DISCUSSION: Prioritization in the Critical Infrastructure (CI) Group

COMMENT THREAD

• Local planning
  

  Submitted by Joel Palmer on 12/5/07 06:49 AM

  To a limited extent those questions have to be addressed by the local and state planners.
  
  In my community I am working with our critical infrastructure personnel to identify the weak points such as the Cl supply for the water system (made more important by the recent research indicating that standard chlorinization of water is effective against H5N1 in the water supply). The key for us is to get them to identify as many of the places where they depend on anything other than their own people and plan to go without.
  
  The weaknesses inherent in the just-in-time system that most companies use today was brought up yesterday, and I think is an issue that most planners need to get deeper into. Most services and businesses just don't operate with many months of raw materials on hand anymore.

  • Water Purification
    

    Submitted by Diana Tolladay on 12/5/07 02:13 PM

    Of course we need to be concerned about maintaining supply chians, but not at the expense of CI or American Lives. I believe there are a number of resources for individual families to buy water purification systems/tablets/chlorine to tide them over, and this could be one of the products that the nation generates a modest stockpile of.
    

• Supply chain
  

  Submitted by Terry Adirim   on 12/5/07 07:05 AM

  Nick,
  You bring up a big concern for planners. And it is something we are working on.
  
  Modelers are looking at this issue to determine more specifically which CI/Key Resources (KR) are likely to fail, and which are robust enough to withstand a pandemic. Careful consideration has been given to the less redundant CI/KR and is why those CI/KR that are likely to be a problem are prioritized.
  
  State and local planners also need to give careful consideration to this issue. There are some places, such as some lower socioeconomic urban areas, where there are few sources to get food for example. In most places there are redundancies (many supermarkets, other places to get food) so local planners need to plan for those places where there aren't these redundancies.

  • Supply chain and "just in time" inventory
    

    Submitted by Stuart Capper on 12/5/07 07:36 AM

    This supply chain concern is a big deal in pharmacy.
    
    If we lose the wholesale supply chain in any part of a state, pharmacies will quickly be depleted of essential maintenance meds such as hypertension drug, hyperlipidemia meds, and insulin for diabetics.
    
    This is because they use “just in time” inventory management methods to help control costs and hence stock very low quantities of these meds at any given time.
    
    We have begun working with faculty in our business schools locally who specialize in industrial distribution to look at possible planning scenarios.

    • That's right...
      

      Submitted by Terry Adirim   on 12/5/07 07:39 AM

      ...and is why the pharmaceutical industry is prioritized. Good point. Thanks for bringing it up.

      • Pharmacies and supplies
        

        Submitted by Philip Eisner on 12/5/07 01:12 PM

        Not enough attention is being given to pharmacies, their stocks , and wholesale suppliers .

        • Pharmacists priorities in Pan Flu Lacking
          

          Submitted by Charles Thomas on 12/5/07 01:33 PM

          I agree . Pharmacists proved in Alabama that they were a critical key to the pharmaceutical supply chain. Many evacuees would have not been able to access maintenance medications if the pharmacies had been closed due to illness such as pan flu. This is first hand expierence gained by this state after Katrina.
          In addition shipments of maintenance drugs would be impaired and with the just in time inventories on pharmacies shelves it would be a disaster whether the pharmacy was closed as a result of illness or they couldn't get maintenance and acute meds due to the distribution system being delayed.
          I can see many people dying from lack of insulin, blood pressure meds, warfarin and the like that actually keep people alive or prevent health problems.
          
          Pharmacists need to be in tier 1 at a minimun for a severe course of contagious disease for both vaccines and antivirals. The pharmaceutidal distribution system should as well. They should be in Tier 2 for less severe outbreaks.
          

          • I would reverse it... severe later / milder earlier
            

            Submitted by Roy Kamen on 12/5/07 04:22 PM

            This is how i see it. In a severe pandemic (60-80%CFR) no one will be goint to the pharmacy and the pharmacy probably wont have any supplies. Naturally moving those in the industry further back in line.
            
