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28. aprill 2006

Nature artikkel pandeemia-piiramise võimalustest

Strategies for mitigating an influenza pandemic
Neil M. Ferguson1, Derek A. T. Cummings2, Christophe Fraser1, James C. Cajka3, Philip C. Cooley3
& Donald S. Burke2

Development of strategies for mitigating the severity of a new influenza pandemic is now a top global public health priority.

Influenza prevention and containment strategies can be considered under the broad categories of antiviral, vaccine and nonpharmaceutical (case isolation, household quarantine, school or workplace closure, restrictions on travel) measures. Mathematical models are powerful tools for exploring this complex landscape of intervention strategies and quantifying the potential costs and benefits of different options. Here we use a large-scale epidemic
simulation6 to examine intervention options should initial containment of a novel influenza outbreak fail, using Great Britain and the United States as examples.

We find that border restrictions and/or internal travel restrictions are unlikely to delay spread by more than 2–3 weeks unless more than 99% effective.

School closure during the peak of a pandemic can reduce peak attack rates by up to 40%, but has little impact on overall attack rates, whereas case isolation or household quarantine could have a significant impact, if feasible.

Treatment of clinical cases can reduce transmission, but only if antivirals are given within a day of symptoms starting. Given enough drugs for 50% of the population, household-based prophylaxis coupled with reactive
school closure could reduce clinical attack rates by 40–50%.
More widespread prophylaxis would be even more logistically challenging but might reduce attack rates by over 75%.

Vaccine stockpiled in advance of a pandemic could significantly reduce attack rates even if of low efficacy.
vt ka graafikuid artiklist endast (pdf)
Estimates of policy effectiveness will change if the characteristics of a future pandemic strain differ
substantially from those seen in past pandemics.

UK: haiguse levikuks piisab mustadest jalanõudest

A 'dirty boot' was enough to breach bird flu defences
By Valerie Elliott, Countryside Editor

INFECTED faeces from a wild bird carried into a chicken shed on a workman’s boot are thought to be the most likely source of a bird flu outbreak on a farm in Norfolk.

Such a breach in biosecurity will be of major concern to Britain’s £3 billion-a-year poultry industry, which prides itself on the strict hygiene, cleansing and disinfecting standards observed on commercial farms.

Early indications were that the virus is probably the less virulent, low-pathogenic strain of the H7 flu which can devastate birds but is generally not a threat to human beings.

However, the Department for Environment, Food and Rural Affairs said that confirmation of the precise strain and virulence of the virus would be delayed until today.

The bird flu case, at a farm at North Tuddenham, is the first in a British commercial unit since the deadly form of avian flu, the H5N1 virus, arrived in Europe. Poultry industry and tourism chiefs admitted that they were “extremely nervous” that the highly virulent H7 strain had arrived in the county. It could effectively close down many villages.

Poultry is worth £1 billion a year to Norfolk and 40,000 jobs depend on the industry. Free range farmers in the county immediately locked up their birds to protect them from the disease threat.

State vets and epidemiologists were urgently tracing possible sources of contamination at Witford Lodge Farm, one of 30 units in Norfolk run by Banham Poultry UK. A 1km surveillance zone was set up around the infected farm and movement restrictions were in place on all other premises operated by Banham.

Sources at the company said that the most likely reason for contamination was wild bird faeces picked up outdoors and carried into a chicken house on foot. A cull of 35,000 chickens on the farm will begin early today. All the birds will be humanely despatched. Each will be caught, stunned, then placed in a chamber where carbon monoxide will gas them.

The birds were breeding stock and not destined for the dinner table. Banhams is expected to claim as much as £100,000 in compensation for the cull. A Banhams spokesman insisted last night that staff followed the strictest possible bio-security rules. Birds and eggs were transported in company vehicles. Only two or three men worked on the infected farm.

Norfolk accounts for a third of British poultry production and farmers voiced their fears about the knock-on effects of the bird flu virus yesterday.

Mark Gorton, director of Traditional Norfolk Poultry, which has eighteen organic chicken and turkey farms, two of which are near Witford Lodge, said: “We are worried about it as it devastated the Dutch industry. We are keeping our fingers crossed it’s not going to spread.”

He said that the real worry was where the virus had come from. “The birds are inside so it can’t have been from a wild bird and if it was from a vehicle, where did the vehicle come from and where has it gone? “The poultry industry is a huge industry here, with an enormous amount of local suppliers and distributors. The knock-on effects would be very serious but we’re hoping that we’ll come out the other side.”

Paul Leveridge, who keeps about 15,000 ducks on a farm about two miles away in Mattishall, said: “Every poultry farmer is worried, especially as this is now in Norfolk, the heart of the poultry industry.”

The H7 flu virus has been found in chickens in northern Italy since 1999, but the last outbreak in the UK was in 1998 on a turkey farm in Northern Ireland.

Nigel Joice, the eastern region representative of the National Farmers’ Union poultry committee, said that while members were concerned they were not in a panic. Mr Joice, who runs a poultry farm in Fakenham, said that they were more worried that people would stop eating poultry than the outbreak. He said: “It’s not great, unfortunately. People associate it with a pandemic.”

Mr Joice said that the East Anglian industry was different from that in the Netherlands, where an outbreak of H7 strain of the virus wiped out a third of poultry and cost millions of euros in 2003. “We’ve learnt a lot of lessons since then and the Dutch poultry industry is a lot more densely populated than ours.”

27. aprill 2006

majanduse pandeemiasimulatsiooni tulemused

Influenza Pandemic Simulation Reveals Challenges in Delivering Essential Services During Widespread Outbreak

NEW YORK, April 27, 2006 – A simulated influenza pandemic conducted by the World Economic Forum and Booz Allen Hamilton found that a widespread outbreak of avian flu would severely challenge governments and the private sector to manage essential services, limit the spread of the pandemic and communicate essential information.

Nabarro järeldus simulatsioonist: ükski infra-süsteem ei kesta praeguse seisuga üle 28 päeva..

Key insights from the simulation participants include:

The world will shift from “one of equals” to “not all equal,” as essential workers in health care and other industries need to be vaccinated so they can keep working.
Essential services and employees need to be prioritized – before an influenza attack – to maintain continuity.
Non-essential services must be shut down in an orderly manner.
Telecommunications will likely be overwhelmed early in the pandemic. Some experts speculated that the Internet could shut down within two to four days of the outbreak. This implies that government and businesses must coordinate and plan for the use of alternative communications channels—and telecommuting will not be a viable option. A method of prioritizing Internet access would be needed to allow key organizations and individuals to access information and communicate necessary actions.
Governments will likely direct the general population to stay in their homes, and to minimize social contact.
As a result, the government may need to assume national control, as in wartime, of critical infrastructure and resources including food, fuel, and healthcare. In addition, governments will need to assume responsibility for the “last mile” in delivery of food and other critical supplies to the populace.
“Maintaining business continuity is critical to the welfare of the general population,” said Alain Baumann, Director, Healthcare Industries for The World Economic Forum. “The business community will play an essential role in an effective response.”

Additional findings from the simulation include:

Governments will need to establish and communicate guidelines to the public for seeking healthcare—as well as priorities for application of prevention and treatment by the healthcare sector. Rules will need to be made for the consideration of the critically ill versus others. Alternate facilities, such as schools and churches, will need to become hospitals.
The recovered will need to fill vacant essential jobs; conscription of the recovered (now in effect vaccinated) will likely be necessary to fill vacant essential jobs. These individuals will probably require a minimal level of training to perform the critical functions.
Media can play an important role in communicating critical information from the government and businesses to the public and employees. People will want to know what is happening—and “flu-casters” can help calm and assure the public that progress is being made.

26. aprill 2006

Euroopa riikide pandeemiaplaanide analüüs

ahhaa, üles leidsin :))

How prepared is Europe for Pandemic Influenza?
An Analysis of National Plans

koostajaks siis London School of Hygiene and Tropical Medicine

kahjuks ei ole iga konkreetse riigi kohta eraldi kokkuvõtet tehtud :S
igas valdkonnas on riigid jagatud kolme gruppi, ma eesti kohta püüan mingi kokkuvõtte teha :p

ühe valdkonna tooks esile:

* Completeness of essential services planning in country preparedness plans.
Eesti kuulus sellesse gruppi, kel plaan PUUDUS
, koos 6 teise maaga (Austria, Leedu, Poola, Rumeenia, Hispaania, Shveits)
ehk - siseministeeriumi tegemata töö

Essential services
* National contingency plans should be developed and clearly incorporated into plans
* The roles and responsibilities of different government departments should be made obvious

A substantial number of plans (7) do not address the need to prepare for the maintenance of essential services during a pandemic. Only 8 plans note that a contingency plan has been developed for the maintenance of essential services. This lack of clarity may reflect the leading role that the Ministry of Health takes in the process of planning for a pandemic in many countries.

In countries that mention the existence of a contingency plan, the Ministry of Interior or local authorities are generally documented partners in the planning process. In 2 cases, the pandemic response is actually led by the Ministry of Interior or the Emergency Services (France, the Netherlands). A basic (though often incomplete) list of essential personnel is described in 11 of the plans and in 7, replacement personnel are identified to supplement essential workers. These include military and NGO personnel who will support or replace regular personnel in providing essential services or support for confined persons.


