Saturday, October 11, 2014

Surfing USA


One fine sunny morning in California, the San Andres Fault finally rips loose, there's an 8.5 earthquake, followed by a couple of 6.4 aftershocks just a few miles off the coast. Within minutes, the Santa Monica Pier is sitting 40 feet above the waterline, with a few fish flopping around on the glistening sand and kelp puddles that were in twenty to thirty feet of water just a few minutes earlier. Standing on the beach, you look offshore, and see a slight bulge in the waterline, not very high, but it seems to be moving fast inbound. It's 200 yards to the parking lot, and there's a downed streetlight sitting across the hood of your car anyways.
So how do catch the incoming tsunami and ride it safely home?

You and the family are enjoying a nice vacation to Hawaii at Volcano National Park. Your only son, ignoring repeated stern warnings, climbs up on top of the boundary fence near an open crater, and before your horror-stricken eyes, slips and tumbles into a pool of glowing red lava. How do you dive in and save him?

You're an hour out of Miami headed for London, the plane is humming along, the co-pilot's doing everything like a pro, you're at 35,000' in clear skies, when suddenly there's a loud thump, all the alarms and lights in the cockpit go off at once, and as you're struggling to assess your problems and options, you can hear the fight attendant screaming through the cockpit door that apparently the tail and both wings, including all your engines, just fell off. How do you glide in for a landing?

The answer to all three questions is the exact same:
Don't be there. Be someplace else, far, far away. Period.

In comments to recent posts, several times, I've been asked to please tell folks what medical supplies to stock to care for family members if they become infected with Ebola. It's a serious subject, a serious question, and to all appearances, asked by serious people. So let me give you a serious answer to "How do I care for family/friends with Ebola?"

DON'T.

"But Aesop, you don't understand, I love my wife/husband/son/daughter/brother/sister/aunt/cousin/grandpa/parents/pet giraffe, and I HAVE to help them!"

No problem.
1) Make out your will.
2) Do whatever you like. Don't bother with PPE. Treat their symptoms.
Result: They're (90% odds) going to die, you'll get infected, and then (90%) you're going to die too. Scatter any others under the same roof in there randomly as individually appropriate.

And there's absolutely nothing you're going to "stock up" on that will help, or change that reality.

Let me break it down, so that it's obvious I'm not just being a fatalistic dick about this.
Working in an Ebola Treatment center requires meticulously donning an impervious coverall, gloves, booties, hood, high-efficiency bio-hazard mask or powered respirator, goggles, apron, and more gloves. It typically takes two attendants to dress one person, to make sure everything's on right, tied closed, zipped up, and all the pieces in place, including places you can't see, like in front of your face and behind your back.

This all requires a clean, infection-free dressing area. Then they enter the patient treatment area through a door or doors that keep the infection locked in. The patient area needs to have everything the patient or caregiver needs stored within, because once you go in, you can't come out until you're decon'ed and all contaminated garments are removed.
So you have to have all medical supplies there, plus a bathroom area for the patient(s), and all sealed off from any outside contact.

Then you need another area to be decon'ed, and strip off the PPE, layer by layer, slowly and flawlessly, without contaminating yourself in the process, which requires more attendants to spray you with bleach solution, plus drains, disposal bins, showers, sinks, incinerators, etc.

Then you need a means to incinerate the waste, and a handy supply of ever-fresh new disposable supplies, for every time you suit up, and a crew to decon the re-usable stuff, with flawless precision each and every time.

And if you screw it up, you go into quarantine for 21 days. If you really screw it up, you move to the patient ward yourself, because you are one. To date nearly 400 healthcare workers in Africa have made that last transition, and most of them are dead now.

The easiest thing to do in this outbreak is get Ebola and die, as over 4000 people could tell you now themselves, if we'd only reconstitute their charcoal incinerated atoms and resurrect them to chat with us.

Setting up such a facility is such a royal PITA, most major hospitals don't even attempt it for training without weeks of meetings and prep, and they usually screw it up royally even then, despite hordes of trained professionals, thoughtful planning, and budgets any of us would envy.

So, what part of that could you reproduce, when failure = slow lingering death by liquification of your internal organs (while you're still using them)?

"But...but...IT"S MY WIFE!SON!BABY!MOTHER! I LOVE them!"

Noted. Of course you do. So be a hero, dive into the lava pool, and see how far you get.
After all, I could be wrong.

