Editor’s Note: This is an updated and revised edition for 2018.
It seems like every time we turn around there is some deadly disease in the news. In recent years, there has been Ebola and the Avian influence A (H7N9) virus. There has also been MERS-CoV and many more. While these are epidemics of serious proportion, they are not yet pandemics, but they could be.
The best time to prepare for a pandemic is when a serious disruptive event of the pandemic-type is not on the immediate horizon. That said, a pandemic can occur at any time. It is this unknown aspect of pandemics that make them a potential reality we must prepare for.
- 1 The Spanish Influenza Pandemic
- 2 What is the Difference between an Epidemic and a Pandemic?
- 3 Can a Pandemic Really Happen?
- 4 More Recent Outbreaks
- 5 How to Safely Shelter in Place During a Pandemic
- 6 Skills, Strategies, and Supplies You Need to Prepare for a Pandemic
- 7 Lessons from the 1918-1919 flu pandemic
- 8 Recommendation: Bug In or Bug Out?
- 9 Additional Resources
- 10 The Final Word
The Spanish Influenza Pandemic
My father is buried in a beautiful old southern cemetery studded with azaleas and old growth trees. It’s a good place to sit on a bench and meditate life and death. As I was walking through this place one bright spring morning, I came across a uniform row of small grey headstones.
I read each stone in that sad row. It started with an infant child, and then followed a succession of nine siblings. Each died a few days apart, followed by their mother.
The date on the stones? Nov. 1918: the height of the Spanish influenza pandemic.
Those tombstones were a very powerful visual to me as I reflected on the suffering and sadness that was endured by people who had lived in this area. Thousands of families all over the world suffered such great loss. This kind of devastation is difficult for us to truly imagine today.
But we need to come to attention and realize that epidemics and pandemics are situations for which we need to be as prepared, just as prepared as for any other threat to our wellbeing and safety.
The pandemic of 1918-1919 killed more people than the Great War, known today as World War I (WWI), at somewhere between 30 and 100 million people, depending on where you get your statistics. It has been cited as the most devastating epidemic in recorded world history.
Although it is mostly referred to as an epidemic, it does not meet those criteria. Strictly speaking, an epidemic is a marked rise in disease in a region affecting a localized population, while a pandemic refers to a disease outbreak that is worldwide and affects global populations. The Spanish flu outbreak of 1918 – 1919 was worldwide and so qualifies as a pandemic.
What is the Difference between an Epidemic and a Pandemic?
Because of their similarities, the terms epidemic and pandemic are often used interchangeably, but it is incorrect to do so. The difference between the two is the scope. Let me explain.
Both happen quickly, usually spreading to a large segment of the population in days or weeks. However, an epidemic is typically contained in a defined area. You might say that pandemics are epidemics that have gotten out of control and have spread to multiple areas worldwide.
Here is something else you need to know. Widespread diseases are not all pandemics. To be a pandemic, the disease must also be deadly. It must also be contagious.
You might not even know there are pandemic diseases that could become an issue for you personally. An example is H1N1 that evolved into a pandemic in 2009. There are even oldies rearing their ugly heads once again such as cholera, malaria and the measles.
Just remember this: in most cases, these diseases start out as regional outbreaks. At that point, they are an epidemic. If they spread out and become national or global, they become a pandemic. That is the difference between the two.
Can a Pandemic Really Happen?
Pandemics are popular science fiction fodder. Most people have seen the movies detailing the horrors of living through a pandemic. Such popular current shows like “Contagion” show the serious side-effects that go beyond the immediate terror of the disease. The point is, there is more to deal with when a pandemic breaks out than just staying healthy. You have to stay safe from other dangers as well.
Alas, scary movies about pandemics don’t make the threat real to most people. In spite of hearing about pandemics, they don’t seem to be a real threat. Being a victim of a pandemic will typically fall into the “it will never happen to me” mindset aka the normalcy bias.
