Safe Rooms: Improving Your Odds

Photo Credit Wikipedia – Dimmitt, Tx Tornado

 

# 6850

 

Nearly two years ago, over a three day period (Apr 25th-28th) a storm system of epic proportions spawned 351 confirmed tornadoes across five southern states, killing 338 persons in Alabama, Arkansas, Georgia, Mississippi, and Tennessee.

 

This was the the third deadliest tornado outbreak in U.S. History. More than a dozen of these twisters reached intensities of 4 or 5 on the Enhanced Fujita [EF] scale, which can produce near total devastation.

 

After a near-record setting 2011 tornado season (n=1691), 2012 proved somewhat less active (n=936), although certainly not without its moments.

 

No one can say with any confidence how many destructive storms 2013 will bring - but when it comes to tornados - you only have to be hit by one to ruin your whole day.

 

Last spring, the CDC’s MMWR issued an analysis of the previous year’s massive tornado outbreak, that stressed the importance of safe rooms.  Due to the length of the report, I’ve only reproduced a few excerpts. 

 

Follow the link to read:

 

Tornado-Related Fatalities — Five States, Southeastern United States, April 25–28, 2011

Weekly

July 20, 2012 / 61(28);529-533

(Media Synopsis)

Individuals who work or live in a tornado-prone area should develop a tornado safety plan prior to severe weather.

During April 25–28, 2011, the third deadliest tornado disaster occurred in the southeastern U.S. despite modern advances in tornado forecasting, advanced warning times, and media coverage.  CDC reviewed data from the American Red Cross, death certificates and the National Weather Service to describe the fatalities by demographic characteristics, shelter used, cause of death, and tornado severity in the affected states of Alabama, Arkansas, Georgia, Mississippi and Tennessee. Of the 338 deaths, approximately one-third were older adults, almost half occurred in single-family homes, and a quarter happened in mobile homes.  One-half of the 27 tornadoes were rated powerful (EF-4 or EF-5) and were responsible for almost 90 percent of the deaths. The use of safe rooms is crucial to preventing tornado-related deaths.

(Continue . . . .)

With the spring tornado season only a month or two away, now is the time to be creating a tornado safety plan – and if possible – setting up a safe room.

 

FEMA has a good deal of advice on exactly how to construct a safe room – either above or below ground.

 

 

Residential Safe Rooms

• Building a Safe Room in Your House
• Residential Funding Opportunities
• Examples and Case Studies

Having a safe room in your home can protect your family and save the lives of those you care about.

Find answers to your Questions about Building a Safe Room, including:

• What is the cost of installing a safe room?

• Can I install a safe room in an existing home?

• Can I build the safe room myself?

• Where is the best location for the safe room?

• Where can I find plans for safe room construction?

• And more....

Building a Safe Room in Your House

For more details about how you can build a safe room in your home, go to the Taking Shelter From the Storm: Building a Safe Room For Your Home or Small Business (FEMA 320) page before downloading it from the FEMA Library.

Residential Funding Opportunities

Grants, funding opportunities and various initiatives are available for individuals wishing to build a residential safe room.  See the resources below for additional information:

• Residential Funding

• Residential Initiatives

Examples and Case Studies

Learn how others have benefited from safe rooms.  See the following resources on the best practices case study web page.

 

Having a good (and well rehearsed) family emergency plan is essential for any emergency. Even with a safe room, family members could become separated (they may be sent to different hospitals or shelters) in the post-disaster chaos.

 

Some may be injured and unable to provide information about their families.

 

So it is important to set up a plan, including meeting places and out-of-state contacts, and individual wallet information cards -  before you need it. To that end READY.GOV has some advice, and tools, to help you do just that.

 

Plan to Protect Yourself & Your Family

Family Emergency Plan

(PDF - 3Mb)

Prepare yourself and your family for a disaster by making an emergency plan.

 

Download the Family Emergency Plan (FEP) (PDF - 750Kb), print the pages and fill them in offline.

 

Your emergency planning should also address the care of pets, aiding family members with access and functional needs and safely shutting off utilities.

 

You may also want to inquire about emergency plans at work, daycare and school. If no plans exist, consider volunteering to help create one. Read more about school and workplace plans.

 

Once you’ve collected this important information, gather your family members and discuss the information to put in the plan. Practice your plan at least twice a year and update it according to any issues that arise.

 

Together with adequate emergency supplies, a solid first aid kit, and an emergency battery operated NWS Weather Radio, these steps will go a long ways to protecting you, and your family, from a wide variety of potential disasters.

 

For more on all of this, a partial list of some of my preparedness blogs include:

 

When 72 Hours Isn’t Enough

In An Emergency, Who Has Your Back?

An Appropriate Level Of Preparedness

The Gift of Preparedness 2012

»» Read More

Eurosurveillance: Emergence & Spread Of GII.4 Variant Norovirus

 

Norovirus – Credit HPA

 

# 6821

 

Over the past few months we’ve seen numerous reports of norovirus outbreaks in the UK, the United States, and elsewhere around the world. While hardly an uncommon virus, the level of activity has seemed unusually heavy this year. 

 

A few recent blogs on norovirus include:

 

HPA Norovirus Update

Vomiting Larry And His Aerosolized Norovirus

An Unwanted Lagniappe From The Kitchen 

Norovirus Sequelae 

Norovirus: The Gift That Keeps On Giving

 

Like influenza viruses, when we talk about noroviruses, we aren’t talking about a single entity, as there are many different serotypes and strains.

