Surviving severe respiratory disease at home during a badly disruptive pandemic: my shopping list

So, one tries to remain calm and rational.  There are a thousand perspectives on COVID-19, the disease that's either close to or which may already have tipped over into global pandemic as I write this. (We have a Permies thread for discussing whether or not it’s pandemic yet.)

There are many perspectives; here’s mine.

One tries to remain calm and rational.  There are many things in the world we cannot control, and a small few that we can.  I have been focusing my attention on thinking about how the disease is most likely to affect my family, if at all.  And here's how I've reasoned it out.

In the fog of unknowns about COVID-19, a few notions seem to be coalescing into truth.  One, it spreads readily and is hard to control.  Two, for many people, it's just another cold/flu type experience, no big deal.  But for too many people (something like a fifth) it has devastating symptoms, usually respiratory, potentially fatal.  A consequence of that is that it puts a lot of people in the hospital.

Practical responses: turtle up, stay home, avoid exposure.  My family is lucky; we could go on total lockdown for a month or two and not be terribly uncomfortable.  That will be harder for most, impossible for many.  But in a global pandemic situation, there's no quick end to it.  Flu is globally pandemic and has been for at least a century.  

So, figure in a COVID-19 pandemic situation we can't count on avoiding exposure.  We try, but better have a backup plan.

If the pandemic stays below a certain "dull roar" level of infection, nothing changes.  A lot of public health measures, but if you get too sick you still go to the hospital.  And if not, you hunker down, manage your exposure as best you can, and life goes on.

One tries to remain calm and rational.  But if one thinks too long about the limits of our health care system and the complex global supply chain dependencies that support modern life, one begins to apprehend that above some hard-to-specify "dull roar" level, shit begins to crumble.  Store shelves don't get restocked reliably because too many people are sick, or because of too many disruptions to the transportation system, or because of economic impacts on production in source countries.  And, perhaps more importantly, if you're one of the unlucky fifth (or so) whose symptoms are life-threatening, you may not be able to go to the hospital anyway.  Because they'll be full, and/or operating at reduced efficiency.  

There's not a lot we can do as individuals to affect any of that.  Worst case scenario, you're very sick and you're stuck at home trying to live through a respiratory ailment that would be better treated in a hospital.  Now we have finally reached a place of traction for planning; a situation we can, to a limited extent, affect.  Care for the patients (each other) as best we can, treat the symptoms, and live or die as it may be.  

So, I have been thinking about that part of the scenario: we have sick people in the house, we can't go anywhere, and hospital is not an option.  What supplies will I want to have on hand that I won't be able to get, or that would put somebody at risk to go out into the world to obtain?

Food and beverage and daily necessities, obviously, but that's a general prepping question easily researched on a thousand other websites.  We've all done as much of that as we think important, or as we can afford.  This post is not about that stuff.  We do have a thread here on Permies that's all about growing food as a pandemic-disaster response strategy.  (I predict we will have a thread every year, going forward, about growing food in response to the whatever-is-current emergency.)  We've got another thread on herbal preparations and treatments to help treat this particular disease; there's much useful information in it.  You might want to stock up (beg, buy, forage, grow) various medicinally useful herbs.  I know I'm greatly expanding my mint plantings this spring, because it's so useful in maintaining respiratory and digestive function.  

But I'm thinking along much more basic lines than that.  When the going gets tough, the tough go shopping!  But I'm not made of money, and... say it with me... one tries to stay calm and rational.  Speaking only for myself, I think the chance of this disease becoming pandemic to the disruptive extent I've described is non-zero but not extremely large.  So I don't want to spend oodles on useless preps that make me feel silly later.  On the other hand, there's a fairly short list of items we'll want in quantity in that scenario that will be the first stuff gone from shelves.  You'll feel mighty smug then if you had the foresight to stock up.  Where's sweet spot?  What goes on the "calm, rational" shopping list?  This post is to lay out the items I've thought of (and, in most cases, bought) so far.

(Many of the things on this list are chock full of toxins, chemicals, and western-medicine hegemony.  There are LOTS AND LOTS of ways to replace or substitute most of these items with "better" approaches, from the Permies perspective.  I welcome discussion of those ways in this thread, if the herbal thread linked above isn't a better choice.  But in most cases, substitutes are more expensive or more laborious.  Supplies will be limited.  Your herbs may run out; you may be overwhelmed running a mini-hospital in your house for numerous sick relatives.  I tried to puzzle out dirt cheap essentials that you'd be glad to have stocked in bulk in scenarios like that.)

