A Plan for Self Quarantine in Case of a Flu Pandemic

The purpose of the plan is to keep everyone healthy and functioning during a pandemic,
regardless of the severity. Hypothesis is that aggressive, early social distancing in
combination with droplet precautions will achieve this goal

If implemented and strictly followed, this plan does not require any outside help.

Compliance with the plan would be the responsibility of individuals.

Key portion of the plan are:
1) Timely protection
2) Distance
3) Surgical Mask
4) Hand Washing
5) Tissues, Coughing and Sneezing, and
6) Education

The rational for development of the plan is as follows:

• It can be done quickly and inexpensively using a grass roots approach.
• It would likely have more impact on lives than a purely response plan and help keep health
structures less taxed during a pandemic.
• It will teach principles and actions that would likely be included in the plans that were
being developed at the state and national level.
• It will capitalize on the interest that is being generated through national media coverage
• It would start to develop partnerships from non traditional groups that could be utilized
as further planning and response plans would unfold.

If a pandemic starts, individuals would need to practice very strict social isolation and
health care providers would need to utilize personal protective equipment to deal with those
infected. It is felt that every person in the community could be introduced to principles of
isolation precautions usually reserved to medical providers. Individuals would set up
protected cohorts consisting of small groups or families. Inside that group they would not
utilize any specific isolation precautions.

Anyone leaving the protection of this group would consider any human contact as having
influenza and practice strict droplet precautions. Rather than trying to isolate those
identified with illness, healthy individuals would “quarantine” themselves (“reverse
quarantine”). People would not be forced to practice isolation precautions, but would
hopefully comply because of in depth education regarding rational and specifics of the plan.
Instigation of the plan would be announced by local health department leadership in
connection with other community leaders.

Health agencies disagree on the size of the ideal home store, ranging from recommendations
of a ten day to three month supply, with most now recommending a three month supply. As
an emergency approaches, retail store shelves will be rapidly stripped of all supplies. As we
have seen, when storm warnings are issued it takes only minutes for shelves to empty and
may be days before new supplies arrive. The same will happen once the first signs of a
pandemic flu appear.

The most successful quarantines lasted a minimum of two months. You may also be called
upon to help family members and friends, and you will want to be prepared.

Stock up on:

Prescription drugs to insure a continuous supply in your home. You may ask your doctor if
he has samples or can help you to lawfully prepare.
First aid supplies.
Nonprescription drugs including pain and fever relievers, stomach remedies, anti diarrhea
medications, and cough and cold medicines and preventive medications.
Remember, never give young children aspirin. Purchase medications specifically designed
for children.
Fluids with electrolytes.
Vitamins.
Anti bacterial wipes for cleaning up after attending to a patient.
Hand sanitizers should also be included in your first aid supplies. These should be used
every time you are with someone who is ill or after you shake hands with anyone.
Make sure you also have at least one thermometer on hand and alcohol to clean it.
Medical gloves are essential. Purchase a variety of sizes for the needs of all family
members. Remember, some gloves are latex - so if you think you may have a latex allergy
use care in selecting gloves.
N95 particulate face masks. These will help prevent the transfer of germs as you are in
public or caring for a loved one. There are many types of medical masks. The surgical
variety will provide added protection from fluids. These are especially valuable when you
are caring for someone who is sweating, sneezing or vomiting. For the best protection these
need to fit firmly against the face. If you are using masks for children place the mask on the
face and then a bandana. This will help to hold the mask firmly on their face. It can be like
dress up! Make sure you remove the bandana and place it directly into the washer. Then
discard the mask, preferably outside, and wash your child's hands, face and exposed skin
thoroughly with a hand sanitizer. I have heard people advise that masks do not need to be
stored because they cannot be fitted tightly enough to the face. So long as hospitals, police
and fire departments and schools are stocking up with supplies of masks for all their staff
and students, I am stocking face masks, too. When they no longer consider it important, I
will stop. Until then, I believe it is important.
Paper plates, cup, bowls, and utensils will cut down on the possibility that germs will be
passed as meals are cleared. They will also save precious time for those who are the care
givers and a must have should the power fail.
Paper towels, become essential items for keeping your home germ free.
Stock up on TP and facial tissues with anti bacterial properties…you will use more than
you think during a time of illness. Each family will need a different amount of these items.
Don't guess what your need will be. For at least one month keep track of how may rolls of
toilet paper and how many boxes of tissues you use. I suggest you place the wrapper from
the TP roll in a drawer and at the end of the month count how many you have used. You
can multiply this number by three to understand how much you need to store. Add an
additional 25%-50% more to prepare for a pandemic as family members will all be home all
day long, and some family members are likely to be ill.
Large plastic trash bags for soiled clothing,towels, and trash.
Liquid soaps: laundry and dish soaps will be much more useful if there is an interruption in
your utility service.
Bleach for laundry and cleaning, and other disinfectant cleaning supplies should also be
stored.
Remember the foods we discussed in Preparing for a Flu Pandemic with Food Storage.
Alternative to electricity.
For light: Flashlights, glow sticks, and/or lanterns, and batteries.
For heat: Firewood, non-electric heaters (propane or kerosene – follow manufacturer
instructions for safety), and heavy blankets and/or sleeping bags.
For Cooking: Portable propane cook stove, barbecue grill and fuel, can opener.
For Laundry: large tub for washing laundry, rope for a clothes line and clothes pins.
For Communications: Battery/solar/crank radio and/or TV to keep up on the news and
health warnings.
Water: Bleach and other items needed for purification.
Sanitation needs: Port-a-potty with chemicals and liner, kitty litter or sand to help absorb
waste and a plan to bury your waste away from your home. You will also need to be
prepared to bury or otherwise dispose of every day's trash in case services are suspended
temporarily.
Entertainment: Just think about three months at home with no place to go. Talk about
cabin fever! Consider purchasing DVDs that you know your children or spouse would like
to have. Keep them put away until they are needed or until the next major gift giving
occasion. Then replace the old with new titles. You can also establish a stash of age
appropriate books, magazines, puzzles and games. Reading a few classic books as a family
would also be a great way to pass the time. Stock up on craft supplies and even a new hobby
to start with the kids. Cooking can be lots of fun together so make sure your three month
supply includes ingredients to make some fun snacks and meals. A sense of humor is key to
survival, so be sure to choose entertainment that is funny and/or uplifting.
Cash: Should the power fail ATM machines and credit cards will not work. Have a stash of
small denomination bills on hand for emergencies when you are forced to leave your home.
Gas up: As soon as you hear the flu has come to your region, fill all your cars with gas. Not
only will supplies be hard to come by, but if the power fails, so do the pumps.
Develop a list of health care providers in your area including clinics and hospitals. Include
friends in health care, who you can call at home to get advice or direction.
A bell or whistle for your patient to sound when they are in need of help. A whistle can be
heard much easier than the human voice.
Whether you are trying to prevent disease or prevent it from spreading, you will want to
take precautions in every aspect of your family routine. Now is the time to start by teaching
and practicing good habits.

Teach your family the proper way to wash their hands. You do not need to use hand
sanitizers on a daily basis. In fact, this can prove dangerous as sanitizers kill all germs, good
and bad. Hands should be washed with plenty of water, soap and scrubbing. Practice
rubbing all the surfaces of the hands, including the fingernails and between fingers, under
running water every time you wash. Since this needs to take some time children can learn to
be patient and sing either Happy Birthday or the ABC Song while scrubbing. This will help
them to recognize the length of time necessary to do a thorough washing.

Avoid shaking hands with someone who is ill, begin the habit now. If this is impossible,
thoroughly wash your hands as soon as possible or use a hand sanitizer.

Teach family members to always cough or sneeze into a tissue. If this is impossible teach
them to cover their face with their arm, not their hands. Simple bend your arm and place
your elbow over your mouth. This reduces the likelihood that you will pass germs along to
others as you shake hands or touch objects they may also be handling.

Remind your family to stay away from those who are ill. Please don't send an ill child to
school, to after music lessons, or even to church when they are ill. We could avoid so much
heartache if everyone would make it a practice to stay home when they are ill.

Have each family member clear their own dirty dishes after each meal. During a period of
illness you will use paper plates and have them place their dishes in an outside garbage can.
Get a large plastic garbage can that you can set outside the door in the event of emergencies
like pandemic. Dispose of any wet or contaminated garbage in that can. This will help keep
germs outside, instead of inside your home.

Decide now which room in your home will be used to care for those who are ill. A room
with its own bathroom is the best. You will want to keep a patient as far away from healthy
family members as possible. Be sure to have several sets of sheets for the bed or beds in that
room.