Eesti oli keskmisest tugevam järgmistes hinnatud valdkondades:
* Completeness of surveillance in country preparedness plans.
* Completeness of planning for non-medical interventions in country preparedness plans.
* Completeness of health system responses in country preparedness plans.

keskmises grupis:
* Completeness scores of countries’ preparedness plans (un-weighted).
* Completeness of planning and coordination in country preparedness plans.
* Completeness of strategic planning for use of antivirals in country preparedness plans.
* Completeness of communication planning in country preparedness plans.

keskmisest nõrgema kolmandiku hulgas:
* 47 ‘essential’ criteria scores of countries’ preparedness plans.
* Completeness of vaccine strategic planning in country preparedness plans.
* Completeness of operational planning in country preparedness plans.

New Orleansi kogemused

väga huvitav lugemine inimpsühholoogia valdkonnast ..
kuidas käituvad inimesed kriisiolukorras :)
rohutirtsud vs sipelgad :D

Thoughts On Disaster Survival

First Post

I've had over 30 people staying with me since Sunday, evacuating from New Orleans and points south in anticipation of Hurricane Katrina. Only two families were my friends they told other friends of theirs that they knew a place where they could hole up, and so a whole bunch arrived here! I didn't mind, because there were six RV's and travel trailers, so we had enough accommodation. However, I've had the opportunity to see what worked - and what didn't - in their evacuation plans and bug-out kits, and I thought a few "lessons learned" might be appropriate to share here.

1. Have a bug-out kit ready at all times. Many of these folks packed at the last minute, grabbing whatever they thought they'd need. Needless to say, they forgot some important things (prescription medications, important documents, baby formula, diapers, etc.). Some of these things (e.g. prescriptions) obviously can't be stocked up against possible emergency need, but you can at least have a list in your bug-out kit of what to grab at the last minute before you leave!

2. Renew supplies in your bug-out kit on a regular basis. Batteries lose their charge. Foods have an expiration date. So do common medications. Clothes can get moldy or dirty unless properly stored. All of these problems were found with the folks who kept backup or bug-out supplies on hand, and caused difficulties for them.

3. Plan on needing a LOT more supplies than you think. I found myself with over 30 people on hand, many of whom were not well supplied and the stores were swamped with literally thousands of refugees, buying up everything in sight. I had enough supplies to keep myself going for 30 days. Guess what? Those supplies ended up keeping 30-odd people going for two days. I now know that I must plan on providing for not just myself, but others in need. I could have been selfish and said "No, these are mine" - but what good would that do in a real disaster? Someone would just try to take them, and then we'd have all the resulting unpleasantness. Far better to have extra supplies to share with others, whilst keeping your own core reserve intact (and, preferably, hidden from prying eyes!).

4. In a real emergency, forget about last-minute purchases. As I said earlier, the stores were swamped by thousands of refugees, as well as locals buying up last-minute supplies. If I hadn't had my emergency supplies already in store, I would never have been able to buy them at the last minute. If I'd had to hit the road, the situation would have been even worse, as I'd be part of a stream of thousands of refugees, most of whom would be buying (or stealing) what they needed before I got to the store.

5. Make sure your vehicle will carry your essential supplies. Some of the folks who arrived at my place had tried to load up their cars with a humongous amount of stuff, only to find that they didn't have space for themselves! Pets are a particular problem here, as they have to have air and light, and can't be crammed into odd corners. If you have to carry a lot of supplies and a number of people, invest in a small luggage trailer or something similar (or a small travel trailer with space for your goodies) - it'll pay dividends if the S really does HTF.

6. A big bug-out vehicle can be a handicap. Some of the folks arrived here with big pick-ups or SUV's, towing equally large travel trailers. Guess what? - on some evacuation routes, these huge combinations could not navigate corners very well, and/or were so difficult to turn that they ran into things (including other vehicles, which were NOT about to make way in the stress of an evacuation!). This led to hard feelings, harsh words, and at least one fist-fight. It's not a bad idea to have smaller, more maneuverable vehicles, and a smaller travel trailer, so that one can "squeeze through" in a tight traffic situation. Another point a big SUV or pickup burns a lot of fuel. This is bad news when there's no fuel available! (See point 10 below.)

7. Make sure you have a bug-out place handy. I was fortunate in having enough ground (about 1.8 acres) to provide parking for all these RV's and trailers, and to accommodate 11 small children in my living-room so that the adults could get some sleep on Sunday night, after many hours on the road in very heavy, slow-moving traffic. However, if I hadn't had space, I would have unhesitatingly told the extra families to find somewhere else - and there wasn't anywhere else here, that night. Even shops like Wal-Mart and K-Mart had trailers and RV's backed up in their parking lots (which annoyed the heck out of shoppers trying to make last-minute purchases). Even on my property, I had no trailer sewage connections, so I had to tell the occupants that if they used their onboard toilets and showers, they had to drive their RV's and trailers somewhere else to empty their waste tanks. If they hadn't left this morning, they would have joined long, long lines to do this at local trailer parks (some of which were so overloaded by visiting trailers and RV's that they refused to allow passers-by to use their dumping facilities).

8. Provide entertainment for younger children. Some of these families had young children (ranging from 3 months to 11 years). They had DVD's, video games, etc. - but no power available in their trailers to show them! They had no coloring books, toys, etc. to keep the kids occupied. This was a bad mistake.

9. Pack essentials first, then luxuries. Many of these folks had packed mattresses off beds, comforters, cushions, bathrobes, etc. As a result, their vehicles were grossly overloaded, but often lacked real essentials like candles, non-perishable foods, etc. One family (both parents are gourmet cooks) packed eighteen (yes, EIGHTEEN!!!) special pots and pans, which they were going to use on a two-burner camp stove... They were horrified by my suggestion that under the circumstances, a nested stainless-steel camping cookware set would be rather more practical. "What? No omelet pan?" Sheesh...

10. Don't plan on fuel being available en route. A number of my visitors had real problems finding gas to fill up on the road. With thousands of vehicles jammed nose-to-tail on four lanes of interstate, an awful lot of vehicles needed gas. By the time you got to a gas station, you were highly likely to find it sold out - or charging exorbitant prices, because the owners knew you didn't have any choice but to pay what they asked. Much better to leave with a full tank of gas, and enough in spare containers to fill up on the road, if you have to, in order to reach your destination.

11. Have enough money with you for at least two weeks. Many of those who arrived here had very little in cash, relying on check-books and credit cards to fund their purchases. Guess what? Their small banks down in South Louisiana were all off-line, and their balances, credit authorizations, etc. could not be checked - so many shops refused to accept their checks, and insisted on electronic verification before accepting their credit cards. Local banks also refused (initially) to cash checks for them, since they couldn't check the status of their accounts on-line. Eventually (and very grudgingly) local banks began allowing them to cash checks for not more than $50-$100, depending on the bank. Fortunately, I have a reasonable amount of cash available at all times, so I was able to help some of them. I'm now going to increase my cash on hand, I think... Another thing - don't bring only large bills. Many gas stations, convenience stores, etc. won't accept anything larger than a $20 bill. Some of my guests had plenty of $100 bills, but couldn't buy anything.

12. Don't be sure that a disaster will be short-term. My friends have left now, heading south to Baton Rouge. They want to be closer to home for whenever they're allowed to return. Unfortunately for them, the Governor has just announced the mandatory, complete evacuation of New Orleans, and there's no word on when they will be allowed back. It will certainly be several weeks, and it might be several months. During that period, what they have with them - essential documents, clothing, etc. - is all they have. They'll have to find new doctors to renew prescriptions; find a place to live (a FEMA trailer if they're lucky - thousands of families will be lining up for these trailers); some way to earn a living (their jobs are gone with New Orleans, and I don't see their employers paying them for not working when the employers aren't making money either); and so on.

13. Don't rely on government-run shelters if at all possible. Your weapons WILL be confiscated (yes, including pocket-knives, kitchen knives, and Leatherman-type tools); you will be crowded into close proximity with anyone and everyone (including some nice folks, but also including drug addicts, released convicts, gang types, and so on); you will be under the authority of the people running the shelter, who WILL call on law enforcement and military personnel to keep order (including stopping you leaving if you want to); and so on. Much, much better to have a place to go to, a plan to get there, and the supplies you need to do so on your own.

14. Warn your friends not to bring others with them!!! I had told two friends to bring themselves and their families to my home. They, unknown to me, told half-a-dozen other families to come too - "He's a good guy, I'm sure he won't mind!" Well, I did mind... but since the circumstances weren't personally dangerous, I allowed them all to hang around. However, if things had been worse, I would have been very nasty indeed to their friends (and even nastier to them, for inviting others without clearing it with me first!). If you are a place of refuge for your friends, make sure they know that this applies to them ONLY, not their other friends. Similarly, if you have someone willing to offer you refuge, don't presume on his/her hospitality by arriving with others unforewarned.

15. Have account numbers, contact addresses and telephone numbers for all important persons and institutions. My friends will now have to get new postal addresses, and will have to notify others of this their doctors, insurance companies (medical, personal, vehicle and property), bank(s), credit card issuer(s), utility supplier(s), telephone supplier(s), etc. Basically, anyone who sends you bills, or to whom you owe money, or who might owe you money. None of my friends brought all this information with them. Now, when they need to change postal addresses for correspondence, insurance claims, etc., how can they do this when they don't know their account numbers, what number to call, who and where to write, etc.?

