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level 2 - raske gripipuhang

Level 2 - Description of Conditions and Basic Planning criteria

The conditions I am using for planning at Level 2 is that there is a pandemic flu circulating around the world. It is moderately to very contagious, and of moderate virulence. Those people who take sick with it experience a severe case of flu. Many more patients will experience serious issues and complications arising from the infection, and a substantially larger than normal number of fatalities will occur among those groups normally affected adversely by the flu, and now some from those groups normally less affected. For my own planning purposes, I am assuming a death rate from the flu of 1–2 per thousand of population.

In my planning model for Level 2, the flu is beginning to have a substantially greater impact than is usually seen during a normal seasonal flu wave. Substantial numbers of people suffer bouts of the illness ranging from somewhat mild to those who proceed to life threatening severity, and those who while making it through the flu itself develop secondary respiratory (bacterial) infections.

The impact on daily life will be much more noticeable than at Level 1. At this level, whole businesses may close for a period of time due to some combination of excessive absenteeism due to illness, stay-at-homes who do not wish to expose themselves to potentially sick coworkers and the occasional death of key individuals within the business making it difficult to resume normal operations. Schools may close for some period during the height of the wave in any given area.

As in Level 1, there will be local shortages of prescription and over-the-counter medications and other supplies. Stores may have some difficulty in obtaining prompt resupply due to disruptions in staffing either in store personnel or in the delivery crews. As a result, there may be some localized shortages of a number of staple items at supermarkets, but not as a general shortage, just swaths of shelves here and there which are empty due to heavy demand and slow resupply.

Since the US depends heavily on “just in time” resupply, it is not clear to me whether there will be sufficient surge capacity to meet some demands for some products.

Doctor’s offices and hospitals will be substantially impacted. Not only will the demand for treatment exceed any normal or heavy flu season, but the trend over the past decade to reduce the equipment and staffing levels down from “peak” capable to “average” capable will mean that there are insufficient beds, staff and supplies to meet a quickly spreading flu wave of a nastier than usual flu. This coupled with illness among medical Care personnel will mean serious gaps in the ability of some to obtain timely and appropriate treatment.

As in the planning for Level 1, I personally feel it is prudent to assume that all of the members of your household will be down with this flu simultaneously. Since we already provided for this situation substantially in our Level 1 plan, we will now need to determine what additional supplies and preparations are required to get us safely through the Level 2 scenario.

Reasonable Preparations for Level 2

As stated previously, the assumed impact of the Pandemic wave is that of a severe influenza wave more severe than even the worst of seasonal flu years.

As we begin to anticipate the conditions associated with higher planning levels, it becomes more difficult to accurately predict just what will actually be occuring. Thus, our plans should include sufficient lattitude to allow for things going differently than we had thought. This usually means over stocking rather than under stocking. It would be better to be surprised by the fact that things were not as bad as you had planned for, rather than discovering that things were worse than you had provisioned for. Also, since this is a planning exercise, I am electing to state the worst case conditions below. This is not a prediction of how things will actually be during a Level 2 wave, just an attempt to cover all bases…..

From this level upward, it is important that each planner take into account the individual circumstances of their own situation as a major planning point. Thus, where you live, what size town you live in or near, extended family who may need help or shelter all come into play. It is not possible for me to advise you about your own situation, you need to sit down and consider fully what may occur during a flu wave.

I anticipate the following conditions to occur:

1) Doctor’s offices will become unreliable as a source of care. Individual offices may have insufficient staff available to remain open, or will be so overworked that access will be very limited.

2) Hospitals will be overtaxed by the caseload that is presented to them. Along with staff shortages due to illness, there will most probably be shortages of some of the basic supplies and medicines that are needed to continue full operation. Patients may well be triaged such that only the most critically ill will be admitted (or even seen).

3) Local pharmacies will probably be out of stock of many of the medicines needed for flu treatment. Since their supply chain may be overloaded and under staffed, the “just in time” delivery scheme may no longer work for all items at all times.

4) Supermarkets and other outlets may experience shortages of some items, such as experienced in our Level 1 planning. In this case, those shortages will probably be wider (more items), deeper (shortages more acute) and linger than we had planned for in Level 1. In some cases, the shelves may be cleared of some items in response to either actual need, or panic needs. Which items will be affected is not accurately predictable.

5) Businesses will experience high absenteeism. Some employees will be out due to illness, some due to fear of coming out, and here and there due to death either of themselves or of a close family member.

6) Going out in public represents a very real risk of exposure and infection. Visits to stores or other public accommodations will need to be done with the full understanding of the risks involved. Proper protective measures and hygiene are mandatory.

7) Utilities will continue to operate, but if staffing shortages develop, there may be some failures in localized settings. If the systems are challenged by a major external event such as a winter storm, it may take a substantial time before full services are restored to all. If a catastrophic event occurs, it is possible that outages could take weeks to months before services are fully restored.

As in the previous planning levels, your goal is to insure that you have whatever supplies can be anticipated to be needed by your family during this condition. From this level on up, it is also prudent to determine in advance what you would do if faced with certain contingencies. (Examples: Old Aunt Tillie from the City calls and asks if she can come out and live with you as things are cold hungry and scary where she lives. Or some member of your family takes seriously ill to the extent that a hospital is the only alternative. Who goes with, who stays home? Who returns home from the hospital which will be a focus point of infection. If not, where do they go? What if they were turned away at the door?)

