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31. märts 2006

pandeemia korral iga Euroopa riik enda eest väljas

jahah, kas tõesti keegi arvas vastupidist ka või :D
kui on ikka tõsine jama, siis kaotavad igasugused lepingud jõu ja enda eest hoolitsetakse esmajoones
tegelikult võiks selle originaalraporti välja kaevata ju .. siin too ongi :) link
Every man for himself’ in Europe’s bird flu simulation
By Andrew Jack in London
Published: March 31 2006 19:22 | Last updated: March 31 2006 19:22

Plans by Switzerland to seal itself off in the event of a flu pandemic triggered “serious concern” by other countries during Common Ground, a recent simulation exercise, because of its strategic location as home to many drug and vaccine manufacturers.
This was just one of the many differences to emerge between European nations over border closures and emergency health measures in a training exercise whose results were published on Friday.

Similar concerns were raised about France, another important drug production centre, which also said it was considering border closures. However, French officials stressed they would exempt pharmaceutical workers and materials from travel bans.

Although judged “fit for purpose”, national plans paid less attention to international co-operation, including how to care for expatriates, restrict emigration and curb travel.

Several countries had not considered the possibility of school closures, or disruptions to public order, electricity supply and businesses.
The evaluation of the exercise, commissioned by the European Commission from the UK’s Health Protection Agency, called for greater understanding by member states of the laws governing travel restrictions across Europe.

Participants, who came from all EU member countries and neighbouring states, showed reluctance to share antiviral drug stocks with other countries.

The report said there was a need for greater transparency on the location of antiviral stockpiles, and more clarity for manufacturers on how the stocks they hold should be distributed.

The drug companies for their part called for greater guidance on legal liability, and an indication of which authority would decide when they should switch from the production of seasonal flu vaccines to those that would protect people from a pandemic strain. This was most likely to take place if bird flu were to mutate into a form transmissible between humans, which has yet to happen.

In the exercise, the European Commission’s Early Warning and Response System, designed to notify officials of human infections, became overloaded. The report called for back-up communications facilities and greater co-ordination between officials and the media.

matusekorraldus pandeemia ajal

'Mass grave' a possibility for victims if flu pandemic strikes civic workers
Mar 31 2006

VICTIMS of a flu pandemic in Croydon could be buried in a mass grave if the illness hits council workers.

A report into how the town would deal with a flu pandemic on the scale of the one that struck after the First World War has put the number of potential fatalities at 8,000 - with a quarter of the town's 330,000 population becoming infected.

A report into how the town would deal with a flu pandemic on the scale of the one that struck after the First World War has put the number of potential fatalities at 8,000 - with a quarter of the town's 330,000 population becoming infected.

A report drawn up by the council says the number of people dying would increase from 45 to more than 400 a week. At peaks this would mean the crematorium running 24 hours a day to cope and the council employing eight teams of gravediggers.

If the contingency fails, either through excessive staff sickness or through the failure of power supplies, "then the plan falls back on the use of a mass grave," the report says.

It adds: "This will only be used as a last resort as it poses many moral and psychological challenges."

Cllr Paul Smith, cabinet member for public protection and crime reduction, said: "This plan is not intended to scare anyone, quite the reverse. It is about saying we recognise the risk that exists and we are working with other London boroughs to make sure that whatever happens we are there to meet it."

The plan looks at a general flu pandemic but it leaves the council prepared to deal with an out-break if bird flu hit humans.

USA pandeemiaplaani analüüs

TFAH Evaluation of HHS Pandemic Planning
analüüsitud siis USA pandeemiaplaani ja selle täitmist kümnes valdkonnas
1. Leadership; 2. Disease surveillance; 3. Vaccine production capacity and supplies; 4. Antiviral supplies;
5. Medical supplies and equipment; 6. Surge capacity and working with states and localities; 7. Quarantines and other public health measures; 8. Communications; 9. Working with businesses and other sectors; 10. Funding and resources

kriitika on päris karm
aga kui keegi vaevuks tegema sarnase analüüsi Eesti pandeemiaplaanile ja selle täitmisele, siis oleks tulemused ilmselt väga haledad :(


Who is in charge? Are questions of leadership resolved? Is there a single high-level official responsible for coordinating the government’s response to pandemic influenza? Does the plan address leadership both during the planning stages and potential outbreak stages?

March Update: The HHS Update does not address this component in detail. Questions of leadership and jurisdiction are more relevant to the National Strategy document for pandemic preparations as well as the overall National Response Plan for major emergencies. Also, the expected government-wide pandemic flu plan should address the leadership issue.


Will measures be taken to improve efforts to track the disease globally and its possible spread to the U.S.? Will the U.S. increase support for the World Health Organization’s global surveillance efforts? Will the U.S. increase its ability to achieve closer to real-time identification of a pandemic outbreak in the U.S.?

March Update:
Appropriate and detailed surveillance measures are outlined in the HHS Update, including the Department’s collaborative efforts with international organizations and ongoing efforts to improve laboratory testing capabilities.


What specific steps will be taken to build production capacity and ensure enough vaccine for the entire American population? Is the U.S. increasing the amount of pandemic influenza vaccine in the Strategic National Stockpile? Is the U.S. committing to increased research for vaccines, through measures including “candidate” vaccines, dosesparing approaches to vaccine administration, faster production technologies, and a permanent flu vaccine? Is the U.S. committing to contracts or policies that guarantee increased investment in production capacity by the vaccine industry to permit the 600 million doses of a pandemic vaccine that would be needed to protect the U.S. population? Are liability and compensation issues addressed?

March Update: The Update details that progress has been made to improve both vaccine production technology and vaccine production capacity. Additionally, HHS is stockpiling pre-pandemic vaccine based on the current H5N1 strain that will act as a “reference virus” in case of a pandemic emergence.


Is the U.S. planning to purchase enough antiviral medication for 25 percent of the population, the number the World Health Organization says countries should assume will become sick during a pandemic? Also, is increased research proposed to test other antiviral medications for activity against avian influenza?

March Update: The Update highlights the HHS purchase of nearly 20 million courses of Tamiflu and Relenza, although stockpiles on-hand are significantly smaller. HHS is aiming for 81 million courses on-hand by the end of 2008, which is far later than other countries are achieving a similar goal. In addition, as the Update mentions, ongoing questions about distribution capabilities remain. More worrisome, is the Administration’s proposal to ask the
states to purchase 31 million of the planned 81 million antiviral courses with only a 25 percent subsidy. Many cash-strapped states are not likely to follow through. TFAH maintains that where you live should not dictate the level of protections Americans receive during a pandemic, which will be a national health crisis.


Is the U.S. stockpiling enough other emergency medical equipment and supplies? Is the U.S. building the Strategic National Stockpile to address all potential demand or shortages during a pandemic, such as antibiotics, ventilators, masks, and gloves, and ongoing medical treatment needs for chronic care patients?

March Update: Though the HHS Update discusses “planned purchases” of important medical supplies such as ventilators, surgical masks, and appropriate gloves and gowns, the existing supply remains woefully inadequate. The Update document does not go into detail about the production, procurement, and distribution procedures associated with boosting supplies. There is also insufficient attention paid to the stockpiling and accessibility of
routine medical treatment needs for chronic care patients, a problem seen in the post-Katrina environment that added to the public health burden of that tragedy.


What steps will be taken to support health care surge capacity that would be required in a mass emergency and what support will be given to state and local officials to build and exercise their response plans? Does the plan identify steps states, localities, private health care institutions, and the federal health systems (VA, Department of Defense, community health centers, and the Indian Health Service) must take to increase surge capacity? Is there a commitment to provide resources to state and local health departments to increase preparedness? Is there a commitment to set minimum standards for state and local pandemic plans and require regular exercising of those plans?

March Update: The HHS Update does not address surge capacity concerns in significant detail, but does discuss the importance of a well-integrated state and local response. In providing $350 million in support to the states for planning, HHS is establishing benchmarks for progress, an important accountability tool for federal funding. HHS has conducted Regional Pandemic Flu Summits in a number of states and will assist states in the development of tabletop exercises to practice and test state pandemic plans. Far more detailed guidance and assistance will be needed in this area.


Are quarantines, recommendations for use of masks, and other public health measures addressed in detail? Does the plan address the potential effectiveness of measures such as quarantine, restrictions of public gatherings, and use of masks? Does the plan address who has the authority to impose public health measures to assure effective implementation across the country?

March Update: Not addressed by HHS Update document in any detail. Despite concerns over jurisdiction and authority, HHS and the federal government should provide uniform guidance to assure that public health measures are implemented with some consistency across jurisdictions.

Are specific, consistent messages for informing the public, businesses, and the media in place? Is there a plan for educating the public in advance of a pandemic? Are materials prepared for communicating with various sectors, including the public, businesses, media, and medical communities for each stage of a pandemic? Is support provided to state and local health departments to assure consistent messaging?

March Update: The Update addresses the importance of communications and outreach to an effective response. The document also outlines progress made towards this goal, including the development of target audience planning checklists, working with the media, and harnessing new technologies on behalf of public outreach.

Are all potentially impacted sectors, such as businesses and travel, addressed in the plan to ensure that the economy and communities could function during an outbreak? Are all relevant government agencies engaged at the federal, state, and local levels in contingency planning for their own ability to keep functioning through a pandemic, such as considering the potential impact on travel and transportation, the economy, business operations and
stores, and schools? Is the U.S. providing guidance to the business community regarding continuity planning in case of severe absenteeism in the workforce or closure restrictions? Has guidance been provided to the medical community on continuing ongoing care needs during a mass-emergency?

March Update: The communications section of the Update details some of the work the Department has undertaken to work with the business community, including planning checklists and toolkits targeted at the general business community and specific sectors, such as health care providers. Technical assistance will be needed for businesses, communitybased organizations and other planning to continue critical operations during a pandemic. All
government-funded organizations should be required to have pandemic-related contingency plans in place.

Most importantly, does the plan include a request for enough resources to implement it? Are specific levels of funding identified for the various elements of the plan? For instance, state and local health departments cannot exercise their plans or create surge capacity without additional funding; and vaccine and antiviral manufacturers will not increase production without firm financial commitments from the federal government. TFAH estimates funding a comprehensive plan for pandemic preparedness could be between $5-8 billion or higher, depending on levels of commitment to stockpile pharmaceuticals and support surge capacity functions.

March Update: In December 2005, Congress appropriated $3.8 billion of President Bush’s $7.1 billion funding request. Of the $3.8 billion appropriated, HHS received $3.3 billion divided into five categories: disease monitoring, vaccine capacity, stockpiling antivirals, coordinating federal, state, and local preparedness, and strengthening communications and outreach capacity. Congress must provide the remaining funds to keep pandemic
preparedness on track and provide funding for those areas not adequately addressed in the President’s plan (such as federal payment for antiviral stockpiles, broader stockpiling needs, and surge capacity).

30. märts 2006

EL pandeemiasimulatsioonist

et siis seesama, mis sügisel toimus

Simulation shows Europe prepared for flu
Thu Mar 30, 2006 4:29 PM GMT
By Jeremy Smith

BRUSSELS (Reuters) - A European exercise to simulate an influenza pandemic showed the countries involved were reasonably prepared but exposed flaws in the system used to report national health crises, officials said on Thursday.
"Europe is reasonably well prepared for a pandemic, and probably better prepared than it was 18 months ago," John Simpson, director for emergency preparedness at Britain's Health Protection Agency (HPA), told a news briefing.

He was presenting a report on the huge simulation, billed as Europe's first pandemic influenza exercise, that the HPA carried out across the EU's 25 countries in late November at the request of the European Commission, which also participated.

Non-EU Iceland, Norway and Switzerland also took part in the exercise to assess national authorities' abilities to cope with an influenza pandemic hitting all countries at the same time.

Under the simulation, no vaccines were available until the second of two waves of the attack, which had a death rate of 1.5 percent. Antiviral stocks were set at November 2005 levels.

Designed to concentrate a 26-week pandemic attack into just two days, the exercise was largely desk-based but with teleconference calling involving national health officials, emailing and also responses to simulated media queries.

By the end of the exercise, millions of new influenza cases were occurring across Europe every week, with industry grinding to a halt in some areas as raw materials ran out.

Although the exercise was deemed a success, neither the HPA nor Commission officials were prepared to give details of how ready individual countries were to deal with a health crisis.

One problem was the EU's early warning and response system (EWRS), used by the Commission to alert national health authorities to larger outbreaks that have the potential to cross international borders. The flu exercise overloaded the system.

"Such an exercise had never been carried out on this scale, it was a full-blown scenario with the worst that we could be confronted with," said Commission spokesman Philip Tod.

"It (EWRS) is a robust tool but it's clearly not enough to cope with the sheer volume of traffic that was circulating during the exercise to reflect the genuine scenario of a pandemic," he told the briefing.

The exercise also raised what Commission officials called "issues of common concern", such as country coordination on supplies of antivirals, travel restrictions, quarantining and border closures -- sensitive areas of national sovereignty.

"Many of those questions are being discussed at ministerial level. You don't get answers to sensitive political questions during an exercise," Tod said.

Eesti vs Soome: valikud ja tegevused oma inimeste kaitseks

võrdluseks eelnevale jutule siis Soome valikud ja tegevused oma kodanike kaitseks

1) tegi lepingu 20.12.05 täpse vaktsiini ostmiseks hollandi firmaga Solvay Pharmaceuticals, kes kohustub toimetama Soome 5,5 miljonit annust vaktsiini
Soome on järjekorras neljas, ja maksab ainuüksi järjekorrakoha eest(!) 550 000 eurot aastas, vaktsiini eest siis makstakse veel eraldi

2) 23.03.06 sõlmis lepingu esialgse prototüüp-vaktsiini ostmiseks, 5,2 miljonit doosi, maksumusega 21 miljonit eurot.

3) Tamiflud on ostetud 1,2 miljonit karpi

riigi hinnang pandeemiaohule: suur risk

Ministeeriumide ja maakondade riskianalüüsi kokkuvõte 2005Viimati uuendatud: 20. märts 2006

Järgnevalt nimetatud hädaolukordade toimumise tõenäosust tuleb hinnata suureks, st üks kord 1-10 a jooksul ning tagajärgi rasketeks või väga rasketeks, mis on tingitud ennekõike tagajärgedest inimeste elule ja tervisele otseselt või läbi keskkonna ja/või elutähtsa valdkonna toimimise.
* loomataud (linnugripp, suu- ja sõrataud);
* epideemia, pandeemia (gripipandeemia);
* ulatuslik reostus merel, rannikul;
* loodusõnnetusega seotud hädaolukord (torm, üleujutus);
* suure tulekahju/plahvatusega seotud hädaolukord (metsatulekahju);
* transpordiõnnetusega seotud hädaolukord (paljude kannatanutega lennuõnnetus, paljude kannatanutega õnnetus raudteel);
* ulatuslik elektrikatkestus;
* massiline mürgistus.

3.2. Epideemia, pandeemia

Epideemia on nakkushaiguste puhang, mis on põhjustatud nakkustekitaja sattumisest organismi ja mis levib või mille puhul on alust oletada levikut inimeselt inimesele või loomalt inimesele otseselt või kaudselt.

Pandeemiaks nimetatakse erakordselt suurt epideemiat, mis levib üle riigipiiride, haarates paljusid riike ja kontinente ning millega kaasneb inimeste kõrge haigestumine.

Hädaolukorraks tuleb epideemiat pidada juhul, kui Eesti tervishoiuasutus te võimalused haigete vastuvõtmiseks ja abi andmiseks on ammendatud või ammendumas haiglaravi vajavate haigete arvu kiire kasvu tõttu või on suure haigestunute arvu tõttu tegemist suure sotsiaalmajandusliku kahjuga riigile (gripp).

Pandeemiline gripp on agressiivne ja kiire levikuga ning rohkeid tüsistusi põhjustav viirushaigus, mille tõenäosust on tõstnud 2005. a levima hakanud kõrge patogeensusega linnugripp, mis lähikontakti korral on nakatanud ka inimesi. Võimalust linnugripiviiruse ja sesoonse gripi viiruste geneetilisel baasil pandeemilise levikuga uue gripiviiruse tekkimiseks peetakse enamus ekspertide poolt küllalt suureks.

Arvestades võimalikke raskeid tagajärgi inimeste elule ja tervisele ning potentsiaalset nakatunute arvu, tuleb epideemia puhkemise ohtu hinnata kõrgeks riskiks. Kaasaja teadmiste tasemel ei ole võimalik gripipandeemia teket ette määrata ja kujunemist vältida.

Gripipandeemia oht tekib juhul, kui ringlusse ilmub uus, inimpopulatsioonis varem mitte esinenud gripiviirus ja leiab kinnitust uue viiruse aktiivne levimine inimeselt -inimesele ning uus viirus on kõrge inimpatogeensusega. Oht seisneb selles, kui linnugripi viirus satub grippi põdeva inimese organismi, siis võivad viirused vahetada geneetilist materjali, mille tagajärjel võib moodustuda uus kõrgelt patogeenne viirus, mis hakkab kiiresti inimeselt inimesele levima ja mille vastu kogu maailmas puudub vaktsiin ja pole ka tõhusaid ravimeid (WHO soovitab uue gripiviiruse raviks kasutada tamiflud ehk oseltamiviiri).

Tänaseni ei ole tõenduspõhiseid andmeid linnugripi viirustüve A/H5N1 ülekandumise kohta inimeselt inimesele. On viidatud üksikutele juhtumitele, kus nakkushaigel väidetavalt puudus otsene seos haigestunud lindudega, kuid haigestumised ilmnesid eelnevalt lähedaste seas perekonnas. Seega ei ole välistatud, et linnugripi viirustüvi A/H5N1 võib piiratud tingimustel kanduda inimeselt inimesele, kuid tänaseni ei ole see tõendamist leidnud. A/H5N1 adapteerumist inimestele soodustab gripiviirustele iseloomulik kiire evolutsioneerumine (muteerumise ja rekombineerumise näol).

Võimalikke tagajärgi tuleb hinnata rasketeks, pandeemilise gripi puhul väga rasketeks või isegi katastroofilisteks, kuna haigusele on iseloomulik kõrge nakkavus ja haigestunute hulk on väga suur.
Pandeemilise gripi nakkavust on prognoositud ekspertide poolt – eeldatavalt haigestub ühe laine ajal ~ 25% elanikkonnast, neist haiglaravi võib vajada ~1,5 % ehk ligikaudu 6000 inimest kokku. Ühe nädala koormus haiglatele on prognooside kohaselt ~ 1000 tüsistustega haiget. Sellise hulga haigete teenindamiseks on vajalik pandeemia tingimustes osade haiglate ümberprof ileerimine, kuna olemasolevatest nakkushaiguste vooditest ei piisa (vastav plaan on Tervishoiuametil koostöös haiglatega koostamisel).
Tavalisest oluliselt suurem koormus langeb pandeemia tingimustes ka kiirabile ning perearstidele, kuna põhiline osa haigetest ravitakse ambulatoorselt kodustes tingimustes. Vastavad ravi- ja tegevusjuhised on välja töötatud gripipandeemiaks valmisoleku plaani juurde.

Hädaolukorra tekkimise ja lahendamise seisukohalt vajab olukord tähelepanu ka seetõttu, et täielikult nõuetele vastavad tingimused pandeemilist grippi, SARSi ja teisi õhklevi-nakkushaiguseid põdevate haigete isoleerimiseks ja raviks on Eestis olemas vaid ühes haiglas (AS Lääne-Tallinna Keskhaigla Merimetsa Nakkuskorpuses). Samuti puuduvad Eestis hetkel võimalused nende haiguste diagnoosimiseks.

Seega tõenäosus, et pandeemilise gripi, SARSi või mingite uute viirusnakkuste kandumisel Eestisse võib tekkida tervishoiualane hädaolukord, on suur. Ka tõenäosust, et kõrge nakkavusega viirushaiguste puhangu tekkimisel mistahes riigis võib haigus kanduda ka Eestisse, tuleb pidada suureks.

Riskide vähendamine - Sotsiaalministeerium
Hädaolukorraks valmisoleku taseme tõstmiseks on oluline lõpule viia 2004. a koostatud gripipandeemiaks riikliku valmisoleku plaani täiendamine ja selle juurde vajalike rakenduslike lisade ja juhiste väljatöötamine ning SARSi epideemiaks valmisoleku plaani ja bioterrorismiks valmisoleku plaani lõplike versioonide väljatöötamine.

Tagada tuleb tervishoiusüsteemi valmisolek võimalikeks epideemiateks, sh haiglate valmisoleku ja hädaolukordade lahendamise plaanide uuendamine.
Oluline on nõuetele vastavate nakkushaiguste voodite loomine Lõuna-Eesti piirkonda Tartu Ülikooli Kliinikumi planeeritava renoveerimise ja juurdeehitamise käigus, mille valmimine on planeeritud 2009. a. Ohtlike nakkushaiguste epideemiate ennetamiseks ja valmisoleku pa randamiseks tuleb tõhustada nende seiret ning parandada laboratoorse diagnostika võimalusi.

Toronto: SARS'i õppetunnid

hea lugu Toronto kogemustest SARSi ajast ..
kuidas see vanasõna oligi, et tark õpib teiste vigadest ja loll enda omadest ..
et kasutaks juhust ja õpiks nende vigadest? :p

FEATURE-SARS prepares Toronto for bird flu
29 Mar 2006 13:01:05 GMT
Source: Reuters
By Jonathan Spicer

TORONTO, March 29 (Reuters) - Toronto's deadly brush with the SARS virus three years ago has uniquely prepared the city for the possibility of a bird flu pandemic, health officials say.
Drawing on lessons from the 2003 outbreak of Severe Acute Respiratory Syndrome, city and provincial experts promise new screening measures, emergency plans to treat patients from home and tough laws detailing what health workers must do.

Rules still under government debate could ban travel, fix prices and order health-care professionals to provide necessary services in the event of a pandemic.
"I think what puts us ahead of folks who haven't dealt with SARS is that it really has made the potential pandemic more real. We at least have a framework for what we might see with pandemic flu," says Dr. Susan Poutanen, primary author of the first two scientific papers on SARS, published in The New England Journal of Medicine during the Canadian outbreak.

Toronto was the only city outside Asia where people died of SARS. The disease infected 375 people in the city, Canada's largest, and killed 44, prompting a scathing public inquiry and angry lawsuits.

And it could be only a matter of time before Toronto has to cope with bird flu too, as the H5N1 avian influenza virus spreads out of Asia to infect birds in Europe and Africa. Experts agree it will one day reach North America too.

The virus does not easily infect humans -- it has killed just over 100 people in three years -- but scientists fear it could mutate into a pandemic strain that could kill tens of millions.


Ontario's influenza plan aims to free up overwhelmed hospitals by providing telephone and Internet home care to less vulnerable patients.
Late last year, the provincial government proposed legislation that would broaden its power to ban travel and order health workers to provide services if a pandemic struck.

But Ontario's Bill 56, which is still being debated, has drawn criticism from doctors who fear they will be jailed or fined if they refuse to work.

"My initial response when I think about (avian influenza) is that I'd like to run away from it all and protect my family, and that's the sense I get from my colleagues," said Connie Leroux, a nurse who contracted SARS from a patient at a Toronto hospital. "However, I also have a very strong sense of responsibility to our community and our patients, so I'm not sure how many of us would actually leave -- including myself."

Poutanen, an infectious disease consultant at Toronto's Mount Sinai Hospital, named surveillance and diagnosis as key areas where Toronto learned from SARS.

"Surveillance for fever and respiratory illnesses ... has gone from essentially nothing to an Ontario-wide suggestion that all hospitals search (them) out," she said.

Hospitals in the province of 12.5 million will question anyone who arrives with a respiratory illness, even isolate them until the symptoms are deemed noninfectious.

In 2003, hospitals overlooked a single case of SARS, setting off a second deadly wave of the disease and landing thousands in quarantine.

One of those quarantined was Leroux. Now 35 and diagnosed with depression, anxiety and post-traumatic stress, Leroux says she followed guidelines for both protective attire and contact with her family.

"It was very clear to me that (my husband) and two children were at high risk of contracting it as well because I had just seen them and was quite contagious at the time," she said in an interview.

Leroux's family did not contract SARS, but they spent 10 days in isolation, while she was quarantined for a month. The nurse is now one of 53 suing the provincial government for negligence during the crisis.


A public inquiry blamed a "broken" public health care system in its interim report, calling it "unprepared, fragmented, poorly led ... inadequately resourced."

"SARS was contained only by the heroic efforts of dedicated front line health care and public health workers and the assistance of extraordinary managers and medical advisers," Justice Archie Campbell wrote in 2004.

Ontario that year committed C$2.4 million ($2 million) in new health spending and created an emergency management unit to coordinate the province's response to crises like SARS.

"The fundamental problem with SARS was that we took for granted our ability to trump Mother Nature," said Allison Stuart, the unit's director. "We don't have a pill for everything, and we learned that lesson very quickly."

26. märts 2006

riigijuhtide ränk vastutus tegematajätmiste eest

The Pandemic Prophecy
He doesn’t know when it’s coming, or how bad it will be. But Dr. Michael Osterholm, one of the world’s foremost infectious disease experts, believes a flu pandemic is inevitable. And to hear him tell it, we’re nowhere near ready.
By Tim Gihring
Published April 2006

pikk hästikirjutatud artikkel Osterholmist, aga eriti rõhutaks üht lõiku poliitikute isiklikust vastutusest

Last November, Osterholm spoke at a pandemic flu preparedness seminar sponsored by the Minnesota Chamber of Commerce and aimed at local businesses. Osterholm was asked his opinion of the federal government’s commitment to preparedness. He mulled the question so long it seemed he might not answer. Finally, he did. “I don’t give a damn about not being liked anymore—this is too important an issue,” he said. And then he laid into politicians who’ve paid lip service to pandemic preparedness but done nothing. “I’m afraid we’re going to have a commission like [the one convened after] 9/11,” he said. In other words, a sweeping, klieg-lighted investigation into everything that went wrong during the Great Influenza Pandemic of 200–. “And this time,” he says, “we’re all going to be held accountable.”
veel üks hea tsitaat:
When discussing pandemic flu, Osterholm frequently quotes Ben Franklin’s observation, “If we don’t hang together, we’ll all hang separately.
paar lõiku veel:
One hundred eighty million people are dead—two out of every hundred in the world—including 1.7 million in the United States and more than 30,000 in Minnesota. Vaccines are unavailable. Borders are closed, supply lines shut down. Victims huddle on cots in the Metrodome. Doctors and nurses are too scared to come to work. Bodies are piling up in the streets. This isn’t the latest Steven Spielberg thriller; it isn’t the aftermath of a nuclear holocaust. It’s the flu. And former state epidemiologist Dr. Michael Osterholm, for one, believes this scenario could easily become reality.Pandemics happen,” Osterholm is fond of saying, as if it’s a catch phrase from a bumper sticker, as if it’s something we all just know. But most people don’t know that pandemics—diseases that spread across large swaths of geography and population—are as inevitable as earthquakes, hurricanes, and tsunamis.

Some people, such as government officials and business leaders who might mitigate a crisis, should know this. But they don’t, or they don’t believe it, or they don’t know what to do with the information. Not all of them, anyway. Not yet. And that’s why Osterholm, director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, can’t stop talking about pandemic influenza. “I can’t emphasize enough,” he says, “that it’s not a matter of if but when.”

.. Osterholm believes H5N1 is “a 1918-like virus.” Given the way it continues to evolve, to change genetically, it may one day develop the capacity to jump from human to human. Then, Osterholm says, we’ll be updating the death toll not monthly, as we are now in Asia, but by the minute.

“I believe an influenza pandemic will be like a 12- to 18-month global blizzard that will ultimately change the world as we know it today,” Osterholm testified before Congress in December.

On Oprah, Osterholm is asked how regular folks can prepare for the flu. Stockpile food? Certainly, he says. How about masks? Maybe, if they’re the right kind of masks. Think about what you’ll do, where you’ll go, how you’ll work under pandemic conditions, Osterholm counsels. And beyond that, push, as he is, for a more robust public health system. The one thing you can’t do, he says, is hope it won’t happen.

1918: maskidest

As flu pandemic swept world, locals sought isolation

Virus of 1918, which killed tens of millions, meant East Bay residents donned masks, closed public gathering places
By Sandy Kleffman

Concord shut down its saloons, suddenly becoming "a bone dry town." Livermore banned card playing and dice shaking. UC Berkeley required students and faculty to wear masks, creating an eerie atmosphere on campus and more than a little identity confusion.
The 1918 flu pandemic profoundly affected the East Bay. As the virus swept the world, killing 40 million to 50 million people and making many others gravely ill, local residents hunkered down, isolating themselves in often-vain attempts to prevent the virus' spread.

The Richmond city health officer closed schools, pool rooms and bowling alleys "until further notice." The schools remained shuttered for more than two months, according to Times' historical writer Nilda Rego.
"The entire state is practically all closed up," reported the Independent, a Richmond newspaper.

Livermore leaders encouraged residents to avoid public gatherings, including church services, notes historian Gary Drummond in an article on the pandemic. Attendance at funerals was limited to family members.

In Martinez, the Shell Oil Company converted its old mess hall into a temporary hospital for employees. Workers who fell ill had to present a doctor's certificate verifying their recovery before they could come back inside the refinery gates.

Many cities aggressively enforced mask requirements. Oakland created a 300-person special police force to crack down on its residents, notes Rex Adams in an article for the Chronicle of the University of California.
Two days after Berkeley's mask ordinance took effect, authorities arrested 171 men and four women "mask slackers." They faced fines up to $500.

Fears of the virus extended to weddings. On Oct. 28, Abraham Rothenstein kissed his bride, Annie Nicholson of San Pablo, through a gauze mask.

At UC Berkeley, the virus first spread rapidly among members of its Students' Army Training Corps. To protect the city, the university quarantined the SATC students, banning them from leaving campus.

As the virus spread throughout the university, halls and gyms became infirmaries for hundreds of ill students.
Classes continued, but with many empty seats. The UC Berkeley president recommended a moratorium on new class assignments for 10 days to prevent large numbers of students from falling behind.

The demand for masks exceeded supply. UC Berkeley women began producing them by the thousands, as did Red Cross volunteers in Martinez.

One student, writing in the UC Berkeley campus newspaper, remarked on the anonymity of those who wore masks.
"It was rather an unusual sight to see people go about the campus yesterday, trying to decide whether the persons in front of them were or were not acquaintances. No doubt several unintentional 'snubs' were given and probably some may have thought a wildly democratic fever had suddenly seized every member of the university.
"... Few of us stopped to consider the serious side of the order issued to wear masks."

miks epideemia on juhtidele väga raske aeg?

Why to bioattacks present special challenges and high-stakes decisions for leaders?

A deliberate epidemic poses compounded, unfamiliar dangers in today's setting. Most elected U.S. officials, health authorities, and the public have no direct experience with large outbreaks, nor do they know the best ways to control them. Even less familiar is the premeditated use of disease as a weapon.

Epidemics are complicated events due to their biology, but also because they provoke fear, contradictory impulses, and competing social aims:
* An epidemic's outcomes -- suffering, death, lost livelihood and commerce -- are troubling to consider. Leaders and the public may deny that a problem exists, or intervene too quickly without regard to the negative effects of their actions.

Case studies 2003, Fearing SARS, New Yorkers Avoid Chinatown 1976, Swine Flu Vaccination Campaign Too Much, Too Soon 1918, Spanish Influenza Grips the Globe

* People need to make sense of random and terrifying events, but epidemics elude quick and easy explanation. The nature of a disease, a population's vitality, and the responsiveness of health institutions affect how an epidemic unfolds.
Case studies
2003, Information about SARS Elusive
2001, Anthrax Evades Easy Answers

A mysterious disease can trigger the human reflex to isolate oneself and blame others for the tragedy or, in deep contrast, to care for victims without regard to one's own safety.
Case studies
2003, SARS Victims Shunned Globally
2003, Fearing SARS, People Avoid Chinese-Americans
2001, Muslim Americans Face Hate Crimes in Wake of September 11

Features of modern society can speed up and disperse an epidemic's negative impact and make some people more vulnerable than others:
* Global media and around-the-clock news reports cause anxiety and dread in people, even those who are in places far from immediate danger.
Case Studies
2003, New Yorkers Perceive SARS To Be Local Outbreak
2001, Far from Anthrax Attacks, People Anxious

* Today's transportation systems move people quickly across vast distances, potentially accelerating the spread of disease.
Case study
2003, SARS Spread Facilitated by Global Travel

* Epidemics have broad, indirect financial impacts due to close ties among global, national, and local economies.
Case Studies
2001, The High Costs of the Anthrax Attacks
2001, Economic Repercussions of Foot and Mouth Disease
1986, Mad Cow Disease Devastates British Beef Industry

* Poverty, lack of health insurance, and distrust of the healthcare system mean that those who are most vulnerable during disease outbreaks are least able to protect themselves.
Case study
Social and Economic Disparities Influence Public Responses to Bioattacks
1995, Chicago Heat Wave Singles Out the Poor and the Isolated

* Personnel shortages and lean budgets limit the emergency response capabilities of U.S. hospitals and state and local public health agencies; they are spread thin on a "normal" day.
Case Study
Hospitals Unprepared for Epidemic Control

juhtimisest ja usaldusest kriisiolukorras

täiesti võrreldav situatsioon pandeemiaga ju :D
How to Lead during Bioattacks with the Public's Trust and Help

What situations splinter the social trust necessary to cope with health crises, and how might they be defused? Breaches of social trust are a common predicament for leaders during outbreaks and are likely to arise during a bioattack. Social and economic fault lines as well as preconceived notions about "the government," "the public," and "the media" can alienate leaders and the public, and community members from one another.

