Cold Times — How to Prepare for the Mini Ice Age

by Dr. Anita Bailey

  Ideally, you will have a separate building, or at least a separate room, that can be used as a formal quarantine. A caregiver, preferably someone who has had the disease, recovered from it, and now has immunity, will stay with the sick, providing oversight and nursing care. Food and water should be brought to the door and set down, to be picked up after the person delivering has left. A bucket can be used for a toilet should you not have active plumbing.

  Clothing, bedding, anything contaminated with body fluids, cloth tissues and so forth, should be put into a plastic bag or piled together. If the illness is mild, the materials can be thoroughly washed and sun dried. If the illness is severe and causes some deaths, all the contaminated supplies should be burned. The person stays in quarantine until all symptoms of fever, rash, or whatever, have been gone for 72 full hours.

  If only a few people in your group are sick, quarantine might be helpful for slowing or stopping the spread of the disease. If a good percentage are sick, quarantine is not likely to be as helpful. You may consider quarantining outsiders for 10 days before letting them into your group. If they’re sick, it should show before the quarantine time is up. That’ll help prevent disease from getting a foothold in your group.

  Conventional Medical Supplies

  There is no perfect list of medical supplies for the coming Cold Times. Each household should have their own supplies that fits their individual needs (prescriptions and vitamin supplements, for example), and the group itself would benefit from a central medical supply for “in case” situations.

  There is something of a minor controversy on the types of medical equipment that a group should store. One side states that supplies should be suitable for the skill level of the providers – nurses should have nursing supplies, paramedics have emergency paramedic supplies, and so forth. The other side of the argument states that having a well-supplied on-site urgent care suite, with as much medicine and technology as can be afforded, is the ideal. That way, even if the group doesn’t have top level physicians, nurse practitioners, paramedics, or other health care professionals, they have the equipment should one appear.

  Gathering medical supplies is often dependent on two elements: cost, and access. Some items are simply excessively expensive, even though they would be nice to have, and some items are “prescription only” so you can’t get it without first talking a physician or nurse practitioner into writing a scrip for it. In some areas, it’s still possible to get livestock antibiotics, in pill or injectable form at feed stores, but even those may run short during any kind of calamity.

  Here’s a short list to get you started making your own version:

  3 months of routine prescriptions, ideally 12 months’ worth

  Over-the-counter pain relievers: Ibuprofen

  Aspirin

  acetaminophen

  Band-aids

  Gauze

  Medical tape

  Tubes antibiotic gel

  Anti-itch (Cortaid or other similar remedy) cream, spray, lotion

  Anti-diarrheal (Immodium)

  Antacid and anti-gas Pepto-Bismol

  Tums

  Gaviscon, etc

  Ben-Gay, Icy Hot, or Tiger Balm or other rub on pain reliever

  Benadryl (Diphenhydramine) liquid (faster acting than capsules or tablets)

  Multivitamins

  Vitamin C 500-1000 mg tablets

  Vitamin D3 4000-10,000 IU capsules

  Ankle and wrist braces

  Blood pressure cuff (non-electric, manual version)

  Stethoscope

  Otoscope (for checking ears)

  10 or more pounds of Epsom Salts (more is better)

  “Salt Replacer” with potassium – store several pounds

  Standard thermometer (non digital, non battery)

  Medical professionals will want additional supplies and medications.

