Asepsis 101

From Comments:

"I follow pretty strict aseptic procedure - what I learned in microbiology class 42 years ago... but *very* few others do that. If everybody wears a mask, there's no reason for lockdown or quarantine, because the mask can prevent you from passing on the virus to others, something that people just don't seem to get, and the other thing is that it stops you from touching your mouth and nose... and there are simple instructions for making masks from common household materials online."

Yes, but.

You learned this in a higher-level class when Reagan or Carter was president.
That was a different world then.

Dipshits from later generations, by actual firsthand observation:

Wearing mask and gloves, touching everything with said gloves, transmits virus to everything he touches (his car, cell phone, wallet, everything else).
Then, can't get cell phone screen to work with gloves on, so
a) pulls mask down
b) pulls infected contaminated glove off with mouth
c) touches infected contaminated cell phone screen with bare finger
d) puts glove back on and pulls up mask when finished.

Assume afterwards:
e) Can't figure out how he got Kung Flu, and asymptomatically carried and spread it to his entire office group, apartment complex, or dorm.



Fine for everyday use.
Not so bright with nitrile gloves and surgical
 masks, during a pandemic. Sorry if this is news
to you, Common Core grads.
"Virus on my fingers? Wait, whut?"

If you therefore want to require an IQ test and mandatory sterile procedure class, with 100% as benchmark for pass/fail, for being let out of quarantine, I will march in your parade and subscribe to your newsletter.

Otherwise, most people are too stupid to let loose without a keeper, or at minimum, a class on how to do this right run by Dominican nuns with 3' sections of rebar in lieu of rulers.

Hints For Morons:
Do whatever you want. We'll be on lockdown forever. Fuck everybody else, amirite?
Suture self.

Hints For Non-Morons:

After you put it on, the outside of the mask is contaminated.
After you wear them once, the gloves are contaminated.
PERIOD.

You can remove the mask after wearing it for prolonged periods, and put it inside a bag, if you're going to decontaminate/sterilize it, using heat or disinfectants. If you don't do that, don't bother wearing the mask at all, and revert to the instructions for Morons.

The gloves are single use. You may put them on, but once you touch things (doorhandles, products in stores, counter tops, etc.) out in the Big Wide Nasty Infectious World, you cannot touch or handle anything else from the Clean World (like your cell phone, car door handles, steering wheel, wallet, glasses, keys, money, debit card, etc.) You can take the gloves off*, discard them, and then and only then touch your personal items.
You must re-glove with a fresh pair of gloves before touching new contaminated things in the Big Wide Nasty Infectious World, and the same rules for putting them on and taking them off apply, EVERY TIME, WITHOUT FAIL.

Period.

Some of us had personal decon beaten into us by wearing MOPP-4 and going through a gas chamber a time or five, and some of us learned it in well-run microbio classes, like a our commenter. And a subset got it both ways. Those who didn't get it either way ought to pay serious attention.

Don't have a BOX (or BOXES) of gloves? Every day? For every trip outside your personal bubble? Until the lockdowns end?
You can't play this game.

We tried to tell you that long, long ago. Most of you don't have enough supplies for this.
Like the honey badger, a viral pandemic doesn't give a shit.
Do it right, or stay your ass home.

Or else you're going to infect people, and possibly kill some of them with your needless, thoughtless, callous stupidity.

This is why you can't have nice things, and why we're all, most of us (okay, most of you), locked down until further notice. Because Joe Average can't handle the truth, nor follow simple directions. This is what happens when stupid people breed, and there are no saber-toothed tigers handy 24/7 to winnow out the less-than-bright. Kung Flu is standing in for the tigers this year. Mind the pathogen, folks.

The problem is the Gilligans don't have signs on their heads, or we could simply throw them into the volcano right off, and be done with it. Instead, they'll kill us all without realizing it, and have that stupid look on their face after they realize they've done it, but too late to save the non-Gilligans.

And the very worst of them will blame the non-Gilligans for being susceptible.
Like they do.

But if you can master asepsis, and follow it, your chances of having a problem with Kung Flu approach 0% very rapidly.
Now, see if you can see both a way out of quarantine, and spot the Not-So-Hidden Flaw in this approach.







*(Approved glove removal method: Put your dominant hand in your non-dominant hand. Curl it slightly. Peel the dominant-hand glove near - but not under - the cuff, stripping it off that hand and rolling it with the non-dominant hand into a little ball. Take the ungloved hand, slip a finger under the cuff, and strip it off the other hand, turning it inside out, so the sweaty, but clean, inside is now the outside of the whole ball. You now have a dirty glove bundle you can touch with bare hands. Discard it appropriately in the trash. Which does not mean "wherever you feel like throwing it down". In the trash means in the trash, please. No one else wants to handle your nasty contaminated glove ball either.)

I'm Sure There's Nothing To Worry About...

Item One:
In Britain, they have the Official Secrets Act, which means anyone telling tales that affect national security in any way can get racked for it. Here in the U.S., we have fairly wide-ranging freedom of speech and press, so as long as you aren't handing over actual classified data to foreign powers while charged with custody of same, you're a lot freer to pass things along and around.

Item Two:
For reference, the classic signs and symptoms of organo-phosphate poisoning (i.e. exposure to nerve agent, including Sarin, VX, and the rest of the families of post-WWI and subsequent witch's brew of poison gas derivatives brought to the world by the work of I.G. Farben, and subsequently improved on in Britain, the U.S., and Russia.) are:

Runny nose and eyes.

Small pupils or blurry vision.

Coughing, chest tightness, wheezing, or shortness of breath.

Nausea and vomiting.

Abdominal pain or diarrhea.

Fatigue, headache, or sweating.

Muscle twitching or a seizure.

Or, in more technical terms,
lacrimation (tearing of the eyes)
rhinorhea (runny nose)
diaphoresis (sweating)
bronchorrhea (excessive lung secretions)
emesis (vomiting)
urination (peeing yourself)
defecation ($#!^^ing yourself)
Along with headache, fatigue, dyspnea, constricted pupils, abdominal pain and cramps, muscles cramps, twitching, seizure, coma, and death.
In short, if you have a pore or orifice, it begins running like a river, and then you die, as every muscle is short-circuited by the chain reaction of the nerve agent molecules through your nervous system, making everything trigger and keep triggering, affecting you at the nervous, glandular, and organ level. Dosage and route of exposure makes all of this happen in between two and fifteen minutes.