            In a milder pandemic the public will need the pharmacy for meds to treat a very bad flu and everything else they treat today moving them up to Tier 1.
            
            IF the Gov could guarantee that either the vax or antivirals would be in adequate supply for the Nation, then pharmacies would be a natural place for distribution and i would want everyone involved vaxed first.

            • Patients will still be seeking symptomatic relief
              

              Submitted by Mitchel Rothholz on 12/5/07 07:44 PM

              even in severe pandemic (unless we mandate everyone stay in their homes) from their pharmacists and other healthcare outlets. These sites must have protected health care professionals who will be willing to make themselves accessible. In addition, there will be a need for addressing other medical conditions. If these patients are not addressed, these patients will show up in emergency rooms placing a greater strain on the system. Therefore, I would consider pharmacists and community based physicians and nurses essential health care professionals (not just those in institutions)who can address both influenza and other medical needs.
              

            • Topic IS severe pandemic
              

              Submitted by Catherine Jackie Mitchell on 12/6/07 05:08 AM

              Roy, I agree with you except that within these cities and towns procedures may have already been put in place for push packs to be delivered to people in their homes. If we stop the flow of this vital resource then people will die. We need to safeguard some of these industries.

    • Perscription Limitations need to be revised
      

      Submitted by Diana Tolladay on 12/5/07 02:24 PM

      In this case - I'm sure I speak for the many Elderly, Infirmed and Chronically Ill, on medication for life as well. The insurance industry needs to step up and modify the current limitation on medications. It doesn't make sense for someone on birth control, hormone replacement, high blood pressure medication etc . . . to have to go back to the pharmacy every 30 days, 90 days, or even 6 months if the Doctor has already evaluated the patient and decided that they will be on the medication for a longer period than that. Reducing the number of times a person needs to visit a pharmacy also reduces the degree of exposure.
      

      • Patient medication needs could change
        

        Submitted by Mitchel Rothholz on 12/5/07 07:51 PM

        There are legitimate reasons (both medical and safety) for patients to have interaction with a pharmacist or other medical professional. Many studies have shown that patient compliance to medication therapy and therapy outcomes are enhanced when patients work with their pharmacist as their "coach" (reference: Asheville Project). In addition, having excess supply of medications in a community can place children and pets at risk. We are not dealing with a commodity.

    • Tamiflu and Relenza
      

      Submitted by Diana Tolladay on 12/5/07 03:12 PM

      Isn't it also true that the Tamiflu and Relenza reserves that we do have come from overseas suppliers? because of the cost/profit margin? and the lack of willingness on the part of our nations pharmaceutical giants to develop a vaccine here?
      

  • Many supermarkets, other places to get food - Redundancy?
    

    Submitted by Roy Kamen on 12/5/07 07:39 AM

    I think the only redundancy we'll have with all those markets is that they will all have bare shelves and be closed.
    
    These stores are run by people who depend on other people all the way up the food supply JIT chain. It is a long and complicated chain.
    
    I don't think you can say that because New York City has so many stores, you can push them to the back of the line.
    

    • Food chain
      

      Submitted by Terry Adirim   on 12/5/07 07:46 AM

      Well, actually you can. Vaccines right now are a very scarce resource and there are other ways to protect workers. The private sector needs to be involved with pandemic planning to ensure the protection of their workforces. In fact Federal guidances are being released (or have been released) to assist the private sector in its planning. Truckers and railroad personnel who are involved with getting products to where they need to go do not have the exposure that healthcare workers or deployed military in barracks have. Also, they do not have the specific training needed to run a nuclear power plant. Therefore community mitigation measures, antivirals and masks should be considered for these groups.

      • Masks will run out long before a vaccine is available
        

        Submitted by Roy Kamen on 12/5/07 08:15 AM

        Masks, anti virals, etc., will run out long before a vaccine is available. There is no way that the current stockpile can last that long.
        

        • Where are you getting your data?
          

          Submitted by Terry Adirim   on 12/5/07 08:38 AM

          You may be right about masks, but my understanding is that manufacture of anti-virals has been increased and the stockpiled increased as well. Where are you getting your information?