Preventing unproductive fear, denial, or skepticism on the part of the public when delivering crisis updates Case Studies 2001, Mayor Leads Mourning New Yorkers 2001, EPA Reassures Ground Zero Residents that Air Is Safe

* Share what you know. Do not withhold information because you think people will panic. Creative coping is the norm; panic is the exception.
* Hold press briefings early and often to reach the public. Answering questions is not a distraction from managing the crisis; it is managing the crisis.
* Confirm that local health agencies and medical facilities are prepared to handle an onslaught of questions from concerned individuals, in person and by phone.
* Convey basic health facts clearly and quickly so that people have peace of mind that they are safe or so that they seek out care, if need be; similarly, brief healthcare and emergency workers so they have a realistic understanding about job safety.
* View rumors as a normal sign of people's need to make sense of vague or disturbing events. Refine your outreach efforts; the current ones may not be working.

Earning confidence in the use of scarce resources despite existing social and economic gaps

Case Study: Polled Americans Expect Discrimination during Smallpox Outbreak

* Account for income disparities in response plans; anticipate the need for free or low-cost prevention and treatment.
* Make planning transparent so that the public sees that access to life-saving resources is based on medical need and not on wealth or favored status.
* Be open about eligibility criteria for goods and services, especially when tough choices arise unexpectedly -- for example, which botulism attack victims will receive the limited antitoxin that exists.
* Show thorough preparations to protect vulnerable populations like children and the frail elderly, thus bolstering everyone's sense of security.

Maintaining credibility when decisions must be made before all the facts are in

Case studies:
2001, New York City Health Officials Earn Public Trust
2003, Chinese Leaders Withhold SARS Information from Villagers

* Advise the community at the outset if crisis conditions are evolving or could be prolonged.
* Offer more detail rather than less, even when the unknowns outnumber what is known; resist the urge to reassure for reassurance sake alone.
* Be frank about any uncertainty regarding "facts"; describe plans to fill in knowledge gaps.
* Vary your means of reaching the public. Mix high-tech outreach (internet, cable, network, print, radio, cell phone, automated hotlines) with contact through grassroots leaders.

25. märts 2006

Nabarro: enamus peaks valmistuma peitupugemiseks

United States Helping Lead War on Bird Flu, says U.N. Envoy
24 March 2006

International officials are issuing warnings about preparedness because the avian influenza epidemic among animals could evolve into a human influenza pandemic. With an eye toward that potential crisis, Nabarro also discussed the need for governments to develop contingency plans for maintaining continuity of government as well as the rule of law. "In the event of a pandemic, public services are going to be stretched to their limits and certain regions in the world will be vulnerable to a breakdown in law and order," he said. (See related article.) According to Nabarro, avian influenza has spread to 20 countries during the last six weeks alone and has recently moved into the Gaza Strip as well as settlements in the West Bank. "We are very vulnerable," he warned. "Most of us, I think, feel that it's best to be preparing to hunker down."

Dr. David Nabarro - U.N. senior coordinator for avian and human influenza.

Hunker Down Posted by SR on November 15, 2004 at 18:47:54: HUNKER DOWN: The phrase 'hunker down' seems originally to have been Scottish, maybe the eighteenth century? Does anyone know exactly what its origin is? Old Norse 'huka' means to squat. Modern Dutch 'huiken' and German 'hocken,' meaning to squat or crouch. The word is popular in American English, in phrases like 'hunker down' or 'on your hunkers.' The Oxford English Dictionary description of how to hunker: "squat, with the haunches, knees, and ankles acutely bent, so as to bring the hams near the heels, and throw the whole weight upon the fore part of the feet." 'The advantage of this position is that you're not only crouched close to the ground, so presenting a small target for whatever the universe chooses to throw at you, but you're also ready to move at a moment's notice. Hunker down has also taken on the sense of to hide, hide out, or take shelter, whatever position you choose to do it in. This was a south-western US dialect form that was popularised by President Johnson in the mid 1960s. Despite its Scots ancestry, hunker is rare in standard British English.' (WW)

24. märts 2006


Influenza Raport - nüüd kõik peatükid olemas
1. Influenza 2006
2. Avian Influenza
3. Virology
4. Pathogenesis and Immunology
5. Pandemic Preparedness
6. Vaccines
7. Laboratory Findings
8. Clinical Presentation
9. Treatment and Prophylaxis
10. Drugs

lindude gripi laialdase leviku korral kuulutatakse Eestis välja eriolukord

Avalikkuse teavitamine lindude gripi leviku korral Eestis
sellise ppt leidsin siis - tuleb meeles pidada, et jutt käib ainult lindudest

Eesmärk: Kommunikatsiooni korraldamine, avalikkuse/elanikkonna teavitamine (olukorra pidev jälgimine, koostöö teiste asutustega)
Prioriteet – isikute elu ja tervise kaitse, läbi taudi laialdase leviku tõkestamise ning vajaliku informatsiooni jagamise

Kommunikatsiooni korraldamine faaside kaupa lindude gripi leviku korral Eestis

FAAS 1: Eesti lindude nakatumise oht on reaalselt olemas, kuid ühtegi nakkust esinenud ei ole
FAAS 2: Eestis avastatakse taudikahtlusega lind, ametlikku diagnoosi pole
FAAS 3:Eestis on diagnoositud esimene lindude gripi viirusega nakatunud lind/linnud
FAAS 4:Eestis on avastatud lindude gripi juhtumeid mitmes maakonnas

FAAS 5:Lindude gripi levik on ulatuslik, kuulutatakse välja eriolukord

RLTTK juht pöördub põllumajandusministri poole, kes omakorda pöördub VV poole, et kuulutada välja eriolukord
Koguneb riiklik kriisireguleerimise komisjon Siseministeeriumis
Avatakse kriisi veebileht www.kriis.ee
Teavitusgrupp ja maakondlikud pressiesindajad jätkavad tööd

eeskujulik pandeemiategevuskava kindlustusfirmal

kindlustusfirmade pandeemiaks-ettevalmistatuse-uuring ja intervjuu ühe kindlustusfirma asepresidendiga
uuringus ma ei leidnud pealiskaudsel lugemisel midagi eriti põnevat :D
aga vat see intervjuu oli HUVITAV :O
vau, vau!
konkurentsitult põhjalikem ja eeskujulikem firma pandeemia-tegevuskava, mida ma olen näinud
soovitan SOOJALT eeskuju võtta :))
täpsed juhendid töötajatele, foorisüsteem jne
mis mind päris üllatas oli see, et Kollane Tuli rakendus neil juba siis, kui gripis linnud USAsse jõuavad :O
see teema vajab siis ülevaatamist .. ametlikult igal pool muidu kinnitatakse, et gripis metslinnud tavainimese elu eriti ei sega, ainult oht linnukasvatajatele .. huvitav, huuuuvitav :O :O :O

miks ma olen jälginud ka suurte kindlustusfirmade tegevust on just see, et kindlustusfirmades on parimad riskihindajad, omavad parimat infot riskide kohta, ja nad on konservatiivsed ja põhjalikud

Special Report: Avian Flu and Insurers

Part 1: Is Your Company Prepared?
Part 2: Conversation with a Medical Director

Avian Flu: Is Your Company Prepared?

With the rapid spread of the deadly H5N1 strain of avian (bird) flu from Asia to Europe in the last few months, governments and businesses around the globe have begun devising contingency plans so that their business could continue to function if the virus were to cause a pandemic. Five insurers recently participated in a LOMA survey that asked them to explain the status of their contingency plans and what steps they’re taking to prepare for the worst. Here’s what they had to say.

intervjuu Dr. Michael Moore'gea, Nationwide asepresident ja meditsiinidirektor

firma hanked

One of the things the federal government is telling people is that if you have a vital substance that is the lifeblood of your company, then you should make sure you have a supply of it that will last from two to four weeks, because your supply chain may not be reliable. Suppliers are going to have 40 percent absence rates, just like everybody else. So we want to raise awareness of that reality.

kuidas hoolitseda oma töötajate eest?

We also want to get word out to our employees and say, “Make sure you have a survival kit at home.” So we’re going to include a post on our internal Web site that specifies what a survival kit should include, such as how much water per individual per day, and for how many days. We will advise them to make sure they have enough of the medicine that they would normally take during a two- to four-week period, because their drugstore may not be open. We will advise them to make sure they have enough food, flashlights and other necessities.

tegevuskava etapid

Q: Explain the “green-yellow-red” worksheet that Nationwide’s Avian Flu Working Group has devised.

MOORE : Here’s how it works: If situation X happens, we’re in Condition Green; if situation Y happens, we’re in Condition Yellow; and if situation Z happens, we’re in Condition Red.
We’re in Condition Green right now, because there’s been no person-to-person transmission and nothing here in North America yet.
We would go to Condition Yellow >if person-to-person transmission developed outside of the U.S. , or if a case of avian flu is reported in North America .
Finally, we would go to Condition Red if person-to-person transmission were to hit North America .
And each one of those events triggers a certain level of action on our part.

For example,
Condition Green is basically preparation; it’s about making sure you have cleaning supplies. A lot of the things that the government is recommending are very simple steps: Make sure you have cleaning supplies with antibacterial agents that you can use to clean common touch areas, such as doorknobs, stair railings and elevator buttons. Make sure you have gloves available so that if you find something that’s been exposed, you don’t inadvertently expose more people while trying to clean it up. Make sure you have hand cleaner available for people so that they can frequently sanitize their hands.

If we were to ever go to Condition Yellow, only the most essential business travel would be permitted. We would certainly minimize, if not outright ban, travel to any place in which there is person-to-person transmission. We would begin to look at alternative work environments so that people can work from home. A lot of what we do can be done on a computer. Approximately half of our people have VPN (virtual private network) access, so they can get into our systems to do what they need to do to properly do their job from an alternative location. VPN is what our systems people do so that employees can safely get into our systems and still have a secure environment. The idea is that we try to keep the people who are healthy away from the people who are sick, and keep the people who are sick at home and out of the office.

Condition Red would take effect if person-to-person transmission were to occur in North America . In that situation, we would be utilizing what we call “social distancing,” or keeping people from congregating. For example, instead of having a meeting, you would have a teleconference. You wouldn’t shake hands with people. Instead of me walking over to the other side of the building to tell somebody something, I would call them. People who would normally be going to conferences or meetings would dial in instead. We would try to keep people that are able to work out of the office, out of the office so that they are not exposed and are not exposing people to different elements.

olulised soovitused teistele?

Q: Are there any particular stages or aspects of preparation that you think are being overlooked by many companies?
MOORE : At this point, I think that if anything, people are not giving it the attention it deserves. The reaction I received after talking with some of the CEOs at the ACLI Executive Roundtable was, “Well, I heard about this, and I knew it could be a problem—but I never knew it could be that big a problem.” I think many people are thinking of it in terms of localized, weather-related disasters that we’ve dealt with in the past and saying, “Well, we did fine with the hurricane.” Well, a flu pandemic is not like a hurricane. True, it’s not going to knock down buildings, but when you start talking about a 50 percent mortality rate among people who have tested positive for bird flu, you realize this is a different scenario. Also, most people think of flu as affecting just the very young and the very old, but among those who have contracted bird flu, the people who are having the highest mortality rate are ages 15 to 40. That always surprises people.

The other thing I would tell people is, begin now. If you wait until we start to see person-to-person transmission, even in Europe , you’re going to be so far behind, you’ll never catch up. There is a possibility that a pandemic won’t occur, and a few years from now, we may look back and say, “Boy, what were we all worried about?” But this is a disaster for the poultry industry overseas. They’re reporting that about 200 million chickens have been killed in an attempt to stamp out bird flu.
The other news item that broke recently is a reported case of H5N1 in Iraq . And one of the main vehicles by which the Spanish flu spread back in 1918 was GIs returning from World War I. So when I read about the H5N1 case in Iraq , that sent a chill up my spine, because we’ve got hundreds of thousands of American soldiers over there who are rotating back after their tours of duty, not to mention all the private construction people and other expatriates over there who keep returning to the U.S. That sounds eerily similar to what happened in 1918.

I think that we at Nationwide are probably ahead of the curve, in terms of being prepared. But even then, at times it feels like we’re playing catch-up. So if you haven’t begun to think about this, it’s time to put this on the fast track.

1919a gripiravi homöopaatiaga

Favorite Remedies Used in Treatment of Influenza

The prevailing Influenza epidemic has given rise to much discussion regarding the methods of treatment by physicians, and the remedies employed therein. Methods of medication do not lie in the province of a pharmacist, but remedies are to pharmacy all-important.
It has been remarked that Eclectic physicians have exceptional confidence both in their process of medication and their medicines. With a laudable desire for information in this direction, many physicians are seeking authoritative information regarding the remedies used by brother practitioners. With the object of extending this information, as well as of serving the interests of inquiring physicians, we (January 1st) addressed a blank to a number of general practitioners known to rely on vegetable remedies, with a request that they reply to the following: 1. Please name six remedies that you consider essential in the treatment of influenza. 2. Name the one you consider to be most important. 3. Name the remedies you consider necessary in treatment of Pneumonia. 4. Do you use an application to the chest? If so, what do you employ? 5. Do you practice according to principles of Specific Medication? These reports, as received, were (without any exclusions) put into type for the purpose of tabulation, but are of such immediate interest as to warrant us in bringing them before a circle of physicians who, we feel assured, will appreciate the same. They are put into type in the order received. Respectfully, LLOYD BROTHERS. Cincinnati, February, 1919.

23. märts 2006

haiglad: ideaalsed vahendid vs hädapärast piisavad

Experts struggle with issue of what medical masks to stockpile for a pandemic
Helen Branswell, Canadian Press
March 21, 2006

ATLANTA (CP) - The issue of medical masks - who should use them, and what types should be stockpiled - is one of the vexing and potentially explosive questions facing public health experts working to prepare for a possible flu pandemic.

paar lõiku pikemast artiklist:

"If this thing rages for a year, all of this is academic, all of these stockpiles. Because we're going to burn through all of that. So we have to have plans," said Stewart Simonson, assistant secretary of the U.S. Department of Health. "Health care may end up looking, for a little while . . . more like the '50s. And we may run out of rubber gloves. So we're going to have to have some way for people to sterilize their hands so they can safely do things. We've got to start thinking that way, I think." Weighing on the minds of those deliberating is the fear that, while health-care workers will be desperately needed during a pandemic, some may refuse to show up for work if they feel they are not adequately protected. Ontario nurses are already raising the issue, complaining that the federal government is stockpiling inexpensive surgical masks rather than the more costly N-95 respiratory masks.
And those involved in discussions over the use of masks recognize their advice has to cover both what might be best if it is workable, and what might be an acceptable alternative if best isn't available. "It's going to be important to establish the ideal and then plan for the real event," said Dr. Michael Osterholm, an infectious disease expert who has been warning of the amplifying effect the global just-in-time distribution system will have during the next pandemic. "And the real event, we'll be seriously short of many of those essential goods and even some services that we count on on a routine basis," said Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

22. märts 2006

kiri sugulastele

Flutrackers foorumis toob üks ära kirja, mida ta on oma sugulastele saatnud, et Mida Võiks Igaüks Teha ..
paar päris huvitavat punkti oli seal ka minu jaoks :D


The problem with a flu pandemic is that it may not happen for years and yet when it comes it could be everywhere in weeks and panic buying could clear the shops hours after the first announcement on TV. To beat the rush you can get into the habit of checking flutrackers or similar websites on a daily basis to see what the scientific community know about clusters before the mass media broadcast, also regular checking will get you used to ‘normal’ activity levels so you can spot when something is amiss.

Things you can do now

Most of this section is just to get you thinking, everyone’s situation is going to be different.

Go to the supermarket wonder up and down all the isles look at everything they stock check some sell by dates so you get a feel for how long they think things remain in prime condition, remember many items are good long after their sell by dates e.g. canned goods, pasta etc. (a couple recently eat a canned chicken, given to them when they married, on their 50th anniversary). Some items are surprisingly cheap and may be worth buying even if they never get used (milk powder, some types of canned goods) others are not too dear and worth buying in bulk, they will get used eventually salt, matches, candles, paper plates etc. (even if you never have to buy another in your lifetime). Likewise wander around other stores (DIY, camping, garden centre) again thinking about which of these items may be useful if there was no power, mains gas, mains water etc if you have lamps do you have spare wicks & mantles?.

Walk around your house and garden which items would not work if the all utilities stopped how would you manage without them?

Start carrying more of the things you regularly use and prepare a list of items to be purchased - if you think it is imminent - including who stocks them locally and what they cost, look at them now measure up etc.

You may want to consider two lists:
1] for expensive items you would not consider buying normally e.g. A giant propane cylinder and regulator, water butts or rain water collection from the roof, Colman petrol burning lamp & cooker, Jerry cans, a UPS (this is a battery and voltage regulator normally used to keep a computer running for 30min if the power goes down but it gives a mains voltage output and could be used to recharge mobile phones, batteries etc if mains power is intermittent), a generator (be warned this may draw unwelcome attention) etc.

2] additional supply levels for items you already have, and items you do not normally have e.g. powdered milk & eggs, canned goods which you would normally have fresh like veg. Fresh fruit & Veg.

Think about ‘traditional’ panic buy items, torches, candles, batteries (long life & rechargeable), petrol cans (they are bulky so retailers do not hold many), all types of fuel – petrol, coal, gas cylinders, logs, charcoal.

Think about how you may be living - candles for light (fire extinguishers, smoke alarms), hand washing in cold water (buckets, cloths pegs, rubber gloves, a mangle?), heating by gas burner (carbon dioxide alarm), no running water (potties, chemical toilet, somewhere to empty them) etc.

This needs a change of mind set. We are so used to ‘popping out to the shops’ and picking up a few things that we have developed a ‘just in time’ mentality. We think mainly of sell by dates on things in the fridge. You will need to be more organised and a set aside a lot more storage space.

Start to buy more than you need of items like rice, sugar, flour, pasta, oil etc. and carefully stock them with the new items at the back of the shelf so you get used to using them on a ‘first in first out’ basis. Get used to how much you use on a monthly basis (how many loo rolls do you use in 6 months?) and start building up your stock levels so the items taken form the front of the shelf are beginning to approach their sell buy date. Items with very long shelf lives salt, toothpaste, washing powder etc. will also need to be stored in a similar fashion and rotated (remember hand washing powder & washing up liquid not just for machines).

You will need some big plastic stacking bins with lids, or similar, to mouse proof items like rice, flour, beans & pasta. List items in storage boxes with Qty & use by date so you do not have to unpack the boxes to find out what you have left.

Experiment –
How long will potatoes, onions, apples etc keep? Try different storages areas, attic, garage, cellar etc. Try different containers card board boxes, string bags,t
You may not be familiar preparing meals based on some of the dried goods, powdered milk etc try them now, find out what your family likes/will eat so you can increase stocks of those items and do not have too many of the items that don’t work. for you.

Defrost your freezer and make sure it is efficiently packed with useful items. Pork is good; if the power fails large pieces can be cured with salt to make bacon, hams etc. and will keep for months without refrigeration (you will need to keep insects and rodents away).

If you have a local farmer you may be able to buy milk, meat or vegetables but it may be best to make contact now then you can arrange a collection/payment system without too much contact if it starts, the farmer will still have to milk his cows but he may not have anyone to collect the milk.

What are you going to do with your time? If you have children do you have pens, paper, cards, ball games, board games or something similar for them? Plenty of books you/they have not read? Jobs you always meant to do but hadn’t the time – make sure you have the hand tools (not power)/paint/timber etc.

Dogs, cats, birds can all get flu and give it to you. Train your cat to use a litter tray, get it use to staying inside and walking on a lead. Is your garden dog proof? How much pet food have you stored? Cat litter?

If your garden was low maintenance and you plan to be growing your own food check your tools; are they up to the job? Seeds get plenty - particularly things that will keep or produce greens in the winter. If you have a fireplace do you have a chain saw, large bow saw, spare blades & small file to re-sharpen them? Do you have a shed or green house, if so does it have a good lock? No point in prepping and being robbed by someone who didn’t.

If the mains stops you will need a source of water and this could be most people’s biggest problem. We use a lot of water even if we try not to and it is very heavy (allow for pets and plants too, plants in grow bags or containers can go through a lot of water). If you have a stream nearby do you have suitable containers to draw it and transport it? Do you have a cart, trailer, wheel barrow, sack truck, wheelybin? Can you collect rain water in a water butt? If so do you have other bins/barrels to fill from it to increase your storage capacity (also useful if the mains supply is intermittent)? Has it got a lid, a tap, a filter to keep out leaves and other rubbish from the roof? Do you have the right pipes/brackets/fittings to route the down pipe into it? Have you plenty of bleach to sterilise the collected water and orange squash etc. to make it more palatable? Do you have smaller containers with taps that all the family can carry (I recommend the collapsible polythene cubes they are cheap & easy to store until needed).

Do you have cash? ATMs may not have power or anyone refilling them. Do you have somewhere safe to keep it? Do you have items you think might be good for trade? Credit Cards may become of limited use if the phone system is disrupted.

Is your Will up-to-date? Now might be a good time to check/top up your life insurance before rates change (use only ‘Blue Chip’ financial institutions preferably ones that have a broad portfolio i.e. not specialists with a high life insurance exposure, also read the small print to make sure they have not added a Pandemic disclaimer).

Do not be too ostentatious about your prepping. You do not want to have to turn down neighbours pleas for assistance, and you will not know how long your stores will need to last. Do not underestimate the determination of a parent with sick or starving children who thinks you have what they need. Your best option is to try and get them prepping now so they will not need anyone’s help.

Medical supplies are covered in a separate section but if you live in the UK be warned you will need a lot of Paracetamol & Ibuprofen and there is a restriction to the number of tablets you can by at a time (to try and prevent suicides) which means you can not buy what you need at the last minute. You should start stocking up each time you go to a supermarket or chemist. If you need any prescription medication etc. try and see your doctor now about building up as bigger stock as you can.

Finally I am just going to type a list of things for you to consider in addition to those above:
Fire lighters, lots of plain bleach, more salt, contraceptives, tampons, razor blades, mouse traps, lots & lots of matches, refillable lighters, lighter fuel, long ‘cooker lighters’, lamps & fuel, cookers & fuel, toothbrushes, soap, shampoo, cold weather gear, wet weather gear, tobacco & alcohol (may be good for trade), fishing tackle, siphon pumps (fuel & water), garden hose and other tubing, plastic sheeting, bubble wrap, string, rope, wire, chain, books on preserving/curing & smoking/gardening/first aid, duck tape, masking tape, glues, bicycles and spares, pressure cooker (saves fuel), Liquid Sodium Silicate (for egg storage), netting (crop protection & storage), nappy buckets (with lids), nappies, Tupperware, news paper (less bulky that loo rolls, individually wrapping apples etc), more plastic bags, clockwork torch & radio.

Remember to print hard copies of items electronically stored e.g. these instructions, phone numbers, medical advice, stock lists etc.

eesti riskantsemad piirkonnad

vt ka kaarti, mis artikli juures on

Postimees: Gripihirm pöördub linnukasvatuste vastu
22.03.2006 00:01
Andrus Karnau, reporter

Ornitoloogid leiavad, et surmavat linnugrippi levitab pigem kodulindude ja nende kasvatamise eri saaduste transport üle riigipiiride kui vabas looduses elavate lindude ränne.

Surmava linnugripi H5N1 saabumiseks valmistuv riigiaparaat tutvustas eile juhtivate ornitoloogide analüüsi, mis sõelus välja Eesti alad, kuhu linnugripp kevadise rändega varem jõuda võib.

Kõige suurema riskiga piirkond on Matsalu linnuriik ja kogu Väinameri. Löögi all on ka Tallinna ja Tartu lähiümbrus, kus peatuvad rändlinnud, kes võivad praegu teadaolevate andmete põhjal surmavat viirust edasi kanda. Kahes suurlinnas elab rohkem kui kolmandik Eesti elanikest.

Tähtsad rändepaigad

Analüüsi koostamist juhtinud Maaülikooli teadur, ornitoloog Kalev Rattiste märkis, et Tartu lähedal on tähtsad rände- ja pesitsusalad Ropka-Ihaste luht koos Aardla järvega ja Emajõe luht Käreveres.

«Tallinnas on rände ajal väga suur hanede kontsentratsioon, eelkõige suur-laukhani ja rabahani, kes toituvad Tallinna ümbruse põldudel päeval ja ööseks lähevad Ülemiste ja Maardu järvedel,» ütles Rattiste.

Samal ajal märkis ornitoloog, et suurlinnade elanikel pole vaja toas istuda ja paaniliselt linnugrippi karta. «H5N1 on ohtlik eelkõige kodulindudele, inimestele nakkab see viirus väga raskesti,» ütles Rattiste. «Selleks peab olema väga lähedane kontakt, lindu tuleb lahata või süles hoida või midagi intiimset teha. Reaalselt inimesele H5N1 otsest ohtu ei kujuta.»

Rattiste viitas, et üheksa aastaga on maailmas selle viirusega nakatunud pisut enam kui 200 inimest, kuigi Aasias tegeleb linnukasvatusega sadu tuhandeid inimesi.

Ornitoloogid leiavad, et rändlindude kartmise asemel tuleks karta linnuliha ja linnusõnniku ning nendest valmistatud toodete transporti ning pigem tuleb rändlinde kaitsta kodulindude eest.

«Põhiline gripiviiruse levimise viis on transpordivahendid ja linnuliha, siiani pole vettpidavat tõendit selle kohta, et viirus leviks rändlindudega. On viiteid, aga vettpidavat tõestust ei ole,» ütles Rattiste.

«Rännumees» kana

Ornitoloog Andres Kuresoo sõnas, et kanad on teadlaste hinnangul maailma kõige suuremad «rändlinnud». Kuigi nad ise püsivad paigal, siis nende liha, munad, suled ja sõnnik liiguvad ühest maailma otsast teise.

Eesti avalikkust on seni hirmutanud kõige enam surmava tüvega linnugripi leid Saksamaalt Rügeni saarelt, sest see koht jääb enamiku Eestisse jõudvate lindude rändeteele.

Kuresoo pakkus aga, et linnugripi leid Rügenilt ei tähenda seda, nagu toonuks hukkunud kühmnokk-luiged selle kusagilt lõuna poolt kaasa.

Ornitoloogide arvates võis see viirus olla saarel juba ammu, inimene polnud sellesse surnud lindude vastu lihtsalt varem huvi tundnud. Selle versiooni üheks tõestuseks on tõsiasi, et lindude suremus Rügenil ei ole viirusest H5N1 hoolimata tavapärasest suurem.

Ornitoloog Taivo Kastepõld viitas, et Rügenile võis surmav gripp jõuda ka inimese vahendusel. Seni on arvatud, et luiged said gripi Kreekast, kuhu nad rändasid erandkorras külma talve eest. Kreekasse omakorda jõudis see Krimmi poolsaarelt.

Kastepõld märkis, et nn Ida-Atlandi rändetee luiged pagevad tavaliselt pakase eest varju Põhjamerele ja nende ränne Kreekasse on seniste vaatlusandmete põhjal väheusutav.

Kuresoo lisas, et Musta mere linnugripi laine põhjus ei pruugi olla rändlindudes, vaid nakatunud söödas või muus kodulindude saadustes.

«Odessa sadam on üks põhilisi linnutoodete liigutamise kohti,» märkis Kuresoo. Ta möönis, et see on tööversioon, mida tuleb tõsiselt uurida ja tõestust sellele väitele esialgu ei ole. Nagu öeldud, ei ole teadlaste sõnul ka lõplikku tõestust väitele, et surmava viiruse edasikandjad on ennekõike rändlinnud.

Põhjus kaubanduses

Veterinaar- ja toiduameti peadirektor Ago Pärtel ütles, et teadlaste hüpoteesi, nagu oleks viiruse tegelik põhjus kaubanduses ja sealhulgas ka linnusaaduste salakaubanduses, kinnitab see, et massilist suremust metslindude seas ei ole. Ta möönis, et linnugripi levikul kodulinnufarmi on riigil lihtsam süüdistada rändlinde kui tunnistada nakatunud toodete sissevedu.

Eile olid Eesti lähiriikidest linnugripist puutumata veel Soome, Läti, Leedu, Valgevene ja Norra.

21. märts 2006

Kanada: pandeemiajuhend firmadele

90 lk väga põhjalik juhend firmadele pandeemiaplaanide tegemiseks

Canadian Manufacturers & Exporters - Canada’s largest trade and industry association
Preparing for the Pandemic

As a nation, we can’t afford to be unprepared! ... “CME’s guide equips all Canadian business with tools and information to minimize the risk that influenza pandemic poses to the health and safety of employees, the continuity of business operations and the bottom line.”
... Canada’s economy could suffer by as much as $60 billion due to a pandemic outbreak – even more if the Canada-US border were to experience serious difficulties.
To download a copy of CME's - Influenza Pandemic: Continuity Planning for Canadian Business

20. märts 2006

eesti ravimivarudest

Meditsiiniuudised: Linnugripi ja pandeemia puhuks tuleb olla valmis

Viimase poole aasta jooksul on sotsiaalministeerium kaks korda täiendanud linnugripiks ja pandeemiliseks gripiks valmisoleku kava, õnneks pole linnugripp seni Eestisse jõudnud.

Sotsiaalminister Jaak Aab märkis kava tutvustades, et ettevalmistusi on teinud ka siseministeerium ja põllumajandusministeerium, samuti tervisekaitseinspektsioon, tervishoiuamet jt. Kõigil peab olema teada, mida teha siis, kui Eestis avastatakse esimene linnugripi juht inimesel või kui maailmas puhkeb pandeemia. Päris valmis ei saa selliseks olukorraks tema sõnul olla, kuid meie valmidus järjest paraneb.

Kolmanda ohuastme labor
Eesti on otsustanud tervisekaitseinspektsiooni juurde luua kolmanda ohuastme viroloogilise labori, mis võimaldab avastada ka linnugripi inimesele ohtlikku A/H5N1 tüve. Praegu saab vajadusel teha vastava laborianalüüsi Veterinaar- ja Toiduameti laboris.

Tervisekaitseinspektsiooni peaepidemioloog Kuulo Kutsar lisas, et hiljuti sõlmisid nad vastastikuse koostöö kokkulepe Rootsi Nakkushaiguste Kontrolli Instituudiga, mille alusel on Eestile kättesaadav ka neljanda ohuastme viroloogilise laboratooriumi diagnostika. See labor on välismõjude eest täielikult kaitstud, autonoomse ventilatsiooniga, seal töötatakse eriti kõrge ohtlikkusega haigusetekitajatega. “Eestil ei ole vajadust ise sellist laborit asutada, me ostame selle teenuse,” märkis Kuulo Kutsar.

Gripipandeemiaks valmisoleku plaan valmis Eestil 2004. aastal Maailma Terviseorganisatsiooni (WHO) soovituste kohaselt. Eelmise aasta aprillis WHO täiendas oma soovitusi ja seetõttu täpsustati ka meie plaani. See ei ole veel riiklik kava, valitsuskabinetis pole seda kinnitatud.

Kutsar ütles, et kava koosneb viiest osast: planeerimine ja koordineerimine; epidemioloogilise olukorra jälgimine (kliiniline jälgimine, mida teevad arstid; laboratoorne diagnostika ja epidemioloogiline seire; tervisekaitseinspektsioon jälgib olukorda maailmas); pandeemia ennetamine ja leviku tõkestamine; tervishoiusüsteemi reageerimine; kommunikatsiooni korraldamine.

Linnugripp lindude hulgas on tuvastatud juba seitsmes Euroopa Liidu riigis. Nakatumist inimeselt inimesele ei ole tuvastatud ja seetõttu pole olnud võimalust välja töötada vastavat vaktsiini. Lindudele on linnugripi vastane vaktsiin olemas, kuid Eestis seda ei kasutata. Üheks põhjuseks on see, et siis tuleks lõpetada linnuliha ja munade eksport.

Pandeemiat ei puhkegi?
Sotsiaalministeeriumi rahvatervise osakonna juhataja Ülla-Karin Nurm pidas tõenäoliseks, et linnugripi pandeemiat ei puhkegi. Oluline on järgida kõiki ettevaatusabinõusid, et meile ei jõuaks ka linnugripp: vältida kokkupuudet võimalike ohuallikatega, hoida kodulinde suletud ruumides, täita hügieenireegleid jms.

Täpsem info linnugripi kohta ja vastused enamlevinud küsimustele on üleval põllumajandusministeeriumi koduleheküljel www.agri.ee/gripp, või valides www.linnugripp.ee. Sel nädalal alustas tööd linnugripi infotelefon 1676. Nõu saab küsida ka perearsti tasuta nõuandetelefonilt 1220.

