NB- after seeing how big this comment was, and recalling RBT’s instructions to me, I am promoting this comment to a Post.
On an entirely separate subject, pandemic preparedness….
I’m looking thru the CDC’s Flu Pandemic readiness checklist for health care providers and I see a whole bunch of stuff that’s worth thinking about. So I’m highlighting some here:
3.11 Pre-identify strategies and resources to ensure behavioral health support for staff to mitigate adverse stress and grief and loss reactions.
[translation- EMS is gonna have family and friends that die from the pandemic- try to keep them working]
3.12 Determine virtual coordination mechanisms that will enable remote engagement of senior staff to prevent exposures and maximize ability to engage in both daily and incident operations”
[translation- senior staff need to be kept out of the treatment areas to keep them alive while everyone else risks dying.]
“3.21 Develop criteria for on-scene denial of transport by EMS personnel for influenza-like illness and other patients – with or without on-line medical control – ideally regional rather than agency-based criteria and process.
[trans- figure out at what point do you stop bringing flu cases into the hospital and effectively quarantine them at home, and when you let EMS make that decision on their own.]
3.22 Develop/provide patient information sheets on homecare for influenza-like illness
including usual clinical symptoms and course, infection prevention, treatment, and when to seek additional medical care.
[trans- people are on their own at some point, figure out what point, and give them some info about what to do]
3.23 Develop/provide patient information sheets for other conditions that may be left without transport if the service volume suggests a relevant need (e.g., minor injuries).
[trans- again, you’re gonna be on your own, with minimal guidance]
3.24 Determine alternate transport resources and triggers to utilize them, e.g., private
ambulance, wheelchair, contract/courier, for hire vehicles, military assets, buses
[trans- martial law at some point, and how many NG or regular Army units will want to deploy into a Flu zone? How many will be ABLE?]
Here’s a nice one:
4.5 Determine actions that the state emergency management or public health agency is likely to take that affect health care including:
• Suspension or modification of requirements for hospitals or clinics
[when will you be able to use tents, parking lots, warehouses]
• Specific emergency orders or actions that may limit liability or expand scope of
operations (for facilities and providers, including volunteers)
• Requests for 1135 waivers from the Centers for Medicare & Medicaid Services (CMS)
• Crisis standards of care activation
[when will you drop normal operations and just do whatever you can without liability- ie at what point does S really HTF?]
• Issuance of clinical guidelines for care and resource allocation
[when do you start rationing and triage?]
• ‘Taking powers’ of the state relative to medical materials and staff (i.e., does the state have ability to commandeer resources under their emergency powers and does this include medical materials?)
[trans- when will they come for YOUR stuff, and do you need to give it to them. side question- where would ‘the state’ be TAKING the siezed materials????]
• Promulgation or enforcement of legal obligations of medical staff to provide care
[trans- when will they come for YOU, and what if anything can you do about it?? this is where preppers worry about ‘being on a list’ of EMS or First Aid trained, or CERT, etc, can they force you to provide medical aid? what if you are licensed?]
And these are grim:
4.38 Develop a plan for implementing a supplemental facility security/controlled access plan (which may be phased) particularly during the peak pandemic weeks to assure controlled campus ingress and egress and monitoring.
4.39 Provide patients and staff with information about stress responses, resilience, and available professional mental health resources. Develop staff monitoring for those exposed to high levels of cumulative stress or specific severe stressors (death of coworker, etc.).
4.40 Consider ways to maintain staff resilience and morale when congregate gatherings and close physical contact are discouraged. This may need to include memorial services for staff members.
4.41 Determine if the fatality management plan is sufficient for an increased volume of decedents at the facility
There’s lots more and it’s worth looking at. After all, this is what CDC thinks your local health care providers need to consider and plan for WRT flu pandemic.
-EMS not transporting sick people
-facilities and services shut down or reaching capacity and rationing of other treatment
-local authorities SEIZING medical supplies
-local authorities FORCING med staff to work
-deaths among EMS, facility staff, and care providers
-physically securing the treatment areas
-giving priority to staff family and pets
-using the military to provide transportation, reserve medical services, and security
-too many dead people to deal with normally
(the link came to me in the weekly newsletter I get for EM and first responders)