          • Capacity more than supply for tamiflu
            

            Submitted by Nick Kelley on 12/5/07 10:12 AM

            http://www.roche.com/med-cor-200...
            
            They have publicly stated their capacity is over 400 million courses of tamiflu a year, but far less than that has been ordered. So they are tailoring their production capacity. We could not expect them to do anything different-- they are trying to make money, not lose it by maintaining capacity that is not being used.
            
            Granted they can ramp up production, but that takes time.
            

            • Lessons from History - Polio and Questions for anyone who can answer them
              

              Submitted by Diana Tolladay on 12/5/07 03:38 PM

              Lessons can be learned an applied from the development and distribution of the Polio Vaccine. Senate Bill S.2501 authorized grants to the states to assist in providing children and expectant mothers with the vaccination against polio http://www.eisenhower.utexas.edu...
              
              Distribution Highlights
              http://www.presidency.ucsb.edu/w...
              
              Questions:
              
              o How have national, regional, and global efforts to implement vaccine stockpiles been coordinated in the past?
              
              o How has governance of national, regional and global stockpiles been instituted and who are the decision-makers?
              
              o What were countries’ equity concerns about access to vaccine stockpiles and how does this apply to an influenza stockpile?
              
              o How have start-up and maintenance costs for vaccine stockpiles been financed in the past?
              
              o How can issues of prevailing regulatory authority be resolved (national vs. global)?
              
              o How have varying national regulatory requirements been resolved?
              • Vaccine stockpile production, maintenance and distribution:
              
              o What is the optimal number of vaccine manufacturers to guarantee the adequate continuation of the stockpile?
              
              o What lessons regarding infrastructure for storage and distribution from other stockpiles are applicable and informative to a influenza stockpile?
              
              o How can qualified and experienced personnel for a field distribution be maintained?
              
              Source - questions - no answers:
              http://www.hhs.gov/nvpo/research...
              

              • Find the questions that relate to the Guidance Prioritization!
                

                Submitted by Nicholas Dewar   on 12/5/07 03:49 PM

                Diana
                Great questions,. Can you, and others on this thread, find any questions in Diana's posting that relate to the Guidance Prioritization? If you can, please would you highlight them in a separate posting with your suggestion or concerns about how the Guidance should reflect that question?
                That would be very helpful.

          • Tami production increased?
            

            Submitted by Roy Kamen on 12/5/07 11:56 AM

            Last I heard Roche decreased what they were making due to lack of orders.

            • Thats correct
              

              Submitted by Nick Kelley on 12/5/07 12:15 PM

              They did...just like vaccine manufacturer's they wont keep extra capacity running if its not being used.

              • Its correct that they've decreased production.
                

                Submitted by Roy Kamen on 12/5/07 12:21 PM

                My town never bought their allotment with that plan that allowed towns to purchase at $12 a course. Frustrating.

                • How can we find out which towns/cities bought it
                  

                  Submitted by Diana Tolladay on 12/5/07 03:43 PM

                  How can we find out which towns/cities bought it?
                  
                  If not - WHY? - If states are allowed the discretion to purchase and treat their populations then they could in effect undermine any and all attempts to combat the virus.
                  
                  Seriously - don't We The People Have anything to say about it?

                  • Tried with my town
                    

                    Submitted by Roy Kamen on 12/5/07 04:25 PM

                    I couldnt get that info - its classified National Security, as is the list and location of all the stockpiled stuff.

                    • City and town security
                      

                      Submitted by Catherine Jackie Mitchell on 12/6/07 05:01 AM

                      Perhaps for town security reasons it is best that this information is not in the hands of the general public.
                      

                • Towns were told they are not allowed to buy antivirals
                  

                  Submitted by Katharine Fisher on 12/6/07 06:20 AM

                  Towns here in CT were told that they were not allowed to purchase antivirals in conjunction with the federal contract that provided the lowered prices.
                  
                  The State of CT told town leaders that only the state could make these purchases. Towns such as New Canaan, who wished to purchase antivirals under the federal contract (that seemed to seek to encourage state and local entities to do so) were told they could not.
                  