16. Have portable weapons and ammo ready to hand. Only two of my friends were armed, and one of them had only a handgun. The other had a handgun for himself, another for his wife, a shotgun, and an evil black rifle - MUCH better! I was asked by some of the other families, who'd seen TV reports of looting back in New Orleans, to lend them firearms. I refused, as they'd never handled guns before, and thus would have been more of a danger to themselves and other innocent persons than to looters. If they'd stayed a couple of days, so that I could teach them the basics, that would have been different but they wouldn't, so I didn't. Another thing - you don't have to take your entire arsenal along. Firearms for personal defense come first, then firearms for life support through hunting (and don't forget the skinning knife!). A fishing outfit might not be a bad idea either (you can shoot bait! ). Other than that, leave the rest of your guns in the safe (you do have a gun safe, securely bolted to the floor, don't you?), and the bulk ammo supplies too. Bring enough ammo to keep you secure, but no more. If you really need bulk supplies of guns and ammo, they should be waiting for you at your bug-out location, not occupying space (and taking up a heck of a lot of weight!) in your vehicle. (For those bugging out in my direction, ammo supply will NOT be a problem... )

Second Post

Here are some more ideas.

1. Route selection is very, very important. My friends (and their friends) basically looked at the map, found the shortest route to me (I-10 to Baton Rouge and Lafayette, then up I-49 to Alexandria), and followed it slavishly. This was a VERY bad idea, as something over half-a-million other folks had the same route in mind... Some of them took over twelve hours for what is usually a four-hour journey. If they'd used their heads, they would have seen (and heard, from radio reports) that going North up I-55 to Mississippi would have been much faster. There was less traffic on this route, and they could have turned left and hit Natchez, MS, and then cut across LA on Route 84.

This would have taken them no more than five or six hours, even with the heavier evacuation traffic. Lesson think outside the box, and don't assume that the shortest route on the map in terms of distance will also be the shortest route in terms of time.

2. The social implications of a disaster situation. Feedback from my contacts in the LSP and other agencies is very worrying. They keep harping on the fact that the "underclass" that's doing all the looting is almost exclusively Black and inner-city in composition. The remarks they're reporting include such statements as "I'm ENTITLED to this stuff!", "This is payback time for all Whitey's done to us", and "This is reparations for slavery!". Also, they're blaming the present confused disaster-relief situation on racism "Fo sho, if Whitey wuz sittin' here in tha Dome waitin' for help, no way would he be waitin' like we is!" No, I'm not making up these comments... they are as reported by my buddies. This worries me very much. If we have such a divide in consciousness among our city residents, then when we hit a SHTF situation, we're likely to be accused of racism, paternalism, oppression, and all sorts of other crimes just because we want to preserve law and order. If we, as individuals and families, provide for our own needs in emergency, and won't share with others (whether they're of another race or not) because we don't have enough to go round, we're likely to be accused of racism rather than pragmatism, and taking things from us can (and probably will) be justified as "Whitey getting his just desserts". I'm absolutely not a racist, but the racial implications of the present situation are of great concern to me. The likes of Jesse Jackson, Al Sharpton, and the "reparations for slavery" brigade appear to have so polarized inner-city opinion that these folks are (IMHO) no longer capable of rational thought concerning such issues as looting, disaster relief, etc.

3. Implications for security. If one has successfully negotiated the danger zone, one will be in an environment filled, to a greater or lesser extent, with other evacuees. How many of them will have provided for their needs? How many of them will rely on obtaining from others the things they need? In the absence of immediate State or relief-agency assistance, how many of them will feel "entitled" to obtain these necessities any way they have to, up to and including looting, murder and mayhem? Large gathering-places for refugees suddenly look rather less desirable... and being on one's own, or in an isolated spot with one's family, also looks less secure. One has to sleep sometime, and while one sleeps, one is vulnerable. Even one's spouse and children might not be enough... there are always going to be vulnerabilities. One can hardly remain consciously in Condition Yellow while bathing children, or making love! A team approach might be a viable solution here - see point 6 below.

4. Too many chiefs, not enough Indians" in New Orleans at the moment. The mayor has already blown his top about the levee breach: he claims that he had a plan in place to fix it by yesterday evening, but was overruled by Baton Rouge, who sent in others to do something different. This may or may not be true... My LSP buddies tell me that they're getting conflicting assignments and/or requests from different organizations and individuals. One will send out a group to check a particular area for survivors but when they get there, they find no-one, and later learn that another group has already checked and cleared the area. Unfortunately, in the absence of centralized command and control, the information is not being shared amongst all recovery teams. Also, there's alleged to be conflict between City officials and State functionaries, with both sides claiming to be "running things" and some individuals in the Red Cross, FEMA, and other groups appear to be refusing to take instructions from either side, instead (it's claimed) wanting to run their own shows. This is allegedly producing catastrophic confusion and duplication of effort, and may even be making the loss of life worse, in that some areas in need of rescuers aren't getting them. (I don't know if the same problems are occurring in Mississippi and/or Alabama, but I wouldn't be surprised if they were.) All of this is unofficial and off-the-record, but it doesn't surprise me to hear it. Moral of the story if you want to survive, don't rely on the government or any government agency (or private relief organization, for that matter) to save you. Your survival is in your own hands - don't drop it!

5. Long-term vision. This appears to be sadly lacking at present. Everyone is focused on the immediate, short-term objective of rescuing survivors. However, there are monumental problems looming, that need immediate attention, but don't seem to be getting it right now. For example: the Port of Louisiana is the fifth-largest in the world, and vital to the economy, but the Coast Guard is saying (on TV) that they won't be able to get it up and running for three to six months, because their primary focus is on search and rescue, and thereafter, disaster relief. Why isn't the Coast Guard pulled off that job now, and put to work right away on something this critical? There are enough Navy, Marine and Air Force units available now to take over rescue missions.

Another example there are over a million refugees from the Greater New Orleans area floating around. They need accommodation and food, sure but most of them are now unemployed, and won't have any income at all for the next six to twelve months. There aren't nearly enough jobs available in this area to absorb this workforce. What is being done to find work for them, even in states remote from the problem areas? The Government for sure won't provide enough for them in emergency aid to be able to pay their bills. What about mortgages on properties that are now underwater? The occupants both can't and won't pay; the mortgage holders will demand payment; and we could end up with massive foreclosures on property that is worthless, leaving a lot of folks neck-deep in debt and without homes (even damaged ones). What is being done to plan for this, and alleviate the problem as much as possible? I would have thought that the State government would have had at least the skeleton of an emergency plan for these sorts of things, and that FEMA would have the same, but this doesn't seem to be the case. Why weren't these things considered in the leisurely days pre-disaster, instead of erupting as immediate and unanswered needs post-disaster?

6. Personal emergency planning. This leads me to consider my own emergency planning. I've planned to cover an evacuation need, and could probably survive with relative ease for between two weeks and one month but what if I had been caught up in this mess? What would I do about earning a living, paying mortgages, etc.? If I can't rely on the State, I for darn sure had better be able to rely on myself! I certainly need to re-examine my insurance policies, to ensure that if disaster strikes, my mortgage, major loans, etc. will be paid off (or that I will receive enough money to do this myself). I also need to provide for my physical security, and must ensure that I have supplies, skills and knowledge that will be "marketable" in exchange for hard currency in a post-disaster situation. The idea of a "team" of friends with (or to) whom to bug out, survive, etc. is looking better and better. Some of the team could take on the task of keeping a home maintained (even a camp-type facility), looking after kids, providing base security, etc. Others could be foraging for supplies, trading, etc. Still others could be earning a living for the whole team with their skills. In this way, we'd all contribute to our mutual survival and security in the medium to long term. Life might be a lot less comfortable than prior to the disaster, but hey - we'd still have a life! This bears thinking about, and I might just have to start building "team relationships" with nearby Ravens!

7. The "bank problem." This bears consideration. I was at my bank this morning, depositing checks I'd been given by my visitors in exchange for cash. The teller warned me bluntly that it might be weeks before these checks could be credited to my account, as there was no way to clear them with their issuing banks, which were now under water and/or without communications facilities. He also told me that there had been an endless stream of folks trying to cash checks on South Louisiana banks, without success. He warned me that some of these local banks will almost certainly fail, as they don't have a single branch above water, and the customers and businesses they served are also gone - so checks drawn on them will eventually prove worthless. Even some major regional banks had run their Louisiana "hub" out of New Orleans, and now couldn't access their records. I think it might be a good idea to have a "bug-out bank account" with a national bank, so that funds should be available anywhere they have a branch, rather than keeping all one's money in a single bank (particularly a local one) or credit union. This is, of course, over and above one's "bug-out stash" of ready cash.

8. Helping one's friends is likely to prove expensive. I estimate that I'm out over $1,000 at the moment, partly from having all my supplies consumed, and partly from making cash available to friends who couldn't cash their checks. I may or may not get some of this back in due course. I don't mind it - if I were in a similar fix, I hope I could lean on my friends for help in the same way, after all! - but I hadn't made allowance for it. I shall have to do so in future, as well as planning to contribute to costs incurred by those who offer me hospitality under similar circumstances.


Third Post

Over the course of today I've heard back from several of our field reps who were in the hurricane-damaged areas from Wednesday through Sunday, and have also picked up on after-action reports from my contacts in the Louisiana State Police, and, through them, some from the Mississippi State Police. This e-mail summarizes experiences and lessons learned.

1. People who were prepared were frequently mobbed/threatened by those who weren't. This was reported in at least seven incidents, five in Mississippi, two in Louisiana (I suspect that the relative lack of Louisiana incidents was because most of those with any sense got out of Dodge before the storm hit). In each case, the person/family concerned had made preparations for disaster, with supplies, shelter, etc. in good order and ready to go. Several had generators ready and waiting. However, their neighbors who had not prepared all came running after the disaster, wanting food, water and shelter from them. When the prepared families refused, on the grounds that they had very little, and that only enough for themselves, there were many incidents of aggression, attempted assault, and theft of their supplies. Some had to use weapons to deter attack, and in some cases, shots were fired. I understand that in two incidents, attackers/would-be thieves were shot. It's also reported that in all of these cases, the prepared families now face threats of retribution from their neighbors, who regarded their refusal to share as an act of selfishness and/or aggression, and are now threatening retaliation. It's reportedly so bad that most of the prepared families are considering moving to other neighborhoods so as to start afresh, with different neighbors.

