# 1677
Part I is HERE
Part II is HERE
In the first two installments of this series I’ve discussed the need for, and difficulties inherent with, home care during a pandemic. A brief recap of the salient points follows:
- A severe pandemic could sicken tens of millions of people worldwide simultaneously. In the United States alone, 90 million people are expected to be stricken during the course of a pandemic, and that estimate may be low.
- Governments expect only 5% of pandemic flu victims to receive hospital care, the rest must be cared for at home by their families.
- 27 million Americans live alone, while millions more are the sole caregiver / provider in a household. These people (and their charges) are particularly at risk during a pandemic.
- Pandemic flu is likely to be far more severe in terms of illness and death than seasonal flu. Many patients are likely to require weeks of nursing care.
- A failure to provide basic nursing care would inevitably increase the number of fatalities, yet most families are woefully unprepared to deal with an extended medical crisis on their own.
- Infection control - preventing the spread of the disease throughout a household - will be a serious concern.
- `Caregiver fatigue' will be a major problem with home care, with no assurances that the caregiver won't become infected and incapacitated as well.
- Planning and advance preparation will be crucial if the home care option is to be viable.
Your Neighborhood As Your Lifeboat
The problems inherent with a severe pandemic, one that could last a year or longer, go far beyond finding ways to provide medical care to your family - yet for most of us - that will be our highest priority.
In a 1918-or-greater event, commerce may grind to a halt, there may be extended shortages of goods (think: food and medicines), and interruptions in utilities (power & water). Hospital care, even for non-flu related illnesses, may be difficult to obtain. The economy will likely take a tremendous hit.
In short, life will change radically in ways our nation hasn't seen in 90 years. The Federal government has a web site - www.pandemicflu.gov - that describes these very scenarios.
We Americans, particularly in urban areas, tend to be social isolationists. Unlike in our Grandparent's day, we rarely know most of our neighbors, and during a severe and prolonged crisis, this will prove a serious disadvantage.
It will be impossible for 90 million households here in the US, and a billion more worldwide, to become individual self-sufficient fortresses against a pandemic. That idea may appeal to some Ramboesque survival fantasies, but it isn't terribly realistic.
Few families could provide their own security, food, water, heat (in northern climes), and tend to their sick over the course of a year or more with only their own resources.
Like it or not, a community or a neighborhood's best option is to work together during a pandemic.
I've heard many argue that it is folly to help your neighbor during a pandemic because you risk exposing yourself to the virus. I suppose that's true. But regardless of how well prepared any of us are, few will be able to avoid exposure over the period of a year or more.
Simply put, for 99% of us, it won't be possible to hide from a pandemic. Many will still have to go to work every day. We won't all be able to shutter ourselves in our homes for months. Exposure is all but inevitable.
Through the use of NPI's (Non-pharmaceutical Interventions) the risks of exposure can be lessened. Masks and gloves, avoiding crowds, staying 6 feet away from infected individuals, covering our coughs and the frequent washing of hands can go a long way to reduce infections.
We can either choose to have 90 million American households stand or fall in their own personal viral Alamo, or we can learn to band together, and help one another during a crisis.
If we are smart we will set up neighborhood watches, share resources, and spread the workload. By looking out for our neighbor, we in turn have someone looking out for us.
The odds favor working together.
This is the spirit that built this nation. And it is this spirit -if we still remember how - that can help save this (or any) nation in a crisis.
A neighborhood volunteer flu center
Manned by family members from your neighborhood, and setup in a single house or apartment, a volunteer flu center could help alleviate many of problems of home care during a pandemic.
Given the likely attack rate, with 5% of the population stricken at any given time, you'd probably need one home or apartment for every 100 people in your neighborhood.
Rather than it being every household for themselves, with most of them being overwhelmed by the task of caring for one or possibly more victims, select one house on your block, or one apartment in your complex, and designate it as a flu care center.
You could then move suspected flu patients (with their permission, of course) to this house and allow volunteers from their families to assist in providing round the clock care.
There are a number of advantages to this neighborhood approach.
- Instead of being forced to care for a family member 24 hours a day, 7 days a week, perhaps for weeks without a break, by combining forces with your neighbors, individuals might actually be able to get much needed rest. Work 12-hour shifts. While it might seem riskier to volunteer to care for multiple patients than to care for one person in your household, the risks are likely far less.
- You immediately reduce the chances of the virus spreading amongst your family members, thereby decreasing your chances of contracting it. You share the workload with others, and enable yourself the luxury of taking a break, and getting needed rest. This will help keep your immune system in better shape, and with rest, you are more likely to observe common sense infection control procedures and less likely to make stupid mistakes.
- If a visiting doctor, or a nurse, or an EMT is available, even part time, then they only have to visit one site to see multiple patients.
- Infection control will be easier in one location rather than in many houses at the same time. PPE’s supplies would be stretched, as one caregiver could oversee multiple patients.
- And you may be able to rely on someone more dispassionate than you to care for a loved one during a medical crisis. Your neighborhood might even be lucky enough to have a retired nurse or EMT, but even so, the burden of care cannot fall just on them.
For it to work, you and your neighbors will have to work in concert. You will have to accept the idea that, by working together, you all have a better chance of getting through a crisis.
And that means; everyone contributes.
Meals for patients and caregivers could be cooked offsite and delivered. Laundry could be done by volunteers in adjacent homes. Other volunteers could help bring in needed supplies.
Not everyone would have to deal directly with infected patients, but it would have to be a community effort.
Obviously, a suitable location would be needed. And that would likely require someone giving up their home for the duration (or remaining on site to assist). It is possible that arrangements could be made to use a vacant house or apartment - or a detached garage -but in any event, you will need to find a place where flu patients can be sequestered and cared for.
While seemingly ambitious, this idea would work in a lot of places. It eliminates many of the difficulties of the home care option that we will be saddled with.
But, in order to work, it would require planning and cooperation between neighbors. It would also require a commitment from the entire neighborhood: a sharing of the risk, and of the work.
Yes, it’s a lot to ask.
But a pandemic, by its very nature, will ask a lot of each and every one of us.
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