Item Three:
Dateline: Los Angeles, July 2016
Southern California EMS response brought three college-/military-age (20s-30s) males of undisclosed Middle Eastern extraction to two Los Angeles-area emergency rooms, all from one apartment.
Two of them were found in the bathroom(s) on the premises.
All were brought in suffering acute respiratory distress, seizures, and coma, after having been found, in one case, vomiting and crapping themselves on the thinking throne when they seized up.
All were notably tearing, snotting, drooling, sweating, short of breath, and incontinent of urine and feces prior to arrival at two area emergency departments.
All three subsequently suffered complete cardio-respiratory arrest, and despite the best efforts of medical staff there, expired.

In short order, a swarm of black SUVs arrived tagged with government plates, and a number of MIB (Men In Black) wearing earpieces arrived at both EDs, and being from The Government and Here To Help Us, subsequently informed the doctors at one of the EDs that the two victims had died from meningitis. The third victim, expiring similarly at another ED, and having neither external wounds nor bleeding, was explained as having died of a gunshot wound. This despite presenting no such signs, symptoms, nor any other supporting clinical manifestations of such cause(s) of death.

Presumably after further activities, the local fire, police, and coroner's authorities were similarly briefed, the site was investigated and cleaned, and no mention was made of this to any media organizations whatsoever.

But some of us have friends and acquaintances in all sorts of places, the Internet is a thing, and ultimately, secrets get out. (And I knew about this in real time in July, but it took a while to get independent confirmations before I was willing to pass it along.)

But sleep tight, folks, officially, none of this ever happened, it was all in your imagination, and everything's just fine and dandy.

And I'm sure everyone has a military-grade field protective mask, chemical protective suit, boots, gloves, and hood, and atropine and Pralidoxime auto-injectors on them at all times, right? Sh'yeah, right.

Welcome To My World

Ebola is here.

I told ya so. (Seven weeks ago.)

Nota bene he made it past the airport/airline screenings.
Then became symptomatic (i.e. contagious).
Which means everyone he contacted, hugged, kissed, shook hands with, worked next to, etc., has been exposed.
Then, after two days shedding virus like a cat shedding hair, he seeks medical treatment. Exposing all those people.
And GOT SENT HOME, because of course, he just had the flu, right?
Then went to the ER again, and exposed all those people too, plus everyone he saw after the first check-up, including the people who took him to the ER, and everybody between the hospital door and the isolation ward.

Of course, effective tonight, Dallas County and the contiguous counties are being put on a one-day shutdown quarantine, so they can find and escort all those potential infectees to a 21-day mandatory quarantine isolation ward.
And because it obviously isn't going to work, they're shutting off all flights to the US from Africa, if not everywhere.

What's that, you say?
They're NOT doing that?
And even though the CDC sent out a "Holy shit, it's coming!" memo  two weeks ago, the hospital staff screening the guy weren't wearing hazmat suits, hoods, gloves, booties, goggles, and masks?
And neither is the staff at any other hospital in the country, not even the ones nearest to international airports?

Brilliant! That will end well.

I'm betting airline/airport and hospital sick calls tomorrow in DFW set a small record.

I took an indefinite leave of absence.

Good luck, and hope that fingers-in-their-ears-going-La!-La!-La! Strategy works out for the White House, the CDC, every hospital in the country, and you all.

Best wishes.

Things That Make You Go "Hmmmmmmm" - UPDATED

Totally aside from the march of Ebola unchecked or even constructively hindered by anything done so far, as documented multiple places, a couple of things we know, and a couple of more things I'd like to:

FACT: We were told that Nancy Writebol and Dr. Brantley were infected with Ebola.
FACT: Both were medically evacuated to Emory U. Hospital for treatment.
FACT: Beating the not inconsiderable odds, they both survived, and have been discharged as EVD infection-free.
FACT: Discounting WHO's cooked numbers, if you look at the number of cases and the number of deaths, the rough number of deaths now for any point in time, is the same as the number of cases 21 days prior to now (the incubation period of Ebola) if you multiply that number by 90% (the standard prior Ebola max death rate).

Conclusions:
> This strain of Ebola is behaving exactly as every other strain did with regard to speed of progression, and fatality.
> The spread is different, precisely because it got out of the boonies, and into large urban populations, which it's never done before.
> If Writebol and Brantley were truly infected with Ebola, the safest place for them right now is working with the sick in West Africa, because they're both presumably bulletproof as far as Ebola virus is concerned. For life.
> Their combined survival, assuming both had Ebola, is a 1% absolute likelihood on a probability scale. (10% of 10% = 1%).
> If they didn't have Ebola, their dual survival in a BL4 hospital ICU under round-the-clock medical care and observation is a 99.9999999% certainty.

But:
FACT: Neither of them is in West Africa now, despite being so dedicated prior that they were willing to work among a deadly pestilence with sub-par protective gear, and even none, to bring what help they could, and ease suffering; not particularly bright, but on a moral level if not an intelligence one, commendable.

FACT: Either they had Ebola, or they didn't.
FACT: They either knew the truth of their status, or they didn't.

Tinfoil fringe decision matrix in line with the known facts:

If they were infected with Ebola, why aren't they back in action on the ground?
They could now go there without any protective gear, and give unprotected mouth-to-mouth, with no further risk of contracting Ebola. (They wouldn't do it because of any number of other infection risks, but it makes the greater point.)
Since they aren't back nor champing to try to get back, either their prior commitment is suspect, or their immunity is, and they know the truth of both those things at this point.

If they didn't have Ebola, either they knew that, or they didn't. Either way, the CDC knows the truth.
If they didn't have Ebola, why say they did?

If they didn't have Ebola and knew that, why consent to be evacuated and held for treatment?

I could spin any number of wild suppositions. I won't because that's what Daily Kos and Facebook is for.
But all I know at this point is that the undisputable facts don't add up.
2 + 2 = 9 and 11/3rds.
And it's nagging the hell out of me.

When I couple that lack of coherence of what we know with what we've been told and what we may reasonably and logically assume, with CDC today issuing a "Prepare to Shit Kittens" Warning Order to every hospital in the US, I'm even less comforted.

UPDATE (9/30): I saw Brantly's testimony before Congress today. Based on his description of symptoms, I'm as certain as I can be (without running his bloodwork myself) that he had Ebola. He also noted that he was one of only two doctors in all of Southern Liberia treating Ebola patients when he got sick with it. He further noted that the Ebola wards use the few survivors who recover to help care for the others, because they can do so without needing the foofaraw of all the hazmat gear. Which, given his healthy and robust appearance now, and decided lack of any effort to return, means that he is an Altruism fail: the Ebola equivalent of a liberal who's been mugged.

