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32 Comments

  1. I would add one suggestion under “Droplet protection”. In addition to masks healthcare workers often wear eye protection. Everything from clear plastic full face masks to clear wrap around glasses. Probably everyone reading this comment has a pair of clear impact resistant glasses they wear at the shooting range or when using power tools. Perhaps add these glasses to your list of patient care tools. Just remember to sanitize them after use with a patient.

      1. your comment is like a kid ringing the doorbell and running away. I have to discount it as you just dropped a line and ran away. Provide content to be meaningful.

        1. For people who believe in the superstition of homeopathy it is unlikely that any meaningful content will change their mind. “You Cannot Reason People Out of Something They Were Not Reasoned Into.” I am sorry that people are victims of the various quackeries that are out their ensnaring them. I am sorry that they didn’t learn science in school. I am sorry that common sense and reason will not change their mind and maybe save their life or the lives of those they care for.

          For those who do not believe in these health superstitions there is no need to provide content.

          But to answer your question simply type “homeopathy” and “quackery” into your preferred search engine and you will discover millions of examples of meaningful content.

          1. For people who believe in the superstition of homeopathy it is unlikely that any meaningful content will change their mind. “You Cannot Reason People Out of Something They Were Not Reasoned Into.”

            Then why’d ya waste your time? Is this what they call “Virtue Signaling?”

          2. Actually Gene I have to agree with you. Maybe I’m just wasting my time and irritating people unnecessarily. I guess I hope that it puts doubt in people’s minds to not reinforce the superstition and maybe, maybe some young person will read what I said and decide to use real doctors and real scientific cures when their babies are sick. Maybe they will reject the anti-vaxers. Maybe they will think it through. If it actually happens I will never know of course but I hope it does.

          3. Your response begs the question, are you a doctor? Are you an adherent to the AMA doctrine or in any way affiliated with the modern medical, drug industry? If I entered quackery AMA would I come up with equally deleterious responses as you think would come from a homeopathy internet search? And finally you have added absolutely nothing but skepticism to your argument as I could as easily as you have done said: “search the internet”. Again you have ducked the issue, Come up with some meat on the table or just send up the white flat and call it a day.

          4. Meat on the table?? This isn’t all that controversial; Science/medicine good; witch doctor, bad. The problem is that the alternative news sources like to push the superstition and there is money in selling useless and sometimes harmful supplements and additives to the “believers”. Don’t go to the equivalent of the flat earth society for your medical advice. You may well believe in the magic of homeopathy and counter-science medical sources. But I’m speaking over your shoulder to those who still have an open mind. Beware the pushers of Natural and homeopathic medical treatments.

          5. One Guy writes: “But I’m speaking over your shoulder to those who still have an open mind”. I happen to be one of those with an open mind. You assume because I ask you to provide content that I am a defender or adherent to homeopathy, I am not and don’t hardly have any idea of what homeopathy is. A statement “it’s quackery” or such gives zero input to take your word for it. Reminds of a woman who left the Roman Catholic church because she asked questions and got no more response than “because the church says so”. So far I have not heard from OneGuy a single item to base his contention that homeopathy is quackery other than the internet says so. Nobody is going to make their case with me by saying “because the church says so” or “because the internet says so”. Do you actually know enough about homeopathy to speak about it? I just don’t see that you do. I am not arguing against or for homeopathy but for coherent discourse. In that regard you have failed. Put what you know down in writing and submit it to this blog and I will read it with an open mind. I am sincerely interested in all matters of health and am eager to learn; I want to hear what YOU know.

          6. If you do not know what homeopathy is you should research it. If you are not familiar with the many alternative medicines/treatments you should research them. I cannot in the given space hope to present a complete and cogent discussion of the pros and cons. My point, the one I made at the beginning of this discussion, is simply that homeopathy, the various alternatives that claim to be homeopathic and the numerous alternative medical beliefs that do not claim to be homeopathic are false gods and caveat emptor is required.

            The challenge should be on those who claim that alternative treatments are effective. While some traditional or over the counter medications can provide palliative relief they are not “cures”. Often the alternative treatment community conflates these traditional/alternative treatments with actual medicine and will even go to the next step and claim they can “cure” things like strep throat or infections (not to mention the various quackeries around cancer and other serious illnesses). This is a disservice to all and may induce people to try to treat serious illnesses with elderberry or laetrile. I am simply refuting the quackery/superstition in the hope that it would encourage people to do more research and with an open mind so they can come to an informed conclusion. You/everyone must do the research yourselves to avoid making mistakes.

