Open Your Bible to Covidians...

Not mine; someone sent it to me without an attribution.
"From a nurse, on a forum..."
Effing hilarious.

I don't know who wrote this, but I love them like family.

And the Gods of Nursing and Medicine looked down and spake:

Oh thee of Joint Commission and thee of CMS.

May fuck be upon thee.

Thou hast promoted disposal of the Holy PPE for all these years based upon arbitrary expiration dates. This, in spite of evidence to the contrary by SLEP; In spite of other research; and in spite of common sense. Now, those who provide care must do without.

Lead us not by citation, but deliver us from stoopid. Know now that this must end. Your reign of terror is over.

From this day forth be it known that we shall not comply. We shall not waste. We shall not grovel for you.

Instead, we shall rise up, as one, to administer the Whole Pineapple Suppository of the Just to all transgressors. Sideways.
As it is spaketh, thus shall it be done.

~1st Covidians 1:1~

Amen

The $64 Question

Bad, wicked, naughty, evil Zoot.

A month ago I was worried we might have 10-20 cases of Kung Flu. Instead, we have nearly 20 deaths. That means those people got it up to a month ago, from other people who didn't know they had it either.

So far, most of them are elderly, and/or with other co-morbid conditions.

But sooner or later, a relatively healthy 40- or 50-year old with no predisposition is going to croak. Maybe a teacher. Or a school janitor or lunch lady. Then everyone will lose their shit.

The school will be closed. But that person will have infected 40-200 kids, who won't be symptomatic, who will then be locked up at home to infect their whole families, and you'll have a blossom of 1000 cases. Some of whom will still be going to work infected and asymptomatic, and give it to co-workers, who'll give it to their kids, and so on, and so on.

That's how a pandemic marches onwards.
And it will be everywhere.

Take a pair of ordinary dice. There are only 36 possible combinations (6x6). So the raw chance for any roll is a hair under 3% (2.77% for the anal retentive math geek crowd). If coronavirus only has a 3% chance at being transmitted, every time you're out and about, you're rolling the dice. Except you touch things 1000 times a day, and your face about 500 times. (We'll forget about droplets, mucous membranes, and inhalation vectors from coughing and sneezing people for the moment). So, roll the dice every day, and see how long before snake eyes comes up. Remember those thousands of touches, and 500 times touching your face.

After rolling dice 164 times, your chance of getting snake eyes is 99% probable.

So being out and about, in a world becoming saturated with asymptomatic carriers, you're not just likely to get Kung Flu, you're going to get it .

For probably 80% of all persons, two weeks to a month of PITA. For some of them, they may not even know they have it! For 10-17%, you're going to the hospital. But unless you're dying, you aren't getting in. And about 3 people out of every 100 are going to die from it.

If everybody in CA gets it, that's up to 1.2M deaths. Leaving us with 38.8M swinging Richards afterwards. For Texas, it would be up to 870K dead, and 28M still there. Nationwide, up to 10M dead, and 320M still here.

That's if mortality holds at 3%, and everyone gets it. Juggling those numbers around on the slide rule gets you any answer you want.

Bad for the 10M dead, and the 20-50M hospitalized/laid out, but that's not the catastrophe, per se.

The real problem is, the only way to stop this is to send everyone - everyone - home, until 30 days after the last case gets well or dies. Even the idiots among TPTB will figure this out, after exhausting all other half-assed options (just like in China).

If you do nothing, you lose 10M outright, and 50M who can't work for months, and 100M more out for up to a month, but not all at once.

That's the problem. Either of those options screws the economy like a $2 hooker, which is why the stock market is in freefall, why Italy and China have thrown in the towel, and why Korea and the rest of Europe probably will too, before we figure it out.

And until you self-quarantine, and don't pop positive in the next month, you won't know you don't have it already either.

So the $64 Questions is, how long can you miss work, school etc., and how much money, water, food, medicine, and other necessities do you have, to stay home for what may become a mandatory extended quarantine? Will you have a job to go back to when it's over? Will anyone?

We'll leave the discussion of how you hold a valid general election for the President, 1/3 of the Senate, and the entire Congress amidst this sort of thing, for another time.


Local observation:

I note for informational purposes that the local bookseller, B and N, is suddenly light on disaster/survival/preparedness books, which had formerly just been gathering dust, and is now missing every volume on first aid. Because I check those aisles 2-3X/week, and probably know them better than store staff.

Some people are getting edjumicated, apparently.

-----------------

Also, over at WRSA, one of the He's-who-shall-not-be-named observed accurately that contrary to all dystopian fiction, the stores remain open and unburnt, rather than the popular "stripped to the walls in 48-72 hours".

Allow me to respond:

Food isn’t coming here from China (unlike N95 masks), the trucks are still running, and you’re still free to travel, and not under draconian quarantine.
Yet.

