By now, it should be obvious that we cannot rely on this administration to keep Ebola out of our country. It has been unwilling to restrict air travelers from entering or to secure the open land border. The CDC is simply offering lame rationales to support administration policy. Its advice on infection control is inconsistent. Also it is based on categorical assertions that are unproved or demonstrably false. Hospitals are unprepared even by CDC standards.
Americans are at risk of exposure from foreign nationals who have been in West Africa, from Americans who have traveled there or been deployed there by our military, from medical workers who may have treated infected patients (knowingly or unknowingly), and from those who have come in contact with any of the above. A particularly ugly possibility is contact with a terrorist intent on infecting as many people as possible. Not only does law enforcement refuse to profile likely terrorists; alarmingly, some terrorists may be alienated Westerners with a name as common as “John Smith,” a middle-American accent, and inconspicuous dress, who acquired their ideology and training from the Internet.
We need to be increasingly careful in our social interactions, and watch for reports of diagnosed cases near our area. Is it safe to go to a hospital? Even without the Ebola threat, a hospital is increasingly a high-risk environment. As demonstrated by the SARS (severe acute respiratory syndrome) outbreak, hospitals can become major venues for contagious disease transmission.
In Canada 77 percent of probable SARS cases resulted from in-hospital exposures. In Taiwan, the director general of the health ministry stated that after the initial importation of SARS, almost 94 percent of SARS infections were transmitted within hospitals. Then there is the question of whether hospitals will even be available to you. Hospitals are already understaffed. If it takes 20 full-time staff to care for one Ebola patient, how many such patients would it take to disable (and bankrupt) the hospital? How many of the staff will decide to change jobs?
There is also the burden on the economy, and the disruptions in essential services if people self-quarantine instead of reporting to work. And what if other nations decide to impose restrictions on travel and commerce from the new Hot Zone of the United States? To avoid the dire effects of an uncontained outbreak here, we need unceasing activism to urge Congress to block a continuation of this administration’s disastrous policy. Some congressmen are asking some of the right questions, and author Alan Korwin suggests many more.
For example: Why didn’t president Obama seek out a broad coalition of troops before sending our soldiers to fight the Ebola virus? What was Obama’s basis for seeking to fight it unilaterally, deploying troops without congressional approval? Why exactly did he need an extra thousand troops to fight the virus, so soon after the first deployment? Is Russia or China sending in troops to fight the virus? When do our troops come home? Is there a rotation schedule? Do they have to be quarantined for twenty-one days when they do come home? What’s the plan for troops who come back and have Ebola? Has the Veterans Administration been prepared for handling Ebola cases?
Since the situation is likely to get much worse before it gets better, you need an emergency plan. This will be good insurance for various other disasters as well. Remember, do not rely on the government to protect you or help you.
- Watch the outbreaks section of the CDC website, your local news, and the Threat Journal.
- If there has been an outbreak in an area, stay away for at least twenty-five days after the last reported case; preferably wait forty-two days.
- If your child is in public school, consider changing to a private school, or homeschooling. In addition to hospitals, public schools, which must accept illegal foreign nationals without adequate health screening, are prime sites for contagion. Additionally, think of the political indoctrination and moral corruption in government schools.
- Limit travel. If you must use public transportation, take a travel kit (see below), and don’t be shy about setting new fashion and etiquette trends.
- Think twice about attending large public gatherings, especially if new cases of disease are being reported.
- Do you have some food? Before you go for expensive “survival foods” (which some say are becoming unavailable, surely a bad harbinger), stock up on the basics: rice, beans, salt, sugar, baking soda, salt substitute (for your rehydration kit, see below), and canned food that requires no cooking. The best advice for long-term storage is still Cresson Kearny’s Nuclear War Survival Skills, invaluable for all types of disaster.
- You can’t have too much water.
- Do you have cleaning supplies: chlorine bleach, soap, detergent?
- Do you have a stockpile of medications you need?
- Do you have a battery-powered or hand-crank radio and enough batteries in case of power outage? A light source and a means of cooking?
- Stock up on trash bags and ziplock bags.
- Make a shopping list, and add a few essentials to your supplies whenever you go out. Remember that store shelves will empty quickly in an emergency.
- Do not rely on the hospital emergency department for things that can be treated elsewhere. You do not want to be sitting for hours in the waiting room. (You might want to take your travel disinfection kit with you if you do decide to go to the emergency room.) Find a doctor who is not beholden to a hospital or an insurance network, and support him by seeing him for all your medical needs, not just the bad ones.
- Have medical information on your bookshelf. Don’t rely on the availability of the Internet. Suggestions: an old PDR (Physicians Desk Reference on prescription drugs); used medical textbooks (state-of-the art treatment changes, but diseases not so much); a Merck Manual; Dr. Lee Hieb’s suggestions (The Special Operations Forces Medical Handbook and the U.S. Army First Aid Manual).
- There are many suggested lists of medical equipment and supplies, including drugs that your doctor would need to prescribe. The 1987 prices in the Doctors for Disaster Preparedness Basic Medical Kit for a 10-to-20 Person Shelter, which is directed toward physicians but has many items that lay people can use, show how devastating medical inflation has been.