So when a man who'd travel 8,000 miles to treat strangers doesn't want to go back, ponder the diligence of those here, now, tracking down contacts and caring for victims, now that the CDC guidelines that ensured Ebola could get here, have succeeded in accomplishing precisely that result.

EBOLA: Simon Sez You Need To Wake The Eff Up

Just a little more sunshine for your fund of How Bad It Really Is:

CHARLOTTE, N.C. (AP)

The hospital in Liberia where three American aid workers got sick with Ebola has been overwhelmed by a surge in patients and doesn't have enough hazard suits and other supplies to keep doctors and nurses safe, a missionary couple told The Associated Press on Wednesday.

The latest infection -- of Rick Sacra, a doctor who wasn't even working in the hospital's Ebola unit -- shows just how critical protective gear is to containing the deadly epidemic, and how charities alone can't handle the response, they said.

About 250 staffers at the hospital use thousands of disposable protective suits each week, but that's not enough to fully protect the doctors and nurses who must screen people entering the emergency room or treat patients outside the 50-bed Ebola isolation unit, they said.

"We don't have enough personal protective safety equipment to adequately be able to safely diagnose if a patient has Ebola. So they are putting themselves at risk," David Writebol said.

Sacra, 51, a doctor from suburban Boston who spent 15 years working at the hospital, felt compelled to return despite these challenges. As soon as he heard that Dr. Kent Brantly and Nancy Writebol were sick, Sacra called and said "I'm ready to go," SIM President Bruce Johnson said.

Sacra's job was to deliver babies and care for patients who were not infected with Ebola. He helped write the protocols for handling Ebola, his brother Doug said, and he followed all the protections, said Will Elthick, the group's operations director in Liberia.

But Sacra got infected nonetheless by the virus that has killed more than 1,900 people and sickened 3,500 in five West African nations.

The disease is spreading faster than the response for lack of protective gear and caregivers, said Tom Kenyon of the U.S. Centers for Disease Control and Prevention. At least $600 million is urgently needed to provide these tools and extra hazard pay so that more doctors and nurses are willing to risk their lives, the World Health Organization said Wednesday.

Health care workers at other West African hospitals have gone on strike demanding more protections, the Writebols said.

"They see colleagues who have fallen. They don't want that to happen to them. But they are saying, 'I can't go to work safely until there is personal protective equipment available -- the right gear, the right procedures in place. And then, if they don't go to work, are they going to get paid?" David Writebol said.

The Writebols left Charlotte for Africa several years ago; David helped with the hospital's technology while Nancy helped dress and disinfect people entering and leaving the Ebola unit at ELWA, which stands for Eternal Love Winning Africa.

Liberians were already struggling to survive when they got there, but with Ebola it's chaos — the number of patients is surging, finding food and supplies is more costly, schools are closed and people with common injuries or even mothers in childbirth can't get care.

Ebola has "overwhelmed the supply chain," David Writebol said. "They can't get equipment in because there aren't any regular flights coming in. Same thing with aid workers from the international community. There are only a limited number of seats available to come into Liberia. ... That's one of the biggest problems -- getting medicine, protective gear and supplies for health care workers who are there."

Nancy Writebol said people who showed up at the emergency room with symptoms were ushered into triage. But health workers were sometimes exposed as they screened patients who may not have known or advertised that they were carrying the virus.

And sometimes, the sick would leave before finding out if they had Ebola. "Those are the people you really worry about going back into the community, because if they are sick with Ebola, it will ultimately spread," she said.

Sacra immediately got tested for Ebola after coming down with a temperature, and like his colleagues, went into isolation to avoid spreading the virus, his brother Doug Sacra told the AP.
Some other doctors haven't been so rigorous.

The WHO announced today that a doctor in southern Nigeria was exposed by a man who evaded surveillance efforts, and then in turn exposed dozens of others by continuing to treat patients after he became ill. Before he died, his family and church members laid their hands on his body in a healing ritual.

Now his widow and sister are sick and about 60 others in the city of Port Harcourt are under surveillance, the agency said.

Sacra, who left his family at home for this latest trip to Africa, was in good spirits Wednesday and able to send emails, Elthick said. That could mean he's physically well enough to be evacuated.
His wife, Debbie, said in a statement that she's focusing on her husband, but she said "Rick would want me to urge you to remember that there are many people in Liberia who are suffering in this epidemic and others who are not receiving standard health care because clinics and hospitals have been forced to close.

"West Africa is on the verge of a humanitarian crisis, and the world needs to respond compassionately and generously," she said.

It's not clear where Sacra would be treated in the U.S. Experts say any fully-equipped hospital that follows safety protocols could prevent an American outbreak while caring for an Ebola patient. But there are four high-level isolation units designed especially to handle dreaded infectious diseases.

The largest is at the Nebraska Medical Center in Omaha, which was told to prepare to receive a patient, but they were told the same thing before Brantly and Writebol were evacuated instead to Emory University Hospital in Atlanta, medical center spokesman Taylor Wilson said Wednesday.
 The other two units are National Institutes of Health facilities in Maryland and Montana.

So to recap:

* one facility, with but a modest patient capacity, goes through "thousands" of those suits weekly
* the hospitals are out of the suits, routinely, to provide basic protection in order to limit the further spread of the disease and keep staff alive
* the staff at those hospitals are bright enough to say "F--k no!" when asked to work without the suits
* the do-gooders coming in from outside the countries affected aren't that bright
* some staff members, after becoming infected, are becoming Typhoid Marys and actually propagating the spread themselves by wanton indifference to reality
* patients leave before diagnosis and quarantine, guaranteeing further spread indefinitely
* there are a total of four facilities in the entire US capable of properly handling Ebola patients without spreading the disease and making it worse

Which I've far from vaguely hinted at for a few weeks now, despite the "it can't happen here" BS being spewed from the White House, CDC, WHO, and every media jackass in creation.

(BTW, nota bene that the NSC adviser for this crisis, Gayle Smith, is precisely such a medically ignorant media jackass, and Special Adviser To The President, and who has noted that contrary to the requests from actual doctors from Medicins Sans Frontieres, who've been on the scene, and requested bio-incident response teams, Ms. Smith's extensive experience from a lifetime background of journalism school, reporting from African hotels, and poverty pimping on Africa through successive Democrat administrations and multinational boards and such, has led to the recommendation that we ignore the requests of medical professionals, and not risk testing our capabilities by sending our people to the hot zone, but rather just send them more boxes of those disposable suits. Either because our precautions are suspected of being ineffective as well, or because she knows we'll be needing those teams in NYC and Atlanta all too soon, and helping to guarantee that reality by waiting to face the problem until it walks onto our own front porch.
TOP.
MEN.