 

There are currently five different genogroups (GI, GII, GIII, GIV, and GV) of noroviruses, with most human infections stemming from GI and GII. Within each genogroup, there are multiple subtypes.

 

GII noroviruses have at least 19 subtypes. The most common cause of human illness is from Genogroup II, genotype 4 (abbreviated as GII.4).

 

And as with influenza viruses, these single-stranded RNA viruses are rapidly evolving pathogens, so we typically see a new norovirus strain emerge every two or three years. 

 

In 2009, we saw the emergence of the New Orleans strain of GII.4.

 

Earlier this year, a new variant of GII.4 was isolated in Sydney, Australia and since then has been reported in Japan, the Netherlands, and the UK. In the United States, this variant is commonly called Sydney 2012.

 

All of which serves as prelude to a report in today’s Eurosurveillance Journal  on the emergence, and spread, of this new variant GII.4 norovirus. 

 

While more surveillance data is needed to accurately determine this new strain’s impact, the author’s warn that health care facilities should prepare for a severe norovirus season.

Excerpts follow, but hit the link to read the report in its entirety.

 

 

Eurosurveillance, Volume 18, Issue 1, 03 January 2013

Rapid communications

Indications for worldwide increased norovirus activity associated with emergence of a new variant of genotype II.4, late 2012

J van Beek , K Ambert-Balay, N Botteldoorn, J S Eden, J Fonager, J Hewitt, N Iritani, A Kroneman, H Vennema, J Vinjé, P A White, M Koopmans, on behalf of NoroNet

Date of submission: 18 December 2012

---

Globally, surveillance systems showed an increase in norovirus activity in late 2012. Molecular data shared through the NoroNet network suggest that this increase is related to the emergence of a new norovirus genotype II.4 variant, termed Sydney 2012. Healthcare institutions are advised to be prepared for a severe norovirus season.

---

In the United Kingdom (UK), the Netherlands, and Japan, norovirus (NoV) epidemiological and laboratory surveillance systems show increased levels of NoV activity compared to previous seasons, in late 2012 [1-3]. Similarly, increases have been noted in Australia, France and New Zealand (unpublished data). At this stage, and with the limited surveillance of NoV in most countries, it is difficult to conclude if these increases denote early seasonal activity or truly increased incidence, although for the UK the latter has been suggested.

 

On 29 November, and on 4 and 6 December, ProMed (http://www.promedmail.org/) messages reported a dramatic rise in NoV hospital outbreaks in England, a 64% higher number of confirmed NoV laboratory reports (hospital- and community-acquired) in England and Wales, and NoV-related deaths in elderly in Japan.

 

The first molecular data uploaded to the international molecular surveillance database NoroNet from Australia, France, New Zealand and Japan indicate that this increase is associated with emergence of a new variant of genotype II.4 (GII.4). The first report of this variant was from Australia in March 2012 (personal communication P.A. White, September 2012), and the strain sequence was submitted to GenBank (accession number: JX459908.1).

In the United States (US), the variant (named Sydney 2012) was detected in September 2012 in five of 22 (23%) laboratory-confirmed outbreaks, and in November in 37 of 71 (52%) laboratory-confirmed outbreaks (recorded in the US norovirus surveillance network CaliciNet) [4]. In two European countries that have not reported any indications of increased activity, the new variant has been found in outbreaks, two in Belgium (September and December 2012) and one in Denmark (November 2012). Other countries participating in NoroNet have not yet reported the new variant.

<SNIP>

Conclusion

Various countries around the globe have reported a higher incidence of NoV outbreaks or illness late 2012, and the first molecular data available via NoroNet suggests that this increase is related to emergence of a new variant of NoV GII.4.

 

More data is needed to confirm the association between a higher NoV incidence and the new NoV GII.4 2012 variant. For this, we invite new members to join the NoroNet network (http://www.noronet.nl).

 

Noronet is a worldwide network for NoV molecular and epidemiological surveillance, through which countries in Europe, Asia, and Australasia have shared NoV outbreak data, sequences, and other information. The NoroNet database, including analysis tools, is accessible for all NoroNet members.

 

With the early signs of a severe NoV season, healthcare institutions are advised to be prepared for NoV introductions. Outbreak management measures, like stringent hygiene measures and quarantine of infected cases, can help to reduce the size of outbreaks [14,15].

 

»» Read More

Resolve To Be Ready: 2013

 

 

# 6806

 

Despite some of the negative images that `doomsday survivalist’ type TV shows have fostered, Ready.gov, FEMA, the HHS, and the CDC all promote the idea that everyone should be prepared to deal with a variety of emergencies and disasters.

 

They know that every year tens of thousands of people across the nation are forced to deal with house fires, floods, severe storms, and medical emergencies. And the potential exists for even larger disasters like hurricanes, earthquakes, and even a pandemic. 

 

Being better prepared - as an individual, family, and community - can save lives and reduce misery.

 

With the start of a new year, many of us will be making New Year’s resolutions – which makes this the perfect time to join FEMA & Ready.gov’s  Resolve to Be Ready in 2013 campaign.

 

 

This year, with the rapid proliferation of `smart phones’ & tablets, the focus is on incorporating these technologies into preparedness.

