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Thursday

Bio-Event Ready or Die!

     ...or at least get sick. 3 Things to do today to prevent even that!

Biological events can be natural or intentional. The intentional kind is what you'll learn about in a weapons of mass destruction (WMD) training class and you read about in the papers. The naturally occurring kind...SARS or pandemic influenza, for example...are the kind that go on almost every year and we don't pay much attention to. One is intentional, one is natural. Both can be deadly, both have lessons to be learned. We've seen both types in the last ten years; SARS and West Nile Virus...naturally occurring, Anthrax, intentional. Again, both situations with lessons to teach. But did we learn anything?

Here we are in 2009 and many documents and memos are urging us to "get ready" for pandemic flu, H1N1 or otherwise. SARS hit the world back in 2003...what did we learn? It is way past time to be getting ready, we have to be ready. Its not as hard as you'd think and you don't need dozens of pages of plans, either.

Despite the intent, there are similarities between intentional and naturally occurring biological events that we can use to our preparedness advantage. Even the traditional WMD training can be translated to natural event readiness. Unfortunately, most of the WMD training has been a waste of time and preparedness dollars spent on big, shinny things and security cameras.

Traditional responders and the health care system is marginally better prepared today than it was on September 10, 2001. After Anthrax, after SARS.

Recently, the Centers for Disease Control and Prevention (CDC) has predicted that 40% of the United States population will become sick with 2009 H1N1 Swine Flu. That's 40% of the average population. Not to mention those in health care, emergency response, and those with risk factors. And considering the disease as it is today...not accounting for any antigenic drift. Keep in mind H5N1 or Avian Flu continues to lurk and there has been a strain of H3N2 found to be undergoing change.

By way of review, the H's and N's stand for proteins on the influenza type A virus. There are several types H's and N's that, in combination add up to tricky business for vaccine procedures. Influenza vaccine has to match the H and N combination. If not, the vaccine is not effective.

My top three things to do to Be Ready for a natural or intentional biological event:
  1. Train your people on infection control and personal protective equipment (PPE) more than once a year. This is the time to develop good habits for regular cleaning and disinfection of our vehicles. Also, several studies have pointed to practice with masks...getting proper fit and know how to put them on properly...as being more important than annual fit-testing. By the way, numerous sources have also indicated that the N95 mask may be no better standard surgical masks for protection against viruses.
  2. Promote the safety and health of responders and their families. That means getting appropriate vaccine or other medications available for your personnel and at-risk family. Identify those who can't get vaccinated or take medications and take steps to isolate them from infection. Numerous self-report surveys have concluded that one key to keeping your personnel coming to work in a biological event is provide for the safely of the family.
  3. Prepare a Can't Go Home Plan. Stock you stations and facilities with food, water, hygiene products and ready additional bunk areas to keep personnel in-house during extended operational periods.
As always, I look forward to comment and debate. If you have something you'd like to add to the list...email me at mitigationjournal@gmail.com

Wednesday

It's Only Pepper Spray!

Just a reminder here that those non-lethal or less-than-lethal weapons can cause serious issues. Recently, an REI store had to be evacuated due to bear-spray release. Check out the details of the story here: http://www.mercurynews.com/breakingnews/ci_12939095?nclick_check=1

We've been lulled, perhaps by the name, that non-lethal weapons like pepper spray are not serious concerns.

Wrong.

Even when deployed for legitimate reasons and in proper fashion, pepper spray, mace, and other such products can cause a variety of situations. These materials stress the respiratory and cardiovascular systems and precipitate brochospasm. There is also the potential for multiple people to be exposed and in need of treatment. Saturation and prolonged skin contact can cause burns...especially in those hard to reach, moist areas of the body.

Perhaps most important for the responder; remember the need for decontamination. Victims exposed to mace or pepper spray need to be cleaned prior to being placed in a treatment area or in the back of an ambulance. Appropriate removal of outer clothing and water wash should do the trick in many cases. Understand that failing to do so puts the responder at risk of exposure to the material. And just like any other hazardous material event, no patient should be transported to a hospital without being evaluated for need for decontamination.

Lastly, don't forget the psychological impact of these situations. The "worried-well" can clog a system and deplete response resources at a faster rate than actual victims do!

Tuesday

Two Chemical Events...Many Lessons!

Once again proving the point that you don't have to wait for a terrorist attack...

The articles linked below highlight the need for all of us to be familiar with chemical event potential. As I've been saying for years, we don't have to wait for a terrorist attack with a chemical agent to utilize the knowledge/training that we have. When I say "we"...I mean traditional and non-traditional responders...EMS, fire, police, and hospital personnel.

Note to the American Fire Service...I don't buy into the idea the fire department will be too busy to support hospital decontamination/protection efforts in large-scale events. Fire departments must be involved in planning, training, and implementing protective measures at hospitals...even if only one fire officer, to help direct mutual aid companies. Hospitals are critical infrastructure.

The first two links below relate to a chemical event at refuge company. I'm getting the impression that something got mixed in the trash and reacted, releasing an unknown chemical vapor resulting in three critical patients, numerous contaminated, many transported...119 total. The underlying situation is that one hospital was ready with decon...they had drilled for such an event with the fire department. Also, EMS didn't send contaminated patients to the hospital and on-scene decon worked. These articles are preliminary, but I'm thinking this will be an interesting case to follow.

The last link is to an article that is much more disturbing; a situation using a chemical dispersal device, chlorine and an incendiary device were deployed...with intent...with strategy...to a specific target. The mainstream media is calling this a hate crime. I'm looking at it as an act of domestic terrorism.

Tune into Mitigation Journal Podcast for more details...look for edition 118 (expected release 8/5/09)

Unknown gas injuries in MA
http://www.projo.com/news/content/NEW_BEDFORD_INCIDENT_08-04-09_TQF9B2N_v17.3b42d27.html

Emergency Decon Drills Paid Off
http://www.southcoasttoday.com/apps/pbcs.dll/article?AID=/20090804/NEWS/908040324/-1/NEWSMAP

Chemical Attack Hate Crime
http://www.kold.com/Global/story.asp?S=10835087&nav=menu86_2