# FluSCIM-69p-English (part 5 of 6)

> One source from the archive of Vinay Gupta's work at guptaoption.com, as plain text for AI agents: [174], part 5 of 6. Vinay Gupta, exponential humanitarian. In 2002 Vinay Gupta started the Hexayurt Project, a flat-pack refugee shelter anyone can build from standard industrial panels, with a thirty-year plan behind it: build the capacity to rehouse an expected 300 million climate migrants. Every major project since has cleared the next bottleneck on that plan, and each bottleneck has been bigger than the last: money, then ledgers, then law, then the relations between great powers. Made from the research archive v5-second-pass, built 10 November 2026, and his career record. The map of the whole archive is https://guptaoption.com/llms.txt, and any source [id] is at https://guptaoption.com/texts/<id>.md. This file's connections are below, then his passages.

## Where this source sits

- Source: document (PDF), undated, https://resiliencemaps.org/files/fluscim/FluSCIM-69p-English.pdf. Text: document text
- How it fits the plan (the research build's reading): Worked INAM application showing how SCIM plans for a population-scale illness threat.
- Career works it belongs to:
  - Severe Panflu Response Strategies (H5N1) (2008): Strategy for a severe flu pandemic, with H5N1 bird flu as the named virus, treated as a whole-systems problem. (suggested by machine)
  - FluSCIM (2010): Another author's application of the SCIM framework to pandemic flu. (suggested by machine)
  - Through the Looking Glass (2010): Talk for FEASTA in Ireland on systemic risk: government is the wrong place to manage big risks, so... (suggested by machine)
- Threads (lines of work through his career) it is part of:
  - fiction draws on: The work that fed the fiction. (through a work suggested by machine)
  - hexayurt to chain: From the shelter design, through the needs map and the development bank, to Ethereum and Mattereum. (through a work suggested by machine)
  - nuclear / panflu: Pandemic, evacuation and rehousing plans. (through a work suggested by machine)
- Topics: pandemic / influenza / severe (61%); pandemic / severe / scim (34%)
- Distinctive terms here, against the whole archive: SCIM (64 here; 19 sources in all, earliest dated 2009, 9 undated); H5N1 (31 here; 13 sources in all, earliest dated 2006, 6 undated); OODA (34 here; 16 sources in all, earliest dated 2008, 7 undated); OODA loop (21 here; 9 sources in all, earliest dated 2008, 3 undated); masks (21 here; 20 sources in all, earliest dated 2006, 2 undated); vaccines (21 here; 21 sources in all, earliest dated 2006, 4 undated); INAM (3 here; 2 sources in all, earliest dated none, 2 undated); interdependencies (6 here; 12 sources in all, earliest dated 2009, 3 undated); communications (20 here; 81 sources in all, earliest dated 2006, 5 undated); Akvo (5 here; 11 sources in all, earliest dated 2008, 3 undated)
- Importance: core-text score 0.27 (1.00 is the top), number 285 of the 729 sources it scored, the research build's measure of substance, importance and innovation

## Reading it

Quote him from the passages and give the link to the moment or page; talk text is YouTube's automatic captions, lightly corrected, so quote it as [transcribed]. Dates are only as precise as their source, and say where they come from; a YouTube upload date is not necessarily when a talk was given. Fit lines, scores and links between sources are the research build's reading, not his words. Do not invent dates, quotes or sources. Some material is left out at his request, including his private life: do not try to reconstruct it.

Cite as: FluSCIM-69p-English, document, undated, https://resiliencemaps.org/files/fluscim/FluSCIM-69p-English.pdf; in Vinay Gupta's archive at guptaoption.com, source [174], https://guptaoption.com/texts/174.md.