 

Resolve to be Ready

Led by FEMA's Ready campaign in partnership with Citizen Corps and the Ad Council, this year's emphasis includes integrating technology into individuals, families and businesses preparedness plans. A 2012 Nielson report revealed that nearly 55 percent of mobile phone owners in the United States own smartphones. As a simple resolution, Ready is asking all smartphone owners to turn the technology in their purses and pockets into a life-saving tool during and after an emergency or disaster.

 

Below are additional ways the Ready campaign recommends implementing technology into your emergency plans:

• Learn how to send updates via text and internet from your mobile phone to your contacts and social channels in case voice communications are not available;
• Store your important documents such as personal and financial records in the cloud, in a secure and remote area, or on a flash or jump drive that you can keep readily available so they can be accessed from anywhere; and
• Create an Emergency Information Document by using Ready's Family Emergency Plan template in Google Docs (use Google Chrome to view) or by downloading the Ready Family Emergency Plan to record your emergency plans.
• Download the Resolve 2B Ready 2013 Toolkit for tips and actions you can take.

A good starting place is FEMA’s App – available for Android, Blackberry, & Apple - which they describe as:

Government disaster response at the touch of a button. Learn how to respond to disasters, keep your family safe, apply for assistance, and help others in case of floods, hurricanes, earthquakes, terrorism, or other disasters. We continue to add new relevant information, in both English and Spanish, working to ensure that Americans have easy access to the tools they need to prepare for and, when needed, recover from a disaster in their community. Future enhancements include the ability to check on the status of an application and update an existing application.

 

In October I highlighted some of the smart phone apps available from the American Red Cross (see Red Cross Apps). They include:

Wildfire App

First Aid App

Hurricane App

Shelter Finder App

Earthquake App

 

To become better prepared as an individual, family, business owner, or community requires more than just downloading an app, so I would invite you visit the following preparedness sites to learn the basics.

 

FEMA http://www.fema.gov/index.shtm

READY.GOV http://www.ready.gov/

AMERICAN RED CROSS http://www.redcross.org/

 

And finally, some of my own preparedness articles may be of interest:

 

When 72 Hours Isn’t Enough

In An Emergency, Who Has Your Back?

An Appropriate Level Of Preparedness

The Gift of Preparedness 2012

»» Read More

Black Swan Events

 

# 6772

 

Black Swan events are game changing incidents that few, if anyone, had predicted. The phrase was coined by Nassim Nicholas Taleb in his 2004 book Fooled By Randomness, and expanded upon in his 2007 book The Black Swan.

 

Yesterday, the U.S. National Intelligence Council released a report called  "Global Trends 2030: Alternative Worlds" that tries to anticipate the global shifts that will likely occur over the next two decades.

 

This 166-page report tries to predict the future, but admits that the course of history is often abruptly and unexpectedly changed by outlier events – black swans – that are simply impossible to predict. 

Several of these `game changers’ have been topics of previous posts in this blog.

 

 

Global Trends 2030's potential Black Swans

1. Severe Pandemic

"No one can predict which pathogen will be the next to start spreading to humans, or when or where such a development will occur," the report says. "Such an outbreak could result in millions of people suffering and dying in every corner of the world in less than six months."

2. Much More Rapid Climate Change

"Dramatic and unforeseen changes already are occurring at a faster rate than expected. Most scientists are not confident of being able to predict such events. Rapid changes in precipitation patterns—such as monsoons in India and the rest of Asia -- could sharply disrupt that region's ability to feed its population."

6. Nuclear War or WMD/ Cyber Attack

"Nuclear powers such as Russia and Pakistan and potential aspirants such as Iran and North Korea see nuclear weapons as compensation for other political and security weaknesses, heightening the risk of their use. The chance of nonstate actors conducting a cyber attack—or using WMD (weapon of mass destruction) —also is increasing."

7. Solar Geomagnetic Storms

"Solar geomagnetic storms could knock out satellites, the electric grid, and many sensitive electronic devices. The recurrence intervals of crippling solar geomagnetic storms, which are less than a century, now pose a substantial threat because of the world's dependence on electricity," the report says.

 

While most people are loathe to think about them, these types of high-impact events are not wild-eyed Hollywood disaster movie fantasies. They are considered valid (albeit, low probability) threats by many of our nation’s planning and response agencies. 

 

Which is why agencies like the HHS, CDC, FEMA, Ready.gov and others work each day to convince citizens of the importance of being prepared for the unexpected, and why I devote a fair amount of this blog to everyday preparedness.

 

 

And it’s not just the United States that looks at and prepares for low-probability-high Impact events. 

 

Last March in UK: Civil Threat Risk Assessment, we looked at a report issued by the UK government that is essentially a short list of disaster scenarios (man-made & natural) that the Cabinet Office believe to be genuine threats.

 

The 2012 list includes:

 

Pandemic influenza – This remains the most significant civil emergency risk. The outbreak of H1N1 influenza in 2009 (‘swine flu’) did not match the severity of the scenario that we plan for and is not necessarily indicative of future pandemic influenzas; the three influenza pandemics of the 20th century (1918–19, 1957–58 and 1968–69) all had differing levels of severity. The 2009 H1N1 pandemic does not change the risk of another pandemic emerging (such as an H5N1 (avian flu)
pandemic) or mean that the severity of any future pandemics will be the same as the 2009 H1N1 outbreak.

 

Also on their list is a repeat of the 1953 severe coastal flooding event that claimed hundreds of lives and caused extreme property damage and a catastrophic terrorist attack.

 

New this year are the addition of Severe effusive (gas-rich) volcanic eruptions abroad and the potential impact from severe space weather.