1 - Start with face masks.  Sorry, this may already be too late.  I had a bright idea back in January and bought two packages; I read elsewhere that they were all gone or on indefinite back order just a few days later.  This one is not a big deal; there's dispute about how much good they do.  At a minimum, they help remind you not to pick your nose before you wash your hands, while you're out on necessary errands.  Yes, you can improvise with simple cloth to achieve that benefit.  The fancier masks may do a bit more, reports are mixed.  Probably moot at this point anyway.

2 - Hand sanitizer and disinfectant for surfaces.  Alcohol works for this.  Big bottles of rubbing alcohol (isopropyl alcohol) are cheap.  But big jugs of alcohol-based gel sanitizer from your local big box store are also pretty cheap and maybe more convenient to use.  Huge spray cans of Lysol (already getting scarce in stores near me) may provide additional convenience, and work better on surfaces that would soak up too much liquid or gel (like the cardboard box that a coughing UPS driver finally left on your porch, ten days late, full of other essential stuff you ordered online).  For alcohol based products, you ideally want 75% alcohol or more in whatever you are using.  The chemical disinfectants in products like Lysol have their whole own sets of issues for us permies types, but you might be glad you had a can or two regardless.

3 -  Disposable tissues, perhaps the lotionated kind.  Yes, you can use handkerchiefs, formal or improvised.  But one person with a severe respiratory infection can create a lot of laundry.  If everybody in the house is sick, could be a problem.  A dozen (or three dozen) boxes of tissues could come in very handy.   If you stocked up on toilet paper as part of your general preps, this may be redundant.  But I really like the tissues that have a hint of lanolin in them, once my entire face has turned into a raw chapped surface of pain and anguish.  

4 - Medicated chest rub (think mentholated petroleum jelly, Vicks is the dominant USA brand.)  Has several powerful uses in treating symptoms of respiratory disease.  And there are lots of other ways to accomplish anything you can do with this.  But a four ounce tub is five bucks on Amazon and goes a LONG way.

5 - Mentholated cough drops, and soothing throat drops.  (Brands like Halls or Ludens, in the USA.)  Again, lots of home/herbal preparations that can replace these if you haven't got them or don't like the ingredients in them.  But they evaporate like snow under warm rain in our house, even during just a normal head cold or draining sinus infection episode.  To buy them in bulk, best deal I've found right now is large (140 count bags) of Equate brand drops at Walmart, for about $3.50 a bag.  Soothing throat drops (I especially like the citrus-flavored vitamin C drops) cost more, but Equate is still the best bargain out there that I know of.  These are all available in standard or sugarless formulations, but I find the sugar alcohols used in the sugarless ones (xylitol, sorbitol, and the like) can contribute to digestive distress if you eat "too many" -- meaning, as many as you need.

6 - Over the counter pain meds, for controlling pain, inflammation, and fever.  Aspirin, acetaminophen, and ibuprofen are the big three in our house.  We always have lots on hand.  But you can buy a thousand 200mg ibuprofen pills on Amazon for a dozen bucks.  Five hundred aspirin (Equate brand again) at Walmart for less than four dollars.  500 acetaminophen on Amazon for less than eight bucks.   Pick your poison, mix and match.  Different products have different terrifying toxicities, differing degrees of effectiveness versus pain or fever or inflammation, and different effects on every diverse human body out there.  Five hundred pills is a lot.  1,000 might be hoarding.  You doubtless have some of this stuff on hand.  But the easy no-brain solution is to get some of each.  They keep a long time and don't cost much and having enough to share with your neighbors might be no bad thing.

7 - Over the counter meds for fighting respiratory disease.  I only have a few on my list, being items that are cheap, generic, and have proven useful in fighting mundane head colds in my household.  I'm talking expectorants, decongestants, and cough suppressants.  See above comments about toxicities, side effects, and variable effects on diverse bodies.  Again, better to have than not have; you'll have plenty of time to research using them safely if you're on lock-in and lucky enough to still have working internet.  This list starts with guaifenesin, an expectorant.  It loosens and thins hardened mucous in your respiratory tract.  The cheap generic stuff works for four hours and costs about 13 bucks for 300 tablets on amazon.  Your patients could be using up to six a day for as long as they are ill; do the math.  It comes in more convenient extended-release preparations, but those are vastly more expensive.  "Guaf" is a little hard to find as a stand-alone medicine, which is how I prefer it; it's more often mixed with Dextromethorphan HBr, a cough suppressant.  I don't like dextromethorphan and generally don't like taking cough suppressants; suppressing the cough reflex can be dangerous or counterproductive.  But in severe respiratory disease, there comes a time when the act of coughing is actively dangerous; people have coughed so hard they break their own ribs, or lost the ability to get enough air.  Normally you'd be under medical attention and offered oxygen if you were that bad, but in our scenario, you may want/need a cough suppressant.  (All the truly effective ones are narcotic, so you probably won't have any in the USA.)  "Dextro" would be better than nothing.  The usual formulation with guaf and dextro in a common generic pill is usually cheap, but I'm not finding it cheaper than about $16 for a 200 count bottle.  Again, extended-release pills are available, but they are sold in much smaller numbers for very much more money.    You can get dextromethorphan by itself in its own pill if you look really hard on Amazon, but it's for some reason much more expensive than the combined preparation.  And finally, you may want a true decongestant in your goodie box.  The two over-the-counter types are pseudoephedrine  (also used by drugs cookers, so impossible to get in quantity in the USA) and phenylephrine, which costs as little as ten bucks for 225 pills.  Phenylephrine doesn't work very well for me and is notorious for increasing heart rates (possibly dangerous for some users) but it's another cheap tool that might save a life in a desperate struggle to breathe.  