Similar incidents are reported by families who got out in time, prepared to spend several days on their own. When they stopped to eat a picnic meal at a rest stop, or an isolated spot along the highway, they report being approached rather aggressively by others wanting food, or fuel, or other essentials. Sometimes they had to be rather aggressive in their turn to deter these insistent requests. Two families report attempts being made to steal their belongings (in one case, their vehicle) while over-nighting in camp stops on their way out of the area. They both instituted armed patrols, with one or more family members patrolling while the others slept, to prevent this. Seems to me to be a good argument to form a "bug-out team" with like-minded, security-conscious friends in your area, so that all concerned can provide mutual security and back-up.

My take I can understand these families being unwilling to share the little they had, particularly in light of not knowing when supplies would once again be available. However, this reinforces the point I made in my "lessons learned" post last week plan on needing much more in the way of supplies than you initially thought! If these families had had some extra food and water in stock, and hidden their main reserve where it would not be seen, they could have given out some help to their neighbors and preserved good relations. Also, a generator, under such circumstances, is a noisy (and bright, if powering your interior lights) invitation saying "This house has supplies - come and get them". I suspect that kerosene lanterns, candles and flashlights might be a more "community-safe" option if one is surrounded by survivors.

2. When help gets there, you may get it whether you like it or not. There are numerous reports of aggressive, overbearing behavior by those rescuers who first arrived at disaster scenes. It's perhaps best described as "I'm here to rescue you - I'm in charge - do as I say - if you don't I'll shoot you". It appears that mid-level State functionaries and Red Cross personnel (the latter without the "shoot you" aspect, of course) were complained about most often. In one incident, a family who had prepared and survived quite well were ordered, not invited, to get onto a truck, with only the clothes on their backs. When they objected, they were threatened. They had pets, and wanted to know what would happen to them and they report that a uniformed man (agency unknown) began pointing his rifle at the pets with the words "I'll fix that". The husband then trained his own shotgun on the man and explained to him, in words of approximately one syllable, what was going to happen to him if he fired a shot. The whole "rescuer" group then left, threatening dire consequences for the family (including threats to come back once they'd evacuated and torch their home). The family were able to make contact with a State Police patrol and report the incident, and are now determined that no matter how much pressure is applied, they will not evacuate. They've set up a "shuttle run" so that every few days, two of them go upstate to collect supplies for the rest of the family, who defend the homestead in the meantime.

Another aspect of this is that self-sufficient, responsible families were often regarded almost with suspicion by rescuers. The latter seemed to believe that if you'd come through the disaster better than your neighbors, it could only have been because you stole what you needed, or somehow gained some sort of unfair advantage over the "average victims" in your area. I'm at a loss to explain this, but it's probably worth keeping in mind.

3. There seems to be a cumulative psychological effect upon survivors. This is clear even - or perhaps particularly - in those who were prepared for a disaster. During and immediately after the disaster, these folks were at their best, dealing with damage, setting up alternative accommodation, light, food sources, etc. However, after a few days in the heat and debris (perhaps worst of all being the smell of dead bodies nearby), many found their ability to remain positive and "upbeat" being strained to the limit. There are numerous reports of individuals becoming depressed, morose and withdrawn. This seemed to happen to even the strongest personalities. The arrival of rescuers provided a temporary boost, but once evacuated, a sort of "after-action shell-shock" seems to be commonly experienced. I don't know enough about this to comment further, but I suspect that staying in place has a lot to do with it - there is no challenge to keep moving, find one's survival needs, and care for the group, and one is surrounded by vivid reminders of the devastation. By staying among the ruins of one's former life, one may be exposing oneself to a greater risk of psychological deterioration. Do other List members have any experience of, or theories about, this problem?

4. There is widespread frustration over the lack of communication and empathy by rescuers and local/State government. This is partly due to the absence of electricity, so that TV's were not available to follow events as they unfolded but it's also due to an almost deliberate policy of non-communication by rescuers. There are many accounts of evacuees wanting to know where the bus or plane was going that they were about to board, only to be told "We don't know", or "To a better place than this". Some have found themselves many States away from their homes. Other families were arbitrarily separated upon rescue and/or evacuation, and are still scattered across two or three States. Their efforts to locate each other are very difficult, and when they request to be reunited at a common location, all of those with whom I have contact report a blanket refusal by the Red Cross and State officials to even consider the matter at this time. They're being informed that it will be "looked into" at some future date, and that they may have to pay the costs involved if they want to join up again. This, to families who are now destitute! I'm very angry about this, but it's so widespread a problem that I don't know what can be done about it. I hope that in future, some means will be implemented to prevent it happening again. Lesson learned never, EVER allow yourselves to be separated as a family, even if it means waiting for later rescue and/or evacuation. Insist on this at all costs!

5. Expect rescuers (including law enforcement) to enforce a distinctly un-Constitutional authority in a disaster situation. This is very widely reported, and is very troubling. I hear repeated reports from numerous States that as evacuees arrive at refugee centers, they and their belongings are searched without Constitutional authority, and any personal belongings seen as potentially suspicious (including firearms, prescription medication, etc.) are confiscated without recourse to the owner. I can understand the point of view of the receiving authorities, but they are acting illegally, and I suspect there will be lawsuits coming from this practice. Another common practice reported on the ground in the disaster areas is for people to be ordered to evacuate, irrespective of their needs and wishes - even those folks who were well-prepared and have survived in good shape. If they demur, they are often threatened and bullied in an attempt to make them abandon their homes, pets, etc. Lesson learned in a disaster, don't expect legal and Constitutional norms to be followed. If you can make it on your own, do so, without relying on an unsympathetic and occasionally overbearing rescue system to control you and your destiny.

6. Don't believe that rescuers are all knights in shining armor who will respect your property. There have been numerous reports of rescuers casually appropriating small items that took their fancy in houses they were searching. Sometimes this was blatant, right in front of onlookers, and when protests were made, the response was either threatening, or a casual "Who's going to miss it now?". Some of our field agents report that this happened right in front of their eyes. Another aspect of this is damage caused to buildings by rescuers. I've had reports of them kicking in the front door to a house, or a window, instead of trying to obtain access with as little damage as possible; climbing on clean, highly-polished tables with hobnailed boots in order to get at an attic hatch to check for survivors; etc. When they left the house, often the door or window was left open, almost a standing invitation to looters, instead of being closed and/or secured. When the families concerned get home, they won't know who caused this damage, but they will certainly be angered by it. I think that if one evacuates one's home, it might be a good idea to leave a clearly-visible notice that all residents have evacuated, so as to let would-be rescuers know that this house is empty. On the other hand, this might make it easier for looters, so what you gain on the swings, you lose on the round-abouts...


Fourth Post

This will be about broader issues than just bug-out or threat situations. Over the past couple of weeks, I've been watching closely as the whole evacuation and rescue drama has played out, and have been very active in the relief process, learning all I can for future reference. There are some broader issues that might not come to mind at first thought, but which are directly relevant to our own safety, security, and peaceful possession of our homes. Some of these have been mentioned in earlier e-mails, but they bear repeating in the light of the number of incidents of which I've heard.

1. If you choose to help, you may be sucked into a bureaucratic and legal nightmare. Example: a local church in the beginning stages of the crisis offered its hall to house evacuees. Local and State officials promptly filled it up with over 100 people. Their "social skills" proved extremely difficult to live with... toilets were blocked, restrooms left filthy, graffiti were scrawled and/or carved on the walls, arguments and disputes were frequent (often escalating to screaming matches, sometimes to physical violence), evacuees roamed the neighborhood (leading to all sorts of reports of petty theft, vandalism, etc.), church workers were subject to aggressive begging and demands, etc. Requests to the authorities to provide better security, administrative assistance, etc. apparently fell on deaf ears - the crisis was so widespread and overwhelming that a small facility such as this seems to have been very low on the priority checklist. After two days of this, with complaints from the neighbors becoming more and more insistent, the church informed local officials that it wanted the evacuees removed at once, if not sooner. They were promptly subject to bureaucratic heavy-handedness (including threats to withhold previously-promised reimbursement for their expenses); threats of lawsuits for daring to insinuate that the evacuees were somehow "lower-class" in their conduct, and for alleged racism, slander, and general political incorrectness; and threats of negative publicity, in that officials threatened to put out a press release denouncing the church for its "elitist" and "un-co-operative" attitude in a time of crisis. The church initially caved in to this pressure, and allowed the evacuees to stay but within a couple more days, the pressure from neighbors and from its own members became impossible to bear, and they insisted on the evacuees being removed to a Red Cross shelter. I'm informed that repairs to their hall will cost over $10,000. This is only one example among many I could cite, but it makes the point clear - if you offer your facilities to authorities, you place yourself (to a certain extent) under their control, and you're potentially liable to a great deal of heavy-handed, insensitive bureaucratic bullying. Those of you in the same position as this church (i.e. with facilities you could make available) might wish to take note.