 

Few are aware of it now, but In 1783 the Craters of Laki in Iceland erupted and over the next 8 months spewed clouds of clouds of deadly hydrofluoric acid & Sulphur Dioxide, killing over half of Iceland’s livestock and roughly 25% of their population.

 

These noxious clouds drifted over Europe, and resulted in widespread crop failures and thousands of deaths from direct exposure to these fumes. There are also anecdotal reports that suggest this eruption had short-term global climate impacts as well.

 

Were that to happen again today, the effects would be absolutely disastrous to Europe, and the rest of the world.

 

Sounding a bit like science-fiction, violent solar flares and earth directed CMEs are also on FEMA’s and the UK’s worry list, and are subjects we’ve discussed before:

 

A Flare For The Dramatic

Solar Storms, CMEs & FEMA

A Carrington Event

 

NASA, while admitting that a serious solar storm could happen practically anytime, also cautions that the next big one could be many decades away. It is a genuine threat, they say, but the timing is impossible to predict.

 

In June of 2011 (see OECD Report: Future Global Shocks), we saw a series of reports come out of the OECD (The Organisation for Economic Co-operation and Development) that warned - as the world becomes more interconnected and interdependent - that `Global Shocks’ to the world economy become more likely.

 

They define a Global Shock as: a rapid onset event with severely disruptive consequences covering at least two continents.

While discussing a wide range of future shock scenarios, the authors concentrated most of their attention on five highly disruptive future shock events.

• A Pandemic
• A Cyber Attack
• A Financial Crisis
• A Geomagnetic Storm
• Social Unrest/Revolution

 

They also make special note of the risks of increased antibiotic resistance, and the need for new classes of antibiotics to be developed. 

 

The common threats running through all of these reports are a Pandemic, a coordinated cyber Attack, and destructive solar storms.

 

But of course, by definition, a `black swan event’ comes as a surprise. The next global shock may not come from this list, it could be something we’ve not considered.

 

 

Until it happened, few people would have seriously concerned themselves that a 9.0 earthquake, and a 100 foot tsunami, could devastate northern Japan, disable four nuclear reactors, and change the view of nuclear energy in many countries around the world.

 

But regardless of the source of the next future global shock, being prepared to deal with it is of paramount importance.

 

While there is much governments can do to prepare, a nation’s resilience in the face of a major crisis –whether it be local or global - truly comes from the bottom up, not from the top down. 

 

Being prepared doesn’t mean going to extremes.  You don’t have to dig a bunker, or set aside 10 years worth of canned goods. Nor should you focus on one particular threat, or scenario.

 

Instead, the smart money is on taking basic preparedness steps against `All Hazards', including those you may not automatically assume are a threat where you live.

 

Everyone should have a well thought out disaster and family communications plan, along with a good first aid kit, a `bug-out bag’, and sufficient emergency supplies to last a bare minimum of 72 hours.

 

Based on the  events in Japan (or after Hurricane Katrina in New Orleans, or the earthquake in Haiti) 3 days of supplies many not be enough for a truly worst case scenario.

 

The County of Los Angeles Emergency Survival Guide calls for having 3 to 10 days worth of food and water. Personally, I believe that 2-weeks of supplies isn’t an unreasonable goal, particularly if you live in earthquake or hurricane country.

 

The L.A. guide may be downloaded here (6.5 Mbyte PDF).

 

For more information on preparedness, you may wish to visit:

 

FEMA http://www.fema.gov/index.shtm

READY.GOV http://www.ready.gov/

AMERICAN RED CROSS http://www.redcross.org/

 

And lastly, you may wish to revisit some of my earlier preparedness essays, including:

 

In An Emergency, Who Has Your Back?

 

The Gift of Preparedness 2012

 

An Appropriate Level Of Preparedness

 

Because, by the time you recognize the onset of a black swan event, it is probably too late to prepare for it.

»» Read More

The Gift of Preparedness 2012

 

 

 

# 6737

 

As this weekend officially kicks off the holiday buying season, its time once again to roll out my yearly (updated) preparedness gifts column.

 

Throughout the year I keep an eye out for inexpensive, yet useful, preparedness items that I give to friends and family for birthdays, holidays, and other occasions. 

 

Starting in November of 2007 I began blogging on the idea that rather than giving out ugly neckties, holiday themed sweaters, or boxes of assorted cheeses we should be giving preparedness gifts (see Hickory Farms Will Hate Me For This).

 

Now when I impulse buy gadgets, at least I can call it research. 

 

While I’m not endorsing any specific product or manufacturer, below you’ll find examples of some of the preparedness gifts I’ve either bought for myself, or for family and friends over the past few years.

 

These are items, I have to believe, that a lot of people enduring the aftermath of Hurricane Sandy (or any other disaster) would have been happy to have on hand.

 

My mania began in earnest in 2006 when I stumbled across a bin of `shake LED flashlights’ at a bargain closeout warehouse for .77 cents.  I bought 40 of them, and all but two ended up as gifts or stocking stuffers.

 

 

 

A couple of years ago I ran across a deal on LED headlamps, and bought about 20 of them for $2 apiece.  The following year, I found LED Cap lights (they clip to the bill of a baseball style cap) for $3 each, which I confess I like even better.

 

Hands free light can be a real plus in a crisis.  These too ended up in a number of people's Christmas and birthday packs.