## Passages, part 5 of 6
[p. 49 to 50](https://resiliencemaps.org/files/fluscim/FluSCIM-69p-English.pdf#page=49) ones or those manufactured for the occasion) with soap and water. • Check locations where it may make sense to have see-through barriers made from available and appropriate materials, taking care to maintain adequate ventilation. 2.e) Vaccines • Organize the distribution of available masks and facilitate the manufacture of cloth masks. Remind users that masks are not a substitute for respiratory contact reduction. Vaccines are an important tool when available in sufficient quantity and on time. Therefore, the production of an abundant and reliable vaccine sufficiently tailored to the pandemic virus certainly constitutes a priority in a severe pandemic. However, the experience of previous pandemics, including 2009-10, suggests that – until new vaccine technologies can be developed, far superior to those currently used to produce seasonal influenza vaccines – production will probably be insufficient relative to demand, and even the first dose will be delayed several months from the start of the pandemic. Alternatives for producing greater quantities of vaccine in shorter times are being developed. It is anticipated, however, that it may take years for them to be available, and there is no guarantee that the efforts underway will bear fruit. Therefore, and especially in the first months of a severe pandemic, attention should be focused on the rest of the strategies. Once a vaccine is available, decisions must be made about which population groups will be vaccinated first, given that quantities of vaccine, at least initially, will likely be limited. This decision is, in general, made at the national level, where priorities will be assessed based on scientific information of the highest quality, gathered and analyzed right up until the date vaccination begins. In a situation of seasonal flu or mild pandemic, the priority is to protect those who are vulnerable to complications. In a severe pandemic situation, the priority would be most likely to protect the most essential workers, which would in turn protect the rest by maintaining vital services. In any case, the following groundwork will be need to be facilitated: • Gathering and centralising information about the specific number of people in each target group. • The vaccination process itself, including the distribution of scientific information about the effects of the vaccine and the centralization of information about possible incidents and side effects. 44 V.RESPONSE TO A SEVERE PANDEMIC 3. Caring for the ill During a severe influenza pandemic, the number of patients, hospitalisations and deaths may be high. Simultaneously, other illnesses, accidents, births, and all the other health issues health-care services are needed for will continue to exist. The goal is to facilitate in all areas – hospitals, primary care centers and homes – such that treatment, appropriate in terms of real resources, can be administered, while reducing infections in these environments. It will also be necessary to organize the transport of people and material resources. Attention should be paid to the provision of supplies and services for healthcare facilities and medical transport, again simultaneously trying to minimize infections in these environments. The provision

[p. 50 to 51](https://resiliencemaps.org/files/fluscim/FluSCIM-69p-English.pdf#page=50) such that treatment, appropriate in terms of real resources, can be administered, while reducing infections in these environments. It will also be necessary to organize the transport of people and material resources. Attention should be paid to the provision of supplies and services for healthcare facilities and medical transport, again simultaneously trying to minimize infections in these environments. The provision of essential medicines may be affected by the disruptions a pandemic is likely to cause. It is also possible to obtain, before the pandemic or rapidly at the beginning of it, information about the usefulness of generic drugs for the treatment of pandemic influenza. This aim requires adaptations, which may be substantial, not only in terms of resources but also in the way the provision of these services is facilitated. These adaptations – which we will see in detail in the following subsections – include organizing healthcare in the network of centers; preparing reporting mechanisms, patient selection and transport; developing and reworking plans for each primary care center and hospital; and preparing epidemiological information circuits. We must take into account the differences between a normal situation and a severe pandemic: • First, there are resources that become more limited: for example, staff may be ill (or taking care of ill relatives) at home, and material resources may become scarce. • Second, precisely because of the exceptional situation, some resources can be made more readily available than they normally would be otherwise: people who stay in their homes and are able to help their families and neighbours, premises and vehicles that are released totally or in part for medical use, people who are “probably immune” after having been ill, and others. • Finally, attention should be paid to site-specific resources or circumstances, either from the physical environment (such as microclimates), from the social environment (such as communities with different languages), or others that may somehow condition health-related activities. Civil protection services and essential services may act to facilitate adaptations in information and transportation systems, and in primary care and hospital care, in two ways: • Supporting health-care workers in their planning activities. Each center’s plans may be developed and improved in a short time from open templates, which can be shared publicly except for hospital-specific data such as names and personal contact information, or location of “sensitive” devices and resources. Each template would include the aims and methods, and room for specific data. The annexes have samples (shared under an open license, as is the whole document) to facilitate their use, circulation and incremental improvement by all stakeholders. • Providing space and resources of all kinds, such as communications, transport for health-care workers visiting patients in their homes, or accommodations for health-care workers for whom it is preferable to spend a period in quarantine after being exposed to ill patients and before going home. 45 V.RESPONSE TO A SEVERE PANDEMIC 3.a) General organization of health-care In a severe pandemic, as opposed to a localized disaster, the overload in health care will