(I can count on the fingers of my third hand the number of times, when some serious question arose, anyone intelligent replied, "Quick, let's get a news reporter to tell us what's really happening."
But the current administration actually puts them in charge of that. What could possibly go wrong?)

But hey, cheer up:
New numbers  are up, as of September 3rd:

3500+ cases, 1900+ deaths

Note the official transition to the "plus" sign, to scientifically indicate "we have no fucking idea anymore", along with the notably sharper-than-expected upward trend of both categories since the tally on 8/26/2014. It's transitioning from an upward curve to a more vertical spike.

If this still isn't on your dashboard of things to consider yet, the next step is when lights start flashing on the instrument panel, and strange noises and smoke begin to emanate from under the hood.

"Farewell and adieu to you fair Spanish ladies..."

Ebola Breaks Out At The US Benghazi Consulate

Nobody cares.

Officially(tm).

Talking about Ebola = Double plus ungood.

Like turning off a switch, as of last Friday, the media pulled the plug on this story, and now it's back to being fodder for page B26, when they even cover news items from Congobongoland.

Apparently they were getting the cows too upset to give milk, and somebody said "STFU!"

As to who has the juice to convince ABCNNBCBS and Fox to all simultaneously shut up about something, I leave it to internet speculation.
But in practical terms, it's as if Ebola broke out at the US Benghazi Consulate or something.

The official word on this outbreak is to emphasize complacency, and minimize panic, trusting to either a benevolent deity or blind mathematical chance and fate to hope that there isn't one actual infected person anywhere among 300 million of us.

Note this latest line of pure, undiluted bullshit sold as HappyGas powered by unicorns shitting Skittles after eating Magic Beans.
Thirty seconds after one Ebola case is confirmed in the wild in the US, this guy should be strung up by his testicles, then electrified while being set on fire, while being stabbed in the eyes until he dies screaming, all of that televised live, but it'll be too late then.
And of course if it never happens, he's good, so why bother?

For all we know, the Titanic has already hit the iceberg, so why annoy the passengers by waking them up and getting them needlessly upset?

Pretty much the Official Policy On Ebola going back to 1976, but obviously frequently in vogue even as far back as 1912.

But again, once the barn is in flames that've spread to the house, and the family horse is sighted several miles from the barn door, it will be firmly locked, rest assured.

WAR IS PEACE
FREEDOM IS SLAVERY
IGNORANCE IS STRENGTH


IOW: Everyone is on their motherfuckin' own. Plan and prepare accordingly.

Pandemic: How It Works At The Pointy End

First, read this forum post.

This guy nails it, because he knows what he's talking about.

Let me break it down for you.
I've been a nurse for nearly 20 years. Twelve of them at two of the busiest ERs in the country, one of them the busiest ER on the planet.

A healthy chunk of my time at both facilities was primary triage, which is bar none the hardest job in the ER, and the one they assign to the nurses in each ER with the best grasp on emergency nursing.

My job, frequently for weeks on end, including especially during some epic flu epidemic seasons, was to sort people into degree of urgency, do a basic history, screening, and evaluation of presentation, and then get the sickest people in to be seen first, while continuously keeping up with the flow of inbound patients, room availability, incoming ambulance critical cases, admissions, discharges, etc. In a large department, that involved having 100+ people waiting to be seen, 50+ rooms occupied, and keeping workloads appropriate between 6 doctors, a resident, a medical student, four physician assistants and twenty nurses.

On crappy flu season nights, we saw well over 500 patients in one 24 hr. period, and our 24/7/365 average is well north of 300 a day, any and every day.

That and a buck gets me coffee at Denny's. So what?

Let's put ONE patient with latent Ebola into that mix, and look at a worst case.

Patient Zero hits the door, sees the nurse just inside at the front door, there to eyeball everybody, and speedball the critical ones coming in with SOB (shortness of breath, not bastardlyness) or acute Chest Pain, after the patient pulls up in his vehicle, which he's coughed and sneezed in and all over, which is then parked by valets. The valet is infected. Then he grabs the set of keys of a family discharged and heading home, touching their keys, steering wheel, shift, parking break, seat belts, etc. So now that driver is going to get infected.

The valet now goes back, after rubbing his eye, nose, or mouth, and handles a phone, pens, clipboard, and key locker. Now the other 2-5 valets are going to get infected. And all the patients leaving whose cars they park or retrieve. And their families. And the valets' families. If not tonight, then tomorrow or the next day.

Meanwhile, the patient, presenting with sore throat, cough, fever, maybe vomiting and/or diarrhea, clearly non-critical compared to having a heart attack, stroke, or asthma attack, sits down in the waiting area and fills out their short form info sheet: chief complaint, name, personal info. Then brings the clipboard and pen back so the nurse and financial clerk can input them into the computer database, so that their prior records can be matched up, and to put them on the master patient tracker so that the charge nurse, triage nurse, and all the treating physicians can see what's waiting on deck.

The pen and clipboard are now contaminated, along with possibly the nearby patients and visitors, the chairs, maybe the drinking fountain, and perhaps the restroom doorknobs and faucets. Perhaps they go to the cafeteria while they're waiting, or one of the other newly contaminated people does. They grab a few forks from the cutlery bucket, the doorknobs, the food freezer handles. etc., which the entire hospital uses the next day.

Other than an "eyeball survey", they haven't even been seen yet, and they've already killed 200 people, in about a month from now. Including the outside nurse, who took the pen and clipboard from them. And her family. And her spouse's and children's friends. And all the other kids at their school, and in their neighborhood. And their parents. And their parents' friends and co-workers. And their kids. And the other kids and teachers and other staff at their schools. And their parents, and their parents co-workers. And on and on.

In a month or two, just one Patient Zero has wiped out a county of several million people.
And everyone they shake hands with, cough or sneeze on, or whose door handles and shopping carts they handle, everybody on every bus, airplane, or train they ride in, etc.
And just for fun, there are four major destination theme parks nearby, one of them known as the happiest place on earth, which is currently seeing 20,000 visitors a day, from all fifty states and 100+ countries, this week alone. We regularly treat their employees and guests, who then return to work there.