8 -- Something to open an inflamed throat.  It's easy to get a secondary infection in your throat that makes it swell shut or just get so painful that you literally can't swallow water or pills.  I once sat for several hours holding water in my mouth, trying to summon the willpower to swallow against powerfully aversive pain spasms with every swallow.  There are many lozenges and other approaches  (gargling with this or that) but the one that works best for me is the orange-flavored chewable low-dose aspirin tablets.  These cost maybe a buck for thirty or so pills, and can help (some; not much, but better than nothing) with extreme throat pain and inflammation.  Or, sometimes, because they are acidic, they can be too painful to use.  It's a crap-shoot for me.  

That's my list so far: my "how not to die if stuck at home treating multiple patients with severe respiratory disease" wish list of cheap stuff I'd rather have than not have.  The deeper we get into true pandemic (if we do) the harder it will be to find these items.  If you have a bottomless supply of superior herbal alternatives, great!  But make sure you've done the math and considered how many people might need help, and how easy or hard it is to prepare and deploy the alternatives, possibly while even the most hale caregiver is also sick.  If mom makes all the tinctures and mom has been sick for three weeks, do you still have enough?

I am not a doctor and am advising NOBODY on medical issues.  In this post, I've just shared some personal experience and a lot of baseless speculation.  It's my hope -- if you've read this far -- that I might be helping to spark a few thoughts on how you and yours can survive and thrive during a pandemic respiratory disease situation.  I look forward to other people expanding on this list in the same spirit.  What kinds of cheap bulk supplies have you stowed away to help get your family through a serious bout of respiratory diseases?  What similar needs have I totally failed to anticipate?

Final note: One tries to remain calm and rational. One tries to remain calm and rational.  One tries to remain calm and rational.  What I tell you three times is true! (Or, at least, hopefully, soothing.)

In addition, if anyone has a good price on sambucol,  especially in bulk, I would love to hear about it. It's my go-to for all things viral.

Bravo Dan, to fail to prepare is to prepare to fail. You for one didn't fail to prepare.
I missed Chloroquine in your list. Apparently this anti-malaria drug helps pull people through the worst of fevers, buying time to recover.
Check it out.

Hugo Morvan wrote:Bravo Dan, to fail to prepare is to prepare to fail. You for one didn't fail to prepare.
I missed Chloroquine in your list. Apparently this anti-malaria drug helps pull people through the worst of fevers, buying time to recover.
Check it out.

Hugo, thank you!  

Good call on the Chloroquine -- to a point.  I notice Wikipedia currently says it's showing promise against the novel coronavirus in particular.  

However, even if I had known about it, it wouldn't have made the cut for this list.  You can't practically/easily/cheaply stock it up in the USA, where it requires a prescription and costs $5-6 per dose.  It's on the WHO list of essential medicines, and costs just pennies a dose, available over the counter (OTC) in most of the rest of the world.  So if I lived anywhere else, yeah, I'd have some on the list.  

Trace Oswald wrote: In addition, if anyone has a good price on sambucol,  especially in bulk, I would love to hear about it. It's my go-to for all things viral.

Had to Google this -- it turns out to be a registered trademark branded product containing elderberry, zinc, and hops.  "Homeopathic" on the box may mean that the active ingredients aren't present in substantial quantities; I didn't take my research far enough to determine that.  There's lots of discussion of those ingredients in the herbal treatment thread I linked.  Cheapest price I can see is about ten bucks for thirty pills, which isn't cheap enough for my "stock up in bulk without spending much" list.  I believe I would look at alternative sources for these active ingredients.  I, too, would be interested in a good cheap bulk source of elderberry anything.  

Dan Boone wrote:

Trace Oswald wrote: In addition, if anyone has a good price on sambucol,  especially in bulk, I would love to hear about it. It's my go-to for all things viral.