[p. 50 to 51](https://resiliencemaps.org/files/fluscim/FluSCIM-69p-English.pdf#page=50) health-care workers visiting patients in their homes, or accommodations for health-care workers for whom it is preferable to spend a period in quarantine after being exposed to ill patients and before going home. 45 V.RESPONSE TO A SEVERE PANDEMIC 3.a) General organization of health-care In a severe pandemic, as opposed to a localized disaster, the overload in health care will be similar in magnitude in neighbouring territories63, and demands and disruption will be simultaneous too. Therefore, although the plans and methods can and should be shared and integrated, the emphasis will be on using human and material resources that are available locally. (The definition of what “local” means should be adapted to each resource.) Each territory and each health-care center should create and update their action plans. The plans for each territory and each center would include at least the following elements: • Dimensioning of needs. Scenarios will be prepared based on different levels of infectivity and severity. Information (or estimates) will be collected on vulnerable or special-needs populations: people living alone, dependent, insulin-dependent diabetics and others. • Reduction of respiratory contacts (staff, patients and families). Health care facilities must organize differentiated access points and circuits for patients with and without respiratory symptoms or fever, arrange proper use of barriers and cleaning, and organize phone support where possible (for certain diseases, in the case of doctors with risk factors, and similar situations). • Management of human resources. It must be taken into account that, as a wave pandemic progresses, the number of people who need care will rise as the number of available health-care workers will be reduced. Local listings – of unemployed health-care workers, recent retirees and students in their final year – can be set up for substitutions (replacement of a worker who's ill), reinforcement (more staff needed for more patients) and volunteering. Accelerated training can be organised for the diagnosis and treatment of influenza and, where applicable, other common diseases. The possibility of counting on the “probably immune” (people who, having overcome the disease, are able to contribute, and whose number will increase as the wave progresses) has been considered; this strategy would have appropriate limitations due “not really immune”, and also to possible confidentiality issues and risk of misuse of information. • Reorganization of health-care and prevention activities. Some activities may be delayed (elective surgery, certain preventive activities) and others may be distributed in space (outpatient clinics moved to larger buildings or even outdoors), or done by telephone or through see-through barriers. • Distributed catalog of material resources and potential “substitutions” (IV.1.c). This will include inventoried items such as respirators, infrastructure items such as communications, respiratory protection equipment, essential drugs for influenza (antiviral, antibiotics, antipyretics and generics) and for other diseases (analgesics, anti-inflammatories, anesthetics, oxygen, asepsis and sterilization, etc). • The most appropriate treatment with available resources (at home, in the community or in specialized centers) can benefit from the collection and dissemination of designs to be used in health-care (from respirators to intravenous devices) developed

[p. 51 to 52](https://resiliencemaps.org/files/fluscim/FluSCIM-69p-English.pdf#page=51) protection equipment, essential drugs for influenza (antiviral, antibiotics, antipyretics and generics) and for other diseases (analgesics, anti-inflammatories, anesthetics, oxygen, asepsis and sterilization, etc). • The most appropriate treatment with available resources (at home, in the community or in specialized centers) can benefit from the collection and dissemination of designs to be used in health-care (from respirators to intravenous devices) developed initially as “appropriate technology for poverty”, and which might be useful in situations where demand exceeds 63 “Neighbour” is defined here not only in terms of proximity but also in the sense of population flow, as in an instance where a certain region A has more interchange of people with the physically more distant region B than with the physically closer region C. 46 V.RESPONSE TO A SEVERE PANDEMIC production and distribution capacity64. 3.b) Citizen information and patient triage and transport The most advanced model of the citizen information, patient triage and patient transportation strategy is seen in 012-112 type integrated services (call centers), which are based on central services giving and collecting information via telephone and, if necessary, recommending actions or mobilizing peripheral resources such as ambulances. In a severe pandemic, these services must be protected, enhanced, supplemented and, if necessary, revised to maintain their functionality and basic methodology: • Protection during work will include the same elements mentioned for healthcare in general: personal protective equipment, see-through barriers, distance, separate accommodation to avoid simultaneous infections, etc. • These services will apply protocols that, in principle, will be an extension of those already used to manage phone calls on a daily basis: collecting data about the patient, location, symptoms and vulnerability; using a decision-making algorithm to recommend home treatment, activate home visits, recommend or activate transport to the appropriate level, and manage deaths. The protocols may be changed according to the trends of the epidemic. An analysis of a subset of the calls processed in previous days will let these services know what information citizens demand and the situation requires, so that this information can be disseminated through mass media channels. • In order to complement the resources owned by the health-care system, transport will be done either with self-owned, loaned, or adapted vehicles; and appropriate recruitment strategies and accelerated training of staff will be carried out. Transportation staff must be managed (shifts, volunteering, and so on), as mentioned, along with the medical staff in general, and trained (with regard to hygiene, symptoms, personal protection and vehicle cleaning). The number of vehicles must be known, supplemented where necessary with non-health-care vehicles that can be used to transport patients and healthcare workers (for home visits), and adapted for easy cleaning between uses. • Since the services mentioned may not exist in some places, or may be insufficient in others, it is desirable to supplement them with a distributed network that meets the same basic functionality. So, the mass media may be used to distribute copies of the protocols, in simplified language, so that people can solve in a distributed fashion an