  3. Thanks for a well written article. My wife and I have talked about the plague outbreaks in Madagascar. The references you listed will go along way in helping us prepare for disease and infection controls.

  7. The big risk continues to be a influenza (flu) related pandemic.

    Why, exactly as discussed in this article – first, longer incubation periods (3-7 days before the disease or symptoms fulminate and are acutely obvious); second, spread by droplets (coughing, sneezing, surface to mucous membrane contact – so a good mask, plus eye protection and latex gloves if you must care for those that are sick); and third, the high virulence and mortality rates due to a genetic shift that leads to very limited immunity in the broad population.

    Each year, the flu vaccine is an educated guess to immunize against what’s been seen in the last 12-24 months – flu virus have this naughty issue of slight mutations that change how well our immunity protects us. Personally, getting a flu shot each year is the best way to build up immunity for a potential shift that could be deadly – can’t be sure, but given no reliable drug therapies, may be the only hope and reasonably precaution. News is that this years vaccine may have limited effectiveness so we could have a population that is particular vulnerable in densly populated places in the world

    During the Spanish Flu outbreak, the mortality rates were not the same across all groups and there’s speculation that some age groups (e.g., older people had exposure early in their life that gave them some protection) – the worst mortality was with young adults, especially young soldiers – low immunity, close proximity when living in crowded barracks, stress and limited care – leading to 10-20% mortality rates in this outbreak.

    Given the mobility of the world’s population – with tens of thousand of people easily moving and traveling between large populated areas, the risk of multiple hotspots to arise will quickly exacerbate any flu pandemic. There were 83 metropolitan areas with populations of more than 1 million in 1950, a figure that increased to 160 by 1975. In 2000, there are over 348 such cities and this number surged to 441 in 2010. If cities above 10 million are considered, 21 existed in 2010 with Tokyo, the largest, having 36.6 million inhabitants. These 400-500 cities will be where a flu pandemic will be the worst – the health care system will be overwhelmed in less than a month – imagine when 10-20% of the population dies off in these cities, and the ensuing pandemonium.

    At least with Yersinia, you have some opportunity to treat with antibiotics, with the flu virus, limited effective of antiviral medications.

    Good easily understood information at the link below on the differences in a seasonal flu outbreak, and the more serious epidemic and pandemic events.

    https://www.cdc.gov/flu/pandemic-resources/basics/about.html

    There are three big unknowns in our life that could create conditions that will be most challenging worldwide – one is man made, a nuclear confrontation that escalates to a full retaliatory response between the countries with big weapon inventories; the other two are acts of God and nature, a CME (a solar storm that wipes out our electrical and technology infrastructure), and a flu pandemic from a nasty genetic shift that creates high virulence and mortality rates – we’ve avoided the first risk, but have already seen/experienced the latter two in the last 200 years (in the last two or three generations) and have few effective ways at this time to deal with the these events. CME and flu pandemics are low frequency but high severity outcomes – let’s hope and pray we are spared either event while we are on this earth, and at the mercy of the good Lord.

  8. Can anyone tell me how colloidal silver may help with some of these situations? I know it has helped with some bacterialogical problems and I believe it has helped me overcome strep throat, even though it’s viral.

    1. Colloidal silver will of course help you by adding it to water, it destroys all viral and bacterial action in your gut, you can also gargle with it, put it in your eyes for pinkeye, spray it on plague buboes (the pus filled boils), three things i would never be without are a large bottle of colloidal silver, a jar of manuka honey and a jar of Vicks (vicks will cure strep infections, a fingerful shoved down your throat a couple times a day), and manuka honey ingested or dabbed on cuts/sores will help.

  9. Very good thorough article.
    It would have been useful to know whether Maple is an md, or a ph.d in clinical research. I also couldn’t find the PDF.
    I too couldn’t find the Pdf.

  10. 1) I would caution people to double check protective measures. During the Ebola outbreak a few years ago, I checked the US Center for Disease Control’s web site to see its guidance on protective measures. I was surprised to see that CDC’s measures were far more lax than the covering/procedures guidance from the Doctors Without Borders –who were caring for people in Africa.