                  On the other hand, contracts from Texas show that the State of Texas extended the ability to ride on that federal antiviral contract to their county and municipal entities.
                  
                  Why are local jurisdictions here in CT forbidden from joining in the antiviral purchase plan? Here we have localities willing to spend their resources to protect their populations, and they are being told they cannot do so. Why would we not want to encourage any official local government entity that wished to purchase antivirals for their first responders (or for their entire community, for that matter) from doing so?
                  
                  There is no antiviral shortage. They are willing to spend their own resources. This makes no sense.
                  

          • Antiviral and PPE data?
            

            Submitted by Katharine Fisher on 12/6/07 06:12 AM

            Where can we find a clear and current picture of the current status of antivirals in our stockpile(s)? Where can the current data for state and federal antiviral stockpiles be found? Where can we find data on how much PPE our states have purchased or what quantities of PPE will be sent to them from the SNS (Strategic National Stockpile)?
            
            This data is very hard to locate. Without it, it's very hard to have an intelligent conversation about community mitigation. The public cannot have the kind of dialogue central to our participatory democracy if these key facts are not avilable to evaluate and discuss.
            
            To Roy's point, my district public health office has only 100 N95 masks in stock and a couple of hundred surgicals at present. They have no intention of purchasing any more in advance of a pandemic.
            
            When told this is what our local public health officials have ordered and on hand for a pandemic, my local physcians grow pale. (There is no hospital in this district, and no other source of supply for a pandemic emergency for these physicans).
            
            The public health officials, however, cheerfully tell me that the feds will have a push pack at their doorstep within 48-72 hours containing all the masks and other PPE (and antivirals, btw) that they might need for the duration of a pandemic for a district population of approx. 35,000 individuals. If their assumption is untrue, somebody needs to begin to tell them that, and soon.
            
            Also to Roy's point, while many major corporations have attended the various pandemic flu conferences that have taken place (at a high dollar cost for entry) around the country, owners of small stores have not been targeted for this education. They don't have any idea that they should be considering obtaining PPE in order to keep operational.
            
            By the time many businesses realize that PPE is a necessity, pandemic will likely be spreading and supplies of masks (manufactured overseas) will be either difficult to buy or very expensive to buy (speaking of which, will their be price controls on PPE items?).
            

      • Recategorize Haz-Mat Transporters as Water Treatment Personnel
        

        Submitted by Rebecca Smith on 12/5/07 12:58 PM

        With all due respect, they do have very specific training and licensure for handling hazardous materials. Only certain members of the transportation industry are qualified for this critical job. It is not the same as moving other kinds of goods, like clothing and food. Any CDL licensed driver can move that kind of material. I wonder if there should be some cross-categorizing for transportation workers with hazardous materials endorsements that correctly categorize them as water treatment personnel. You can't just let anyone carry chlorine.
        
        [Rebecca-I re-titled your message to ensure a greater response-Donna/Monitor]

      • Truckers vital to infrastructure
        

        Submitted by Diana Tolladay on 12/5/07 03:19 PM

        I agree and Speaking from a historical perspective, the trucking industry is the backbone of the nation delivering everthing from diapers to medications. Without them shelves in stores would empty quickly and stay that way - especially in rural areas. My suggestion is that the store houses for foods, meds, etc. . . be located in rural areas. The chances of them being overrun by panicked massess would be greatly reduced. Another thing to consider ios the delivery system. We've all seen what happens in crisis when supplies do reach an area. In some cases - Those who don't need it, take it. Those who do need it, don't get it.
        

        • Extra Burden on Cities and Towns
          

          Submitted by Catherine Jackie Mitchell on 12/6/07 05:05 AM

          Cities and towns in rural areas should not have to bear the extra burden that you are suggesting. Each city and town must be "on their own".
          
          If a city or town volunteers their services then that is a wonderful thing. While being resilient ourselves we must also look to our neighbors needs and assist when possible.

• Critical Infrastructure
  

  Submitted by larry wright on 12/5/07 08:06 AM

  The only truly critical infrastructure is electric power.
  