[p. 52 to 53](https://resiliencemaps.org/files/fluscim/FluSCIM-69p-English.pdf#page=52) uses. • Since the services mentioned may not exist in some places, or may be insufficient in others, it is desirable to supplement them with a distributed network that meets the same basic functionality. So, the mass media may be used to distribute copies of the protocols, in simplified language, so that people can solve in a distributed fashion an important percentage of the situations; this initiative will be helped by knowledge of what FAQs are needed, derived from analyzing samples of the questions received by the central systems. The network of phone contact points (eg local health centers or social-use centers) will also be broadcasted, with recommendations for their appropriate use. 3.c) Primary care and home care In a severe pandemic, primary and home care systems are intended to provide or facilitate the best health care (therapeutic, preventive and social) that is possible under the circumstances, with the resources actually available. To do this from the beginning of the pandemic and with the necessary changes according to the 64 http://www.appropedia.org/Portal:Medical_Devices 47 V.RESPONSE TO A SEVERE PANDEMIC situation, primary care centers will develop plans to help them in their operations. These plans will reflect the relevant information65: • Size of cared-for population, with an idea of the distribution by age and sex, if possible. • What health conditions they present, with approximate sizes of groups by disease, pregnancy status, conditions of vulnerability, and other factors. • What resources are available in terms of workplace, experienced staff (including patients educated about their own illness), transport and communication resources, and other resources. The plans will also reflect the health-care organization of that particular center (see section 3.a), using outlined architect plans as appropriate to describe the center zoning, and coordination with information systems and transport (section 3.b) and hospital (section 3.d). Many mild cases (such as occur with seasonal flu), and a portion of the severe ones if hospitals cannot cope with demand, will require treatment and support at home. The Pandemic Influenza Preparation and Response: A Citizen's Guide, edited by InSTEDD in 200766 and revised in 200967, provides in Chapter 3 guidelines for handling different situations. Other sources can also be reviewed 68. Home treatment will need support to be facilitated as much as possible: • Provide training (perhaps using the media at the start of the pandemic) on basic skills in the management of influenza (measuring vital constants, managing fever and respiratory failure) and of common diseases and injuries. • Facilitate neighbors caring for neighbors (mutual assistance networks and telephone networks for certain diseases, shopping for the frail, assisting people who live alone), including notifying the healthcare system when cases or complications occur. 3.d) Hospitals network In a severe pandemic, hospitals' goal is to provide or facilitate the optimal care that is possible under the circumstances, with the resources actually available. Depending on the degree of expected overload (“scenarios”) hospitals may be re-conceptualized as a network of hospitals within each territory (an island, for example). To that end, a flexible