So there isn’t any national emergency, for the moment.
{cf. 1940: Phony War. Compare and contrast with Dunkirk, and the Battle of Britain, a few months later.}

Once you can’t go out, it won’t matter what’s on the shelf. The average person and family has three days' food at home. (If you have more, by definition, you’re above average, just like the kids at Lake Wobegone. That also means somewhere there’s some jackass who has less than three days on hand.)

So, how long do store shelves stay stocked (and not gloriously aflame) when the trucks aren’t rolling, and Trayvon Diversity and his posse go emergency shopping after midnight, with a brick and a machete?

And what happens when people who depend on prescriptions, made from precursors that aren’t coming from China, and haven’t been for the last month or two, start getting shorted on their Rx meds, esp. the ones that
a) keep them alive, or
b) keep them sane and functional?

Just curious.
Feel free to extrapolate at your own leisure, as you see fit, considering those new data points.

Planetary Intelligence Is A Constant; Population Is Increasing

h/t Kenny

Behold, the dangers of listening to the horseshit they put in the Washington Compost, and mistaking it for factual information:

Falls remain the leading cause of fatal and nonfatal injuries for older Americans. Hospitals face financial penalties when they occur. Nurses and aides get blamed or reprimanded if a patient under their supervision hits the ground.

But hospitals have become so overzealous in fall prevention that they are producing an “epidemic of immobility,” experts say.

This is easily solved.

Waive all your rights to sue in case of a fall, accept full responsibility for all injury and damages in writing, including to any other parties, and consent to binding arbitration with capped damages, and we can talk.

Refuse, and you're full of shit, and your ass can stay in the wheelchair, or in the bed with the siderails up. Once you're back in your house, you can play by any rules you damned well please, as it should be, okay? But in my house, it's my rules. Fair is fair.

If you make it past that hurdle (literally) we can talk about mandatory drug and alcohol testing (because people lie, pretty much 75% of the time, about that), and about how many people got to the hospital because they fell at home in the first place, and were too stubborn and stupid to use things like a light switch, their eyeglasses, walkers, canes, crutches, etc., and are now lined up for a shiny new titanium hip to replace their new three-piece femur, because they had to get to the bathroom right this minute, in the dark.

Last night's genius wanted to be released, despite being drunk at 3-4X the legal limit, and not able to recollect how he ended up on his face in the street, right up until the CT revealed he had a major brain bleed. Pull the other one, Einstein, it has bells on it.

I had one lady, brought in because she was too weak to get up for seven hours after a fall at home, tell me she was leaving. I told her to go ahead. And waited. And waited. She could barely raise her voice, let alone her body.

Look, I get that it's frustrating when your 60-, 70-, or 80-year old body doesn't act like it does in your still-18-year-old head. But it isn't my job to mollycoddle your weak grasp on reality. It is my job to make sure I don't have to explain - or lose my license and livelihood - for why you're on the floor of your room on your ass, especially when you're frail, feeble, confused, broken, or on narcotic medications. If you could do Gene Kelly's "Singin' In The Rain" with full choreography, you wouldn't be in the hospital, now would you, smartypants?

This is on my bucket list. But not as a patient in the hospital.

"Patients are idiots" should be carved in stone above the hospital front door, because they won't let me wear a button that says DLTDHYITAOYWO. (I'll help out: "Don't Let The Door Hit You..." work the rest out yourself.)

And hockey pants with pads, and crash helmets should be mandatory attire after age 70.
You tell me which is sillier; dressing that way, or those neat-o zipper scars on your hips, and 6-9 months of OT/PT learning to walk again in your 70s and 80s. If you don't fail, stay in the hospital endlessly, get pneumonia and twenty other opportunistic infections, and then just die.
Because in case you didn't notice, you don't bounce as well as you did when you were five or ten years old.

When someone tells me that 98% of tort lawyers are literally dying of starvation due to lack of business, then we can talk about "overzealous" fall prevention from the medical professions.

Until then, it's crybabies wanting to have it both ways. If you don't like being group punished (and sorry about that, but make no mistake, you are) for the 25% of people (minimum) who're just conniving weasels and outright morons, punch them in the throat in the waiting room, and then go burn their ambulance-chasing lawyers' offices and homes.

But thanks for the entertainment.

You'll win this argument when pigs fly outta your butt.

I truly enjoy taking care of people, and I want each and every one of them to go home and enjoy life as near to whole as human wisdom and the medical arts can make possible. Even when they're not smart enough to figure out that I'm going to act in their best interest, even (especially) if it pisses them off or spoils their plans right this minute. Me and my coworkers easing off for ten seconds can turn into 5 years of court appearances, and six-figure damages. Or someone dying.

