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In This Issue
What Is Pandemic Flu?
What's Being Done Now?
What Can Be Done Medically?
What Can Faith Communities Do?
Additional Resources
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Greetings!
 
Our hearts are heavy with the news of deaths and other hard-ships caused by H1N1 (Swine) Flu in communities within our state and around our world. Our prayers are with those grieving, those caring for the ill, and those community leaders making difficult decisions in order to protect the entire community.
 
The World Health Organization officially declared pandemic on June 9, 2009. There is no more "if" or "when." We are in Category I of a possible Category V just like the identification of hurricanes. Cat V would consist of virulent virus, many more deaths, and scarcity of medical resources. We pray that this pandemic will stay at Cat I.
 
The most important thing a faith community can do is to think about and discuss the possible impacts pandemic flu could have on them, and develop policies and procedures to respond. This can begin with leaders in the community developing policies that affect everyone. It should also include discussions within congregations about actions they should take as a group.
 
The S.C. Pandemic Influenza Ethics Task Force, a coalition of state/public agencies, healthcare providers, community partners (including religious leaders), universities and legal professionals formed in October 2008, has been working to identify and address these difficult issues. Their report, "South Carolina Prepares for Pandemic Influenza: An Ethical Perspective," can be viewed at http://www.scdhec.gov/administration/ophp/pandemic-ethics.htm.
 
The following information and ideas are suggested for consideration by faith communities. Distribution to congregational members of this information, tailored to meet specific needs of the community, can be used to proactively prepare to minimize the transition of the influenza (passing it from person to person), assist in the spiritual and physical care of the congregation and the community in which it lives, and prepare the organization for surviving should dire situations arise.
 
Your South Carolina Christian Action Council shares this information as a member of the larger community with responsibility as Christian brothers and sisters to love all our neighbors even in a pandemic.
What Is Pandemic Flu?

Influenza (or the "flu") is an infection that is usually caused by a virus, not by bacteria.  A virus can be spread from person to person by touch (such as handshakes or touching a doorknob recently touched by someone else) or breathing in the air that has the virus in it (such as after an infected person coughs or sneezes).  The virus is NOT spread by eating certain foods.  After being infected, the symptoms of flu include high fever, chills, muscle aches, joint pain, nausea, vomiting, diarrhea, cough and trouble breathing.  Some viruses are so strong, they can overcome the body's defenses and a person can die.  When an infection attacks many people in a region at the same time and spreads rapidly, it is called an "epidemic".  If it spreads to affect almost everyone, it is called a "pandemic".
Is Anything Being Done to Prepare for a  Pandemic Now?
 
As the world enters its first pandemic in 41 years, difficult decisions about medical care, medical resources and personnel may have to be made.  It is important that citizens, businesses and healthcare providers understand the types of decisions that may need to be made and actions that may need to be taken. 
 
The S.C. Pandemic Influenza Ethics Task Force, a coalition of state/public agencies, healthcare providers, community partners (including the faith community), universities and legal professionals formed in October 2008, has been working to identify and address these difficult issues. 
 
Their report, "South Carolina Prepares for Pandemic Influenza: An Ethical Perspective," includes recommendations in the event that difficult choices must be made. The report is available to help the public understand the decision making process. To read the report go to:  

What Can Be Done Medically for Pandemic Flu?

Medical treatment can be divided into three categories: Preventive, supportive and comfort care.
 
Preventive care is designed to protect a person from getting the flu.  Vaccines (the "flu shots") provide protection against particular kinds of flu, and there are a number of different types.  The yearly "flu shot" makes a good guess at the type of flu that will appear that year...but might not be right.  Vaccines for "seasonal flu" are made available, but a special vaccine for a particular flu virus may also be necessary if a new type is spreading.  This year (2009) seasonal flu shots are already available, and a special vaccine for swine flu (H1N1) will be available soon.  Similarly, medications like Tamiflu taken daily can protect a person...but not all types of flu are blocked by Tamiflu.  In a pandemic both vaccines and antiviral medicines may be in short supply.  Public health officials, with advice from the medical community, may have to limit these treatments according to individuals who should be given priority according to their roles in providing healthcare or their disease status.
 
Supportive care is treatment given to a person who has been infected with the flu.  Mild cases may be better taken care of at home with instructions on how to treat the symptoms.  If caught soon enough, medications like Tamiflu can suppress some flu viruses.  Depending on how severely the flu has affected a person, intra-venous fluids, antibiotics for secondary infections, and medications for symptoms like fever, pain, nausea, vomiting and diarrhea can be used. Many people with pandemic flu will have such trouble breathing they will need the help of a mechanical ventilator (respirator).  Unfortunately, pandemic flu may spread so quickly that there may not be enough respirators for everyone who needs one.  Doctors who specialize in emergency medicine, infectious diseases and intensive care have studied this situation and made rules about who could be on a respirator based on the person's chance of surviving the severity of infection they have.  Again, these rules will be applied equally to everyone.
 