Most of us have been exposed to the dangers, though. We just don’t always see the surrounding diseases as something that could produce the effects of the disasters in the movies.
Historically speaking there have been many pandemics that killed large percentages of the population of the world. Current pandemics that exist today include:
More Recent Outbreaks
In the past several years, the U.S. had a few infectious disease scares, the main one being the Ebola outbreak. The outbreak that began in West Africa sickened at least 14,413 people from March through November 2014, killing at least 5,177 of them — making it by far the worst outbreak of the virus in history, according to the World Health Organization.
The virus first arrived in the United States via U.S. missionaries flown here for treatment. The Ebola virus was also unwittingly imported by Liberian tourist Thomas Eric Duncan, who flew from Liberia to Texas with the virus and later died in Dallas.
Two nurses who took care of Mr. Duncan also became ill but both recovered. Dr. Martin Salia, a U.S. resident who contracted Ebola while treating over one hundred patients in Sierra Leone, died of the virus at Nebraska Medical Center. He was the third patient to be treated there and the only one to have died.
Over 100 other people who had come into contacts with infected people were quarantined for various periods of time until their tests returned negative for Ebola. Other people who had been in contact with the disease were never located. The U.S. was fortunate to have had limited spread of this deadly disease.
During and after the Ebola illnesses in the U.S., it became apparent that the CDC protocols were too lax in the beginning and this fact probably caused the spread of Ebola cases to improperly trained hospital staff. Since that time, updated and more thorough guidelines have been established uniformly across the United States.
I was in the hospital a short time ago and one of the first things I was asked upon entering the Emergency Department was if I had recently traveled outside of the United States. This question is now part of the updated CDC protocols mandated in every U.S hospital.
“All of the recent floods, hurricanes, fire storms, and earthquakes have distracted us or drawn our attention away from the health emergencies taking place in the world. While the floods, hurricanes, fires and earthquakes cannot spread long distances and affect us as personally as those who live with them, health emergencies in another part of the world can and do spread long distances and can be our own emergency in a matter of days or weeks.” [CFDPublications]
The following is taken from a recent article in the Washington Post. “In today’s connected world, a disease can be transported from a rural village to any major city in the world within 36 hours.”
Here are other quotes from two Washington Post articles to think about:
- “Outbreaks of life-threatening infectious diseases are spreading faster and with more unpredictability than ever.”
- “An unusually large plague outbreak in Madagascar has killed 106 people since August. About 70 percent of the cases are the more virulent form of pneumonic plague that spreads by coughing, sneezing or spitting and is almost always fatal if untreated with antibiotics. [In as little as 18-24 hours after symptoms appear]
In Uganda, officials are on high alert because of a recently reported outbreak of the deadly Marburg virus that has killed one person and may have exposed hundreds more at health facilities and during traditional burial ceremonies. Marburg is a highly infectious hemorrhagic fever similar to Ebola and is among the most virulent pathogens known to infect humans.”
“In today’s fast-paced world, information flows through unofficial channels much faster than through official ones…Government officials need to be more in sync with that and adjust to that…Officials who rely on once-a-day updates in outbreak situations need to understand the importance of releasing accurate information in real time…”
Other alarming quotes:
- “Although there is more awareness about the issue, experts agree that the world is not prepared for the next pandemic.”
- “Every president since Ronald Reagan has faced threats from infectious diseases, and the number of outbreaks is on the rise.”
- “Global health experts warn that a pandemic threat could be as deadly as a nuclear attack — and is much more probable.”
- “In a speech to a security conference in Munich earlier this year, billionaire Bill Gates said a pandemic threat needs to be taken as seriously as other national security issues.”
- “Whether it occurs by a quirk of nature or at the hand of a terrorist, epidemiologists say a fast-moving airborne pathogen could kill more than 30 million people in less than a year.”
- “If the idea of a government is to protect the United States and its people, then these people [health agencies] contribute as much as another wing on an F-35 [fighter jet], and actually do more to save tens of thousands of lives.”