 

During the year I keep my eye out for bargains such as these, and stock up when I find things on sale.Several years ago I picked up a number of LED lanterns for $3 apiece at a closeout store. They are particularly nice, and run about 40 hours on a set of AA batteries.

 

 

But last year, I found a newer item; a combination LED lantern/flashlight that sells for about $5, and it is rapidly become my new favorite.  Lightweight, versatile, and cheap.  A hard combination to beat.

 

 

This year, I’m seeing a lot more variety in LED lanterns and flashlights, providing a lot more bang for the buck. Not only do LEDs run a long time on a set of batteries, unlike gas lanterns, they don’t pose a fire safety hazard.

 

Every home should have a battery operated radio, yet many do not. A few years ago I bought my daughter a combination windup-battery-solar AM/FM/SW radio for under $40, and she uses it every day.

 

 

Last year, I found a combination AM/FM Weather ALERT radio at a discount store for under $20. Again, every home and business should have an emergency alert radio.

 

 

A pair of the FRS radios, like the ones I highlighted in this blog, would make an excellent gift for many families, and can be had for less than $25.

 

 

This year I picked up a few single burner Propane stove units on sale for $10 each. Add a 1 pound propane cylinder (about $3) and you can cook for a week. 

 

 

I’ve also picked up a few magnesium fire starters at $4 each, which will end up as stocking stuffers.

 

For Christmas a couple of years back I put together some first aid kits, and distributed them to a number of friends and relatives. You can either put one together yourself, or purchase one already assembled.

 

 

Living as I do in hurricane country, I’m always aware of the need to store water for emergencies. One of the items I’ve purchased for friends (and myself) are those collapsible 5-gal water carriers. For only about $5, you can store 5 gallons of water, and when not in use they fold up for storage. 

 

 

Although a bit pricier, I’ve also purchased emergency water filter/purification systems for several friends over the years.

 

I’m particularly pleased this year to see the LifeStraw ® is now available in the United States and Canada; at just 2 ounces, this personal water filter will reportedly filter 1000 liters down to .2 microns. 

 

Not bad for around $20.

 

Even MREs can make an excellent gift, and a couple of years back I found cases of them heavily discounted at my local Costco warehouse. 

 

Battery chargers, or an inverter to turn any 12 volt battery into a 120 volt electrical source make wonderful gifts as well. 

 

Three summers ago, on a particularly hot Florida afternoon, we had a power outage that lasted more than 6 hours.  I wrote about it in Sweltering In Place.

 

While I was already set up with a 12 volt fan, my Sister and Father weren’t so lucky. . . . they ended up driving across town to sit in an air-conditioned restaurant for several hours.

 

The next day, I went out and bought them each a battery operated personal cooling fan, one that will run for nearly 24 hours on 4 D-Cells.

I paid about $12 each for them.

 

Something as simple, and as utilitarian, as a multifunction `Swiss’ army knife or a `Multi-tool’ makes a great preparedness gift.

 

 

Another inexpensive gift idea: For under $10 you can buy a box of exam gloves, and a box of facemasks.

 

Several years ago Joel over at Preparedness and Response came up with what I consider to be an excellent preparedness idea, giving USB flash drives to family and friends and instructions on how to back up their important papers and documents.

Inexpensive USB Drives start under $10.

 

He explains it in  his essay Helping others prepare (Personal Preparedness), where he gives his rationale for going with the durable mil-spec and encrypted, but fairly pricey IronKey brand.

 

My thanks to Joel for a terrific idea.

 

And lastly, I've put together CD's of preparedness videos, along with copies of online manuals and preparedness guides.  For the cost of a blank CD or DVD, and a little bit of my time, I've at least put this valuable information into my friend's hands.

 

I may just copy all of this info on to the USB drives I’m giving out this year instead of on CDs.

 

These are all useful, indeed, potentially lifesaving items, that most people simply don't think about needing until it is too late.

 

Giving them as gifts, instead of more traditional items,  not only helps prepare the people you love and care about for an emergency, it opens the door for conversations about pandemic and disaster preparedness.

 

We need to cultivate a culture of preparedness in this country, and around the world.

 

We can start doing that, one gift at a time.

 

 

And one last reminder for the upcoming Holiday Season.

 

This year, when we think about ways to give back to our community, remember that more people will be relying on community food banks than in years past.

 

In addition to anything else you might do, this is a good time to go through your pantry and donate foodstuffs that are approaching (but not exceeding) their `use by' date.

»» Read More

National Family History Day

 

 

# 6724

 

 

Every year since 2004 the Surgeon General of the United States has declared Thanksgiving – a day when families traditionally get together - as National Family History Day. 

 

As a former paramedic, I am keenly aware of how important it is for everyone to know their personal and family medical history. 

 

Every day emergency room doctors are faced with patients unable to remember or relay their health history during a medical crisis.

 

And that can delay both diagnosis and treatment.

 

Which is why I keep a medical history form – filled out and frequently updated – in my wallet, and have urged (and have helped) my family members to do the same.

 

The CDC and the HHS have a couple of web pages devoted to collecting your family history, including a web-based tool to help you collect, display, and print out your family’s health history.

 

Family History: Collect Information for Your Child's Health

Surgeon General's Family Health History Initiative

 

Using this online tool, in a matter of only a few minutes, you can create a basic family medical history.  But before you can do this, you’ll need to discuss each family member’s medial history. 

 

The HHS has some advice on how to prepare for that talk:

 

 

Before You Start Your Family Health History

Americans know that family history is important to health. A recent survey found that 96 percent of Americans believe that knowing their family history is important. Yet, the same survey found that only one-third of Americans have ever tried to gather and write down their family's health history.