Design a plan to care for extended family and friends if they should become ill and have
no one to care for them. In some cases it will be better to have them move in with you at the
beginning of the pandemic and hopefully avoid becoming ill as they self quarantine with
your family.

Prepare now to work from home if at all possible. You should discuss this with your
employer and develop a plan now. If you are a first responder, be sure your employer is
prepared for the employees to maintain a self quarantine at your work place.

Check with your child's school to determine if they have a plan for a pandemic. Will they
continue to teach using the Internet or a cable TV station?

There is a limit to what government or the health care community can do in advance of a
pandemic outbreak. The U.S. Federal Government, the World Health Organization, and
others are monitoring the avian flu, as well as other pandemic threats closely. The United
States has active national as well as international programs for manufacturing, pre-
positioning, and stockpiling antiviral drugs, masks, and other supplies. A lesson we have
learned from the response to hurricanes Katrina and Ike, the floods in the Midwest , and the
destruction caused by tornadoes, we need to be prepared to care for all of our own needs.
Right to Refuse Medical Care / Right to Die Has Legal Limitations

1) Preamble to the U.S. Constitution- It was insufficient in Jacobson v. Mass., 197 U.S. 11
(1905) to infer the right to refuse to be vaccinated or that being forced to do doing so would
violate his liberty.

2) The right to informed consent under common law, or conversely, the right to refuse.

3) U.S. Constitution and Bill of Rights - Life, liberty, and pursuit of happiness and or property

4) Constitutional provisions under liberty interests in the Due Process clause (Fifth and
Fourteenth Amendment) to refuse medical care.

5) The right to be “secure in our persons” (Fourth Amendment).

6) The unenumerated rights (Ninth Amendment).

7) Jacobson v. Massachusetts, 197 U.S. 11 (1905) Constitutional liberties are limited by state
police
power — the power of the states to protect public health and safety `for the common good, for
the protection, safety, prosperity and happiness of the people. (Immunizations are a police power
and state rights are greater than personal liberties/right to refuse immunizations)

[Ed Note: this early decision was prior to the development of constitutional privacy law and prior
to the determination by the insurance industry that vaccine harm was an uninsurable risk.]

8) Schloendorff v. Society of New York Hospital, 211 N.Y. 125 (1914). The touching of another
person
without consent was battery.

*Experimentation*

9) U.S. Code Title 50 chapter 32 § 1520a allows use of “human subjects for testing of chemical
or
biological Agents.
10) The Feres Doctrine (comes from a U.S. Supreme Court ruling in Ferris v. United States, 340
U.S. 135
(1950)) prevents soldiers from suing the American Government for medical malpractice,
including adverse reactions to vaccinations, even if it results in death.

11) Congress has allowed drug research to include children (21 U.S.C. §§ 355a, 355c). The
number of
mandatory vaccinations for children has risen to 36, and most are required for school attendance
(See: Zucht v. King, 260 U.S. 174 (1922) confirming Jacobson and extended it to all students
requiring vaccination before school enrollment).

12) Tuskegee Syphilis Experiment (1932-1972) Right to Informed Consent not given. (Settled
out of court).

13) Cruzan v. Director, Missouri Dept. Health, 497 U.S. 261 (1990). If no longer competent,
surrogate must
have clear and convincing evidence of wishes prior to incompetence.

*No constitutionally protected right to assisted suicide*

14) Kevorkian v. Thompson, 947 F.Supp. 1152 (1997)

15) Washington v. Glucksberg, 521 U.S. 702 (1997)

16) Schindler v. Schiavo, 403 F.3d 1289 (2005)

In the United States, Secretary Leavitt of the Department of Health and Human Services (DHS)
has stated that "any community [or individual ] that fails to prepare—with the expectation that
the federal government can come to the rescue—will be tragically wrong" (April 10, 2006).

“The first and most basic stage is to go home lock the doors and stay there. DO NOT try to
seal up your home with duct tape and plastic as you will not have enough oxygen to breathe
within a very short time. This method is used for chemical events where you need to be
indoors for a very short period of time. Most Quarantines will last days if not weeks and
months. At this stage you can actually go out in to your front yard or back yard and
breathe the air just fine just as long as you do not breathe someone else’s air that might be
infected with an airborne communicable disease or virus. This could include certain
animals and insects, all depending on the biological involved.”
The first four essential steps are:

“1. Have a Family Call-out Plan. When the pandemic starts, activate the call-out plan – make
calls out to every family member to get everyone home ASAP.
2. If still on the road and/or in public, pull out gas mask, with bio-filter, from kit in auto.
3. Keep radio tuned to local stations you trust for local updates.
4. Upon arriving home, start quarantine process by bringing everyone inside including pets.
5. Put a “Quarantined” sign on front door.”