There is a 100% chance of having a pandemic (influenza or another disease) in the future and it will probably be sooner than most expect.
Do you know how to prepare? Do you know what to do if one occurs? Let’s go over things we can now to be better prepared for an epidemic or pandemic.
How to Safely Shelter in Place During a Pandemic
With Ebola in the news, Frank has written to me about something we all should be concerned with, namely how to safely shelter in place during a pandemic. What he has to say is important because while we may be familiar with the need for plastic sheeting and duct tape when sheltering in place, what about fresh, filtered air?
An Open Letter from FJ Bohan: Sheltering in Place During a Pandemic
Dear Gaye and Backdoor Survival readers:
The concerning events of the last few months have had me thinking about writing you.
There are many threats to U.S. citizens in the news. Ebola, along with nearly every third-world disease we as a nation had eliminated decades ago, is back at our door and infiltrating the nation as the masses of illegal immigrants are (transported by our own government), reaching every corner of the country.
Meanwhile, the CDC is busy issuing guidelines to hospitals and mortuaries detailing how to handle Ebola patients and the proper disposal of bodies, but it has yet to announce whether or not Ebola is now an airborne pathogen.
It is for these reasons I fear there may well be a pandemic coming our way soon.
I want to let you and those who follow your website know how to protect themselves and their loved ones should a pandemic crisis come to their neighborhood.
If, indeed, Ebola (or any other virus) is airborne (spread through the air/breathing), isolation is the only true protection. Difficult choices will have to be made by anyone in an area which is infected. Once it has been decided to stay home from work until the pandemic passes from the community, protecting the home will be the next step.
Having stored food, water, and other living essentials already at home may prove to be a life saver. Imagine taking your vacation leave in order to protect your family, only to catch the virus while standing at the checkout counter of the grocery store?
In neighborhoods with confirmed cases of infection, filtering your air might be the only thing that prevents you from acquiring the virus.
In my book, Emergency Air for Shelter-In-Place Preppers and Home-Built Bunkers, I detail how to take a regular wet/dry vac along with a HEPA filter and convert them into an air filter for the home/shelter/bunker.
By using a shop-vac type vacuum (purchased virtually anywhere) along with a HEPA filter that fits the unit and by following the FEMA guidelines for sheltering-in-place (using plastic sheeting and duct tape to seal a room or shelter), anyone can make a flow-room, of sorts, to protect them self from airborne viruses.
Buy drawing air from outside of the sealed room and running it through the HEPA filter, the vacuum’s exhaust port will be blowing filtered air into your room. Airborne contaminants will be contained in the vacuum (see my book for details of how to seal the vacuum).
Even though viruses are smaller in size than the HEPA can filter, they (viruses) generally lack the mass to penetrate the electro-static shield formed over the filter as air flows through it.
I would advise sealing an inner room of the home and drawing air with the vacuum/filter from an adjacent room.
Stay home and indoors.
Do not open your doors to infected people.
Remember to run the vacuum/filter for 10 minutes every half hour and allow a small opening near the floor for CO2 to escape into the adjacent room while the vacuum is running. This will keep the sealed room’s air supply fresh.
NOTE: Failing to run the vacuum or failing to use the system at all will see everyone dead from suffocation!!! Sealing a room without a filtered air system is just like putting a plastic bag over your head. You will run out of breathable air! Do not follow any FEMA sealed-room instructions without using a filtered air supply!!!
I know, Gaye, you have read my book and realize how important this issue is. Please feel free to share this letter of concern with your readers.
How to Shelter in Place
Sheltering in place is not difficult. In the simplest of terms, you take some duct tape and plastic sheeting, add some ventilation and seal yourself up in a room. The following diagram depicts this setup:
For a downloadable flyer, check out this document from the State of Washington Emergency Management Division: Sheltering in Place – Creating a “Safe Room” in Your Home. Just don’t forget that you will also need some emergency air as well a food, water, lighting and amusement (games, puzzles, reading material) to get you through the sheltering period.