  Without the electric power grid, every other primary requirement fails- communications, water, food, fuel. All of our secondary requirements fail, too.
  
  I would argue that the single most important thing the U.S. government can do is to preserve the production and distribution of electrical power.
  
  Short term, those directly involved in production and distribution of electrical power should receive the highest priority for prophylactic anti-viral medications, should have special support for their families, and should be first in line for vaccine production if and when.
  
  Every other function in the United States relies either directly or indirectly upon continued generation and distribution of electrical power.
  
  We do not have the resources to protect all of the supply chains for all the things we now take for granted. Health care, food distribution, water distribution all can be accomplished if there is a functioning electrical power system. WIthout that, we're [up the creek].

  • Emergency Support of Critical Infrastructure Group
    

    Submitted by Ed Brown on 12/5/07 08:26 AM

    We need to plan to replace the expected 40% of critical employees missing from work with some of the Tier 1 military folks. Perhaps the plan would include certain pre-training for such activities.

    • Interesting comment....
      

      Submitted by Terry Adirim   on 12/5/07 08:42 AM

      I don't think it's clear that 40% of "critical" workers will be out.
      
      And not only that, the 40% figure is supposed to be the guess at the entire workforce and at the peak of a pandemic. The day to day absentee rate may be significantly lower.
      
      With regard to military personnel, I would think that the National Guard (who are prioritized in Tier 2) would serve the role you described. That would be a State and local issue as the National Guard is a State asset. Good point.

      • Worker Absenteeism is the most important planning issue
        

        Submitted by Justin Kamen on 12/5/07 10:52 AM

        Terry,
        
        Everything I have read predicts 30-60% woker outages.
        
        To say 40% is the short-lasting peak is the same as saying we should only prepare for a 2% CFR. While I realize we are not here to bicker about figures, I feel this needs to be addressed. If the grid goes down due to worker outages, nothing else will matter.
        
        Preparing for worker absenteeism is perhaps the most important aspect of pandemic planning. We should not shy away from this fact.
        
        - Justin
        
        [Justin: I edited your title to draw more respondents. Donna/Monitor]

      • people won't be sick for a few days,
        

        Submitted by larry wright on 12/5/07 01:25 PM

        they may be severely ill for weeks, and will be MONTHS recovering if they survive a severe pandemic. If half the people in this country get sick from a pandemic, even if only 1% of them die, most of the rest will be out for weeks to months. You will indeed have a situation where a significant portion of the US population will not be able to work.
        
        Moreover, as I stated elsewhere, the skills needed to run a power plant are not acquired quickly. It takes many months to train a power plant op, or an electric lineman. The Guard will not be able to fill the gap.

        • Training and Funding Question
          

          Submitted by Diana Tolladay on 12/5/07 03:50 PM

          Is the training worksite specific?
          
          Are their currently enough - or rather more then enough workers to cover employees who are sick?
          
          Who pays the salaries - or rather who needs to be encouraged to hire and train more personell?
          
          Would it make a difference in the day to day operations pre-pandemic?
          

      • 30% of power industry out = no power
        

        Submitted by Roy Kamen on 12/5/07 04:28 PM

        I doent remember where but i read a report by the energy industry in 2005 that they couldn't function with more than 30% of their workers out. This was reinforced by conversations i've had with oil companies.

  • Very good point...is the guidence clear for them though?
    

    Submitted by Nick Kelley on 12/5/07 12:22 PM

    I know that the electrical industry is very worried about this. Many of the larger companies have been planning for a long time. I am not sure that the guidance is clear enough. Utilities are Tier 2. Maybe they should be bumped up to Tier 1.
    
    Another point to consider is that some of the companies are planning to move critical staff and family onsite for the duration of a pandemic. Not sure how the vaccine prioritization would play out if thats the case.
    

    • SIP for utility companies
      

      Submitted by larry wright on 12/5/07 01:19 PM

      Makes a lot of sense given the scarcity and possible loss of effectiveness of antivirals, the lag between pandemic onset and vaccine availability, the possible ineffectiveness of vaccine, and the projected inadequacy of vaccine supply in any case.
      
