What happens when disaster strikes Aspen?
You wake up one morning, glance at the front page or turn on the TV and it’s everywhere: Bird flu has struck. It’s a worldwide pandemic and nowhere is safe.What now?Everything stops. Airports are closed. Schools shut their doors. Business comes to a halt – some stores are even boarded up to prevent looting.Do you have enough food in the cupboard? How about drinking water? Should you go to work? What would you do?
“Your government is working hard on things you don’t even think about,” said Ellen Anderson, the emergency management coordinator for Pitkin County. “But the other link is self-preparedness.”The first step in readiness for any major disaster, Anderson said, is getting people to think and talk about it. And while Pitkin County is uniquely prepared, and there are systems and teams already in place to handle a number of major catastrophes, Anderson says that personal planning and preparation in the home is vital.
Major disasters fall into two categories: natural and man-made. Citizen reaction to disaster follows two models: “Run away” or “hunker down.”Wildfires and floods generally trigger a “run away” plan, under which citizens are asked to evacuate quickly. Bird flu or another pandemic, on the other hand, would likely follow the hunker-down model, Anderson said. If there is a massive outbreak of illness, then nowhere is safe. Local emergency teams would ask residents to wait it out in their homes.Anderson said emergency responders are prepared for a number of threats. But all potential disasters, from flood to fire to bioterrorism, are covered by the county’s “all hazard” plan. And a cadre of local officials and emergency responders is planning and training for the worst.
Dr. Morris Cohen, public health officer for Pitkin County, said a pandemic of avian influenza is his top concern.So, what if that familiar emergency tone on radio and TV were really followed by a set of detailed instructions to stay home because of avian flu?Cohen said the disease could move fast. A five- to seven-day incubation period would mean that those initially infected would have plenty of time to travel before they were contagious or experienced any symptoms. And by the time the disease were detected, Cohen said, each carrier could infect from 12 to 20 people. There is currently no inoculation for bird flu, and no cure.”We don’t want to frighten people, but we want to get people prepared,” he said. As health officer, Cohen is a member of the incident management team for pandemic flu.In the past Cohen has monitored diseases like SARS and the West Nile virus. Despite the fact that bird flu is the “problem of the day” in the media, Cohen said it is still a distinct threat. If an individual Pitkin County resident were to fall ill with bird flu, they would be put into quarantine , and everyone they had contacted recently would be asked to stay in their homes.A full-blown pandemic would likely constitute a state or national emergency. In that event, Cohen would recommend communitywide isolation. All nonessential businesses would close, and residents would be asked to stay in their homes and avoid contact with others. Compliance would be voluntary. School would be canceled, grocery stores closed. There would likely be some relief efforts and food supplies from government sources and the Red Cross, and gloves and masks made available, but citizens would be left to their own devices.The world has survived pandemics in the past. “La Grippa,” or the Spanish flu, killed more than 40 million people between 1918 and 1919, according to the World Health Organization (WHO), more than who died in World War I. The Swine Flu scare of 1976 killed more people from vaccinations than from actual spread of the disease.An “epidemic” is a disease that spreads locally – like a winter flu outbreak – but a “pandemic” is worldwide. To be a pandemic, an outbreak must satisfy three conditions: It must be a new virus; it must have a high mortality rate; and it must be easily communicable from one person to another.Cohen said that Avian Flu (H5N1) fits two of the conditions: It is a new virus, and the mortality rate of people infected is high (60 percent). H5N1 is the most deadly strain of common avian viruses. It is easily communicable among bird populations – millions of birds have died or been killed in parts of Asia – and is usually fatal.Currently, bird flu is only transmittable from birds to humans. And most human cases of the disease were contracted by people who work closely with birds, handling feces or blood on feedlots and slaughterhouses, mostly in Asia.According to the WHO, of the 252 cases of human infection since 2003, 148 people have died. Health officials are not concerned with the number of cases so far, but they do fear that the disease could mutate and become easily communicable from human to human.Avian flu has not yet made that transition despite being around for nearly 10 years.Still, Cohen said, “we don’t want to wait until it can be transmitted from human to human.”The county’s bird flu incident management team works with Cohen to run through scenarios for a possible pandemic in Pitkin County.