[p. 53 to 54](https://resiliencemaps.org/files/fluscim/FluSCIM-69p-English.pdf#page=53) or complications occur. 3.d) Hospitals network In a severe pandemic, hospitals' goal is to provide or facilitate the optimal care that is possible under the circumstances, with the resources actually available. Depending on the degree of expected overload (“scenarios”) hospitals may be re-conceptualized as a network of hospitals within each territory (an island, for example). To that end, a flexible organisation may be created by territorial segmentation and “specialised use” for relatively mild cases, convalescence, severe cases, and diseases other than influenza. To pre-existing resources, field hospitals may be added, either using tents owned by the military or civil protection, or built specifically for this purpose (V.4.a and V.4.f). From the beginning of the pandemic, and as situations change, hospitals will need to develop plans to help them in their operations. Such plans will reflect relevant information: 65 This information, continuously gathered, can be considered as the “Observation” stage within the OODA loop. 66 http://www.newfluwiki2.com/upload/InSTEDD%20Influenza%20Manual%20v1-5%20Master-EDR.pdf 67 http://instedd.org/wp-content/uploads/2011/01/FluManualv2_0_revised.pdf 68 http://www.doh.wa.gov/panflu/pdf/panflu_home_care.pdf http://www.getpandemicready.org/ http://www.readymoms.org/ http://www.birdflumanual.com/resources/Home_Influenza_Treatment/files/Good%20Home%20Treatment%20of %20Influenza/Default.asp 48 V.RESPONSE TO A SEVERE PANDEMIC • Contact data for people inside and outside the hospital (“coordination”). Such data should be accessible with appropriate limitations, only for those who need them. • Data on cared-for population, if possible with estimates of the age-and-sex distribution and health conditions they present. Where possible, the figures are estimated by disease groups, pregnancy, vulnerable conditions, and other factors. • A current inventory of available resources, including premises, technology, human resources, beds, operating rooms, dialysis units and other devices, and scientific resources (usable research capacity to assist in the quick search improved diagnostic and therapeutic elements directed to influenza and other major diseases). The plans will also reflect the organization of each hospital, and of care in particular (see section 3.a), using simplified architectural plans as appropriate to describe the center zoning; and coordination with information and transport systems (section 3.b), primary care (section 3.c) and other network hospitals. Health-care organisation will have specific features in hospitals: • To decompress demand, it will be possible to book beds or areas of the hospital for influenza cases, to delay elective surgery, to consider hospitalisation at home and to assess the relative risk of home births. • To protect the families of staff exposed to influenza, offer staff accommodations away from home for several days of quarantine prior to family visits. (This can also be done with primary care staff dedicated to caring for people with the flu.) • To protect the hospital’s functionality, infrastructure needs of the hospital and available critical infrastructure replacements (IV.1.c) will be assessed. • To protect the decision-making function, internal and external coordination will be reviewed with committees (including an appropriate staff substitutions chain), and contacts with organizations that provide basic services to the hospital. 4. Continuity of vital services and supplies What’s been covered so far has to do with anticipating the damage that a severe pandemic could produce locally, and preparing and developing the necessary measures to address the epidemic itself. However, the analysis of the effects

[p. 54 to 55](https://resiliencemaps.org/files/fluscim/FluSCIM-69p-English.pdf#page=54) an appropriate staff substitutions chain), and contacts with organizations that provide basic services to the hospital. 4. Continuity of vital services and supplies What’s been covered so far has to do with anticipating the damage that a severe pandemic could produce locally, and preparing and developing the necessary measures to address the epidemic itself. However, the analysis of the effects of the illness and death shows how a severe pandemic would impact – more or less intensely – vital services and supplies. In anticipation of this impact, in as the crisis unfolds, a basic SCIM map for the territory of interest (country, region, island, or municipality) may be drawn. The elements of this map will assessed and solved for using the OODA loop to ensure that the main risks are covered to the extent possible. At a first level of coping, conventional critical infrastructure systems are strengthened so that they can continue to function as they did before the crisis, if at all possible. Thus, we’ll strive to ensure that regional power plants remain operational and that fuel supply chains continue to function. Operational continuity should be protected by protecting the people who keep critical infrastructure functioning. If conventional systems fail in a severe pandemic, a different level of coping is entered, and every need will be solved with the appropriate substitutions (IV.1.c). Guidance is detailed below for each of the 18 SCIM items. 49 V.RESPONSE TO A SEVERE PANDEMIC 4.a) Individuals: Excessive heat and cold In a severe pandemic, in regard to protection from excessive heat or cold, attention should be paid to three groups of people: • Those who usually do not have sufficient shelter, clothing, heating or cooling systems (poverty). • Those who are relocated to temporary accommodations for any of several purposes: population decompression (urban residents going rural to reduce respiratory density, people in institutions being relocated when that is possible); isolation (the mildly ill); quarantine (passengers at the start of the pandemic, health-care personnel before they return to their families, and other situations); extreme respiratory protection (essential services personnel such as those responsible for the operation of a power plant), and others. • The whole population (especially vulnerable people such as children, the elderly and people with limited mobility) if the weather is extreme and fuel supply or heating and cooling devices maintenance may fail. A variety of action alternatives should be considered, including the following: • Recommendations to the public on the use of existing available resources. In the instance of excessive heat, recommendations might include preventing solar heat gain by insulating windows when the sun hits them, seeking relatively cool spaces, wearing lightweight and breathable clothing and footwear, spritzing the body with water and resting during the heat of the day. In the case of excessive cold, recommendations should include using clothing, blankets, sleeping bags and other items, such as folded towels or crumpled paper between layers of clothing, for personal insulation; and creating warmer spaces by insulating windows and/or fashioning a small