Note please that Patient Zero hasn't even been triaged yet, let alone put into a room to see a doctor. And Ebola is "droplet precautions", i.e. the virus is transmitted by body fluids, including cough and sneeze droplets, which fly through the air and land on clothing, surfaces, etc., as well as secretions like tears and snot, not to mention linger on the hands when someone is less than surgically sterile after washing up from a bout of vomiting or diarrhea.

Thing is, at this point, no one knows the patient has Ebola.

Test for it?
No problem. Takes 2-3 days, after sending the sample to CDC in Atlanta.
Take precautions just in case? Sure.

The best-equipped ER I've been in had a total of four negative airflow rooms, where the air is sucked inside under negative pressure to keep snot drops and such from migrating out, and the air is exchanged through HEPA filters multiple times per hour to filter out contaminants, for things like patients with known or suspected TB, etc.
All the other rooms share airflow with the normal circulation system, which is all of the ER, the co-located X-ray department, the financial services office, the observation unit next door, and the main waiting area.
And each time on that shift that someone goes in, they have to don a new set of gloves, put on a new disposable gown, and Ebola requires fully enclosed goggles and a head-covering hood which we don't even carry or stock. So that's a full box of gloves and gowns per patient, per shift, even if no one goes in more than once an hour on a twelve hour shift. That would be a shipping pallet of such disposables per day, for a hospital that doesn't go through that stuff at the rate of a pallet a week. So in hours we'll be out of all the supplies we'd need to adequately and safely care for even one or two such patients if we only suspect Ebola, and take appropriate precautions.

Sneezing, cough, fever, vomiting, and diarrhea is the nightly symptom set of 1/3 of all ER patients every night, forever. {As noted in a prior post, by the time they start vomiting and crapping blood and their internal organs, and bleeding from the eyeballs, the freeways to Anywhere But Here will be bumper-to-bumper outbound, and there won't be anyone triaging or treating them, least of all yours truly.}

And being non-critical on arrival, if it's a busy day or night (most people come at night, because stupid, and because why miss work when it costs you money, when you can come by after 6PM when most of the hospital is closed and your private doctor is home or asleep, right?) they'll wait up to an hour to be initially triaged, and on horrible nights during flu season, four or six hours to be seen. During which time, they're coughing, sneezing, and perhaps vomiting - with splashback - out in the main ER waiting area, with not just up to 100 patients, but their families, including any number of unrestrained and unsupervised children from ages 2-17, who typically run around like wild baboons on crack.

So after infecting everyone nearby, they get put into a room, see a doctor, infect their treating nurse, the tech who takes their vital signs, perhaps the housekeeping staff who comes in after a vomit or diarrhea episode that misses the target, their doctor(s) - one may leave at the end of their shift, and hand the patient off to a second doctor, the x-ray techs who take a chest x-ray, the relief nurse who comes in during the primary nurse's break period, the financial person who does their in-room interview after the doctor sees them, and then anyone else whom those staff members see, touch, care for, etc., and their families and random contacts as well. (Try to recall that 300-500 patients a day thing, when you realize that the medical staff - doctors, nurses, techs, etc. will be back the next night, and the next, only now even more infectious as the Ebola they unknowingly contracted multiplies in their systems too, until they're finally sick enough to call off.) And if somehow they're miraculously admitted for what is generally a non-fatal set of symptoms, multiply this by all the staff and visitors on an upstairs ward, which equals more disease spread, faster.

So let's say that patient came in to Somewhere Unlucky ER last Friday, August 1st. By the end of the month, everyone in the hospital is infected or dead. In six weeks, the county is all sick or dead. At seven weeks, the entire state is. In eight to twelve weeks, the country and the world. 

Halloween isn't going to have nearly the same meaning when 60-90% of everyone's dead, will it?

And that's with first-world health care, at generally excellent facilities, because there's no effing way to put everyone there in a spacesuit 24/7/forever, and put all incoming patients into a bubble and a HEPA-filtered mask and gown for everything until Hell freezes over.

And that's what's one unlucky patient away from us all, with nothing more stringent than airlines asking people where they've been, and occasionally checking the sick-looking ones for a fever. Only British Air and Emirates have fully suspended flight service to the affected countries. (Which means if the disease skips to other non-quarantined countries, it won't work even for them.)

Bear in mind that both of the American victims brought to Emory in Atlanta walked into the hospital under their own power days after being confirmed as infected. And try to recall that people desperate to flee for their lives might actually -gasp!- lie on an airline screening form.

Sleep tight, cupcakes.

Biological Problems: What You're Looking At, vs. What You Should Be

This is most particularly in light of the current Ebola epidemic, but applies more or less generally.

First, let's get the stupid shit out of the way, specifically:

"ZOMG, they're importing infected Ebola victims to the US! Run for the hills!"

If that's your take, to any degree whatsoever, this is addressed to you:

Shut the fuck up, you ignorant hysterical jackasses.

At this point, the two known infected American healthcare workers are being returned to the US to Emory University Hospital's Infectious Disease unit.

Why?

I suspect it's:

1) Because I have more leftover health care and medical supplies laying around in just my storage unit than all that there probably is in all of Sierra Leone.
2) Because the local community hospital in Hootin Holler, Appalachia is more advanced than any ten hospitals within two tanks of gas in a Prius from the locus of this outbreak, let alone what's available at a Tier One first-world teaching and research hospital a short trip up the road from the CDC - like Emory.
3) Because one of the Americans was injected with the sole existing dose of way-pre-pre-pre-experimental Ebola vaccine, while the other one was transfused with blood from a previous Ebola survivor, and thus either or both may generate successful antibodies.
4) Because they're going to be in isolation that makes The Andromeda Strain precautions look quaint, as opposed to them being dropped onto the salad bar at the local TGIFridays, or seated on the mid-level at Yankee Stadium to drool blood and cough their internal organs onto passersby during a double-header.

This is as close to zero risk as is humanly possible, with an upside that something worthwhile may come from the research. Not to mention decreasing the load on medical resources over there, where they don't need it, and bringing them here, where if you hadn't read about it in the papers, you wouldn't even know it was going on in the first place.

It's also a non-shitty thing to do, considering the family may at least get to see them, through 4 layers of glass and vacuum seals, and talk to them, before they lapse into a coma, die in agony, and then get flash incinerated at 1500 degrees for a funeral.
And for the same reason we don't just shrug and say, "Oh, tough $#!^, they're dead..." when somebody gets killed any other way, and why we've sent recovery teams to scrape a few bones and some rags out of mildewing rusted debris that went down in Laos 50 years ago, and any other ends of the earth. Because we're not callous selfish bastards, and neither is the aid agency that these two worked for.