Aspen will look like “offseason plus” during a hunker-down scenario for avian flu, Cohen said. Citizens should be ready to stay in their homes for as long as a month or six weeks.”The problem with a pandemic is where are you going to go?” Cohen said. “There is no safe place.”In the case of a fire or flood, people could escape harm by leaving the area, and the county could get help from neighboring counties and states. But a pandemic would mean voluntary quarantine of all areas, and an estimated 30 days where residents would be asked to stay in their homes. Because surrounding counties would be under the same orders, help would have to come from within the county.Cohen estimates that only about 40 percent of people would go to work. Those who can would work from home.Essential workers, like those who provide electric power, sanitation and emergency services, would be encouraged to continue working. Those who continue working would wear masks and maintain a 3-foot distance between one another. Cohen said that no one would be coerced to work, but every effort would be made to maintain vital services.
Like planning for anticipated problems during Y2K, hunkering down for bird flu would have two scenarios: “lights on” and “lights off.” Loss of power in winter would mean loss of heat for many, even loss of gas pumps needed to keep police and emergency vehicles on the road.”Your home is the safest place,” said Lisa Robbiano, the current director of the Community Health Services, a nonprofit public health nursing service. Robbiano heads the county’s pandemic flu incident management team. She said some towns are hiring special managers for just this kind of hunker-down scenario. Robbiano said that Aspen, as a resort town, has a unique concern: “How do we protect visitors?” The team is working with The Aspen Skiing Co. and hotel owners to find solutions for tourists and short-term visitors who might have to extend their stays under a quarantine. A pandemic would shut down the airport, and visitors would be stranded in their hotels.”We have an advantage because we are a small community,” Cohen said.The city of Aspen is easy to quarantine, Cohen said, because there are only two ways into town, via Highway 82. The east and west entrances to Aspen, Cohen said, could easily be cordoned off with vehicles; there could be a triage trailer and checks for delivery trucks.But Aspen is also at risk, Cohen added, because visitors from all over the world could bring any disease with them. For that reason, locals should prepare, just as the county is doing.
“Pitkin County is far ahead of the curve,” Robbiano said, “but we need to be prepared individually.”Personal preparedness starts with an annual flu shot. Not only does immunization prevent spread of deadly flu epidemics – Cohen said that up to 40,000 people die every year from common influenza – but if everyone is immunized, medical responders will be able to differentiate between different varieties of flu.The avian flu team recommends that people assemble enough food, water and supplies for one month (see related article). In the event of “quarantine isolation,” citizens would be on their own, behind closed doors and forced to make do with what is in their homes.There would be no treatment for pandemic victims at local hospitals. Emergency officials might create temporary treatment centers in churches or community buildings.”We have to keep the hospital for what the hospital is for,” Cohen said. Despite any pandemic, Cohen said, babies will still be born and there will still be emergencies. The hospital would be locked and guarded. Injury and emergency victims would be screened outdoors for bird flu before they were admitted.Community quarantine isolation would be voluntary. A public information campaign would appeal to people’s humanity and ask for cooperation, but Cohen said the laws on enforcement of quarantine are unclear.Sheriff Bob Braudis agreed that voluntary compliance is the key to success in fighting a pandemic. But executive orders from the president or the governor would give the county broad powers to enforce laws and, if necessary, to assemble a posse of residents to enforce order. The most important job of law enforcement, Braudis said, would be to educate and inform citizens.Braudis said he believes in the goodness of mankind, and says that a pandemic would force the community to work together. In the event of pandemic and loss of power, Braudis would urge his constituents and neighbors to “make a new friend.”