Had to Google this -- it turns out to be a registered trademark branded product containing elderberry, zinc, and hops.  "Homeopathic" on the box may mean that the active ingredients aren't present in substantial quantities; I didn't take my research far enough to determine that.  There's lots of discussion of those ingredients in the herbal treatment thread I linked.  Cheapest price I can see is about ten bucks for thirty pills, which isn't cheap enough for my "stock up in bulk without spending much" list.  I believe I would look at alternative sources for these active ingredients.  I, too, would be interested in a good cheap bulk source of elderberry anything.  

I think we are talking about 2 different products possibly. Sambucol is just elderberry extract, no zinc or hops. I've never seen homeopathic on the box, but maybe the pills are different. I only use the liquid.

Hugo Morvan wrote:Bravo Dan, to fail to prepare is to prepare to fail. You for one didn't fail to prepare.
I missed Chloroquine in your list. Apparently this anti-malaria drug helps pull people through the worst of fevers, buying time to recover.
Check it out.

Hugo - do you have a source for dosage/instructions? I happen to have a bunch of hydroxychloroquine (100 + tabs) in my medicine cabinet prescribed for something else. I stopped taking them after a few years, because they caused bad stomach upset, but I know the malaria dose is far lower than the dose I was taking. I wouldn't start taking them unless I became really worried, but it's nice to know.

Dan - Great list. The chloroquine prices you list are ridiculous (yes, I believe you, but they are still crazy). The newer form, hydroxychlorquine is prescription here in Canada, but less than $2, possibly less than $1 a tablet if I recall correctly, and available in various generics.

A  disinfectant could be hydrogen peroxide to clean doorknobs and such this is not a manufacturing and disposal problem like chlorine.  A quart of hydrogen peroxide is $1 or less ( dollar store, walmart0

They make natural hand sanitzing sprays that are basically rubbing alcohol and essential oils, you could make this.  

I usually use bar soap tht I make to wash hands.  It may be more sanitary for this to have a pump type hand washing soap, could be Dr Bronners, etc... next to the sink .  That way you could use hydrogen peroxide to sterilize the pump and water faucet routinely.

It may be a good idea to have alot of cloths, old towels ripped in half or what have you to not have the same hand towel.  Could be you would want to not use the hand towel again that you used for washing hands when you get home ntil it has been washed.  Might be best to wash in realy hot water or boil, or leave out in the sun after washing in cold water to kill germs on these hand towels, we will be using more hand towels

Good discussion!  I've battled seasonal sinus infections all my life.  Besides eating local honey, I finally discovered that aggressively drying out the membranes cut off the infection phase.  Less moisture, less bacterial overgrowth, much shorter misery.  So antihistamine is my key medicine.  I've found that the green and red gelcaps at the dollar stores work the best for me.

After reading about the influenza pandemic of 1917, I began keeping a large supply on hand.  The quick rate of fluid build-up in the lungs was quite remarkable.  My reasoning extended my theory - keep it dry!

I have made two lifestyle changes in response to covid-19.

We don't yet know how closely Covid-19 mimics the life-cycle and biochemistry of the common flu.   Vitamin D has a strong protective effect against being infected by the common flu. Perhaps it is similarly effective against Covid-19. My current strategy -- in addition to getting sunlight whenever it is available, over as much of my body as possible, to make my own vitamin D --  is to supplement with vitamin D.

In addition, due to my general deficiency of Zinc, and it's reputation for reducing the duration of respiratory illnesses, I am supplementing with zinc.

At some point, I may apply strong peer pressure to my friends and family to do likewise.

If/when the virus enters my local community, I will endeavor to get plenty of sleep, which seems to be strongly protective against infections.

Joseph Lofthouse wrote:My current strategy -- in addition to getting sunlight whenever it is available, over as much of my body as possible, to make my own vitamin D --  is to supplement with vitamin D.

In addition, due to my general deficiency of Zinc, and it's reputation for reducing the duration of respiratory illnesses, I am supplementing with zinc.

I like both of those suggestions -- thanks!  

These supplements are a bit of a mess on Amazon, so I'm gonna have to do a bit more research before settling on products to buy.  But after a bit of Googling, I'm sold in principle.  

Staying hydrated is something most people don't think about beyond drinking more water. Dehydration is a real threat from the flu.  Keeping enough salts in your system to retain the water in your system can be difficult with any flu.  I would add your preferred electrolyte to your list of things to keep on hand.  I use Lyteshow drops because they are easy to add to a drink and they don't have any forms of sugars or artificial sweeteners in them.  

I also keep the ingredients for a Hot Toddy on hand for when you have that sore throat that hurts to breath or drink.

A Hot Toddy with some cloves steeped in will sooth and numb my throat just long enough for me to fall asleep.   It can be made with or without the whiskey. I don't normally drink so that whiskey is enough to help put me to sleep.  

