A Health Guide for the Public in Disaster Planning and Recovery

1. A Health Guide for the Public in Disaster Planning and Recovery

2. As we have seen recently, you may be unable to obtain needed resources for some period of time following an event, even from government agencies. You may not have access to food, water, and electricity for days, or even weeks. • You should be prepared with enough stored emergency food and water supplies for your entire family for at least 48 – 72 hours.

3. FAMILY DISASTER SUPPLY KIT Pack at least a 3 day supply of food and water. Store it in a portable container and in a handy place. Choose foods that are easy to carry, nutritious and ready-to-eat. Also pack these emergency items: • Medical supplies and first aid manual • Hygiene supplies • Portable radio, flashlights and extra batteries

4. FAMILY DISASTER SUPPLY KIT • Shovel and other useful tools • Money and matches in a waterproof container • Fire extinguisher • Blanket and extra clothing • Infant and small children's needs (if appropriate)

5. PREPARATION FOR SHELTERS • SHELTERS SHOULD BE A REFUGE OF LAST RESORT • Do not report to a shelter until it is officially opened. The media will announce shelter openings. • Choose 2 or 3 shelters closest to you. Shelter openings depend upon storm direction, intensity, and other factors. Some shelters fill up quicker than others.

6. PREPARATION FOR SHELTERS • Tell a friend or relative where you are going. • Consider volunteering at the shelter. • Pets, firearms, and alcoholic beverages are not allowed in shelters.

7. Bedding Beach or lounge chair Medications (prescription and over the counter). Include vitamin, mineral, and protein supplements in your stockpile to assure adequate nutrition. Medical alert tags Clothing and personal care items Flashlight/batteries First Aid Kit PREPARATION FOR SHELTERSSuggested Items to bring

8. PREPARATION FOR SHELTERSSuggested Items to bring • Identification, insurance, and other valuable papers • Cash, traveler’s checks • Books, games • Infant care items • Drinking water, snacks, and a 24 hour supply of non-perishable food.

9. PLAN AHEAD FOR YOUR PET DO NOT LEAVE PETS AT HOME MAKE arrangements with a friend outside the area For care contact: • Pet friendly hotels and motels • Veterinarians • Kennels

10. PLAN AHEAD FOR YOUR PET Make sure: • Vaccinations are up to date • Collar has ID tag and a leash • Carrier is large enough so pet can stand, sit, and turn around • PROVIDE food, bottled water and medications for at least a week and a photo of pet with family member to reclaim in case it is lost

11. Health Care Precautions After An Emergency Following a disaster, special precautions should be taken to protect your health. You should focus on controlling injuries and illnesses that may cause disease outbreaks.

12. Health Care Precautions After An Emergency Ways to prevent injuries and illness include: • Never walk or drive into moving water if you do not know how deep it is. • Before beginning any cleanup activities make sure electricity and gas is turned off to the structure. Always follow utility company instructions for restoring gas and electrical services. Do not turn the power back on until electrical equipment has been inspected by a qualified electrician. • NEVER HANDLE A DOWNED POWER LINE!

13. Use a small portable generator to power a single freezer, well pump or other appliance by plugging an extension cord directly into the generator. NEVER bring gasoline/diesel generators, pumps, pressure washers, grills, or lanterns, indoors (this includes garages and basements) or use them near windows or doorways due to carbon monoxide which is colorless, odorless, and deadly! (Symptoms of carbon monoxide include headache, dizziness, weakness, nausea and confusion). Health Care Precautions After An Emergency

14. Health Care Precautions After An Emergency • Wash hands frequently with soap and clean water to help prevent illness. If soap and water are not available, use an alcohol-base hand sanitizer. • Flood water often contains hazardous materials from dislodged or damaged drums, pipes, and equipment. Limit your contact with flood water whenever possible.