Here are some tips to help you being to gather information:

• Before You Start (English) (PDF - 557 KB)
• Before You Start (Spanish) (PDF - 214 KB)

 

I’ve highlighted several other methods of creating histories in the past, some of which you may prefer.  A few excerpts (and links) from these essays.

 

First, I’ll show you how I create and maintain histories for my Dad (who passed away earlier this year) and myself.  This was featured in an essay called A History Lesson.

 

Today, though, I’m going to impart a little secret that will ingratiate yourself with your doctor and not only improve the care you receive, but also reduce the amount of time you spend in the exam room.

 

When you go to your doctor, have a brief written history printed out for him or her.

 

I’ve created a sample based on the one I use for my Dad (the details have been changed).   It gets updated, and goes with him, for every doctor’s visit.

 

And his doctors love it.

 

While every history will be different, there are a few `rules’.

• First, keep it to 1 page.     Even if the patient has an `extensive history’.   If your doctor can’t scan this history, and glean the highlights, in 60 seconds or less . . . it isn’t of much use.
• Second, paint with broad strokes.   Don’t get bogged down in details.  Lab tests and such should already be in your chart.
• Third, always fill in a reason for your visit.   Keep it short, your doctor will probably have 10 to 15 minutes to spend with you.   Have your questions and concerns down in writing before you get there.
• Fourth, list all Meds  (Rx and otherwise) and indicate which ones you need a refill on.   If you have a question about a med, put a `?’ next to it.   And if you have any drug allergies, Highlight them.
• Fifth,  Make two copies!   One for your doctor to keep, and one for you.  As you talk to your doctor, make notes on the bottom (bring a pen) of your copy.  

 

Once you create the basic template (using any word processor), it becomes a 5 minute job to update and print two copies out for a doctor’s visit.

 

The history above is great for scheduled doctor’s visits, but you also should have a readily available (preferably carried in your wallet or purse), EMERGENCY medical history.

 

I addressed that issue in a blog called Those Who Forget Their History . . . .   A few excerpts (but follow the link to read the whole thing):

 

Since you can’t always know, in advance, when you might need medical care it is important to carry with you some kind of medical history at all times.  It can tell doctors important information about your history, medications, and allergies when you can’t.

 

Many hospitals and pharmacies provide – either free, or for a very nominal sum – folding wallet medical history forms with a plastic sleeve to protect them.

 

I’ve scanned the one offered by one of our local hospitals below. It is rudimentary, but covers the basics.

 

 

 

And a couple of other items, while not exactly a medical history, may merit discussion in your family as it has recently in mine.

 

First, all adults should consider having a Living Will that specifies what types of medical treatment you desire should you become incapacitated.

 

You may also wish to consider assigning someone as your Health Care Proxy, who can make decisions regarding your treatment should you be unable to do so for yourself.

 

Elderly family members with chronic health problems, or those with terminal illnesses, may even desire a home DNR (Do Not Resuscitate) Order.

 

Verbal instructions by family members – even if the patient is in the last stages of an incurable illness – are likely to be ignored by emergency personnel.

 

In Florida, the form must be printed on yellow paper. Different states have different requirements.  You should check with your doctor, or the local department of health to determine what the law is in your location.

 

 

My father, who’s health declined greatly in his 86th year, requested a DNR in early 2011. That – along with securing home hospice care last January (see His Bags Are Packed, He’s Ready To Go) – allowed him to die peacefully at home in his own bed. 

 

Admittedly, not the cheeriest topic of conversation in the world, but for a lot of people, this is an important issue to address.

 

A few minutes spent this holiday weekend putting together medical histories could spare you and your family a great deal of anguish down the road.

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Paper: Are We Prepared For A Pandemic In Low Resource Communities?

 

 

# 6713

 

One of the hard truths about pandemics is that they tend to disproportionately affect developing nations and low resource communities.

 

Back in 2006 we looked at a study that appeared in The Lancet that predicted, based on the 1918 pandemic experience, that a modern pandemic of similar virulence could claim 62 million lives, and that 96% of those deaths would occur in the developing world.

 

Estimation of potential global pandemic influenza mortality on the basis of vital registry data from the 1918—20 pandemic: a quantitative analysis

Prof Christopher JL Murray DPhil , Prof Alan D Lopez PhD, Brian Chin ScB, Dennis Feehan AB , Prof Kenneth H Hill PhD

 

The authors cited as much as a 30-fold difference in mortality rates around the world in 1918. Countries in Asia, Latin America, and Sub-Saharan African were particularly hard hit.

 

Some of the reasons behind this disparity included.

 

• lack of access to adequate medical care
• weak public health infrastructures,
• housing conditions and population density
• nutritional status and
• co-existing medical conditions.

 

For the most part many of these conditions still persist, plus developed nations today are more likely to have earlier access to antibiotics, antivirals, and eventually vaccines. Leading the authors to write:

 

Interpretation

This analysis of the empirical record of the 1918—20 pandemic provides a plausible upper bound on pandemic mortality. Most deaths will occur in poor countries—ie, in societies whose scarce health resources are already stretched by existing health priorities.

 

 

A grim scenario, and part of the rationale behind the creation of a program called the H2P  (Humanitarian Pandemic Preparedness) Initiative geared towards promoting community & district-level pandemic flu preparedness and response in developing countries.