A TRAVEL KIT
- You need several pairs of powder-free disposable gloves (nitrile, latex, polyisoprene, or neoprene), some N-95 masks, a small bottle of hand sanitizer, some individually wrapped sanitizing wipes, a one-gallon ziplock plastic bag for contents of the kit, and several 1-quart ziplock bags for disposing of waste.
- Practice taking the gloves off without touching the outside with your fingers; turn them inside out as you do so.
- Alcohol-based hand sanitizers are effective against many bacteria and enveloped viruses such as Ebola. For nonenveloped viruses such as norovirus, alcohol is ineffective. Zylast uses benzethonium chloride. Other products are hydrogen-peroxide based, though plain 3 percent hydrogen peroxide is said to be ineffective.
Look for disinfectant wipes shown to be effective against norovirus. They won’t have been tested against Ebola, but enveloped viruses like Ebola are easier to inactivate. If they don’t come individually wrapped, put them in a ziplock bag. The EPA has a sixty-five-page list of products registered as effective against norovirus.
- You should still vigorously wash your hands for twenty seconds with soap and water at every opportunity.
DISINFECTANTS IN HOME OR SICK ROOM
- A 1:10 dilution of hypochlorite can be prepared from household chlorine bleach (hypochlorite at 5.25-to-6.25 percent). This is equivalent to 5,000 parts per million (ppm) chlorine. To make this, add 11/2 cups of household bleach to one gallon of water. The effectiveness of diluted hypochlorite decays over time, so working solution should be prepared fresh every twenty-four hours. Paper towels or cotton cloths should not be used in open cleaning buckets because cellulose reduces the effectiveness of hypochlorite and hydrogen peroxide. Do not mix chlorine bleach with other agents, to avoid generating poisonous chlorine gas.
- According to the Kimberly Clark Ebola virus disease precautions brief of September 19, 2014, a contact time of ten minutes should be sufficient if there is no organic matter present.
- Remember that toilet flushing generates aerosols filled with pathogenic organisms. If caring for someone with vomiting or diarrhea, it might be helpful to pour bleach in the toilet and allow it to stand for at least ten minutes before flushing with the lid closed. (Then disinfect the lid.)
- Ultraviolet radiation from the sun is the primary germicide in the environment. The time it takes for sunlight to inactivate filoviruses has been studied under various conditions. For example, filovirus activity is reduced by 90 percent on a clear day at midday in April in Griffin, Georgia, in about one hundred minutes.8 Viruses are protected by the presence of organic matter.
- UV-C, a shorter wavelength than found in sunlight, is more effective. Ultraviolet “Ebola-zapping” robots are being used to disinfect hospital and nursing home rooms. The UV lights commonly present in isolation rooms in hospitals have fallen out of favor; literature on them is decades old. You can purchase air-purifying devices with HEPA filters and UV light (see EbolaReady.com for suggested sources). Efficacy against viruses is unproven, but the devices at least purify the air of allergens. Your eyes must be protected if you are looking at a UV source, and sunglasses are not adequate.
- Viruses are degraded over time. “Quarantining” a room for a week after cleaning and disinfection provides an added margin of safety.
- Surprisingly, the majority of people, even in the sunny Southwest, are deficient in vitamin D, which is essential for immune function. There is some evidence that optimal levels of vitamin D may be even more protective against influenza than immunizations. The best possible method is to expose a goodly portion of your skin to sunlight for twenty minutes a day, without sunscreen. As that is difficult for most people, supplements are a good idea and are safe; 10,000 IU of vitamin D3 each day is recommended.
- Vitamin C needs to be in your food stockpiles, as it is essential for all, and fresh fruits and vegetables may be impossible to obtain during a crisis. Fighting infections depletes your vitamin C level, so you need more when you are sick. Sugar also depletes vitamin C. Vitamin C tablets deteriorate over time, so your supply needs to be rotated.
Taking large doses at frequent intervals to “bowel tolerance” (backing off when you get diarrhea) is suggested by some practitioners at the first sign of any illness. Lypo-Spheric vitamin C, available online, is expensive but may be tolerated in higher doses. In fact, it may be combined with tablets, as the two forms may act somewhat differently. This is not mainstream medical advice. There are no good efficacy studies, but it is very unlikely to be harmful.
- Numerous other supplements are touted, but discussion of them is beyond the scope of this booklet. One caution is not to spend all your money on unproven remedies if you don’t have the basics covered. And do not make any assumptions that you will be protected and can thus take a risk of exposure.
- Patients who might otherwise recover can die rapidly from loss of fluid through diarrhea and vomiting. Given the present shortage of basic medications in the United States, even essentials such as sterile intravenous solutions, it is imperative to have the ingredients for oral rehydration.
- Formula for homemade rehydration solution: Take one quart of water, add one scant teaspoon of Morton’s Litesalt or other salt substitute containing potassium chloride, 25 10 teaspoons of sugar, and 1/3 teaspoon of sodium bicarbonate (baking soda).
- If using a salt substitute that contains potassium only (read the label), use 1/2 teaspoon of the substitute and 1/2 teaspoon ordinary table salt.
- Sip slowly; the patient might be able to retain enough even if vomiting.