Alongside that consideration, someone's momentary butthurt is not a medical complaint, it's a character flaw for them to work out on their own.


Don't like hospital rules? Don't get sick, injured, or old. (As if, but that's the truth of it.)
No one's going to come to your house to enforce them on you. Problem solved.

Why Doesn't This Happen As A Policy? Everywhere?

(I mean, besides the fact that none of the suit-and-tie wearers or lab-coated clipboard commandos of "higher" practice thought of it.)

The sitch is that E.D. is frequently slammed. (I know, who knew, right?) Like, multiple ambulance gurneys in a conga line out the door and down the ramp to the street. No, for real, not just in blog-perbole. We literally have fire engines blocking the street because they can't get in to park when I get to work.

So one night I'm coming in to sign in, knowing it's going to be a special slice of heaven already, and Staffing is telling a perfectly good ICU nurse "Hey sorry, we tried to call you off before you came, we don't need you." So I jumped over the counter and started pummeling him with a fire extinguisher because we were already four nurses short on a ten-nurse shift suggested to him that they send the "extra" ICU nurse to the critically overloaded and understaffed E.D. for the night, instead of telling him to go home, make no money, and leaving us (and 100 patients) hanging. Because mothereffing DUH. We don't expect him to chart, or fully take over care, with zero departmental indoc, but for cripesakes he gets the same patients we send upstairs all friggin' night, so it's not like working the E.D. would kick his ass. (And I'm the outsider here, not a staffer. I just work there more days and hours than the full-time staff do.) And lo and behold, Staffing does it! So we made him the extra float nurse for the whole department.

And this dude kicked ASS! He was a friggin' rockstar for twelve solid hours!

The nurse I was paired with, who was also a float from our step-down Tele floor, who we'd love to steal permanently from them if he wasn't too smart to do it, takes Awesome ICU nurse under his wing, gives him the ten-cent tour, and then we turn him loose for the entire shift.
He passes meds when any given nurse is busy with other patients, and he starts, by actual count, 23 IVs that night. He transports 75% of the tele-monitored patients upstairs, which leaves the regular E.D. nurses free to stay and get sh*t done in the E.D., and we can drag in an empty gurney and turn over a room in 60 seconds instead of 15 minutes, and the nurse doesn't walk into a crapstorm with an unstable patient who's been sitting there untouched while he/she was gone. Which cleans out triage and ambulance overflow in a few hours, instead of the hospital lingering on ambulance diversion all night long.

So now Rockstar has a blast, only charts the care he renders (starting IVs, giving meds, etc.), and if he gets a chance, he wants to come back. And he has a whole new perspective on what E.D. is like, and why, when someone says "I need to give you report on this patient now" they really mean "I'm up to my ass in alligators here and someone tied pork chops around my neck! Hook a brother up and take this patient NOW!" without him being beaten over the head about it.

And he'll pass that perspective on to his co-workers who've never set foot down here.

If you're keeping score at home, I think that's win-win-win-win-win-win-win-win.

So all I want to know is why, in the name of heaven, they can't make a policy for full-time staff that EVERY RN in the hospital will pull a blazing one whole shift in a department that they either get patients from, or send them to, each calendar year. And every year has to be someplace they haven't been before, until they've been everywhere. Where they'll then gain a little 'walk a mile in my shoes" appreciation, insight, and empathy for the people they barely interact with from other floors and departments. Maybe even get to know a few of them a little.

It wouldn't break the bank, it wouldn't cause mass chaos, no patients would be harmed, and people from the back door to the top floor would probably start to feel like they were kind of all on the same team. (What a concept, right?)

We'll forget about the fact that people who move up to management would have multi-department skillz and contacts built in, and everybody would get a free taste of other departments and practice areas, and thus maybe transfer within the hospital, rather than just bail, and leave the clueless monkeys in HR wondering where to find another round peg for the newly empty hole, at a per-hire search cost of $50K, on average. (It's scary, almost like I've thought about this or something, as if it made sense on multiple levels.)

And when I note the specific experience on one shift, the management I tell about it are all smiles. When I suggest they do it as an annual experiment staff-wide, apparently it's like my Invisibility Cloak has descended, and they suddenly have an urge to go to the bathroom, do a bedpan inventory, or something equally urgent.

So now, as I drag myself off to more education, remind me why management with BSNs and advanced degrees means a better-run hospital. Because I need some ibuprofen, or a softer wall to bang my head against.

Refugees, Take Two

Apparently, according to one response, because I'm not culturally suicidal, I'm nasty and embittered (Moi? Mai non!) towards "Syrian refugees". And fail to recognize that some of them are really nice people.