2. Law enforcement problems will often be "glossed over" and/or ignored by authorities. In many cities housing evacuees, there have been private reports of a significant increase in crime caused by their presence but you'll find that virtually all law enforcement authorities publicly deny this and/or gloss over it as a "temporary problem". This is all very well for publicity, but it ignores the increased risk to local residents. I've been tracking crime reports in about a dozen cities, through my contacts with local law enforcement and the Louisiana State Police. All the LEO's I speak with, without exception, tell me of greatly increased crime, including rape, assault, robbery, shoplifting, vandalism, gang activity, etc. However, you won't see these reports in the news media, and will often see senior LE figures actively denying it. The officers with whom I speak are angry and bitter about this, but they daren't "go public", as their jobs would be on the line if they did so. They tell me that often they're instructed not to report certain categories of "incident" at all, so as not to "skew" or "inflate" the "official" crime figures. I've also heard reports from Texas, Alabama and Tennessee of brand-new high-end motor vehicles (e.g. Cadillacs, Lincolns, BMW's, etc.) with New Orleans dealer tags being driven through various towns, on their way North and West. The drivers were described as "gang-bangers" (and sundry less complimentary terms). However, there have been no reports of stolen vehicles from New Orleans, because there are no workers to check out dealer lots, or report thefts, and no working computers to enter VIN's, etc. into the NICS database of stolen vehicles - so officers have had no choice but to let these vehicles proceed. Draw your own conclusions.

3. Your personal and/or corporate supplies and facilities may be commandeered without warning, receipt or compensation. I've had numerous reports from in and near the disaster zone of individuals (e.g. boat-owners, farmers with barns, tractors, etc.) and corporate groups (e.g. companies with heavy equipment, churches with halls, etc.) finding an official on their doorstep demanding the use of their facilities or equipment. If they demurred, they were told that this was an "emergency situation" and that their assistance was being required, not requested. Some of them have lost track of the heavy equipment "borrowed" in this way, and don't know where it is, whether or not it's still in good condition, and when (if ever) it will be returned - and in the meantime, they can't continue their normal operations without this equipment. Others have had their land and facilities effectively confiscated for use by rescue and relief workers, storage of supplies, etc. In some cases, in the absence of their owners, the property of the individuals and groups concerned (e.g. farm gasoline and diesel supplies, the inventory of motor vehicle dealers, suppliers of foodstuffs, tarpaulins, etc.) have been commandeered and used by law enforcement and relief workers, without permission, receipts, reimbursement, etc. Protests have been met with denials, threats of arrest, insinuations of being "uncaring" and "un-co-operative", etc. Lesson learned if you've got what officials need in a time of crisis, forget about Constitutional protections of your property! Sure, you can sue after the fact, but if you need your goods and facilities for your own survival, you're basically SOL. Those of us who stockpile necessities for potential crises like this might want to consider concealing our stockpiles to prevent confiscation and if you need certain equipment for your own day-to-day use (e.g. tractors for farmers, generators, etc.), you might have a hard time retaining possession of these things. This problem applies to relief workers also I've had several reports of private relief workers (e.g. those sent in by churches, etc.) having their vehicles and supplies commandeered by "official" relief workers, without compensation or receipt, and being kicked out of the disaster area with warnings not to return. The fact that the "private" workers were accomplishing rather more than the "official" workers was apparently of no importance.

4. If you look like you know what you're doing, you may be a target of those less prepared. There have been many, many reports of individuals who were more or less prepared for a disaster being preyed upon by those who were not prepared. Incidents range from theft of supplies, through attempts to bug out with these persons (uninvited), to actual violence. It's genuinely frightening to hear about these incidents, particularly the attitude of those trying to prey on the prepared they seemed to feel that because you'd taken steps to protect yourself and your loved ones, you had somehow done so at their expense, and they were therefore "entitled" to take from you what they needed. There's no logical explanation for this attitude, unless it's bred by the utter dependence of many such people on the State for welfare, Social Security, Medicare/Medicaid, etc. Since they've always been dependent on others, and regarded this as an "entitlement", in a disaster situation, they seem to automatically assume that they're "entitled" to what you've got! In one case, the family's pet dog was held hostage, with a knife at its throat, until the family handed over money and supplies. In two cases, families were threatened with the rape of their women unless they co-operated with the aggressors. In four cases that I know of, children were held hostage to ensure co-operation. There have also been reports of crimes during the bug-out process. Families sleeping in their cars at highway rest areas were a favorite target, including siphoning of gas from their tanks, assaults, etc. The lessons to be learned from this are obvious. One family can't secure itself against these threats without great difficulty. It's best to be "teamed up" with neighbors to secure your neighborhood as a whole, rather than be the one house with facilities in an area filled with those less prepared. If you're in the latter situation, staying put may not be a safe option, and a bug-out plan may be vital. When bugging out, you're still not safe from harm, and must maintain constant vigilance.

5. Those who thought themselves safe from the disaster were often not safe from refugees. There have been many reports of smaller towns, farms, etc. on the fringe of the disaster area being overrun with those seeking assistance. In many cases, assistance was demanded rather than requested, and theft, looting and vandalism have been reported. So, even if you think you're safe from the disaster, you may not be safe from its aftermath.

6. Self-reliance seems to draw suspicion upon you from the authorities. I've mentioned this in a previous e-mail, but I've had many more reports of it from those who survived or bugged out, and it bears re-emphasizing. For reasons unknown and unfathomable, rescue authorities seem to regard with suspicion those who've made provision for their safety and have survived (or bugged out) in good shape. It seems to be a combination of "How could you cope when so many others haven't?", "You must have taken advantage of others to be so well off", and "We've come all this way to help, so how dare you not need our assistance?" I have no idea why this should be the case... but there have been enough reports of it that it seems to be a widespread problem. Any ideas from readers?

7. Relief workers from other regions and States often don't know local laws. This is a particular problem when it comes to firearms. I've had many reports of law enforcement officers sent to assist in Louisiana from States such as New Jersey, California, etc. trying to confiscate firearms on the streets, etc., when in fact the armed citizens were legally armed, under local law. One can't reason with these officers in the heat of the moment, of course, and as a result, a number of people lost their firearms, and have still not recovered them (and in the chaos of the immediate post-disaster situation, they may never do so, because I'm not sure that normal procedures such as logging these guns into a property office, etc. were followed). I understand that in due course, steps were taken to include at least one local law enforcement officer in patrols, so that he could advise officers from other areas as to what was legal, and what wasn't. Also, in Louisiana, law enforcement is conducted differently than in some other States, and officers from other States who came to assist were sometimes found to be domineering and aggressive in enforcing a law enforcement "authority" that doesn't normally apply here. So, if you're in a disaster area and help arrives from elsewhere, you may find that the help doesn't know (or care) about local laws, norms, etc. Use caution!

8. Relief organizations have their own bureaucratic requirements that may conflict with your needs. A good example is the Red Cross. In many cases, across three States, I've had reports that locals who needed assistance were told that they had to register at a particular Red Cross shelter or facility. The help would not come to them they had to go to it. If they wished to stay on their own property, they were sometimes denied assistance, and told that if they wanted help, they had to move into the shelter to get it. Also, assistance was often provided only to those who came in person. If you left your family at home and went to get food aid, you might be denied aid for your whole family because there was no evidence that they existed - only the number that could be physically counted by relief workers (who would not come to you, but insisted you come to them) would be provided with food. Needless to say, this caused much anger and resentment.

I hope that these "lessons learned" are of use to you. I'm more and more convinced that in the event of a disaster, I must rely on myself, and a few friends, and never count on Government or relief organizations for the help I'll need. Also, I'm determined to bug out for a fairly long distance from a disaster in my home area, so as to be clear of the post-disaster complications that may arise. Once again (as it has countless times throughout history), we see that to rely on others (let alone Government) for your own safety and security is to invite complications at best, disaster at worst.


A short update (2006-04-25) in response to some questions I received about his being paid back for his expenses. My friend replies.

"No, some of the checks never did clear, but those who gave them to me sent money via other means to replace them. I ended up being "out" about $500, but as I said in the posts, I didn't mind too much - I considered it my own contribution to disaster relief.

"I had several chats with my friends about not bringing others along. One was OK with this, and apologized. The other thinks I'm a bit anal-retentive and unsympathetic. I've assured him that that's true!

"No, I've not had offers to send money to update my preparations, but then I wasn't looking for any, so that's fine."


väga hea vaatenurk muide :)
ja kindlustustegelasi tasub riskide osas kuulata küll

Think the worst - then prepare for it
(Filed: 17/04/2006)

The chief of the world's largest insurance broker tells Andrew Cave about his fears of an infodemic

The world feels increasingly risky to Michael Cherkasky. The chief executive of the world's largest insurance broker, Marsh & McLennan, is convinced that it will be afflicted by a global pandemic within the next decade.

"I have been told by a series of virologists at some of the world's great institutions that a pandemic is something that's likely to occur, just because of the nature of our transportation and communications," he declares. "That's what we have to make sure we prepare for."

Cherkasky, 56, doesn't believe that pandemic will be avian flu but is worried about what he calls an "infodemic".

"Sars," he says, "on a conservative estimate, killed fewer than 1,000 people but cost $40bn. Traditional flu killed 100 times as many people that year.

"Can you imagine what would happen in London if two or three children died from avian flu and it was on the headlines? What do you think the reaction would be, even though we know that every day children die of a different kind of influenza?

"We have to understand that information and sometimes exaggerated information is going to spread very rapidly. And our institutions have to be able to cope with that?"
Cherkasky sees risk everywhere. "Because of the incredible rapidity of communications, the rapidity and cheapness of transportation and information exchange, the just- in-time manufacturing, the outsourcing and offshoring," he cries, "we're interconnected with communities and cultures and societies as never before and the pace of change is phenomenal.