  Sutures of various sizes

  “needle drivers” (vet supplies will work)

  Hemostats and tissue forceps

  Gauze – sterile and non-sterile

  Syringes, 3-6 cc, with 21 gauge 3” needles

  Antibiotics (see following)

  Specialist supplies Casting material for setting broken bones

  Scopes for examining the interior of the eye

  IV fluids including sterile saline and dextrose

  IV sets, needles

  Nebulizer and albuterol

  Vaginal speculum, metal, medium size

  Injectable lidocaine/Marcaine

  Injectable epinephrine

  Injectable propofol, versed, and anti-nausea medications for light sedation

  Injectable meperidine, morphine, toradol

  Injectable antibiotics such as cefriaxone

  Injectable tetanus toxoid and antitoxin (refrigerated)

  Injectable insulin, Humalog, Levimir

  Injectable steroids such as Kenalog or dexamethasone

  Oxygen tank, filled

  Oxygen tubing, masks, nasal cannula

  Sterile and non-sterile nitrile or latex gloves

  Pressure cooker for autoclaving metal tools

  Multiple stainless shears, hemostats, probes, and forceps.

  Antibiotics

  In the world of preparedness, there is a general sense that if things go bad, antibiotics will be in short supply or gone entirely. Given the difficulty in producing mass quantities of healing drugs, and given the problems currently associated with shortages and deliveries, there’s a lot of merit to that assessment. Just as in any other preparedness issue, the obvious course is to acquire supplies now that could be used in the event of a need then.

  The problem is that antibiotics aren’t like stored toilet paper or freeze dried veggies. Each antibiotic has a limited range of effectiveness in different body systems and against differing bacteria. There’s no “one size fits all” medication. And, there’s no “one size fits all” sick person, either. He or she may be allergic to the appropriate antibiotic, so a secondary choice has to be used instead.

  Keeping that in mind, the following is a basic guide to the most critical oral antibiotics (pills or capsules) currently on the market. In most cases this is focused on generics, simply because they are affordable. What follows is a discussion of the general classes of antibiotics and their primary uses. After that, we’ll get down to specific cases. Finally, we’ll close with a list of recommended antibiotics to keep on hand.

  About Antibiotics

  All medications are risky. Anyone can have an allergic reaction, or face dangerous side effects – even when taking an antibiotic they’ve used in the past without problems. Although I’ve used good sources for the following medical material, it is provided for informational purposes only. You can find the same info in any medical or nursing textbook.

  Antibiotics are primarily “bactericidal.” They kill germs during the phase when they are dividing. A few antibiotics (Tetracycline, for example) are “bacteriostatic.” They stop the germs from reproducing, without actually killing them, so the germ population ages and shrinks until the person’s immune system can wipe them out. Bactericidal antibiotics may be ineffective if given with bacteriostatic ones, because the germs stop reproducing so they can’t be killed during cell division. Antibiotics do not work against viruses, such as Chicken Pox or Influenza, although taking an antibiotic may help prevent “bacterial sequelae” (bacteria-caused secondary infection) following a viral infection.

  Antibiotics can interfere with the effectiveness of some other medications, especially oral birth control agents, making them less effective. They also can make some medications more effective, such as the blood thinner Coumadin/warfarin, leading to risk of bleeding or other nasty side effects. Some antibiotics appear to interfere with heart rhythms in susceptible people. One class has been associated with tendon ruptures. To repeat: all medications are risky. We balance the risk of taking the antibiotic against the risk of not taking it.

  Most antibiotics can give the person a mild case of
diarrhea. This occurs because the antibiotic kills not only disease-causing bacteria, but kills off the beneficial bacteria we have in our guts, as well. Mild diarrhea can be controlled with daily yogurt or probiotic use, or an anti-diarrhea med such as Imodium. Severe, watery, bad smelling, bloody, or hard-to-control diarrhea that starts after you begin taking an antibiotic means you must stop taking that antibiotic.

  Worst case antibiotic-related diarrhea can be caused by a particularly unpleasant bug called Clostridium Difficile (known as C. Diff among medical professionals) leading to a condition called pseudomembranous colitis, which can be life threatening. If this occurs, you must decide if the severity of the illness that called for the antibiotic is worth the risk of damaging the person’s intestinal tract and possibly killing him or her that way. Stopping the antibiotic is often the most prudent course. Always take probiotics, and fermented foods (yogurt, sauerkraut, etc), daily whenever using antibiotics.

