It’s Back: How to Prep for Ebola 2.0

Author of Be Ready for Anything and Bloom Where You’re Planted online course

The second biggest Ebola outbreak in history is going on in the Democratic Republic of Congo right now. It’s second only to the 2014 outbreak that infected nearly thirty thousand people and killed more than 11,000.

And now, it may be here in America.

An American healthcare worker was exposed to the virus while treating patients in the DRC. The worker, whose name has not been released, flew back to the United States on Saturday and was put into quarantine for up to two weeks at the University of Nebraska Medical Center (UNMC) in Omaha.

A few things that are important to note here.

The healthcare worker has not tested positive for Ebola, nor is the person showing any symptoms.

If the worker develops Ebola, it still doesn’t mean that he or she would have made fellow travelers sick. Ebola is not contagious until symptoms are exhibited, so if it’s true that there were no symptoms when the person was admitted to the UNMC, then it’s unlikely that the virus was passed on to others.

So it’s not the time to panic. But it’s time to be watchful.

Some details about the current Ebola outbreak in the DRC

The current outbreak in the DRC could easily get out of the country because it’s spread to cities that are major transportation hubs to the rest of the world.  There are other variables that are also making it difficult to contain.

WHO’s emergencies chief, Dr. Peter Salama, called it a “sad toll” as Congo’s health ministry announced the number of cases has reached 426. That includes 379 confirmed cases and 47 probable ones. So far this outbreak, declared on Aug. 1, has 198 confirmed deaths, with another 47 probable ones, Congo’s health ministry said.

Attacks by rebel groups and open hostility by some wary locals have posed serious challenges to health workers that Ebola experts say they’ve never been seen before…

…Day by day, reports by health organizations note one new difficulty after another in this latest outbreak, even as their work sets milestones that have given new hope in the fight against one of the world’s most notorious diseases… the risk of Ebola spreading in so-called “red zones” — areas that are virtually inaccessible because of the threat of rebel groups — is a major concern in containing this outbreak. (source)

This outbreak is also affecting a previously-unseen large number of infants.

Local traditions and fears are making the spread more difficult to contain.

Another major issue with the current outbreak is the lack of understanding of the virus from the locals. Many local traditions and fears are worsening the outbreak.

For example, a group of young people broke into a morgue last week and stole the body of an Ebola victim so that the family could provide a traditional burial – which generally includes a “dance” with the corpse. This is horribly dangerous because the contagion remains after death.

Levels of Ebola virus remain high after death, thus bodies of those who have died from Ebola virus disease must be handled only by people wearing appropriate personal protective equipment and must be buried immediately. WHO advises that bodies of people who may have died from Ebola virus disease should be handled only by trained burial teams, who are equipped to properly bury the dead, safely and with dignity. (source)

And that’s not all. People who are being treated in hospitals frequently make their escapes. Sometimes this is due to fear of the treatment, and other times it’s because the hospital itself is attacked in the ongoing violence in the DRC. This happened over the weekend when 24 patients fled a hospital that was under attack.

Really, it’s a perfect storm – and the world will be lucky if Ebola is contained.

It really seems like it’s not a case of if it gets out…but when.

Why Ebola is so worrisome

Part of the reason Ebola seems particularly terrifying is the graphic presentation, which is the stuff of horror movies. It is a hemorrhagic disease, which means that it can cause bleeding from the mouth, eyes, nose, and rectum. Here’s how it progresses:

The incubation period, that is, the time interval from infection with the virus to onset of symptoms is 2 to 21 days. Humans are not infectious until they develop symptoms. First symptoms are the sudden onset of fever fatigue, muscle pain, headache and sore throat. This is followed by vomiting, diarrhoea, rash, symptoms of impaired kidney and liver function, and in some cases, both internal and external bleeding (e.g. oozing from the gums, blood in the stools). Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes. (source)

But it isn’t just the gruesome visuals. The risk of death from Ebola can be anywhere between 50-90%, depending on the strain. This outbreak is the Zaire strain of Ebola, which is the same one that made it to America back in 2014.

The 2014 outbreak that could have spread through America

If you recall, the fact that it didn’t become widespread in the US during the 2014 scare was NOT because it was handled properly.  It was sheer luck. source

When American Patient Zero, Thomas Duncan, first showed up in a Texas emergency room, he wasn’t tested, despite the fact that he told them he was from Ebola-stricken Liberia.  Proper practices were not followed, and one of the nurses who cared for him became the second victim. All sorts of near misses occurred, like the fact that the plane that carried an Ebola patient made FIVE trips before it was sanitized.