"If there were to be a monetary crisis in Thailand, it would have repercussions in London and New York. If there was a labour strike or disruption in China, it would have implications throughout the globe.

"There's strategic risk in India and China; phenomenal strategic risks for governments, for communities, for business. What are the implications of offshoring to Asia if there is political disruption?

"I hate to say it but because of just-in-time, a single bridge closure across the Canadian-US border for three days after 9/11 started to disrupt car production in the US because parts couldn't move across that bridge; a single bridge.

"There are those kinds of risks today because we're trying to do things efficiently. Our efficiency at times, if we so consolidate things, can be a risk factor in itself."

Gosh! It's a wonder Cherkasky ever goes out of his New York house, let alone jets over to London to oversee Marsh & McLennan's 8,000 UK staff. Doesn't he worry about all this stuff?

He laughs. "You know, the advice that I give clients, I take myself," he confides. "Three million people died last year from smoking. 250,000 people worldwide died from automobile accidents. Less than 5,000 people in the last five years have died from terrorism, excluding Iraq.

"My advice is get in your car, do up your seatbelt, don't smoke and go about your business because that's really all you can do.

"Do I in my briefcase carry a flashlight? Do I carry certain pills? I do. Do I account to my children about certain aspects of travel? I do. Do I have a service that provides me with travel updates on my blackberry, an alerting system? I do. I feed in my itinerary and if there are any warnings, ranging from a spike in crime to a labour unrest situation or an intense weather story where I'm going to be travelling, it gives me an alert.

"At home, do I have a backup generator? I do but, having said that, overwhelmingly I go about and live my life." What did his gadget warn him about when coming to London? "The only thing was there were some air traffic issues in France." Did it make him feel safe? "It did," he laughs. "I take the trains, I take the Tube. I went for a run this morning. I felt fine."

Well that's a relief. Of course, Cherkasky feels that Marsh & McLennan, spanning the Marsh insurance brokerage, reinsurance specialists Guy Carpenter, reinsurance broker, human resources consultancy Mercer, money manager Putnam Investments and corporate investigators Kroll, is best-placed to advise the world's corporations how to deal with all this risk.

"We can help companies assess, quantify, and mitigate these risks and if need be we can help transfer those risks by using insurance," he says. "There's no company that can do all the things we can do.

"From A to Z, we're the company that can best react to crisis and we can also help you prepare for that crisis, whether it be avian flu, or the next terrible global warming event or something that's extraordinary like terrorism."

"The well-run company understands that they have worked hard for what they have and now they have to plan to keep it by doing all kinds of contingency planning. Something's gonna happen.

"Do I think we're going to have all kinds of sub-committees and government meetings saying: 'why weren't we prepared'? I will tell you that as certain as the day follows the night, that's what's going to happen. People will start to scream: 'Why weren't we prepared. Why didn't we see it coming?'

dieetõe soovitused 2 ndl toiduvarudeks

tähendab, muidu, nojah, aga mind häiris lõpus olnud väide et "see toit jääb söömata"
miks siis? osta tuleb sääraseid asju, mida niikuinii tarbid - ja neid siis regulaarselt ära süüa/uuematega asendada ..
või kasutada võimalust heategevuseks - iga 3a tagant konservid koerte varjupaigale annetada ja uued osta :D
ära ei pea nüüd küll midagi viskama, see on otsene rumalus :(

Government Recommends Shopping For Bird Flu
4/25/2006 8:03:23 AM

The U.S. government says we all should be well prepared personally in the event of a bird flu outbreak among humans. In fact, it says to have at least a two week stockpile in our homes of food and water.

But what does that mean?

First off, there’s no sign at all that it’s here... yet.

And there’s a question of whether the bird flu will ever truly mutate into a virus that goes from person to person.

Still, the government says buy a whole lot of tuna and other non-perishables to hold your family for a while.

Sarah Yakubov, who has four kids, says, “The government says a lot of things. I don’t have space for all that food.”

So, maybe not all of us are gung-ho about the idea, but we still wondered, what does it mean to store at least a two week supply for a family of four?

To make sure we got the right stuff, we asked registered dietician Amy Fleishman of Mt. Sinai Medical Center to take us shopping at B.J.’s.

First into the cart: dried fruit.

“Good source of calories not really a good source of protein, but something to have on hand if you want to stockpile something for a disaster,” says Amy.

We also bought beef jerky! “This lasts a long time and it’s high in protein this would be a good thing to store,” Amy states.

Amy says given that protein and carbohydrates have the same number of calories per gram—four—the focus is more on the protein, because she points out, “The protein is important for the muscles. It can be canned tuna canned chicken canned salmon canned protein is a good source it’s compact and moderately priced.”

“These canned beans can be a good source as well. It’s fairly cheap,” she adds.

Soup was a big choice. “Maybe we’ll get some vegetables in there.”

And surprisingly, so was high grain pasta! ““If you have one serving or less you’re going to get 200 calories and ten grams of protein.”

And at 5.59 per huge container with 32 servings, “It’s a good bang for your buck.”

Add the screw top sauce and we were all set.

We also got two big cans of peanuts, two big boxes of crackers, oatmeal for breakfast, canned fruit, some apple juice and sports drinks in large plastic containers, tang powder to add to the water, so the kids get more nutrients and don’t get bored with plain old h2o.

But the most important thing of all—water-is actually the biggest problem. We only put one box on the line because of size and weight; for a family of four, you need ten!”

Overall you need a gallon of water per person per day: two quarts per person per day for foot preparation and cleanliness, another two for drinking.

Other pointers:
Don’t forget the plastic and paper utensils and plates and the can opener.
Avoid caffeinated beverages--they dehydrate.
And, avoid salty food as much as possible; it makes you thirstier.

When all was said and done, the total: $287.70. Not a lot for two weeks, but that’s two weeks of food that might never get eaten.

Zulay Urbistonvo who was shopping that day, remarked, “I feel sorry for people who don’t have the money.”

25. aprill 2006



22. aprill 2006

IMF värske prognoos pandeemia mõjust majandusele

Appendix 1.2. The Global Implications of an Avian Flu Pandemic (pdf, lk.64)

pikk jutt, kopeerida ei viitsi, aga asjalik ja ratsionaalne tekst :)

juhend ettevõtetele ja kodanikele

ühe ettevõtte tehtud pandeemiaplaan omale ja oma töötajatele

hästi ratsionaalne, selge, konkreetne .. üks paremaid, mida ma näinud olen igatahes :)


Personal Protection and Home Management
This section provides practical advice for routine behaviors in day-to-day life. The information contained here will educate you and your family on the best way to protect yourself from contracting diseases such as colds and flu, which are transmitted through casual contact. Many of the recommendations can be implemented immediately, and some are meant to be used in the worst case scenario of an avian influenza pandemic outbreak.

Protecting Microbix Employees
Microbix is taking a proactive approach to prevent the spread of influenza in the workplace and to protect its employees and their families against flu at home and in public places. This document is based on common sense, which is often overlooked due to habitual behavior.

By developing this policy Microbix is providing its employees with information they can use to reduce their exposure to the flu. In addition the plan advises them to be prepared for possible extended periods of interruption of access to goods and services generally taken for granted, such as grocery items, supply of electricity, water etc, due to illness, layoffs or fear.

No one can predict the response of the general public during an outbreak so we are preparing for a worst-case scenario.

loe edasi lingi alt:

Protect yourself and your family
Examples of Day-to-Day High Risk Behavior and Steps You Can Take to Mitigate Your Risk of Infection
Microbix Pandemic Response ToolKit
Managing Our Business

20. aprill 2006

EL riikide pandeemiaplaanide analüüs

hahaaa, see on küll hea lugu :)
kannatamatusega ootan raporti avaldamist ja luban eesti osa ära tõlkida :DDD

"ühel EL liikmesriigil oli antiviraalide tagavara nii pisike nagu 2%" .. see saab ainult eesti olla :D
kuigi 3000 karpi on 0,2%, mitte 2% :DDD

Wall Street Journal: Study Finds Europe Bird-Flu Defenses Vary Widely
April 13, 2006

A study slated to be published in a prominent medical journal has found wide variations in the plans European countries have drawn up for a possible bird-flu pandemic among humans, raising politically sensitive questions for some governments.

Of 21 national plans examined, seven don't mention the role of veterinary services, many don't include a strategy for containing an original outbreak and fewer than half address how to maintain essential services in the event of a pandemic, according to the study, by the London School of Hygiene and Tropical Medicine.

Titled "How Prepared Is Europe for Pandemic Influenza?" the study is due to be published in a coming issue of the Lancet. A draft dated February 2006 was reviewed by The Wall Street Journal. The study's methodology has already attracted criticism, and there may be changes in the published version. The report's authors declined to provide the most recent version before publication.

The authors, Sandra Mounier-Jack and Richard Coker, tested the national plans against 169 criteria laid out by the World Health Organization, including how antiviral drugs and vaccines would be distributed and to whom they would be given and whether restrictions would be placed on international travel.

The study scores countries according to how many of the WHO criteria their plans include. Overall country scores in the draft range from more than 80% to under 30%, with a European average of 54%. France, the Netherlands, the United Kingdom and Germany top the list, while Italy, Portugal and Lithuania bring up the rear.

The study, which was funded by Swiss drug maker Roche Holding AG, also addressed what percentage of certain countries' populations would be covered by their stockpiles of antiviral drugs, such as Roche's Tamiflu. The authors said there was a "strong correlation" between those countries that scored well and those that had large stocks of antiviral drugs.