Of course, preparedness is essential. You need to keep a couple weeks supply of food and
drink on hand. You need to have a family plan, as recommended by our expert. We also
believe that natural remedies can help support a vibrant and effective immune system, even
in the worst of situations.

AFTER-NOTES

1. UN Universal Declaration of Human Rights – Article 12 – “No one shall be subjected to

arbitrary interference with his privacy, family, home or correspondence, nor to attacks upon his
honor and reputation. Everyone has the right to the protection of the law against such
interference or attacks.”

2. CDC: “Isolation and quarantine are public health practices used to stop or limit the spread of
disease. Isolation is used to separate ill persons who have a communicable disease from those
who are healthy. Isolation restricts the movement of ill persons to help stop the spread of certain
diseases. For example, hospitals use isolation for patients with infectious tuberculosis.
Quarantine is used to separate and restrict the movement of well persons who may have been
exposed to a communicable disease to see if they become ill. These people may have been
exposed to a disease and do not know it, or they may have the disease but do not show
symptoms. Quarantine can also help limit the spread of communicable disease. Isolation and
quarantine are used to protect the public by preventing exposure to infected persons or to persons
who may be infected.”

Vaccine Exemption Cases

11. Amendment 4 – United States Constitution: The right of the people to be secure in their
persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be
violated, and no Warrants shall issue, but upon probable cause, supported by Oath or affirmation,
and particularly describing the place to be searched, and the persons or things to be seized.

12. The Declaration of Helsinki: It is the duty of the physician to promote and safeguard the
health of patients, including those who are involved in medical research. The physician’s
knowledge and conscience are dedicated to the fulfillment of this duty.

The Declaration of Geneva of the WMA binds the physician with the words, “The health of
my patient will be my first consideration,” and the International Code of Medical Ethics
declares that, “A physician shall act in the patient’s best interest when providing medical
care.”
CDC – Isolation and Quarantine

3. Regulations to control communicable diseases:

42 USC 264(b) “Apprehension, detention, or conditional release of individuals – Regulations

prescribed under this section shall not provide for the apprehension, detention, or conditional
release of individuals except for the purpose of preventing the introduction, transmission, or
spread of such communicable diseases as may be specified from time to time in Executive
Orders of the President upon the recommendation of the Secretary, in consultation with the
Surgeon General…”

42 USC 264(b)

4. National Strategy for Pandemic Influenza: “limitations on gatherings, or quarantine authority

may be an appropriate public health intervention.”

National Strategy for Pandemic

5. Department of Defense:

“Voluntary, community-based measures, such as limiting public gatherings, closing schools, and
minimum manning procedures, are most effective to limit exposure to the disease if implemented
before or at the onset of the event. Quarantine and other movement restrictions, especially if the
restrictions are involuntary, will have minimal effect on the spread of the disease due to a very
short incubation period and the ability of asymptomatic individuals to shed the virus.”

“DoD Category #13: Quarantine Assistance to U.S. Civil Authorities. When directed by the
President, DoD may assist U.S. civil authorities responsible for isolating and/or quarantining
groups of people in order to minimize the spread of disease during an influenza pandemic.
Isolation is a commonly used public health practice for the separation and restriction of
movement of ill persons to stop the spread of a contagious illness. People in isolation may be
cared for in their homes, in hospitals, or at designated health care facilities. Isolation is primarily
used on an individual level, but may be applied to populations. It is often voluntary, but may be
mandatory. Quarantine, in contrast, applies to the separation and restriction of movement of well
persons presumed to have been exposed to a contagion. Quarantine may be enacted at a home or
other residential facility. It may also be voluntary or mandatory.”

“Interagency Planning Support 6.3.2.1. Guidance on Community Containment

HHS, in coordination with DHS, DOT, Education, DOC, DOD, and Treasury, shall provide
State, local, and tribal entities with guidance on the combination, timing, evaluation, and
sequencing of community containment strategies (including travel restrictions, school closings,
snow days, self-shielding, and quarantine during a pandemic) based on currently available data,
within 6 months, and update this guidance as additional data becomes available. Measure of
performance: guidance provided on community influenza containment measures”