If Pandemic Strikes

May 1st, 2010
This article is featured in the Global Health (May/June/July 2010) issue of Circuit Rider

Historically, there has perhaps never been a more visible display of the Church in action, loving and caring for people in distress, than its response to major disasters. I have watched churches mobilize thousands of people to sacrificially give of their time and money to reach out a helping hand to the survivors of hurricanes, floods, earthquakes, and terrorist attacks.

A pandemic outbreak presents unique problems not experienced in most disasters, which may prevent churches from responding in a way that seems natural for them. In times of disaster, people often feel an innate need to come together to provide aid to people in distress. However, to provide an effective response that helps people and prevents the spread of the pandemic, congregations must strategically and carefully plan their response and put protections in place that may seem unnatural, unfamiliar, and contrary to those activities that are normally a part of a community of loving fellowship.

To help keep communities healthy during a pandemic outbreak it will take all of us—community and faith-based organizations, government, businesses, and schools—working together. As trusted community leaders, clergy can communicate important health information in an effective and motivating manner. You know the people in your community who are most vulnerable and hard-to-reach and are uniquely positioned to help keep people healthy in an outbreak.

A pandemic occurs when a disease spreads rapidly, affecting most countries and regions of the world. Influenza pandemics have occurred periodically throughout history, including a major pandemic in 1918, and smaller pandemics in 1957, 1968 and in 2009 and 2010 with the novel H1N1 virus. Influenza viruses are constantly changing, producing new strains. An influenza pandemic occurs when a virus emerges that is so different from previous strains that few, if any, people have any immunity.

It is critical that church leadership carefully plan in advance for how they will handle a pandemic outbreak and intentionally prepare congregations for an effective response. The following are some things that church leadership can do to help prepare their staff and congregation for a pandemic outbreak.

Severe Pandemic Planning Assumptions:

  • A pandemic could last 6-8 weeks and include several waves over the course of a year.

  • Up to 30 percent of the workforce could be out sick during a pandemic. Up to 2 percent of the 30 percent who fall ill may die. Absenteeism could reach 40 percent during the peak of a pandemic. People may decide to stay home to care for family members or for children when schools are closed. Fear of exposure may lead to higher rates of absenteeism before an actual outbreak begins.

  • Employer flexibility will be necessary and might include staggered shifts, expansion of physical space between work stations, or allowing employees to work from home.

  • Leave policies may need to be flexible.

  • Employees may need personal protective equipment (PPE) to maintain Priority Service Functions. This requires implementation of PPE policies and procedures and ensuring that the required training and fit testing is done.

  • Availability of supplies may be scarce because of hoarding, combined with limited production and transportation challenges.

  • Community buildings may need to be used as alternate care facilities and standards of care may need to be adjusted when hospitals are overwhelmed. Consider how your church may be used.

  • Assistance from outside organizations and county, state, and federal government will be limited.

Hard-to-Reach Populations

People in vulnerable and hard-to-reach populations may never receive important health messages because they are not connected to mainstream communication networks or because they cannot understand English. Others may be unable to afford healthcare or to access the services they need to stay healthy. Often it is churches which provide services to these population groups and may be one of the few trusted sources for effective outreach. Although vulnerable and hard-to-reach populations may vary from community to community, they can include:

  • Low-income individuals and families

  • Non-English speakers

  • Homeless individuals and families

  • Shut-in or homebound individuals

  • Migrant workers, immigrants, and refugees

  • People with physical, sensory, mental health, intellectual, and cognitive disabilities

What can my church do to help vulnerable and hard-to-reach people in my community?

Your church can provide programs and services critical to helping vulnerable and hard-to-reach individuals and families. Here are some suggestions:

  • Identify which members of your community might need extra assistance.

  • Translate documents and health materials into languages spoken by members of your community.

  • Ensure that messages are simple and clear for low literacy audiences.

  • Develop a “necessities bank” to provide needed items to individuals who cannot afford them.

  • Provide transportation for community members who can't drive or who rely on public transportation systems.

  • Organize services for members needing assistance picking up medication, equipment, or supplies.

Most activities in churches involve services or meetings that bring people together. During a pandemic, CDC and your local health department may suggest that people avoid close contact with others and avoid attending large gatherings, a practice often called social distancing. These measures are intended to slow the spread of disease. Religious traditions and obligations may make it difficult to implement social distancing measures. However, faith-based and other community groups can do some specific things to help keep their members healthy. Churches should explore alternative means of communicating. With the advances in modern technology, communicating services and meetings via the Internet is a simple and cost-effective alternative to communal gathering.

What steps can leaders of religious services or community meetings take if there is an outbreak in my community?

  • To the extent possible, make decisions in accordance with your state and local health departments about community gatherings and religious services during widespread illness in your community. People should not be discouraged from gathering unless advised by public health officials.

  • Encourage people to wash hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub. If soap and water are not available and alcohol-based products are not allowed, other hand sanitizers that do not contain alcohol may be useful.

  • Remind people to cover their mouth and nose with a tissue when coughing or sneezing. It may prevent those around them from getting sick.

  • Reduce crowding as much as possible.

  • Identify which activities may increase the chance of spreading disease. Work with your local health department to make decisions about changing or limiting these activities in order to help keep people healthy.

    • People gathering in close proximity may increase the risk of transmission.

    • Many religious services and community meetings involve a time of greeting or recognition by shaking hands or hugging. Encouraging interaction without physical contact and implementing social distancing measures may reduce the risk of transmission.

    • Some religious traditions and rituals emphasize eating and drinking from communal dishes and vessels. Transmission may be possible in these circumstances. If flu or another illness is circulating widely in your community, faith and community leaders may consider adjusting such practices.

  • Encourage people with flu-like illness to stay home for at least 24 hours after they are free of fever without the use of fever-reducing medications.

  • If there is widespread illness in your community, discuss the risks of attending gatherings for those at high risk of medical complications from the flu or other diseases.

  • Provide alternative options and venues for participation whenever possible for individuals who are ill, homebound, or at high risk of complications.

For additional information and practical tools relating to congregational pandemic planning, look under the “community planning” tab at http://www.flu.gov.

Kevin Ellers is Territorial Disaster Services Coordinator for The Salvation Army Central Territory and coauthor of The First 48 Hours: Spiritual Caregivers as First Responders.

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