Must stsenaarium
Linnugripiks ja gripipandeemiaks valmisolek tähendab ka musta stsenaariumi koostamist. Tervishoiuameti peadirektor Üllar Kaljumäe ütles, et Euroopa Liidu ja Ameerika tervisekaitseorganisatsioonide mudeli põhjal võib gripipandeemia puhul haigestuda veerand elanikkonnast, meil siis umbes 370 000 inimest. Haiglaravi vajaks neist 5200–5300 inimest kaheksa nädala jooksul.

Selleks tuleks valmis seada 1100 haiglaravi voodikohta, ümberprofileerimine võtaks aega kaks-kolm ööpäeva. Kaljumäe sõnul suudaksime maksimaalselt ette valmistada 2500–2700 haiglaravi voodikohta. See eeldab suuri jõupingutusi kõigilt kesk- ja piirkondlikelt ning ühelt kohalikult, Jõgeva haiglalt.

“Sellel perioodil lõpetataks plaaniline ravi. Praegu tehakse haiglates umbes kaks kolmandikku ravist erakorralisena ning tervishoiusüsteem peaks kindlustama sel ajal erakorralise ravi jätkumise,” ütles Kaljumäe.

Alates eelmise aasta septembrist on tervishoiuamet valmistanud ette juhendmaterjalid ning läbi töötanud haiglakohtade ümberprofileerimise korra. 1. juuliks peaksid olema kõik juhendid üle vaadatud ja asjaomaste asutustega läbi arutatud.

Kaljumäe lisas, et gripipandeemia puhul tuleksid patsiendid peamiselt perearstide ja kiirabi vahendusel ning inimeste aitamisel oleks väga oluline roll ka apteekidel. Perearstidele mõeldud juhendid käivituvad siis, kui riigis kuulutatakse välja gripipandeemia. Juhendid on kättesaadavad perearstide seltsi koduleheküljel www.perearstiselts.ee ja tervisekaitseinspektsiooni koduleheküljel www.tervisekaitse.ee.

Varud on varutud
Ülla-Karin Nurm ütles, et olemasolevatest ravimite ja meditsiinitehnika varudest piisab arvutuste kohaselt järgmiselt: valu ja põletikuvastastest ravimitest jätkub 40 päevaks, südame-veresoonkonna ravimitest 35 päevaks, infektsioonivastastest ravimitest, plasmaasendajatest ja infusioonivahenditest ning intensiivravi vahenditest 20 päevaks.
Gripipandeemia korral kuluks riskirühmade (linnukasvatajad, meditsiinitöötajad jt) vaktsineerimiseks 60 miljonit krooni ja kogu elanikkonna vaktsineerimiseks 150 miljonit krooni.

1918: surevus erinevates USA linnades

oluline siis see, et oli suhteliselt erinev .. link allikale


19. märts 2006

gripihaige põetusest

juhend, kuidas ravida väga rasket gripihaiget kodus


Good home treatment for influenza can help to relieve symptoms. Good hygiene will help to prevent the spread of the virus. Both may also help lower your risk of developing complications.

1. Bed rest can help you feel better. It will also help avoid spreading the virus to others. Infected family members should be kept apart from the main living areas.

2. Drink plenty of fluids to replace those lost from fever. Fluids also ease a scratchy throat and keep nasal mucus thin. Hot tea with lemon, water, fruit juice, and soup are all good choices. A person with a fever should not eat heavy meals. Clear fluids and broths will be better on their stomach. If the flu sufferer becomes dehydrated the body cannot fight off the virus.

3. If fever is uncomfortable, take acetaminophen or ibuprofen to lower it. You may also sponge the body with lukewarm water to reduce fever. Do not use cold water or ice. Lowering the fever will not make symptoms go away faster, but it may make the flu sufferer more comfortable.

4. To relieve body aches and headache, take aspirin, acetaminophen, or ibuprofen. Do not take aspirin if flu sufferer is younger than 20 unless a doctor tells you to do so. Also, aspirin and ibuprofen can upset the stomach, while acetaminophen does not.

5. Try a decongestant or nasal spray if for a stuffy nose. Look for a single-ingredient decongestant that contains phenylephrine. If nasal drainage is thick, a decongestant that contains guaifenesin may help keep it thin and drain. Do not use medicated nasal sprays or drops more often than directed.

6. Breathe moist air from a hot shower or from a sink filled with hot water to help clear a stuffy nose. Avoid antihistamines. They do not treat flu symptoms and may make nasal drainage thicker

7. If the skin around the nose and lips becomes sore from repeated rubbing with tissues, apply a bit of petroleum jelly to the area

8. Use cough drops or plain, hard candy to help ease coughing. Take a nonprescription cough medicine that contains dextromethorphan if a dry, hacking cough develops. Some products contain a high percentage of alcohol. Use them with caution. Children should not be given any medication with alcohol in it at any time.

9. Elevate the head with an extra pillow if coughing keeps prevents rest. The may also help with general chest congestion.

10. Avoid smoking and breathing secondhand smoke. This is good advice any time, but it is especially important when there is a respiratory infection or the flu

11. In some instances people develop bowel complaints with influenza. If the flu sufferer develops diarrhea, it is even more important to make sure they have plenty of fluids. (see #2)

During recovery:

If a flu sufferer has not had any food for longer than 72 hours or has had a persistent fever accompanied by vomiting and/or diarrhea, it is extremely important that you introduce solid food back into their diet slowly. You should start with water and clear fluids (give a better explanation here).

It is very important to take any influenza infections seriously. Possible complications of flu include:

Pneumonia, which is an inflammation of the lungs. Some people are at increased risk for developing a specific type of pneumonia.

Primary influenza viral pneumonia, which occurs most often in people who have heart disease. It develops soon (24 to 36 hours) after flu symptoms start and does not get better with antibiotics. It rarely causes death in young, healthy people, but it can often be life-threatening in older adults, people who have other diseases, and pregnant women.

Secondary bacterial pneumonia, which occurs most often in older adults and people who have lung disease, heart problems, and other diseases. Secondary bacterial pneumonia most often develops after a period of improvement following classic flu. People with this type of pneumonia usually get better with antibiotics.

Bronchiolitis, which is an inflammation of the small air passages (bronchioles). Bronchiolitis usually affects children younger than 2 years of age and is the leading cause of serious lower respiratory illness in infants.

Sinusitis, which is an infection or inflammation of the mucous membranes that line the inside of the nose and facial sinuses. Facial sinuses are hollow spaces, or cavities, located around the eyes, cheeks, and nose.

Croup, which is a swelling or obstruction in the windpipe (trachea). It causes a distinctive hoarseness and a barking cough, a high-pitched sound (stridor) heard when breathing in, and difficulty breathing.

Worsening of chronic obstructive pulmonary disease (COPD).

Inflammation of the heart muscle (myocarditis), inflammation of muscles (myositis), or inflammation of the sac around the heart (pericarditis).

Fatigue and a lack of energy that persist after flu symptoms are gone. People may take several weeks to fully recover, although no cause for the symptoms has been identified.

1918 vs 2006

FluWIki koostas väga laheda sisukorra oma foorumi teemadest :)

ja sealt leidsin ühe teema, mida polnud juhtunud lugema ja mis oli tõsiselt huvitav:
1918 Shortages
võrdlus 1918a ja praeguse aja vahel, väga ..ee .. õõnes lugemine oli :S

paar lõiku allapoole ka

The main food problem in 1918 was not so much a shortage of food per se, but people dying because they were too weak to get out of bed to get food and there was no one available, either family or others, who were willing or able help. In some cities, entire hospitals were overseen by just one or two doctors and a handful of nurses. One hospital in Philly (IIRC)had a staff that consisted entirely of only 3 nurses and no doctors at all. It would be impossible for 3 nurses to cook for and feed several hundred patients no matter how hard they tried. On a smaller scale, the same thing was happening in families who had a number of members sick or dead. People died from simple lack of basic bed side care and lack of water and food.

Currently too many people don’t keep enough things at home nor near to hand if they got sick, or live alone, or live with people that don’t recognize the dangers of dehydration, ect, nor when to call a doctor/ambulance, let alone what to do if one couldn’t send a sick person to hospital.

Another difference is in 1918 they did not know what caused the sickness. Authorities told people to wear gause masks to prevent infection. People willingly went out and worked in completely ineffective masks. So the supply chain continued. Today’s citizen is better informed and more likely to stay home - which will break the supply chain.

In 1918, you might be concerned that you building’s electrical power might go out, but if it did, you just lit the gas lamp and tossed a couple more logs on the fire and went on with your day. Today, you can’t do that unless you have purchased a gas or oil lamp already and live in a home that happens to have a fireplace which many modern homes do not.

IF as many have predicted there will be 20% to 50% of the workforce not at work on a given day during a pandemic, that means that a significant number of the workers still working will have been forced to take on additional workload and tasks that they are unfamiliar with. They will be overtired, very unhappy and unsure of what they are doing. This in my mind sets up a situation in which mistakes will be made much more often than is the norm and the potential for larger mistakes resulting in larger disruption goes up also.

After living thru 3 major hurricanes over the past year including the surprise in our area of Wilma, I have really become versed in the psychology of the unprepared. Even with several days of warning, people do not prepare unless really pushed. Panic sets in very quickly. Shelves clear in the blink of an eye and are not replaced for many days even weeks. The very next day there are people wandering the streets to find something open. Unbelievably there are many people who do not even have a days worth of food or water stored.

1918 has nothing to do with us.
We all live a very spoiled life. They did not.
Our expectations are very high. Theirs were not.
They got a lot of exercise. We don’t.
They were used to alot more bacteria than we are. We are anti-bacterial everything.
They were used to working physically alot harder than we work. They were used to death alot more than we are.
We think a doctor can fix everything and when they can’t, we get mad and sue. They accepted it as God’s work.
In all, I think they were alot more prepared than we are, even without the constant newsfeeds that we have.

18. märts 2006

miks ja mida on vaja varuda

java presentatsioon toiduvarudest&muudest varudest link
suurepärane :)
vt ka teisi presentatsioone


Acute Respiratory Distress Syndrome (ARDS)

Adult respiratory distress syndrome describes the respiratory failure caused by acute lung injury. Bird Flu infection can lead to ARDS. The exchange of carbon dioxide and oxygen is reduced due to inflammation and the accumulation of fluid in the air sacs (aveoli) in the lungs. This is a life threatening condition.

The ARDS Foundation
Below are some commonly asked questions about ARDS.

What is ARDS?

Acute respiratory distress syndrome (ARDS) is defined as an acute process, which results in moderate to severe loss of lung function.

What do we mean by lung function?

The cells in the body need to have oxygen to perform all their normal functions. The respiratory system includes the trachea (windpipe), bronchi, and alveoli (air sacs). The alveoli in the lungs are responsible for supplying oxygen to the blood, which will deliver it to the cells of the body. The oxygenation of the blood is accomplished by a transport of oxygen from the inhaled air in the alveoli to the surrounding blood vessels. During this exchange of gases in the alveoli, carbon dioxide is brought to the lung from the blood to be exhaled as body waste.

Then, what happens in ARDS?

In ARDS there is intense inflammation of the lung tissue, which can be caused by a variety of factors. This inflammation in the lung results in a loss of function. The alveoli lose their ability to exchange oxygen and carbon dioxide with the blood. This loss of function of the alveoli is due to collapse of the air sacs and leakage of fluid (which is called edema) into the air sacs. This sequence of events can happen rapidly. It can start in one lung and advance to the other. If the inflammation persists over time, the lungs will eventually attempt to heal the damage, which results in the formation of scar tissue. The formation of scar tissue will continue to create a problem with gas (oxygen and carbon dioxide) exchange.

Are there other lung conditions that
can mimic ARDS?

Yes and this often is a challenge for the physician. Pneumonia (infection of the lung), when severe, can have a similar presentation to this syndrome. Congestive heart failure (caused by a decrease in the pumping strength of the heart) can be confused with ARDS due to a collection of fluid in the air sacs but without the alveolar damage caused by ARDS. These disorders require different treatments and therefore often further tests and diagnostic procedures are often needed to help the physician identify the condition causing the problem.

Is ARDS common?

There are about 150,000 cases reported per year in the US.

What causes ARDS?

New causes of ARDS are continually being reported with more than 60 different causes having been indentified already. This means that there is still a lot of information that we don't know and there is a continuing need for further research.

The most common causes of ARDS are pneumonia, sepsis (an overwhelming infection in the body), aspiration of fumes, food or stomach contents into the lung, and trauma. These conditions cause the body to manufacture substances that may cause inflammation in the lungs. Once inflamed, the alveoli (air sacs) are then unable to perform the normal oxygenation of the blood.

What is my relative/friend feeling?
Is there any pain?

Because ARDS results from many different causes, the symptoms can be variable. Some of the most commonly expressed are shortness of breath, cough with white/pink expectoration, and fatigue. Also important are the symptoms associated with the possible triggering cause of the disease. Examples of these include:abdominal pain in pancreatitis; fever, cough, and breathlessness in pneumonia; chills and lightheadedness in initial severe infections. After the patient is diagnosed, supportive treatment will be started or continued. Proper treatment includes pain control and sedatives to keep the patient calm and comfortable.

What can be done to treat the problem?

At the present time, no specific therapy exists to treat this disorder. The treatment is mainly supportive care in the intensive care unit. Many of the patients will require mechanical ventilation and oxygen therapy. The ventilator is a machine which assists the patient's own breathing and helps support the delivery of oxygen to the cells. The patient is connected to the ventilator by a tube, which goes through their mouth or nose to the windpipe (trachea). This tube (referred to as an endotracheal tube) passes through the vocal cords and thereby makes it impossible for the patient to speak. The patient is closely monitored in the ICU and frequent adjustments are often made to the ventilator to make sure that adequate oxygenation is occurring.

With mechanical ventilation, the patient must be kept in a comfortable, relaxed state. This is often achieved with the use of sedatives and pain medication. In severe cases of ARDS, it is often necessary to paralyze the patient for a short period of time to achieve adequate oxygenation. If the underlying cause of the syndrome can be identified, treatment is instituted to correct this problem. Treatment may include antibiotics, immunosuppressants, blood pressure supporting medications, tube feedings, and diuretics, which are used to reduce the fluid in the lungs.

What are the most important complications?

A number of different complications can occur with ARDS. Secondary bacterial infections are a common complication and contribute to continued lung injury. It is often difficult to diagnose a secondary bacterial infection in the lungs since the underlying chest x-ray is already abnormal due to ARDS. Often secretions from the lung are sent to the laboratory for bacterial analysis. These secretions can be obtained either by the nurse or respiratory therapist suctioning the patient or by a special procedure called a bronchoscopy. In a bronchoscopy a physician inserts a thin tube in the lung. This procedure is often done to obtain secretions from deeper in the lung and to allow for direct visualization of the airways.

Infections may also occur in other parts of the body such as the bloodstream, urinary tract, sinuses, skin, or gastrointestinal tract. These infections are usually discovered due to symptoms such as pain or increased temperature, which would then lead the physician to perform additional testing. Appropriate treatment, such as antibiotic therapy or drainage of the infection would routinely be instituted when infections are diagnosed.

Trauma to the lungs due to mechanical ventilation can also occur. The lungs are already weakened due to their diseased state and the additional stress caused by the ventilator to maintain adequate gas exchange may result in rupture of one of the alveoli. This results in a condition called pneumothorax, which will require the insertion of a tube into the chest to prevent or reverse lung collapse.

As discussed earlier, there are often multiple causes which lead to the development of ARDS. These underlying problems may also result in a lack of sufficient oxygen to the other organs of the body. Over time these organs may suffer damage due to the lack of adequate oxygen. The organs most frequently affected include the kidney (acute renal insufficiency), the heart, the liver (liver failure or shock liver), the brain, and the blood. Damage to these organs may complicate the care of the patient and require additional treatments.

What can we expect during the course of the syndrome?

This is difficult to predict. Most of the patients need ventilatory assistance for a minimum of several days, and often weeks. The severity and progression of the injury determine the degree of support. Other factors that may influence the course of the syndrome include age or the presence of underlying health problems. Young, previously healthy patients often recover well and the lung injury heals rapidly. However, patients with older age or underlying health problems may have a more severe course of illness. Further deterioration of their vital organ function and an inability to tolerate the organ damage may result in death.

Some patients are able to survive from the serious complications, but continue to have slow healing of the lungs requiring prolonged mechanical ventilation. These patients usually need to have a different type of tube placed to facilitate prolonged mechanical ventilation. This type of tube is called a tracheostomy and requires a surgical hole to be placed in the patient's neck. This tube is more comfortable and allows for a more stable airway as the healthcare team works to free the patient from the ventilator. The recovery of these patients is much slower and requires careful, vigilant care to prevent any further complications during the recovery phase.

What is the Survival Rate from ARDS?

Recent data show that about 40% of patients die from ARDS. These statistics have vastly improved from a 70% mortality reported in the past. Increased awareness, better understanding of the disease process, better control of the ventilator, and improved diagnosing and therapy have been responsible for the improvement in survival.

What is the lung function of somebody who recovered from ARDS?

Recovery can be complete in ARDS survivors. The majority of patients have full recovery of lung function. The rate of recovery often depends on the individual patient. For some patients, there continues to be feeling of shortness of breath, fatigue, continued cough, or a continued need for oxygen therapy, which usually abates within the first year. Further follow-up after discharge is required so the physician can perform specialized tests to monitor for improvement or worsening of lung function.

Is there a way for the family or friends to give support during this illness? Click here for 1001 Loving Ways to help a patient or family dealing with ARDS.
Family and friends are critical in order to maintain the well being of the person suffering from ARDS. It is important for the family to act on behalf of the patient to work with the healthcare team in making decisions regarding treatment. To facilitate decision-making, the family members or friends need to interact with the healthcare team, ask questions, and read about the disease.

Most importantly, the family and friends should be present for the patient and attempt to impose a positive feeling. Try to assure the patient that you are there for them and are acting to provide the best possible care for them. Even patients who are sedated or paralyzed can often understand what is being said to them and these assurances by loved ones can help decrease their anxiety. You may want to record what happens on a daily basis so that you can answer questions that the person may have after recovery.

It is also important that you remember that this is a serious condition and that many people die from ARDS and it complications. Therefore, make sure you understand what is happening. Don't be afraid to ask questions and seek clarification. This helps to create an environment of trust and support between the patient's family and the health care team. Having everyone working together towards the patient's recovery makes the process proceed smoothly.

17. märts 2006

linnugripivõitluse rahastamine USA vs Eesti

Eesti eraldas raha - 6 miljonit krooni
USA - 3,3 miljardit dollarit, sellest üle poole vaktsiinide väljatöötamisele

Eestis on 0,43% elanikke USAga võrreldes
võtame 0,43% USA eraldatud rahast, arvame maha vaktsiinide väljatöötamise osa (milleks eesti niikuinii võimeline ei ole) - saame võrreldavaks rahasummaks 86 miljonit krooni, mitte 6 miljonit ..

USA- 300 000 000
Eesti - 1 300 000
Eestis on elanikke võrrelduna USAga 0,43%

Eesti eraldas raha: EEK
põllumajandusministeerium - 1 304 770
vet-toiduamet - 979 415
vet-toidulabor - 3 785 000
kokku- 6 069 185

USA tervishoiuministeeriumi gripivõitluse eelarve: link

ühik - USD/ EEK/ EEK*0,43%
vaktsiinide väljatöötamine - 1 781 000 000/ 23 153 000 000/ 99 557 900
Tamiflu jt antiviraalid- 731 000 000/ 9 503 000 000/ 40 862 900
kohalikud ettevalmistused - 350 000 000/ 4 550 000 000/ 19 565 000
meditsiinivarustus - 162 000 000/ 2 106 000 000/ 9 055 800
jälgimine ja laborid - 133 000 000/ 1 729 000 000/ 7 434 700
rahvusvaheline jälgimine ja abi- 125 000 000/ 1 625 000 000/ 6 987 500
riskikommunikatsioon- 38 000 000/ 494 000 000/ 2 124 200
kokku - 3 320 000 000/ 43 160 000 000/ 185 588 000

sõltumatud communityd

suurepärane artikkel!

Spectrum - Wednesday, March 15, 2006
Guest Opinion: The urgent need to 'build resilient communities'
by Peter Carpenter

Our current disaster-preparedness system is built on the basis of mutual aid. When one community has an extraordinary event then mutual aid is the perfect solution because it allows nearby communities to contribute resources.

But when there is an areawide, nationwide or worldwide disaster (a "Pandisaster" like human transmissible avian flu or a 7+ earthquake) mutual aid will no longer be a viable solution — there will be no available resources from neighboring communities. We must therefore develop truly Resilient Communities — communities that have planned, prepared and tested the capacity to help themselves in the event of a Pandisaster. Designing and implementing a Resilient Community will not be easy. It will require 'civilianizing' our current disaster-preparedness-and-response model — our current emergency responders must become teachers rather than doers. We must build resilience into each neighborhood and every family.

This will require a community ethic of individual preparedness rather than the current 911 mentality. It will require mobilizing schools, business, social groups, service organizations and churches in totally new ways. And it will require periodic testing.

Resilient communities would have trained-citizen coverage in every neighborhood, business area and school. Each of those CERTs will need to have greatly expanded medical training. If we have an avian flu pandemic there will be virtually no medical facilities with capacity to treat most victims and nowhere to send non-flu emergency cases. Citizens will need to be trained to perform triage, provide extended and extensive primary medical care — and to perform a mortuary function. Even within families we need to build capacity to diagnose and treat many of the patients, flu or otherwise. And we need to develop neighborhood and family measures that could imperde the spread of an epidemic.

Families will need to take care of most of their emergency needs without relying on normal emergency services. We will need to have prepositioned emergency supplies in every neighborhood — and each family will need to create its own multi-week supply of emergency food, water and supplies.
Given the unusually large numbers of elderly and infirm citizens, the many citizens who lack personal transportation and the numerous pets in our communities, we need to develop realistic shelter-in-place or evacuation plans for these at-risk populations — down to the levels of individual homes and their assignment to specific organizations.

The recent disasters should have taught us that good communications are essential and that reliance on bigger, better, more expensive technology is very risky. Not only do high-tech systems frequently fail to perform in disasters but also our expectation that they will work has often left us without alternatives when we most need solid, reliable communications. We need to develop a reliable non-electronic emergency-communications system that relies on neither electricity nor the Internet — some type of low-tech messaging system using runners and bulletin boards (possibly enlisting trained Scouts/Explorers, student athletes and others).

The Palo Alto Airport represents a unique disaster-response asset. It could serve as a triage site, a transportation base and a command site. Working with the 21 other general aviation airports in the Bay Area, we could create a highly redundant emergency transportation and communication network. Planes based there could do aerial damage assessment and serve as aerial radio-relay stations.

Our ability to provide a range of post-disaster services could be greatly enhanced if all new (and many existing) public, educational and large business buildings, and theaters and conference centers, were required to incorporate specific disaster-support elements such as emergency generators and water supplies.

It is a certainty that the Bay Area will have a major earthquake sometime in the next few decades, with significant property loss and substantial damage. The long delays in making transportation-related repairs or relocations after the 1989 Loma Prieta earthquake and in deciding how to rebuild New Orleans after Hurricane Katrina are preventable. Rebuilding quickly will be essential, but to do that we need a Disaster Recovery Planning and Project Approval Ordinance that is designed to dramatically streamline rebuilding while actually improving the outcome.

The key question is: Are we all prepared to undertake this challenging effort or will we simply continue to expect "someone else" to take care of us when disaster strikes — especially when "someone else" will not be there when a Pandisaster occurs? n

Peter Carpenter is a director of the Menlo Park Fire Protection District, chairman of the Joint Community Relations Committee for the Palo Alto Airport and is a former Palo Alto Planning Commission member (1973 to 1977). He can be e-mailed at Petercarp@aol.com.

USA armee ellujäämiskäsiraamat

U.S. Army Survival Manual FM 21-76
vt eeskätt psühholoogia-osa


Teateid Euroopast
Vahur Afanasjev

kured tulnud
linnud gripis

haned tulnud
kassid gripis

luiged tulnud
lapsed gripis

gripid läinud
euro ei tule

16. märts 2006

eriti algelised toiduvarud

mõned variandid veel..

cureventsi foorumist

one person, one month:
20 pounds rice (uncooked)
8 pounds dry beans,your choice, or equivalent in cans (1/4 cup dry=1 cup wet)
6 pounds fat (your choice, lard/veg shortening keep the best)
Personally, I would allow 1 onion a day, and 1 can of veg per day (30), but you might not be that nuts about onions.
Bullion or something to flavor the rice
This is just to get started.

Basic FEMA Family Unit
This unit will feed two column A persons and two column B persons (chart, above). Each Family Unit will include at least 900 lbs. of Wheat, 480 lbs. of Other Grains, 250 lbs. Legumes, 230 lbs. of Sweeteners and 40 lbs. of Salt with a little left over for one year.

Kastitäis Toitu Üheks Kuuks

ONE MONTH IN A BOX, submitted by Robert Waldrop

One 20 quart size powdered milk (4 pounds) One 10 lb bag rice Two 4 lb bags beans Two 3 lb bags of macaroni Three 13 ounce quick oats Two 5 lb bags flour One 8 ounce baking cocoa One 4 lb bag of sugar One 10 oz baking powder One 8 oz baking soda One 4 lb jar of peanut butter One 1 qt bottle of syrup 30 miscellaneous cans (soups, vegetables, chili, etc.) One bottle hot sauce One bottle soy sauce 9 miscellaneous spice bottles 2 vitamin bottles One 4 ounce bottle of vanilla extract One 4 ounce bottle of yeast One 16 oz bottle of jalapeno peppers One copy Better Times Cookbook and Almanac of Useful Information for Poor People

I found a 23 inches by 21 inches by 10 inches computer box, and all of above food fit into the box, with the lid folding flat and would fit underneath a bed or table. . The above would provide the following daily servings: (for one person)
2-1/2 cups milk
1-1/2 cups cooked rice
1-1/2 cups cooked beans
1-1/2 cups cooked macaroni
1 cup cooked oats
1 cup flour
4 Tbs. peanut butter
1 miscellaneous can of food
Plus daily sugar and spice

I am not in the business of giving nutritional advice, but it seems that if a half gallon or so of cooking oil, another can per day and a serving of fruit juice (equivalent of another can) are added, which wouldn't fit in this space, you'd be all right for a month. Depending on the assortment of cans, a variety of stuff can be made from these ingredients, including cinnamon rolls, oatmeal cookies, peanut butter cookies, tuna casserole, etc.

This box would fit under my bed.-----------Robert Waldrop

15. märts 2006

mida peab tegema?

How to prepare if bird flu comes
Posted March 15 2006

State and federal health officials have compiled a list of precautions residents can take to prepare in ways that mirror hurricane preparations.

>Buy extra canned goods each time you shop, along with other nonperishable foods such as dried beans, rice, peanut butter, crackers, canned juices, granola bars, powdered milk and bottled water. Widespread flu infections could require grocery stores to close or to limit deliveries if employees are too sick to work. Such stocks can also be used in other types of emergencies.

>Have nonprescription drugs and other health supplies on hand, including pain relievers, stomach remedies, cough and cold medicines, fluids with electrolytes, and vitamins. If you have young children, stock up on baby food and diapers.

>Stock up on batteries and candles, and be prepared for rolling brownouts or blackouts, and the possibility of no phone service.
SourceS: U.S. Department of Health and Human Services, Florida Department of Health

14. märts 2006

eesti tamifluvarudest

Rahvaliidu fraktsioon soovitab sotsiaalministeeriumil paremini teavitada avalikkust linnugripiga toimetuleku abinõudest

Riigikogu Rahvaliidu fraktsioon kohtus sotsiaalministeeriumi asekantsleri Ivi Normetiga, et saada täpne ülevaade Eesti valmisolekust võimalikuks linnugripi levikuks inimeste seas ning viia end kurssi nende meetmetega, mida ministeerium on rakendanud seoses Eestitki ohustava võimaliku haigusega.

Rahvaliidu saadikurühma liikmed pärisid Ivi Normetilt, miks on Eestis tellitud vaid 3000 doosi preparaati Tamiflu, mida Maailma Tervishoiuorganisatsioon on seoses linnugripi levikuga soovitanud, ning tundsid huvi, kas Riigikogu saaks probleemide lahendamisel abiks olla. Ivi Normet ütles, et sotsiaalministeerium valmistub võimalikuks haiguse levikuks koos teiste ministeeriumidega, kuid et oht lindude haiguse ülekasvamiseks inimesi ohustavaks pandeemiaks on suhteliselt väike: viimaste aastate jooksul on maailmas täheldatud ca 160 haigusjuhu ülekandumist lindudelt nendega vahetus kokkupuutes olnud inimestele. Samas pole seni veel loodud inimesi ohustava viirusetüve vastast vaktsiini ning ka preparaadi Tamiflu haiguse toimet leevendav mõju on epideemia tingimustes veel kinnitust leidmata.

Eesti tellitud 3000 ravidoosi on mõeldud pidevalt gripihaigetega kokkupuutuvate tervishoiutöötajate profülaktiliseks kaitseks gripipuhangu puhul ja need saabuvad Eestisse lähinädalail. Sama ravimit on Maailma Tervishoiuorganisatsioon varunud 3 miljonit doosi, et operatiivselt aidata piirkondi, kus peaks ilmnema haiguse levik inimeste seas.

Rahvaliidu fraktsioon võttis teadmiseks, et nimetatud ravimi varumine 25 protsendi Eesti elanike tarbeks läheks maksma 90 miljonit krooni ja arvestades Šveitsi ravimifirma tänaseid tootmisvõimsusi, oleks see võimalik 2007. aasta jooksul. Sotsiaalministeerium kutsub lähipäevil kokku spetsialistidest koosneva nakkushaiguste nõukogu, kes peaks langetama otsuse nimetatud ravimi varu suurendamise otstarbekuse kohta.
Rahvaliidu fraktsioon toonitab kõigi asjaomaste ministeeriumide ja ametkondade konstruktiivse koostöö vajadust, samuti ootame rahva paremat teavitamist võimaliku linnugripi kõigist ohtudest.

13. märts 2006

linnugripikriis - majandusanalüüs

dr.Sherry Cooperi kolmas analüüs

soovitaks lugeda igaühel, kes vähegi majandusest miskit jagab - graafikud, arvud..

kusjuures, ma lugesin tema kahte eelmist analüüsi ka, ja mu meelest on see viimane ikka märkimisväärselt süngem kui eelmised
ja ta on autoriteetne tegelane, mitte mingi kõmuajakirjanik

mõned värvikamad lõigud allapoole ka :)

mõned punktid kokkuvõttest:

* Global economic interdependencies, China’s importance in commodity markets and in exports of low-priced goods increase the economic disruption from a human pandemic. So does the prodigious volume of international trade and travel. Supply chains are global and inventories are managed on a just-in-time basis.

* Unlike other natural disasters or terrorism, pandemics are prolonged and pervasive, so the net economic loss is substantial and extended.

* Immediate losers—in addition to the poultry industry and its ancillary businesses— would be tourism, travel and transport sectors, the hospitality industry, public transportation, life and health insurers, theatres, casinos, sports facilities, spectator sports, religious facilities, convention halls, restaurants, retailers of nonessential goods, and providers of nonessential services or those that could directly spread disease such as dentists and hairdressers.

* A pandemic would lead to considerable supply and demand effects. Loss of labour and trade would dominate the supply-side effect and social distancing and fear would increase the demand for essentials such as non-perishable food, water, medical supplies and health-care services, but reduce the demand for virtually everything else.

* If there were a cytokine storm, as in 1918, pregnant women and 15-to-40 year olds would be proportionately the hardest hit. This would have a lasting impact on population characteristics and, therefore, a sustained effect on society and economic activity all over the world. Birth rates would plunge and the average age of the population would increase significantly.

kui on raske - 1918a võrreldav - pandeemia:

Fear and panic would no doubt ensue, at least temporarily, which could lead to unruly or criminal behaviour and most communities would have inadequate numbers of fi rst responders. These first responders and health care workers should be among the fi rst to get prophylactic antiviral medication. Safety and security would be a primary issue, particularly as shortages of Tamiflu, water, and food emerge.

Employees would look to their employers for frequent, clear and accurate information; but rumours would be rampant and media hype could well contribute to the panic. Leadership would be essential, as we saw with Rudy Giuliani’s handling of the World Trade Center attacks in stark contrast to Ray Nagin’s (mayor of New Orleans) handling of Hurricane Katrina.

Some of the big immediate losers, joining the poultry industry, would be the tourism sector, travel and transport businesses, the hospitality industry, and luxury goods suppliers. We saw this vividly with SARS in Toronto, China and Hong Kong. Planes, to the extent they took off, would be virtually empty.

Public transportation would be shunned. Life and health insurers would be devastated by the rise in death rates and the overwhelming demands for medical services. All public and private gatherings of people would likely cease, even if they weren’t offi cially prohibited. Theatres, casinos, sports facilities, religious facilities, convention halls and restaurants would quickly empty. All food-service businesses would be hit, but particularly those that
specialize in chicken. No one would go to the dentist or to doctors, except for flu or emergency conditions. Business as usual would be virtually nonexistent.