Nobody's asking any of us to take them home and care for them in the spare bedroom, or even chip in for their plane ticket. This is not a problem.

And bringing them home is the right thing to do.



The real problem is the non-symptomatic guy who was exposed, skipped out early, transferred in some European hub to an American air carrier, got off in Atlanta or Miami or Philly or Chicago, with no screening or quarantine, and is shivering and crapping his guts out in some flophouse right now, where in a week or two, he'll be found, after infecting god-knows-who-or-how-many family, friends, and random contacts going to the WalMart and gas station to get aspirin and tissues.

You wanna freak, freak about that.
And hey, how likely is THAT scenario, really?!?

Contagion was a so-so movie, but when it plays as a documentary, it should scare the $#!^ out of people.

Philadelphia, for one example, has a population of 10,000 Liberian-origin persons, including US citizens, legal residents, and illegals. Any one of whom could be the real Patient Zero for a US Ebola outbreak, rather than hissy fits over the two relief workers being treated at Emory Hospital.

That there aren't currently screening measures for all international travelers, quarantine for any recent visitors to the affected region, and a total embargo on all flights from Sierra Leone, Guinea, Liberia, and any contiguous countries (except for returning mercy flights each undergoing specific decon measures), right this effing minute, is a scandal presaging a tragedy leading to a catastrophe. It's playing Russian roulette with the entire country.

And for the people wearing both tinfoil hats on too tight, there's no secret reserve of Ebola vaccine, except in mediocre sci-fi movies. No matter what you read on WhackjobConspiracyTheorist.com. They don't keep the mythical vaccine just down the hall from where GM is sitting on a 400MPG carburetor, and where GE has secret perpetual motion Tesla coils sitting for when oil runs out. Or next to the room with the secret AIDS vaccine, all stored with loving care in the Secret Mountain Cave Of The Underpants Gnome. (Probably the same place they're hiding our flying cars, laser guns, and jetpacks too. Fuckers!) It simply doesn't exist.

If there were an actual vaccine for Ebola, the developed countries of the world would pay for it to be given away free to every swinging Richard from Casablanca to Capetown, just to be free of having to deal with it ever again. Airlines and hoteliers would simply slap a $20 or $50 or whatever surcharge for everyone coming and going to Africa, and countries would add it to their visa fees, and that would be that. Maybe someone will recall what we as a species did about smallpox?

But getting a vaccine of any type through Stages II, III, and IV testing takes years. So far, they have one vaccine that's a candidate to begin Stage II, and the Stage I testing only confirms that it doesn't kill people outright, not whether it actually works. So we may never get an effective vaccine. The cost at that point is minimal, since the US .gov could spring for the $1B out of petty cash, given that they blow through that amount every 2.5 hours, 24/7/forever.

Oh, and the total number of viruses that we can cure after an infection manifests fulsomely, to date, since the dawn of time: 0.

I'm here to tell you, if and when the epidemic gets here in force, I won't be going to work. Not because the protective measures don't work - they do - except when they're not followed scrupulously, like anywhere in West Africa, which is why the healthcare workers there are regularly infected and die. And like they won't be followed here when things go to hell because of an influx of hundreds to thousands of people, which no hospital in Creation has stocked enough basic everyday supplies to handle, nor practiced to any degree to cope with properly and sensibly. (Ask me how I know that.)

Two people in a Level Four biohazard isolation unit is an easy day's work for a few people.

Two hundred people with fever and diarrhea in any ER I've ever worked in, where the price of any lapse, however minor, in standard precautions and infection control is a slow, agonizing death, is a recipe for killing the only people who can help.

Homie don't play that.

And it's far too late to clock out when people start staggering in bleeding from the eyeballs, shitting blood, and quite literally puking up their internal organs, or dropping in the streets. Like is happening now in West Africa.

An outbreak here that becomes a pandemic isn't going to be solved by everyone wearing Tyvek suits, N100 masks and enclosed goggles. (Those are all good to have anyways, but stupid to use unless absolute necessity forces your hand, and even then as a strictly one-time deal - like on a bug-out - not a daily gear-up.)

It's going to be solved by keeping your ass home, living on your canned goods and cash reserves for anywhere from a few weeks to a few months, and waiting it out until the stupid people either die off or learn that basic lesson. If you can do it away from crowds in a relatively rural environment, so much the better.

Ebola isn't going to blow in your chimney and ass-rape you, or drift up the driveway on the evening breeze to kill you in your sleep; there's no need to seal your house in plastic sheeting or get into MOPP IV to water the lawn.

But the mail is going into a trash bin (until they stop delivering it at all), the front gate is getting locked, the "No Trespassing" and "UNWelcome mat" are going out, and anyone coming over the fence is going to die where they lay when I drop them, and if I'm feeling moderately charitable, they'll get a Viking funeral with a couple gallons of regular unleaded, and a few words of benediction ending with "Flame on!".

If you're not geared up for that, you're not ready, and you're worrying about the wrong things.


 

Good Training? HAI!

For all troops in the military, and especially those of us who were Cold Warriors, training for chemical warfare attacks is a sad reality, a legacy of World War I, and then or now it's a hot, sweaty, claustrophic, and generally damned uncomfortable experience.

Taking this, and multiplying the fun-factor by sub-tropical weather, and a relative humidity of more than 90%, and you have what proud officers call "good training", and what the rank and file refer to as "a serious pain in the @$$".

Thus imagine my joy upon the revelation that we'd be conducting battery emplacement/displacement drills in those nice, quilted, MOPP IV suits, in Okinawa's Central Training Area, in August.

And to provide added incentive and realism, a number of our NCOs were assigned to help stimulate the realism by occasionally tossing CS tear gas grenades amongst us.

So, as we were merrily jumping into and out of our trucks, lifting the trail end of 15,000 pounds of howitzer, and digging holes for the back end to dig into for their imaginary fire missions, then undoing all that to get them ready to drive away, on an island hundreds of miles from Japan (or anywhere else) in the Pacific, and uncomfortably close to the equator for those wearing rubber boots, rubber gloves, and the chemical protective snowmobile suits, topped with a nice comfy rubber gas mask, you can imagine exactly how much any one of us wanted to be there. In case taking the rubber gloves off between go arounds to pour out the glovefuls of accumulated perspiration that was pouring off everyone wasn't a big enough clue.