15. Health Care Precautions After An Emergency • Pace yourself during clean up work. Work during cooler times of the day and watch for signs of heat stroke (dizziness, fainting, cramping). • Wear protective clothing such as heavy footwear, rubber gloves, goggles, dust masks, and long sleeves. Wear rubber boots and insulated clothes when working in water that is cooler than 75 degrees. • Before entering any building that has been flooded, check its foundation for cracks that could indicate shifting • Make sure the surface you are about to stand on is stable.

16. Health Care Precautions After An Emergency • Use teams of 2 to lift heavy (more than 50 lbs) or bulky objects to avoid back strain. • Never take small children to clean-up sites. • Never mix/combine cleaning supplies. • Always make sure the area where you are using heavy duty cleaning solutions is well ventilated to keep from being overcome by fumes.

17. Health Care Precautions After An Emergency • Use extreme caution around overhead power lines when working with ladders. • Comply with all boil water orders for public water supplies. • Make sure food and water supplies are safe for consumption. Eating or drinking contaminated products can cause varying degrees of symptoms such as nausea, vomiting, and diarrhea.

18. Lime is often applied to mud after flood waters recede to help control breeding of flies and odors. Limit contact (especially children and pets) with lime as it can cause chemical burns to the skin. It is recommended that straw be placed on top of the lime in areas where there will be foot traffic. Health Care Precautions After An Emergency

19. Preparing An Emergency Food Stockpile • If activity is reduced, healthy people can survive on half their usual food intake for an extended period and without any food for many days. Food, unlike water, may be rationed safely, except for children and pregnant women. • If your water supply is limited, try to avoid foods that are high in fat and protein, and don't stock salty foods, since they will make you thirsty. Try to eat salt-free crackers, whole grain cereals, and canned foods with high liquid content.

20. Preparing An Emergency Food Stockpile • You don't need to go out and buy unfamiliar foods to prepare an emergency food supply. Familiar foods are important as they can lift morale and give a feeling of security in time of stress. • Use • canned foods that won't require cooking, water or special preparation • dry mixes • other staples on your cupboard shelves.

21. Preparing An Emergency Food Stockpile: Storage Tips • Keep food in the driest and coolest spot in the house--a dark area if possible. • Keep food covered at all times. • Open food boxes or cans carefully so that you can close them tightly after each use.

22. Preparing An Emergency Food Stockpile: Storage Tips • Wrap cookies and crackers in plastic bags, and keep them in tight containers. • Empty opened packages of sugar, dried fruits, and nuts into screw-top jars or air-tight cans to protect them from pests. • Inspect all food containers for signs of spoilage before use.

23. What to do with food when the electricity goes off • First, use perishable food. If the temperature of perishable foods rises above 41° F for more than 4 hours, it should be discarded. • Foods in the freezer will remain frozen up to 24 hrs. if the freezer door is not opened. To minimize the number of times you open the freezer door, post a list of freezer contents on it. • In a well-filled, well-insulated freezer, foods will usually still have ice crystals in their centers (meaning foods are safe to eat) for at least three days.

24. What to do with food when the electricity goes off • After 24 hours, if the food is still partially frozen, it should be safe to refreeze. • If frozen foods have thawed and have been stored at temperatures above 41° F for less than 4 hours, they should be safe if used immediately. However, if they have completely thawed and have been above 41° F for more than 4 hours, they should be discarded. • FINALLY, begin to use non-perishable foods and staples.

25. How to Cook When the Power Goes Out For emergency cooking outdoors only (due to the chance of carbon monoxide poisoning) use: • a charcoal grill • camp stove Inside you can use: • a fireplace • candle warmers • chafing dishes • fondue pots. Canned food can be eaten right out of the can. If you heat it in the can, be sure to open the can and remove the label first.

26. Nutrition Tips In a crisis, it will be vital that you maintain your strength. So remember: • Eat at least one well-balanced meal each day. • Drink enough water to enable your body to function properly (two quarts a day). • Take in enough calories to enable you to do any necessary work. • Include vitamin, mineral, and protein supplements in your stockpile to assure adequate nutrition.

