Philanthropy's Response to the Avian Flu Pandemic Threat

In early 2006, the Council convened a strategic planning symposium, "Avian Flu and Philanthropy's Response," to discuss the philanthropic sector's leadership role in preparing our communities for the possibility of an avian flu pandemic.

Grantmakers In Health and top medical experts outlined the threat of this illness. There is a huge gap in our public health preparedness for this - or other - widespread infectious diseases. The grantmakers who gathered for the symposium identified a number of activities in which the foundation community can play a valuable leadership role in concert with public officials and community organizations.

• Executive Summary [pdf]
• Discussion/Action Guide [pdf]
• Attendance List [pdf]
• Resource List [pdf]
• Sample agenda for a regional or local meeting [pdf]

For more information about this initiative, contact the Emerging Issues Staff.

Additional Resources

Preparing Your Family for an Avian Flu Pandemic (March, 2006)

John Ruthrauff, EMT

It is not certain when the world will experience a major flu pandemic at the level of the 1918 pandemic. Hurricane Katrina demonstrated that government at every level is ill prepared to handle major emergencies. When the avian flu virus (H5N1) mutates to human-to-human transmission it will spread very rapidly around the world, in a matter of weeks. This can occur year round, not just in flu season.

Because there will be little time to prepare after human transmission occurs, it is prudent to take basic steps prior to the flu's mutation to protect yourself and your family. During the 1918 pandemic 675,000 Americans died. A comparable figure today is 1.7 million. Cities were hardest hit though people died all over the country. In 1918 the mortality rate was approximately 2.5%.

People are highly contagious for two or three days before they have symptoms and seven days after symptoms end. A general rule is to stay at least six feet from someone to avoid contagion. Avoiding crowds or close contact is essential including public transportation, theaters, churches, schools, and meetings, even elevators. Because of the rapid spread of the virus precautions should begin immediately when human-to-human transmission occurs in the country.

Many modern buildings are centrally heated and cooled with re-circulated air. Flu germs are transmitted through the air and live outside a body for up to three days. Touching an infected person, their clothes, or anything an infected person touched or coughed on can transmit the virus, for up to three days. Some doctors describe "self-quarantining" or isolating yourself and your family at home as the most effective preventative measure. However this should not be in an apartment building with central air because if one person in the building is infected it will spread throughout the building. Most current air filters will not prevent contamination. Self-quarantining at home requires stockpiling food and supplies prior to the pandemic.

Flu pandemics tend to spread in three waves. In 1918 each wave lasted six to eight weeks with several months between waves. There can be up to12 months between waves. Based on the 1918 pandemic (see John Barry, The Great Influenza) a highly contagious and deadly flu pandemic will cause major disruptions in government, communities, businesses, transportation, distributions systems, etc. In 1918 most retail stores, restaurants, and many businesses closed and employees refused to work. In cities it became very difficult to obtain food. Hospitals and health professionals were completely overwhelmed. Preparing for the Coming Influenza Pandemic, by Grattan Woodson, MD, has very useful lists of supplies and procedures; available at http://www.fluwikie.com/annex/WoodsonMonograph.htm.

Preparations to consider prior to the pandemic for a two to three month self-quarantining

Highest priority steps

1. Develop a family contingency plan and select a shelter site:
   - In most cases a shelter site will be a person 's home, unless the home is an apartment in a building.
   - Dependents, e.g. students, should plan to move to the family 's selected shelter site.
   - Infirmed or elderly relatives in care facilities should plan to move to the shelter site.
   - Plan alternatives to public transportation.
   - If living in a city or in an apartment building with central air, explore an alternate shelter site; this could be a vacation home or a relative 's home.
2. Stockpile food, supplies, water, etc. (see below for suggestions)
3. Everyone should get a flu and pneumococcal vaccination (for pneumonia) immediately.
4. Purchase latex or vinyl gloves and N-95 paper facemasks. The NIOSH rated N-95 mask protected people from the SARs virus and is the best protection available, but it has not been tested with avian flu. N-95 masks are in short supply but may be available at medical supply stores (not pharmacies). Masks should be purchased as soon as possible; 3M brand N-95 masks costs $80-$90 for 20. Masks need to be disposed of after each use.
5. A very thorough washing of hands, front and back, plus an alcohol-based hand sanitizer, e.g.: Purell provides some protection.
6. Insist your employer develops a contingency plans for workers.

Second-level Priority Steps

1. Complete needed repairs and replacements including home security.
2. Set up home office or up-date home office to be able to work at home.
3. Keep car full of gas. Consider storing additional gas in out buildings.
4. Consider protecting investments. The World Bank estimates an $800 billion recession.
5. Consider cable TV for news (CNN) and diversion.
6. Prepare for possible electrical and water supply problems by stocking:
   - Working flashlights, portable radio, and extra batteries
   - Potable water containers: 1 gallon per person per day is recommended
   - Oil lamps, long burning candles, and kerosene heaters.
   - Landline phone, not portable, will work longer without local electricity.
7. If your water source is a well consider an electric generator and water containers. This will avoid constantly running the generator to have water, conserving fuel.

Stockpiling

Stock non-perishable food and other supplies to last 2-3 months: foods that you enjoy and would use over time anyway. Each family will be different; but some examples include:

• - Canned fish and meat, dried beans and rice
• - Canned fruits, vegetables and juices.
• - Salt, sugar, cooking oil, vitamins, powdered milk
• - Tissues, toilet paper, light bulbs, matches, pet food, kitty litter, cash.
• - Disposable latex or vinyl gloves and disposable N-95 paper facemasks. }
• - Alcohol-based hand sanitizer, e.g.: Purell.
• - Prescription medicines, cold medicines, broad-spectrum antibiotic.

Stock home treatment supplies for flu (from Woodson article, see article for instructions).

• Table salt, 1 lb - Sugar, 10 lbs
  Baking soda, 6 oz. - Household bleach 1 gal.
• Tums Ex: 500 tablets - Acetaminophen 500 mg #100 tablets
• Ibuprofen 200 mg #100 tablets. - Tea, caffeinated, dry loose, 1 lb.
• Electronic thermometer #2 - Blood pressure monitor
• Measuring cup with 500 cc (two cup) capacity
• Diphenhydramine (Benadryl) 25 mg capsules #60

Woodson 's article recommends stocking the following prescription products:

• Tamiflu 75 mg, #20 (Tamiflu should NOT be purchased via the internet.)
• Promethazine (Phenergan) 25 mg tablets #60
• Hydrocodone with acetaminophen (Lortab-5) #60 (5 mg/325 mg)
• Diazepam (Valium) 5 mg #60

Further Resources

• www.fluwikie.com
• www.pandemicflu.gov
• www.cdc.gov
• www.who.org/
• Preparedness or Panic: Resources for Health Grantmakers [pdf]
• Birds, Bugs, and Business: Preparing for Crisis
• Resource list from the Global Business Network