But on the theory I'm not, realize this: 
Healthcare authorities yesterday threw in the towel with respect to Sierra Leone.
All of Sierra Leone.
They're going to start distributing home healthcare supplies there.
That stuff is going to enable family members to care for each other. And as a result, one infected family member will kill their fellow family members, with a 70-90% efficiency.
The charities involved have come to the conclusion that Sierra Leone's 5.7M people need to be cut loose, and they'll give them what they need to do minimal comfort care for family members, for whom there are simply no beds, and the disease will run rampant until it runs out of people to kill there. Probably nearly all of them, unless someone has the means and supplies to stay inside unexposed until 5.2M of their friends and neighbors have died, and the virus runs out of hosts or growth media, like decaying corpses. To the tune, potentially, of about half the entire Nazi holocaust, in total size.

The entire country has just been put on hospice, because we simply can't catch this virus.
It'll take weeks to burn out, thousands, perhaps millions more will die, and the people running the medical relief groups know all this right now.

What you can do:

You aren't going to be going out with a mask and such here if Ebola becomes more "than that one guy in Dallas". If you're riding on planes and busses with a mask on, you're an idiot. In short order, you'll be an infected idiot. And shortly after that, an ex-idiot. Don't be that guy.

You don't need masks, gowns, gloves, etc.

You need WATER. A source, not just a faucet. Barrels, bathtub, well, rain collection. Hell, pull your cars out of the garage, and put an above-ground pool up, and fill it with water.
Get a water purification filter, unscented bleach, etc., to keep drinking water clean.

You'll need FOOD. Not 3 days, but more like 3 WEEKS, and more likely 3 MONTHS worth. Ebola started in March in Africa. By next May, as things look now and with no change, it will be well on the way to wiping those nations off the planet, with 70-90% efficiency. So, have you got a year's food? Canned goods keep from 2-5 years. Dried/dehydrated for longer, but it's a lot pricier.

You're going to need a way to cook food, stay warm in the winter, etc. So power/electricity/fire. More ways is better.

If you have stored water, food, and means to purify/prepare both, you don't need to go out into the contagion.

You're going to need basic medical/first aid supplies, because going to the hospital during that time for a cut or broken bone isn't going to be an option.

You're going to need a way to be your own 911 - medical, fire, and police, because those folks may not be there to pick up when you call. Assuming calling is even an option at that point. Can you fix your own boo-boos? Put out a fire? Be your own cop? Get cracking.

The likeliest decontamination supplies will rarely be bleach (mixed in water), and more often than not a gallon of unleaded and a road flare, for the bodies that drop too near, or don't get picked up right away. If you think you want to gown up and play with them, drag them around, and/or give them a Christian burial, best wishes. We'll all split your gear after you're gone.
If I have to deal with any bodies, they're getting a Viking funeral, and an "Amen" by way of services.
If they aren't within throwing distance of a road flare from the property line, they're not my problem, nor within my jurisdiction.

If this outbreak gets contained where it is, great. Hallelujah.

If it doesn't, it isn't something you're going to get through.
It's going to change life as we know it, for years.
You're either going to totally avoid it, or it's going to weed you and your family out of the gene pool permanently and painfully.

And anybody who tells you anything different is either afraid to tell you the awful truth of that, woefully under-informed, or selling you a bill of goods. Or all of the above.

The only way to take care of family members with Ebola is not to have to.

The only possible exception is if you have a big enough tribe/family/group/whatever that you really do have a compound, buttloads of supplies, dedicated clinic space, and enough people to care for one or two persons who get infected (knowing that 50-90% of them will die anyway, and with the mental and physical preparation and means to deal with the disposal problem if that happens too). And if you're that well-prepared, you don't me to tell you how to handle things.

Personally, I'm betting outside of publicly funded entities, the number of groups to whom that would apply could be counted on your thumbs.

I hope anyone considering the future in the case that this becomes an epidemic here will recognize this as the definitive answer to this question, and not press for more. It simply doesn't exist.

I can't tell you anything more, because there's essentially no way to accomplish what some of you are thinking about, and it would be immoral and unethical for anyone to suggest otherwise. I certainly will not.

The best way to prepare for this getting worse is not by going to the drug store.
It's by going to the supermarket.

I understand what a rude shock that may be right now to a lot of folks.
Imagine what it's going to be like for people who don't get the lightbulb-over-the-head moment until after it's too late to get ready.

1 comment:

  1. The keyword for Ebola infected care is......Draconian.

    ReplyDelete