27. Shelf Life of Foods for Storage (Remember to Rotate Stock) Use within six months: • Powdered milk (boxed) • Dried fruit (in metal container) • Dry, crisp crackers (in metal container) • Potatoes

28. Shelf Life of Foods for Storage (Remember to Rotate Stock) Use within one year: • Canned condensed meat and vegetable soups • Canned fruits, fruit juices, and vegetables • Ready-to-eat cereals and uncooked instant cereals (in metal containers) • Peanut butter • Jelly • Hard candy, chocolate bars, and canned nuts

29. Wheat Vegetable oils Corn Baking powder Soybeans Instant coffee, tea Vitamin C * * Rotate every two years Cocoa Salt Noncarbonated soft drinks White rice Bouillon products Dry pasta Powdered milk (in nitrogen-packed cans) Shelf Life of Foods for Storage May be stored indefinitely (in proper containers and conditions):

30. Short Term Food Supplies • It is unlikely that an emergency would cut off your food supply for two weeks, however, you should prepare a supply that will last that long. A two-week supply can relieve a great deal of inconvenience and uncertainty until services are restored. • The easiest way to develop a two-week stockpile is to increase the amount of basic foods you normally keep on your shelves. Remember to compensate for the amount you eat from other sources (such as restaurants) during an average two-week period. • You may already have a two-week supply of food on hand. Keeping it fresh is simple. Just rotate your supply once or twice a year.

31. Special Considerations to Keep in Mind • As you stock food, take into account your family’s unique needs and tastes. Try to include: • foods that they will enjoy • are also high in calories and nutrition • foods that require no refrigeration, preparation or cooking are best • Particular attention needed for • individuals with special diets and allergies • ill • babies/toddlers • elderly • nursing mothers may need liquid formula, in case they are unable to nurse

32. Special Considerations to Keep in Mind • Canned dietetic foods, juices, and soups may be helpful for the ill or elderly. • Make sure you have a hand operated can opener and disposable utensils. • Don't forget nonperishable foods for your pets.

33. How to Store Your Short Term Stockpile • Keep canned foods in a dry place where the temperature is fairly cool--not above 70 degrees Fahrenheit and not below freezing. • To protect boxed foods from pests and extend their shelf life, store the boxes in tightly closed cans or metal containers.

34. How to Store Your Short Term Stockpile • Rotate your food supply. Use foods before they go bad, and replace them with fresh supplies, dated with ink or marker. Place new items at the back of the storage area and older ones in front. • Your emergency food supply should be of the highest quality possible. Inspect your reserves every other month to make sure there are no broken seals or dented containers.

35. Long Term Food Supplies • Build up your everyday stock of canned goods until you have a two-week to one-month surplus. • Rotate it periodically to maintain a supply of common foods that will not require special preparation, water or cooking. • From a sporting or camping equipment store, buy commercially packaged, freeze-dried or air-dried foods. Although costly, this will be your best form of stored meat, so buy accordingly.

36. Long Term Food Supplies Stock the following amounts of staples per person, per month: • Wheat--20 pounds • Powdered Milk (for babies and infants)*-- 20 pounds • Corn--20 pounds • Iodized Salt--1 pound • Soybeans--10 pounds • Vitamin C**--15 grams * Buy in nitrogen-packed cans ** Rotate every two years

37. Long Term Food Supplies • Supplement these staples with commercially packed air-dried or freeze-dried foods and supermarket goods. Rice, popcorn, and varieties of beans are nutritious and long-lasting. The more supplements you include, the more expensive your stockpile will be.

38. Storage and Preparation of Food Supplies • Store wheat, corn, and beans in sealed cans or plastic buckets. • Buy powdered milk in nitrogen-packed cans. • Leave salt and vitamin C in their original packages. • If these staples comprise your entire menu, you must eat all of them together to stay healthy.

39. Storage and Preparation of Food Supplies • If you have wheat, corn, and beans in your long term food stores, it is suggested that you also have the means to prepare these goods for consumption. Needed equipment can be obtained from health food stores. A vast amount of information on preparation can be found on the internet. All of this needed equipment and info should be obtained in advance and placed in storage with the food supplies.