    2) CDC finally admitted (grudgingly) that its protective measures were inadequate after two US nurses became infected while caring for a patient admitted from Africa. Yet CDC is supposed to be the US authority on infectious disease and US medicine is supposed to be the best in the world. But rep doesn’t substitute for hands on experience, evidently.

    See
    https://www.reuters.com/article/us-health-ebola-protection/experts-fault-changing-u-s-guidelines-on-ebola-protective-gear-idUSKCN0I52YI20141016

  11. Appreciate the article and intend to get the manual. However, it might be helpful to say where the flu comes from and how to follow its progress.

    Influenza A is avian flu, bird flu. From wild
    aquatic birds that go everywhere. They pass it on to other birds, to chickens and turkeys, to pigs and the moment the virus mutates to make it easy to pass to humans is when we need to cross our fingers and try to catch it in the bud before it takes its worldwide trek. That’s why you hear of whole flocks of poultry being culled so as to try to prevent it from spreading.

    Where are millions of birds and millions of people packed together to best get this thing rolling? In the food markets of China, Asia and
    factory farms (think chickens and pigs) of the American Midwest.

    It is my understanding that it will take a minimum of 9 months to get a vaccine should a
    pandemic arise. If we are lucky. Since it is a virus antibiotics won’t help it. Thinking to use an antibiotic if you get a secondary bacterial infection such as pneumonia?

    Those who died in the 1918-1919 pandemic were the
    strongest and fittest. Many died from a “cytokine storm” which is an immune system overreaction which shuts down internal organs
    sometimes within 24 hours. Here’s what Michael T. Osterholm. MPH, PhD, has to say about that in his book Deadliest Enemy: Out War Against Killer Germs,…”We can’t retrospectively separate out the viral deaths from the subsequent bacterial deaths, but the indications are that most of the
    morbidity and mortality was from the initial virus, so even if they had had antibiotics in those days, they wouldn’t have been of much use.”

    Short of a vaccine, isolation is the number one preventive. When the time comes you do the best you can and keep the trips away from home to a minimum. Wear N95 masks, and maintain strict hygiene practices. Preppers certainly have a head
    start on this.

    How to keep from overreacting to an outbreak of
    Zika, MERS, SARS and all the alphabet diseases
    which show up in the world? Go to good sites such as WHO, the CDC and the like. I personally would go to CIDRAP (cidrap.umn.gov) founded and headed by Dr. Osterholm mentioned above. You’ll get good information when something is a regional epidemic and when something starts moving in the direction of a pandemic. You’ll
    also find out under disease descriptions (that
    part very scientific and technical) if a particular disease is gram negative or gram positive which guides you on your antibiotics
    use at home. For when there is no doctor…

    Homeopathy is not scientific but in a dire situation such as a pandemic without a vaccine
    it should be an entirely personal choice as to
    whether you go that route. When there is nothing else to use, why not?

    All of what I’ve said is what I’ve learned from
    Dr. Osterholm’s books and I recommend them highly. The site “Get Pandemic Ready” is great
    for… getting ready. Additionally, CIDRAP has
    some nice things to say about it.

    So where did the 1918-1919 flu start? Here’s a
    thought Id like to leave you with from the book.

    “Though it is called the Spanish Flu, it may have started in the United States, specifically in Haskell County, Kansas, in an agricultural setting. Whether this particular strain began in pigs and spread to humans or ice versa is not clear Epidemiological evidence suggests that from Kansas it probably traveled east to the large army base at what is now Fort Riley, and then went with the recruits to Europe. The high concentration of soldiers living in close confines as they trained for combat in the Great War certainly exacerbated the situation, as did the large-scale movement of troops across the oceans.

    1. $57.00 doesn’t seem to be high for a 729 page textbook. According to the rankings on Amazon it’s within the top 10 on 3 different rankings. It has to be very good going into its 20th edition. The book company prices their product not the author or editor.

      You need to get a little education my friend.
      Get off the internet and read a real honest to goodness serious thoughtfully researched book
      sometime. You know, the stuff with paper between the covers. But I’m showing my age.

      I’m grateful the author of this article brought it to our attention.