      Avoiding infection by isolating people in small groups may be a much more cost effective strategy than attempting to treat sick people, witness the experience of American Samoa in 1918. And electrical utility workers, by the nature of their jobs, are already pretty isolated.

    • Families are key
      

      Submitted by Ellen Rice on 12/5/07 02:10 PM

      So the electric plants ARE talking about what happens with the families. That is essential for plans to work. It might be crowded, the food might be bland -- but there is a plan and a worker can focus on work.
      
      During the Battle of Britain, many city children were relocated to the countryside so that their worker parents would have less worry. It wasn't easy, but it did help.

  • Bump Electrical Utilities to Tier 1
    

    Submitted by Nick Kelley on 12/5/07 12:24 PM

    If we loose the grid we are going to need a lot more than those that are vaccinated in Tier 1 to deal with the fall out.
    

    • electrical linesmen take months to train,
      

      Submitted by larry wright on 12/5/07 01:21 PM

      Power plant operators take years to train.
      
      These personnel are NOT 'plug and play' people.
      
      Specialized skills are required.

      • Move em up
        

        Submitted by Roy Kamen on 12/5/07 02:08 PM

        In a severe pandemic (60-80% CFR) they should be in tier 1 with the military according to age.
        
        http://www.wpro.who.int/NR/rdonl...
        

        • Age as a Factor?
          

          Submitted by Diana Tolladay on 12/5/07 03:59 PM

          I'm sorry but I just don't see how age could be be a logical factor. A 20 something still living at home with the folks or possibly still in school with few, if any life skills, and less ability to do than to party - doesn't provide any kind of advantage or critical status over the 50 or 60 something Man or Woman with knowledge, training, life skills, discipline and experience. In the electrical industry all I am hearing from the experts is that it takes years to train them before they can be a productive part of maintaining the system. I trust that.
          

          • My son would not get vaxed
            

            Submitted by Roy Kamen on 12/5/07 04:33 PM

            Diana,
            what i mean is that the job they do is first, followed by age.
            
            For instance a 21 year old power worker would get it before a 21 year old student - I do not say that lightly because MY son is 21 year old student. As a matter of fact he is participating on the dialog also contributing because he knows this will be very personal to his generation.
            
            Its going to be a very personal experience for everyone of us.

      • Electrical Power workers
        

        Submitted by Dennis King MD on 12/5/07 03:02 PM

        I am a primary care physician in Connecticut but am very concerned that the nuclear power plant workers should be in tier 1. Hate to loss control of one of those nuclear power plants

        • Can they be safely shut dowm?
          

          Submitted by Diana Tolladay on 12/5/07 04:01 PM

          Good commentary. Could the power plants be shut down. Is the loss of power from them so dramatic that it is vital to the infrastructure. If so, then yes, the power plant engineers needs to be in tier 1.
          

    • THE GRID MUST STAY UP
      

      Submitted by Roy Kamen on 12/5/07 04:40 PM

      THE GRID MUST STAY UP

  • Electric power
    

    Submitted by Philip Eisner on 12/5/07 01:44 PM

    An alternative to the electric power grid for many circumstances is emergency diesel powered electric generators such as hospitals use. Unfortunately, absent national and state leadership, our country appears to be doing a poor job taking action in this regard.

    • Where are they going to get their diesel
      

      Submitted by Nick Kelley on 12/5/07 01:48 PM

      Granted many places have diesel on site, but I am not aware of any place that has more than a 3 day supply. Hospitals have to have backups, but when they have outages they divert incoming and sometimes transfer patients until the situation stabilizes. They wont have that option in a pandemic. Diesel is a just in time delivery product.
      
      Its part of the Utilities CI category that I think should be bumped to Tier 1.

      • Diesel electric generators
        

        Submitted by Philip Eisner on 12/5/07 02:03 PM

        Note that drug stores and pharmacies could use back-up generators. people at home with respirators could also. In fact, if a pandemic strikes in the winter as it is expected to do, then home owners throughout our northern states will need electricity to keep their furnace fans going! Power outages are a disaster and we need government action to improve this infrastructure.