The news came out this morning that the second American nurse diagnosed with Ebola flew on a plane with 132 other passengers from Cleveland, Ohio to Dallas, Texas.  Amber Vinson had a low-grade fever when she boarded the plane, and was admitted to Texas Presbyterian Hospital just hours after disembarking.

The latest horror?

Not only were 132 people who flew with Vinson exposed to Ebola.

In the time it took the CDC to notify Frontier Airlines of the issue, 5 more flights were made. (source)

That sounds like the plot of a cringe-y movie, where you watch the sneeze spray of an infected person in slow motion landing on everyone nearby. But that wasn’t the only mind-boggling thing that happened.

But that wasn’t the only mind-boggling thing that happened. We brought some exposed people back to the US and put them in hotels.

A couple of days ago an American healthcare worker who had been definitively diagnosed with Ebola was brought back to the US for treatment at the National Institute of Health (NIH) in Bethesda, Maryland.  Eleven more patients have been isolated and are on their way to the United States as well, after having had  “potential exposure” to the disease.

Now, about those people who were “potentially exposed”?

They aren’t being hospitalized. Oh no.  They are being brought back to stay at hotels “near” three different hospitals in different regions of the country. I couldn’t make this up if I tried. (source)

So, I think we can all agree, looking to the National Institute of Health, the CDC, and the WHO to keep us “safe” is not the best fall-back plan. We have to be prepared to take action ourselves should this outbreak turn into a pandemic.

Don’t panic. Just pay attention.

There is usually a little bit of warning before an outbreak becomes severe enough to warrant the title “pandemic.” It isn’t like The Walking Dead, where suddenly 80% of the population is affected overnight. With a pandemic, you hear a little hum about it before it gets bad. The World Health Organization makes some flyers, reports are given, and there is a mention on the evening news. But, generally speaking, officials are stingy with information because they don’t want to “start a panic.” This means that the judicious prepper needs to pay close attention when new viruses begin to be mentioned.

Now, just because a virus is mentioned, it doesn’t mean that it’s going to become a pandemic, of course. However, it can be an early warning sign that you need to get your ducks in a row.

Think of it like a tropical storm.  You hear about it gathering steam out over the ocean well before it ever makes landfall. Just because there is a storm somewhere in the Atlantic, it doesn’t mean that it’s going to hit, but it means that the wise person begins to pay closer attention to the weather reports, makes certain that the basics are stockpiled, and puts together a plan just in case the time to board up the windows arrives.

How to Prep for Ebola: Worst Case Scenario

Avoiding contact with people who have the illness is the only way to prevent getting it. Should an outbreak occur, isolating yourselves is the best way to stay safe and healthy.

This is the tricky part: How do you know that the time has come to get the family inside and lock the doors behind you? Lizzie Bennett, a retired medical professional, wrote an incredibly helpful article over on her website Underground Medic during the initial outbreak. Bennett recommends social distancing as the only effective way to protect yourself and your family from an outbreak of disease.

How long you should remain isolated depends primarily on where you live. For those in towns and cities it will be for much longer than those living in rural retreats where human contact is minimal. Though those fortunate enough to live in such surroundings should remember that if the situation is dire enough, people will leave the cities looking for safety in less populated areas. In large centres of population there will be more people moving around, legally or otherwise, each of these individuals represents a possible uptick in the disease rates, allowing the spread to continue longer than it would have they stayed indoors and/or out of circulation. Even when the initial phase is on the wane, or has passed through an area, people travelling into that area can bring it back with them triggering a second wave of disease as people are now emerging from their isolation…

…

One hundred miles is my buffer zone for disease, of course it could already be in my city, but practicalities dictate that I will not stay away from people because hundreds in Europe are dropping like flies. Maps of disease spread look like a locust swarm moving across the country and this allows disease spread to be tracked on an hour by hour basis. One of the few instances where mainstream media will be useful. (source)

Once you’ve gone into lockdown, how long you must stay there is dependent on the spread of the illness. Times will vary.  Bennett suggests these guidelines:

Once the doors were locked we would stay there for at least two weeks after the last case within 100 miles is reported. A government all clear would be weighed against how long it had been since the last case was reported in the area I have designated as my buffer zone. There is of course still the chance that someone from outside the area will bring the disease in with them causing a second wave of illness. You cannot seal off cities to prevent this. Going out after self-imposed isolation should be kept to a minimum for as long as possible, and if you don’t have to, then don’t do it. Far better to let those that are comfortable being out and about get on with it and see if any new cases emerge before exposing yourself and your family to that possibility. (source)

What does it mean to go into lockdown?

