DOOMSDAY DOLTS AGAIN!

Then again perhaps some common sense discussion is in order on this “all is good in the World” day. Just what constitutes a true Doomsday scenario? We’ve read and talked about just how fragile our JIT systems are in terms of food and other essentials. We’ve discussed just how vulnerable our transportation system is to different types of breakdowns in the grid etc.. In keeping with the theme of “doomsday” I thought I might discuss and area that I have some very personal expertise in just to provoke some thought and maybe just maybe it might help some of us someday should the “unthinkable” happen. 

I have been involved in emergency planning for several cities in the U.S. during my lifetime including medium large cities and small cities. They all have a variety of needs that aren’t obviously common. Just for instance. In your smaller communities/emergency planning, one of the key bottlenecks in mass casualties is how to not only care for them but how to transport them to larger more complex institutions. This scenario applies to mass casualty situations like tornadoes, where your community is devastated and your hospital is overwhelmed. This is all well and good but what happens when your higher level transfer centers are overwhelmed….or worse….destroyed. Your community hospital becomes ground zero for this disaster and is incapable of delivering life saving care after the first few critical patients overwhelm it. You are now isolated at your own structure or what is left of it. Do you have any simple precautions taken to provide some minimal level of survival while the area you live in is hopefully repaired and supplies find there way to your community? 

The real reason I am writing this is for a situation that is a real threat to the system that not too many people discuss. What happens your community and virtually every community in your country when a “high mortality” viral…SARS type epidemic breaks out? I know……”I’ll deal with it when or IF it happens”…….or…..”That’s what the CDC is for and it will warn me”……or…..”That’s what our doctors, hospitals, and emergency system is for”….”I’ll get my vaccine and take my antibiotics”….

Is this a “high probability” event? It certainly becomes a higher probability event over time for a variety of reasons such as population congestion, antibiotic over-usage, genetic modification etc….. BUT again let’s get back to something no one wants to discuss in the field of “disaster planning”….. People like budfox believe that contingencies for this are all dealt with, but I will tell you from being in these planning sessions that the following scenario is NOT discussed. 

I ask periodically for a show of hands from groups of doctors and nurses in emergency care how many would show up for work in a 50% mortality rate epidemic such as a SARS outbreak. The answer is surprisingly quick and virtually unanimous which actually surprises me knowing how the bravado permeates this particular group. The answer is NOT ONE…….NONE…….would show up for work. The reason is they have dealt with fatal respiratory infections in young healthy people secondary to aggressive viruses like MRSA staph, and many others. They want NO part of high mortality H1N1 outbreak that’s mutated (either naturally or otherwise). They know that in a hospital they would be ground zero and more than likely in a 50% mortality epidemic, they would die if exposed…..at least that is what they say. I agree.

They know there only hope would be to keep themselves and their family isolated from the “vectors” carrying the disease which means “more than proper handwashing”.  I’ll stick with the emergency care providers and how they will react BEFORE the epidemic becomes widespread. What about other areas of the system? Wal Mart? Grocery stores, Quick Trips? Of course this is only “fear mongering” and nonsensical since it cannot happen and you will have plenty of time to “prepare”…… gl