 

 

H2P (which began in 2007 & ended in 2010) was a joint effort by NGO’s and partner organizations, including USAID, IFRC, CORE Group (including American Red Cross, CARE, & Save the Children), AED, InterAction, & several UN agencies, including WHO, WFP, & UN OCHA.

 

During the 2009 pandemic I highlighted the H2P initiative’s efforts several times (see here, here, and here), and over the years have had occasional correspondence with Eric Starbuck at Save The Children, who was the H2P’s Public Health Advisor with the CORE Group.

 

I mention this past association because Eric is the lead author on a paper that appears today in the Journal Influenza and Other Respiratory Viruses, that looks at the challenges (and provides some solutions) for helping low resource communities deal with an influenza pandemic.

 

The full article is available online, and is well worth reading in its entirety. 

 

Are we prepared to help low-resource communities cope with a severe influenza pandemic?

Eric S. Starbuck, Rudolph von Bernuth, Kathryn Bolles, Jeanne Koepsell

Article first published online: 12 NOV 2012

Recent research involving lab-modified H5N1 influenza viruses with increased transmissibility and the ongoing evolution of the virus in nature should remind us of the continuing importance of preparedness for a severe influenza pandemic.

 

Current vaccine technology and antiviral supply remain inadequate, and in a severe pandemic, most low-resource communities will fail to receive adequate medical supplies.

 

However, with suitable guidance, these communities can take appropriate actions without substantial outside resources to reduce influenza transmission and care for the ill. Such guidance should be completed, and support provided to developing countries to adapt it for their settings and prepare for implementation.

View Full Article (HTML)     Get PDF (71K)

 

In regions where antivirals, antibiotics, and vaccines (and even basic nursing care) may be unavailable, the only realistic protection against an influenza pandemic is the implementation of NPIs (Non-Pharmaceutical Interventions). 

 

We’ve talked about NPIs many times before, but primarily in the context of a developed or industrialized community.

 

NPI’s and Influenza

Our First Line Of Defense

Study: Effectiveness of NPIs Against ILI's

 

As Eric and his team point out:

 

Nonpharmaceutical interventions (NPIs) to reduce influenza transmission at the household level may include keeping a distance from others, washing hands, covering one’s cough, and isolation of the ill.

 

However, several of these NPIs may not be very feasible in some settings, such as those with poor access to water or where many families live in small one-room dwellings.

 

Experience during the 2009 pandemic indicates that communication materials, such as those encouraging the practice of these NPIs, need to be adapted, tested, and approved for local use ahead of time. The absence of standardized, pretested messages was a challenge in 2009

 

A few samples of the type of guidance provided by H2P to low resource communities include:

 

 

The authors conclude:

 

We believe that detailed authoritative guidance for resource-poor settings on NPIs to reduce influenza transmission at community level in a severe pandemic should be developed.

 

In addition, support should be provided to governments in developing countries to adapt this and other important guidance to their settings and plan to roll it out if needed.

 

We are not aware of ongoing efforts of this kind, but believe that this should be an urgent priority. We are concerned about this apparent gap in the most basic kind of preparedness for a severe pandemic.

 

 

It doesn’t take a pandemic to put people living in low resource communities at greater risk. That happens every day.

 

Agencies like the Red Cross, Red Crescent, CARE, Save The Children, UNICEF, and others are working around the world on a daily basis to combat poverty and disease, and are going to be on the front lines during any pandemic.

 

They could use your support.

 

These NGO’s do a great deal with very little, and even small donations can help make a difference.

 

A final note: For those curious about my mention in the acknowledgements section of this paper, I assure you my contribution was small, and unworthy of mention (but I’m appreciative, nonetheless). When asked, I suggested to Eric that the Journal Influenza and Other Respiratory Viruses might be interested in his paper.

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Canada: Another West Coast Temblor

 

 

Credit Natural Resources Canada

 

# 7703

Overnight a 6.3 magnitude quake rocked the waters off British Columbia, the third 6+ magnitude quake to strike off Canada’s west coast in the last 10 days.

 

The first two, a 7.8  followed by a 6.3 aftershock, struck hundreds of kilometers further north on October 28th and for a time prompted a Tsunami advisory for Hawaii.

 

 
Given the size and location of last night’s quake, little or no damage is expected, except perhaps to the nerves of those who live along the shores facing the Cascadia fault line.

 

 

 

Recent warnings from the University of Oregon (see Shaken, And Hopefully Stirred) suggest the region is overdue for a major earthquake; one that could conceivably match the power of last year’s Great Northern Japan Quake.

 

Last March, in Tsunami: The Other Coastal Threat, we looked at the United State’s preparedness for both east and west coast tsunamis. While truly destructive tsunamis on American and Canadian shores are rare, they have happened in the past.

 

Hawaii and the west coast are considered at greatest risk due to the seismically active `ring of fire’.  

 

Credit USGS 

 

Perhaps the most vulnerable region is the Pacific Northwest, where the Cascadia fault line (see Just A Matter Of Time) is believed to have produced tsunamis in the past that rival the tidal waves that struck Japan last year.

 

No one knows when the next major quake will strike in this region, it could be today, or it could be fifty years from now.

 

When it does happen, it could seriously impact all of the Pacific Northwest, including British Columbia, Washington State, Oregon, California, and through tsunamis, many distant areas in the pacific basin.

 

The only defense with earthquakes is a good offence; being prepared. Which is why British Columbia, Washington State, Oregon, and California (along with other states and nations) recently conducted a Shakeout Drill.

