EMERGENCY PREPARADNESS

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Where to Stay in case of flu Pandemic

Evaluate your current abode; is it urban, suburban, or rural? There is no one single clear-cut definition for any of these, as urban can mean apartment, townhouse, or single family home. It can mean a high- or low-crime city. It can mean reasonable room to store provisions for several months, or a highly space-restricted efficiency (i.e., the sleeper couch serves as the bed every night). How well prepared might the nearest neighbors be? How about the larger community? How about the city itself? Will there be sufficient vaccine distribution arrangements, measures to continue electricity/water/sewage, and contingencies for law enforcement absenteeism? An aid to understanding where can be found in the Decision Support Matrix below. You have to determine the feasibility of any potential location based on the potential for who and what, primarily.

If the urban area you reside in is prepared (or preparing), then provisioning for and riding out a pandemic at home could be entirely feasible. Indeed, you will likely be safer at home when the pandemic hits than on the crowded road in the midst of potential fuel shortages with other pandemic refugees (and opportunists preying upon them). If you have concerns with the security potential of your current residence for any combination of reasons, then consideration of all alternatives is prudent.

Questions to answer:

   1. Do I plan to ride out the pandemic with my immediate family? Extended family? Friends? Other like-minded people? Some combination?
   2. What is the potential of the current location for civil unrest that may jeopardize my (family’s) safety? What is the potential for household, neighborhood, community, and town/city protective measures?
   3. What is the potential for food and water storage in the residence? What is the potential for food and water resupply? 

Distancing vs. Stay-in-Place (SIP)

At some point, you will have to determine the approach you will take to isolating yourself from others during the pandemic. The major choices are;

    * No isolation; continue as normal
    * “Distancing” (keeping at least 3 feet from anyone in public)
    * Staying home when sick or to care for children when schools are closed
    * Staying home altogether when a pandemic wave is in your region 

There is no one approach that will fit everyone’s family and work situation; after reading the rest of this book, have a frank discussion with those you plan to ride out the pandemic with and work out an agreement that all can support.

State and local government preparation

Part of your evaluation will be to determine the breadth and depth of the approach to preparedness your regional and local government is undertaking. Different localities will have different needs and will require a variety of responses to a pandemic. Often, this is because of the scope of involvement the State/Province/National authority has elected to assume. The direct effects of the pandemic on yourself, your family, and neighborhood will depend, in part, upon local government preparedness, so that should be your starting point.

The primary criteria you can use to gauge the local government’s current response status are:

    * Does the municipality have a local health official tasked as the designated health advisor for a pandemic?
    * Does the municipality have an Emergency Operations Center? This operations center will be the fulcrum for command and control of health, security, transportation, utility coordination, and local public information dissemination. (There can be backup sites and/or distributed operations as well.)
    * Have critical government functions been identified, and has training been established to shift staff around in case of high absenteeism
    * Has the local municipal critical infrastructure (i.e., electricity, water, sewage) been evaluated for sufficient capacity and operational mitigations to the risk of a pandemic event? How long could the water supply continue if the electrical grid were inoperable for an extended time?
          o If in the U.S., does the utility have in place a Continuity of Operations Plan - Extended (COP-E) as described in the Department of Homeland Security’s Pandemic Influenza Preparedness, Response, and Recovery Guide for Critical Infrastructure? Simply having a standard Continuity of Operation Plan (COOP) is not sufficient, as described in the DHS guide. 
    * If privately owned, what plans and procedures does the utility have to continue operations during a pandemic?
          o If in the U.S., does the utility have in place a Continuity of Operations Plan - Extended (COP-E)?
          o If not in the U.S,;
                + Have critical functions been identified with staff trained to cover absentees in these areas?
                + How secure is the fuel supply from disruption to extraction, transportation, refining, and distribution operations?
                + What level of spare parts will be stockpiled to mitigate supply disruption risks?
                + How will maintenance be prioritized during high levels of absenteeism?
                + What are the arrangements with other neighboring electrical service providers to maintain grid synchronization?
                + What procedures are in place in case power plants lose functionality (i.e., rolling blackouts)? 
    * Have alternative treatment and triage sites been established to handle a pandemic treatment surge?
    * Has there been coordination with grocery stores and pharmacies to ensure that citizens will be able to resupply without fear of infection?
    * Are policies established to identify which public areas will be closed and the specific criteria for closing? Have policies and criteria been established for reopening?
    * Are plans and detailed procedures established for the mass distribution and administration of vaccinations (if and when a vaccine is developed and produced for the pandemic strain)?
    * Has there been coordination with private, volunteer, and neighborhood organizations to develop and synchronize local response?
    * Has a plan been established to account for surge operations at the mortuary and related services?
    * Has the local government coordinated completely with State/Province/Regional authorities and satisfied their requirements?
    * Is there a public health education campaign underway that addresses the local government’s response, as well as recommended citizen responses?
    * Are there mutual aid agreements with neighboring localities?
    * Are there any considerations for controlling the movement of people and commodities or out of the community?
    * Have the health, social service agencies, and fire departments created a registry of former and retired personnel and suitable volunteers?
    * Has the law enforcement agency created a registry of former and retired law enforcement personnel and suitable volunteers who could provide continued civil order, traffic control/restrictions, security at clinics, etc.?
    * Has a public communications medium been established that will reach people during power outages? Do citizens know what communications devices they need (e.g., solar/crank powered radios)? 

If local preparations appear to be slow, stalled, or too narrowly focused (i.e., predominantly medical), then seek to improve the chances of you, your family, and your community by contacting local officials and advocating timely and sufficient pandemic preparedness measures. Appendix I contains a sample letter to local council members/supervisors/assemblypersons that can also be used for speaking notes during a citizen’s input session normally provided at council meetings or public hearings. Don’t be shy, your local officials are “servants of the people,” and pandemic preparedness is relevant to their mission of ensuring the health, safety, and welfare of you and your family.

Consideration of Other Locations

Regardless of the type of disaster, you should always have another location identified and confirmed in case the situation at your home or primary site becomes unsafe for any reason. If you decide to consider riding out the next pandemic at a site other than your home, reflect first on the benefits you and your family can bring to that site. Are you going to bring extra food for your hosts and pre-position it so that you can leave for the site without extensive preparation time and the potential for an overloaded vehicle? Do you bring a special skill to the group (i.e., medical, electrical, mechanical, security, food preparation, gardener, etc.)?

There are three important measures to take when traveling during an elevated pandemic state:

   1. Take an emergency supply kit with at least 3 days worth of supplies
   2. Take spare vehicle fuel (or if biking, spare tires, patch kit)
   3. Have an extensive map of the areas you will travel through. Plan at least 2 alternate routes. 

Questions that must be answered when meeting up with others at another site include:

   1. What is the specific trigger point/event at which you leave?
   2. Will you impose restrictions on when members of your Support Group are allowed into the refuge due to possible contagion?
   3. How might these trigger points align with possible quarantining of the local metropolitan area?
   4. What supplies do you promise to pre-position?
   5. When are they to be in place?
   6. What skills do you bring, and what tools are required for you to exercise your skills?
   7. What contingency plans will the group at the refuge execute? Are you expected to be a part of the site’s security arrangements?