  13. Thanks for the thought-provoking article, Maple. I realize that your main point highlights procedure rather than the details, but, for the sake of accuracy, I would like to add a few details re: Tx of plague (pneumonic or bubonic):
    Streptomycin is currently available in the U.S. from one manufacturer, but has been on/off the market many times in the past few decades, and is expensive and sometimes hard to get now. The dose is 30mg/kg/day in two divided doses, intravenously (IV) or intramuscularly (IM), with a MAX dose of 2,000 mg (2g) per day. A much better/more available choice is gentamicin. But not at 3 mg per day!
    Gentamicin is usually administered IV in the hospital, and closely monitored with blood tests to achieve adequate blood levels without inducing the kidney failure for which it is famous. In TEOTWAWKI, the most reasonable regimen would be 5 mg/kg (~ 350 mg in an avg. size man) IM daily x 10-14 days, and hope for the best. (note: the 3mg dose cited probably should have been 3 mg/kg).
    If the patient can take (and hold down) oral meds, a couple of “better’n nothing” alternatives would be:
    Doxycycline 200mg orally every 12 hrs x2 doses, followed by 100mg every 12 hrs for 10-14 days.
    OR
    Levofloxacin (Levaquin) 500 mg orally daily x 10-14 days.
    Some references recommend continuing therapy until the pt has been without fever for at 48 hours.
    Remember: 1 kg = 2.2 lbs
    I’m a practicing clinical pharmacist, and these recommendations come from current references that we use in the hospital daily.
    Merry Christmas to all!

    1. SH. thanks for your input. I guess my feelings are that in a true pandemic hospitals will be understaffed and overwhelmed. It is probable that most of us will have to rely on stockpiled medications which would include fish antibiotics. Levofloxacin is not one but Ciprofloxacn is. I’m thinking that would be the best hope for most of us.

      Reviewing my preps showed me adequately supplied with cipro but doxy not so much. I found an online eBay supplier for same that says he is located in Romania and had doxy at a very good price. I placed an order and it is held up in Moscow for the past two weeks! I can not figure out why, if this seller is located in Romania the shipment is coming by way of Russia. Neither can my brother who actually lives in Romania. Now I’m wondering if I ordered a counterfeit. the origin is supposed to be Thomas Labs and they do have a good reputation.

      Caveat Emptor

  14. Author Stephen Hartford Buhner talks at some length about treating the “cytokine cascade” with natural remedies in his book Herbal Antivirals. I used many of them last year after contracting the flu. They were easy to source and included elderberry syrup, fresh ginger root, kudzu, and Japanese knotweed.

  15. Two readily available and highly effective non-prescription anti-virals (as well as anti-bacterials) are:

    Elderberry concentrate, 1 to 2 oz per day. Natural Sources is an excellent brand. Growing your own is much better, long term. Good barter item.

    High dose Vitamin D3. Bio-Tech makes D50, which is 50,000 IU per capsule, you can contact them at http://www.BioTechPharmaceutical.com.

    When I had swine flu during the epidemic in 2008, I immediately took 100,000 IU, and an hour later was fine. Note that I took it IMMEDIATELY on diagnosis; had I waited longer, larger quantities and more doses would have been needed.

    According to the VitaminDCouncil.com, which is a research collator for Vitmain D research, you can take up to 200,000 IU for up to six weeks without harm.

    However, if you continue to take these very high doses once symptoms of overdose develop, you will have flunked the Darwin test. It will eventually be fatal.

    The appropriate supplement, as opposed to medicinal dosage, of Vitamin D is 1,000 IU per 22 lbs of body weight (10 kg). Vitamin D is a body-weight dose-dependent vitamin. Thus a 110 lb. person would need 5,000 IU, and a 220 lb. person would need 10,000 IU.

    Blood levels optimally should be between 90 to 100 for good health and disease resistance.

    This is why so many of those who died of swine flu were obese. Given the same amount of sunlight as a thinner person, they had less Vitamin D in their blood, and thus less anti-viral protection against the flu.

    If no Vitamin D is available, you can sit out in the sun. Stay out for as long as possible without burning. When you go inside, do not wash, except perhaps for a little spot cleaning, until at least the following day. It takes time for the sunlight to alter the oils of the skin, and penetrate. A nice, hot, soapy shower will send it all down the drain. This is especially important for children.

    Remember that these extremely high doses of 50,000 IU and highter are MEDICINAL ONLY, and should NEVER be taken for supplement purposes.

    You can take both the elderberry concentrate and the Vitamin D together.

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