I'll happily stipulate that some of them are.
And note that much like the guy who turned into the car in front of me last month, he missed most of the oncoming traffic. Care to speculate how that turned out for him and his passengers?
Or the people in the other car(s)?

We could cast about no further than these two happy folks, one a State-Department-vetted legal immigrant, and the other the son of same; not refugees at all, in fact being both well-paid professionals:

Or we could ask the relatives of these fourteen folks:

I said relatives, rather than direct questioning, because the first two happy additions to the American melting pot killed the other bunch of actual Americans (and shot another two dozen who luckily didn't die). Because Diversity!
(And just between you and me, I wouldn't trade an ocean liner full of the first two for any one of the other fourteen. But then, I'm nasty and embittered.)
.
Or we could just note, as I replied,

It isn’t the “nice ones” that concern me.
Sorry, I couldn’t hear the rest of your argument over the gunfire from San Bernardino, just down the road from here.

Our own director of the FBI – an Obama appointee – has flat-out stated that we have no way to ever adequately or properly vet such refugees, and that any claims to the contrary are simply outright fabulism. So this isn’t a D/R thing, it’s a wise/foolish thing 

If you feel inclined to send them aid over there, then yes, by all means do. Even with my tax dollars. I’ll even kick in extra on top of what I already send, just for that.

But failing to strain out the problem children, as we certainly will, with the guarantee that incidents like the San Bernardino Christmas bloodbath will become a regular occurrence here, is a lose-lose deal. If those refugees want to get in line behind the 93 million unemployed Americans already here, who need no such importing, and us with a government debt increasing by trillions and trillions, we can talk about how many more outsiders we can afford to carry piggyback. 

And nota bene in the pic above [in the original post -A.], the strange preponderance of fit, healthy, well-fed military-age males in that picture, and the utter dearth of starving women and children. Perhaps the latter wasted away entirely before the photographer could get a snap of them?

If all they wanted was regular meals and a roof over their heads, there are a dozen or more countries between here and Syria where they share a common culture, language, and religion. Not to mention identical culinary preferences. 

So I find it breathtakingly disingenuous to pretend that this is anything Maslowian in action, rather than acknowledging the obvious facts that it’s driven simply and entirely by a desire to feed at the deepest trough to which they can make their way, aided and abetted by quisling leaders who would gladly throw their daughters to rape mobs to curry the favor of people who would happily cheer the throat-slittings of Westerners to come afterwards, as they already do now. 

If room can’t be made for them in Jordan, Iraq, Turkey, or Lebanon, let alone anywhere from Morocco to Pakistan, they have no special claim on our favor to re-locate here, and if they have the means to move 10,000 miles away from home in the first place, they’re hardly incapable of finding someplace two continents closer to their ancestral home than this country, where we have all this annoying freedom. Our women get to freely express their views on the Internet, run around without sacks on from head to toe, and without being molested en masse every New Years’, nor be mutilated by their patriarchs, or slaughtered in family honor killings. 

I’m kind of a fan of importing people with a higher quotient of freedom toleration from the get-go, rather than bringing folks here whose traditional cultural method of settling differences starts and ends with bloodshed.  

If they have that much time and energy, they might more profitably occupy themselves with overthrowing Assad, and setting their own nation’s house in order, rather than clamoring that the Great Satan of Nations welcome them with open arms and clutch them to our national breast as long-lost cousins. 

In fact, when last I looked, there was nothing in the US Constitution forbidding other countries from adopting it wholesale and reaping its benefits, if that’s all they have in mind in the first place. We could certainly use some more like-minded friends over there. 

Nurses meet people in need every day.
We don’t bring them home with us.
If things are so slow where anyone works that they don’t have enough people right in front of them that could use further efforts and assistance, I suggest what’s needed isn’t a refugee visa program, but rather perhaps a closer look around – within driving distance. 

But if, despite all that, you still want to buy the world a Coke, please do it with your nickel, and invite them to live in your house at your expense first, before you kindly sign the rest of us up for the privilege.
The problem with socialism is that eventually you run out of other peoples’ money.

Sorry, but that's not nasty or embittered at all.
And I don't despise Syrian refugees (or the other 98% that make up the hordes descending on the rest of the Western world pretending to be refugees, or Syrian, and/or both.)
I just have an extremely low threshold tolerance for simplistic bullshit.
And when you walk into metaphorical thorns up to your neck, on the Internet, the best thing to do is probably to back out quietly, with a minimum of whinging, rather than doubling down on it.

I anyone wants to talk about what we "owe" the rest of the world, have at it.
I'm not isolationist by any stretch, but it seems to me there are about a metric fuckton of American graves filled with our sons sacrificed on behalf of the rest of the world, in contrast with two statues of foreigners here who ever did anything notable for us.
(I'm not discounting any of the individual sacrifices on our nation's behalf by literal hordes of foreign people - who were, in the truest sense, simply Americans in their souls who were born somewhere else - just noting the dearth of any official response by other nations as such since Lafayette & Co. landed here in the thirteen colonies.)