40. Food Contamination The indiscriminate use of food, household products, medicines, and cosmetics that have been exposed to contamination may pose a threat to your health. Such items should be immediately destroyed in a manner approved by your local health department. You should listen to public service announcements for directions on how to dispose of food contaminated by chemical spills or radiological fallout after an event.

41. All fresh fruits and vegetables exposed should be destroyed Fruits and vegetables in home gardens should be destroyed All meats, including fresh, dried, and frozen should be destroyed All home canned food products should be destroyed Foods such as cereals, bakery goods, dried fruits, flour, frozen foods, sugar, salt, and similar foods in paper or plastic containers or wrapping should be destroyed Household products, medicines, and cosmetics in containers with screw caps should be destroyed Food Contamination The following may help guide you in handling food supplies that have been contaminated by exposure to flood water.

42. Food Contamination At your own risk, you may salvage commercially canned foods (free from severe dents, split seams or leaks) using the following method: • removing the labels • washing the containers in water containing a detergent • rinsing in clear water • submerging in a solution containing laundry bleach Note: Two tablespoons of laundry bleach per gallon of water will be sufficient. This solution should be freshly prepared frequently during the washing process. • rinsed in cool water from a safe source • air dry • re-label the containers as to contents for future use

43. Water: The Absolute Necessity • Water stocking and purification should be among your top priorities in preparing for an emergency. • A long term supply will have at least a two-week supply of water for each member of your family. • Everyone's needs will differ depending upon • age • physical condition • activity • diet • climate

44. Water: The Absolute Necessity • A normally active person needs to drink at least two quarts of water each day. Hot environments can double that amount. Children, nursing mothers, and ill people will need more. • You will need additional water for food preparation and hygiene. Store a total of at least one gallon per person, per day. If your supplies begin to run low, remember: Never ration water. Drink the amount you need today, and try to find more for tomorrow. You can minimize the amount of water your body needs by reducing activity and staying cool.

45. How to Store Emergency Water Supplies • You can store your water in thoroughly washed plastic, glass, fiberglass or enamel-lined metal containers. • Never use a container that has held toxic substances, because tiny amounts may remain in the container's pores. • Sound plastic containers, such as soft drink bottles, are best. You can also purchase food-grade plastic buckets or drums. • Before storing your water, treat it with four drops of chlorine bleach per quart of water and stir. It will prevent the growth of microorganisms. Use unscented liquid bleach that contains 5.25 percent sodium hypochlorite and no soap.

46. How to Store Emergency Water Supplies • Seal your water containers tightly, label them, and store them in a cool, dark place. • Commercially bottled water can be stored for 2 years without any affect to quality or taste. Water that has been bottled at home should be replaced every 6 months.

47. Hidden Water Sources In Your Home If a disaster catches you without a stored supply of clean water, you can use: • water in your hot-water tank • in your plumbing • in ice cubes. • the water in the reservoir tank of your toilet (not the bowl), as a last resort and purify it first (described later)

48. Hidden Water Sources In Your Home • Water beds can hold up to 400 gallons. Some water beds contain toxic chemicals that are not fully removed by many purifiers. If you designate a water bed in your home as an emergency resource, drain it yearly, and refill it with fresh water containing two ounces of bleach per 120 gallons. It is recommended that this water be used for bathing but not for consumption.

49. Hidden Water Sources In Your Home Do you know the location of your incoming water valve? You'll need to shut it off to stop contaminated water from entering your home if you hear reports of broken water or sewage lines. • To use the water in your pipes • let air into the plumbing by turning on the highest faucet in your house • draining the water from the lowest one. Note: If the water supply was contaminated, you will need to boil/disinfect and possibly filter the water before using it.

50. Hidden Water Sources In Your Home To use the water in your hot-water tank • be sure the electricity or gas is off • open the drain at the bottom of the tank • start the water flowing by turning off the water intake valve and turning on a hot-water faucet. • Do not turn on the gas or electricity when the tank is empty. Note: Water may be discolored with rust.