STOB 4-9

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GLOSSARY

Author’s Note: Welcome to Hell’s Kitchen, the new home of Badger’s Sett fiction

Chasseur sent up a cloud of black smoke as her donkey engine came to life. On the beach the last of the water barrels rolled down to the shore, guided by seamen. Another party clustered on the mole, ready to cast off the mooring line as the marines closed their perimeter inward in preparation for departure. Several fathoms below Philip the Badger’s crew scrambled into place hauling on the cable that bound her to the mole, bringing the messenger to the donkey and clapping nippers on. The bosun, supervising the operation, waved his hand, the engineer engaged the donkey, and the Badger paid out the cable to give the men on the mole slack to work with.

Out to sea the Spaniard settled on her new tack. Her new course would take her past the English brigs, probably within random shot. Philip held her in the glass, considering. Yes, it was better to fight from his current position: the Spaniard would have to sail into his fire if she was to attack. “On deck, there, Mr Horrace, belay that last order! Send the men to quarters and fire a gun to windward! On the mole! We will remain at anchor, return to the sloop! Chasseur! Prepare to fight at anchor!” He collapsed the telescope and slung it over his shoulder, took the speaking trumpet in his teeth, and grasped the backstay, wrapping his legs around it and shooting down to the quarterdeck.

Badger now resembled an upturned anthill, with some men fulfilling his new orders, others still recovering from his old orders, and three of the stupider landsmen trying to scrub the deck. Philip turned away from the chaos – it was for his officers to sort out – and came face to face with Dr M’Mullen, incongruously sipping tea from a china cup. “Doctor, how do you do?” asked Philip, but at the same time one of the Badger’s guns went off, and he had to repeat his question before Dr M’Mullen understood.

“Well enough, I thank you,” he said. “I imagine you’ve seen the ship that’s now approaching.”

“I have,” said Philip.

“Do you suppose she’s the enemy?”

“I think she is.”

“She appears quite large.”

“Even so, I mean to sink, take, burn, or destroy her. Mr Wilkins!” Philip broke off to hail the midshipman. “run out when ready!

Author’s Note|First Post|Previous|Next
GLOSSARY

Cross-posted at http://badgerssett.blogspot.com/2010/02/stob-4-9.html

Why we’re asked about eggs when we get the flu shot

When we receive the flu shot (influenza vaccination) we’re typically asked a few things, such as are we currently sick, have we ever had Gullian Barre’ Syndrome (GBS), and are we allergic to eggs. We’re asked if we’re sick because the vaccine triggers our immune system, and if we’re sick, our immune system is already busy. Depending on how sick we are, perhaps it’s better to allow our immune system to finish off our illness before presenting it with the vaccine. We’re asked about GBS because having it once suggests that we may get it again. I discuss GBS and the flu vaccine in more detail here. Eggs are my focus on this post, and that explanation requires a little bit of background on how a virus (such as the flu) reproduces (copies itself).

A Little Virology (Study of Viruses)
A cell, whether it’s one of the cells in our bodies, or a cell from our pet cat or dog, or whether it is a bacterium (1 bacterium + 1 bacterium = 2 bacteria, and each bacterium is a single cell) contains everything it needs to reporduce. All we need to do is feed the cell, and it does the rest – it repproduces its DNA and all of its internal parts, and then splits into two new cells.

A virus can’t do this on its own. It lacks some of the machinery needed to reproduce, and needs to break into a cell and trick the cell’s internal machinery into reproducing the virus.

Making the Vaccine – the Chicken Egg Connection
The flu vaccine works by showing a weak or inactivated copy of the flu virus to our immune system, so that if we later see the real flu virus, the immune system can quickly pounce on it and kill it off. As I’ve said before (see this post for details), the vaccine is kind of like a test prep course for our immune system, where the flu is the actual test: taking the vaccine leaves our immune system better able to take the flu.

The point for this post is that in order to make the vaccine, we need to make a lot of copies of the flu virus, and the easiest way for us to do that is to put the virus in a cell and let the virus do its thing, hijacking the cell and making lots of copies of itself. The cell we use for this is a chicken egg (a chicken egg is a cell).

Since we grow the virus up in a chicken egg, we can end up with some egg in the vaccine itself. So, if someone is allergic to egg, then perhaps the vaccine isn’t for them.