1½ ounce brown liquor such as brandy, whiskey or rum
1 tablespoon honey
½ ounce lemon juice
1 cup hot water
3 whole cloves

A lot of excellent advice. Thanks for starting this thread, Dan. The subject has certainly been on our minds a lot the past couple of weeks and like many of these slow-motion train wrecks, we have no idea how it will play out.

I'd add one caveat to the list of medications: Aspirin is often best avoided when the underlying condition is a viral infection in kids (including teenagers) because of the chance of Reye's Syndrome. Other pain relievers are probably better options in this case. At least there are lots of decent choices.

Dan,

I have only one major disagreement.  500 to 1000 pills is not hoarding, it is economical and sensible.

I always believe in buying in bulk to save money.

If you have a family, it can be surprising how far 500 pills won’t go.  Also, as the supply gets low, I always start to conserve, which means I need a new supply before the old one is exhausted.

Buy in Bulk!

Eric

Kate Muller wrote:I also keep the ingredients for a Hot Toddy on hand for when you have that sore throat that hurts to breath or drink.

A Hot Toddy with some cloves steeped in will sooth and numb my throat just long enough for me to fall asleep.   It can be made with or without the whiskey. I don't normally drink so that whiskey is enough to help put me to sleep.  

1½ ounce brown liquor such as brandy, whiskey or rum
1 tablespoon honey
½ ounce lemon juice
1 cup hot water
3 whole cloves

This is not far off my go-to "sick" beverage.  I like the idea of cloves but I've typically used cinnamon (not as soothing/numbing) so I want to try it with clove.  I put the liquor in  hot herbal tea (usually mint and chamomile) with honey and any citrus juice that I have.  Fresh ginger goes in there too if I have any.

Phil Stevens wrote:A lot of excellent advice. Thanks for starting this thread, Dan. The subject has certainly been on our minds a lot the past couple of weeks and like many of these slow-motion train wrecks, we have no idea how it will play out.

I'd add one caveat to the list of medications: Aspirin is often best avoided when the underlying condition is a viral infection in kids (including teenagers) because of the chance of Reye's Syndrome. Other pain relievers are probably better options in this case. At least there are lots of decent choices.

You're welcome, Phil!  The warning about aspirin is worth me quoting it just to repeat it.  I meant to mention it in the original post, but it was long and not everything I wanted to say made it in.  I hope everybody who is in a position to give meds to kids already knows it... but what I hope and what is true are not always the same.

Eric Hanson wrote:Dan,

I have only one major disagreement.  500 to 1000 pills is not hoarding, it is economical and sensible.

I always believe in buying in bulk to save money.

If you have a family, it can be surprising how far 500 pills won’t go.  Also, as the supply gets low, I always start to conserve, which means I need a new supply before the old one is exhausted.

Buy in Bulk!

Ha, our disagreement isn't so very major.  I don't have a large immediate family, but the extended family living nearby is large, and as far as I know none of them are taking any precautions yet (or, probably, before it's too late to buy anything cheaply in bulk).  So I'm doing a "what's the most I could need" calculation, doubling it for safety because sometimes the world throws something at us that's far worse than we imagined, and then start throwing in a fudge factor large enough that in extremis, I can say "sure, give a couple hundred pills to your cousin, we've got lots" instead of having to start doing grim counts and calculations.  

Really I only mentioned hoarding as a gentle reminder that folks not go overboard.  I'm not gonna try to tell anybody what "overboard" should mean to them, but I did think it was worth slipping in one subtle hint that "overboard" is a possibility.

Catie, i don't know how much Chloroquine you must take.  

Great thread, and very similar to my thought process this morning about what I can do to prepare.

We tend to not find the cough drops (or when I do, someone eats them all like candy) so we tend to do a lot of steam inhalation with eucalyptus oil (the old bowl-of-hot-water-and-towel-over-your-head trick). Also our go-to sick drink is ginger tea, maybe with some honey and lemon if your throat is bothering you.

I second Joseph’s mention of vitamin D.  We started taking it maybe twelve years ago as part of my on-going efforts to find things other than prescription drugs that will help my youngest daughter, who is autistic and has lupus.  It does help her quite a bit.  But after our first year taking it, I realized that I hadn’t had my annual ‘flu that almost put me in the hospital.’  I used to get that every single winter, but have not gotten it, or it’s been extremely mild, since we started taking vitamin D.  I don’t know for sure that it will be helpful against this virus, but noticed it was also being recommended by the CDC.  

Dan Boone wrote:So, one tries to remain calm and rational.  There are a thousand perspectives on COVID-19, the disease that's either close to or which may already have tipped over into global pandemic as I write this. (We have a Permies thread for discussing whether or not it’s pandemic yet.)

There are many perspectives; here’s mine.