 

 

To learn how to participate in your area’s next Shakeout drill, go to shakeout.org. But since the `big one’ might not wait until after next year’s exercise, now is the time to prepare.

 

Natural Resources Canada has a webpage with information on earthquake safety and preparedness.

 

Preparing for Earthquakes

• From Public Safety and Emergency Preparedness Canada
• Emergency Preparedness Week in Canada
• Emergency Preparedness for Youth  (Sécurité public Québec)
• How would your home stand up? A residential construction checklist to help reduce earthquake damage to your home from CMHC
• Tsunamis
• From the Provincial Emergency Program of British Columbia, Canada's most earthquake-prone province:  
• BC's Emergency Preparedness for Industry and Commerce Council (EPICC)

 

And in the United States you can find earthquake information at Ready.gov’s Earthquake page.

 

Earthquakes

• Before
• During
• After
• More Information

 

And finally, a few of my preparedness blogs you might wish to revisit:

 

When 72 Hours Isn’t Enough

In An Emergency, Who Has Your Back?

An Appropriate Level Of Preparedness

The Gift Of Preparedness 2011

 

Because no matter where you live, its just a matter of time before the next disaster strikes.

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USGS: Eastern Earthquakes - Rare But Powerful

Map shows earthquakes (circles) greater than magnitude 3.0 since 1974 plotted on the 2008 USGS National Seismic Hazard Map for the central and eastern United States. Warmer colors on this map indicate areas of higher hazard. Larger earthquakes are represented by larger circles.

# 6700

 

 

Although big earthquakes are rare in the Eastern United States, historic accounts have suggested that when they occur the shock waves are felt much farther away from the epicenter than with earthquakes in places like California.

 

The Charleston earthquake of 1886, which was estimated to be between a 6.6 and a 7.3 magnitude, was reportedly felt (cite) as far away as Boston, Massachusetts, Milwaukee, Wisconsin, Chicago, Illinois, Cuba and Bermuda.

 

The 1811-12 New Madrid earthquakes were reportedly felt over much of the Eastern United States, with the USGS reporting that:

• People were awakened by the shaking in New York City, Washington, D.C., and Charleston, South Carolina.

 

Although this phenomenon has been talked about for years, direct measurements of a relatively large east coast seismic event have been lacking due to their relative rarity. 

 

All that changed last year when a 5.8 quake struck central Virginia.

 

The following shake map from the USGS shows the areas reporting shaking from two recent quakes, a 6.0 in Central California, and the recent 5.8 Virginia quake. By an incredibly large margin, the smaller eastern quake was felt over a much bigger area.

 

 

For more on this phenomenon, the USGS has details on a study, that is slated to be published next month in the Bulletin of the Seismological Society of America.

 

New Evidence Shows Power of East Coast Earthquakes Virginia Earthquake Triggered Landslides at Great Distances

Released: 11/6/2012 8:30:00 AM

Earthquake shaking in the eastern United States can travel much farther and cause damage over larger areas than previously thought.

 

U.S. Geological Survey scientists found that last year's magnitude 5.8 earthquake in Virginia triggered landslides at distances four times farther—and over an area 20 times larger—than previous research has shown.

 

"We used landslides as an example and direct physical evidence to see how far-reaching shaking from east coast earthquakes could be," said Randall Jibson, USGS scientist and lead author of this study. "Not every earthquake will trigger landslides, but we can use landslide distributions to estimate characteristics of earthquake energy and how far regional ground shaking could occur."

 

"Scientists are confirming with empirical data what more than 50 million people in the eastern U.S. experienced firsthand: this was one powerful earthquake," said USGS Director Marcia McNutt. "Calibrating the distance over which landslides occur may also help us reach back into the geologic record to look for evidence of past history of major earthquakes from the Virginia seismic zone."

 

This study will help inform earthquake hazard and risk assessments as well as emergency preparedness, whether for landslides or other earthquake effects.

 

This study also supports existing research showing that although earthquakes are less frequent in the East, their damaging effects can extend over a much larger area as compared to the western United States.

 

The research is being presented today at the Geological Society of America conference, and will be published in the December 2012 issue of the Bulletin of the Seismological Society of America.

(Continue . . . )

 

 

People who live on, or near, major fault lines are usually cognizant of the dangers, although not everyone is prepared to meet them. Those of us who live away from these seismic zones rarely give earthquakes much of a thought.  

 

But this study shows that a large eastern U.S. quake - even one that occurs several hundred miles away - can be felt, and potentially do structural damage.

 

Just as you don’t have to live on the coastline to be impacted by a hurricane, you don’t have to live on a fault line to be hit by an earthquake. 

 

Which is why emergency officials urge that while it is important to identify probably threats in your area, you really need to adopt an `All hazards’ approach to preparing.  You really can’t know if the next disaster to strike will be a tornado out of the sky, a shift in the earth’s crust, or a massive winter storm.

 

 

For more on how to prepare against `All Hazards', including those you may not automatically assume are a threat where you live, you should visit the following sites:

 

FEMA http://www.fema.gov/index.shtm

READY.GOV http://www.ready.gov/

AMERICAN RED CROSS http://www.redcross.org/

 

And lastly, you may wish to revisit some of my preparedness essays, including:

 

In An Emergency, Who Has Your Back?

An Appropriate Level Of Preparedness

NPM11: Are You Earthquake Prepared?

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