See Also:
Thoughts on the flu vaccine
Badger’s Sett, HK’s parent blog, where this post was originally posted
* Why we need the flu shot every year
* Immune system basics

A few thoughts on the flu vaccine

[what follows is an exerpt from the parent blog, Badger’s Sett]

In 1976, a study showed a possible connection between influenza vaccination (the flu shot) and Guillain-Barré Syndrome (GBS). In GBS, the body attacks its own nervous system, causing weakness and paralysis. Most people recover completely over several weeks or months, but some do have permanent problems, and about five percent of people who get GBS die. So, a connection between influenza vaccination and GBS alarmed a lot of people (and rightly so) because we don’t want to be giving people GBS when we vaccinate them against the flu. Since 1976, many other studies have looked for a connection between influenza vaccination and GBS.

Only one study has found a connection: it stated that for every one million poeple vaccinated against the flue, one person “may be at risk of GBS associated with the vaccine.” Not “will get GBS,” but “may be at risk.” And again, no other studies have found any connections between the vaccine and GBS.(1) (See also (3))

What this means is that there may have been a real connection between the vaccine and GBS. Unfortunately, we cannot rule this out absolutely. there is a chance – a very small chance, but a chance – that today’s vaccine is somehow connected to GBS.(1)

Does this mean that we shouldn’t get vaccinated against influenza? Not necessarily. To decide whether or not to get the vaccine, we need to look at what might happen if we do get the shot and compare it to what might happen if we don’t get the shot. We’ve already looked at the biggest potential negative of the shot. The smaller negatives include things like redness at the injection site, soreness, headache, etc, most no different from the results of placebo treatment. For a small group of people there is an additional negative – if you’re allergic to something in the vaccine, the vaccine can give you an allergic reaction. (This is why they ask you if you’re allergic to eggs, for instance, since eggs are used in the preparation of the vaccine).

There have also been concerns regarding vaccines and autism. This originated with the MMR vaccine. Hilton, Hunt and Petticrew, writing in 2007, note that

The aetiology of autism remains unclear. The suggestion that MMR vaccination may be a cause received wide-spread publicity, although subsequent scientific research has failed to support a link.(2)

On a different note, people who get the vaccine sometimes still get the flu – the vaccine matches what the virus looked like when the vaccine was being made, but the virus looks slightly different now. But the vaccine is still useful, since it primes the immune system, and people who get the flu after getting the vaccine have a milder case of the flu – the illness isn’t as bad. So if you’ve ever gotten the vaccine and later gotten sick with influenza, you would have been even sicker without the vaccine.

Next, we need to look at the positives of getting the vaccine, and then the positives and negatives of not getting the vaccine. Then we’ll be able to make an educated decision on whether or not to get the vaccine.

The benefits of the vaccine are that it provides protection from the flu, as I discuss in this post. Some readers may also be aware of the study that showed that people who received a flu shot are less likely to die – from any cause – over the following year, but I suspect that this is because that those who receive a flu shot are also receiving better all-around medical care – I doubt that the flu shot is a panacea (a cure for all ills). So for our discussion, we’ll focus on the flu, which means we need to talk about what the flu actually can do to us.

Next up: the flu
Also: Why do we need a flu shot every year?

SOURCES:
(1) Centers for Disease Control and Prevention, “Seasonal Flu and Guillain-Barré Syndrome (GBS)” at http://www.cdc.gov/flu/about/qa/gbs.htm, on 13 October 2009
(2) Hilton, Hunt and Petticrew, “Autism: a Focus Group study: MMR: marginalised, misrepresented and rejected?” Archives of Disease in Childhood. downloaded 21 March 2008 from adc.bmj.com
(3) World Health Organization, “Influenza vaccines: WHO position paper.” downloaded form http://www.who.int/entity/wer/2005/wer8033.pdf on 16 October, 2009

The lion and the piano

Emergency management, ultimately, is people management.  The emergency manager may have legal authority over emergency responders, but even if she does, what the law says people should do and what actually happens are often two different things.

Two items recently came across my desk that speak to this directly.  The first is an article at HarvardBusiness.org, by Peter Bregman, entitled “The Easiest Way to Change People’s Behavior” (link below).  Mr Bregman notes that changing people’s behavior is simple, if it is approached correctly.  The secret is to make the new behavior enjoyable and easy.  If we make people want to change, they will.  He also notes that our environment dictates what is easy, and to some extent, what is enjoyable.