This Ebola thing could go bad in a hurry. And by bad I mean that the last time around, it killed well over half of the people who contracted it in West Africa.

If the situation hits close enough to home that you decide to go it’s time to isolate yourselves, the rules to this are intractable.

No one goes out. No one comes in.

I know this sounds harsh, but there are to be no exceptions. If you make exceptions, you might as well go wrestle with runny-nosed strangers at the local Wal-Mart and then come home and hug your children, because it’s the same thing.

Once you have gone into lockdown mode, that means that the supplies you have on hand are the supplies you have to see you through.  You can’t run out to the store and get something you’ve forgotten.

That means if a family member shows up, they have to go into quarantine for at least 4 weeks, during which time they are not allowed access to the home or family, nor are they allowed to go out in public.  Set up an area on your property that is far from your home for them to hang out for their month of quarantine. If at the end of the month they are presenting no symptoms, then they can come in.

It sadly means that you may be forced to turn someone away if they are ill, because to help them means to risk your family.

Now is the time to plan with your preparedness group how you intend to handle the situation. Will you shelter together, in the same location, and reserve a secondary location to retreat to if the situation worsens further or if someone becomes ill? Will you shelter separately because of the nature of the emergency?  Decide together on what event and proximity will trigger you to go into lockdown mode. Make your plan and stick to it, regardless of pressure from those who think you are over-reacting, the schools that your children have stopped attending, and any other external influences. If you’ve decided that there is a great enough risk that you need to go into lockdown, you must adhere to your plan.

Prepare an isolation area.

In the event that a member of your group becomes ill, they need to immediately be quarantined from the rest of the group. By the time they’re showing symptoms, it could be too late to prevent the spread of illness but effort should still be taken to isolate them.

Here are some tips on isolating a patient.

• The sick room should be sealed off from the rest of the house.  Use a heavy tarp over the doorway to the room on the inside and the outside. This will make a small breezeway for the caretaker to go in and out.
• The caretaker should cover up with disposable clothing, gloves, shoe covers, and hair covers.
• The caretaker should wear an N95 mask.
• The sick person should use disposable dishes and cutlery.  All garbage from the sick room should be placed in a heavy garbage bag and burned outdoors immediately.
• The sick person should not leave the room.  If there is not a bedroom with a connected bathroom, a bathroom setup should be created within the room.  Great care must be taken with the disposal of this waste.

You can learn more about preparing a sick room HERE.

Do you have the supplies you need to weather a pandemic?

It’s time to do a last minute check of your preps because by the time a general quarantine is announced in your area or you hear the mainstream suggesting that people should stay home, it will be too late to get the rest of your supplies. As well, at that point, the path of the pandemic will have progressed so much it will be unsafe to do so.

You need to be prepared to go into family lockdown mode for a minimum of 6 weeks should things get bad in your area, and preferably longer than that in the event that this takes a long time to contain.  It’s most likely that services such as public water and electricity will remain intact, but you should prepare as though they won’t be, just in case.

Here’s a quick checklist along with some links to resources.  Base amounts on the number of family members you’ll be sheltering.

• Drinking water (1 gallon per person per day)
• Food (including items that don’t require fuel for preparation)
• Heavy duty garbage bags
• Sanitation supplies such as toilet paper, paper towels, baby wipes, and feminine hygiene supplies)
• Entertainment – you’ll want to be able to keep children and restless family members  busy so get craft supplies, books, games, and puzzles
• Basic medical supplies (here’s a list)
• Pandemic kits that contain protective clothing (we have a Pandemic Flu Kit for each family member)
• Extra N100 masks – N95 are better than nothing at all, but not sufficient)
• Nitrile gloves – be sure to order appropriate si
• Safety goggles with an elastic band to ensure a snug fit
• Antibacterial cleaners such as disposable wipes, bleach, and spray cleaners
• Antibacterial hand sanitizer (12 pack of Purell Pump Bottle)
• Bleach for cleaning

Note – we do not commonly use anti-bacterial products but in a situation like this, it’s important to have this type of thing on hand in the event that there are issues with sanitation.

Download the Pandemic Prepping Shopping List here. See the links above for specific product recommendations.

Books and Reference Materials:

• Prepping for a Pandemic (This is the definitive guide.)
• Preppers Natural Medicine
• Ebola Survival Handbook: A Collection of Tips, Strategies, and Supply Lists From Some of the World’s Best Preparedness Professionals
• The Prepper’s Blueprint: The Step-By-Step Guide To Help You Through Any Disaster
• The Prepper’s Water Survival Guide
• Build a Better Pantry on a Budget