With thanks I use the following, with permission, from Cheryl Driggs, CDF Publications. Mrs. Driggs serves as Preparedness Specialist, Houston Public Affairs Council. www.simplyprepared.com
Skills, Strategies, and Supplies You Need to Prepare for a Pandemic
Most of the historic pandemics lasted for more than 2 years. Some are still going on. Others are popping up such as the Zika virus. Dealing with a long-term outbreak takes some special preparations.
- Know the symptoms
It is important to know what to look for regarding the prevailing illness. If you must meet with an outside person, it will help you identify whether it is safe to approach.
Knowing what to look for will also help you keep an eye on loved ones during isolation, and to prepare to quarantine them immediately at the first sign of symptoms. It is important to remember that w hen in doubt, always assume infection. It is much better to be safe than sorry.
- Wear protective gear
When dealing with outsiders, always wear protective gear, even if they don’t seem infected.
- Learn how to properly disinfect your home and your clothing
Make washing your hands with plenty of soap and water a habit now, before sickness settles in. Also become proficient at using essential oils, alcohol, and bleach as disinfecting agents.
Additional Reading: Survival Basics: Hand & Surface Hygiene When There’s No Water to Spare
- Develop sealed air ventilation
Locking yourself inside your home isn’t enough. It will protect you from the angry mobs roaming the streets. It won’t necessarily protect you from the reason the mobs exist.
If the virus or disease is airborne it can infiltrate a home. You need to have supplies to seal up all vents, windows and doors.
But then how will you get fresh air? Sealed rooms would be fine for a few days, but not months or more. You can find out how seal your home and build a sealed air ventilation system by reading Safely Shelter in Place During a Pandemic.
- Create a “sick room”
Heaven forbid anyone in your family does get sick, but if they do, you need to be prepared. When you are confined for long periods of time, it may not even be the danger outside that causes the illness.
People become hurt, catch colds, and get headaches. It is a fact of life. You can’t just run out to the store easily when there is a pandemic going on. You have to have all of the supplies you need ready.
Make sure you have the common pain killers and antibiotics. If anyone in the home needs prescription medications, it is a good idea to have a rotating supply that will last. You should also have plenty of sanitation supplies like disposable gloves, bleach, alcohol, hydrogen peroxide and masks.
- Learn how to Effectively Use Essential Oils
Essential oils store well and a little goes a long way. Become proficient at using essential oils for common first aid ailments (see DIY Miracle Healing Salve) and for relief from aches an pains.
Essential oils are also powerful antimicrobials, and can ward off sickness and germs when used topically or diffused into the air with an essential oil diffuser. Two especially useful oils are Oregano and Shield Blend (or other thieves-like blend).
- Prepare for Possible Outdoor Excursions
Anytime there is a long-term disaster, the possibility of needing to leave home for an emergency run for supplies becomes a possibility. When the disaster is a pandemic, however, there is the added danger of exposure.
Always wear an N95 medical mask to protect yourself from airborne disease. Wear long sleeves and long pants. Preferably seal the cuffs of sleeves and pant legs. Stay clear of other people if at all possible.
- Stock Up on Games
That may not seem like something important during serious illness outbreaks, but boredom sets in quickly. You are likely going to be stuck in a small space with your entire family for a long time. Having board games, card games and even video games at the ready will help alleviate frustration and cabin fever.
- Store Plenty of Food and Water
Have enough food and clean water to survive in isolated quarantine conditions for up to a year or more.
- Set Up Sanitation Stations
Have bleach trays and sanitations stations set up at entrances to walk through before entering the home.
- Use Disinfectant Liberally and Often
Have spray bottles filled with a bleach/water mixture to disinfect the home and clothes. Use them liberally and use them often. Remember, however, that bleach has a shelf life and should be rotated and replaced on an annual basis.