One tries to remain calm and rational.  There are many things in the world we cannot control, and a small few that we can.  I have been focusing my attention on thinking about how the disease is most likely to affect my family, if at all.  And here's how I've reasoned it out.

In the fog of unknowns about COVID-19, a few notions seem to be coalescing into truth.  One, it spreads readily and is hard to control.  Two, for many people, it's just another cold/flu type experience, no big deal.  But for too many people (something like a fifth) it has devastating symptoms, usually respiratory, potentially fatal.  A consequence of that is that it puts a lot of people in the hospital.

Practical responses: turtle up, stay home, avoid exposure.  My family is lucky; we could go on total lockdown for a month or two and not be terribly uncomfortable.  That will be harder for most, impossible for many.  But in a global pandemic situation, there's no quick end to it.  Flu is globally pandemic and has been for at least a century.  

So, figure in a COVID-19 pandemic situation we can't count on avoiding exposure.  We try, but better have a backup plan.

If the pandemic stays below a certain "dull roar" level of infection, nothing changes.  A lot of public health measures, but if you get too sick you still go to the hospital.  And if not, you hunker down, manage your exposure as best you can, and life goes on.

One tries to remain calm and rational.  But if one thinks too long about the limits of our health care system and the complex global supply chain dependencies that support modern life, one begins to apprehend that above some hard-to-specify "dull roar" level, shit begins to crumble.  Store shelves don't get restocked reliably because too many people are sick, or because of too many disruptions to the transportation system, or because of economic impacts on production in source countries.  And, perhaps more importantly, if you're one of the unlucky fifth (or so) whose symptoms are life-threatening, you may not be able to go to the hospital anyway.  Because they'll be full, and/or operating at reduced efficiency.  

There's not a lot we can do as individuals to affect any of that.  Worst case scenario, you're very sick and you're stuck at home trying to live through a respiratory ailment that would be better treated in a hospital.  Now we have finally reached a place of traction for planning; a situation we can, to a limited extent, affect.  Care for the patients (each other) as best we can, treat the symptoms, and live or die as it may be.  

So, I have been thinking about that part of the scenario: we have sick people in the house, we can't go anywhere, and hospital is not an option.  What supplies will I want to have on hand that I won't be able to get, or that would put somebody at risk to go out into the world to obtain?

Food and beverage and daily necessities, obviously, but that's a general prepping question easily researched on a thousand other websites.  We've all done as much of that as we think important, or as we can afford.  This post is not about that stuff.  We do have a thread here on Permies that's all about growing food as a pandemic-disaster response strategy.  (I predict we will have a thread every year, going forward, about growing food in response to the whatever-is-current emergency.)  We've got another thread on herbal preparations and treatments to help treat this particular disease; there's much useful information in it.  You might want to stock up (beg, buy, forage, grow) various medicinally useful herbs.  I know I'm greatly expanding my mint plantings this spring, because it's so useful in maintaining respiratory and digestive function.  

But I'm thinking along much more basic lines than that.  When the going gets tough, the tough go shopping!  But I'm not made of money, and... say it with me... one tries to stay calm and rational.  Speaking only for myself, I think the chance of this disease becoming pandemic to the disruptive extent I've described is non-zero but not extremely large.  So I don't want to spend oodles on useless preps that make me feel silly later.  On the other hand, there's a fairly short list of items we'll want in quantity in that scenario that will be the first stuff gone from shelves.  You'll feel mighty smug then if you had the foresight to stock up.  Where's sweet spot?  What goes on the "calm, rational" shopping list?  This post is to lay out the items I've thought of (and, in most cases, bought) so far.

(Many of the things on this list are chock full of toxins, chemicals, and western-medicine hegemony.  There are LOTS AND LOTS of ways to replace or substitute most of these items with "better" approaches, from the Permies perspective.  I welcome discussion of those ways in this thread, if the herbal thread linked above isn't a better choice.  But in most cases, substitutes are more expensive or more laborious.  Supplies will be limited.  Your herbs may run out; you may be overwhelmed running a mini-hospital in your house for numerous sick relatives.  I tried to puzzle out dirt cheap essentials that you'd be glad to have stocked in bulk in scenarios like that.)

1 - Start with face masks.  Sorry, this may already be too late.  I had a bright idea back in January and bought two packages; I read elsewhere that they were all gone or on indefinite back order just a few days later.  This one is not a big deal; there's dispute about how much good they do.  At a minimum, they help remind you not to pick your nose before you wash your hands, while you're out on necessary errands.  Yes, you can improvise with simple cloth to achieve that benefit.  The fancier masks may do a bit more, reports are mixed.  Probably moot at this point anyway.