Shortages would emerge very quickly as supplies of water, food, medical products, and all other essential items would rapidly be consumed. Machinery and equipment might cease to function if key parts were no longer available, not to mention that there could be a shortage of sufficiently trained labour to provide many essential
goods and services. This is why continuity planning is so important.

We can’t rule out the possibility of prolonged government-service disruptions. Insufficient waste management, clean water and fuel might exacerbate the crisis all over the world. The electricity grid—already old and inadequate in the U.S. and Canada—might shut down for extended periods. Power generation, transmission and distribution are already running near full capacity and brown outs regularly occur during extreme heat, or cold weather. The average age of the infrastructure in the U.S. is 42 years; the average age of workers is over 50. The power systems have little shock-absorbing capacity. Pandemic would make any repairs very difficult and most industry experts suggest that outages will occur. Power outages
already cost the U.S. roughly $100 billion a year.

Prolonged power outages would have huge disruptive effects. Once systems break down, it is very costly and time consuming to start them back up. Without electricity, many would be without Internet access or other sources of news. Telephone service could continue for some period without power, but not indefinitely.

Cash machines would not work and credit card validation equipment might not function. Gasoline stations could not pump gas, reducing the value of generators as the gas runs out. Airports keep only a few days of fuel on hand at any one time. For deliveries, UPS and Fed Ex have very detailed continuity plans that they have not, thus far, released to the public for competitive reasons. Refineries would power down. Fresh food and certain medications would spoil. Hospital equipment would function only for as long as the generators were fuelled.

Preparedness planning is critical for government, businesses, hospitals, and individuals. Battery-operated radios and fl ashlights, large supplies of batteries, stockpiles of bottled water, gasoline, and non-perishable foods might be life saving. Extra supplies of essential medications for chronic conditions, syringes, face masks, antibacterial soap and cleaners should also be considered. According to Tommy Thompson, former head of U.S. Homeland Security, 80% of pharmaceutical ingredients come from outside the U.S. and supplies would quickly dry up.

pandeemiaplaneerimise checklist arstipraksistele

pandemicflu.gov: Medical Offices and Clinics Pandemic Influenza Planning Checklist

Planning for pandemic influenza is critical for ensuring a sustainable healthcare response. The Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) have developed the following checklist to help medical offices and ambulatory clinics assess and improve their preparedness for responding to pandemic influenza.
This checklist is modeled after a pandemic preparedness checklist for hospitals and should be used in conjunction with guidance on healthcare preparedness planning in Supplement 3 of the HHS Pandemic Influenza Plan. Many of the issues included in the checklist are also relevant to other outpatient settings that provide episodic and chronic healthcare services (e.g., dental, podiatric, and chiropractic offices, ambulatory surgery centers, hemodialysis centers). Given the variety of healthcare settings, individual medical offices and clinics may need to adapt this checklist to meet their unique needs. Further information can be found at www.pandemicflu.gov.

This checklist identifies key areas for pandemic influenza planning. Medical offices and clinics can use this tool to identify the strengths and weaknesses of current planning efforts. Links to websites with information are provided throughout the document. However, actively seeking information that is available locally or at the state level will be necessary to complete the development of the plan. Also, for some elements of the plan (e.g., education and training programs), information may not be immediately available and it will be necessary to monitor selected websites for new and updated information.

osta varusid ja koosta Oma Pere Pandeemiaplaan

selliseid lugusid tuleb järjest ja järjest juurde
muidu OK artikkel, ainult et üks nädal on lootusetult vähe, viimasel ajal räägitakse järjest enam kuuest nädalast

What You Should Do to Prepare For an Epidemic
Stock Up on Essentials and Have an 'Outbreak Plan'

March 12, 2006 — Will there be an outbreak of avian flu that threatens humans? Many experts disagree on when or if a human pandemic will occur, but do say there is a chance that the virus could mutate, leading to widespread infection. In that case, the best thing you and your family can do right now is to prepare for that possibility.

Here's what you need to know to help keep yourself healthy.

Stock up on Essentials

If there is an avian flu pandemic, you'll want to minimize your chance of catching it by staying indoors; you might even be required to stay home if the government asks that people remain in quarantine or "shelter in place." Stocking up today on at least seven days' worth of essentials such as water, nonperishable food, emergency and medical supplies will help you get through an extended time at home if an outbreak happens. Once you've purchased these items, store them in a place where you will not be tempted to dip into them for everyday use. See the checklist below for guidelines on what and how much you need.

Have an Outbreak Plan

It may feel odd or uncomfortable to talk to family members and loved ones about the worst-case pandemic scenario. But if that scenario strikes, you'll all be much better off if you have a plan decided on and ready. Talk with your friends and family about how you'd respond to an epidemic. Figure out how you would care for them and what your first response and responsibilities would be; this is an especially important conversation to have with those with special care needs. Get involved with local groups and community efforts aimed at preparing for a pandemic. If your community has no program in place yet, find out how you and your neighbors can get one started.

Pick up the Habits of Healthy Behavior

The habits that can help keep you healthy in an outbreak are the same good health habits that can keep you from catching the common cold: maintain a balanced diet, exercise regularly and get sufficient rest. Particularly in a flu outbreak situation, it will be important to wash your hands thoroughly and often, reminding loved ones — especially children — to do the same. Be diligent about covering coughs and sneezes with tissues, teaching any children in your family to do the same. Also teach children to stay away from others as much as possible if they are sick and stay home from work or school if you are sick.

Know Your Emergency Contacts and Information
Compile the phone numbers you'd need in case of the emergency, keeping the list somewhere safe and visible. Make sure everyone in your household knows where to find it. According to the Department of Health and Human Services, you should include information for:
Local and out-of-town personal emergency contacts
Hospitals near your work, home and school
Family physician
Your state public health department (full list at www.cdc.gov/other.htm#states)
Employer contact and emergency information
School contact and emergency information
Religious/spiritual organization

Also, know your essential health information such as blood type, allergies, past or current medical conditions, and current medications and their dosages. Make a list of that essential information for all the members of your household. Keep that list safe and make sure everyone in your household knows where it is.

HHS has sample sheets that you can print out and fill in with all your essential contact and health information.


What Else Will I Need

Make sure you have:

Food and nonperishable items, such as ready-to-eat canned meats, fruits, vegetables, and soups, protein or fruit bars, dry cereal or granola, peanut butter or nuts, dried fruit, crackers, canned juices, bottled water, canned or jarred baby food and formula, and pet food.

Medical and practical items, such as prescriptions drugs and medical supplies such as glucose and blood-pressure monitoring equipment, soap and water, or alcohol-based hand wash, medicines for fever, such as acetaminophen or ibuprofen, thermometer, anti-diarrheal medication, vitamins, fluids with electrolytes, cleansing agent/soap, flashlight, batteries, portable radio, manual can opener, garbage bags and tissues, toilet paper, and disposable diapers.

Source: the Department of Health and Human Services

1918: faktiline ülevaade

stanfordi ülikooli viiruseuurijate faktiline ülevaade 1918a pandeemiast
The Influenza Pandemic of 1918
Graphs of the Influenza Epidemic Impact
The Public Health Response
Authoritative Measures
Preventative Measures
The Scientific and Medical Response
Clinical Descriptions
Treatment and Therapy
The Etiology of Influenza


eile oli siis hispaania gripi alguse 88.aastapäev :D
Tõnis Erilaid kirjutab SL Õhtulehes
1918: Ameerika Ühendriikides pääses valla kogu maailma laastanud linnugripp ehk Hispaania tõbi

11.märts 1918 algas USA sõjaväebaasis Kansase osariigis Fort Rileys (sinna olid majutatud I maailmasõja tandritelt koju ravile või puhkusele saabunud sõdurid) rahulikult.
Kuid päeval tulid arstide juurde mõned mehed, kes kurtsid köha ja palavikku, nii et algseks diagnoosiks pandi kopsupõletik. Alles hiljem, kui need mehed olid surnud, ning algul sajad, siis juba tuhanded inimesed teise ilma olid läinud, diagnoositi haigus õigesti - tegemist oli gripiviirusega H1N1. Siiani pole päris täpselt teada, kuidas sõdurid nakatusid - kas nad tõid viiruse Euroopast kaasa või peab paika arvamus, et kokk, kes armeebaasis süüa tegi, puutus kokku haigete lindudega, või levis H1N1 hoopis Kansase koduloomadega. Kiiruga püstitati baasi telkhospidal, mis õige varsti kõiki tõbiseid enam ära ei mahutanud.

Kogu maailmas möllanud viirus viis eri hinnangutel hauda kuni 100 miljonit inimest, ja kuivõrd kõige rängemalt kannatas Hispaania, siis on toda haigust, mis tühjendas terveid linnu, nimetatud ka Hispaania tõveks. Eeskätt põhjusel, et sõja pärast tsenseeriti haiguse levikust kõnelevaid uudiseid rangelt ning üksnes Hispaania ajakirjandus - riik ei osalenud sõjas - võis asjast vabalt kirjutada. Nii jäigi mulje, et haigus puudutab rohkem Hispaaniat kui muud maailma.

Nüüd teame, et tegelikult põdes H1N1 grippi vähemalt viiendik, võimalik aga, et isegi pool maailma elanikest ning üle 3% haigestunutest suri. Ainuüksi Indias 17 miljonit inimest (USAs kuni 675 000, Prantsusmaal 400 000 jne). Tõveohvreid oli rohkem kui suri inimesi kõigil I maailmasõja lahinguväljadel kokku. Tähelepanuväärne on see, et haigus vahepeal pisut vaibus, kuid siis avastati Prantsusmaal Brestis selle veelgi ägedam vorm ning surmajuhtumite hulk kasvas kiiresti. Mõne kuuga levis tõbi üle maailma. Teadaolevalt on ainus tihedamalt asustatud paik, kus Hispaania tõbe ei leitud, Marajo saar Brasiilias Amazonase suudmes.

Põhimõtteliselt ei erine H1N1 eriti praegusest linnugripist H5N1, mis aga pole muteerunud inimeselt inimesele kanduvaks ja on tänu sellele nõudnud ka üsna tühise arvu ohvreid.

12. märts 2006

kas must katk oli viirus?

artikkel teemal, kas keskaja must katk oli tegelikult hoopis viirus

A third of Europe's population died over four years due to the Black Death. But was it really spread by rats and fleas? Could it have been caused by a virus? And what has that got to do with the modern-day spread of HIV? Peter Lavelle delves into the dark history of the great pestilences to look for answers.

tsitaadikogumik - mida arvavad eksperdid?

fluwikiest Quotes from Officials and Experts about BF Pandemic Possibility (Taken from news articles between February and March 2006):

I found that this list of quotes (updated from my earlier one) has a big impact on some people who are in denial that there is a significant proabability of a pandemic in the near future. Some people just read news headlines and not the entire article, thus missing the entire message. Hopefully this will get the point across. Pass it on to those in the hopes that it will get them to prep!

Quotes from Officials and Experts about BF Pandemic Possibility (Taken from news articles between February and March 2006):

1) March 3 (Reuters) - Chinese Vice-Premier Hui Liangyu has warned that China could see more human cases of bird flu during the spring season when migratory birds return, increasing the risk of spreading the virus. http://

To at least one expert, the Chinese statement sounded like a hint that avian flu in China is more widespread than the government has been acknowledging. “Many of us believe that this type of discussion by someone as high as the vice premier really indicates that this situation is already occurring,” said Michael T. Osterholm, PhD, MPH, director of the University of Minnesota Center for Infectious Disease Research and Policy, publisher of the CIDRAP Web site. http://www.cidrap.umn.edu/cidrap/co…r0206avian.html

2) U.S. Secretary of Health and Human Services Michael Leavitt said on March 6 that, “The H5N1 virus has continued to [evolve] over the past 18 months. We continue to monitor its evolution.” Leavitt said. “We will have seed viruses reflecting this drift that can be quickly available for vaccine testing and production.” http://usinfo.state.gov

3) Dr. Niman says recombination has been steadily occurring and this Spring we might be presented with some nasty consequences. http://www.recombinomics.com

4) Masato Tashiro, director of the Department of Viral Diseases and Vaccine Control at the National Institute of Infectious Diseases in Tokyo, warned that cases in which the virus transmitted from birds to humans had begun to rise recently and human-to-human virus transmissions are likely to be seen in the near future. “Avian-human transmission happens sporadically, but the number of cases are increasing,” Tashiro said, “Flu viruses are constantly undergoing mutations, which could result in human-to-human virus transmissions, which is the worst case scenario.” Tashiro added that an avian flu case needs to be contained within three weeks. After three weeks, the infection will accelerate to the extent that makes it difficult to contain. - March 2006 http://www.taipeitimes.com

5) “Only two mutations are needed for it to become easily transmissible among humans,” thus sparking a pandemic in which millions of people could die, David Nabarro, the world body’s coordinator on avian influenza, told Portuguese newspaper Expresso in February 2006. http://news.xinhuanet.com

6) John Oxford, Professor of Virology at Barts, claims the likelihood of a human avian flu pandemic was “high and within a span of, say, 18 months”. -Feb 2006 http://www.24dash.com

7) “Still, epidemiologists have been stunned by the rapid advance of the disease. ‘’The virus is moving quite substantially into new locations,” said David Nabarro, the official responsible for coordinating the UN response to avian and human influenza. ‘’The truth is, this virus is undergoing changes. This warning that nature is giving us has to be heeded.” –Feb 2006 http://www.boston.com

8) From the same article: ‘’The danger is grave, the threat is real,” said Dr. Albert Osterhaus, a virologist at the Erasmus Medical Center in Rotterdam, head of the Netherlands National Influenza Center, and one of Europe’s top virus hunters.” Another pandemic is probable, not just possible. It’s only a matter of time,” he said in a telephone interview. ‘’Whether [the H5N1] virus will be the basis of the next pandemic is impossible to say. But the virus is already highly pathogenic.” -Feb 2006

9) “One amino-acid replacement in the genome remains to make the virus transferable from human to human,” said Dmitry Lvov, the director of a virology research institute at the Russian Academy of Medical Sciences….”Lvov said the pandemic virus could strike at any moment, and would most likely come from China, leading to tens of millions of human deaths, or one third of the global population. He added quarantine measures could delay the pandemic for a few days but not prevent it, and that vaccination would not stop people getting sick.” –March 8, 2006 http://en.rian.ru

10) Reports that cats have contracted bird flu could mean the virus is adapting to mammals and poses a potentially higher risk to humans, a World Health Organisation official says. Michael Perdue, a scientist with the organisation’s global influenza program, said “If it is true, it would imply the virus has changed significantly.” –March 7, 2006 http://msnbc.msn.com/id/11710674/

Also on the same note…

In Germany, Agriculture Minister Horst Seehofer said on March 7 that the discovery of the dead cats a week after the first feline infection in Germany signalled a heightened risk of infection for humans. “This means that the virus is not confined to a single case of a mammal but has spread to several cases. Therefore, bird flu has clearly moved closer to humans,” he told Bayerischer Rundfunk radio. http://en.chinabroadcast.cn/706/200…9/189@59646.htm

11) The U.N. agency met in Geneva to discuss global efforts to prepare in case bird flu mutates into a form easily passed between humans, potentially triggering a global pandemic. “Dr. Margaret Chan, who is spearheading WHO’s efforts against bird flu, told more than 30 experts that the top priority was to keep the deadly H5N1 strain of bird flu from mutating. “Should this effort fail, we want to ensure that measures are in place to mitigate the high levels of morbidity, mortality and social and economic disruption that a pandemic can bring to this world,” she said.” March 6, 2006 http://www.mercurynews.com

12) Bird flu might spread more with the arrival of spring, said the spokesman from the World Health Organization (WHO), Dick Thompson, who added in an interview for a radio station that the risk of humans being infected with the virus is very small. “What worries us,” he said, “is that a mutation of the virus could transform the H5N1 into a human virus.” He “warned that many experts believe there is a strong connection between the weather and the spread of the virus, explaining that cold weather hinders its spreading and warm weather makes it easier.” http://www.daily-news.ro

13) U.S. Health Secretary Michael Leavitt told a Senate committee March 1, 2206 that the H5N1 virus might spread to the U.S. ``soon. The virus’ appearance is ``just a matter of time; it may be very soon, he said in his testimony. http://www.bloomberg.com/apps/news?…refer=australia

14) `There will be a pandemic sooner or later, Nabarro said during a news conference today at the UN. `It could start any time. We have a virus capable of replicating inside humans. We have a virus that humans are not resistant to. We have a virus about which we don’t understand everything. It is at this stage of a pandemic alert that we have the luxury of being able to be prepared. –March 8, 2006 http://www.bloomberg.com/apps/news?…top_world_news#

15) “I think it’s within the next six to 12 months,” Nabarro (WHO) told a news conference, “And who knows — we’ve been wrong on other things, it may be earlier.” – March 8, 2006 http://www.cbsnews.com

16) “In 2004 we said it will be an international crisis if we don‘t stop it in Asia, and this is exactly what is happening two years later,” said Joseph Domenech, head of FAO‘s Animal Health Service. “We were asking for emergency funds and they never came. We are constantly late.” –March 6, 2006 http://www.localnewsleader.com/olber…news&id=153308

17) “If we try to contain a pandemic,” said Keiji Fukuda, coordinator of the global influenza program at the World Health Organization, “there really is a very good chance we will fail, that we will not be able to stop it.” He added, “However, there is also a very good chance that if we mount this kind of effort, we may slow down the spread of a pandemic virus early on.” March 10, 2006 http://www.iht.com/articles/2006/03/10/business/flu.php

peamine eesmärk - vee ja elektri tagamine

Maintaining water, power may be job one in pandemic

Jan 30, 2006 (CIDRAP News) – Keeping the taps flowing, the lights glowing, and food on the shelves may be a higher priority than caring for the ill during an influenza pandemic, the United Nations' coordinator for avian and pandemic flu has said.

"It may be more important to concentrate on the essentials of life for those who are living than it is to focus on the treatment of those who are sick," said David Nabarro, as quoted in a Jan 28 Reuters report following a pandemic simulation exercise.

The simulation focused on what might happen in one European country 40 days into a pandemic, according to Reuters and a Jan 29 story by TurkishPress.com. The exercise, run in connection with the World Economic Forum in Davos, Switzerland, revealed preparedness gaps.

"It is only as governments have begun to do simulations that countries are realizing they are nowhere near prepared for the kind of damage this does," TurkishPress.com quoted Nabarro as saying. "If we do not all work together effectively and get properly prepared, we will be badly hit by that pandemic."

Every government now has a preparedness plan, according to Nabarro's remarks as quoted by the Turkish Web site. Other parts of society must be involved as well, however. Governmental groups, non-governmental organizations, businesses, and media have "real potential for synergies and coordination," he added.

The UN is examining fixed partnerships with key groups, including businesses, to respond to a pandemic, Nabarro said.

"The focus on business is important," Reuters quoted Nabarro as saying. "They have skills and can do things that governments cannot."

Communications will also be important, he added. One idea: The UN is contemplating using "flu-casters" operating in a World Health Organization bunker to broadcast flu updates much as television weather forecasters predict conditions.

11. märts 2006

mida saab kodanik teha

U.S. Department of State
Bureau of International Information Programs
Washington, D.C.
March 9, 2006

fact sheet


To avoid contracting or passing flu viruses to others, individuals should wash hands after touching blood, body fluids, secretions, excretions and contaminated items; after removing gloves; and between physical contacts with other people. Wash with either plain or anti-microbial soap and water or use alcohol-based products (gels, rinses or foams) that contain an emollient and do not require the use of water.

They also should:

• Avoid touching eyes, nose, mouth, or exposed skin with contaminated hands. Avoid touching surfaces doorknobs, keys, light switches without clean gloves.

• Use gloves and eye protection if in contact with blood, body fluids, secretions or excretions.

• Contain and dispose of solid waste in accordance with community health guidelines.

• Make sure building ventilation systems are well maintained to protect people inside from airborne threats.

Families should stock cupboards with enough nonperishable and prepackaged food products to last four weeks to five weeks. Supplies should include bottled water, canned meats, fruits, vegetables, soups, protein or fruit bars, dry cereal, granola and fruit bars, crackers, peanut butter or nuts, canned juices, canned or jarred baby food and formula, and pet food.

To avoid opportunities for exposure, shoppers should consolidate trips to the grocery store by purchasing larger quantities than normally and avoid dining outside the home during the initial months of a pandemic.

Other important precautions include stockpiling prescription drugs, if possible, as well as medical supplies like insulin and blood-pressure monitoring equipment, soap and water or alcohol-based hand wash, anti-diarrheal medication and fluids with electrolytes and vitamins.

investeerimisanalüüs linnugripist

külm investeerimisanalüüs pandeemia võimalikest mõjudest majandusele
kel aktsiatega pistmist - lugemine kohustuslik! :)
Citygroup: Avian Flu - Science, Scenarios and Stock Ideas

allapoole panen mõned üldisemad lõigud

hea kokkuvõtlik võrdlus SARS vs H5N1

Why H5N1 would be different from SARS
A potential human H5N1 virus would have several key differences to the coronavirus that caused SARS:
1) H5N1 would be much more easily transmissible — Influenza viruses are airborne, easily transmitted by a cough or a sneeze; SARS was droplet-borne: only close face-to-face contact transmitted SARS.
2) Carriers of H5N1 would be infectious before falling ill — People infected by influenza viruses are infectious before they themselves are sick. This means the basic measures that helped control SARS, such as fever-checks, airportscreening
and isolating sick people, would be of little or no use against a possible human H5N1 virus.
3) Influenza has a much shorter incubation period — SARS’s incubation period is 10 days, giving time to trace contacts and quarantine suspects. Influenza has a 2-to3-day incubation period, so these measures would be useless.
Once pandemic influenza begins to spread internationally, it will be unstoppable,” says the WHO.
4) As a result, H5NI could potentially spread to all five continents within weeks – Once SARS became virulent in early 2003, it spread from South China to Hong Kong, Vietnam and Canada within three weeks. A human H5N1 virus could potentially move faster and further, carried by intercontinental jets.

WHO ..
Ten things the WHO wants you to know about pandemic influenza
1. Pandemic influenza is different from avian influenza.
Avian influenza refers to a group of influenza viruses that primarily affect birds. On rare occasions, they can infect other species, including humans. The majority of avian influenza viruses do not infect humans. An influenza pandemic happens when a subtype emerges that has not previously circulated in humans. Avian H5N1 is a strain with pandemic potential since it might adapt into a strain that is humanly transmissible.
2. Influenza pandemics are recurring events.
Three influenza pandemics occurred in the 20th century: “Spanish influenza” in 1918, “Asian influenza” in 1957, and “Hong Kong influenza” in 1968. The 1918 pandemic was exceptional, killing an estimated 40–50 million people — one of the deadliest disease events in human history. Later pandemics were milder, with an estimated 2 million deaths in 1957 and 1 million in 1968.
3. The world may be on the brink of another pandemic.
Health experts have monitored a new and extremely severe influenza virus – the H5N1 strain – for almost 8 years. The H5N1 strain first infected humans in Hong Kong in 1997, causing 18 cases and 6 deaths. Since mid-2003, this virus has caused the largest and most severe outbreaks in poultry on record. Since December 2003 over 100 human cases have been laboratory-confirmed in 4 Asian countries, and more than half of these people have died. Fortunately, the virus does not jump easily from birds to humans or spread readily and sustainably among humans.
4. All countries will be affected.
Once a fully contagious virus emerges, its global spread is considered inevitable. Countries might, through measures such as border closures and travel restrictions, delay arrival of the virus, but cannot stop it. The pandemics of the previous century encircled the globe in 6 to 9 months, even when most international travel was by ship. Given speed and volume of international air travel today, the virus could spread more rapidly, possibly reaching all continents in less than 3 months.

3 kuud on reaalne ainult siis kui lennuliiklus koheselt 100% lõpetatakse :D
muidu - mõned päevad, maksimaalselt mõni nädal - ja see aeg kulub juhtumi registreerimisega

5. Widespread illness will occur. Because most people will have no immunity to the pandemic virus, infection and illness rates are expected to be higher than during seasonal epidemics of normal influenza. Current projections for the next pandemic estimate that a substantial percentage of the world’s population will require some form of medical care. Few countries have the staff, facilities, equipment, and hospital beds needed to cope with large numbers of people who suddenly fall ill. 6. Medical supplies will be inadequate. Supplies of vaccines and antiviral drugs – the two most important medical interventions for reducing illness and deaths during a pandemic – will be inadequate in all countries at the start of a pandemic and for months thereafter. Inadequate supplies of vaccines are of particular concern, as vaccines are considered first line of defence for protecting populations. On present trends, many developing countries will have no access to vaccines throughout the duration of a pandemic.
mitte ainult gripiravimid, kõik ülejäänud ravimid samuti muutuvad defitsiitseks
7. Large numbers of deaths will occur. Historically, death rates during pandemics have varied greatly, depending on the number of people who become infected, the virulence of the virus, the characteristics of affected populations and the effectiveness of preventive measures. All estimates of the number of deaths are purely speculative until the pandemic virus emerges. WHO uses a conservative estimate – from 2 million to 7.4 million deaths – based on the comparatively mild 1957 pandemic. Estimates based on a more virulent virus, closer to the one seen in 1918, are much higher.
irw @ palju kõrgem .. ei julge välja öelda, jah? :D 1918a oli rahvaarv ca 1,5 miljardit - surevus hispaania grippi oli 50-100 miljonit, märksa madalama asustustiheduse juures praegu on 6,5 miljardit - samad numbrid oleksid siis 200-500 miljonit, venelased on öelnud ka miljard ei tasu unustada, et enamus sellest 6,5 miljardist elab samades või halvemates tingimustes kui sajand tagasi ja praegune arstiabi tugineb praktiliselt ainult keemiale ja tehnikale, millest ei piisa pandeemia korral
8. Economic and social disruption will be great. Past pandemics have spread globally in two and sometimes three waves. Not all parts of the world or of a single country are expected to be severely affected at the same time. Social and economic disruptions could be temporary, but may be amplified in today’s closely interrelated and interdependent systems of trade and commerce. Social disruption may be greatest when rates of absenteeism impair essential services, such as power, transportation, and communications. 9. Every country must be prepared. WHO has issued a series of recommended strategic actions for responding to the influenza pandemic threat. The actions are designed to provide different layers of defence that reflect the complexity of the evolving situation. Recommended actions are different for the present phase of pandemic alert, the emergence of a pandemic virus, and the declaration of a pandemic and its subsequent international spread.
10. WHO will alert the world when the pandemic threat increases. WHO works closely with ministries and public health organizations in surveillance of influenza strains. A system that can detect emerging influenza strains is essential for the rapid detection of a pandemic virus. Six phases have been defined to facilitate pandemic preparedness planning, with roles defined for governments, industry, and WHO. The present is phase 3: a virus new to humans is causing infections, but does not spread easily from one person to another.
see viimane punkt on naerukoht :S esiteks, WHO-l võtab praegu ühe linnugripisurma kinnitamine aega nädalaid .. kuidas on reaalselt üleüldse võimalik õigeaegselt hoiatada sellisel juhul? ja kuidas nad üldse julgevad sellist lubadust anda? täielik müstika .. selle aja peale kui WHO annab ametliku pandeemiateate on viirus ammu igal kontinendil ja praktiliselt igas riigis

ja mis puutub faasidesse - irw
siis nad ei julge faas 4 välja kuulutada, kuna sellega on seotud igasugused pandeemiaplaanide käivitumised, mis hakkavad kohe majandusele mõju avaldama
ja seega muutsid nad lihtsalt eelmisel aastal faas 4 definitsiooni ära :DDD
eelmise versiooni kohaselt oleme ammu neljandas faasis, kui mitte juba viiendas

ma usun kindlalt, et pandeemiast saab enamus teada mitte WHO käest, vaid telekas näidatavate laibamägede kaudu .. vähemus tuvastab alguse internetis leviva mitteametliku info kaudu
muuhulgas jälgib ka WHO väga hoolikalt foorumites levivaid kuulujutte :p

10. märts 2006

kanu tuleb kaitsta


ülemuste ülesanne on planeerida

It pays to expect the worst
By Carly Chynoweth

Terrorist attacks, “mad cow” disease or bird flu epidemics are not everyday events, thankfully. But should they occur the best way to deal with them is to be prepared ARE you bored with bird flu yet? Yeah, me too. While senior executives are all resilience planning this, training day at a plush conference centre that, the rest of us are left to get on with our everyday tasks. But come the revolution (or the radiation attack on the City/alien landing on your building/blooming bird flu), junior and middle managers will have to act. You’d better hope that someone has a plan . . .
1. It’s all about the plan. This is — or should be — detailed and comprehensive. “Business continuity has to be appropriate, which means you have to do the right thing at the right time,” says Andy Tomkinson, a director of the Business Continuity Institute (www.thebci.org). Senior executives and experts will prepare it; your role is to know that it exists, and to know your part in it. If your organisation doesn ’t have a plan, start pushing it to develop one.

2. Find out more. This is your first step when something calamitous happens, says Alan Calder, the chief executive of IT Governance, the information security specialists (www.itgovernance.co.uk). “Before you do anything (other than dealing with any immediate threat) you should find out what’s going on.” The exception: if the plan says that you should be doing something else.

3. Stick to the plan. “The mistake that most people make is to try to come up with a solution on their own,” Calder says. Having ten different people trying to send people down ten different untested evacuation routes when the building catches fire isn’t a good idea.

4. You’re not an official. Your company does not need to buy shotguns so that staff can spend lunchbreaks on the roof culling pigeons, and there’s no point getting your own JCB to clear a path through the rubble if there’s been a bomb in the street outside your building; you won’t be able to do anything until the police say so.

5. Keep your contacts handy. Ideally a wallet card that has the names and contact details of your boss, your boss’s boss and the emergency response team as well as the numbers for your key team members, Tomkinson says.

6. Be prepared to step up. There’s no guarantee that your boss will be available. “Make sure you know what your boss does and what your boss’s boss does,” Calder says. You should have a copy of the plan that delineates their responsibilities as well as your own. Equally, you need people identified to whom you can delegate.

7. Keep something in reserve. You can’t make good decisions when you’re exhausted, Tomkinson says. Work out a rota that includes rest.

8. Inform and reassure staff. Keep calm. Your demeanour will be noticed. “Once you know what’s going on make sure that your people know,” Calder says. If you don’t know the answer to a particular question, don’t guess — say you don’t know, then find out. “And when you are briefing staff the main thing is to give it to them in writing”, as well as face to face, Tomkinson says. It gives the message weight; it also makes it clear that someone is in control.

9. Keep other contacts in the loop. Rather than having ten people from each of your customers ringing ten people at your company, arrange one point of contact with each. With family and friends, speak to one person and ask them to ring everyone you know — it will save you from being disturbed by a hundred concerned calls.

10. Find out more. See www.ukresilience.info.


veidi hardcore jutt, aga tasub lugeda ja kaasa mõelda :)
Basic First-Aid Needs
Basic Light Needs
Basic Communication Needs
Basic Shelter Needs
Basic Heating Needs
Basic Water Needs
Basic Tool Needs
Basic Food Needs

Basic First-Aid Needs

In a crisis or emergency situation, you will need to be your own doctor and dentist. A comprehensive first-aid kit would be a good idea so you can treat minor injuries. At a minimum, you should have gauze pads, gauze rolls, medical tape, topical anti-septic, 'Band- Aids,' pain reliever, and an anti-diarrhoea medication. You can get these things at any drug store. It would also be a good idea to include a first-aid manual for reference.

If you or members of your family are taking long-term prescription medicines, you should make arrangements to have a supply on hand so you don't run out after the stores have closed down.

Basic Needs:

• If anyone needs prescription medicines on a regular basis, make sure you have a supply on hand to meet your duration goal
• Standard first-aid kit capable of handling most injuries
• Over-the-counter medicines for pain relief, allergies, diarrhoea, etc.
• Check with your doctor about getting some general antibiotics and how/when to use them
• If possible, an extensive medical kit and first-aid training
• Emergency dental kit

Basic Light Needs

All of us have become very accustomed to having light at the flip of a switch. When the power goes out, you'll need to have another source of light. Flashlights are probably the easiest to use, but you'll need some extra batteries to keep them going. Candles and lanterns are another option.

Make sure that any candle you plan on using in an emergency are going to remain lit. Many of the cheaper, decorative candles will not stay lit very well as they were made for decorations and not for burning. Some of the best candles to get are the 10- hour votive candles available in nearly any department store.

Non-electric lanterns are another choice for providing light. You can get a lantern that runs on one of the following fuels: white gas, unleaded gas, propane, kerosene, and oil (the scented kind).
The kerosene and oil lanterns are not as bright as the first three, but a couple of kerosene lanterns might be more practical to use if you have a kerosene heater. You'd only have to store one type of fuel.