Y'all give a holler when Syria, or any other twenty nations combined, hits the shores here to save us from tyranny. Let alone sends us so much as a fruitcake at Christmas, because they like us.

That'll be the day.

Refugees, Politics, and an instructive fable

In reference to the most recent post at Florence Is Dead, regarding the thought that 2,290 Syrian refugees here since 2011 is not enough, the following:

We currently accept around 1,000,000 immigrants per year to the U.S., and that's just the ones who come here legally. (We can ignore the other 10-20 million here illegally we're currently supporting every day for another discussion another time.)
That's more than the sum total of legal immigration for all other countries combined, on the entire planet, and has been so for decades, year in and year out.

So given that the "refugees" in question are some 5,000-10,000 miles away (depending on where in the US we're talking about), and have to pass over any two of three continents, or over two complete oceans between them, to arrive here in this hemisphere, skipping past any 40-50 other countries en route, the correct number of Syrian refugees we ought to be accommodating here is therefore right around zero.

If you can find any of them who relish individual liberty, representative government by democratic republic, long for the benefits of our Constitution and Bill of Rights, the blessings of (mostly) free market capitalism, and eschew enforcing religious tyranny on all others at the point of a sword, and they have a working knowledge of English and our American history, by all means, send them - to get in line behind everyone else seeking a better life.
Just because 8 billion people want to move here (or to Europe) as part of the Free Sh*t Army doesn't nor should it grant them any claim to American citizenship, nor even to legal immigration status. Which is precisely the reason most of Europe is calling up troops and building fences to keep their hordes out, and why the governments there who ignore that are about to find themselves ousted. Or worse.
(That's the best event, assuming another couple of Paris-style incidents don't push the entire continent to the cattle trains and barbed-wire camps stage, which is hardly a new or surprising thing over there, historically speaking.)

But importing hordes of people to this nation from Third World poverty, without any marketable skills, and saddled with an allegiance to a repressive theocracy which authors the most brutal forms of repression, torture, and slaughter against women, gays, and every other religious faith is right up their with someone wondering what would happen if a person shoved a grenade up their tailpipe with the pin pulled out.

The two clearest examples of what that looks like for real need be gathered from no further back in history than Beirut in the 1980s, and Sarajevo in the 1990s. Anyone in any doubt should vacation there, and report back to the group on the experience.

And the enclaves of precisely the second generation economic refugees in Europe already admitted in better times (from Syria, Lebanon, Algeria, etc. - all former French colonial leftovers), and now without prospects, plus bearing no love for the country that sustains them, were the precise breeding grounds for those who conducted the Paris attacks. The correct term for those who kill their hosts isn't "refugees", it's "parasites". So let's be scientifically and pathologically accurate, shall we?

If someone is feeling the call to help Syrian refugees (who comprise some single-digit fractional percentage of the hordes now descending on Europe - the rest are from anywhere and everywhere other than Syria), then by all means, send as much of your personal resources as you'd like: to help them survive and make their way on their own continent, ideally in some safe enclave in their own country, or at worst nearby and geographically much closer. They belong in a place where they have some reasonable hope of someday returning to their own native homes, and staying alive in the meantime without resorting to trying to float to Europe on a raft made of floating debris, or walking on foot to the countries with the best welfare payments.

Better for them, better for us.

Anything else is tongue-kissing syphilitic lepers, and doing mouth-to-mouth on drug resistant TB patients, because compassion without cogitation.

Nursing is about using our heads along with our hearts to help people.
My namesake's fable about The Scorpion and The Frog comes to mind.

 

Bonus points for bravery/stupidity: putting this question to nurses at Loma Linda UMC in San Bernardino, today.

Over there someplace --->>>
there should be a new addition to the blogroll:

Hogwarts' School of Grid-Down Medicine.

AKA providing medical help for you and yours, when you're all there is, or is likely going to be, for any number of reasons.

Doc Grouch, Ivymike, and myself had it suggested upon us courtesy of Concerned American over at WRSA.
We promptly all fell all over ourselves thinking what a great idea it was. Doc Grouch and Mike did just about all the work of launching it.
My input was some tinkering, and then I got a vacation, and then my return to reality, as previously noted, has been a bit...bumpy lately.
Thus any credit due to me for it so far is right about nil, so I'm not being immodest to tell you the site looks great, and there's stuff there you should read, learn, and pay attention to, if you think big shiny white hospitals and endless streams of Government Bux to pay for visits there will not last forever, in all places and times, for the rest of your life.
In other words, if you have any grasp on medical and sociological realities, let alone an awareness of the frequency of life's normal allotment of natural disasters.