His first example is himself.  On moving to a new house, his family bought an outdoor table and some chairs to go with it.  They placed them outside and intended to eat their meals there.  But they didn’t; they ate inside, where the food, utensils, oven, etc all were located.  Eating outside was, he says, “too much effort.”

How much effort was “too much”?  Only about ten feet and four steps down, because when he moved the table ten feet closer and four steps up (and thus immediately outside of the kitchen), their behavior changed: they ate “every meal” at the table.

Mr Bregman also discusses other examples.  Serving food on a big plate causes us to eat more than on a small plate, for instance.  His greatest example may be a lion in a safari park.  Rangers wanted the lion to be on display to the safari riders, but you can’t tell a cat what to do.  They do what they want, as anyone with a pet calico or tabby will tell you.  The park rangers encouraged to sit on a rock near the safari ride by regulating the temperature of the rock: it was warm on cold days, and cool on warm days.  The lion sat on the rock because it was comfortable, and the safari riders got to see the lion.

The second item that speaks on this was a video (link below) of a public health project to convince people to use a staircase, rather then the escalator that ran parallel to it.  To do so, the staircase was changed into a stair-piano (think of the floor piano in <i>Big</i>, but each step of the staircase functioned as one key of the piano.  After installing the piano, the video claims that “66% more people than normal chose the stairs over the escalator,” and based on the footage shown, that number may be correct.  Here, the issue wasn’t making the steps any easier to use, or placing them in a more accessible location.  The issue was making them fun.

Taking all of this together, what do we see?  In the simplest terms, if people want to do something, they’ll probably do it.  If they don;t want to, they probably won’t.  And the environment (a smaller plate, a heated rock, or a musical staircase) influenced what people wanted to do.  What does this have to do with emergency management?  Emergency managers are tasked with getting people to do things that they don’t necessarily want to do, or that it doesn’t occur to them to do.  By making those tasks easy and/or fun, we can influence more people’s behavior for the best.

PS: One commentator on the piano video suggested that turning the escalator off would be just as effective, if not more so. This is true, but some people need the escalator, perhaps due to a disability.  Further, people like thinking that they have a choice.  Turning off the escalator will probably lead to grumbling, whereas installing a piano made people happy (as seen on the video).

LINKS:
Peter Bregman, “The Easiest Way to Change People’s Behavior”
The Fun Theory “Piano stairs”

Resources for an emergency manager to tap

Just to get you thinking (no list is complete) …
* Bus companies: Busses and operators, both for transportation and as short-term, on site shelters for rescuers and survivors
* Cab companies: Cars, drivers
* Cable television company: Communications equipment and specialists, power generators, utility and cherry picker trucks, and the personnel to run them
* Construction companies: Earth and debris-moving equipment and operators
* Faith-based and other community organizations: Organized groups of people (e.g. for food services or data management), communication with the public
* Food service, restaurants: Water, food, and catering services and personnel
* Gas stations: Fuel
* Golf course: Golf carts for transportation
* Grocery stores: Water, food, sundries
* Ham and CB radio operators: Communications services during response and recovery
* Hardware stores: Hardware, lumber, tools, generators, sundries
* Internet, television, radio and print media: Communications expertise and networks
* Landscaping companies: Light trucks, garden tractors with trailers, personnel
* Medical and psychological health professionals and providers: Health services, knowledge of types of disabilities faced by community members, surveillance for insidious incidents, medical personnel and supplies
* Oil delivery services: Heating oil, diesel fuel
* Package delivery services (e.g. FedEx, UPS, USPS): Trucks, drivers, inventory tracking and control specialists and equipment
* Pharmacies: Pharmaceutical and health supplies for survivors
* Pool service companies: Water, water treatment
* Postal Service: See Trucking companies
* Private citizens: Traffic and crowd control, debris removal, engineering expertise, carpools for evacuation, assistance to elderly, infirm, or handicapped residents, resource management, administrative and secretarial services, four-wheel drive vehicles, mitigation ideas and their execution: just about anything they possess or know how to do
* Public health: Disease and vector tracking and control, EOP and mitigation development and maintenance guidance, surveillance for insidious incidents
* Public transit: Busses and trains, with operators, both for transportation and as short-term, on site shelters for rescuers and survivors
* Schools: Administrative and secretarial support, large facilities for short term shelters, clinics, or other needs
* Social workers: Predisaster guidance regarding health and psychological needs of the community, and how to meet them, postdisaster social and psychological assistance to survivors and rescuers
* Telephone company: Communications equipment and specialists, power generators, utility and cherry picker trucks, and the personnel to run them
* Trucking companies: Trucks, drivers, inventory tracking and control specialists and equipment, shipping containers, refrigerated trucks for food and medicine storage, or as temporary morgues
* Utility companies: Utility repair equipment and specialists, power generators, utility and cherry picker trucks, and the personnel to run them
* Veterinarian professionals: Veterinarian services, guidance on pet shelters
* Water company: Water, water treatment, fire hydrant hookups
* Web designers: Internet communications experience, personnel