2 - Hand sanitizer and disinfectant for surfaces.  Alcohol works for this.  Big bottles of rubbing alcohol (isopropyl alcohol) are cheap.  But big jugs of alcohol-based gel sanitizer from your local big box store are also pretty cheap and maybe more convenient to use.  Huge spray cans of Lysol (already getting scarce in stores near me) may provide additional convenience, and work better on surfaces that would soak up too much liquid or gel (like the cardboard box that a coughing UPS driver finally left on your porch, ten days late, full of other essential stuff you ordered online).  For alcohol based products, you ideally want 75% alcohol or more in whatever you are using.  The chemical disinfectants in products like Lysol have their whole own sets of issues for us permies types, but you might be glad you had a can or two regardless.

3 -  Disposable tissues, perhaps the lotionated kind.  Yes, you can use handkerchiefs, formal or improvised.  But one person with a severe respiratory infection can create a lot of laundry.  If everybody in the house is sick, could be a problem.  A dozen (or three dozen) boxes of tissues could come in very handy.   If you stocked up on toilet paper as part of your general preps, this may be redundant.  But I really like the tissues that have a hint of lanolin in them, once my entire face has turned into a raw chapped surface of pain and anguish.  

4 - Medicated chest rub (think mentholated petroleum jelly, Vicks is the dominant USA brand.)  Has several powerful uses in treating symptoms of respiratory disease.  And there are lots of other ways to accomplish anything you can do with this.  But a four ounce tub is five bucks on Amazon and goes a LONG way.

5 - Mentholated cough drops, and soothing throat drops.  (Brands like Halls or Ludens, in the USA.)  Again, lots of home/herbal preparations that can replace these if you haven't got them or don't like the ingredients in them.  But they evaporate like snow under warm rain in our house, even during just a normal head cold or draining sinus infection episode.  To buy them in bulk, best deal I've found right now is large (140 count bags) of Equate brand drops at Walmart, for about $3.50 a bag.  Soothing throat drops (I especially like the citrus-flavored vitamin C drops) cost more, but Equate is still the best bargain out there that I know of.  These are all available in standard or sugarless formulations, but I find the sugar alcohols used in the sugarless ones (xylitol, sorbitol, and the like) can contribute to digestive distress if you eat "too many" -- meaning, as many as you need.

6 - Over the counter pain meds, for controlling pain, inflammation, and fever.  Aspirin, acetaminophen, and ibuprofen are the big three in our house.  We always have lots on hand.  But you can buy a thousand 200mg ibuprofen pills on Amazon for a dozen bucks.  Five hundred aspirin (Equate brand again) at Walmart for less than four dollars.  500 acetaminophen on Amazon for less than eight bucks.   Pick your poison, mix and match.  Different products have different terrifying toxicities, differing degrees of effectiveness versus pain or fever or inflammation, and different effects on every diverse human body out there.  Five hundred pills is a lot.  1,000 might be hoarding.  You doubtless have some of this stuff on hand.  But the easy no-brain solution is to get some of each.  They keep a long time and don't cost much and having enough to share with your neighbors might be no bad thing.

7 - Over the counter meds for fighting respiratory disease.  I only have a few on my list, being items that are cheap, generic, and have proven useful in fighting mundane head colds in my household.  I'm talking expectorants, decongestants, and cough suppressants.  See above comments about toxicities, side effects, and variable effects on diverse bodies.  Again, better to have than not have; you'll have plenty of time to research using them safely if you're on lock-in and lucky enough to still have working internet.  This list starts with guaifenesin, an expectorant.  It loosens and thins hardened mucous in your respiratory tract.  The cheap generic stuff works for four hours and costs about 13 bucks for 300 tablets on amazon.  Your patients could be using up to six a day for as long as they are ill; do the math.  It comes in more convenient extended-release preparations, but those are vastly more expensive.  "Guaf" is a little hard to find as a stand-alone medicine, which is how I prefer it; it's more often mixed with Dextromethorphan HBr, a cough suppressant.  I don't like dextromethorphan and generally don't like taking cough suppressants; suppressing the cough reflex can be dangerous or counterproductive.  But in severe respiratory disease, there comes a time when the act of coughing is actively dangerous; people have coughed so hard they break their own ribs, or lost the ability to get enough air.  Normally you'd be under medical attention and offered oxygen if you were that bad, but in our scenario, you may want/need a cough suppressant.  (All the truly effective ones are narcotic, so you probably won't have any in the USA.)  "Dextro" would be better than nothing.  The usual formulation with guaf and dextro in a common generic pill is usually cheap, but I'm not finding it cheaper than about $16 for a 200 count bottle.  Again, extended-release pills are available, but they are sold in much smaller numbers for very much more money.    You can get dextromethorphan by itself in its own pill if you look really hard on Amazon, but it's for some reason much more expensive than the combined preparation.  And finally, you may want a true decongestant in your goodie box.  The two over-the-counter types are pseudoephedrine  (also used by drugs cookers, so impossible to get in quantity in the USA) and phenylephrine, which costs as little as ten bucks for 225 pills.  Phenylephrine doesn't work very well for me and is notorious for increasing heart rates (possibly dangerous for some users) but it's another cheap tool that might save a life in a desperate struggle to breathe.  