  Allergies to antibiotics can be mild, appearing just as an itchy skin rash, or severe, such as difficulty breathing. Occasionally, a person’s mild rash allergy to an antibiotic they must have can be treated with Benadryl (diphenhydramine) – but more severe allergies indicate that the particular antibiotic should not be used at all. If a person is allergic to one antibiotic within a class, they should be considered allergic to that entire class -- so someone allergic to penicillin should not take amoxicillin either, both in the “cillin” class.

  Some women may develop a yeast infection after taking antibiotics. This is an overgrowth of candida albicans fungus in the vaginal area, and is characterized by a white chunky vaginal discharge that causes genital skin redness and an itching, or burning or irritated feeling. This isn’t contagious, but it can be uncomfortable. Diflucan 150mg, one time, is the pre-fan treatment of choice, although most yeast infections will go away if the person reduces sugars and starches in their diet and increases yogurt consumption. Douching with 20/80 white vinegar/clean water will sometimes resolve the problem.

  Antibiotic Classes

  There are eight basic classes of antibiotics appropriate for preparedness uses. There’s a few others that are intravenous only, or have such terrible side effects that their blood levels must be checked – we won’t consider those. Each class has uses that are distinctive, but overlapping with other classes. Ideally, you would have a general Big Picture of each class and its areas of treatment in your mind, when you begin to consider which one to use. Here are the classes, names, and uses on the following pages. Additional comments on each item are numbered on the right hand side and explained on the Notes pages.

  NOTES

  1) Children who have been treated repeatedly for ear infections or strep throat will do better with Cephalosporin or Azithromycin. Okay to use in pregnant or infants who are not allergic.

  2) If a person is allergic to cillins, there is a small risk of cross-sensitivity to cephalosporin. Monitor for allergic reactions!

  3) Not for infants less than 2 months old. Avoid in late pregnancy.

  4) Increasing bacterial resistance to Zithro, may require refill and longer dosing. If the person is not improving after 3 to 4 days, consider switching to another antibiotic class. Clindamycin should be saved for last resort as it has more severe side effects and has a history of leading to C. Diff. Macrolides can cause Q-T prolongation (changes in heart's ability to beat) and cause heart attacks (rare).

  5) Not recommended for children 8 and under due to possibility of staining of permanent teeth. However, in a lifesaving situation, dental staining should be considered of lesser priority than restoring health. Skin becomes very sensitive to sunlight and person can sunburn severely. Medicines in this class can become toxic over time. Avoid using if there are color or odor changes in the meds, or if exposed to moist or humid conditions.

  6) Rare side effect of tendon rupture - discontinue use if pains in heels or shoulders or elsewhere occur. Should not be used in those under 18 years old or over 60 years old, as risk of tendon rupture increases. In lifesaving circumstances, risk of tendon rupture may be outweighed by survival possibilities. Fluoroquinolones can cause Q-T prolongation (changes in heart's ability to beat) and cause heart attacks (rare).

  7) Not recommended for children or the first trimester of pregnancy. Azoles are specific for fungal and yeast infections

  8) Some women who experience bladder infections following sexual intercourse benefit by taking this routinely, 100 mg daily. Do not use in late pregnancy.

  How to Calculate Doses

  If you notice in the dosing calculations, adults are provided a routine dose (say, 500 mg twice daily). This dosing is actually based on the “average” adult weight of 150 lbs. For most people, even heavier people, this is still a suitable dose. For children or adults who weigh less than 100 pounds, however, the dose is lower and is based on weight. Typically, and unfortunately, the weight is stated in kg or kilograms.

  Step one: change weight from pounds to kilograms using this formula…

  Weight in pounds divided by 2.2 equals kilogram weight

  Example: 100 pound person divided by 2.2 equals 45.45 kilograms

  Written like this: 100 lb / 2.2 kg/lb = 45 kg

  Step two: multiply weight in kilograms times the dosage

  Example: Dose is 7 mg (milligram) per kg (kilogram)

  Child weighs 82 pounds.