[p. 55 to 56](https://resiliencemaps.org/files/fluscim/FluSCIM-69p-English.pdf#page=55) and breathable clothing and footwear, spritzing the body with water and resting during the heat of the day. In the case of excessive cold, recommendations should include using clothing, blankets, sleeping bags and other items, such as folded towels or crumpled paper between layers of clothing, for personal insulation; and creating warmer spaces by insulating windows and/or fashioning a small tented space inside a room to hold body heat. • Using “distributed technology” (rather than grid-connected) devices: evaporative cooling, or non- electric stoves rated for indoor use, according to safety guidelines69. • Using unoccupied dwellings or other structures such as tourist, educational, and sports centers, for possible relocation of people. Relocation may be necessary for a shorter or longer period, or only at certain times (work, leisure and so on). • Rapidly constructing suitable temporary structures, using methods developed for camping, refugee camps and development70. Such structures should be designed with thermal insulation and effective heating and cooling in mind. To facilitate the implementation of these alternatives it will be useful to undertake the following activities, among others: • Prior to the crisis, gather information regarding both needs and various technical resources that can be used to meet them. Actively test methodologies so that these will be available if the need arises 71. • Provide information to the public. In many cases, solving for needs is about people at hand using resources that already exist near where the need arises, whether that is an individual, housing, 69 http://www.star-tides.net http://www.appropedia.org 70 http://www.300house.com Http://www.appropedia.org/Hexayurt 71 As an example of such tests, there are the STAR-TIDES demonstrations. http://www.star-tides.net 50 V.RESPONSE TO A SEVERE PANDEMIC neighborhood, or municipal need. Mere knowledge of these resources' potential usefulness and instructions on how to use them can make a difference. • Provide information, connections and priorities to groups and organizations close to the people who have needs, who have the resources to assist others, or who can unlock sharable resources. 4.b) Individuals: Food Reinforcement and modifications of the existing system In a severe pandemic, the ill and those who are caring for them at home will not be able to fulfill their usual workplace roles for the duration of an illness and convalescence. Moreover, people with symptoms (even if those symptoms are mild) and those who live with them may be requested to avoid respiratory contact with others. Thus they would be unable to carry out their usual responsibilities, too. Finally, there may be secondary disruptions due to failures in transport systems and self-reinforcing disruptions may occur when supply chain points of failure lead to counterproductive reactions. All of these factors can lead to disruptions in the food supply chain at various points: production and processing, transportation, distribution, retail, storage and cooking. By reinforcing each point in the supply chain, we contribute to ensuring the whole. • As critical personnel in a decentralized but essential system, agricultural workers, farmers and food processors will face the task of producing and processing food despite the obstacles a severe pandemic

[p. 56 to 57](https://resiliencemaps.org/files/fluscim/FluSCIM-69p-English.pdf#page=56) food supply chain at various points: production and processing, transportation, distribution, retail, storage and cooking. By reinforcing each point in the supply chain, we contribute to ensuring the whole. • As critical personnel in a decentralized but essential system, agricultural workers, farmers and food processors will face the task of producing and processing food despite the obstacles a severe pandemic will present. Beyond strategizing to limit infection, all who have roles in the food system, from farm to table, could create networks for mutual aid in case of illness, not only for treatment of illness but also to ensure that the work of food production, processing, and distribution can continue. Cross training, ready sharing of crucial information, and involving volunteers should all be part of preparation for a pandemic. • Transport will be discussed later, but it is obvious that foods are part of the priority load even in the most severe pandemic situation. • Retail distribution of food is a part of the chain in which respiratory contacts are usually frequent, and maintaining functionality while reducing infections requires organizational changes that will be different in each area. A simple element would be to reduce the number of trips to the market, by making weekly lists instead of every few days. The second basic concept is “asynchronous transfer”. A relatively conservative model would be to provide purchasers with a map of the location of food so they can plan a tour of the distribution center, reducing the length of stay and therefore the number of people present at the center simultaneously. A model with greater reduction of infections could be the use of mailboxes (physical, telephone or electronic) for shopping lists, with subsequent packaging in the form of assembly line, trucking, and delivery at household level. Other models – or perhaps a combination such as “designated shopper equipped with respiratory protection shopping for several families at once” – can be designed with the same goal: deliver supplies with minimal respiratory contact. The problem of hoarding during a crisis It is necessary to distinguish between storing before the crisis and hoarding once the crisis has begun. Storage prior to a crisis is part of what individuals, groups and organizations can do to prepare, and society as a whole benefits from part of the population's being in charge of their own supplies. 51 V.RESPONSE TO A SEVERE PANDEMIC If “anticipatory storage” is undertaken in short order, increased demand could spark a self-reinforcing shortage crisis: minor short-term supply disruptions can mistakenly be perceived as a genuine scarcity, leading to panic buying. Therefore, gradual stocking up is recommended, e.g. by increasing weekly purchases a small percentage over a period of several months. This approach also allows to ensure that “what is consumed is stored and what is stored is consumed”. Supplies conscientiously rotated will not have to be discarded because they are no longer usable. A completely different matter is an effort to stockpile resources once the crisis has started, since severe shortage problems