The draft study singled out France and the Netherlands as having enough antivirals to cover 53% and 30% of their populations, respectively, while one unspecified country had coverage as low as 2%.
The study is likely to prove sensitive among European governments, which could encounter domestic political pressure for failing to prepare adequately for an epidemic. It already prompted debate at a recent meeting of Europe's top public-health officials in Vienna, where the study's findings were presented.
"It doesn't look too good for some of the countries," says Gudjon Magnusson, a director at the WHO's regional office in Copenhagen, who was in Vienna and reviewed the report. He said critics pointed out that the researchers reviewed only published bird-flu plans, potentially missing national legislation that deals with disasters without specifically referring to bird flu.

Concerns also were raised in Vienna that the authors had overlooked plans that had been updated or released more recently. The draft study only included plans published through November 2005, while bird flu arrived in Europe in force over the past few months. Previously it had spread from Asia as far west as the Balkans.

Roche's role as a source of funding for the research raised some eyebrows in Vienna. But Ms. Mounier-Jack said Roche's backing didn't represent a conflict of interest, and that the aim was for "countries to learn about each others' strengths." Dr. Coker added that funding from the private sector was important to this research because "individual countries aren't going to fund this," referring to the research as "very sensitive."

In a recent two-page opinion piece in the European Journal of Public Health, Ms. Mounier-Jack and Dr. Coker wrote that marked differences in the amount of antiviral drugs stockpiled in different countries raised questions about the role of the European Union in coordinating a response to the possible health threat.

Scientists and public-health officials have been warning for years that a particularly lethal strain of avian influenza, which has emerged in recent years, could quickly mutate into a form that spreads easily among humans and spark a global pandemic. Those worries have prompted governments around the world to prepare for a possible outbreak.

So far, the strain, H5N1, has killed at least 109 people in nine countries since late 2003. Most, if not all, of those people appear to have contracted the disease from birds. So far, H5N1 hasn't developed into a major health threat for humans.

Some health officials point out the difficulties of using written plans to generalize about a country's level of preparedness for a pandemic.

"It's like looking at the wiring diagrams of a Maserati and a Ferrari, and looking at which one handles better on the road without turning on the ignition," said Angus Nicoll, influenza coordinator for the European Centre for Disease Prevention and Control in Stockholm, who was sent an early draft of the study for review. However, he called the study "a useful piece of work."

Ben Duncan, a spokesman for the center, added that some new member states of the European Union "are, in fact, much better prepared than Coker's study suggests."

18. aprill 2006

linnugripifilm :D

haha, ameeriklased :))


April 18, 2006 -- ABC announced its May Sweeps' bird-flu movie yesterday - which came as a complete surprise in a business nearly devoid of surprises. But that's just what the producers of "Fatal Contact: Bird Flu in America" intended. "We did that because of its topicality," co-producer Diana Kerew said.

"The world changes very quickly, and we wanted to make sure at the point we were ready to unveil [the movie] that we were accurate and up-to-date."

"Fatal Contact," airing May 9, stars Stacy Keach, Joely Richardson, Ann Cusack and Justine Machado in a tale of a worst-case scenario, if the bird-flu virus was transmitted to humans in America.

"We feel we're providing a level of awareness and we've gone to great effort to make sure the film is accurate," co-producer Judith Verno said. "We've included a lot of information we believe people need to know."

"We had wonderful consultants who were actually ahead of the [bird-flu] curve," Kerew said. "The way the disease popped up in China, then moved to Turkey and Africa, were things we already knew about."

"Our movie has a character who was in Iraq and got the bird flu there and survived - and, as we were shooting, the bird flu hit Iraq," Verno said.

Cidrap ülevaade arengutest

Avian flu outbreaks wax, wane

Apr 17, 2006 (CIDRAP News) – Poultry deaths due to the H5N1 avian influenza virus are spreading in some parts of the world as cases decline elsewhere.
In Pakistan, the health of four poultry workers was being tracked following an outbreak of H5N1 on a farm near Islamabad, according to a story today by Reuters news service. About 3,500 birds on the farm were culled recently. Authorities were asking people in a 3-mile radius of the farm if they were experiencing any avian flu symptoms, the story said.

Although they haven't found any human infections since the poultry outbreaks began in February, officials expressed concern because a lack of resources is affecting monitoring, Reuters reported.

"An effective system needs money, and that is what we don't have," said Rana Ikhlaq, deputy commissioner of the agriculture ministry.

The Pakistani Agriculture Ministry confirmed the poultry outbreak on Sunday.

Concerns about a potential outbreak in the West African country of Ivory Coast rose earlier this month when five dogs died after eating poultry carcasses from a large bird die-off in the town of Bondoukou, according to the Independent Online (IOL) Web site from South Africa. Bondoukou is 500 kilometers east of the city of Abidjan.

Authorities in Ivory Coast today announced that local tests showed the outbreak was not related to the H5N1 virus, according to Today Online of Singapore. The tests were conducted at Bingerville laboratory in Abidjan. The results have not been confirmed at a World Health Organization (WHO) lab. In addition, authorities did not offer an explanation for the rapid deaths of more than 200 chickens found dead at the end of March in the village of Soko.

Two villages in Cambodia have confirmed the influenza virus in poultry since Mar 20. About 700 birds were involved in an outbreak in Tuol Prich village in Kompong Speu province, and about 247 birds died or were culled in Kamakor village of Kompot province, Cambodian authorities confirmed Apr 13 in a report to the World
Organization for Animal Health (OIE).

In Russia, the H5N1 virus is waning, according to a story today in Russian News and Information Agency Novosti (RIA Novosti).

"The bird flu situation has now improved, and the number of quarantine zones has been sharply reduced," Agriculture Minister Alexei Gordeyev said. "Birds are being vaccinated in migration stopover areas for wild birds."

Fourteen towns in four regions continue to have avian flu outbreaks in Russia today, the agriculture ministry announced today, according to RIA Novosti. About 1.1 million birds have died and roughly another 300,000 have been culled, the story noted.

12. aprill 2006

pandeemiaga seotud positiivsed aspektid

musta huumori sõpradele lugemist :)

Don't panic! Good times might be just around the corner.

If the worst happens and pandemic bird flu sweeps the globe, then this could be great news for you. Thousands stand to gain - admittedly at the expense of those who don't make it, but all you have to do is make sure you survive!

Here is why:-

House prices will fall
Are you telling me that is a good thing? I own a house already. Yes, you may own a house already, but wouldn't you like a better one? If house prices decrease almost everyone stands to benefit. If lots of people die, it's inevitable that house prices will fall, it's a supply and demand thing. Let me explain by giving you an extreme example of why this is good though.

You have a $100,000 outstanding on your mortgage and your house falls in value to $1. Disaster! Well no actually, because for $5 you can buy a house five times better than your house, 15 bedrooms, indoor pool, heliport etc by only increasing your mortgage to $100,005. Tad-a! House price falls are a good thing.

The Black Death
OK a little history lesson here. When the Black Death ended in Britain in 1350 the population had almost halved. This led to the peasants living conditions and salaries improving considerably as there was a lack of workers and an abundance of uncultivated land. The large landlords had to increase wages and conditions to attract any tenants leading to the 'virtual slavery' of serfdom disappearing in a few short years. OK, for 'peasant' substitute 'you', and for 'large landowner' substitute your 'boss'. Your skills will be super valuable in the post bird flu years and companies will be so desperate to hire you that your salary will go through the roof. Of course the companies themselves will suffer short term, but in the longer term they will bounce back too.

Chances are you've never inherited a penny in your life and when the death of a near and dear relative occurs then it is a terrible tragedy, but if great aunt Agatha who lived 1300 miles away and you haven't seen her since you were aged 3 were to pass away, leaving you a few hundred thousand, then that would be less of a tragedy perhaps?

You love buying stuff. New stuff, old stuff. Well the price of stuff will probably come down too. New stuff, cars, furniture, clothes etc will probably come down in the short term as manufacturers try to empty their warehouses to cut their costs. Old stuff will drop even more. You fancy that vintage Ferrari, Andy Warhol original or classic antique Rococo console table well, it might just be within your grasp now...

Population problems solved
Global warming, Oil prices rising, fish stocks dwindling let's face it, it is all because there are just too many of us on this little planet. Now if there were a lot less of us, then gas prices would drop - supply and demand again, global warming would be reduced due to the cut in the burning of fossil fuels etc. Less people eating fish, hunting endangered animals and cutting down the rainforests.

Well OK, perhaps this is all a bit far fetched, but one positive thing has happened already. Chicken prices are going through the floor in Europe. You can pick it up for up to half of what it cost a few months ago and if you cook it properly it's a quick, healthy, tasty meal.

There you go, a quick summary of some - yes, only some of the great things that bird flu can do for you. So next time you're worrying about yourself or your nearest and dearest, then think of the positives, for those who survive, life will never be the same again.

11. aprill 2006

uuring isetehtud kaitsemaskide kohta


Simple Respiratory Mask
Emerging Infectious Diseases Vol. 12, No. 6
June 2006

To the Editor: The US Department of Labor recommends air-purifying respirators (e.g., N95, N99, or N100) as part of a comprehensive respiratory protection program for workers directly involved with avian influenza–infected birds or patients (1). N95 respirators have 2 advantages over simple cloth or surgical masks; they are >95% efficient at filtering 0.3-μm particles (smaller than the 5-μm size of large droplets—created during talking, coughing, and sneezing—which usually transmit influenza) and are fit tested to ensure that infectious droplets and particles do not leak around the mask (2–4). Even if N95 filtration is unnecessary for avian influenza, N95 fit offers advantages over a loose-fitting surgical mask by eliminating leakage around the mask.