Got thoughts of your own?  Leave a comment.

[adapted from my thesis]

Sinking cities

We’ve already seen, in New Orleans, how flood water management schemes can lead to floods, and as part of that discussion we learned how the loss of wetlands at the Mississippi River’s southern end has left portions of the Gulf Coast (including New Orleans) vulnerable to storm surges.  Today, the BBC is reporting on a similar phenomenon in other parts of the world.

In short, the deal is that over time, the land at the end of several rivers (the river deltas) is being lost.  That in itself is not a huge issue, as this is expected to happen naturally, but normally the river carries more land down to replace what is lost.  The river carries silt, or suspended dirt, which sinks to the river bottom when the river slows as it enters the sea.  This silt replaces what is lost.  But without the silt (and I’m coming to why we’ve lost the silt) there is a steady loss of land.  Over time, cities perched on this land, and on nearby land, slowly sink, leaving them more vulnerable to flooding.

So, where is the silt going?  It’s being diverted.  When rivers are dammed, the water slows down, so the silt falls out of the water, winding up behind the dam instead of at the river delta.  Some silt-carrying water is pulled out of the river for irrigation projects, and in some cases the river’s path is diverted by construction, and the silt is diverted with it.

If any of you think that this sounds similar to the loss of the wetlands south of New Orleans, you’re correct.  The sinking deltas are due to similar mechanisms.

The emergency manager as stage manager

I’m currently working my way through FEMA’s IS-1 online course, and the authors compare the successful emergency mananger to a stage manager.  I see their point – the emergency manager’s job is not to deliver the lines, dim the lights, or set the microphone levels any more than the stage manager’s job is to suppress a fire, administer vaccinations, or provide housing.

I might quibble with this, and propose that the emergency manager’s job is more akin to production management than to stage management (the stage manager, for the most part, works only and specifically with the actors and director until tech week, only then working with the designers and board operators – it is the production manager who coordinates between the lighting designer and electricians, and the technical director and carpenter crew, etc, during the rehearsal process.)  But that leads to a discussion of the production stage manager, and I’m getting away from what I want to be commenting on.  Because the real point of this is that it lead me to thing about project management.

Because really, emergency management is project, or program, management.  Emergency management wrestles with finite resources, which it must marshal to meet the goals of reducing or eliminiating mortality and morbidity, and redicing or eliminating property losses.

Photographic records

Photo of statue at Stanford University, San Fransisco, showing a result of the 1906 earthquake. Source: http://en.wikipedia.org/wiki/Image:Agassiz_statue_Mwc00715.jpg

A perhaps often overlooked aspect of disaster management is how to communicate the magnitude of the disaster to the outside world.  It is these communications that prompt the delivery of assistance.  This is most important in wide spread disasters, where the need for assistance far outstrips local resources.

It may be worthwhile to include an event recorder(s) in an EOP, in order to quickly obtain, organize, and provide these images to those organizing the requests for aid.

The future of the Atchafalaya River

In my previous post, I wrote about the likelihood (certainty) that the Atchafalaya River will capture the Mississippi River, most likley within our lifetimes.  The Old River Control Structure can only hold out against so much water, and eventually, heavy snowfalls up north will be followed by a warm, rainy spring, and the thing will be done.  As I worte at the time, New Orleans will be left marooned in the middle of a bayou, to the dettriment of its importance in the national economy.  I think I also wrote that in 1973, the structure was almost overcome during a flood.