Doc and Ivymike have done great things there thus far.

As my situation stabilizes, and I get back to regular posting, I'll have more of a share carrying my end of the log, along with Doc Grouch, IvyMike, and anyone else we can cobble together to keep it a going concern, and improve it.

Start at the beginning, read the posts, do the homework.

Our goal is not online medical school. (There are probably laws against that anyways.)
It is that everyone with the time and inclination be provided with the guidance, resources, and gentling prodding (of a solid boot in the ass, metaphorically) to be as prepared as they may choose to be to deal with medical emergencies anywhere, with what's in your pockets, or even better, with the prudently-stocked contents of your home version of Somewhere General Hospital. And anyplace on that spectrum between those two. Guided by what we have invested and reaped from a combined goodly number of decades each and all trudging through the corridors practicing our medical arts.

Go.
Pay attention.
Learn stuff.
Practice it.
Save Lives.

Potentially even those that mean the most to you personally, at a time when you may be their best, or only, chance.


(And though Life's been kicking my butt a tad lately, I'm kicking back, and I'll shortly be back with more Shepherd stories - from a host of new assignments, and a number that have been kicking around for awhile, as well as seeing what Ebola is doing these days besides killing people as efficiently as ever. So whatever you've been coming here for will return in short order, once things settle down a bit for me. thanks for your patience.)

Home Water Storage

This is not exhaustive, obviously, but it's a handy overview. The full range of options are as unlimited as your own imagination and inventiveness, provide you think about all the aspects regarding weight, bulk, safety, accessibility, and cleanliness of the supply.
From bottom-end to top, some choices to get you thinking:

G.I. 1-quart plastic canteen.
Water for 6 hours or so. $5-10.

GI 5-gallon plastic water jug.
Water for 5 days for 1 person. $35-50.

Aqua-tainer 7 gallon water jug.
Water for a week for 1. About $20.

Water Bob 100-gallon bathtub water storage bag.
Water for 3 months. $30.

Food grade 55-gallon water barrel.
Water for 2 months or so. $75-ish. (Shop around. You can do better than this. Also, some opportunistic jackholes are asking $175 and more for the same thing. If you're willing to pay over 2 times market price, go to the tattoo parlor and have "SUCKER" emblazoned on your forehead.)

IBC 330-gallon caged palletized water tank.
Water for nearly a year for 1. Over $500 new, plus shipping.
Used ones can be had; make sure they were used for water, and not something like vinegar, or some toxic chemical. This is why IMHO, new is your friend unless you're a careful customer. Also nota bene the filled weight is nearly a ton. This mixes with stick-built upper floors in apartments rather poorly, especially in seismically active areas, but it will help you meet the downstairs neighbors. And their insurance adjuster.
OTOH, if you mount one on 3/4-5/4 plywood set on top of two levels of cinder blocks in a ground level garage or other concrete slab, the drain spigot will be handily elevated to fill smaller jugs and buckets. If you mount one or several in series at elevation, and plumb them to the home system, you can create low water pressure to supply whatever.

 

Above-ground pool.
Various sizes. This one holds 425 gallons, and goes for $57 @ Wal-Mart.

You could get an 18' diameter x 52" tall metal-walled monster that holds 7700 gallons (a year's drinking water for 20 people) for a bit over $900.
Even bigger models are available. BTW, the best time to buy is now, with retailers and manufacturers sitting on last summer's leftovers, and sales prices in full effect.
Notes: if you can put it up inside a garage and put the cars outside, it's secure, and on a stable and accessible surface spot. You'd want to cover it, still be best off by purifying/filtering the water before drinking or cooking, and want to sandbag or build some diverters in case of leakage or failure. But you could cook and drink for years, and have enough left over to wash a set of clothes in a bucket once a week, and then use the after-wash to occasionally flush a plumbed toilet, even in a multi-level condo with garage in the 'burbs. Obviously, you wouldn't be able to leave it set up perpetually, but in a pinch, with between a couple of hours to a day, you could fill it up while the muni taps are still running. Think about that.

There are obviously even larger storage options, including in-ground pools and water tanks. As you approach that point, and get into the means to fill/recharge them manually or naturally, you're getting more into water sources than water storage.

Which I'll visit another time.

Best Practices

{Not an Ebola post, and nothing many of you don't already know. If that applies, take the opportunity to make the current crisis a teachable moment. And give the new kids a chance to catch up. Or, skip this one.}

From Comments:

I guess I have to add to that the fact that no one has any idea what they should or can do when a local case or two show up. Dallas, you'll notice, is still there with people in it. What were they supposed to do as a practical matter? What is anyone to do who doesn't have a remote farm, a big bank account, and a place to put all the needed stuff (much less the right weapon and ammo to defend things and people should it come to that)?