Here is a the disinfecting: ratio: 1/4 (minimum) to 3/4 (maximum) cup of bleach to 1 gallon of cool water or 1 tablespoon (minimum) to 3 tablespoons (maximum) of bleach to 1 quart of water.
Contact Time: Let stand for 2 minutes, then wipe or air dry
- Set Up a Quarantine Area
The quarantine area should be set up outside, if at all possible. Having a quarantine area will allow late arrivals to remain isolated until you are sure they are safe to enter. The quarantine spot should be well-stocked with food, water, and amusements such as books and games.
- Have a Plan for Safe Burial
If the unthinkable happens and authorities have lost control of the situation, there will be sickness and death. This is an aspect of prepping no one likes to talk about but the reality is that with a massive pandemic, there will be deaths.
- Be Prepared!
Nothing beats having things in place when you need them. By the time an outbreak happens, it will likely be too late to gather up the necessary supplies. I realize that this may seem as though I am preaching to the choir, but get your food, water, and first aid supplies together, know what you need to do to shelter in place, and gather everything you need to set up a sick room in your home.
Lessons from the 1918-1919 flu pandemic
- Plan and prepare ahead.
- Have food stored in your home.
- Have medical supplies in your home.
- Have savings.
- Have alternate fuel supplies.
- Have multiple communications methods.
- Prepare for self-medication.
- Social distancing makes a difference. Cities that implemented social distancing had a much lower incidence of infection spread than cities that did not. This limited frequency of and closeness of contact between individuals in a public setting.
- Prepare to have religious services at home.
- Prepare to have children home from school.
- Volunteer your help; don’t be afraid to help. Terror was created in 1918 when officials and the press did not report the truth of what was happening. “The public could trust nothing and so they knew nothing…this terror prevented one woman from caring for her sister, prevented volunteers from bringing food to families too ill to feed themselves and who then starved to death, prevented trained nurses from responding to the most urgent calls for their services. The fear, not the disease, threatened to break the society apart.”1
- Survivors who had the flu are immune. Survivors are invaluable volunteers in subsequent waves of the flu because they are immune.
- Lead out, if necessary. If you see a need, lead out.
What can I do NOW?
- Store 3 months of food for each person in your household. This should get you through two waves of flu.
- Store medications for pain, fever, diarrhea, vomiting, and respiratory infections as well as medical supplies and learn how to use them.
- Keep extra prescription medications stored.
- Store at least 2 weeks (14 gallons) of water for each person in case water is disrupted.
- Store fuel for alternate cooking, heating and light sources in case utilities are disrupted.
- Have more than one way to communicate with others outside your household.
- Prepare to have children home from school for an extended period
- Prepare to work from home.
- Have some cash at home and savings in the bank in case you are unable to work.
- Have life insurance in case the worst happens.
- Find out if there is a pandemic plan for your community.
- Help your family, friends, and neighbors to get prepared.
- Get involved in community volunteer groups such as CERT (Community Emergency Response Teams)
Help limit the spread of influenza
You can help limit the spread of influenza by practicing some self-protection methods. You should begin when the flu first strikes the United States because it can spread cross-country rapidly. Also practice these methods when going anywhere that infection can enter the country, such as international airports.
- Avoid shaking hands. Viruses can be unknowingly transferred from infected individuals or from surfaces they have previously touched.
- Wear a surgical mask/respirator. The flu virus is often transmitted through the air. A tight-fitting surgical mask that is resistance to fluids provides adequate protection. It should be worn at all times when you are in contact with individuals outside of your home. The masks can be hung to dry and reused unless they have been contaminated with body fluids or blood.
- Clean hands often. The flu virus can live up to two days on surfaces. You can spread the virus by touching those surfaces and then your mouth or eyes or other people before washing. Anti-bacterial soap or alcohol based hand cleaners are most effective. (I would add here that when using alcohol based and cleaners use at least 70% alcohol, and then rub your hands together vigorously, making sure to get between the fingers and include the backs of the hands.)