  First, 82 lb / 2.2 kg/lb = 37 kg

  Then 37 (kg)x 7 (mg/kg) =259 mg of medication

  Round the dose to 260 or even 275 mg.

  Step three: Divide the dose as indicated, if needed.

  Example: Dose is 10 mg per kg, in two divided doses daily

  Child weighs 67 pounds

  First 67/2.2 = 30.45 kg

  Then 30.45 x 10 = 304.5 mg (round to 300)

  Then divide by 2: 300 mg/2 = 150 mg

  So this child receives 150 mg once in the morning and once in the evening, for the length of the treatment course.

  Storing Antibiotics

  Store all antibiotics in a cool, dry place out of sunlight or fluorescent light. It is not necessary to freeze these meds, and freezing may cause unexpected changes in the product, especially if there are variations in temperature as occurs in freezers that are opened often.

  Antibiotics in pill or tablet form are surprisingly stable over time. Recent government studies indicated that Cipro, for example, retained its bacteria killing ability 10 years past its expiration date! Medications in capsules are a little less stable. Penicillin in capsules will tend to become less potent, so you may need to increase the dose somewhat several years after expiration.

  One class of medication that is problematic, though, are the tetracyclines. They may become toxic over time. Tetracycline is a fine yellow powder. If an opened capsule shows color changes of any kind, or if the powder is clumpy or granular, discard that medication completely. Better not to use it than risk damaging your internal organs by using it.

  Group Supply

  Given a limited amount of space and money, plus the recognition that we may never need these medications, this quantity can be stored in several shoeboxes and covers the majority of common needs:

  Penicillin VK, 500 mg, 200 capsules. This is roughly 5 full treatment courses of 40 tablets (4 daily for 10 days).

  Amoxicillin, 500 mg, 500 capsules. 30 capsules is one treatment course (3 daily for 10 days), so this is about 16 courses.

  Cephalexin (Keflex) 500 mg, 500 capsules. At 30 capsules over 10 days, this is 16 courses.

  Cipro 500 mg, 1000+ tablets. Dosed at 20 tablets per treatment course, this is 50+ treatments.

  Levaquin 500 mg, 200 tablets. At 1 tablet daily for 10 days, this is 20 courses. Reserve Levaquin for more severe upper respiratory disorders, such as pneumonia.

  Bactrim DS 800-160mg, 200 tablets. 2 tablets daily for 7 days for bladder infections, provides 14 courses.

  Metronidazole 500 mg, 100 tablets. Dosing at 2 tablets daily for 7 days, this provides about 7 treatments

&nb
sp; Zithromycin 250 mg (as a Z-Pack of 6 tablets). Ten Z-Packs, providing 10 courses.

  Clindamycin 300 mg, 200 tablets. At 3 tablets daily for 10 days, this provides about 6 courses.

  In total, this is about 140 treatments for various ailments, which works out to roughly 10 treatments per person in a group of 14 individuals. Assuming that most of us are fairly healthy, and hoping that infections are caught and treated before they require antibiotics, there would probably be several year’s-worth of medications in this supply, enough to get through the initial difficult stages of the Cold Times. This assumes you are not treating or giving prophylactic treatment for anthrax, and only treating a possible Lyme’s disease once or twice.

  There are some new studies that indicate the full 10-day course is not necessary. The take-home point of one study was that a person should take antibiotics ‘until they feel better’, then hold off taking any more unless they relapse. If you follow this route, your group’s medications will probably last longer, since people often feel better after only two or three days of antibiotics.

  For children who do not or cannot take pills, you can crush tablets or open capsules and provide reduced doses based on their body weights. Crushed pills may be mixed into fruit, applesauce, chocolate syrup, flavored drinks, popsicles, peanut butter, or whatever it takes to get it down.