Basic Needs:

• Standard flashlights with extra batteries
• LED flashlights with extra batteries (last much longer than standard flashlights, though not as bright)
• Lanterns with extra fuel (white gas, unleaded gas, propane, kerosene, oil) to last your duration goal
• Candles, long burning type (decorative candles make poor choices as they don't burn well)

Basic Communication Needs

You'll need to be able to get information to find out what's going on. One of the easiest ways to get news to listen to AM or FM radio.
There are radio stations in every town that are designated emergency broadcast stations. They usually have a generator, so in case the power goes out, they can still broadcast. Make sure you have spare batteries for your radio.

Keeping communications between family members has gotten easier recently. In the past, the only choice we had for public radio communications was the Citizen's Band radio. Now, there is the Family Radio Service (FRS) band which doesn't require a license. FRS radios are sold everywhere, are relatively inexpensive, and run on common batteries.

Basic Needs:

• Battery-powered radio, AM and FM
• Extra batteries
• Police scanner, optional, it would be nice to hear what's going on in and around your neighbourhood
• FRS radios

Basic Shelter Needs

You need to be able to provide shelter and repair shelter. If your home gets damaged, like in a storm, you will need to make immediate, temporary repairs. If your home becomes inhabitable, you will need to provide shelter for you and your family.

Basic Needs:

• Ability to fix broken windows and holes in structure (plastic sheeting and staples or nails)
• A tent or tents to accommodate everyone in your family comfortably (even if you don't plan on relocating, you might be forced to leave)
• Tarps for extra weather protection
• Cordage and stakes to secure tents and tarps
• Ability to construct shelter (chainsaw, axe, hammer, nails, etc.)

Basic Heating Needs

Power outages during the winter are common. If you live in the northern part of the country, this means it will be cold. Maybe very cold. You'll need a heat source to keep warm. If you have a fireplace or wood-burning stove, make sure you have enough wood.

Keep in mind though, if you have a standard fireplace, it won't be able to heat up much more than the room it's in. This means you might need to drain your pipes so they don't freeze.

Another method would be to get a kerosene heater and a supply of fuel. Kerosene heaters have become very efficient and don't smell nearly as much as they used to. However, there is a bit of a cost in buying a kerosene heater and storing kerosene, so you may want to consider the all the alternatives before you decide.

Another possibility would be to buy a generator capable of running your heating system for your house. While this method would keep the whole house warm, generators are rather expensive and you'd need a fairly large one to run your furnace. If you do decide to get a generator, have a qualified electrician wire it to a switchbox in your house so you can run on either house power or generator power.

Basic Needs:

• Need to have a method of heating your home, or at least one room, and enough fuel to last for your duration goal
• Everyone needs to have a sleeping bag or warm blankets
• Preferable for everyone to have a sleeping pad (may have to sleep on floor next to heater)
• If you have relocation plans, make sure you can start a fire under all conditions and have the ability to gather firewood

Basic Water Needs

We all know that we need water to live and that we can get water from the faucet any time we want. But, would you know where to get water if it stopped flowing from the faucet? Most of us wouldn't.
But, there are a few things that you can do to ensure that you have water available.

The first thing you can do is to store water. Either buy water from the store, or get some plastic containers, like those used for camping, and store water in them. There's also a supply of water in your hot water heater (if you haven't lately, you should flush your water heater. Not only will this keep the water cleaner, but will make your heater run more efficiently). Simply connect a hose to the bottom and open the drain. You might need to open a hot water faucet to get all of the water out of the heater. Another highly recommended thing to do is to fill the bathtub(s) and any available containers if you think the water may be shut off or otherwise be unavailable. This will help give you extra water if you need it.

In addition to having a supply of water, you should also keep a bottle of plain Clorox around so you can purify it needed. Why would I need to purify water? Anytime you get water from a questionable source (including water that has been sitting in your tub) you should purify it. To purify, add 8-10 drops of Clorox bleach per gallon, stir it and wait 30 minutes. If it doesn't have a faint odor of chlorine, add another 8-10 drops and wait another 30 minutes.

You can also boil water, for at least 5 minutes, to purify it. However, this will require extra fuel in order to be able to purify large quantities.

A very good way of providing clean water is to buy a water filter, like those used in camping. However, there are many different types of filters on the market and you should research which one is best for your needs. Many camping stores can provide information on the filters they sell. You can also search the Internet for more information.

Basic Needs:

• Two week supply of water stored on hand
• Ability to filter or purify more water on a continuous basis
• Locate a nearby source of water that's reasonably clean

Basic Tool Needs

You'll need hand tools in order to make repairs to your home and equipment. Take a look at what you have already and compare that to what you might need to make repairs.

Basic Needs:

• Common tools to have would include axe, sledge hammer, wedge
or maul, shovel, pickaxe, pliers, wrenches, wire cutters, duct tape, pry bar, wood saw, nails, socket set, etc.

Basic Food Needs

Even though you can survive many days without food, it's not a pleasant experience. Also, in the event of a sudden crisis, having food (and other supplies) on hand will prevent you from having to go out and face confused, panicky people at the grocery stores and on the roads. We all have seen on the news how people react when there's no food on the grocery store shelves. Fistfights have broken out over the last loaf of bread or last pound of ground beef (very common in the Northeast just before a large snowstorm. You can avoid potential injury simply by having extra food in your pantry.

How much extra food do I need? Good question. Most likely, you probably have about two weeks worth of food in your home right now.
A good amount would be to double it to a one-month supply for everyone in the house. One month! Good grief ... that's a lot!! Not really; and if you buy a little extra each time you go food shopping, you'll soon have a month's worth of extra food. Be sure to rotate it out with new stuff you buy. For example, when you buy a can of corn, instead of using the can you just bought, use one from your pantry and replace it with the one you just purchased. Don't forget to consider anyone in your family that has special dietary needs such as infants, the elderly, and the diabetic.

Think of this extra food as an insurance policy. But, you can eat this insurance! Try doing that with your car or life insurance.
Minimum amount to cover your duration goal:

• Quick-fix meals (those that require very little preparation time)
• Rotation system for your everyday foods you bought from the grocery store
• Storage food (those that were packaged for a long shelf-life)
• Ability to hunt
• Books on edible wild foods
• Recipes using storage food
• Spices to help liven up usually bland storage food
• Paper plates, paper towels, napkins and plastic cutlery will help keep down the use of water (and disease spread)

Preparedness: A Concept of Life

Basic Preparedness Concepts

Earthquakes, floods, fires, lightning, crime, tornados, chemical spills, hurricanes, vehicle accidents, urban violence, food shortages, extreme temperatures, power outages, nuclear accidents.
How many of the above threaten your safety and that of your family's? A realistic analysis of the risks shows the answer to be more than we care to think about. In order to keep yourself and your family as safe as possible from harm and discomfort, you need to prepare for anything that might happen.

Does this mean you need to spend every extra nickel and every spare minute in preparation? Is this an end to quality time with your family? The answer is...No. Preparedness doesn't need to be an all- consuming task. And the reason for this is that most of the preparation for one risk will work for another.

For example, no matter what calamity occurs, you'll always need the basics of water, shelter, fire (heat/cooking), first-aid, clothing, and food. If you take a look at past disasters, you'll find that people are always in need of the same things: fresh water to drink, a place to stay, medical treatment, something to eat, etc. If everyone took the time and spent a little money putting away the basics, there would be a lot less people looking for handouts from the Red Cross, Salvation Army, and various governments.

Okay, now that you know most preparations will get you ready for most things, where do you start? At the beginning, of course. The very first thing you need to do is a risk analysis of the area where you live and work, as well as for everyone in your family. School can be considered work for those getting an education.

Start with the big three: Vehicle accidents; Fire; Crime. Odds are that you'll be affected by one of these before anything else. What comes next on the risk list depends on where you are. The key is to be realistic. If you are trying to prepare for foreign invasion, but don't have any auto insurance, you're not being realistic.

Once you've done your risk analysis, you can move into the planning phase. Keeping the possible risks in mind, devise a plan to accommodate any contingency. These contingencies will outline where you and your family are when the disaster strikes.

If everyone is together, it's just a matter of getting your supplies and staying safe. If the family (for the purpose of this article, "family" can mean a close group of friends) is not together, communication becomes very important. Knowing where someone is and that they're safe will relieve vast amounts of stress during an emergency.

There are several forms of communication that you should consider.
They are, but not limited to, landline telephone, pager, cellular telephone, and two-way radio. Landline telephone is the same phone we use everyday, it's connected to the phone company by wires.
During a crisis, you may not be able to call anyone in the affected area due to blocked lines, but you'll most likely be able to call outside of the area. Therefore, you should have a distant family member or close friend act as a contact point. This way, everyone can call the contact person and leave messages about their well- being.

Pagers have become extremely cheap, lately, making them quite affordable. In addition to staying in touch during normal times, through the use of simple codes, you can relay information to each other. Unless the disaster is quite severe, the paging transmitters should still be working as long as you can get an open phone line.
The cost of having a cellular phone has also come down to a level where they're affordable. Especially if you get a package designed for emergency use only and don't use it except when necessary.
Cellular phones connect into the landline phone circuits at the cell sites and are subject to the same disruption as landlines. However, having a cellular phone to use when you are stranded, or caught in a minor emergency, is invaluable.

If you noticed, the above three forms of communication all have one thing in common. Every one of them needs to go through a phone company to work. This leaves you quite dependent on someone else.
Using a two-way radio precludes having to rely on a "middle man."
However, there is one drawback; you are limited by the range of the transmission. For more information and a look at what's available, visit a radio-electronics shop. If they don't know the answers, they should be able to point you in the right direction.

Another part of your plan that could fall under communication is called the meeting place. You should have at least one meeting place, and it's location should be a safe place right outside your home. If a fire were to break out while everyone is sleeping, chances are that not everyone will use the same escape path. In order to know who got out okay, assign a point outside your home, a neighbor's tree, for example, where everyone will meet after escaping. This allows for rapid accountability.

The next part of your plan should outline what people should do if they are separated from the rest during a disaster. What should they do? Where should they go? Who should they call? Planning this out beforehand will save a lot of aggravation and prevent stress later.
Other parts of the plan should include things like, who'll pick up the kids from school? If someone is at home, should they stay there?
If they leave home, what should they do first, if possible? Go through your risk analysis list and discuss all the "what-ifs" that you can think of.

After you've completed the communication and what-to-do planning, the next step is to gather your emergency supplies. What do you include in your supplies and gear? First, start with the basics:
water, shelter, fire, first-aid, and food. How much and what quality to buy depends on your budget. If you can afford it (and congratulations if you can), buy everything at once and of the best quality there is. Otherwise, think frugal. The water filter can be one that works well but isn't rated for long term use. The tent used for shelter can be a budget-buy on sale. And so forth.

After the basic home supplies are acquired, do the same for each vehicle. Keep in mind that the temperatures in a vehicle can be very hot or very cold, depending on the season, and buy your supplies accordingly. If your entire family spends most of it's time on the road, you might be better off to make up the vehicle kits first as these can also be used at home. Since only you know your situation, only you can decide the best course of action.

After the basic supplies and gear are acquired, start adding the extra stuff that will make surviving more comfortable. Things like flashlights, compasses, maps, tools, hygiene stuff, etc. Anything that will increase your comfort level will make surviving the disaster more bearable.

After your plans have been laid, conduct drills and practice sessions to make sure everyone knows what is expected of them and what they need to do. Once an emergency occurs, the way you were trained and how you practiced will be the way you and your family do it for real. Consider this when trying to decide whether or not to take a shortcut during a practice or training session.

There are many ways of going about your preparedness plans and actions. Don't forget to include things like getting insurance for your home and vehicles, and medical insurance for every family member.

When putting together your supplies, try to think of what you'll need to do in order to survive. Camping trips, drills, and practice sessions can help identify those items you might have forgotten but will need.


• Be aware by recognizing danger. Have communication such as a radio, CB, or scanner. Use your senses. Panic spreads fast so when you feel threatened like your hair standing on end and the adrenalin working. Take action. Fight down the panic and stay calm.
• Get away-stay out of harm's way. Avoid trouble areas and/or dangerous parts of cities. Move away from dangerous cities.
• Avoid confrontation and try go around potential problems. Have an escape route that you have selected ahead of time. Remember, "Those who live by the sword, die by the sword." You might end up the target of a person's built up anger even though you are not a part of the problem.
• Act like the natives. Try to blend in so you don't attract attention. Be careful of what you wear. Be aware of your surroundings.
• Hide equipment/supplies away from your home. Have a retreat or place where you can escape to as a safe haven. As governments get more totalitarian they make the citizens outlaws by banning things like gun or gold. Bury things or have them hidden away.
• Learn to defend yourself. Choose an art that is compatible to your beliefs such as karate, aikido, mace, pepper spray, or shooting. If you face trouble head on, you should resist with everything possible in a life or death situation.
• Don't get involved in mobs or mob behavior. They become mindless and objectivity is lost.
• Crushed in a crowd? Self preservation is the key. Try to ride it out like a bouy in the sea. If caught in a crowd surge, stay away from anything solid like a wall, barrier, or pillar. Keep hands out of pockets and loosen tie.

suurus on oluline


toidupood New Orleansis

Things to come.jpg

9. märts 2006


linnugripi tekitaja :D


Polly wants-.gif

You know you're prepping when...

cureventsi naljad :) link
kuidas ära tunda andunud varudesoetajat - mõned andekamad versioonid :D

ee .. jah, selleks et naerda kõht kõveras üle kontori nagu ma tegin,
peab olema toda cureventsit ilmselt mõned kuud lugenud muidugi :DDD

You know you're prepping when...

...you return from Target with 31 pounds of cat litter. And you don't own a cat...and you're wondering if that's enough...
..........you ask for a Wheat Grinder for your Birthday to grind the 600lbs of Wheat Berries you already bought. (which I did, and got)
..........your request for a 30th Wedding Anniversary gift is a more powerful Whole House Generator.
..........when your computer breaks down and the electronic guru asks what chip it has and you respond with "Pringles".
.............no one in the family remotely likes Spam or powdered milk but, you buy it anyway, just in case.
.......when you've already done your Christmas shopping for 2006 and 2007, wrapped the gifts, and buried them in the yard.
.........when you have taught your cats how to use the can opener by themselves.
..........when your on a first name basis with all the Fed Ex drivers in your area....
when you leave your Rolex on the coffee table, but hide a can of pork&beans under the bed..
You threaten the kids with grounding for a month if they throw an empty 2 liter in the recycling bin after its taken you years to get them to do it.
Your teenage kid asks for hand sanitizer to keep at school.
You've replaced pictures of you kids for last minute prep lists in your wallet.
You ask for cases of canned food for your birthday.
...you mention Tamiflu blankets to your spouse & they don't ask what colors they come in.
...clearing out old clothing doesn't make you smile because you can hit spring clothing sales but because you can now cram in another two 24 packs of toilet paper.
...you now don't mind if your cats are looking a bit plump. 16 pounds of moggy will feed you for a day more than a thirteen pounder.
...there's an intervention with a drug counseller about to happen at your place but your TEENS are setting it up for YOU - all that talk about Tamiflu, prednisolone, Sambucol & Reversatrol are making them nervous.
...instead of his & her bathrooms, your new 'move up' house & has his & her prep rooms.
......you can name every bean on the grocer shelves and know at least 6 recipes for each
........and all the neighbors are standing outside everyday taking bets on who is getting the delivery.....and you are getting so paranoid about them knowing that you put a lock on the prep room door.
*When you find yourself ecstatic because you have just ordered a new cookbook containing recipes using canned hams, canned salmon and tuna.
*You are terribly disappointed you didn't get a smoker for Valentines Day.
*Buying a smoker whether dh wants one or not.
*Wandering through a sporting goods store and thinking it wouldn't hurt to get two more boxes of shotgun shells.
*When you are debating with yourself if 12 feet of sausage casings is too small an amount.
*Standing in front of your preps and breathing a huge sigh of relief.

Top 10 signs you may be obsessing about Avian Flu.
10. You look for shopping carts with heavy duty shocks.
9. You keep singing "I'm a prepper. She's a prepper. He's a Prepper. They're a prepper. Wouldn't you like to be a prepper, too?"
8. You’ve tried repeatedly to warn Sylvester to stay away from Tweety-bird.
7. You’ve bough a windshield squeegee with a 10 foot handle
6. The stock boys at every supermarket in town know you by your first name, and run when they see you coming.
5. You’ve installed an in-line chlorinator for your lawn sprinkler system.
4. The CurEvents logo is burned into your monitor’s screen
3. If a pandemic doesn’t happen, your backup plan is to use your preps to open a pharmacy.
2. You’ve started telling your spouse that you’re surfing porn sites instead of admitting you’re back on the Flu Clinic again.
And the number one sign you may be obsessing about Avian Flu
1. You can use Orthomyxoviridae and hemagglutinin in the same sentence.

You know you are prepping when you sneak out of the house at 2 AM to empty your car of groceries.

You replace your curtain tie backs with color coordinated bungee cords - they'll come in handy when It's Time
You replace the canopy on your canopy bed with a very thick guage tarp - cuts the drafts & you can now shove more pallets of paper towel & TP on top of the canopy.
Forget furniture made of milk crates & 2x6s - amazing what you've learned to do with water barrels & fabric remnants.
You won't buy any electroncic appliance unless it also comes with a hand crank.
You've trained your Rottweiler to pull a wagon, sled, travois & in a pinch he'll carry your three year old on that long trek to your bug out place.
When buying a dog, your main criteria is how much it will have to eat.
Just In Time means how quickly you hope to learn about a pandemic strain.
You know 4 uses for every item on your multi-functional Leatherman tool. Your teen is smug because he knows at least 5 for each.
You know 7 troutes to your bugout location - including 4 that don't exist but look good on paper.

.......when the doctor calls you for medical advice...

When your dehydrator has permanantly replaced the toaster and coffee pot on the counter
When you know 3 different ways to cook rice and none involves a pot or bowl.
When you plan to spend a Saturday night pre-marking the toilet paper into 2 square sections to get a jump start on your "when we need to ration" list.

Worse than this is bringing home a van full of preps.......taking them into the house spread out over several days AND into the night. Putting them into smaller plastic bags so it doesn't look so much like you just brought home a sheet load of stuff.
........breaking down large boxes of stuff into smaller ones so you don't have to ask for help carrying a heavy weight up the apt. stairs.
........changing labels or removing them from cartons.
........having vendors wrap your order in plain brown paper for delivery by UPS so the snoopy people in the apt complex won't have a clue.

When you buy so much rice the check out lady ask you.How many kids did you adopted from china.

You actually KNOW how to make a medicinal elderberry tincture out of those berries growing in your yard.
You know what Sambucus nigra is.
You debate long and hard a $2000 repair of your dying transmission versus how much more preps $2000 would buy.
You have the plans and knowledge for how to build an outhouse in your backyard.
You've seen Frugal's videos for how to quickly and quietly kill a rabbit with your hands.
You've become a master at using the Babelfish language-translation website for translating foreign news stories the MSM isn't reporting.
You particiapte in lengthy online debates about TEOTWAWKI versus TSHTF

.....when you know your weight in fish pounds in order to take the right number of antibiotics.

When wal mart gives you plaque for employe of the month, and you don't ever work there.

When your son asks, "Hey, Mom, what's all this pasta doing in my dresser drawer?"

....when you buy and eat things you dont really like just for the empty glass jar.

.......When you spend $4300 on LASIK after wearing glasses for 28 years becuase you have a feeling it might be tough to find a decent optometrist before too long.
And you might be a prepper if you have already figured which pet you are going to eat first if you get hungry (Sorry Peanut!) and have actually discussed it with your spouse...

When you hide food plants like lettuce and chard among the ornamental flowers so that roving bands of TEOTWAWKI zombies might not find your veggie garden.

When you grow turnips even though you don't like them to convince other people you don't have any food worth taking.

When you open "any and every" cupboard in your house and cans fall out.

You stop letting the kidlets have friends in... "for fear they will spot your preps"...and tell their parents.

You have 50 cans of Spam and you have never even opened a can of it before.Is it corned beef ???

You have a list on "Word" of last minute preps to be bought WTSHTF.Just print and run.

Your beer fridge is loaded with bottles of Elderberry Vodka.

if you've dumped 15 rubbermaid tubs filled with kids toys, replaced 3/4 of the contents with food preps, threw toys on top of the food and kept them marked as 'toys' to hopefully fool the maruders.

Also, when you buy 12 cans of Vienna sausage when you have no earthly idea what Vienna sasuage is or tastes like.

Your GPS has waypoints programmed in for previously placed caches of "stuff" you may need to pickup if you have to bug-out without your gear.

Your laptop bag carried to work everyday doubles as a Bug-Out-Bag, complete with Poncho/shelter, Leatherman, flashlight, firestarter, Mountain House freeze-dried meals and Gatorade packets.

Your cubicle walls have color-coded maps showing more current spread of Avian Influenza than even the WHO has access to.

You groan when gas goes up ten cents a gallon, but think nothing of dropping $250 for a water filtration system.

You know how many gallons of water you'll get from a half-inch of rain based on the square footage of tarps covering your roof, and you've already rigged the downspout for diversion into 55 gallon barrels.

You know how much unscented liquid bleach a 55 gallon barrel of water requires to render it safe.

. . . .you have more bottled water in your basement than most people have in their backyard pool.
....when you find your self making heavy eye contact with the guy at Costco because he has a cart full of only bottled water and toilet paper. You both look away quickly.....

...you have enough toilet paper stored to insulate a small room

...you no longer procrastanate that hair cut, dental cleaning, or eye exam; thinking that this might be the last time you have the chance

...you get misty eyed when you see the stocked shelves at Costco

You have sat in Grocery Outlet's parking lot with a can opener and a fork checking to see if something's worth going back in for a case...or 2...or 3.....

You know your car's GVW, and what bridge you'd better not go over on your way -back- from Cash & Carry....

...when you have two shotguns, one 38 revolver, one 40cal. automatic, a 22 long-rifle automatic with a ten-shot magazine, and roughly 10,000 rounds of ammunition.
And you wonder whether or not you ought to think about buying a weapon.

When shopping you look at expiration dates before the price.

....when you're thrilled that the family doctor doens't laugh you out of the room when you discuss the potential side effects of turmeric and garlic

...when your son asks for the U.S. Army Survival Manual Fm 21-76 for his birthday and you order two copies, one for the both of you

...when same son asks for a Benchmade knife and you not only know exactly which one he's talking about but also ask him if he wants the plain or serrated blade

When you need to check JUST ONE MORE LIST to make sure you haven't forgotten anything.

When you check FC before you do to bed, whenever you wake up in the middle of the night, and first thing when you get up in the morning.

When you already know who Gerberding, Nabarro, Chen, Webster, Osterholm, and Niman are; you don't need first names.

When you buy so much basmati rice at the local Pakistani store that the owner asks if someone is getting married....

when you mention to your husband a few weeks before your birthday that the present you want the most is solar panels....

you know how many dried eggs fit in a number 10 can.

you buy vodka and dont drink it.

when you agree to spend the money on a backyard pool-but only because youre thinking it solves the pesky water storage problem.

when you have a dogeared copy the Encyclopedia of Country Living on the shelf with your cookbooks.

you've actually eaten wheat berries. more than once.

the food bank has you on speed dial.

~when you go to the thrift store and buy every word fill in book they have for .25 cents each because you will need something to do if the power goes out to keep your mind sharp!
~when you happen upon the Friday sale at Amazon.com for TP and order 2 cases then celebrate like it's your birthday when it comes in at the post office and they comment on the large number of packages you have been getting lately!
~you urge you husband to get more ammo for his gun even though you abhor guns and are very uncomfortable even having them around.
~when most of you ILL books from the library are "survival" oriented.
~you freak out when you hubby opens a can of SPAM to eat now...those are your preps for goodness sakes!!!!:yikes:
~you refill your perscriptions early that you have multiple refills on even if you don't need them right now "just in case"
~in the middle of a power outage you carefully watch the candles and measure how much they each burned down within a certain time period so you can calculate how many you are going to need for a 6 month period if necessary! You and your hubby also look at each other and thank God that you did not get rid of all you candles from your wedding ...even though you have been married for 21 years now!!! (yep, just what we were thinking about last night!)
~all your kids have cell phones and know that if mom calls and says
"book it home now! " it means that we are going into quarentine
~you are afraid the neighbors are going to come sneaking around to see exactly what it is you have been stuffing your storage shed with so you make a note to make curtains for the windows even though the preps are all covered.
~you buy a huge bottle of cheap wine and you don't drink!!!!

You're attending your grandchild's Sunday School presentation & you could SWEAR that the little 6 year old girl opening the presentation said: In the beginning, there was the bird..."

. . when you wonder if it's better to cut up the old newspapers into tp sized sheets now or wait until TSHTF.

When you ask your husband for a huge roll of barbed wire to help protect the house for Valentine's Day. When you get this you are happy! And then your birthday present request is for either a milk goat or a security gate at the end of the driveway.

whilst you're looking out the window a bird craps on the glass...
You jump back, then quickly close the window.
Then debate 'clean it off' versus letting the rain wash it off... but worry about small particles that would leave on the window sill.
So you tape up the window.....
...and realize you forgot to add tape to your 'next stock-up trip to the shops' list.

1918: loomad ja õppetunnid

pikk jutt, aga asjalik ja ülevaatlik ning mõne mõistliku järeldusega :)

1918: Pete Hesser's Children, la Gourme, and New Information on the Flu Pandemic
By John M. Saul
February 1, 2006

How much do we really know about the origin and spread of the 1918 flu pandemic? Comparisons with other pandemics reveal patterns and lingering mysteries.
Watching the Animals "The horses growing better, a cough and sore throat seized mankind." This was the news from Dublin toward the end of 1727, reported in Charles Creighton's monumental History of Epidemics in Britain -- Volume II -- From the Extinction of the Plague to the Present Time, Creighton's "present time" being 1894.

Matters had been much the same in 1688 as in 1727. A "short time before the general fever, a slight disease, but very universal, seized the horses too: in them it showed itself by a great defluxion of rheum from their noses." Creighton's source "was assured by a judicious man, an officer in the army of Ireland…there were not ten horses in the regiment that had not the disease." In Dublin "not one [man] in fifteen escaped."

Then in Huxham in 1732, some months prior to an influenza outbreak, the horses were affected by "the strangles." This seriously unpleasant term seems to be the most common synonym for horse flu, though in World War I, la gourme, a term used by the French military's veterinarian staff also crept into English. (You can look it up, though Google will first ask if you didn't mean "la gourmet.") Whether called gourme, horse flu, or the strangles, this was a nasty disease. By April 1918, civilian horses in France had also been affected. The April timing is intriguing because the first reported cases of the disastrous "Spanish Flu" among humans had been in March. But that had been among soldiers at a cavalry training site in Kansas.

At a professional meeting in 1924, a Dr. Reece, about whom I know nothing more, spoke of the "remarkably large number of observations" of coincidences between influenza epidemics and "epizootics of the same character," starting in horses, then "dogs, cats, and the like." It seemed that aside from the disease itself and coincidences in timing, however, the only common element among dogs, horses, and humans was crowding. Sir William Hammer added that "epizootics may precede or follow epidemics," and they may accompany epidemics, too. Horse flu and human flu had both been troublesome in 1657-1659, 1727, 1737, 1743, 1760-1762, 1775, 1788, and 1889-1890, but a recurring question for modern epidemiologists is whether the diseases, equine or human, had been correctly identified. Creighton, a century ago, was cautious about making such judgments, as when he noted that "if Whitmore has made no mistake in his dates," the spring of 1658 and possibly the following year saw:

universal coughs and catarrhs,

as if a blast from the stars

Although the sequence of events in not entirely clear, this explosion of an influenza-like illness was apparently followed by "a great death of coach-horses almost in every place...and it has [now] come into our fields."

From daily experience, Creighton and all his sources had been familiar with cities in which large numbers of horses had been kept. In times past, people would have had detailed knowledge about horses in cities, knowledge that has been universally forgotten in the generations brought up in the age of the automobile. But as recently as the 1920s, annual statistics for horses were cited for places such as Omaha, Nashville, Atlanta, and Chicago, in some instances tabulated along with cause of death, somewhat as they are for humans. The problems of horses in cities had even given rise to a tongue-in-cheek warning that by such and such future date, the streets of London would be filled to the second story with horse manure.

Horses and mules -- which are less susceptible to equine flu -- had also been ubiquitous in all the world's armies. Pigeons too had been a common accompaniment of the military in World War I. (In the Paris Flea Market in the 1980s, I stopped at a stall with a stock of World War I pigeon-carriers. Pointing out details of their design and construction, the dealer assured me they were from the American army, not French, "the perfect thing for an American in Paris.")

There were also historic flu epidemics that were not associated with reports of a corresponding disease in horses or mules and episodes of equine flu with no flu-like illnesses among humans. But the association of the two appears to have been well known. Yet while insisting on this matter, I have avoided mentioning a key observation: people do not catch the flu from horses. Creighton's compilation of 1894 seems to contain nothing to indicate the contrary nor, really, does A.J. Williams' "Analogies between Influenza of Horses and Influenza of Man" in the Proceedings of the Royal Society of Medicine for February 24, 1924. Williams had perhaps been too ambiguous in his original oral presentation, however, so a Professor Hobday rose to insist that there were no reports of transmission from horses to men or vice versa. This is how things then stood and pretty much as they now stand. About the best we can do is quote a statement made in 1919 by George A. Soper, a major in the United States Sanitary Corps whose conclusions were cited and emphasized by Alfred Crosby in his America's Forgotten Pandemic (first published in 1976 under the title Epidemic and Peace: 1918). In a contribution to The New York Medical Journal, Major Soper noted that despite many epidemiological and clinical similarities, horse flu and human flu were not identical, nor were they transmissible from the one species to the other, but "it would seem probable that a more thorough knowledge of the disease in horses would yield facts of great value." As concerned horses, Soper mentioned transmission via the respiratory tract, sudden onset, fever, cough, indications of muscle and joint pain, and explosive spread over whole continents on occasion, features that characterize human influenza as well. Soper also included an element I have not seen elsewhere, that horse flu was thought to be transmissible via feces and stable dust.

Dogs can catch influenza directly from horses, and humans can get it directly from pigs and vice versa. Humans can also get the flu from diverse avian species. Direct species-to-species transmission is relatively rare, however. Usually a mixing-bowl species or individual is needed, with a reassortment of viral genes taking place in a creature -- human or not -- that has become co-host for viruses originating in different species.

The Nightmare of 1918

The "Spanish Flu" wasn't Spanish at all. But at the time the flu raged through Europe, many countries were at war. Spain was neutral and did not impose press censorship, so journalists there could print the demoralizing truth, namely, that the country was going through a horrific epidemic. Elsewhere people whispered, muttered, or screamed that it was an Allied plot or that the Hun had once again let loose a poisonous gas. And what censor would pass an article saying that the enemy had been so terribly successful? In truth, the whisperings, mutterings, and screams, whether from the Allies or the Axis, seemed to have had some logic to them, for those most targeted by the 1918 flu were in the prime of their lives, military age, essentially those between the ages of twenty and forty.

Influenza is also an endemic seasonal disease that is always with us. In the U.S., some 35,000 flu deaths occur in non-epidemic years, primarily among children, older people, and others who lack fully-functioning immune systems. In 1918, by contrast, those in the fifteen to thirty-four age bracket who came down with influenza or pneumonia (the most common and deadly complication of the flu) were about twenty times more likely to die than had been the case in 1917, a non-epidemic year. And, of course, many, many more were catching the flu in 1918. Estimates vary. Twenty million died worldwide. Or perhaps fifty million. Or 100 million. Or some other large figure. In India, with its youthful population, mortality reached an estimated fifty per thousand. As in the U.S., the disease in India followed the railroads, and when military horses shipped from Australia to Calcutta arrived with a nasty strain of equine flu, it spread across India with the rail transport of cavalry.

The flu of 1918 was exceedingly contagious and is estimated to have affected over one fourth of the U.S. population and one fifth of the population worldwide. These estimates are not necessarily at all accurate. It is true that doctors everywhere were badly overworked and that quite a few medical personnel were dead before they could fill out and sign death certificates or other forms. But the real problem in trying to make estimates is simply that influenza was not a universally reportable disease in those days. Until 1918, it had not been considered sufficiently serious. But in 1918, the flu virus became "unlike any strain ever seen."

It was not just deadly. It was quick. According to a young woman working at the military laundry at Camp Funston, Kansas: "We'd be working with someone one day, and they'd go home because they didn't feel good, and by the next day they were gone" (Barry, 2004). Within months of the start of the epidemic, gauze face masks were being widely used and vaccines and various treatments were available. None of them actually worked, but they did much to calm nerves. Many people eventually came to terms with the fact that doctors could not do much. What was really needed was nursing care, and calls went out to anyone with the least bit of training in nursing. Many of the best were overseas with the troops, but older women and student nurses came forth. Young and old, many of these courageous volunteers caught the flu and died themselves, with mortality among the younger women commonly running exceedingly high. Another group particularly susceptible to the 1918 flu were pregnant women; one study showed an incredible 71% death rate among pregnant women who had been hospitalized with the flu.