- Cough or sneeze into a tissue or your elbow. Infected droplets can be projected 1 yard in front of you and you are contagious 48 to 72 hours before symptoms appear.
- Avoid touching your eyes, nose and mouth to lessen the chance of infecting yourself.
- Limit contact with those outside your home especially inside buildings. Consider everyone outside your own home as potentially infected. Distance yourselves from others by not going into public places such as school, church, cultural events, sporting events, and social activities and possibly even work. It is recommended that you stay more than 3 feet away from anyone else when you are around others. You may even decide to reverse-quarantine or go into self-isolation by staying in your home and not going out at all when the flu is active in your community.
1The Great Influenza: The Story of the Deadliest Pandemic in History by John M. Barry, page 462.
Recommendation: Bug In or Bug Out?
Your best bet during a pandemic is to bug in (also used interchangeably with the term “hunker down”) and stay safe. Bugging out is not a good option during a pandemic for a couple of reasons. First, going outside exposes you to the prevalent disease. Second, going outside exposes you to the desperate masses who were not prepared.
Remember, a pandemic is not something that will be short in duration. You and your loved ones need to be prepared to hunker down and survive until the danger is past. That could take months, maybe up to a year before the outbreak is under control.
In some cases, it could take longer and indeed, some historic pandemics took many years to contain. Between 1347 and 1453 the Black Death decimated a third of the population of Europe. Even though the US is a much younger country than others doesn’t mean it is immune. Between 1900 and 1904, the San Francisco bubonic plague decimated the West Coast.
The US has also had several outbreaks of Cholera, the measles, scarlet fever, typhoid, polio, whooping cough, diphtheria, the Spanish Flu and of course HIV/AIDS.
Throughout this article, there are a number of links you can click to learn more about preparing for a pandemic and especially about bugging in during a shelter in place situation.
Here are some additional resources:
- 15 Things You Should Do Today to Prepare for a Pandemic Flu
- 16 Items To Help You Hunker Down in Comfort
- How to Make DIY Hand Sanitizer With Essential Oils
- Zika Virus Handbook: A Doctor Explains All You Need To Know About The Pandemic
- 11 Things To Do When You Must Hunker Down in Place
The Final Word
Pandemics are difficult because you are battling three separate problems:
- Staying healthy
- Staying safe
- Staying sane during isolation
That being said, being aware of the seriousness of the situation, and what you need to do to survive a pandemic gives you a big advantage over your neighbors who may not be at all prepared.
Former U.S. Department of Health and Human Services Secretary Michael Leavitt has said “What happens before [a pandemic] is far more productive [than what happens after one starts] and individual preparations on a household basis are the key. It’s not just state and local governments – every tribe, business and family needs to talk through a pandemic plan.”
Preppers have a unique advantage in that they come to this table with a strong self-reliance mind set. Most have already thought about various crisis situations and what might be needed to meet those scenarios.
So the challenge to every Backdoor Survival reader is to take this information to heart and follow through with plans to fill in any gaps in your total preparedness plan wherever you see a need. Preparation is not static. We are constantly learning how to be more self- reliant and better able to take care of ourselves and our families in any situation.
Prepare to self-quarantine with everything you might need for three months. Consider the recommendations in this article. Research your local emergency preparedness resources to see if your town or city has them available. If they don’t then perhaps you could be the match which ignites the flame.
Sit down with those in your household and brainstorm specifically about what would be needed for physical, emotional, spiritual, recreational educational and medical well-being if you were required to shelter within your home for an extended period.
If you live alone, there are other considerations as well. There may be special needs individuals whose requirements come into consideration. I’m an advocate of brainstorming with others, followed by methodical planning.
After the plan is made, begin putting the plan into action until it is as complete as you can make it. We need to be proactive and prepare now instead of being reactive under emergency conditions.
Being prepared will increase the chances that everyone in your home will be able to deal with it all, and come out on the other side in good shape.
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