The U. S. Fire Administration has issued “Infogram 17-09” that lists some precautions for first responders who may come into contact with victims of swine flu (H1N1):
Review state and local pandemic plans and apply applicable provisions.
Implement acute febrile respiratory infection screening for all callers or patients with nasal congestion, cough, fever, or other flu-like symptoms.
Request additional information from the dispatcher when sent to respiratory, sick person, and fever-related calls, but given only limited initial information.
Perform initial interview of all patients from more than 6 feet away to determine if personal protective equipment precautions are necessary.
Place a standard surgical mask on all patients with suspected influenza symptoms before approach.
Maintain strict adherence to hand hygiene by washing with soap and water or alcohol-based hand disinfectant immediately after removing gloves following any contact with patients.
See more detailed recommendations at the Interim Guidance for Emergency Medical Services (EMS) Systems and 9-1-1 Public Safety Answering Points (PSAPs) for Management of Patients with Confirmed or Suspected Swine-Origin Influenza (H1N1) Infection.
How will a possible swine flu H1N1 pandemic affect the way we suppress large fires?
On Wednesday the World Health Organization raised its pandemic alert to the second highest level, a phase 5 alert, meaning it believes a pandemic or global outbreak of the disease is imminent. But we don’t want to over react. The Centers for Disease Control (CDC) estimate that 36,000 people die each year from the flu. As this is written there has been only one death in the United States from the Swine flu. This is a new virus and the CDC says they don’t know how it will behave yet. It may turn out to be no big deal, but until we know for sure, we need to be prepared for the worst, while hoping for the best.
If there is a widespread outbreak or pandemic in the United States, it is likely that travel and congregating in large groups will be discouraged. Some firefighters and others qualified to serve in incident management organizations will make the personal decision that under those conditions they will choose to minimize their risk to themselves and their families by not accepting assignments to large fires.
If a pandemic occurs, we can also assume that Incident Management Teams will be activated to deal with the direct or indirect impacts of the disease, perhaps managing receiving and distribution centers as they frequently do following hurricanes or other disasters.
And if large wildfires occur, firefighters will, as usual, be dispatched across the country to suppress them, which of course will involve long distance travel and congregating in large groups. At most fires, sanitary and shower facilities are limited, at best. Washing clothes is sometimes possible, but not always. Firefighters will be working long hours and getting inadequate sleep. Is this a recipe for the accelerated spread of the disease and putting our firefighters at risk?
The Command and General Staff of California Type 1 Incident Management Team #3 was activated on April 27 to plan for the eventuality of a major swine flu outbreak. One of the members of a NIMO team told me on Wednesday that two Type 2 IMTeams have been activated to assist in distributing supplies. The city of Phoenix has activated their all hazards incident management team. Other teams as far ranging as Aspen, Colorado and New Zealand have teams that are already involved in planning for a possible outbreak.
Planning for fire suppression during a pandemic
I talked with several high-ranking people in the land management agencies and some that are assigned to the Command and General Staff on Type 1 incident management teams, and none of them were aware of any planning that may be in place for how their teams would be affected if asked to respond to a pandemic-related incident or a wildfire during a pandemic.
The U.S. Forest Service’s California Region prepared a “Pandemic Response Plan” in April, 2006. Motivated by the emerging avian flu, it was written by three safety officers and Mellie Coriell, PhD. As far as I know it has not been updated since 2006.
The 55-page plan contains a great deal of information about how to monitor employees for the disease and how to reduce the chances of spreading it within the workplace. Beginning on page 48 is Appendix 11 which provides guidance on the management of an incident within the environment of a pandemic. Prepared by the medical unit leader of California Type 1 Incident Management Team #3, it assumes a team has been requested to assist with quarantine or isolation.
The appendix includes information about:
personal protective equipment
pre-screening medical exams
14 days of quarantine post deployment
various camps for different types of exposure to the virus
documentation procedures for exposure to the virus
specialized positions and unit leaders that would need to be filled
Where do we stand?
Several U.S. Forest Service employees in the national offices did not return phone calls after we left messages asking for more information about this issue. And the ones we did talk to have no knowledge of any preparations or plans that may be in place or ongoing, in spite of the one plan that exists in California. But it is encouraging to know that a few members of California Team #3 have assembled to put together some plans.
As we said earlier, the swine flu may not amount to much, or, it could drastically hamper our ability to find firefighters who are willing to fight fire during a pandemic and to travel to a large fire. It could also make it difficult to assemble hundreds or thousands of firefighters in one place without putting our people at risk.
Fighting fire or managing a large all-hazard incident during a pandemic will require a great deal of personal protective equipment and other supplies that we don’t normally use on fires, such as:
N-95 masks and respirators
Latex or Nitrile gloves
Tyvek surgical gowns or coveralls
Eye protection (splash protection)
Maybe the fire warehouses have some of these items now, but if we wait until we absolutely need them, we will be competing with millions of other people trying to obtain the same items. It may be too late already.
We are not going to attempt to cover the spread of the new swine flu virus, H1N1, (which has killed dozens in Mexico and has now been found in California, Texas, Kansas, and New York) but here are a couple of interesting links.