It was an awful disease, which, due to the war and the accompanying censorship and the jolly peace that followed, was half forgotten until Crosby's book in 1976. It was also a peculiar disease. Although it eventually struck a broad portion of the population, it had seemingly started among the young and most fit, and from beginning to end it would be most efficient at killing individuals whose immune systems were the best H. sapiens can produce. There are no usable statistical measures, but here and there doctors in hospitals, nurses in wards, sailors on ships, and soldiers in barracks reported that it was the most robust, strongest, most fit, disease-free athletic sorts who suffered the worst. Post mortem studies on such victims of the 1918 epidemic often showed enormous damage to the lungs, which could not at that time be explained. Years later, it was realized that such victims had literally drowned in the waste products of their own powerful immune reactions to the virus. As Crosby put it, "a springtide of fluids overwhelms the lungs." Thus in 1918, in contrast to other flu epidemics, many robust young people died of the influenza itself -- rather than from secondary infections of pneumonia-causing bacteria, the standard cause of death among those with weaker immune systems. They died so rapidly that pneumonia-causing bacteria had had no time to establish secondary infections.

Darkness in Kansas

Despite the name "Spanish Flu" and the endless accusations aimed at the Hun and speculations that the epidemic had started in China, the first clinically demonstrated cases were at Camp Funston, Kansas, a site established to train troops in World War I. (Funston still exists, incorporated into Fort Riley.)

A recurrent complaint at Funston in those days arose from a twofold unpleasantness. First, in common with much of the American Midwest, the camp was subject to severe dust storms. The experience at Funston was doubly unpleasant, however, due to the great concentration of horses and mules on the base and the manure they produced. I have not seen any figures for the actual number of animals, but they were sufficiently numerous to produce nine tons of manure a week.

On March 9, 1918, despite an impending dust storm, standard practice at Camp Funston was followed and the manure was burnt. The result was a stinging yellow haze with the sun going "dead black." Or so it is said. There had been similar days at Funston in the past and presumably elsewhere, but this event (if it actually occurred as related) was remembered as particularly severe, and the clean-up that night supposedly involved a hundred men and many hours of raking and sweeping.

According to some websites, it was two days later, "shortly before breakfast March 11th," that Company cook Albert Gitchell reported to the infirmary with a "bad cold." The March 11th date is most probably incorrect, however, and is perhaps a storyteller's concoction intended to tie in with the account of the manure-burning. Better sources give March 4th as the date of Gitchell's illness. In any case, Corporal Lee W. Drake was right behind Gitchell with similar symptoms, and by noon the Camp Surgeon had a 107 flu patients on his hands. Within three weeks, the number of sick and dead at Funston was above a thousand. In the next two months, over 500 prisoners at San Quentin penitentiary also came down with the illness, followed by comparable outbreaks at Camps Hancock, Lewis, Sherman, and Fremont. It is said that there were few incidences of the flu within the general population during these months, and although self-censorship at the newspapers has to be taken into account, later investigators have concluded that there had been nothing special to report. Civilians had remained healthy that summer.

In September the disease reached Boston, first affecting sailors and shipyard workers, then soldiers, and then moving into the general population and overseas. Some of the most awful-sounding accounts are those of outbreaks on the badly overcrowded troop transports on their way across the Atlantic. An often-cited sailor's diary reads, "October 5 -- fifteen more bodies have just been buried from the President Grant." During the last two months of the war, over 4,000 American servicemen died at sea or after being put ashore for hospitalization at Halifax. There were also those who died the first few days after arriving in Europe. Troopships disembarking large numbers of sick and dying men in French ports hindered the Allied effort, but such things were only written about after the war.

Some people have associated the flu outbreak at Camp Funston with episodes of manure burning, whatever the exact dates. But in his The Great Influenza: The Epic Story of the Deadliest Plague in History (2004), John M. Barry suggests that the ultimate origin of the 1918 pandemic is to be found elsewhere. Barry went back to original sources, always the best procedure if time is available, and in doing so, he identified a Dr. Loring Miner who in 1918 had had a decades-old medical practice in sparsely-populated Haskell County, Kansas, some 300 miles west of Camp Funston. Doing his rounds from town to town in "late January and early February 1918," Miner encountered a new ailment that he diagnosed as influenza, signaling the U.S. Public Health Service to warn of "influenza of severe type."

Newspapers across the U.S. in 1918, whether large or small, had been reluctant to publish items that might hurt morale. Nevertheless, on February 14, 1918, the Santa Fe Monitor in Haskell County (as cited by Barry in 2004), reported: "Mrs. Eva Van Alstine is sick with pneumonia. Her little son Roy is now able to get up...Ralph Lindeman is still quite sick...Goldie Wolgehagen is working at the Beeman store during her sister Eva's sickness...Homer Moody has been reported quite sick...Mertin, the young son of Ernest Elliot, is sick with pneumonia...Pete Hesser's children are recovering nicely...Ralph McConnell has been quite sick this week." A week later, the same paper reported, "Most everybody over the country is having lagrippe or pneumonia."

In 1918 the population of Haskell County was 1,720, including many fit military-age men, all of whom trained at Camp Funston along with some 50,000 others before being shipped overseas or being buried as flu victims. The issue of the Santa Fe Monitor with the news that "most everybody over the country is having lagrippe or pneumonia" also reported that "Dean Nilson surprised his friends by arriving at home from Camp Funston on a five days furlough" and that Ernest Elliot left "to visit his brother at Funston just as his child fell ill" (Barry, 2004). The February 28th issue recorded the departure of John Bottom for Funston, and it is clear that there must have been very many other comings and goings between the camp and parts of rural Kansas, of suppliers of fodder, for example. It is also clear that there must have been comings and goings of horses.

Tracing the Spread

The incubation period for influenza is very rapid, just one to three days, which partially explains how and why the flu is able to spread so rapidly. Another reason is that individuals about to come down with the flu may spread the virus before they develop symptoms. (These same properties characterize most epidemic diseases.) Influenza subsides once it runs out of susceptible people to infect, but after an estimated ten to thirty passages through humans, the virus may change and adapt to a different sub-population.

The flu virus in the fall of 1918 was not identical to that of the spring disease, and toward the very end of 1918 additional mutations gave rise to a third wave. This was less deadly than the second but still a truly terrible disease to which individuals who had survived infection during one of the earlier waves had only partial immunity. The flu was still present through 1919, and in 1920 the reported death rate by influenza among young adults was still well above normal. "Just-married" couples were mourned throughout the epidemic, and the parents of young children sometimes died within days of each other. During the second wave, feverish, newly-orphaned children were found dazedly wandering city streets.

Differing by a week with the sources mentioned above, Crosby and Barry give March 4th as the day the first soldier at Camp Funston reported ill with symptoms of influenza. This fits Barry's claim that the epidemic may have originated in Haskell County in January or early February 1918. If so, as Barry writes, it might readily have died out for lack of susceptible human hosts in sparsely-populated Haskell, where the epidemic was so short-lived that school had reopened with healthy children by mid-March. But, Barry writes, the war then brought the flu to Funston.

There is nothing obviously wrong with Barry's belief that the epidemic started in Haskell County, but it is of limited value because it leaves so many important questions unanswered. Why Haskell County? Why Funston? Why the virulence of the disease? Why was it especially severe among individuals who were fit? Was the disposal of horse manure crucial? Valid answers would also have to be consistent with the very recent claim that the human virus of 1918 had an avian source.

The Santa Fe Monitor mentioned two-way traffic between Haskell County and Camp Funston, but there seems to be nothing special about Haskell County aside from the presence of the flu-like disease somewhat before March 1918. Camp Funston, on the other hand, was special. First of all, there was the crowding. Then there were the horses and mules and their weekly output of nine tons of manure. And then there was the select presence of fit young men and women to the near exclusion of anyone else. (There were enough young women at Funston for weekend dances but, I would guess, few babies, children, or older people other than some senior officers and their wives.) So if a weak or "standard strength" flu virus had been brought to Funston, perhaps by birds feeding on undigested seeds in the manure, it would have found itself in proximity to an unreceptive human population whose members all possessed well-functioning immune systems. A soldier who caught this flu prior to March 1918 would have presumably been subject to a few coughs and perhaps some aches in his joints. He might well have avoided a visit to the camp hospital, since in the wartime society of the U.S. during this period, the very worst thing to be was a "slacker." (Following a disappointment in love, my grandfather's brother Jake left home as a very young man and joined the U.S. Customs Service in the Philippines. There, around the turn of the century, he caught a tropical disease and had to be repatriated. He was later exempted from military duty. When the draft was again activated in the 1940s, Uncle Jake was at pains to explain to anyone who would listen that he had not been "a slacker" during The Great War.)

Weak or standard-strength versions of avian or avian-equine or equine-avian influenza may have passed from soldier to soldier at Funston without necessarily exhibiting consequences severe enough to be preserved in military records or memories. And those who carried the virus might have included men belonging to the prime-of-life cohort, such as Dean Nilson, who had made a round trip between Funston and Haskell County while on furlough. In Haskell they would have encountered people whose immune systems were far weaker, some whose identities are known to us: "Pete Hesser's children," "Mrs. Eva Van Alstine's little son Roy," and "Mertin, the young son of Ernest Elliot," who had been "sick with pneumonia."

In these children and anyone who may have picked up the virus from them, the particular viral strain would have undergone changes that could then have been brought back to Camp Funston. While this is hypothetical and will perhaps forever remain so, we know that while the children of Haskell County were recovering and heading back to school, a highly contagious version of the flu began to run its course through the soldiers in training at Camp Funston. At this stage, the illness gave few signs of becoming the horrific thing Barry calls "the deadliest plague in history." According to Crosby, the flu at this stage usually meant "two or three days of misery" and in any case the epidemic at Funston waned rapidly, "bobbing up only now and then as new lots of draftees arrived." It was much the same story throughout March and April 1918 as the disease spread through Camps Oglethorpe, Gordon, Grant, Lewis, Sherman, Doniphan, Fremont, Hancock, Kearney, Logan, McClellan, Sevier, and Shelby, an unpleasant countrywide epidemic in the military that at this stage had still not spread into the civilian population. Some unfortunate soldiers at Funston and other camps had indeed died, but the cause of their deaths generally appears to have been pneumonia and other secondary complications. For although it was highly contagious, the Funston-style version of the 1918 flu -- "the first wave" -- was not itself a great killer. The second wave, which was the dreadful pandemic itself, would not come until the autumn when it would break out from the military camps on the East Coast.

The sequence of events described above depends on mutations of the 1918 flu virus. These produced a sequence of events that could not and cannot be predicted in advance. Simultaneously, a different sort of disease pattern was being traced out within particular populations, military camps, towns, and cities (and perhaps ships). This pattern depended on the number of local person-to-person passages of the virus, and the pattern produced by the sequential passages was always the same: those struck in the first ten days were far more likely to become severely ill than those affected after the virus had undergone a number of person-to-person passages. By October 1918, mutational changes to the virus had rendered it especially deadly. It then weakened everywhere with passages from person to person, and by late November conditions were briefly very much better. But additional mutations then set off a third wave in December. In common with the second, it was worldwide. Crosby, who touched on such matters at many points in his study, concluded that a patient's outcome depended primarily on the virus rather than the care he received.

It looks as though the human version of the "1918" epidemic had started at Camp Funston at the end of 1917 or toward the beginning of 1918 with birds, horses, manure, and the burning of manure all perhaps implicated. It was not then able to cause human illness sufficiently severe to be recorded or remembered. Yet it had enormous potential for harm because it was by then already adapted to people with first-class immune systems, passing among them and perhaps producing the occasional cough or touch of fever, if that. Its ecological niche was strictly among the healthy. It knew no other type of host environment. In February and perhaps January 1918, carriers of this flu variant had mixed with the general population in Haskell County where, as is typical, the virus passed from person to person, undergoing unknown changes. When it returned to Funston in late February or very early March, it spread, causing considerable short-term miseries, but not as an especially deadly disease. The virus at this stage was active, contagious, and disease-causing but it was confined to an inhabitual ecological niche characterized by host-individuals with strong immune systems: army nurses, men in military training camps, troops moving about on trains, dockers, miners, and men in prisons. And as luck and the Kaiser would have it, these individuals were frequently forced into crowded circumstances, tightly packed among others with similar immune profiles and then shipped from one camp to another and then overseas.

As a consequence of its passage through the general population in Haskell County, some of the early strains of the 1918 influenza virus were capable of surviving and multiplying outside their preferred niche and eventually more or less thriving in other environments. Still, it would always remain a disease of the robust, one Swiss doctor recording that he had never seen a severe case in anyone over fifty.

The virus might be compared to a Wall Street employee who could readily thrive if transferred to a high-stress environment in Washington or London but might or might not be able to adapt to a low-stress job as a pool cleaner. In general, it is only the individual creature itself -- human, animal, or microbial -- who determines whether a new environment is a good one. That's why zookeepers have so much trouble keeping certain animals. It is much the same with medical researchers, who can do little better than trial and error in selecting a suitable medium on which to try to culture unfamiliar bacteria.

Lessons from 1918

Some potentially useful lessons emerged while researching this material.

One involved the immense danger of crowding and insufficient ventilation. Men in wind-blown trenches had far less flu -- or perhaps it was less flu with pneumonia -- than those living in crowded barracks behind the lines. The risk of the flu was far higher in the spic-and-span military camps on the East Coast of North America than in Europe's muddy trenches, and this was not something it took a statistician to detect. French soldiers who left the crowded barracks for the front reduced their chances of getting the flu by a factor as much as twelve (Crosby, 2003, p. 153). The dangers of crowding were apparently double, a greatly increased risk of catching the flu -- and, it seems, a similarly greatly increased risk of dying from it. Sailors on ships came down with the flu just as frequently as the tightly-packed troops they were transporting. But their onboard living conditions and daily routines -- which presumably excluded playing cards for long hours below decks -- provided them with a systematically lower mortality rate, lower by a factor of three to five.

Another potentially useful lesson relates to what have (inexactly) been called "relapses." Deaths among recovered patients were not necessarily caused by the flu itself, nor its secondary complications. The risk for newly recovered patients was that their immune systems were so exhausted that exposure to most any infectious agent at all in the four to six weeks following recovery from the flu could be fatal. The cause of death could be a tertiary factor, such as the sniffles.

There are other lessons, too, though they do not always apply to today's world. It is clear, for example, that the flu could be avoided by total isolation. Eskimos were so severely affected by the epidemic that there had been talk of the possible disappearance of the entire people, but at least one Eskimo family who were living by themselves with no contact with others had had no incidences of disease.

One symptom of the pandemic of 1918-1920 may not have been given sufficient attention. In diverse countries around the world, flu patients complained of diarrhea (see Crosby, 2003, Ch. 9). Diarrhea is not "supposed" to accompany human flu -- yet when stool tests for the usual bacterial culprits and for amoebas were carried out on U.S. military personnel, the results were systematically negative. Whether or not there is a useful lesson here, this anomaly should not be ignored, and it should be noted that in birds the flu virus normally infects the intestinal tract.

Another highly troubling issue was the impaired judgement and mental stability of many after recovering from severe cases of influenza -- a matter which may not be specifically limited to the flu of 1918-1920. "Toxic involvement of the nervous system" was one term and " slowed cerebration" was another. Individuals who were touched appear have included Woodrow Wilson who, according to one aide, had "manifested peculiarities" after coming down with typical symptoms of influenza plus severe diarrhea in early April 1919.

The good news is that the conditions in 1918 were a product of the times and are unlikely ever to be repeated. Although Creighton's survey of historic epidemics shows that the flu can be very unpleasant indeed, a strain of influenza will probably never again be offered such a highly specific and frightfully dangerous niche within the human population. Barring bad luck, the 1918 epidemic will permanently retain its title as "The Deadliest Plague in History."

8. märts 2006

kolm peamist pandeemia-fakti linna/valla jaoks

suurepärane jutt Reverelt
Three points about bird flu to tell others

Today a colleague called to say she was asked by her local Board of Health (of which she is member) to educate them on bird flu. In five minutes.

She is a scientist and knows a lot of the technical basis for influenza and the town is a well-to-do bedroom suburb with many professionals. But that just made it more difficult to boil down the message to five minutes. So she asked me for help. Here's what I told her.

I suggested a message of three major points.

* We don't know what the biology of this virus has in store for us. But if it has the makings of a pandemic agent, nothing we will do between now and then will be able to stop it. Thinking that we have the ability to stop a pandemic is a waste of time and a dangerous distraction.

* This means the major task of her community is managing the consequences of a possible pandemic. It will have to cope on its own, because all the communities surrounding it and the ones surrounding those will be facing the same problem. There is no "outside" from which to get help in a pandemic. The federal government has already said it can't help.

* The major consequences are not the "obvious" ones of vaccine distribution or even ones that are primarily medical or public health. They are the effects on essential functions of prolonged and widespread absenteeism. Many of these are things they probably never thought of. She should give an example. If hourly employees have to have their time sheets totalled and submitted (a "turnaround"), what happens if the person responsible for tunrarounds is out sick for weeks or worse? The town can anticipate this and show others how to do that function or arrange to have those employees converted to salaried employees for the duration. I suggested this only as an example of a "non-medical" prep that can be planned for in advance. There are many more.

Three points are plenty, especially if you want to get some action. But there are other things she could suggest later as a member of the Board of Health. A few select town officials and citizens (say the health director, the veterinarian or animal contol officer, a member of the Chamber of Commerce) could meet every couple of weeks for an hour to go over recent developments and try to anticipate what they might mean for their town. If they were to do that today they might discuss the discovery of H5N1 infected cats. What if people started letting their pets loose out of fear, or started vigilante round-ups of loose or feral cats and dogs? What policy should the town have in such a circumstance, even in the absence of human cases? This situation is already a reality in Europe. It isn't a stretch to imagine it here.

These easily visualizable circumstances are the foot in the door for talking about everything else. Once a mind set is established, people become self-motivated and they begin to involve others.

Finally, I told her it would be good to remind everyone that the cities and towns that coped best in 1918 were the ones whose citizens were prepared by credible sources of information. In those towns neighbors helped neighbors and they got through it with the least pain. San Francisco is John Barry's example. Most other places, where the news media and public officials lied and kept the very existence of the epidemic from their readers, neighbors fled neighbors and the pain was terrible.
A lesson about civic life from 1918.

6. märts 2006

veel linnugripinalju

maitsetu aga fun mäng kanade tapmisest :D - link

multikas: Burt Flu, the bird with bird flu teaches kids how to never get infected

perearsti tegevusjuhis gripipandeemia ajal

Perearsti tegevusjuhis gripipandeemia ajal.
Koostanud Madis Tiik ja Ruth Kalda, aluseks on võetud Tervisekaiste inspektsiooni ja infektsionistide juhised

Gripipandeemia definitsioon Pandeemiaks nimetatakse erakordselt suurt gripi epideemiat, mis levib ulatuslikult üle riigipiiride, haarates paljusid riike ja kontinente ning millega kaasneb inimeste kõrge haigestumine ja suremus. Kaasaja teadmiste tasemel ei ole võimalik gripi pandeemia teket ette määrata ja kujunemist vältida.

Gripipandeemia oht tekib juhul, kui
• Ringlusse ilmub uus, populatsioonis varem mitte esinenud gripiviirus ja
• Leiab kinnitust uue viiruse aktiivne levimine inimeselt-inimesele ja
• Uus viirus on kõrge inimpatogeensusega

Antud tegevusjuhis rakendub olukorras, kus Eesti Vabariigis on välja kuulutatud gripipandeemia

Olukorra kirjeldus:
- gripipandeemia ajal võib haigestunute arv tõusta 15-20 võrra päevas ühe perearsti kohta, samuti suureneb vajadus koduvisiitide järgi
- osa perearstidest ja abipersonalist langeb välja haigestumise tõttu
on häiritud abiteenistuste töö, häiritud võib olla ühiskondlik transport (suureneb veelgi koduviisitide vajadus)

Gripi definitsioon
Gripi definitsioon – Palavik ja äge köha (või köha ägenemine kroonilise kopsuhaigusega isikul) keskkonnas tsirkuleeriva gripiviiruse tingimustes.

Järgnev kirjeldus baseerub peamiselt pandeemiatevahelise, tüsistumata gripi kirjeldusele. Erinevad viiruse alatüübid varieeruvad haiguse raskuse ja iseloomu osas. Uue, pandeemilise gripiviirusega seotud kliiniline pilt ei ole ette prognoositav ning võib seetõttu erineda hooajalisest, pandeemiatevahelisest gripist.

Gripi inkubatsiooniaeg on 2-4 päeva (1-7 päeva). Täiskasvanutel algab haigus reeglina ägedalt palavikuga ja alljärgnevate sümptomitega:
köha ca 85%
halb enesetunne 80%
külmavärinad 70%
peavalu 65%

isutus 60%
nohu 60%
müalgia 53%
kurguvalu 50%

Palavik on tavaliselt 38-40 kraadi vahel (kuni 41), ilmub 24 tunni vältel haiguse algusest ja püsib kuni 3 päeva (1-5). Köha on tavaliselt kuiv (kuni 40%-l produktiivne). Müalgia tavaliselt selja-ja jäsemete lihastes. Gastrointestinaalsed sümptomid (oksendamine ja kõhulahtisus) on täiskasvanutel haruldased (<10%).
Haiguse algul toksilised nähud – niiske ja kuum nahk, punetav nägu, injitseeritud konjunktiivid ja hüpereemia nina ümbruses ja neelus. Kaela lümfadenopaatia ca 10%-l ja hingeldus ning räginad kopsudes sagedamini kroonilise kopsuhaigusega patsientidel (10%).
Haiguse kestus tavaliselt 7 päeva, kuigi köha, halb enesetunne ja roidumus võivad kesta nädalaid.

• Inimeselt-inimesele otsese kontakti kaudu (kuni 1 m kaugusele!) või ka infitseeritud käte ja pindade kaudu
• Võimalik on ka õhu kaudu kanduv piisknakkus, kuid see on vähem olulisem

Laboratoorse diagnoosi kinnituse kriteeriumid.
Tõenäoline diagnoos.
• A- või B-gripiviiruse antikehade kõrge tiiter ühes vereseerumi proovis
Kinnitatud diagnoos
• Gripiviiruse antigeeni avastamine või viirusspetsiifilise RNA tuvastamine või
• Gripiviiruse isoleerimine kliinilisest uurimismaterjalist või
• Vähemalt 4-kordne A- või B-gripiviiruse antikehade tiitri tõus paarisseerumides
Haigusjuhu klassifikatsioon
Võimalik diagnoos
• Gripi haiguspildiga juht, mis on epidemioloogiliselt seotud kinnitatud diagnoosiga haigusjuhuga (koodid juurde!)
Kinnitatud diagnoos
• Gripi haiguspildiga laboratoorselt kinnitatud haigusjuht

1. Eelnevad
- vaktsineerida personal gripi vastu (psühholoogiline +bioloogiline kaitse)
- koostada/üle vaadata täpsed tegevusjuhised sanitaarhügieeni kohta (kaitsevahendite kasutamine, puhastus-desinfektsioon)
- tutvustada personalile bioloogilise saaste keskkonnas töötamise iseärasusi ning viirus ja baktersaastuse leviku ted ning patogeneesi
- koostada kalkulatsioon reservide käivitamiseks (nii majanduslik kui ressursi põhine – ületunnitöö, desinfektsiooni ja kaitse vahendid jne), koostada nimekiri vajaminevatest ressursidest
- hankida vajalikud kaitsevahendid, ning puhastus-desifektsiooni vahendid
- veel üks oluline väga preventsiooni viis on – piirata juba tõenäoliselt nakatunud patsientide ja ka töötajate visiite perearstikeskusesse. Hoida lahus nakatunuid ja mitte nakatunuid on võtmeküsimus!

1. Triaaž
 Eraldi vastuvõtu ajad (N. Gripikahtlased hommikupoolikul, teised pärastlõunal) kui võimalik ooteruumid eraldi
 Pereõe rakendamine triaazi läbiviimisel ( perearsti vv-le vaid raskemad ja riskigruppi kuuluvad haiged)
 telefonitriaaz ja nõustamine meditsiiniõe või arsti poolt
 koduõe kaasamine koduvisiitideks, pereõe koduvisiidid

2.Puhastada üle (desinfitseerid kogu aeg üle) korduvalt kasutusel olevad töövahendid: stetoskoop, EKG aparaat, kusett jm)
3. Kui võimalik, kui praksises on mitu õde, siis üks teenindab tavapatsiente, teine nakkuskandjaid
4.Tervete laste ja täiskasvanute prof. läbivaatused ja plaanilised visiidid, mida annab edasi lükata, tühistada

2.Pandeemia ajal. Nakkusohutussoovitused A(H5N1)-gripile eksponeeritud tervishoiutöötajatele
A(H5N1)-gripile loetakse eksponeerituks need tervishoiutöötajad, kes puutusid kokku A(H5N1)-gripiviirusega, A(H5N1)-gripihaigega, tema eritistega või haige eritistega saastunud pindadega. Eelkõige nendeks on perearstid, kiirabi, erakorralise meditsiini osakonna, nakkusosakonna, intensiivravi, diagnostikakabinettide ja labori personal. Eraldiseisvate ravikorpuste ümberprofileerimisel monoprofiilse nakkuse raviks – selle korpuse kogu personal.

• Käte pesemine ja antiseptika nõuete järgimine .Käsi pesta vee ja seebiga! või desinfitseerida pärast iga kontakti patsiendiga, pärast kokkupuudet saastatud vahendite või pinnaga või pärast kinnaste käest võtmist.
• Individuaalsete kaitsevahendite kasutamine haige vere, kehavedelike, eritiste käitlemisel .Kogu personal kannab kogu tööpäeva jooksul hingamisteid kaitsvaid vahendeid, mida vahetetakse vastavalt maski tüübile (4-6h). Haige, kelle juurde tuleb tervishoiutöötaja või külastaja, kannab vähemalt kirurgimaski. Maskide juures on oluline see, et maske ei tohi kätega puudutada, kui eemaldatakse, siis järgnevalt alati käed pesta või desinfitseerida! Üks kaitsevahend on veel kindad! Neid tuleb nii või teisiti kanda teatud protseduuride ja tegevuste juures. Pärast kinnaste käest võtmist tuleb käsi kindlasti pesta. Kindad asetada spetsiaalsesse konteinerisse.
• Enesekontrolli korras mõõta kehatemperatuuri paar korda päevas ja jälgida gripi haigusnähtude, eeskätt kõrge palaviku ja köha, ilmumist
• Nende haigusnähtude ilmumisel mitte minna tööle, eraldada end pereliikmetest/kaastöötajatest eraldi ruumi ning teavitada tööandjat 1) võimalikust nakatumisest linnugripi viirusega ja 2) oma lähikontaktsetest isikutest ning kaastöötajatest
• Instrumentide, voodi- ja haigevarustuse ohutu käitlemine
• Naha- ja limaskesta vigastuste vältimine
• Haige poolt saastatud esemete ja pindade puhastamine/desinfitseerimine
• Nakkusohtlike jäätmete ohutu käitlemine
• Soovitada personalil võtta viirusevastast preparaati. Pärast kokkupuudet või potentsiaalset kontakti gripihaigega, kellel on kinnitatud A(H5N1)-gripiviirusnakkus, alustada võimalikult kiiresti, hiljemalt 48 tunni möödumisel, viirusevastast ravimprofülaktikat
o oseltamiviriga - 75 mg üks kord päevas vähemalt seitsme päeva või näidustusel - kuni kuue nädala jooksul

tüsistused ja sümptomaatiline ravi:


2-38%. Sagedamini ja raskemini krooniliste südame-ja kopsuhaigustega patsientidel.
a) primaarne viiruspneumoonia

48 tunni vältel haiguse algusest, hingeldus, kuiv köha, mis kiirelt muutub produktiivseks ja vereseguseks.Tsüanoos, tahhüpnoe, bilateraalselt krepitatsioonid ja vilinad ning leukotsütoos. Rö-s kahepoolselt interstitsiaalne infiltratsioon peamiselt keskväljades, võib esineda ka koldevarjustusi. Kiirelt võib kujuneda hingamispuudulikkus. Suremus >40% ka intensiivraviga. Surm tavaliselt 7 päeva vältel hospitaliseerimisest.

b) sekundarne bakteriaalne pneumoonia

Tüüpilisel juhul ilmuvad sümptomid varases rekonvalestsentsperioodis (4-5 päeva haiguse sümptomite algusest). Rö-s tavaliselt lobaarne varjustus. Suremus 7%-24%.
Etioloogia sarnane keskkonnatekkese pneumooniaga: Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, A,C ja G beeta-hemolüütilised streptokokid. Stafülokokiline pneumoonia on seotud sagedasema kopsuabstsessi tekkega ja halvema prognoosiga kui muu etioloogiaga pneumoonia.

c) segaetioloogiaga (viirus-bakteriaalne) pneumoonia

Rö-s lobaarne koldevarjustus bilateraalse diffuusse infiltratsiooni foonil. Suremus kõrge (>40%).

Nõustamisel antav informatsioon patsiendile:

1. grippi põhjustavad gripiviiruse erinevad alatüübid
2. gripi peiteaeg on 1-4 päeva ja täiskasvanu on nakkusohtlik 1 päev enne haiguse algust kuni 5 päeva peale sümptomite ilmumist.
3. palavik langeb tavaliselt 2-3 päevaga ja normaliseerub 6.päevaks
4. köha, nõrkus ja halb enesetunne võivad püsida 1-2 (vahel kuni 6) nädalat
5. antibiootikumid ei toimi gripiviirusele, kuid võivad osutuda vajalikuks sekundaarsete tüsistuste ravis

Sümptomaatiline ravi

Palaviku, müalgia ja peavalu raviks paratsetamool või ibuprofeen
Voodireziim on oluline
Rohke vedeliku joomine
Suitsetamisest loobumine
Võib proovida auruinhalatsioone, toopilisi rögalahtisteid, kurguvalu leevandajaid, füsioloogilise lahuga ninatilkasid

Korduva arsti väljakutse näidustused

1. Hingeldus puhkeolekus või väikese füüsilise koormuse ajal
2. Valulik või raskendatud hingamine
3. Verine röga
4. Palaviku püsimine 4-5 päeva ja enesetunde mitteparanemine
5. Uus palaviku tõus ja enesetunde halvenemine peale esialgseid paranemise tundemärke
6. Uimasus, desorientatsioon või segasusseis

Tegutsemine sõltub:
1. kliinilisest raskusastmest
2. patsiendi kuuluvusest riskigruppi
3. kohalike tervishoiuametnike soovitustest olenevalt pandeemia epidemioloogiast

juhised linnugripihaige põetajatele

tervisekaitseameti juhend - Juhised kontaktsetele

Juhised inimese kõrgeltpatogeense (sh A/H5N1) linnugripi viirusnakkusega haigega kokkupuutunud isikutele

Üldised nakkustõrjesoovitused linnugripi haige kontaktsetele isikutele · Tervishoiuteenuse osutaja märgib üles ja edastab tervisekaitseametnikele gripihaige või haiguskahtlase isiku nime ja kontaktandmed. · Haigega kokku puutunud isik täidab nakkustõrje standardmeetmeid. · Haigega kontaktne isik jälgib tervishoiuteenuse osutaja juhendite kohaselt oma terviseseisundit (haigusnähtude võimalikku ilmumist) kuni 7 päeva jooksul pärast kokkupuudet gripihaigega/haiguskahtlase isikuga ning teavitab kohe perearsti nende nähtude ilmumisest. · Kontaktne isik, kellel on tekkinud haigusnähud, kannab tervete inimestega suhtlemisel kaitsemaski. · Kontaktne isik, kellel on tekkinud haigusnähud, kannab tervisekeskuse/haigla ooteruumis ja arsti vastuvõturuumis kaitsemaski. · Kontaktsel isikul, kellel on tekkinud haigusnähud, ei ole soovitatav: a) minna tööle, kooli jt kollektiivi ning külla, b) minna tervisekeskusesse, vaid ta kutsub arsti koju, c) kasutada ühistranspordivahendit, d) mitte sõita nendesse piirkondadesse, kus gripp ei ole levinud. e) Kontaktsel isikul, kellel on tekkinud haigusnähud, tuleb alustada 24-48 tunni jooksul gripiviiruse vastast ravi.

Nakkusohutussoovitused haiget külastanud isikutele
Hoiduda külastamast haiget, kellel on diagnoositud kõrgeltpatogeenset linnugrippi nakkusohtliku perioodi jooksul – täiskasvanut 7 päeva ja kuni 12 aasta vanust last 21 päeva.
Juhul, kui siiski külastate kinnitatud linnugripi diagnoosiga või selle kahtlusega haiget, järgige tervishoiutöötajate nakkustõrjesoovitusi – kandke kaitsemaski/respiraatorit, kitlit, näokatet/prille ja kindaid.
Pärast haigepalatist/isolaatorist väljumist võtke ära eelnimetatud individuaalsed kaitsevahendid ja peske hoolikalt käsi.
Juhul, kui puutusite kokku kõrgeltpatogeenset linnugrippi põdeva haigega nakkusohtliku perioodi jooksul, jälgige oma terviseseisundit 7 päeva. Juhul, kui tekivad gripinähud ja kõrge palavik, pöörduge kohe arsti poole viirusevastase ravimprofülaktika alustamise eesmärgil.