The World Health Organization recommends protective equipment including masks (if they not available, a cloth to cover the mouth is recommended) for persons who must handle dead or ill chickens in regions affected by H5N1 (5). Quality commercial masks are not always accessible., but anecdotal evidence has showed that handmade masks of cotton gauze were protective in military barracks and in healthcare workers during the Manchurian epidemic (6,7). A simple, locally made, washable mask may be a solution if commercial masks are not available. We describe the test results of 1 handmade, reusable, cotton mask.

For material, we choose heavyweight T-shirts similar to the 2-ply battle dress uniform T-shirts used for protective masks against ricin and saxitoxin in mouse experiments (8). Designs and T-shirts were initially screened with a short version of a qualitative Bitrex fit test (9) (Allegro Industries, Garden Grove, CA, USA). The best were tested by using a standard quantitative fit test, the Portacount Plus Respirator Fit Tester with N95-Companion (TSI, Shoreview, MN, USA) (10). Poor results from the initial quantitative fit testing on early prototypes resulted in the addition of 4 layers of material to the simplest mask design. This mask is referred to as the prototype mask (Figure).

A Hanes Heavyweight 100% preshrunk cotton T-shirt (made in Honduras) (http://www.hanesprintables.com/Globals/Faq.aspx) was boiled for 10 minutes and air-dried to maximize shrinkage and sterilize the material in a manner available in developing countries. A scissor, marker, and ruler were used to cut out 1 outer layer (≈37 × 72 cm) and 8 inner layers (<18 cm2). The mask was assembled and fitted as shown in the Figure.

A fit factor is the number generated during quantitative fit testing by simulating workplace activities (a series of exercises, each 1 minute in duration). The Portacount Plus Respirator Fit Tester with N95-Companion used for the test is an ambient aerosol instrument that measures aerosol concentration outside and inside the prototype mask. The challenge agent used is the ambient microscopic dust and other aerosols that are present in the air.

A commercially available N95 respirator requires a fit factor of 100 to be considered adequate in the workplace. The prototype mask achieved a fit factor of 67 for 1 author with a Los Alamos National Laboratory (LANL) panel face size of 4, a common size. Although insufficient for the workplace, this mask offered substantial protection from the challenge aerosol and showed good fit with minimal leakage. The other 2 authors with LANL panel face size 10, the largest size, achieved fit factors of 13 and 17 by making the prototype mask inner layers slightly larger (22 cm2).

We do not advocate use of this respirator in place of a properly fitted commercial respirator. Although subjectively we did not find the work of breathing required with the prototype mask to be different from that required with a standard N95 filtering facepiece, persons with respiratory compromise of any type should not use this mask. While testers wore the mask for an hour without difficulty, we cannot comment on its utility during strenuous work or adverse environmental conditions.

We showed that a hand-fashioned mask can provide a good fit and a measurable level of protection from a challenge aerosol. Problems remain. When made by naive users, this mask may be less effective because of variations in material, assembly, facial structure, cultural practices, and handling. No easy, definitive, and affordable test can demonstrate effectiveness before each use. Wearers may find the mask uncomfortable.

We encourage innovation to improve respiratory protection options. Future studies must be conducted to determine levels of protection achieved when naive users, following instructions, produce a similar mask from identical or similar raw materials. Research is needed to determine the minimal level of protection needed when resources are not available for N95 air-purifying respirators since the pandemic threat from H5N1 and other possible influenza strains will exist for the foreseeable future.

10. aprill 2006

Maaleht: Eesti kodulinnukaart

Maaleht: Eesti kodulinnukaart 06.04.2006 Heino Laiapea

Veterinaar- ja toiduameti andmetel on Eestis üle 2,5 miljoni linnu, kelle eest inimesed hoolitsevad ja neid omaks peavad.


7. aprill 2006

Barry: 1918a õppetunnid

Kanada CBC telejaama intervjuu John Barry'ga, intervjuu tehtud 2005a lõpus ja oli eetris 11.01.06

esimest osa ei hakanud siia panema, üldine jutt viirustest kui säärastest
järgnev osa siis 1918a ja praegu ..

väga asjalik jutt igatahes :)

How did a person die with influenza in 1918?

The overwhelming majority of Westerners who got influenza in 1918 had exactly the same disease that you are familiar with today. You have a terrible three days, and a week later you are fine. But a minority, and it wasn’t a tiny minority, had an entirely different experience. Their symptoms were extraordinarily varied, and severe.

People could turn so dark blue from the lack of oxygen that physicians had reported they had difficulty distinguishing black patients from white patients. Some of the more horrific symptoms included bleeding from your nose and mouth, and from your ears and even your eyes. In some cases, literally, the floor would be covered in blood. It was an incredibly gruesome situation.

What did people in the communities do to protect themselves?

People isolated themselves. I think a lot of that was because we had two things going on. First, you had the government line. The Surgeon General of the United States said: “There is no cause for alarm.” There was cause for alarm, but his reassurances were repeated over and over by local officials practically everywhere. Meanwhile, people see their spouses die horribly, in less than 24 hours, and undertakers are not available, cemeteries are full.

People rapidly lost all faith in authority, and didn’t trust anything that they were told. This created a sense of alienation, and made it every person for himself, or herself. It spread terror and isolation.

The Red Cross reported that people were starving to death – not from lack of food, but because people were too frightened to go near the sick to bring them food. In most cases, you know, the communities began to fall apart.

What seemed to work that we could look at now?

Nothing really worked in 1918, nor would it really work today. Cities passed ordinances against shaking hands, against spitting. Washing your hands constantly could work. Limiting your contact with people could obviously limit your chance of infection.

The streets in many cities around the world virtually emptied in 1918. It just froze society once it got going. Absentee rates were 40, 50, 60 per cent in some of the war industries.

In the army camps, scientists reported that in the camps that used quarantine rigidly, they did seem to have some effect on the course of the virus. But if the quarantine was not rigidly enforced, if there were any exceptions made at all, it didn’t seem to have any effect whatsoever.

Who was at most risk to die in 1918?

If you were a healthy young adult, and you interacted with people, you were at the highest risk of dying. The one demographic subgroup was probably pregnant women – they are young adults already, and they have the additional burden and stresses of pregnancy on their body already. Pregnant women had the highest rates of mortality - sometimes extraordinary - mortality rates.

In 1918, how did they deal with the people dying so quickly in such a short period of time?

The ‘death system,’ the mortuaries, the cemeteries, and so forth, they were just overwhelmed. Bodies lay in homes for days at a time, sometimes more than a week. In Philadelphia, you literally had priests driving horse-drawn carts driving down city streets calling upon people to bring out their dead.

They were buried in mass graves, dug by steam shovels. It was a horrific circumstance. In some cases, where they had funerals, there were no coffins. They were, for each funeral, renting coffins. They would have a service with somebody in the coffin, and then the body would go to the cemetery without a coffin, and then that same coffin would be reused for another service 15 or 20 minutes later.

What were the biggest mistakes in 1918 that made things worse?

Not taking influenza seriously. The second biggest mistake was that governments did not tell the truth to the public.

I don’t think that would occur now. Since 2003, and even more recently, influenza has gotten an enormous amount of attention and governments are taking it seriously now. At least Western governments are.

The second problem, not telling the truth to the public, I’m not so confident that that would not repeat itself. It’s already been demonstrated that governments in Asia haven’t entirely told the truth.

In the end, what can 1918 teach us? So much has changed scientifically, the general health of people, is it really useful looking at something from that long ago?

1918 teaches us how lethal influenza could be. It teaches us certain things about the importance of telling the truth when there is a major event of any kind. Even when the population was totally panicked, people who were trained did their jobs. Not just nurses and doctors, who behaved with unbelievable heroism and went into the worst areas and died in large numbers, but the police and volunteers who removed the bodies from homes. The lesson is that these people, if they have a sense of what they are supposed to do, they will do their jobs. If people are actually trained and know what to expect, they will continue to function.

But if there is no leadership and no preparation, you run the risk of a disintegration of services. It’s very important not just to have plan but also to practice that plan, and to prepare people.

What would you personally do if H5N1 developed into a pandemic?

I think it’s important to recognize that any pandemic is a serious event. We are most worried right now about H5N1 because it’s been killing half of the people it infects. But, we don’t know that the next pandemic – and there will be another pandemic, the nature of the virus virtually guarantees it – we don’t know if it’ll come tomorrow, or if it’ll come in 20 years.

Our society has changed so much even since the last pandemic in 1968, which was so mild that most people who lived through it aren’t even aware that a pandemic occurred. Yet that mild virus, if it struck today, would today kill between 89,000 - 200,000 Americans. That’s a pretty severe blow.

And the impact on the economy would be even greater than it was in 1968, because our habits have changed. Businesses have become so much more efficient because there is no slack. You have just in time inventory, you more people more frequently eating out at restaurants, you have no excess hospital beds, you have all sort of things that mean even a mild pandemic would be more severe today than it was in 1968.

In terms of what I personally would do, frankly I would cut down on my contacts with people. I would sit at home as much as possible with my family. I certainly wouldn’t shake hands, and I would have a large store of canned goods and bottled water and hunker down.

linnugripinakkus lennukis


1. aprill 2006

1918a pandeemia pildid

Images- 1918 Influenza Pandemic UK Department of Health 2005 [PDF]