        • You need fuel for that
          

          Submitted by Roy Kamen on 12/5/07 02:06 PM

          And fuel may be in very short supply Philip

      • Bump hospitals up?
        

        Submitted by larry wright on 12/5/07 02:15 PM

        Nick, I agree with most of what you say, but the solution is NOT to lose grid power, rather than to try to beef up the epower system for hospitals. Health care systems will be irrelevant during a pandemic.
        
        As I said in separate comments, it isn't just the hospital, it's all the support staff, too. Your staff aren't going to leave their families alone in the freezing dark to go work in a hospital that may or may not be open.
        
        I apologise in advance for harping on this point, but I think it is an absolutely essential meme that everyone needs to be infected with and pass on.
        That is- The grid MUST STAY UP.
        
        That priority should be absolute. EVERYTHING depends on that.
        
        THE GRID MUST STAY UP.
        
        No grid power means no whatever else you are worried about.
        
        Worried about health care availability?
        
        The GRID must stay up. No grid power means no hospitals, no blood banks, no staff, no supply manufacture or delivery. No communications to call for doctors or nurses. No staff.
        
        Worried about food availability?
        
        THE grid MUST stay up. No grid means no running farm tractors, no transport of food, no way to operate food distribution. No refrigerators.
        
        Worried about civil order?
        
        the grid MUST STAY UP. No grid means no radio, no TV, no police department, no National Guard.
        
        Whatever your concern, the grid must come first, because without grid power, everything we depend upon fails. The grid must stay up.
        
        And that means that whatever policies are adopted must, first and last, ensure that electrical power is generated and distributed. To me, that means that electrical power plant workers and linesmen get first in line for anti-virals, for vaccines, for family protection, for any kind of special treatment needed to keep them on the job. Electrical power is the one absolute essential element in every modern endeavour. Period.
        

        • Grid is critical
          

          Submitted by Nick Kelley on 12/5/07 02:25 PM

          Larry I totally agree with you. I dont think beefing up hospitals is the way to go either. The electrical grid must not come down. Almost every aspect of society depends on it working.
          

        • THE GRID MUST STAY UP
          

          Submitted by Roy Kamen on 12/5/07 04:39 PM

          THE GRID MUST STAY UP

          • Yes, the grid must stay up
            

            Submitted by MoMos Mom on 12/5/07 04:47 PM

            Larry, I couldn't agree with you more on this assessment. If the grid goes down, then all of the other pieces of our technology pyramid will come crashing down. We could back pedal with diesel generators, but then you have to get the diesel from point A to point B. Suddenly, your tier 1 requirements for keeping the power going would increase dramatically. If you're trucking the diesel, you have to have a hazardous materials CDL driver to get it there. You would also have to have security for the tanker. 18 wheelers are already hijacked in some cities, like New York, right now with no pandemic. If you have no power, and you see the truck rolling by, that fuel would be worth more than gold.
            
            The grid must stay up in order to maintain our modern society.

    • I wish gensets could solve the problem, but...
      

      Submitted by larry wright on 12/5/07 01:58 PM

      there are a number of issues with generators.
      First, a 1 megawatt generator uses a lot of diesel fuel. With current environmental restrictions on how much fuel you can store at a location, most large generators can only run for a day or so. Once that fuel stock is gone, how do you get more, in the context of a large-scale outage? Hand pumps? Buckets? remember that the pipelines aren't running and neither are the pumps at the fuel distributors or at the gas stations.
      
      Next, no hospital could afford complete "off grid" power- it would be far too expensive to buy and still more expensive to maintain. The last hospital generator plant I was involved with installing was 3 2 megawatt Caterpillar generators for 6 MW total out of a design demand of over 60 MW. These only ran the emergency lights, some air circulation, and a few selected elevators. No hospital I am aware of can run totally "off grid" for any length of time.
      