Nakkusohutussoovitused linnugripihaige lähikontaktsetele/pereliikmetele
Hoiduge kokkupuutest haigega nakkusohtliku perioodi jooksul (täiskasvanud haige 7 päeva, kuni 12 aastane haige laps 21 päeva alates haigestumise algusest).
Juhul, kui peate vältimatult linnugripihaigega kokku puutuma või teda hooldama, kandke maski/respiraatorit, kitlit, kaitseprille ja kindaid.
Pärast haigeruumist väljumist võtke ära individuaalsed kaitsevahendid ja peske hoolikalt käsi.
Juhul, kui puutusite kokku haigega nakkusohtliku perioodi jooksul, jälgige oma terviseseisundit 7 päeva, gripi haigusnähtude ja kõrge palaviku tekkimisel pöörduge kohe arsti poole, teatades talle, et puutusite kokku linnugripihaigega.

kui tegemist on üksiku linnult haiguse saanud inimesega, siis läheb ta haiglasse ja seal saab piisava ravi ja hoolduse, okkei

kui tegemist on pandeemiaga - siis võite 3x arvata, kas on võimalik minna poodi ja osta sealt "maski/respiraatorit, kitlit, kaitseprille ja kindaid" :DD

kitli mingi kodust ehk ikka leiab :) - aga maske, prille ja ühekordseid kindaid tasuks küll tagavaraks hankida .. need on ühed esimesed asjad, mis müügilt kaovad kui kuskil pandeemia lahti läheb

Saastunud pindade desinfitseerimine

Tervisekaitseameti juhend: Saastunud pindade desinfitseerimine

Haige vere ja kehavedelikega saastunud esemed ja pinnad – 1% Na-hüpokloriid, 5% Na-hüpokloriidi lahust lahjendatuna 1:5 veega. Tualettruum – kloorlubja lahus 7g/L. Lauapinnad, metallpinnad jm pinnad, kus kloorlubjalahust ei või kasutada – 70% etanool, metanool, isopropüül (lasta kuivada). Pesta käsi pärast haige/haiguskahtlase isikuga või tema ümbruse saastunud/potentsiaalselt saastunud pindadega kokku puutumist. Tuba/korterit ei desinfitseerita, kasutatakse niisket koristust. Ruumi õhku ei desinfitseerita. Põetusruumist väljunud isik ei pea desinfitseerima riideid, jalatseid, tarbeesemeid ning temale ei pea tegema sanitaartöötlust juhul, kui ei ole ilmset saastumist.


Cureventsist siis

A bear, a lion and a chicken meet. The bear says: "if I roar in the forest, the entire forest shivers with fear." The lion says: "if I roar in the jungle, the entire jungle is afraid of me." "Big deal," says the chicken. "I only have to cough, and the entire planet sh**s itself."

Austraalia: juhendid ettevõtetele

ettevõtte pandeemiaplaani vajalikkuse põhjendus ning selgitus, kuidas koostada

White paper: Avian flu and continuity management

lisatud on ka exceli tabel, mis võimaldab oma pandeemiaplaani auditeerida
haa - uus biznizidee audiitorfirmadele? ;)

5. märts 2006

radikaalsed mormoonid

hard-core-mormon-survival, viljavarude ja koduse relvaarsenaliga :D

ilmne overkill absoluutsele enamusele, aga vbolla annab mõningaid kasulikke mõtteid - ja huvitav lugemine oli küll

Surviving in the City

Mormon author unknown Submitted by Miles Stair www.EndTimesReport.com Forwarded by: www.beaconguild.cjb.net


While we all want to do our best to prepare for a coming crisis, and many of us realize the city is perhaps the worst place to live, very few people are really prepared to pack up the old Winnebago and head for the hills. Most Americans, whether they’re aware or not, are going to stay in the cities.

This is not a hasty decision for most people. Most of us depend on the city for our livelihood, and we can be better prepared by continuing to live in the city, earn a good income, and make preparations for exiting the city at the appropriate time or by staying in the city and living off existing supplies.

This special report explains some of the most critical dangers of living in a city and presents some solutions to surviving them. If you are one of the people who has decided to stay in the city, you’ll benefit greatly from this information.

Cities are artificial Every city is an artificial construct. Cities formed as people came together to conduct business, participate in social interaction, and benefit from efficiencies in public services (such as schools, sewers, water, etc.) and a common defense. Yet cities cannot survive alone. They need resources from the country; most notably, food, water and electricity. While electricity and water can sometimes be created or found within city limits, the acreage requirements of food dictate that no city could possibly feed its own people.

Read that last phrase carefully: No city can feed its own people. Not one. Cities are, by their very nature, dependent on the importation of food. The advent of just-in-time delivery systems to our grocery stores means that most cities would run out of food within a week if supplies were for some reason disrupted.

Remember, cities are not self-sufficient. Although they may seem to be in 2005, they have for a long time been entirely dependent on the American farmer for their support, something almost all Americans take for granted (except the farmer, of course.)

Risks in the City
The city presents some serious risks during a crisis. The four most serious ones are: 1. the collapse of social order (riots), 2. the failure of the water treatment and delivery systems, 3. the depletion of food supplies and 4. the failure of the power grid.

While not every situation will appear in every city, every situation will most certainly appear in some cities. Will that include yours? We’ll tackle these one at a time:

1. The Collapse of Social Order “Social order” is a delicate thing, and it exists as a psychological barrier that could easily collapse under the right conditions. We all saw this during the L. A. Riots following the Rodney King trial verdict as citizens of L. A. set fire to their own town, yanked people from vehicles and beat them literally to death, and even fired guns at firemen attempting to save their buildings! More recently we were all witness to the looting, violence and total breakdown of society following Hurricane Katrina in New Orleans.

What allowed this to happen? Simple: the simultaneous melting away of the psychological barrier of “order.” Once people realized 911 couldn’t handle the load, or was offline, that the local police were helpless or had simply abandoned their posts, “Law and Order” ceased to exist in their minds. They then conducted their lives in the way they always wanted to, but couldn’t because of the police. That is, they ran out to the local stores and just took whatever they wanted (looting). They took our their racial frustration on innocent victims who happened to be driving through the area, and they let loose on a path of destruction that only stopped when men with rifles (the National Guard) were called in to settle things down. In other words, only the threat of immediate death stopped the looting and violence. Rifles work wonders.

Imagine store owners lying prone on the roofs of their stores with AK-47′s, firing at anyone who approached. This is exactly what happened in Los Angeles. But worse, imagine the lawless horde firing at the rescue copters trying to bring in supplies to the desperate masses.

The National Guard eventually got things under control. This event was isolated, however, to one city. Imagine a hundred cities experiencing the same thing. Will the National Guard be able to handle the load? Not likely. What about local police? They aren’t fools; if things look bad enough, they’ll grab their families and head for the hills, just like they did in New Orleans. No pension is worth getting killed for. A few U. S. cities could be transformed into literal war zones overnight. It would require all-out martial law and military force to have any chance whatsoever of bringing order to these streets. And the reality is that there are not enough military in the USA to secure all of the cities if this happens.

This collapse of social order is perhaps the greatest risk of staying in the city during a crisis. What, exactly, would cause this collapse of social order? Lack of three things: food, water, and money. When people run out of food, some will begin ransacking their neighborhood, searching for something to eat. (Remember that in a city, a “neighbor” does not mean the same thing as a “neighbor” in the country. They are not necessarily your friends.) It won’t take long, then, for violence to take over in some cities. While certain regions will certainly manage to keep things under control and people will form lines at the local (depleted) Red Cross shelter, other cities will see an explosion of violence. Imagine the gang- infested regions of L. A., Chicago, New York, St. Louis & New Orleans. Do you think those people are going to stand in line and wait? They already have guns; now they finally get to use them. Pent- up racial tensions & hostilities will simply serve as justification for shooting people of the same or other color in order to get their food.

Even if the food somehow gets into the cities, lack of money (due to the government not sending out checks) could cause the same thing. Eventually, lack of money results in looting and mass theft. As the stealing balloons, it also results in a collapse of social order. Water; the same thing (but faster). The collapse of social order is also very dangerous because it doesn’t require any “actual” collapse of the power grid, telecommunications, transportation or banking. Social order is a psychological artifact. It is a frame of mind, and any global panic can quickly remove the mental barrier that right now keeps people basically “lawful.”

The Failure of Water Treatment and Delivery Systems
Will the water treatment facilities fail during a crisis? Many will. Some won’t. The problem lies in figuring out whether yours will. Certainly, they depend on electricity, and testing conducted on some plants has already revealed weaknesses in the system.

In one such test, the water treatment plant released a fatal dose of fluoride into the water system when tested. The computers thought they were 99 years behind in releasing minute doses of fluoride, so they made up the difference. If you happened to be downstream, drinking that water, you were dead. Fluoride, no matter what misinformed dentists tell you, is actually a fatal poison. A major crisis likely to demonstrate this fact in more than one city.

The most important question here, though, is about what will happen when the water stops flowing (or if it is flowing, but it’s not drinkable). As you are probably aware, while people can live without food for long periods of time (2–3 weeks), water is needed on a daily basis. You can go 2–3 days without it, at most, but beyond that, you’ll quickly turn to dust. [See www.EndTimesReport.com/water.html ]

That means people will do anything to get water, because to not have it means death. And guess where it’s going to be the most difficult to actually get water? You guessed it: in the cities. During the first day of the water crisis, many people still won’t figure out what’s going on. They’ll figure it’s a temporary breakage of a water main and the government will get it fixed within hours. As those hours stretch into the next day, these people will get very worried.

By the second day, more and more people will realize the water isn’t coming. At that point, you could easily see a breakdown of social order, as described in the previous section (as you can see, these things all tend to cause each other.). People will begin their “search for water,” and the first place they’re likely to go is where they always go for liquids: the grocery store, the local Wal-Mart, the 7–11. The shelves will be cleaned out rather quickly.

Beyond that (because those liquids aren’t going to last long), you’re going to see people engaged in a mass-exodus from the cities. They’ll take the gas they have left in their tanks and they’ll leave the city in search of water. Some will go to “Grandma’s house” out in the country where they might at least find a pond or stream to drink from. Others will simply go on an expanded looting mission, stopping at any house they see and asking the residents (with a gun in their face, likely) if they have any water to “donate.”

As a result of all this, if water stops flowing, here are the events you can expect to see in some of the worse-off cities:

Looting of all the grocery stores by the second or third day (remember New Orleans?)

Minor outbreaks of violence during the looting. Shop owners, for example, may attempt to defend their shops with firearms (ala L. A. Riots)

Mass exodus of residents from the city in search of water
Ransacking of any houses or farms within a gas-tank radius of the city, presumably by desperate people with guns

Mass traffic jams on the outbound highways as people run out of gas and abandon their vehicles (if bad enough, this could actually block the highways and trap people in the cities) (Remember Hurricane Rita?)

Mass outbreak of water-borne diseases as people use streams and rivers as both a water fountain and a bathroom. People crapping upstream are going to infect the people drinking downstream. Very few have any kind of water filtration device. That last point is really critical. Once the water flow stops, disease is going to strike.

The Depletion of Food Supplies
The food supplies will likely dwindle quickly as we approach a possible crisis due to people stocking up just in case. Once the crisis actually hits, expect to see breakdowns in the transportation sector that will result in major delays in food delivery. This means food may arrive in sporadic fashion in some cities (if at all).

Once this happens, food suddenly becomes really valuable to people (even though they take it for granted today). And that means any small shipment of food that arrives will be quickly grabbed and eaten or stored. It only takes one week without food to remind people how much they actually need it, so expect the atmosphere to be that of a “near panic” if food is delayed by as little as three days. The level of panic will vary from city to city. Some cities or towns may experience very little difficulty receiving food. Others may face near-starvation circumstances.

Remember, the cities depend entirely on food shipped in from the farms and food processing companies. Also, note that if there’s a water problem as mentioned in the previous section, and the mass exodus begins, the highways may be jammed up at critical locations, causing gridlock for the trucking industry. If we’re lucky, some trucks will continue to roll. If we’re not, assume that nothing gets through. [See www.EndTimesReport.com/food.html ]

A shortage of food ultimately results in the same behavior as a shortage of water. First, people eat what’s in the pantry, then they loot the grocery stores. After that, with all local supplies depleted and no hope on the horizon, they leave the city and start ransacking nearby homes. Some will hunt in nearby forests, but most city-dwellers don’t know how to hunt. In any case, anyone with the means to leave the city will likely do so soon after their food shortage begins.

The Failure of the Power
Grid Nothing is as suddenly obvious nor has such a gigantic psychological impact as the failure of the power grid. When the electricity stops, almost everybody knows it at the same instant (unless it happens at night).

Naturally, during the first few hours of the power failure, if it occurs, people will assume it’s a temporary situation. Maybe a tree fell on some power lines, or perhaps a transformer blew up somewhere nearby. They’ll sit tight and wait for the power to come back on.

What if it doesn’t? Then the city faces a severe problem. Without power, obviously, everything shuts down. Within hours, the looting begins in the more crime-ridden cities (we saw this in New York a few decades ago.). The longer the power stays off, the worse the social disorder.

The loss of power will bring the entire city to a halt. While vehicles may get around for a few more days (using whatever fuel they have left), businesses obviously won’t be operating. Houses that depend on electricity for heat will quickly reach Winter temperatures, freezing many occupants to death. [See www.EndTimesReport.com/kerosene.html ] While those that depend on electricity for Air Conditioning will just as quickly reach Summer temperatures, resulting in death from heat stroke. Hospitals and police stations may have generators on hand, with a few days worth of fuel, but in short order, that will be depleted, too.

But the water treatment plant will almost certainly be off-line without power, causing all the events mentioned in the water section, above. Let’s face it, the power is the worst thing to be without in the city. If you have power, you can survive a food shortage, perhaps even a short water shortage. But without power, all bets are off. If you have a “bug-out” vehicle stocked and ready to go (see below), this might be the time to bail.

Solutions in the City
Okay, so you’re stuck in the city. You’ve made the decision to stay. You’ve read the problems above, you believe they make sense, and you’re intelligently frightened. What now? You really have two strategies. You can:

Stay and defend your house
Bug out (leave the city and head for the hills)

Important! This is not an either/or situation. You can begin by staying in your house and assessing the situation. You’ll want to have a “bug-out” vehicle stocked and ready, just in case, if you can afford one, but you may never actually choose to bug out. You’ll have to be the ultimate judge of this. Just remember that when you bug out, you face major risks and disadvantages. Among these: 1. You’re severely limited in how much you can carry - 2. You have limited range due to fuel - 3. You expose yourself to social chaos, roadblocks, random violence, etc. - 4. Your house will certainly be looted while you’re gone - 5. You run the risk of mechanical breakdowns of your vehicle - 6. You must have a place to go that you know is in better shape than where you currently are.

In general, unless you have a specific, known safe place as your final destination, I don’t advise people to bug out. Just “heading for the hills” is a very poor plan. You might not make it. But heading for Grandma’s house or some known, safe place could be a very good plan indeed, depending on whether Grandma is ready, willing and able to accept you!

For these reasons (and more), staying and defending your house is sometimes the only reasonable course of action, even if it seems dangerous. For the most part, looters and people looking for food are going to have plenty of easy victims, so if you show a little willingness to use force to defend your property, you’ll likely send people on to the next house. [See www.EndTimesReport.com/homedefense.html ]

That is, until the next house is already empty and you appear to be the last house on the block with any food and water left. If you’re in a bad enough area, your neighbors may “gang up” on you and demand your supplies or your life. This is truly a worst-case scenario, and unless you literally have a house full of battle rifles and people trained to use them (and the willingness to shoot your neighbors), you’re sunk. This is why the best situation by far is to keep your neighbors informed and help them get prepared. Then you (both your member and non-member neighbors) can act as a group, defending your neighborhood and sharing the supplies you have with anyone willing to help defend you.

When you have this kind of situation going, your neighbors realize you are their lifeline. You supply them with food and water, and they will help support you because they are, in effect, supporting their own lives. The best situation is when your neighbors and other ward members have their own food and water supplies. That way, they aren’t depleting yours, and they have a strong motivation for getting together with you defend your neighborhood. (More on this below.)

Storing (and Hiding)
Your Food Storing food is just as important in the city as in the country, but hiding it is far more important. That’s because in the worst areas, marauders will be going from house to house, demanding your food or your life. If you’re dumb enough to put everything you own in the obvious places, you might as well not buy it in the first place. They will find it. To count on having any amount of food left over after the marauders break in, you’ll need to hide your food.

One alternative is to plan on defending your home with force. If you have enough gun-wise people in the house, and enough firearms and ammo, you can probably pull this off. But most of us aren’t nearly as experience with firearms as the gang members. A better alternative might be to plan on bringing you supplies to your ward/stake building where all of the Saints can both pool and defend their resources. This of course will depend greatly on your local Bishop and Stake President.

Back to hiding: the best way to hide your food is to bury it. You’ll need airtight containers, long-term food that won’t rot and you’ll need to plan ahead. Bury your food at night so nobody will notice, and make sure you don’t leave the map on the refrigerator door! (Better to memorize it!) Try to get the ground to look normal after you’re all finished. You’ll want to bury your food as early as possible because it gives the grass time to regroup over the spot. If you’re in an area that snows, you’ll have a great concealment blanket! Most food marauders won’t go to the trouble to dig up food, especially if you insist you don’t have any.

Best plan: Have some smaller amount of food stashed around the house, letting them find something. Better to give them something and send them on their way. The art of hiding your food is an ancient one. You’ve got to get creative. Use the walls, the floors, and the structure of the house.

If hiding your food is simply not an available alternative, then try not to advertise it. Keep it put away in your house or garage in as discreet a manner as possible. Don’t make a point of telling people that you have a years supply (or more). Word gets around fast that Bro. Jones has a ton of food in his garage. Boxes of food fit nicely under beds, behind furniture, in the attic, etc.. Be Creative!!

To sum up the food storage, you really have three strategies here:

Store it all in your house and plan on defending it by force.
Bury it in your yard in case you get overrun by looters.
Store part of it in your house, and hide the bulk of it.
Relocate all of it as soon as you recognize a major disaster is in progress

One of the best ways to store food for burying, although it will only last 2–3 years in high-humidity areas, is to purchase 55-gallon good-grade steel drums. You can get them from: Memphis Drum Service, 3299 Tulane, Memphis, Tennessee 38116 (901) 396–6484; (800) 960- 3786) The drums are only $16.50, but shipping them is around $30 each. Once you obtain the drums, dump in your grains or other food items. If you purchase bags of food from Walton Feed, this is the perfect way to store it. Don’t leave it in the bags unless you’re actively eating it. [Note: Plastic barrels do not rust.]

Then sprinkle some diatomaceous earth into the drum. You’ll need about two cups to treat a 55-gallon drum, and it must be mixed in well. Diatomaceous earth is made from ground up sea shells, and it kills bugs by getting into their joints. You can get some from: Perma-Guard, Inc. 115 Rio Bravo S. E. Albuquerque, New Mexico 87105 (505) 873–3061

This diatomaceous earth is food grade, and on the bag it says, “Fossil Shell Flour.” Their prices are one pound, $4.90; 2 lb., $8.05; 5 lb., 14.70, 10 lb., $18.00; 50 lb., $24.95.

Once you get these drums filled and sealed, you can then bury them in your yard. This is actually a HUGE UNDERTAKING and is a LOT more difficult than it sounds, since you’ll need to dig to a depth of around 5 or 6 feet in order to sufficiently bury these drums. You’re likely to attract a lot of attention unless you do it at night, and you’ll definitely be removing a lot of dirt that you’ll need to find some use for. Because the drums are steel, they will also deteriorate unless you line the outside with plastic (a good idea) and treat the drums with some kind of protectant or oil. (Don’t use WD-40.) Even Vaseline would work well, although you would definitely need a lot to coat a 55-gallon drum.

When you’re all done, you should have your protected grains in 55- gallon drums, buried in your yard and protected against the humidity of the surrounding earth. It’s a big effort, but then again, the food inside may save your life. You’ll find it much more efficient to bury several barrels at once; side by side.

In reality it would be faster and easier to simply build a false wall in your garage and seal up your food behind the false wall. Sure, you might loose 2–3 feet of useable space in your garage, but the tradeoff is knowing everything is safe and sound.

Storing Extra Water
Water can be stored in exactly the same way, although you might want to bury the barrel before you actually fill it with water. Make sure you treat your storage water, rotate it or have filters on hand when you get ready to use it.

If you don’t have a yard, or it’s not practical to bury your water, you’ll have to store water inside your house. This can get very tricky because water takes up a lot of space and it’s very difficult to conceal. It’s best to get containers made for long-term storage, but in a pinch, you can use almost any container: soda bottles, milk jugs (although it’s very difficult to rinse the milk out), and even rinsed bleach bottles (in that case, you won’t need to add bleach). But a lot of these containers will deteriorate quickly, and they may break easily. Also, consider what happens if your water may be subjected to freezing. Will your containers survive? Be sure to leave enough air space to handle the expansion. [See www.EndTimesReport.com/water.html ]

In order to prepare yourself for the water shortage, assuming you’re going to stay in the city, stock at least six months of water at a minimum two gallons a day per person. That’s nearly 400 gallons of water if you have two people.

Of course, even with the best in-house preparations, you may find yourself depleted of water supplies. In this situation, one of your best defenses is to have a really good water filter (like the Katadyn filter) that can remove parasites and bacteria from the water. You can also treat your water in other ways (iodine, distillation, silver solution, bleach, etc.). Armed with these items, you can safely use stream or river water (or even pond water) for drinking.

By far, the best solution for obtaining long-term water supplies is to drill a well. Buy the best-quality hand-pump available (cast-iron pumps available from Lehman’s) and a good cylinder. They will last a lifetime if installed properly. With this setup, you’ll have a near- unlimited supply of water.

The total cost of doing this, depending on where you live, ranges from about $4000 - $6000. Is it worth it? If you’ve got the money, I think so. However, many cities simply don’t allow the drilling of wells, so you may not be able to get one drilled even if you want to.

The deeper your well, the more expensive it gets. Most well drilling companies charge by the foot. When water is deeper, you also need a bigger pump and a more powerful cylinder, so the costs tend to really grow the deeper you go. If you can find water at 20′, you’re very lucky and it might not cost you even $2000. If you have to go down to 200′, it might cost you $7500, and you’re at the depth limit of hand-powered pumps anyway.

Defending Your Life and Property
Let’s talk about force. No doubt, there are plenty of nice people in this country, and I think that in small towns and rural areas, people are going to find ways to cooperate and get along. I also think, however, that some cities will suffer complete social breakdown and violence will rule. If you happen to be stuck in one of these cities, you’re going to need to use force to defend your house. The section that follows discusses what I consider to be extreme responses to violence in the most dire situations. Hopefully, you won’t find yourself in these circumstances, but if you do, the information below may be valuable.

Important: Do not use your lights at night. If you are stocking propane-powered lanterns, solar-powered flashlights, or other unusual supplies, using them at night will announce to everyone within line of sight that you have more than the “usual” supplies. Expect them to come knocking in your door. [See www.EndTimesReport.com/lighting.html ] At most, let a fire burn in the fireplace, but in general, avoid drawing attention to your house.

Defending your house is a crucial element on your stay-in-the-city plan. Make your house your fortress, and hold drills to help other family members practice some of the more common activities such as hiding, defending, evacuating, etc. Some useful items for home defense include:

A guard dog
Pepper spray
Smoke bombs (military-grade)
Trip wires

Let’s go over these: The guard dog is certainly a welcome addition to any family trying to defend their house. Although he probably eats a lot of food, the investment is worth if. Dogs also tend to sleep light, so let them sleep right next to the food storage areas, and make sure you sleep within earshot. If the dog barks, don’t consider it an annoyance, consider it an INTRUSION.

Pepper spray is a great alternative to the firearm. It will incapacitate people and certainly give them a painful experience to remember. On the downside (potentially), it might just remind them that next time they come back for food, they better kill you first. So understand the limitations of pepper spray.

Firearms are useful for obvious reasons. In the worst-case scenario, when looting is rampant, you may have to actually shoot someone to protect yourself or your family. If you’re squeamish about pulling the trigger under these circumstances, don’t plan to stay in the city. Use the “bug out” plan instead.

Smoke bombs can be useful for covering a planned escape from your house. You can purchase high-volume smoke bombs that will quickly fill up any house with an unbreathable cloud of military-grade white smoke.

Trip wires are great perimeter defenses. You can buy them from Cheaper Than Dirt (they run a few hundred dollars). They will give you early warning if someone is approaching. You can connect the tripwires to flares, shotgun shells, light sticks or other warning devices. This way, you can have an audible or visible alert, your choice.

In addition to these devices, you can make significant fortification- style improvements to your home. While none of these are very affordable, they certainly help defend your home:

Replace glass windows with non-breakable Plexiglas
Add steel bars to the windows
Replace all outside door locks with heavy-duty deadbolts
Replace all outside doors with steel doors, preferably without windows

Remove bushes and other shrubs where people might hide
Black out the windows entirely to avoid light escaping at night
(similar to what residents of London did during the WWII bombing raids)

Build secret hiding places for food, coins, or even people
Create escape hatches or passageways
Rig pepper-spray booby traps

These aren’t as absurd as they might at first sound. Many people living in rough cities already have steel bars covering their windows, and removing extra bushes and shrubs is a well-known tactic for making your home a safer place.

To light your home when there’s no electricity, try the following:

Use LED flashlights and rechargeable solar-charged batteries. You can buy all these items from the Real Goods catalog [Also see www.EndTimesReport.com/survival_shop.html ]

Use propane-powered lanterns. You can find these in the camping section of your local Wal-Mart. Be sure to purchase extra mantles and store lots of propane.

Purchase quality oil lamps from Lehman’s and stock up on oil. You
can also purchase cheap kerosene lamps from the Sportsman’s Guide or Wal-Mart, then simply purchase and store extra kerosene.

Buy extra candles.
Purchase lots of olive oil. Not only can you cook with it (and besides, it’s a lot healthier than corn or vegetable oil), olive oil also burns as a clean candle fuel. You can float a wick in a jar half-full of olive oil and light the wick. Viola, a home-made candle. Olive oil is a fantastic item for your storage anyway because even if you purchase all the grains in the world, you’ll still need cooking oil, and you obviously can’t buy powdered cooking oil. Well-stored olive oil can last for thousands of years.

Did you know that people won’t steal giant logs? Although they may easily steal wood you’ve already chopped, most people won’t have any way of stealing logs. They’re too heavy, and the vehicles won’t have any gas left. For this reason, your best bet in regards to stocking fuel for your house is to stock up on UNCUT wood logs.

It takes a lot of extra research to find out how to get them (took me a few weeks of asking around), but you can find a source if you look hard enough. Or you can usually get a permit to go out and cut your own. The effort is worth it, because this will give you a ready- to-go source of heat and fuel that cannot be easily stolen.

The catch, of course, is that you’ll need equipment to cut and chop the wood. A chainsaw is REALLY nice in this way, but it requires fuel. Fortunately, chain saws don’t use much fuel, so if you have a way to store as little as 50 gallons or so, you’ve got enough to power your chainsaw for a few years (at least!). You’ll need fuel stabilizers, too, which you can buy at your local Wal-Mart. (Be sure to buy extra chains for your chainsaw, too.)

You’ll also need splitting hardware. You can buy log splitters or just buy an axe, a wedge, and a sledgehammer. [This is too simplistic: See www.EndTimesReport.com/woodcutting.html ] Better yet, buy all four so you have a choice of what to use. And remember, wood splits much better when it’s frozen, too, so you might just wait until the cold hits in Winter to start splitting your wood. Only split a little at a time, because you don’t want to end up with a big pile of nicely-split wood sitting out in your yard. It will invite theft from people who don’t have any. If you already have trees on your property, you’re all set. Cut down about 4–5 cords right now, so they can start drying out, then chop them as you need them.

A “cord” of wood, by the way, is a volume measurement. It’s 8′ x 4′ x 4′, or 128 cubic feet of wood (stacked). Some people that sell wood will try to rip you off, so make sure you know what you’re buying. If you purchase logs, it’s better to get a price per linear foot, based on the diameter of the log. For example, you might ask for logs that are an average of 10″ in diameter, and you’ll ask how much the charge per linear foot would be. Something in the range of $1 - $2 would be great. [See www.EndTimesReport.com/storing_firewood.html ]

Relations With Neighbors
I’ve already mentioned the importance of getting along with your neighbors. It really is crucial to your city-based survival plan. The best situation to be in, as mentioned before, is to have neighbors & other church members who are aware of the issue and who are getting ready for it by stocking their own food, water, and other supplies. Every neighbor & member that becomes self-reliant is one less neighbor or member you’ll have to support.

The range of neighbor situations, from best to worst, is as follows:

Best case: your neighbor is current Recommend holder, is aware of and both temporally & Spiritually prepared for an emergency with their own supplies and training.

Good case: your neighbor is aware of a potential crisis, and even though they don’t have their own supplies, they’re willing to help defend yours as long as you share

Bad case: your neighbor is a non-member that didn’t prepare for it, figuring they would just steal from you if things got bad. They are aware of YOUR supplies but don’t have their own.

Worst case: your neighbor isn’t aware of anything, he is anti- mormon and he’s a violent, angry neighbor just released from prison. He is going to be caught off guard by the ensuing events and will likely attempt to use violence to get what he needs or wants.

Your decision on whether to stay in the city may depend greatly on the quality and quantity of your neighbors. If you do live in a bad neighborhood, do what you can to relocate. If you live in a good neighborhood, do the best you can to educate and inform your neighbors. This might well be the most important missionary work you ever do for your own temporal salvation!

Gun Control in the Cities
No matter how you felt or thought about gun control in the past, it’s time to face disaster-induced reality. The gun-control politicians (and the people who supported them) have placed Americans in a situation where not only can the police not protect us in a timely manner, but we cannot lawfully defend ourselves. Criminals unlawfully have firearms; citizens lawfully don’t. Intentionally or otherwise, gun-control supporters have created a situation where an unfortunate number of innocent men, women and children are going to be in danger during a crisis simply because they could not obtain the tools of self-defense.

It also happens that the cities where the rioting will likely be the worst are precisely the cities where firearms are most likely to be banned from lawful ownership (and where criminals may wield near- absolute power for a while.). Perhaps when society recovers from it, we can review the fallacy in the cause / effect logic that keeps people voting for gun-control laws, but in the mean time, millions of people are going to have to resort to breaking the law in order to protect their families. And yes, you too will have to resort to breaking the law if you are to acquire a firearm in an area where guns are entirely banned from private citizens (like New York, Los Angeles, etc.).

After the disaster hits, if the rioting gets really bad, we’re going to see local police begging law-abiding citizens for help. Your firearm will be a welcome addition to the force of law and order, believe me. No local cop is going to mind you having a handgun if you’re manning a roadblock protecting a neighborhood of families with children. Act responsibly, tell them what you’re doing, and they’ll probably give you a big thanks. But if you’re carrying a gun while you smash a window of the Wal-Mart and walk off with a stereo; well that’s a different story. Be prepare to get shot.

See, cops don’t mind private ownership nearly as much as we’ve all been led to believe. I know, I work with law enforcement officers in a small town, and I ask them about topics like this. When the crisis hits, they’ll be more than happy to have your cooperation. We’re all going to need as many law-abiding gun-toting citizens as possible in order to fend off the criminals and establish some degree of order.

One More Reason To Move Out
If you really feel you need a firearm to protect yourself and your family, your best bet may be to move to a city or state where people are a lot more accepting of firearms. You’d be surprised what a difference the locale makes. Check the gun laws in any state you’re considering moving to. Obviously, “cowboy” states like Arizona, Texas and Wyoming will have fewer restrictions on firearms (and, interestingly, they have less of a problem with gun violence). States where the population is more dense (like California & New York) tend to have much greater restrictions on private ownership of firearms.

Bugging Out Suppose it’s July 14, 2006, and you’ve changed your mind about this city thing. You happened to be right smack in the middle of one of the worst-hit cities in the country. The looting is getting worse, the power has been out for two weeks, and your water supplies are running low. You still have enough gas in your truck to make it out of town if you can get past the gangs, that is. You’ve decided to BUG OUT!

Some basic pointers:

Don’t try to bug out in a Chevy Geo. You will likely need a big
heavy 4×4 truck in order to go off-road and around stalled vehicles

Get something that can carry at least 1000 pounds of supplies. A
big 4×4 pickup will do nicely! Yes, it requires more fuel, but you can carry the fuel as cargo.

Don’t bug out unless you can have someone ride shotgun, literally.
You will need an armed passenger in case you run into not-so-nice people

[Overly simplistic. See my booklet Evacuation and Relocation.] Ahh, the bug-out supply list. All this will fit in your truck. Here’s what you should take if you’re preparing to bug out with two people:

Your 96 hour kits for each person in the vehicle
20 gallons of water
40 gallons of extra fuel or more (and a full gas tank)

As mentioned earlier, if you have a designated place of refuge (Grandma’s house, a cabin in the woods, etc.), head straight for it. If not, you’re basically driving anywhere you can go, so try to head for an area that forested and near a creek or river where you can get some water.