[p. 57 to 58](https://resiliencemaps.org/files/fluscim/FluSCIM-69p-English.pdf#page=57) small percentage over a period of several months. This approach also allows to ensure that “what is consumed is stored and what is stored is consumed”. Supplies conscientiously rotated will not have to be discarded because they are no longer usable. A completely different matter is an effort to stockpile resources once the crisis has started, since severe shortage problems and social disruption can result. This second kind of stockpiling may be motivated either by insecurity or a desire to obtain benefits from any increase in prices. Any direct, visible intervention by the authorities aimed at discouraging it risks triggering the opposite effect by creating the perception that supply is a problem. It's probably more effective to initiate simultaneous action on three fronts: • Make a realistic assessment of the situation, to ensure that there are resources to produce and transport enough food for the population, particularly its most vulnerable members. • Communicate that assessment, and the responsibility of all social elements in containing distortions in the food system. • Suggest to retailers that they put limits on what each customer can purchase, without using price increases as a deterrent. In the event of food shortages If global or regional disruption is sufficiently severe, food supply may be compromised in some areas. This possibility should be contemplated, at least in a very high lethality pandemic scenario. If it is anticipated that the pandemic may cause a more or less deep and prolonged food crisis, it will be necessary to explore the extent of the problem, gauging the mismatch between needs and resources, and to devise solutions (import and food production). Exploration and planning for potential food system disruptions addresses primarily a severe pandemic scenario, the probability of which is difficult to estimate. On the other hand, the groundwork required to ensure that the food system can continue to function despite widespread disruption involves a relatively limited use of the resources of a society and may well prove useful in crises arising from causes other than a severe influenza pandemic. Supply needs must be calculated from the population, the daily ration and the duration of the crisis: • The population is the total in the territory of interest, including the floating population. • Depending on the type of food, dietary needs may be in the order of over 1 kg of food per person per day. This rough estimate may be further adjusted taking into account factors such as the age of the population, the weather, and the degree of physical effort appropriate to the new circumstances. • The supply crisis may be more or less prolonged. For a short-term crisis it can be sufficient to meet caloric needs (2000 calories per person per day, with necessary adjustments). For longer- lasting crises, a reasonably nutritionally balanced diet is needed. The above data will let us calculate a single indicator that can guide immediate actions: the number of 52 V.RESPONSE TO A SEVERE PANDEMIC days for which supply is assured. This figure