Glad you're putting it out there for those who missed it first time around. But some practical best practices guide for normal people along in here would be useful.

I note for the record I have no remote farm (yet), nor a big bank account. I do have the place for the stuff here, and the means to keep it in my possession.

Now about the details...

I can't tell anyone else when they should decide the time has come to drop out, and either load the car and go, or drop the drawbar across the front door. There are way too many variables (job, family, dependents, location, size of the outbreak, your own resources, etc.) for me to offer anything concrete in a one-size-fits-all manner.

What I can say is that each person should look long and hard at their life, and decide on a threshold for how close you're willing to let it get before you'd act. Realize that your friends and neighbors will do that too, even if it's ad hoc/on the fly, so factor that in as well. Don't be the last one standing when the music stops.

Whatever event or circumstances is your bubble, it has to be enough that you shouldn't and won't rationalize it away when it happens. Every year they find the bones of pilots who skipped a step, or had get-thereitis, and drivers and backpackers who kept going long past the point where they should have said "I'm lost" and stopped, or turned around, but instead kept going thinking things would sort themselves out. They generally find what's left of them the next spring (or five) later, much the worse for wear.

Don't be that guy.

If you're not going to take drastic action until your neighbor gets Ebola, or until people are dropping in the halls at work, because you're out of vacation and sick days, that's fine, it's a free country, but it's your hide. At that point, your bosses' prudence may be the deciding factor, because if they close up the shop, you're done either way.

But if they're idiots, you'll die in obedience to their lack of common sense. Choose wisely.

As far as other best practices, it's much easier.

Water

You need water pretty much daily. One day without it will make you very thirsty. Two days will make you thirsty and debilitated. Three days without it will probably kill you. This all shortens in hot environments, or when doing a lot of heavy work, coupled with high stress (which makes your heart beat faster and increases respiration) - like say the stress of a deadly virus running rampant.

If you have a well, and a bombproof back-up power supply (or three) to run the pump, nifty; you're golden.
Most of us don't.
Blue barrels work great. A trash dolly to move them, a place to store them, and a means to get the water out (which could be as simple as 6' of plastic food-grade tubing for a simple siphon) and you're looking good.
Figure a minimum need of 1 gal/person/day for cooking and drinking.
Better than blue barrels is a cistern - an underground or above-ground storage tank. Big, and buried below the frost line is ideal. For someone in a condo, not so much.
Got garage? If you can put the car somewhere else, you can get an above ground pool that would hold enough water for a family for quite a while. Fill it, tarp it, and purify what you take from it, but for lots of quick storage, it's better than wishing.
If you have a second bathroom, treat it as the luxury it is (tough though that may be in a house with teenagers, but still, tough it out), and get a Water-bob for 60-100 gallons of drinking water stored in the tub.
Catching and purifying rainfall or snowmelt may also be a regional possibility.

Whatever you elect to do, without water, you're not going to make it.

Food

As I've said several times, canned, canned, canned.
Greatest variety, 2+ year shelf life on avg. (ignore "Best by" freshness dates per se, we're worried about only two things - is it safe, and is it nutritious), and best cost to quantity value.
Downsides are bulk/weight. There are whole books on storing food. Get one, and bone up.
Personal advice, figure out, for whatever family-unit you're contemplating, a menu for one week's meals. If necessary, start with one day's meals.
For instance:
Breakfast -
oatmeal
raisins/applesauce/brown sugar (to put IN the oatmeal)
OJ/Tang
coffee/sugar/creamer if you've got the habit
or
cereal
sugar
dried fruit
non-fat powdered milk

Lunch
PB and J
raisins, banana chips, dried apples, etc.
or
canned tuna
mayo and mustard (packets)
dried croutons, olives, etc.
drink mixes (Koolaid, Gatorade, lemonade, etc. make water all the time one helluva lot more palatable)

Dinner
canned meat (beef, chicken, ham, salmon, etc.)
beans
rice
potatoes
misc.veggies
canned or dried fruit
soup
condiments, spices, etc.

Those are just a couple of examples. Whatever personal menu you work out, try to get cans where you'll use the entire can at one meal. Then nothing gets spoiled, and you don't need to store leftovers.

Don't forget a can opener or three. Not everything has an easy-open top.
Once you've planned a week's meals, buy them. Then try them out for a week, no cheating, and field test your menu. Tweak it as necessary.
Then go buy another week's worth of the improved menu.
Do that every other week in a year's shopping, and you've got a 6-month food cushion for a pandemic, or any other disaster, including illness for a parent, or loss of a job. Not all disasters affect the whole community.

