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Sunday, 16 February 2020

BASIC EPIDEMIC / PANDEMIC PREPARENESS

                                                                           
A short commonsense no panic look at basic preparation for an epidemic / pandemic, biblical proportioned factors aside.


                           THIS POST DOES NOT REFLECT ANY SINGLE PATHOGEN
                                           ALWAYS FOLLOW OFFICIAL ADVICE

                   What to prioritise -
Following sensible evaluation and news.
Staying aware, avoiding misinformation.
Infection prevention.
Staying safe when out.
Stating safe at home.
Dealing with the sick.

                                Knowledge -
Know your enemy. A broad and sensible understanding of the pathogen, it's source, how it infects, how long, what happens when it does, it's symptoms, an appropriate procedure to prevent infection and spread.

                                                                                                                                    slideshare.net
                    News and updates -
Following 'Voluptuous Vicky and the Virus' on You Tube may seem like a good option at the time although will probably prove to be no more of a distraction, as nice as that may be ha ha . 
Remember keeping an ever watchful eye on local and global activity even outside of a major outbreak is a wise idea. Build your news feed, as with any major situation having a reasonably reliable source of information is more than essential. 
A typical general 'situational news feed' this can be adapted to include different sub divisions within the pandemic frame such as ECDC, WHO, Area Health Authority, NHS, Public Health England.

       Some useful links to include or be aware of
          European Centre For Disease Control
                      Public Health England
                                  NHS
                                                          GOV.UK
                           (Any current outbreaks of concern are highlighted with 
                        relevant links on the home pages of  PHE, NHS, GOV.UK)
                                                             Promed
                                                        CDC
                                                     Health Map
                                     Outbreak Monitor Map
                   Royal Society Of Tropical Medicine
Remember to include local responders, hospitals etc many have Twitter feeds.
Avoiding infection -
This will to some extent depend on the pathogen at play and understanding it's routes of infection etc.
                                                                                                                                          slideshare.net
                           Venturing out-
Depending on the severity of the situation consideration could be given to all but necessary travel, avoiding populous areas, large meetings, public transport and such. 
Precautionary measures-
Regular hand washing where possible, avoid consuming 'quick on the move' snacks in public, remember other people have rummaged through those crisps and touched shop surfaces. Do not forget multiple use items risk, card machines if you do not have contactless, cash machines, self service machines, doctors surgery / hospital appointment sign in screens, many others to think about. When entering anywhere, train, shop, etc hand sanitise in, hand sanitise out, avoid touching your face.  
A personal sanitiser is a good idea when out and about, it would be wise to keep it handy such as on a clip, going through pockets or a bag for every use could increase risk via surface spread.
Adding a simple clip to your sanitiser.
                                                 
The question of masks. With guidelines, some contradictory, abound on these things in the context of pandemic so i guess it is make your own mind up time on this one. Protect from sneeze and cough, i would think anybody in that condition given it would be a serious illness would probably be at home, in bed, aching and sweating, much the same for advice on carrying tissues, walking around with full blown flu, nope, in bed aching and sweating, yes.
Within the NHS pandemic preparedness strategy both surgical and FFP2 are stockpiled for frontline staff within a clinical setting.
Dr David Carrington,  St George’s University  London “Routine surgical masks for the public are not an effective protection against viruses or bacteria carried in the air.”Most viruses” were transmitted by being carried in the air, and the masks are typically too loose, no air filter and left the eyes exposed, they may help lower the risk of contracting a virus through the “splash” from a sneeze or a cough and provide some protection against hand-to-mouth transmissions. 
Jonathan Ball, professor of molecular virology at the University of Nottingham “In one well-controlled study in a hospital setting, the face mask was as good at preventing influenza infection as a purpose-made respirator. When you move to studies looking at their effectiveness in the general population, the data is less compelling.
It would be deemed far more likely for you to be exposed via surface contact exposure than airborne droplet exposure. Consideration to regarding type of mask, if it fits properly, type of pathogen. 
Sneezes and coughs, droplet range about 2mtrs, these do not necessarily have to be breathed in, a contact with a mucosal surface, in some cases the eyes. Again knowing the pathogen in play will gain further detail.
For matters of interest here we look at two common types of mask. 
The surgical mask to EN14683:2005 types 1 and 2, splash and non splash resistant.

  FFP masks to EN149/2001. FFP2 and FFP3  
Surgical masks aside, these afford the wearer protection to standards indicated assuming that said mask both fits and is used correctly.
               
The only sure way to know that your mask reaches the level of cover it can provide is by means of an official fit test (a legal workplace requirement if you need one at work) 
                                Filteration
                   FFP2  94%

                   FFP3  99%

                                                                                                                                     slideshare.net
Previous Facebook post showing ease of spread with multiple infection points from a single person.                                          


Home -
A place of safety, hopefully. Limit visitors, have a sanitiser station for all to use.
Create a general cleaning routine for indoor surfaces but not forgetting the outside, door knobs, bell push, gate latches etc. It might be wise to stock some cleaning supplies as the possibility of shop stocks running out as with


any other type of scenario could be considered. 
See additional post on this blog 'create a home sanitisor station' regarding further information of keeping your home safe.
                                                         
                                                                                                                                              slideshare.net
The sick -
Isolate. Carer advisory, suitable PPE / care in relation to pathogen involved.


              
An example regarding the COVID-19 situation. This could vary pathogen dependant. A (Facebook posting at the time) Note always follow official guidance.

Dispose of used and likely contaminants safely.

                           Basic Biological Kit
         
                 
                                   LINKS
              Can surgical masks protect you ?
              News article. Next flu pandemic U.K
                 Preparing for a pandemic
           Understanding FFP protection types
   Pandemic flu guidance for planners GOV.UK
                Pandemic response GOV.UK



                                          
                                          
                           Also on this blog


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*This post does not intend to represent or replace any official guidance.