And then doing it again, while the selected sergeants randomly tossed tear gas right in amongst us, to make sure no one had forgotten (accidentally or on purpose) to completely take the exercise seriously.

And finally, to rub salt in the wounds, we were working right near the fenceline border with the civilian community that is greater Okinawa.

So just as we're getting a well-deserved water break, and getting an appropriate lecture on our tasks in the shade, the group of whiny protesters du jour march up the road to the fenceline 30 feet away, carrying their banners, and yelling at us in Japanese and Engrish (that's not a typo), "Yankee Go Home!"

For background, the Japanese still hate us because they got their @$$ handed to them in WWII, and polite as they are overall, the resentment is there 24/7, just because we're still here, at that point, more than 40 years after redecorating several of their cities, including 2 via thermonuclear means. That isn't the sort of thing you "get over" right away, and they haven't, official protestations to the contrary notwithstanding.

The Okinawans, meanwhile, are pissed at us too. Ethnically descended from Japanese, they nonetheless regard themselves as a separate people, and hold the status in Japan that Indians held in American society circa 1880. So they're royally pissed that after WWII, we didn't give them their independence, but instead returned the island to Japan. And of course, there's also a smidge of peevishness over having shelled, bombed, and napalmed their parents for a couple of months back in 1945, prior to rompystomping through the place with a few divisions of Marines and soldiers too.

But every man jack of us is on an unaccompanied tour, leaving wives, sweethearts, families, and even hamburgers, 8000 miles and more westward, back in the land of the big PX. Were it left up to us, we'd have entirely skipped coming to "the Rock" as it's none-too-affectionately known, with about 1 second's careful thought, had the decision been ours, instead of one made by people in pay grades far above reality.

So to come protest us and our presence because your community college class was boring, is like bitching at the guy who cleans the floors at Exxon for their company having spilled a tanker on your beach. Which is to say, rather annoyingly misplaced. But the whiny entitled juvenile I'm-against-everything class is much the same on every continent: brains are entirely optional, and rather seldom in evidence.

So listening to a bunch of pampered college kids and pissed off dithering housewives rant through 2/3rds-size bullhorns in Engrish that we should go back home and stop warmongering kind of pissed us off. We also seem to recall a certain field trip their fathers and grandfathers organized to Pearl Harbor in 1941, and a little hike across Bataan they took some of our forefathers on shortly afterwards, which memories seems to have slipped their collective notice for 40 years, as they do to this day.

And worst of all, it's really just an annoyance, but it's just loud enough that the lecture is becoming problematic, thus finished in abbreviated fashion, forcing us all to suit back up, and go back to playing howitzer-on/howitzer off, in the lovely noonday humidity and heat of a 90-degree Okinawa afternoon. Again. Thanks, @$$holes.

So we're about one or two iterations into the process. Right next to the fenceline, with only that and a short hedge separating us from the lovely and gracious hospitality of these model citizens of Okinawa.

I should also mention that when you put 150 or so Marines in identical quilted woodland camo suits, gas masks, gloves, and booties, other than height, there is no discernable difference between a captain, a sergeant, and a private, nor anyone in between.

So we'll never know who did it, but at some point when we were going through the motions, one of the dozens of CS tear gas grenades getting tossed seems to have been accidentally pitched the wrong way, and landed about 20 feet over the fence, and ever so slightly upwind of the Charge of the Pissed Off Brigade.

So instead of repeated Engrish demands that "Yankees Go Home!" we heard "Yankees COUGH COUGH  Go COUGH CHOKE RETCH  Aaaaaaahh! VOMIT COUGH PUKE  ahhh......"! followed by what was surely the Japanese version of "Run away! Run Away!".

Followed, in short order, by sounds last witnessed when Godzilla was stomping on plastic tanks on a Tokyo soundstage, and the pitter patter of little feet retreating rapidly away from our exercise.

It's hard to hear in MOPP Level IV protective gear, but I know I heard 150 guys laughing their asses off, and could see their heads and chests vibrating as proof as they chained the howitzers back to the trucks just before things were brought to a halt.

The field command investigation was suitably short.
The CO asked "Who did that?"

All the NCOs carrying gas grenades looked like choirboys and asked "Sir, did what?"

And we were returned to our barracks, having yet again vanquished the human waves of the yellow horde on their own turf. Take that, ye Minions Of Stupidity. Or as they might put it there, "Banzai!"

You've Gotta Keep Breathing

The last few times, we went about getting ourselves the wherewithal to gain a few minutes to work things out. When it comes to breathing, a few minutes is exactly what you’ve got.

“But....that’s ridiculous! I’m not going to worry about that. What could possibly interfere with me breathing?”

 

 As people streamed into the Staples Center for the night’s game, the sun was just going down on a beautiful early spring day in Southern California. At separate entrances, and separated by several minutes between arrivals, 12 elderly Middle Eastern senior citizens were wheeled inside by doting younger relatives. Grandfathers and grandsons, uncles and nephews. Each one sat in a standard folding wheelchair. Behind each elderly man were 12 identical “C” size oxygen canisters. Each passenger helpfully had a nasal cannula hooked beneath their nose, but a carefully placed blanket or jacket in each case concealed the fact that they weren’t connected to the cylinder outlets, just dummied in place. One by one, they found their seats at the railing of the upper level, spread  at each number of the clock, beside an aisle. The chairs were left behind the back row, folded up, but the O2 bottles were carefully carried alongside each elder until the pairs had found the seats and settled in. They say down and waited. They stood for the national anthem, and let the game start. Precisely 5 minutes into the first period, each pair got up. To get a hot dog, visit the bathroom, whatever. As they stepped away, each young attendant, having checked to see the spray outlet was pointed at the center of the arena over the rail wall, quickly but nonchalantly twisted open the valves, and then hopped a quick couple of steps, calling after their elder charges, and headed to the upper landing. Whereupon a miraculous change in spryness enabled each pair to calmly but quickly exit the arena, again by different exits, and were picked up in each case by a third accomplice who brought the cars near the curb. Within a couple of minutes, they were all heading outbound towards one of the nearby multiple freeways, and back to their safe houses.