What I didn’t write about at that time is what will happen along the Atchafalaya if it is suddenly faced with a sudden, major increase in the amount of water it carries.  The answer shouldn’t surprise you: there will be floods.  Devastating floods.  The floods in the Midwest this past summer will be nothing in comparison, in part because those floods came gradually; this will be on the magnitude of the Johnstown flood.  Trees and bridges swept away.  Houses wept away.  Towns swept away:

In the aftermath of the huge floods that would cause the main flow of the river to jump to the Atchafalaya River, aside from the cost, anxiety, tragedy, and aggravation of dealing with massive amounts of water being in the wrong place, there would be lingering issues that would change the way of life on the lower Mississippi.  Instead of 70% flow down the lower Mississippi and 30% flow down the Atchafalaya, the percentages would probably reverse.  The Atchafalaya would be a rushing, raging river, even during the fall for a period of time until it scoured the channel and filled in the lower reaches so that the flow would diminish.  Morgan City would have to be relocated, as would other communities and many businesses, possibly including the massive infrastructure of the offshore oil and gas industry….(source)

“Morgan City would have to be relocated.”  Hmm.  How does one relocate a city?  How does one relocate a city in the face of a raging flood?  Not without a few curses and broken fingernails, I expect.

To prevent this, we need to accept that Mother Nature always wins, and move on with our lives.  Allow the Atchafalaya to take capture the Mississippi, but instead of forcing it to do so cataclysmically, allow it to occur gradually, so the communities on both of the rivers have the chance to react.  Otherwise – well, yeah.  Disaster.

Why we need to think twice about rebuilding New Orleans

Does anyone remember New Orleans?  That was that city we all watched drown three years ago, after Hurricane Katrina stopped by for a visit.  You know, the Superdome, the Convention Center, the levees. A lot of it is still a mess.  And if we’re able to put emotion and politics aside for a moment, we might wonder if it’s worth rebuilding.

New Orleans has a few things against it, and most of them have nothing to do with Katrina.

1.  New Orleans isn’t going to be able to stay on the Mississippi for very much longer.  Maybe it will last a few decades.  This isn’t because the city will move, of course; it’s because the river will.

This is because the Mississippi River is a restless river. It keeps changing.  Mark Twain, in Life on the Mississippi, wrote that steamboat captains had to be alert to changes in the river – the development of new shallow areas, changes in current, etc, every time they went out.  These are only the most mild of changes, however.  As the Mississippi flows south, it wanders to the east and west in S-curves, slowly carving away at the outsides of the curves, and laying down silt along the inside of the curves.  Every once in a while, the curve on the bottom part of the S carves its way into the top of the S, short circuiting the river, which abandons the S-curves for the new, straighter path.  Then the process starts again.  Maps of the river from Mark Twain’s time are no longer useful for anything other than history lessons.

The most severe changes are when the main flow of the river is captured by one of the river’s offspring (distributary) rivers.  As the Mississippi approaches the Gulf of Mexico, it slows down and starts to deposit all of the silt it has accumulated.  Thus, the bottom of the river keeps rising.  Eventually, the bottom gets high enough that the river simply falls off to the side.  The abandoned river bed slowly fills in to become, in most casaes, a bayou.  This happens every thousand years or so, and presently, the US is spending a lot of money to try and prevent it from happening again.  The Old River Control Structure is designed to prevent the Atchafalaya River from capturing the Mississippi.  If this happens, the new course of the river will bypass New Orleans, leaving it surrounded by bayous.  I have nothing against bayous, per se, but you can’t sail a ship through one, and New Orleans would cease to have any importance as a port.

2.  Another problem New Orleans faced before Katrina was that it is sinking.  Much of the city is actually built on silt that the Mississippi deposited years ago, and that silt isn’t very tightly packed.  Now that we’ve perched buildings on top of that silt, we’re slowly squashing it down.  The removal of fossil fuels may also be involved, though I’m not sure that I buy that.

Let’s pause for a moment here and recap: New Orleans is sinking as the river beside it is rising. (Remember all of the silt being put down by the river?  That raises the riverbed, which raises the river.)  At the same time, the river is preparing to pack up its bags and leave.

So, if the river stays, the city will drown (more on why New Orleans is destined to flood again in another post).  If the river leaves the city will be lost in the middle of a swamp.  We lose either way.  How much do we want to spend on a city that cannot be mainatained?