Once you've got 6 month's food, one week out of every month, eat 1 weeks' supplies, starting with the oldest stuff. (Write dates on the can lids with a Sharpie/Magic Marker). Replace what you eat, and always eat the oldest, and over two years, you'll be using your food without losing any of it to time and spoilage, getting the family used to the fare, and dining one week per month at prices from two years ago.

MREs are a heat and shelf-life limited, expensive, and generally nasty alternative, but they'll do in a pinch for the short term.
Dehydrated packed canned foods last longer, but cost a lot, and have less variety.
Do anything you like, just understand the pros and cons.
But do something.

Other things

Winter is cold, summer is hot, and you need to be able to cook that food, maybe boil the water, and keep the place hot/cool.
So energy/power generation are a good idea. In severe winters, lifesaving.
That can be solar panels and battery storage.
It can be a big propane tank.
It can be a few cords of firewood.
Or a generator and stored fuel.
Ideally, many or all of the above. If you have only one way of doing anything, that's your failure point.
So have two, or five.

Most of the year in most of the country, you could cook dinner every day with nothing more complicated that a solar oven. You can buy one or make it, and most of what you need is sheet metal, black high-temperature BBQ/stove/engine paint, a big glass cover, and a dark cook pot, all pointed at the sun for a couple-three hours.

I've seen Gilligan's Island-style indoor fans rigged out of a bicycle wheel windmill wheel, thirty feet of bicycle chain, and an axle to an indoor fan blade. Thirty MPH desert winds outside, through the magic of Schwinn and Shimano, turned into an indoor variable-speed fan that also pulled out the hot attic air. A little grease and 3-in-1 was the annual maintenance.

One patio balcony solar panel, a deep cycle battery, and an inverter will charge laptops and cell phones indefinitely. And run a microwave long enough to nuke a bowl or cup of something. A bigger set up gets you LED lighting everywhere.

I've done laundry with a five gallon bucket, a GammaSeal lid, some soap, and some vigorous shaking. It works. So do clothes lines in the sun or over a heat source. Welcome to the 19th century.

You should have basic first aid supplies.
Not Ebola supplies - unless you have a death wish - but at bare minimum the basic everyday stuff to take care of small emergencies. A box of bandaids isn't enough.
Don't forget dental emergencies.
Right now, you should be able to handle minor burns, cuts and wounds, sprains, strains, etc.
If you're serious about things, some facility with other problems, when 911 and the ER aren't 10 minutes away, would be prudent as well.

Money.
Cash, not just plastic; junk silver when you can get some too.
If you haven't built up a minimum six month's cash financial cushion, readily accessible, even if you have to do it with a mayonnaise jar and your daily spare pocket change, you're not doing it right.

The ability to put out a small house fire, and perhaps even a larger one.

And the ability to take care of localized income redistribution specialists (thieves, robbers, burglars) et al. Whether that's something from the local dog pound, or from Colt or Glock, or both: your call.

At that point, you've now taken responsibility for replacing the water utility, the supermarket, the power company, the ER, the bank, the fire department, and the police.

There are entire bookshelves of books on each and all of these topics. I know, because I have most of them, including all of the good ones. Add those, along with some good reading books*, a few games, and some DVDs, and you've also replaced the library, television stations, and the movie theatre.

Add some local and SW radio receiving abilities (sending would be good too at some point), plus the internet while it lasts, and you've got the same news abilities of the major networks.

Look that over. They're listed from most important to least important, generally.
Correct your deficiencies. And don't get one perfect, and neglect the others. A million gallon cistern won't feed you, and a full pantry won't heal an infected cut, or stave off an armed robber. Get a basic level of capability in each area, then flesh it out, make it deeper and more resilient, and add redundancies, because things wear out, break, get lost or just walk away, or they go to the Island Of Missing Socks.

And remember: having only 72 hours of emergency supplies guarantees that you'll be in a FEMA refugee camp on Day Four. Go deep.

That's best practices, until you can put all of that together on a remote farm, and amass a big bank account.

Having those basics now improves your chances of getting there eventually.
Failing to do so puts you at the mercy of other people, and your best interests are seldom in theirs.




*(A favorite thought-game: At the end of The Time Machine, the out-of-time protagonist grabs three books to take back and help the Eloi rebuild society. Think about which three books you'd take.)

Math Just Is

Epidemics are, first and foremost, a math problem: how many people, infected how fast, increasing at what rate. It's not daunting, but some peoples' eyes glaze over at anything beyond checkbook math. But one good instructor can solve that with a clear explanation.

From Frozen Patriot, and posted at WRSA, a short, simple, and laser-beam clear explanation of the math underlying this outbreak:

                                                             Math Just Is.

Go there, and Read The Whole Thing.

Then, make appropriate plans, based on the implications for your own life.