Back in the arena, a dozen cylinders all poured out an invisible vapor of aerosol droplets. The twelve tanks had been smuggled north from Mexico, after being delivered from a freighter off the coast, and run into a shore rendezvous off Baja, then smuggled along drug routes through the border deserts before winding up at the group’s warehouse near downtown L.A. Each was painted to resemble an oxygen tank of medical O2, but all in fact held under pressure a particularly well-made batch of Sarin liquid nerve agent. Air currents inside the venue distributed it widely, and within minutes, people on the lower level began to feel “wrong”. Their vision was constricted by closing pupils and teary eyes, they were coughing, then noses ran, then they began to gag and gasp and vomit. Their nerves spasmed, they stumbled, and as they all began to slump to the ground, lost control of their bladders and bowels as they landed heavily on the floors and aisles. As others noticed that something must be going on, they tried to flee, but the vapor cloud found most. Especially bad was the fact that everyone inside the ring of death had to pass under the cascading droplets from above. Pretty much everyone on the lower level was minutes from death the moment the cylinders were cracked. The people on the upper level had things somewhat better, having only gotten a mild dosing from what the air circulation system distributed. But what nerve gas didn’t kill, panic did. Dozens were trampled in the melee for the exits. Some who’d received gas in their eyes, noses, and mouths began to go down in ones and twos, in a trail leading from the seats to their cars. Others who had a few more minutes from skin exposure lost it trying to get to their cars, strewing bodies all over the parking lots. Some smaller number succumbed on nearby streets and freeways, creating the mother of all traffic jams in every direction, and every accident a contaminated hazmat response.

And all the while the carnage was broadcast live on TV to millions of viewers, some by stunned cameramen, some by cameras whose operators were dying under the lenses. In the confusion and panic, it was over 3 minutes before someone in the truck yanked  the signal feed circuit. One of the vehicles was simply driven away with no attempt to disconnect, and toppled a dozen fleeing bystanders before the cable snapped on a fenceline.

At Los Angeles OCD, dispatch started getting panicky radio calls, and several fire and police units were dispatched. Long before they arrived, they were called off, and a perimeter was called for upwind. The Hazmat Response crews were dispatched. By the time they arrived twenty minutes later, and took another ten minutes to get suited up properly, it was a body hunt and forensic investigation. Inside over 10,000 people were dead. Another 1000 bodies were scattered throughout the facility, and there were over 200 nearby traffic accidents. An unfortunate number of the first arriving paramedics and patrol officers became secondary casualties in short order, leading to futile attempts to establishing several hundred secondary contamination zones, and evacuating thousands of residents nearby and downwind. Between 24 hour news and sports radio, and cell phones, panic spread at the speed of electrons.

The populace collectively lost their minds. Between nearby residents and those listening and watching the game, it quickly became obvious that somebody had used something. People started grabbing car keys, and maybe whatever they could grab in 30 seconds, and hit the road en masse. A cascading traffic snarl spread outward from south of downtown, near the original incident. As word spread from city radios to commercial broadcast about the secondary sites at accidents nearby, getting in a fender bender, instead of getting out to exchange info, became a game with rules somewhere between a demolition derby and Death Race 2000. And as the cars fled the locus of disaster, outlying cities and surrounding counties fumbled and wondered what response to take. No one had ever tried to deal with 5 million cars all headed out of L.A. at the same time, driven by people ranging from cautiously determined to ragingly hysterical.

Between the incredible number of traffic accidents, including the contaminated victims, and the number of slightly contaminated or uncontaminated but terrified spectators and their families arriving in the local ERs, hospital after hospital was flooded with patients. Operating on the ragged edge of disaster on a good day, the entire county’s emergency medical system had a stroke. Ambulances nearby were contaminated, some crews dead, others couldn’t get to calls, let alone the normal nights’ tally of gunshot victims and heart attacks. Diversion of ambulances to and from farther and farther away spread like ripples in a pond, and within an hour crashed the entire system. Which in turn impacted the systems in surrounding Ventura, Orange, San Bernardino, and Riverside counties. By 10PM, nearly 10% of the population of the United States –  30 million people - centered on Los Angeles was effectively left without any emergency medical service until further notice.

Not that there were more than a 100-200 doses of atropine in all the local hospitals combined, and it would be hours before anyone could access federal stocks of nerve agent antidote. By which point, everyone who’d need it would probably be cold and dead anyway.

 

 

But no, that could never happen to you, because you don’t live near L.A.

And you don’t live in a town where there’s a stadium, or mall, or movie metroplex, or any other target, and because it’s so hard to smuggle small bundles of stuff into your state from Mexico. (You know this because the local home Depot doesn’t have 20 illegal aliens standing out front 7 days a week, right?) And there’s no chemical or nuclear plants near you, nor do any trainloads of hazardous material by the metric boatload pass nearby, and you’ll never have a fire at either a chem/nuke plant or at a train crash. And you’ll never hit black ice on a bridge and end up in a pond, stream, or river either. And of course, no protesters in your town will ever start a riot over anything, and leave you needing to evacuate through clouds of riot control gas, smoke, or what have you. Nor will you ever be in a burning building or airplane cabin, because that never happens either.

Riiiiiiight.

 

The rest of us might have to deal with some or all of that stuff, and there’s ways to go about it.

Available for purchase online are any number of high-tech, save-your-life military or better grade chemical protective masks. For the price of one rifle, you could have a mask with hood, multiple spare filters, a protective suit, butyl gloves and booties, and duct tape to seal the seams. And if any of the preceding concerns you in the slightest, you and everyone you hold dear should consider putting an NBC/CBRN (two acronyms meaning the same thing – chemical, biological, or radiological/nuclear nastiness) exposure prevention bag together.

For staying put, assuming you’re not downwind of Hell Central, visqueen and clear plastic sheeting in rolls sufficient for all the holes in your house, plus duct tape, staples, nails and furring strips to hold it there for some time, along with a larger filtration system, would be the next logical step after that.

And if needing actual breathing oxygen because your car ended up underwater is something you consider a potential situation, you can get pony bottles of breathing air at any scuba shop, once you’ve gotten a scuba cert card in your hand. Obviously a possibility in states with creeks and ponds and little lakes everywhere, but someone out in a dusty desert could find themselves in an irrigation canal, so think carefully on where you travel and what could happen.

And lastly, for “poor man’s hazmat”, a set of swim goggles and a quality N95 or N100 (which numbers denote how much particulate junk they successfully filter) mask, can get you through sooty brushfire or volcanic ash clouds (briefly) and minimize the irritation from things like CN, CS, and OC pepper spray. There are even little cannisters than contain a clear hood and mouth filter than are specifically designed to let you breath while escaping from a building or airliner gloriously aflame.

I’m not hawking brands, but if you found this site, your Google-fu should enable you to find, compare, and acquire any or all of the above, as your wise consideration dictates.

 

If you do that, you’ll have bought yourself the time to handle the next necessities on your survival pyramid.