Comfort care (sometimes called Palliative Care) is used when preventive or supportive care is medically ineffective.  Comfort care focuses on relieving pain and suffering while respecting a person's dignity.  An important part of comfort care is the support of loved ones and spiritual support in the face of death and dying.

What Can Faith-based Communities Do Now?

The most important thing a faith-based community can do is to think about and discuss the possible impacts pandemic flu could have on them, and develop policies and procedures to respond. This can begin with leaders in the community developing policies that affect everyone.  It should also include discussions within congregations about actions they should take as a group. 
 
Group Services:
1. Large group meetings or religious services may be suspended for six to eight weeks. This suspension could occur up to three times over a twelve month period. Can other modalities (i.e., television, radio, internet) be used instead?
2. Physical contact such as hand shaking, hugging, etc. should be limited.
3. Masks and hand sanitizing equipment may need to be provided. Sneeze and cough precautions should be taught.
 
Financial Impact:
1. If group services are suspended, what will that mean for revenue collections?
2. If protective equipment is to be provided, how will it be funded?
3. If support systems (use of a church building to house and feed flu victims or displaced community members) are to be provided, how will they be funded?
 
Community Contact:
1. How will the community assure itself that all members have been contacted regularly? The use of phone trees can be especially important but require a coordinated effort.
2. Faith-based communities may provide a trusted source of accurate information on how to respond to symptoms and situations...whether to contact a personal physician, go to the emergency department, or watch for further symptoms.
3. Communication between faith-based communities can reassure that justice and fairness prevail. Mutual support and shared resources can also develop.
 
Spiritual Support:
What can be done for individuals, families, small groups and the whole faith-based community?

Counseling:
- Grief support, anxiety and anger management.
- Clergy should collaborate with mental health professionals. For some this will mean enlarging their network, for others this will mean saying "Hello, can we work together?" for the first time. Clergy without M.Div. (or equivalent education) and pastoral fellowship certification should refer to a pastoral counselor, LMSW (licensed master of social work), psychologist or psychiatrist when prayer and listening are not effective.
 
Outreach:
Contact and support of quarantined individuals/families, transportation to healthcare centers, feeding those who cannot feed themselves. 
 
Questions to ask: 
1. Are there parish nurses in the faith-based community, and what role would they take? Options could include: Reinforce the public health messages (such as routine precautions the public should take to prevent transmission of the virus; the symptoms that indicate the need for an emergency department visit versus a call to the family physician's office, versus home treatment; and over-the-counter medications that may be used).

2. Are there healthcare professionals in the faith-based community who would act as resources or volunteers during a pandemic influenza crisis? What role would they take?
 
3. Are there lay volunteers that would be willing to assist, and in what capacity?
 
4. Are there volunteers who would offer temporary housing for the sick?
 
5. If schools or services are suspended, are there volunteers to help with childcare?
 
6. If parents become ill, are there volunteers who would care for the well children of working parents?
 
7. Are there volunteers to provide ad hoc services such as preparing meals and taking meals to the sick? If the local "meals on wheels" program is suspended, are there volunteers who would identify these people and make arrangements for their meals?

8. Is there a phone tree or email list serve which acts as a 'hot line', how is it activated, and what is its purpose?
 
9. Is there redundancy in the role of volunteer leaders and volunteer workers in case critical volunteers cannot perform due to their own illness or that of their families?
 
10. What other ways can the faith-based community assist their larger community?
 
11. Has a dialogue been initiated regarding preventive health measures, such as:
- Suspension of shaking hands/hugging during worship services,
- Utilization of webinars instead of in-person services or meetings,
- Hand hygiene informational signs and strategic placement of alcohol-based hand sanitizers,
- Cough etiquette information distribution.
- Provide a list of resources
 
These ideas are suggestions for faith-based communities to consider. Distribution to the congregation of information, tailored to meet the specific needs of the community, can be used as a way to proactively set up a system that will minimize transition (passing the flu from person to person) of the influenza virus and assist in the physical and spiritual care of the congregation.

Additional Resources Available

- "A Guide to H1N1 for Community and Faith-based Organizations": http://ww.flu.gov/professional/community/cfboguidance.html
 
- A SC speakers bureau and medical services volunteer websites-SC Statewide Emergency Registry of Volunteers: https://www.scserv.gov/ 
 
- Swine Flu Prevention and Education: http://www.muschealth.com/swineflu
The Reverend Brenda Lynn Kneece
Executive Minister 
South Carolina Christian Action Council
PO Box 3248, Columbia, SC 29209  
Office: 4209 N Main St, Columbia, SC
803-786-7115