8 -- Something to open an inflamed throat.  It's easy to get a secondary infection in your throat that makes it swell shut or just get so painful that you literally can't swallow water or pills.  I once sat for several hours holding water in my mouth, trying to summon the willpower to swallow against powerfully aversive pain spasms with every swallow.  There are many lozenges and other approaches  (gargling with this or that) but the one that works best for me is the orange-flavored chewable low-dose aspirin tablets.  These cost maybe a buck for thirty or so pills, and can help (some; not much, but better than nothing) with extreme throat pain and inflammation.  Or, sometimes, because they are acidic, they can be too painful to use.  It's a crap-shoot for me.  

That's my list so far: my "how not to die if stuck at home treating multiple patients with severe respiratory disease" wish list of cheap stuff I'd rather have than not have.  The deeper we get into true pandemic (if we do) the harder it will be to find these items.  If you have a bottomless supply of superior herbal alternatives, great!  But make sure you've done the math and considered how many people might need help, and how easy or hard it is to prepare and deploy the alternatives, possibly while even the most hale caregiver is also sick.  If mom makes all the tinctures and mom has been sick for three weeks, do you still have enough?

I am not a doctor and am advising NOBODY on medical issues.  In this post, I've just shared some personal experience and a lot of baseless speculation.  It's my hope -- if you've read this far -- that I might be helping to spark a few thoughts on how you and yours can survive and thrive during a pandemic respiratory disease situation.  I look forward to other people expanding on this list in the same spirit.  What kinds of cheap bulk supplies have you stowed away to help get your family through a serious bout of respiratory diseases?  What similar needs have I totally failed to anticipate?

Final note: One tries to remain calm and rational. One tries to remain calm and rational.  One tries to remain calm and rational.  What I tell you three times is true! (Or, at least, hopefully, soothing.)

Hi Dan, I noticed that you listed sanitizer, but not soap. perhaps because you already have it on hand. However, I though it worthwhile to mention soap as (per my understanding) the molecular structure of Covid-19 is at one end hydrophilic and at its opposite end hydrophobic, so the friction of rubbing your hands together with soap is actually a lot more effective at braking the virus apart than say, alcohol, which can dry too quickly to be effective. Alcohol (type sanitizer) still works but you must use enough to cover your entire hands and rub together for at least 20 seconds.

Vanessa Alarcon wrote:
Hi Dan, I noticed that you listed sanitizer, but not soap. perhaps because you already have it on hand. However, I though it worthwhile to mention soap as (per my understanding) the molecular structure of Covid-19 is at one end hydrophilic and at its opposite end hydrophobic, so the friction of rubbing your hands together with soap is actually a lot more effective at braking the virus apart than say, alcohol, which can dry too quickly to be effective. Alcohol (type sanitizer) still works but you must use enough to cover your entire hands and rub together for at least 20 seconds.

Hey, Vanessa.  This is exactly right.  In my mind, hand sanitizer was included on my list for use when soap-and-water washing is not an option or very inconvenient -- the hand cleaning you will do is always better than the better hand cleaning that doesn't happen because it's a pain in the ass.  

That said, looking at my original post I really failed to make that clear.  I was writing about a fairly extreme "stay home and go nowhere" scenario -- which is a circumstance where water and soap should always be reasonably easy.  I think I included hand sanitizer because I expected what is currently happening -- a fairly lengthy period when people are in fact going out to do essential errands, even if staying home would be more prudent.  And that situation -- when you're out and about -- that the sanitizer is kind of essential.

I also find myself in the situation of sharing my stash of hand sanitizer with extended family elements who are not yet convinced they need to stop going out, but who will use sanitizer if they have it -- which they do not.  I didn't expect that.  These things never go quite how you imagine they will.  The trickiest element of stocking up sensibly involves brainstorming about what might be useful in contingencies you cannot imagine yet.

In truth I should have mentioned hand soap.  As you speculated, we did/do have quite a bit on hand; this is the kind of household where spare bars are sitting in baskets in various bathrooms and there's at least a bit of backstock under the bathroom counter.  But once the reality of extensive frequent thorough hand-washing began to hit home, we took account and found ourselves unsatisfied with the inventory on hand.  Our preferred brand being already out of stock in local stores, we ordered a brick of new bars via Amazon Prime.  They did come, but slowly; and the specific item/packaging we ordered is now out of stock indefinitely.