As in previous planning levels, we will start with the assumption that you are building upon a base of a full complement of supplies for the previous level. Your individual planning will depend to a great degree on your own circumstances and values. Do you intend to go into isolation while the rest of the world faces the influenza. Will you remain out in your community? Will you volunteer to help others? All of these will create different planning situations. How you proceed is strictly up to you. Some basic guidelines:

Food: Build up from the two week supply you laid away for Level 1. At this point, at a minimum, you should be able to go without any outside supplies of any sort for at least 4–6 weeks. You need to look at shelf stable items such as ultrapasteurized milk to fill in some of the normally fresh foods you buy frequently. Bread can either be replaced by rice or pasta, or else you might acquire a bread machine and start using it now, so you are fully comfortable with it and the bread it produces. Sufficient flour and other ingredients to turn out enough bread to go that long would then become a stocking item.

At this point don’t forget comfort foods. The situation will probably be stressful and depressing to you and your family. A supply of whatever foods you find soothing and comforting will be a valuable addition to your stock.

Medicines: Building on top of your Level 1 preparations, you should now increase your reserves of your maintenance medicines to last for 6 weeks. If you are on maintenance meds, it makes little sense to provide for food and water if you also don’t have a supply of the meds you need to keep you healthy and functioning. As in Level 1, you should endeavor to work with your Doctor to preposition those medicines which he thinks will be needed in the event of a severe influenza outbreak. As in Level 1, you should plan to work with your Doctor to understand when and how he would want those reserves used.

Toiletries - You should remember to include sufficient toothpaste, toothbrushes, toilet paper and anything else you will find you need to maintain a comfortable and familiar lifestyle. You use it anyway, so it can easily be rotated out of a standing stock as needed during “normal” times.

Clothing and Laundry products - Remember that during an extended period, you will need sufficient clothing to maintain a healthy and sanitary existence. This is especially true if you have ill family members. Bedding and bedclothes may need to be cleaned multiple times during such an illness. Even without power, I have managed to wash some simple things in a sink using detergent and warm water. Be prepared to improvise if need be. Make sure you have enough clothing so that if you need to go out, you can change into fresh apparel on the way in so you can disinfect your outdoor clothes. A plentiful supply of bleach and white vinegar would be a good idea.

Water: I still don’t personally think you need to worry about substantial stocks of water. A two week supply should be adequate except for situations in which you derive your water from an electrically pumped well. Then if you do not have a backup generator such that you can pump water into storage after the loss of power, you should prepare a supply sufficient to last for the 6 weeks of this planning period. I would still not maintain this large of a stock during “normal” times, but would rather wait until it is obvious that an illness wave is a real probability. Then I would fill my stock. It would therefore be prudent to acquire sufficient acceptable storage containers for the purpose now, and stroe them until needed. For planning purposes, assume that you will need to have at least 1 gallon perperson per day as a minimum. Don’t forget that a water heater tank holds 30–60 gallons, and so can be counted into the stock for planning purposes.

Backup Lighting and Heating (Cooling) - At this point, your planning should begin to take into account the possible need to operate for some periods of time without utilities. As I noted above, it is anticipatble that due to absenteeism, the utilities may be hard pressed to keep things up, and may have great difficulty fixing things when they break. I do not, however anticipate that the utilities will be off, as a general rule, at this level.

Depending on your life style, there are many (and some very expensive) things you can do to support your comfort during extended outages. In my case, I have a generator large enough to run and heat the house. Unfortunately, to do this full time, I would require about 15–20 gallons of gasoline per day. Obviously this won’t be how things can go for weeks at a time. So think about how you would retreat into a more manageable “survival module” within your home, allowing portions of the house to run cold and dark. You will therefore require far less energy. Solar cookers, solar battery chargers and the sun coming into a Sotuh facing window are all areas to look into.

To keep things habitable, I have on hand auxiliary propane heaters which can operate far more economically than a whole-house generator. You need to plan this kind of appliance with care. Carbon monoxide and fire are always dangers with these devices, so you must have appropriate CO monitors and extinguishers at hand to support your use of the heater.

Battery consumption of lighting devices is a very important but manageable issue. Incandescent flashlights are about the worst consumers of battery power. Flashlights which use LEDs and area lights which use compact fluorescent lamps are far more energy efficient. As an example, I have a fluorescent area light which runs for 20 or more hours on 4 D cells. I have a bunch of LED flashlights which will run 40–50 hours on 3 AA batteries. if you will be depending on batteries for light for any period, then you will need to look into more modern devices than the old fashioned flashlight.

Radio - I personally have a hand cranked radio that runs for about an hour on 100 turns of a crank. It never requires batteries. Or you can insert rechargeables and run for hours on an extended period of cranking.

Information resources: Same message as before. Do your research now. before you are in a stressful, or dangerous situation.

Again, this is a planning exercise first and foremost. Sit down and ask yourself “What will I be doing during such a situation?” then based on what you determine, you need to plan out how you will deal with normal and abnormal situations and what supplies you will need on hand to deal with them. Once you have made a detailed list of the required supplies, you can figure out how you are going to acquire and store them.

I am not able to provide you with specific instructions on provisioning your family, just planning recommendations and general guidelines. You will need to take over from here.

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trüki see kood alumisse tühja lahtrisse. aitäh :)