Conclusion Choosing to remain in the city is a rational choice for many people in many situations. However, as you have seen from the dangers described here, the further away you can get from the population centers in general, the better your chances of surviving.

Most people, perhaps yourself included, have a difficult time actually accepting that a major disaster is going to be as bad as described in this report. And after all, if you leave the city, sell out, quit your job, move to the country, and then nothing bad happens? You will have disrupted your life, and you may find yourself broke, jobless, and homeless. You COULD assume it will be a mild event, which I suppose is also a credible possibility. In that case, surviving in the city will be quite feasible, especially if you have neighbors that can support your efforts and you don¹t live in a dangerous city with high racial tensions. However, the very nature of a major disaster means that if only one or two major infrastructure components goes down, the ripple effect will quickly create a much worse scenario. It seems there is very little room for “mild” effects unless they are miniscule. The most likely scenario at this point clearly points to massive disruptions, severe shortages in food and water, loss of power in some areas, and a breakdown of social order in certain areas where the population density is high.

But you can survive anything with good planning, an open mind, and plenty of practice. Why not start now?


ühe fluwikie foorumikirjutaja mõtted, kuidas vältida nakkuse sattumist korterisse link

My proposals:

1 open the windows in bottom and top, this will create a drag that changes the air. A hot air-fan oven will also clean the air, and strengthen the drag due to heated air moves upward (chimney effect)

2 Make a disinfection mat, and place it by the main entrance. Use a cantina tray, place a towel or something spongy-like in it. Fill with bleach solution. ( 1ml bleach/ 1 liter water). Change solution everyday since bleach content is vaporizing. All entering must step in the mat.

3 Wash stair often with bleach solution. Don´t use vacum cleaner.

4 Place a dispenser with hand disinfectant near entrance. A spray bottle with alcohol 70–80% solution (isopropanol, ethanol, car window fluid, moonshine ;-) mixed with glycerin to prevent skin-dryness can be made very cheap. Even cheaper is concentrated carwindov fluid (ethanol, citrus perfume and small amount of ammonia). Paper-towels is not needed when using alcohol, it dries in seconds.

5 Place shoes and other clothing outside the flat. Using a thin rain suit is better, since it can be disinfected with bleach solution. Don´t spray clothes with alcohol, remember that it is highly flameble. Teach children about how to handle correctly.

6 Place a bucket with bleach solution to flush gloves, disposable masks, and to clean protection glasses, before disposing them or reuse. Don´t reuse masks after bleach treatment, it will destroy filter efiency. ( See reuse mask tread)

7 print and display posters on correctly removal of protection gear.


jutt siis sellest, et kuidas peaks inimesi teavitama pandeemiast ja selle ajal
ja pärineb ameerika psühholoogide assotsiatsioonilt

Life-saving communication

If a flu pandemic strikes, psychologists' expertise could help keep society running and ensure that the people who need treatment get it. By Christopher Munsey

A U.S. House of Representatives briefing called for more attention to the role social science research can play in communicating with the public, as part of the national strategy for dealing with a potential flu pandemic.

Rep. Brian Baird (D-Wash.), a committee member and clinical psychologist, hosted the briefing in December, pointing out that if a flu pandemic occurs, it is unlikely there will be sufficient vaccines or antiviral drugs to slow its spread.

"Social distancing, effective communication and other public health measures will be our only realistic line of defense, and this is the realm of social science," he said.

The briefing, sponsored by Rep. Bart Gordon (D-Tenn.), ranking member of the Committee on Science, featured presentations from three experts, including psychologist and APA Fellow Baruch Fischhoff, PhD, Clete DiGiovanni, MD, a physician and scientist with the Defense Threat Reduction Agency, and Monica Schoch-Spana, PhD, a medical anthropologist at the University of Pittsburgh's Center for Biosecurity.

Worldwide, health officials worry that the H5N1 avian flu virus, which has caused outbreaks among poultry flocks in Asia and Europe, will evolve into a form easily transmissible from person to person. Since 1997 when the virus was first detected in Hong Kong, there have been cases of bird-to-human transmission, usually among people living and working near poultry flocks. So far, about half of the people who have been infected by the H5N1 virus have died.

With no vaccine yet developed to protect people against such an outbreak, containing it may depend on enlisting the public's cooperation in public health measures to control its spread. The potential toll in human life from such a flu pandemic could be high. Historically, the 1918–1919 flu pandemic was the deadliest, killing as many as 50 million people worldwide, including more than 500,000 Americans.

If and when the next influenza pandemic strikes, knowledge about effectively communicating with people about health risks could help government authorities stem the death toll and keep society functioning, the panelists agreed.

Based on research about how people best evaluate risk and respond to threats, psychologists can help public decision-makers craft effective messages, said Fischhoff at the briefing. The public needs clear, concise and truthful messages about the scope of a pandemic and information about what they can do to stem its spread, experts said.

Sending the right message

Among the most important social science research findings on effective communication in such situations is the need to speak with candor, said Fischhoff, a social and decision sciences professor at Carnegie Mellon University and past-president of the Society for Risk Analysis.

"People want to know the truth, even if it's worrisome," said Fischhoff during his remarks at the briefing. "They want to know what they're up against in order to have the best chance of figuring out what to do for themselves, their loved ones and those they're responsible for."
Besides candor, Fischhoff included the following points as key to effective communication:

People absorb only a limited amount of new information at a time, so messages should include only the most critical facts.

• People have difficulty understanding how small risks mount up over repeated exposure, so messages have to reflect that weakness.

• Audiences must be treated respectfully to avoid provoking emotional reactions that can interfere with well-reasoned decisions.

To design effective messages, Fischhoff recommends officials pull together experts from four groups, specifically: specialists in social services, law and education; experts in risk and decision-making; psychologists and cognitive scientists who can identify audience beliefs; and communications specialists who can ensure that the messages get through to the right audiences.

At the briefing, DiGiovanni supported Baird's contention that communicating with the public, and public health measures, represent the best available choice for dealing with a flu pandemic.

"In the absence of pharmacological agents to deal with pandemic influenza, we're going to have to rely on public health measures to control its spread in the human population," DiGiovanni said.

In her statement, Schoch-Spana called for more attention to the role that civic groups and social networks could play in responding to such a pandemic, given the way people mobilize on their own to confront crises in their communities.

False positives

Fischhoff's emphasis on giving people information is echoed by other psychologists studying risk communication, such as Len Lecci, PhD, a psychology professor at the University of North Carolina, Wilmington, who studied people's reactions to the anthrax attacks in the fall of 2001.

With fellow psychology professor Dale Cohen, PhD, Lecci and a team of students evaluated people after asking them to read news articles about the event, in which someone deliberately spread anthrax spores through the mail to media figures and congressional offices. Of the 22 people infected by anthrax, five died.

Locally, Lecci and his students found high levels of fear about anthrax, despite the fact that there were no recorded cases of infection anywhere near the university. His findings and other psychological research illustrate the damage that fear can cause: Too many people may think they are sick and seek medical attention, bogging down the medical system and preventing those who are really infected from getting treatment.

To prevent those problems, messages about a flu pandemic from authorities should be specific about what's understood about the outbreak, where outbreaks have occurred and steps people can take in their daily lives to reduce their risk of exposure, he says.

The goal of such communication, says Lecci, is warning the public about the threat, motivating everyone to take steps to avoid infection and emphasizing information about who is most at risk, so that treatment remains concentrated on people who might actually be infected.

"If it really is a high-threat situation," says Lecci, "we make sure the public perceives it as a high-threat situation, and ideally, we give them something to do"–such as recommending hygiene measures to avoid infection or listing symptoms of the feared condition that they can evaluate themselves for. That helps reduce anxiety and keeps people functioning, he said.

Communication failures

Psychological research can inform decision-makers about better ways to communicate with the public. One example that has not benefited from such research is the U.S. Department of Homeland Security's (DHS) color-coded terrorist attack alert system, says Roxane Cohen Silver, PhD, a trauma researcher and professor of psychology and social behavior at the University of California Irvine, currently serving on a senior advisory committee for DHS.

The system is color-coded to communicate terror risk, with green for "low" risk rising to red for "severe" risk. The system wasn't designed for alerting the public, she says, but as a way to advise law enforcement agencies about conditions for possible terrorist strikes in the aftermath of Sept. 11, 2001. Silver says that system is flawed because it tells people that there's a terrorist threat, but doesn't give them specific actions they can take in response.

If no attacks occur after repeated warnings, she says, and if those warnings don't advise specific actions for responding to a threat, people may stop listening to them.

"If the messages are not appropriately framed, if they're not seen as trustworthy, if they're not tied to something people can do, I think they will be dismissed or not attended to appropriately,"she says.

If a flu pandemic occurs, telling people some actions they can take to control its spread is an important aspect of helping them maintain their psychological health, she says. Giving people a way to focus on taking action helps them adjust and prepare for unsettling events, Silver says.

People will want to know about measures they can take to lessen their chances of contracting flu and their family's risk, she says.

And keeping people healthy psychologically will help keep society functioning in the event of a flu pandemic by encouraging people to "press forward" with their daily lives.

"Feeling some sense of control facilitates coping," she says.

3. märts 2006

infra sõltub inimestest

Bird flu spreading rapidly; U.S. government warns population
Posted Thursday, March 02, 2006 by Mike Adams

A recent poll conducted in the U.S. by the Harvard School of Public Health reveals that if a bird flu outbreak hits the U.S. population, an astounding 68% of the population will stay home and skip their jobs. (Similar behavior is expected across Europe, although the number might not be exactly the same.)
This means that a bird flu outbreak in humans can be expected to cause massive infrastructure disruptions as the people who keep the national infrastructure running stop coming to work. Imagine the chaos that would ensue if 2/3rds of the truck drivers and train conductors across the country just stayed home. Think about it: no deliveries of fuel, food, car parts, industrial chemicals, livestock feed or even coal for power plants. The situation could be far worse than most people realize. The virus isn't the only threat: It's the infrastructure failures that are also a huge concern.

Just this week, U.S. Health and Human Services Secretary Michael Leavitt warned that the bird flu virus infecting U.S. birds was, "only a matter of time." It's unusual for the U.S. government to so blatantly acknowledge such a threat, but perhaps the reason is because Washington knows it can't possibly rescue the entire population from a pandemic. Individuals and families are on their own, according to the U.S. government's document, "National Strategy for Pandemic Influenza" (NSPI), which encourages people to start preparing for infrastructure disruptions. That same document also deliberately says that you should not rely on the government to save you. Most of the U.S. public, of course, has done nothing to prepare. When an outbreak is actually reported in the mainstream media, this lack of preparedness will inevitably lead to panic runs on face masks, antiviral medicines (including herbal tinctures), and even basic supplies like water and sleeping bags (to keep warm when the heat is gone).

õpime klassikast - Naksitrallid

aiteh Kitile :)
kes luges Naksitralle ja leidis, et sealne linnavõimude ja kodanike tegevus rotihirmus oli kiiduväärselt kiire ja põhjalik :)))

et oleks siis tulevikus linnavõimude ja kodanike tegevus gripihirmus sama kiire ja põhjalik ;)

Eno Raud Naksitrallid Teine raamat (Kogu see tegevus toimus ühe ja sama päeva raames.)

* Kontrollpunktis
[...]Kui furgoon valtapuu taga seisma jäi, astusid kontrollputkast üksteise järel välja kolm meest.[...]
Kontrollpunkti ülem vangutas etteheitvalt pead.
"Kuu pealt olete kukkunud või?" torises ta. "Kas te siis ei tea, et rotid eile linna tungisid? On välja kuulutatud rotivastane häireolukord ja sellega seoses tuleb kõik sõidukid varustada rotivastaste vahenditega."
Ta nohises tähtsalt, pöördus siis valge kitliga isanda poole ja lisas torisedes:
"Ma ei imestaks muuseas põrmugi, kui neil sellidel oleks ka kaitsepookimine tegemata."
(Putka sees:)
Kingpool ja Sammalhabe asusid tõendeid oodates silmitsema seinale riputatud plakatit, millel oli väga loomutruult kujutatud suur pruunikashall rott.[...]
"Meile on antud korraldus, et kõik autod tuleb läbi otsida," ütles kontrollpunkti ülem, võttis lauanurgalt dokumentide kausta ja hakkas seda lehitsema. "Üks hetk, kohe loen teile ette."
Veidi aega paberilehti lapanud, leidis ta otsitava koha üles ja hakkas lugema:
"Rotivastase võitluse kontrollpunktides tuleb kõik liiklusvahendid põhjalikult läbi otsida, kahjutuks teha liiklusvahenditest tabatud rotid ja eemaldada liiklusvahenditest kõik rotipärane..."

* Linnas
"Eks kooli," pomises poiss. "Ma käin õhtuses vahetuses."
"[...]Eile õhtul katsetati kassilõhnaga ja nüüd oleneb kõik sellest, kuidas see mõjub."
"[...]Ja ega peale selle ühe valge meie linnas vist rohkem kasse polegi.
Sellega pidi vanatädi nüüd igal pool ringi käima ja kassilõhnaga head äri tegema."
Inimesi oli tänavatel üsna harvalt liikumas. Ning needki vähesed, kes välja olid söandanud ilmuda, käisid rutakalt oma teed, pea hirmunult õlgade vahele tõmmatud, ahjuroop, kirves või lihtsalt mõni madjakas rottide tõrjumiseks käes.
Naksitrallid panid tähele, et käekotid, mapid, portfellid, kandekotid ja kohvrid olid tänavapildist täiesti kadunud. Nende asemel kanti mitmesuguseid kinnisi plekknõusid, nagu piimamannerguid ja kanistreid. Plekk näis üldse olevat kõvasti moodi läinud - paaris kohas oli hakatud isegi maju plekiga üle lööma.
Ühel tänavanurgal möödusid naksitrallid soomusautost.
"Kas näete!" hüüatas Muhv. Isegi sõjavägi on välja aetud!"
Kuid poiss raputas pead.
"See on hoopis autokauplus," selgitas ta. "Kõik harilikud poed on rottide pärast suletud, kaupa müüakse nüüd ainult teraskonteineritest ja soomusautodest, sest sinna ei pääse rotid sisse."

* Tee vabaks kassidele!
Mida lähemale naksitrallid linnale jõudsid, seda tihedamaks muutus liiklus.
Peamiselt hakkasid nüüd silma põgenikud, kes rotihirmu tõttu olid linnast lahkunud. Küll üksikute perekondade, küll tervete vooride kaupa astusid nad vaevatuna mööda maanteed, kandes käe otsas või turjal igapäevaseid tarbeasju, mis kiiruga olid pampudesse kokku seotud. Paljud põgenikud olid väikeste lastega, paljud olid põgenemisähmis ka ebavajalikku kraami kaasa haaranud ja nägid nüüd vaeva oma põrandalampide, seinavaipade ja lillepottidega.
Iga kord, kui auto põgenikest möödus, kõlas läbi lehtri Kingpoole võimukas hüüd:
"Tee vabaks kassidele!"

Tore oli vaadata, kuidas inimeste näod selle peale selginesid ja lausa särama lõid. Nii suured kui väikesed lehvitasid autole ja kassikarjale rõõmsalt järele ning enamik põgenikest otsustas sealsamas kohe linna tagasi pöörduda.

EE: Kus on sinu kodune kriisivaru?

ehee, kiitus eesti ekspressi kriisitoimkonnale :)))
kes eestikeelses meedias e-si-mest korda julgesid rääkida sellest, et igal kodanikul võiks olla omal ka midagi varutud
suurepärane :)))
kõik olulisem on üles loetletud, kel raha vähem - võib sealt muidugi nätsud, kommid ja viina välja jätta :D
st - seal kirjeldatud on nö mugavusvaru, et elad täiesti rahulikult edasi
ehtne kriisivaru maksab märkimisväärselt vähem :)

a muidu - no supertublid! :)))

Kus on sinu kodune kriisivaru? Eesti Ekspress koostas kolme­liikmelise perekonna (kassiga) üleelamisvaru ootama­tuteks päevadeks.

Ja saabub päev, mil sa pead avama oma külmkapi ukse ning mõtlema – esimest korda tõsiselt mõtlema – selle üle, mida sa näed. Asjadele, mis on su külmkapi sees, ja asjadele, mida seal pole. On seal poolik purk päiksekuivatatud tomateid, sushiteost ülejäänud tuub wasabi’t, jogurt, äraviskamist ootav kapsas, kolm muna ja apelsinimahl? Ülejäänud osa moodustab tühjus – ning kui külmkappi vahepeal mitte täita, on see tühjus päev hiljem suurem. Juba märksa suurem.

Ajal, mil kaubanduskeskusi kerkib kui seeni; ajal, mil nii ööl kui päeval on vähemasti suuremates linnades võimalik rahuldada iga pähetulevat ostusoovi, oleme kadestamisväärse osavusega unustanud oma – või oma vanemate – nõukogude mineviku. Mineviku, mille lahutamatud koostisosad olid kappidesse laotud pesuseebid, sool, jahu, Ekstra sigarettide plokid ja kilekottidesse pakendatud rohelised kohvioad.

Alati ei läinud neid varusid vaja. Lausa enamasti ei läinud. Aga oleks võinud, ja see on peamine. Sellele tasuks mõelda nüüd, päevil, mil massimeedia pakub välja maailmalõppu kolmel erineval moel, alustades gripipandeemiast ning lõpetades läänemaailma üldise kokkuvarisemisega.

Niisiis, mis on sinu kodus varuks juhuks, kui sa ei taha poodi ega apteeki minna? Ei taha või koguni ei saa, sest põhjusi võib olla mitmeid – kassadesse tekkinud rüselevatest hiigelsabadest massirahutuste, nakkusohu, üleujutuse (mõelgem ka looduskatastroofidele) või kaubandusvõrgu lihtsa tühjaksjooksmiseni välja.

EE kriisitoimkond pakub välja kolmeliikmelise perekonna "üleelamisvaru" kaheks nädalaks – ajaks, mida kardetud gripipandeemia asjatundjad nimetavad haigestumise laineharjaks; perioodiks, mil üleliigsete kontaktide vältimine võib olla kõige parem ellujäämisstrateegia.


KARTULID JA KARTULIPUDER: 7 kg + 3 pakki, 98 krooni

LÄÄTSED, ODRAKRUUP, MAKARONID, RIIS: kõiki 1,5 kg, 105 krooni

HAUTATUD LOOMALIHA + TUUNIKALAKONSERVID: soovitatavalt kergesti avatavad, 7+7 karpi, 150 krooni


KAUA SÄILIV NÄKILEIB: 14 pakki, 165 krooni

TAIMEÕLI: toitude praadimiseks, 2 pudelit, 30 krooni

PURGISUPID: rassolnik, borš, hernesupp või muu meelepärane. 10 purki, 250 krooni

OAKONSERVID: lihtne ja toitev. 7 purki, 56 krooni

TOATEMPERATUURIL SÄILIV SALAAMI: kaks kangi hedonistlikumaks hetkeks või toitude maitsestamiseks, 138 krooni.

VILJAHELBED: 3 pakki, 45 krooni

PUUVILJAKONSERV või moos: 5 purki, 65 krooni

KASSIKONSERV: lemmikloomale. 10 purki, 100 krooni

PANNKOOGIJAHU: ideaalne pühapäevadel, 2 pakki, 25 krooni

JAHU: küpsetamiseks või kastmeteks, 2 kg, 20 krooni

PÄRM: küpsetamiseks või B-vitamiini sisaldavaks pärmijoogiks, 2 pakki, 3 krooni

KÜPSISED JA TERAVILJAKREEKERID: teekõrvaseks, 5+5 pakki, 70 krooni

ŠOKOLAAD + KOMMID: lohutuseks või kiireks energiasüstiks, 5 tahvlit + 5 pakki, 120 krooni

NÄRIMISKUMM: väike asi, mille puudumine võib kibedalt tunda anda. 14 pakki, 91 krooni

SUHKUR: lihtsalt hädavajalik. 5 kg, 100 krooni

SOOL: kriisivaru klassika, 2 kg, 16 krooni

Maitseaine, kaSTMED JA KETŠUP: aitavad ühekülgset toiduratsiooni huvitavamaks muuta, 1+7+3 pudelit, 85 krooni

PULJONGIKUUBIKUD: abiks toiduteol või turgutava joogi valmistamiseks, 4 pakki, 28 krooni

KÜÜSLAUK JA SIBUL: asendamatud toitude maitsestamisel ja immuunsüsteemi tugevdamisel, 1+3 kg, 105 krooni

MÄDARÕIGAS: armastatud maitseaine, millel lisaks rahvameditsiinist tuntud tugev haigustevastane toime. 3 purki, 30 krooni

NÕUDEPESUVAHEND + PESUPULBER: 2 pudelit + 1 pakk, 40 krooni

VAAKUMPAKITUD KOHV JA PAKITEE: turgutava kuuma joogi valmistamiseks. 1,5 kg + 40 kotikest. 157 krooni.


SIIRUP: morsi tegemiseks või toitude magustamiseks, 3 pudelit, 39 krooni.

ÄÄDIKAS JA SOODA: 1 pudel + 2 pakki, 12 krooni.

PUHAS VESI: kraanivee saastumise või kadumise puhuks, 84 liitrit (2 liitrit inimese kohta päevas), 630 krooni

APTEEK: aspiriini, paratsetamooli, söetablettide, kaaliumpermanganaadi, raviteede, plaastrite, allergiavastase vahendi, kraadiklaasi, marlimaskide, kummikinnaste, desinfektsioonivahendi, polüvitamiini, unerohu, rahustavate tilkade ja kõigi isiklikust tervisest lähtuvalt kasutust leidvate ravimpreparaatide varuga. 600 krooni

PRÜGIKOTID: ettenägematuteks juhtumiteks või puhuks, kui pole võimalik prügi välja viima minna. 20 kotti, 15 krooni

LAMBIPIRNID JA PATAREID: igaks juhuks, kumbagi 4 tk, 58 krooni

PABERTASKURÄTID: tilkuva nina jaoks, 42 tk, 63 krooni

WC-PABER: 16 rulli, 40 krooni

HAMBAPASTA, SEEP, ŠAMPOON: asjad, mille puudumine viib moraali kiirelt alla. 2+2+2 ühikut, 94 krooni

TIKUD: sest kes oskab pulgaga hõõrudes tuld teha? Kindluse mõttes vähemalt 25 toosi, 13 krooni

KAUAPÕLEVAD KÜÜNLAD: elektri kadumise puhuks, vähemalt 10 tk, 90 krooni

KAUSTIK JA PASTAKAS: ajalooliste ülestähenduste tegemiseks, 25 krooni

VIIN: asendamatu viinasokkide tegemisel või desinfitseerimisel, samuti stressi leevendamisel või altkäemaksu andmisel. Kümme 0,2 l pudelit, 390 krooni

SIGARETID: tubakast sõltuvale pereliikmele või altkäemaksuks, 2 plokki, 750 krooni

SUHKRUGA JA SUHKRUTA KONDENSPIIM või kookospiim: 5+5 purki, 90 krooni

PIIMAST TEHTUD PIIMAPULBER: mõeldud lastele, kuid sobib ka täiskasvanutele. 2 pakki, 84 krooni

PUTUKATÕRJEVAHEND: mõelda võiks ka rotilõksule. 1 tk, 37 krooni

HÜGIEENILISED SALVRÄTID: tööpindade, käte ja kõige muu desinfitseerimiseks. 20 tk, 222 krooni


KOKKU: 5435 krooni

pandeemiaplaani koostamise juhend infrastruktuurifirmadele

Planning Guide for Infrastructure Providers
eeskujulik uus-meremaa valitsus on koostanud juhendi oma infrastruktuuri ettevõtetele, kuidas pandeemiaks valmistuda :)
sobib kasutamist mõistagi ka teistele, aga erinevalt nööbipoest ja audiitorfirmast:D, on eesti energia, elioni ja tallinna vee töövõimelisus inimestele kriitiliselt oluline ..

Document Table of Contents
List of Tables
List of Figures
1. Introduction
2. Context
3. Pandemic Contingency Planning for Infrastructure Providers
3.1 Short, Medium and Long-Term Planning
3.1.1 Influenza Manager
3.1.2 Medical Advisor
3.1.3 Activation of Pandemic Continuity Plan
3.1.4 Communication with Staff
3.2 How Will Essential Business Activities Be Maintained?
3.2.1 Identification of Core People and Core Skills
3.2.2 Business Planning for Absence
3.2.3 Knowledge Management
3.2.4 Communications
3.3 How Might Shortages of Supplies Affect Business Operations?
3.4 How Can We Protect Staff and Visitors from Getting Sick?
3.4.1 Restrict Workplace Entry of People with Influenza Symptoms
3.4.2 Personal Hygiene
3.4.3 Workplace Cleaning
3.4.4 Air Conditioning
3.4.5 Increase Social Distancing
3.5 Managing Staff Who Become Ill at Work
3.6 Contact Management
3.6.1 Contact Definition
3.6.2 Contact Management Mandated by Law
3.7 Staff Travel
Example - Screening Checklist for Detection and Management of Suspected Pandemic Influenza Cases
Example - Notification Form
Example - Contact List
3.8 Personal Protection Equipment
Using Masks
Protective Barriers
3.9 Where Can We Find More Information?

Appendix 1: Background Information on Influenza Pandemic
Why Plan For Influenza Pandemic?
What Are the Symptoms of Influenza and How Is It Spread?
Is Medication Available to Prevent or Treat Pandemic Influenza?
Appendix 2: Ministry of Health Scenarios for Pandemic Influenza
Scenario 1 - Pandemic Disease Recognised Overseas
Scenario 2 - Cluster(s) in New Zealand
Scenario 3 - Severe Pandemic in New Zealand
Appendix 3: Pandemic Management Phase - Standard Planning Assumptions

2. märts 2006


üks jutuke sellest, et mis võib kõik valesti minna, kui ei ole kriisiplaneerimist perekonnas :D
The Bug Out
mõned mõtted olid päris huvitavad :)
ei ole küll päris teemasse, aga kaudselt ikke

inimeste arv

shokeeriv fakt ühest foorumist ..
hiinas elab praegu 1,3 miljardit inimest - ja seda on samapalju kui aastal 1918a elas kogu maailmas :O
ma teadsin ju neid numbreid, aga see võrdlus lõi tummaks :O

ettevalmistused kui kindlustuse vorm

Why I'm not gambling with my life

I am not a gambler. I don't play the slots at Vegas, I don't buy lottery tickets, and I don't gamble with the safety of my readers when it comes to telling the truth about the bird flu virus. The truth is that this virus is one mutation away from becoming a global pandemic that could kill tens of millions of people around the globe. And yet most people do nothing to prepare.

Do not be caught unprepared. Start preparing right now, even if it means just filling empty 2-liter bottles with water and storing those in a closet. Remember, you'll need 2 - 3 gallons of water PER DAY per person just to survive. How much water do you have stored right now? The wrong thing to do is nothing. Do not let this "pre-panic" opportunity for calm preparedness slip by. Stay ahead of the crowd. Beat the rush. Start preparing today, just in case. It's like insurance. You buy insurance for your car. You buy it for your house or belongings. And if you're like most people, you probably even buy insurance for your body (health insurance). Insuring yourself against infectious disease only makes sense. Preparedness is cheap, but being caught unprepared can literally cost you your life. If this is all a false alarm, and bird flu never becomes contagious in humans, then you've wasted nothing, because now you're prepared for anything: Hurricanes, floods, power grid failures, tornados, earthquakes and civil unrest (LA Riots, remember?).

In other words, there's no downside to preparing. But failure to prepare could literally jeopardize your life (and the safety of your family). Besides, the U.S. government has already blatantly said it can't help you (read the NSPI report yourself to see). Don't even think of hoping to be saved by the National Guard. There simply won't be enough medicine, water or food to go around unless the outbreak is contained to a few local regions.

Fortunately, preparing is affordable and simple to do if you plan ahead. And once you're prepared, you can rest easy, confident that you are fully equipped to survive whatever natural disasters the world throws your way. It will make you feel safer and more secure. Don't be scared, be prepared!

linnugripi mõju majandusele (vol x)

inimeste käitumine on ju etteprognoositav .. :)

Avian flu and business continuity
By Tim Armit

Published UK statistics estimate that if an outbreak of avian flu occurs, there will be at worst a 25 per cent infection rate in each area impacted. The infection will then spread across the country, affecting each person who contracts it for about eight days. As such, in a family of four, if one falls ill on day one, the next on day two and so on, the last will recover on day 12. So we could expect every member of such a family to be away from work for 50 per cent longer than the expected infection time.

But even with 50 per cent of their staff unable to work, most businesses would be able to cope. Although an avian flu outbreak would be likely to affect large areas of the country, for businesses, it is already within scope of existing contingency plans.

In the event of an avian flu outbreak, businesses would, to some extent, be able to plan it into their operations. For example: * If it were proven that the disease could be passed from human to human, businesses should assume that work would stop or be adversely affected and plan operations with this in mind. * Food retailers should plan for a rush on goods as people begin to stockpile supplies. * Retail banks should plan for a rush on ATM withdrawals as people hoard cash. * Assuming that people would not want to leave their homes, a sharp increase in demand for internet services could be expected. * Food retailers offering internet shopping and home delivery should expect an increase in demand. * Call centre operators would not want to work together. Companies should plan to implement telephony systems that would allow operators to work from home.

pääsu ei ole :D

veidi nalja ka :)
keri veidi allpoole, cartoons - ja vasakpoolseim, No escape

eriolukorra seadus

eriolukorra seadus

seda seadust saab vajadusel rakendada
1) loodusõnnetuse või
2) katastroofi korral või
3) nakkushaiguse leviku tõkestamiseks

§5 Nakkushaiguse leviku all mõistetakse käesolevas seaduses: 1) taudina, kaasa arvatud loomataudina, levivat eluohtlikku nakkushaigust, mille tagajärg on massiline haigestumine ja mille puhul on vaja rakendada ulatuslikke tõrjeabinõusid; 2) rahvusvaheliselt kontrollitava, taudina levida võiva eriti ohtliku nakkushaiguse Eestisse toomist, mille leviku tõkestamiseks on vaja kohe rakendada ulatuslikke tõrjeabinõusid massilise haigestumise vältimiseks.
nii et linnugripipandeemia korral on võimalik seda seadust rakendada mis õigused see seadus siis valitsusele annab pandeemia korral?

§18 lg 1 annab eriolukorra väljakuulutamise õiguse valitsusele (ei mingit riigikogu), kes määrab siis ühe ministri eriolukorra juhiks (edaspidi siis täisvolitused praktiliselt, vt § 19) ja samuti määrab päästetööde juhi (kes juhib päästetöid reaalselt, väga suured volitused, vt § 20)

mida saab siis inimesi sundida tegema?

§8 lg 2: Eriolukorra ajal, mis on välja kuulutatud nakkushaiguste leviku tõkestamiseks, võib [...]
1) piirata füüsiliste isikute õigust vabalt liikuda ja Eestisse sisse sõita;
2) keelata füüsilistel isikutel koguneda ja koosolekuid pidada eriolukorra piirkonnas;
3) kohustada füüsilisi isikuid töötama päästetöödel.
(3) Eriolukorra piirkonnas võib [...] piirata füüsilise isiku õigust elu- või muu ruumi või territooriumi puutumatusele

§ 21. Füüsiliste isikute rakendamine päästetöödel eriolukorra ajal
(1) Eriolukorra ajal võib päästetöödel rakendada 18-50-aastasi isikuid.
(2) Päästetöödest eriolukorra ajal on vabastatud:
1) rasedad ja kuni kolmeaastaste laste emad;
2) isikud, kes kasvatavad lapsinvaliidi;
3) alla 12-aastase lapse üks vanematest või hooldaja;
4) invaliidid;
5) vaimsete või füüsiliste puuetega isikud ja nende hooldajad.

korralduste mittetäitmise eest määratavad karistused on küll võrreldes tolle Kanada seaduseelnõuga märksa leebemad, kuni 300 trahviühikut (mille suurus on 60 kr), ehk siis 18 000 kr maksimaalselt

millised võiksid olla "nakkushaiguste leviku tõkestamiseks vajalikud päästetööd"?
haigete hooldus, karantiini valve, matusetööd, toidujagamine, korravalve .. variante on :)

1. märts 2006


hahaa, hea :))
Antonio Proveritate · eesti elu poeetilisi peegeldusi

Gripiohus maa

Rahutuna rahva rind
küsib gripihaige lind
millal väisab Eestimaad

murelik oh meelelaad
jälitamas mõte sind:
kõlab kui iroonia
welcome to estonia

Eesti infomaterjalid

yahoo uudistest :DDD
võib lugeda, et märtsis plaanib põllumajandusministeerium üllitada teabelehe linnugripist, mida levitatakse kõigi peamiste ajalehtede lisana

eelmise nädala maalehe vahel ilmus ka üks vihik: Infovoldik Maaelu Heaks linnugripist

veel üks voldik: Veterinaar- ja Toiduameti koostatud lindude gripi infovoldik