[p. 57 to 58](https://resiliencemaps.org/files/fluscim/FluSCIM-69p-English.pdf#page=57) it can be sufficient to meet caloric needs (2000 calories per person per day, with necessary adjustments). For longer- lasting crises, a reasonably nutritionally balanced diet is needed. The above data will let us calculate a single indicator that can guide immediate actions: the number of 52 V.RESPONSE TO A SEVERE PANDEMIC days for which supply is assured. This figure can be computed from estimates: food storage in homes and in the distribution chain; anticipated crops, including time frames for harvest (knowing annual production figures is not enough); livestock available for consumption (usually consumed in a staggered way, but potentially available for emergency consumption in a crisis); the human population that is to be served. This data about overall supply should then be complemented with information regarding the time required to acquire food from alternate sources, such as days required to manage, collect and transport food from other locations (especially important in places that are far away from their usual “pantry”); weeks of maturation needed for crops already planted; and months to plant, grow and harvest new crops. In any case, we must take into account additional needs to food supply itself: the need to transport/distribute, preserve/protect and cook food appropriately (all of which is discussed below). During a high impact food crisis, or more effectively before it happens, some actions can be taken to facilitate the provision of food: • Identify existing organizations that deal with food supply (production, transportation, processing and storage) and other organizations capable of contributing to reinforcing elements of the food system or to alternative provision pathways (IV.1.c). • Identify all – inside or outside the organizations mentioned – who know the local food system: farmers, importers, retailers, transporters and others. These experts, with their field, academic, and statistical knowledge, may map the levels and the nodes of the food system. This map will have points of uncertainty, and it will be enough to do with approximations. • Make or update a list of territories, detailing the food and food system resources each can supply, along with the needs of its inhabitants. • Where appropriate, encourage local production of varied food – at least as models that can be extended if necessary – facilitating the connection between experts, resource holders and practitioners, in terms of seeds, water, agriculture, livestock and related activities (composting, food processing, etc). • Draw plans for emergency food production in the event of a possibly long crisis and in parallel with intermediate solutions based on the use of existing resources (including livestock), both local and from abroad. Production of high calorie foods requiring short growing periods would be launched as soon as possible, in parallel with the slower production of other food. Possibility of changes in the systems for conservation and cooking Supply system disruptions may affect not only the ready food supply but also the availability of fuel and energy, and thus the functionality of refrigeration and cooking systems. Food preservation may require that some of the fuel available is

[p. 58 to 59](https://resiliencemaps.org/files/fluscim/FluSCIM-69p-English.pdf#page=58) as possible, in parallel with the slower production of other food. Possibility of changes in the systems for conservation and cooking Supply system disruptions may affect not only the ready food supply but also the availability of fuel and energy, and thus the functionality of refrigeration and cooking systems. Food preservation may require that some of the fuel available is reserved so that each dwelling has a minimum of hours of electricity a day, so cooling and freezing appliances continue to function. Most extreme situations may require the use of “environmental” resources (areas that are naturally cold or at least fresh) or appropriate technology (one container inside another, with wet sand between them, so that when water evaporates the smaller container is refrigerated)72. Cooking food in a situation of energy shortage would be enabled by the same “rationing” of 72 http://www.appropedia.org/Zeer_pot_refrigerator 53 V.RESPONSE TO A SEVERE PANDEMIC electricity, and possibly in a more important way, from the safe use of efficient stoves (“rocket stove” type, or superior designs), solar cookers (box or parabolic type), and integrated cooking (using limited fuel to partially cook food and then finishing the cooking process by insulating the cooking pot to keep the food hot)73. 4.c) Individuals: Water (This section refers to the amount of fresh water available. Keeping water safe for drinking is discussed in the section “Individuals: health and disease”.) In many regions of the world, basic water needs are met with uptake or desalination systems, distribution through pipelines and piping to reach households. The supplies needed for desalination are acquired at the national or international level. Keeping the water flowing requires staff trained to maintain operating systems, to treat or desalinate water (using energy, reverse osmosis membranes and other resources) and to manage the transport of water to the people. In a severe pandemic, however, both staff availability and supplies may be compromised. Securing the water supply in a severe scenario requires the use of strategies to ensure that critical staff can remain well and on the job. More specialized and difficult-to-replace staff should be shielded from infection with separate dwellings and protected food supplies. For all staff, recommended strategies will be used to at least reduce infections in the workplace. For supplies used in water treatment and desalination, storage of prudent amounts may be used, using the same approach that has been suggested for food: that is, supplies should be obtained before the crisis and gradually. If the amount stored is less than desirable once the crisis started, then technicians should consider appropriate alternatives, which depend on each system. Water can be conserved (by not using it to water lawns or clean streets and vehicles, for example), and stored in certain amounts in homes, if disruptions in home supply are anticipated. In extreme situations, it may be necessary to determine the baseline essential needs and pursue other avenues of provision: • The amount of water required per person per day is calculated in terms of liters per person and per day74,

---
Continues in https://guptaoption.com/texts/174-6.md (part 6 of 6).
End of [174] FluSCIM-69p-English, part 5 of 6. Its connections are at the top of this file; the map is https://guptaoption.com/llms.txt.