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How To Prepare For A Pandemic

They had the right idea: During the worldwide flu epidemic that began in 1918, women in this U.S. office wore cloth masks.
Bettmann Archive
They had the right idea: During the worldwide flu epidemic that began in 1918, women in this U.S. office wore cloth masks.

No matter how you slice it, outbreaks are becoming more common. Overseas, there's been Ebola, Zika and yellow fever. And here at home, we're seeing a surge in tick-borne diseases, with Lyme leading the way.

For the past month, NPR has been looking at why this is the case. Deforestation lets animal viruses jump into people. Factory farming amplifies the problem. And then international tourism spreads the new diseases around the globe.

But throughout our series, there's been something else on people's minds.

Listeners and readers sent in 250 questions about pandemics. One kept popping up: "If we believe that an unknown pandemic is overdue, what precautions are reasonable to take now?" asked Wade Schuette.

We turned to four infectious disease experts for answers. From their collective advice, we created NPR's Pandemic Preparedness Kit (no trademark necessary).

Now, this isn't your traditional kit that you tuck under the kitchen sink. This kit is scattered around your life. In your car. In your purse. In your blood. And in your brain.

And there are only three items. Good luck collecting them all!

(If you really want to create a traditional "emergency kit" for outbreaks, the Centers for Disease Control and Prevention has suggestions. But chances are very, very low that you'll need extra batteries and a gallon of water for a flu pandemic. Thank goodness.)

1. Vaccines

At first this sounds like public health propaganda — just another excuse to plug the MMWR vaccines. How could a vaccine for known diseases prepare you for a pandemic for a new disease that doesn't have a vaccine yet?

"It absolutely can," says Dr. William Powderly, an infectious disease doctor at Washington University in St. Louis and the president of the Infectious Diseases Society of America.

Here's an example.

"Suppose we have an outbreak of a new influenza, something that's deadly — and so new that there's no vaccine for it," he says. "Well, how do people die of influenza?"

It's not just from the virus itself. "One of the most common causes is secondary pneumonia — people getting pneumonia on top of the flu," Powderly says. "Completely new infections can weaken your immune system and set you up for a known infection."

And guess what we have a vaccine for? Yup, the bacteria that cause pneumonia.

"We recommend the pneumococcal vaccine for people over age 65 and those with certain underlying illness, like chronic heart disease," Powderly says. "Right now, though, just under half that population has taken the advice."

So to maximize your protection from a new disease, make sure you and your family are up to date on vaccines for known diseases, from the flu and pneumonia to shingles and whooping cough.

2. Virus knowledge

For this one, you're gonna need the old noggin. And some skepticism.

One of your best weapons during a disease outbreak is knowledge, says Dr. Jonathan Temte of the University of Wisconsin.

"Keep up with the news and try to understand what threats might be out there," he says.

For example, new types of influenza are one of the biggest threats right now — in terms of pandemic potential, Temte says. But if you know how to protect yourself from one type of influenza, you can protect yourself from all of them.

"All forms of influenza spread through people coughing and sneezing — the respiratory route," he says. "So you can break transmission simply by maintaining distance and wearing a mask around sick people."

Picking up a mask at the corner drugstore is easy. Finding accurate information on the Web isn't quite as simple.

There's a lot of information about diseases on the Web, but it can be hard to tell what's accurate. So Temte recommends going to governmental sites.

If a disease catches your eye on a news media site, then look up the topic on governmental or nonprofit websites, Temte says, such as the World Health Organization or the CDC.

"Just go to your favorite search engine and type in the disease you're concerned about and then add 'WHO' or 'CDC' along with it," Temte says.

These websites also post information about current disease outbreaks on their home pages — even when the outbreaks are small. So if you check them on a regular basis, you'll stay one step ahead of any developing pandemic.

Other good sites are those hosted by state health departments, CIDRAP at the University of Minnesota, and Medline at the National Institutes of Health — although while Medline isn't typically up to date on the latest outbreak news, Temte says, it's good for background information.

3. Very clean hands

When swine flu hit the U.S. in 2009, Dr. Abigail Carlson was on the front line. She was working in a hospital and was exposed to the virus every day.

But she never got sick. Why? "I got my vaccines and washed my hands. A lot," says Carlson, an infectious disease expert at Washington University in St. Louis and an epidemiologist for the VA St. Louis Health Care System.

"Every emerging disease is different," she says. "But many of the basic control measures — like washing your hands — will work to combat it. They are still the most effective ways."

The CDC calls hand-washing the "do-it-yourself vaccine." And all the experts repeated the recommendation: Learn how to clean your hands properly and do it.

"It's shocking the number of people who don't do basic hand hygiene," says Dr. Elizabeth Lee Daughtery, who studies infection control at Johns Hopkins University.

"That means washing with soap after the bathroom, before you cook, after you've been shopping — really anytime after you've after been out in public places, opening a bunch of doors, pressing a bunch of elevator buttons, touching the grocery cart," she says.

And don't skimp on hand sanitizer and wipes, Daughtery says. Have them in the car, in your purse or backpack and around the house. And make sure you have enough stockpiled for when an outbreak hits.

We're talking about regular sanitizer and soap here, not those labeled "antibacterial." There's no evidence that antibacterial compounds improve the effectiveness of soap and santizers, the Food and Drug Administration reports.

Finally, don't forget the kids. Make sure they are practicing good hand hygiene as well, Daughtery says. Have them sing "Happy Birthday" — two times — while they're scrubbing under the water. Then they'll be sure to knock off all those bacteria and virus particles from their skin.

Thanks to our readers who submitted questions to #CuriousGoat. Want to propose a question for our next callout, on the topic of climate change and global well-being? Click here.

Copyright 2021 NPR. To see more, visit https://www.npr.org.

Michaeleen Doucleff, PhD, is a correspondent for NPR's Science Desk. For nearly a decade, she has been reporting for the radio and the web for NPR's global health outlet, Goats and Soda. Doucleff focuses on disease outbreaks, cross-cultural parenting, and women and children's health.

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