducks are in Asia, with about 75 per cent of that in China and Viet Nam. Thailand has about 11 million ducks.
Dipl.-Ing. Wilfried Soddemann - Epidemiologist - Free Science Journalist soddemann-aachen@t-online.de
Well, I will be running to the store to get my collection of hand sanitizer, and dust masks. I already have two cans of Lysol spray that I think would help.
This is a very serious thing we may have to deal with. I feel it is my job as a parent to be over prepared, rather than getting caught without nothing.
There are several simple and inexpensive things that towns and cities can do that will have a major impact in limiting avian flu.
1) Lay in large stores of hand sanitizer and dust masks well ahead of time. When the epidemic hits, issue quarts of hand sanitizer and masks to all public establishments, to place inside their main entrance with a sign strongly recommending their complimentary use by the public. It has been recently determined that colds and flus are spread more by hand contamination than by coughing and sneezing.
2) Set up a city automatic phone bank that will autodial every phone in the city with recorded message information about the epidemic at intervals.
Key-presses after the message for special services such as to report an initial-stage illness in their home, dead animal recovery, request a mortician, etc. This will assist emergency services.
3) The most dangerous national shortage the US has, that will cause many unnecessary deaths, is of medical ventilators. Every extra ventilator a city has may save half a dozen lives.
4) Mortality from avian flu can be predetermined by a chest X-ray with reasonable accuracy. This knowledge will enable critical triage efforts by medical personnel. So it is vital that they be able to perform multiple X-rays in a rapid manner.
5) Schools should have an action plan by which teachers in public schools can conduct classes via the Internet. With the cooperation of the local cable TV provider, unused channels might be used for this purpose as well.
"According to the Centers for Disease Control, local planners should prepare for three waves of the virus, each lasting from eight to 16 weeks."
I wish more communities would get this message out as clear as you have stated in this article.
Three cheers for Bailey. This is information that needs to be spread far and wide. The only thing missing is the information that the current bird flu (H5N1) is getting closer to becoming infectious in humans all the time and that it is hundreds times as lethal as the 1918 Spanish flu was. And people should know that all of three of the influenza pandemics of the last century were bird flu that mutated. So, it can easily happen again, only so much worse.