      Finally, even if the hospital building could run off grid, what about all the people who work there? Can THEY function without grid power? Would you leave your family behind in a freezing cold winter day with no heat to go to a hospital that might or might not be open? How many people have emergency power for their homes now? 1 in a thousand? less? *I* wouldn't leave my family alone in such a situation even though I DO have a genset.
      

      • Diesel generators
        

        Submitted by Philip Eisner on 12/5/07 02:21 PM

        Diesel fuel is essentially home heating fuel oil. Both can be stored in large tanks if deemed necessary. Are we trying to solve the potential problems caused by a pandemic, or not?
        
        We have to provide solutions whether they are convenient or not or expensive or not. Having lived through two NYC blackouts plus numerous smaller ones in NJ, I believe thoroughly that maintaing our electric power grid is vital, a first priority. This will require Federal planning, Federal authorizations, and Federal money because of the vast interstate nature of the grid. Indeed, since Canadian electric power is accessed by the grid, it is an international problem.

        • Very good point...
          

          Submitted by Nick Kelley on 12/5/07 02:27 PM

          Since money is not being invested on this topic...not as much as needed, shouldn't the people that keep the grid up and running being some of the first in line for the vaccine.
          

          • Electrical workers are #1 in line
            

            Submitted by larry wright on 12/5/07 02:39 PM

            I agree with you. #1 for Tamiflu, for ventilators, for doctors, for vaccines, for everything.

        • the present fragility of the power grid
          

          Submitted by larry wright on 12/5/07 02:38 PM

          is due to the US congress adopting "deregulation" The effect of this legislative effort is to require power transmission systems to be as lean and as cost competitive as possible. The system has been 'lean engineered' for maximal cost efficiency, NOT for maximal reliability. My judgement is that it would take several years to reverse this trend, at a minimum. Such change would probably be opposed by those who would stand to lose economically by the change.
          
          As regards diesel fuel, that would also require significant change in existing environmental regulation, change which would be strenuously opposed by most envirinmental interests. In any case, that is not a solution for reason already recounted.
          
          I am not saying that these issues are not capable of resolution; they are.
          I am saying that within the framework of the world as it presently exists, the political will to make the significant changes required does not exist.
          
          My suggestion to my friends and colleagues is to buy their own power generation capability, because barring a drastic public policy change, the grid is at risk. That is the reality.
          

      • Qty of stored fuel,.
        

        Submitted by Diana Tolladay on 12/5/07 04:05 PM

        It may be different elsewhere - but in California its against the law to store more than 50 gallons of fuel on your property. Any one know how long that would last?
        

        • fuel usage-
          

          Submitted by larry wright on 12/6/07 12:15 PM

          My diesel genset (12 KW diesel) uses about 0.12 gallons per KWH;
          
          I get about 6 KWH per gallon.
          
          The average 2 person household uses about 15 KWH per day; allowing for losses, inefficiency etc thats about 4 gallons of diesel per day assuming that there is some sort of energy storage device for low demand but continuing loads. For most people, who don't have a large battery back, they have to keep running the genset at low load. That means that you run 24/7 which increases the demand to around 6 gallons+ per day. You'd get about a week out of 50 gallons of diesel for a small diesel genset, or about 4 or 5 days for a gasoline genset of aroudn 7.5 KW.

  • THE GRID MUST STAY UP
    

    Submitted by Roy Kamen on 12/5/07 04:41 PM

    THE GRID MUST STAY UP

  • THE GRID MUST STAY UP
    

    Submitted by Roy Kamen on 12/5/07 04:42 PM

    THE GRID MUST STAY UP

  • Prioritize Essentail Workers
    

    Submitted by Jay Schmid on 12/6/07 06:46 AM

    Living in the midwest and expecting a pandemic to occur at an unseasonable time of the year, I think it is absolutely essential to include at least a percentage of essential employees i.e. facility managers of the electrical and natural gas supplies in Level A of the Critical Infrastructure (CI). We will IMO need to keep the lights and heat going for if not everyone, at the very least the medical services that will be so desperately needed and to avoid the chaos and panic that would follow if those services were to ever go out.