Despite the specter of a pandemic or natural disaster, the good news for valley residents is that local officials are planning ahead. The county has a comprehensive emergency management plan, and emergency responders meet regularly to discuss disaster scenarios. The Pitkin County Public Safety Council includes the heads of various emergency entities – police, fire, ambulance, search and rescue, and hospital officials. They get together every two months and organize “Incident Management Teams” (IMTs), or task forces of local experts who brainstorm and train for specific problems.Ellen Anderson, the county’s emergency management coordinator, facilitates these meetings and works with emergency responders. She said September 11 was a tragic lesson in emergency preparedness, because New York’s fire and police units were on different radio systems and could not communicate with each other.Pitkin County has heeded this lesson. Making use of federal and state grants, the county now has a “black box” radio system which makes a solid connection between different agencies’ radios.Pitkin County follows the Incident Command System (ICS), which ensures swift and clear decision-making in the event of almost any emergency. The system relies on preplanning for different scenarios, and sets up an instant chain of command, a communication network, and support in the way of food, clothing and shelter.The Oct. 4 mountain rescue on Lost Man Trail, in which a mother and three children survived a cold night near the Continental Divide, she said, was a textbook example of the ICS system in action. After a 6 p.m. telephone call to police about a group of lost hikers, responders followed ICS procedure and appointed a sheriff’s deputy as incident commander. The commander called in Mountain Rescue Aspen and sent four “hasty teams” to begin searching for the hikers. Searchers were connected by radio to the central command in Aspen. Calls went out for food and supplies for the rescuers. The incident commander had airplanes and helicopters on hold waiting for better weather. Because of preplanning using ICS, responders followed simple procedures and saved precious time.Search teams found the children – wet, cold, hungry and tired – the next morning. The group held a press conference to get the news to the public, and the operation was wrapped up.Anderson said the planning is already in place, the lines of communication firm, to put ICS to work in any disaster, from a devastating avalanche to a flu pandemic. Agencies in Pitkin County have done tabletop theoretical exercises and practiced in the field. Aspen is an unlikely terror target, but with visiting heads of state – like the recent costly visit from the Iraqi president to the Forstmann Little & Co. conference – emergency planners practice scenarios for assassination attempts and bio-terror.Local officials can use a reverse 911, which would automatically call every phone in an area. And the Public Safety Council is at work on a new system that would call or send text messages to every cell phone or send e-mails communitywide to alert locals. Agencies like the Red Cross are always on-call.
But while government and emergency agencies are hard at work to prevent and plan for disaster, emergency responders say individual citizens must prepare themselves. That does not mean training to fight wildfires or buying expensive equipment; instead, residents should be prepared to run away, or to hunker down.Ellen Anderson asks citizens to think about “what is in your head, in your hand and in your home.” In your head, she said, you need a disaster plan that includes family meeting points or a common contact person outside the area should families be split up. In case the family home is inaccessible, families should have a second meeting point.
In hand, Anderson said, you need copies of important documents (insurance information, for example), and a kit of essentials if you have to evacuate quickly (see related article).In your home, Anderson said, you need enough supplies to remain self-sufficient – with or without power – for about one month.Dr. Cohen reminds folks to get their flu shot. Locally, there will be three flu clinics. The morning of Nov. 3 is the Senior Health Fair at Aspen Valley Hospital from 8:30 to 10:30. On Nov. 6 from 9 a.m. to 1 p.m. and again on Nov. 9 from 2 p.m. (until supplies run out) there will be a flu immunization clinic at Health and Human Services (next to AVH) for all ages. The cost for a flu shot is $20.It is vital, adds Dr. Cohen, that people take responsibility for themselves, wash their hands often and cover their nose and mouth when sneezing. This fights the spread of disease even under normal circumstances. In the case of a pandemic, it will be indispensable to survival.”Local preparedness is the key to saving lives,” said Sheriff Braudis. With a “tight plan and tight management teams” already in place, he said the county rates an “excellent” for preparedness. Charles Agar’s e-mail address is firstname.lastname@example.org
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