The Oil Drum

This does raise two important questions though:

1) Is the best strategy to avoid getting infected and needing antibiotics in the first place?

2) If so, what strategies does one employ to minimize one's risks of becoming infected?

I'd guess that most people would say that the answer to the first question is "yes". "An ounce of prevention is worth a pound of cure". If antibiotics become hugely expensive and rare, then an ounce of prevention might become worth a ton of cure.

So, that takes us to infection prevention strategies. I'm out of my league here, so I'll have to yield to others more knowledgeable than myself. I do tend to share cjwirth's scepticism toward the "sanitize everything" chemical warfare approach. It is almost certainly unsustainable, as antibacterial chemicals will become increasingly scarce and expensive along with everything else. Also, I believe that there is a school of thought to the effect that such an approach is actually counterproductive - that what we really need to do is to build up our natural resistance to germs that are ubiquitous in our environment, and that minimizing the exposure of our immune systems to these germs only causes the immune system to weaken.

There is also a school of thought that hospitals (and maybe medical care facilities generally) are actually iatrogenic - that they are breeding grounds for dangerous, antibiotic-resistant germs and pools of contagion. I am sure that any health care worker will confirm that extreme measures must be taken to prevent the health care workers themselves from becoming an unwitting vector for disease transmission; sometimes even those extreme measures are not enough.

Speaking of vectors, what can be worse than our modern system of transport, shuffling people, animals, foodstuffs, and other potential carriers of infection very quickly across the entire world?

Arguably, isolation and quarantine might remain the most effective and reliable tools to prevent the spread of infectious disease. That isn't something that most people want to hear, but it is true.

Given the above, might I suggest a few preliminary rules of thumb that might prove helpful for those that wish to minimize their risks of infection:

1) Stay put. The less travel one undertakes, the less likely one is to become exposed to an infectious agent not ubiquitous to one's local environment. Learn to be content with where you live, and arrange your affairs so you don't HAVE to travel.

2) Live in a small town or rural area. Large urban populations tend to be most susceptable to pandemics. Rub shoulders with fewer people and there is less chance of catching something from them. Small, isolated populations tend to eventually end up all sharing the same germ populations too, and build up natural immunity to those.

3) Avoid crowds. Don't attend mass spectator events, avoid shopping malls, etc. Try to establish oneself in a career where one works independently or in a small workplace instead of a large one.

4) Children are especially vulnerable to infectious diseases -- go to any cemetery more than 100 years old, and look for all the graves marked by very small headstones, or just rocks, it is a very sobering experience of the reality of childhood mortality due to infection. Many adults catch their illnesses from the kids that got them first. Large public schools are breeding grounds for infection. Transporting kids from a variety of distant neighborhoods and mixing them together only makes it that much worse. Home schooling or small neighborhood schools are preferable from an infection prevention perspective.

5) Try, if at all possible, to minimize the number of people that one must deal with personally - especially strangers and people from out of town. This presents a real challenge for people involved in sales and customer service; this might thus be another reason why, in a declining economy, these careers will literaly be "dying out". If you must interact with other people, try to keep your distance. Rural people are stereotyped and made fun of by city folks for standing far apart from other people and not facing them directly when speaking to them; there is actually unconscious, evolved folk wisdom in this practice - it reduces the risk of catching something from the person you are talking to.

6) WASH YOUR HANDS - FREQUENTLY! Fancy antibacterial soaps are not really necessary, plain soap and hot water will do if done frequently enough.

7) Try to be as healthy as possible. The stronger your general health, the better the human body is able to resist and to throw off infection. The Russians have a saying about the best friends of good health being fresh air, clean water and sunshine, and there is a lot of truth in that. One could add to that list: the consumption of a balanced and diverse diet of healthy (organic), whole foods in sufficient (but not excess) quantities; plenty of exercise and/or physical work, preferably outdoors; and a good night's sleep. Growing some of your own food is especially important; gardening in the local soil and eating what you grow will expose your body to the local population of germs and thus exercise and strengthen your immune system.

8) Avoid accidents & injuries. Anything which damages your body, even just a cut or a scrape, creates a potential opportunity for an infectious agent to gain a foothold. Equip yourself with the best possible safety equipment, exercise extreme caution in all that you do, and avoid undertaking any risky, hazardous activities unless absolutely necessary. Be equipped and prepared to administer effective first aid promptly for any type of injury that you do sustain.

9) Try to avoid the health care system, and especially hospitals, if possible. I say this not to demonize anyone in the health care system, but just to recognize the reality that one does risk exposing oneself to infection with each encounter with the health care system. Add to this the reality that a declining economy will be able to afford less health care, and it becomes obvious that we've all got to start now learning how to do with far less institutionalized health care than we've become accustomed to in the past. Learning to self-diagnose and self-treat is crucial; this won't eliminate 100% of your need for institutionalized health care, but it might cut it down substantially. If you must visit a health care facility, try to get an appointment for first thing in the morning - there will be fewer germs lingering in the air from other patients, and the health care workers will have interacted with fewer patients. Try to locate and utilize smaller facilities treating a smaller population of patients to further minimize your exposure. DO EVERYTHING YOU POSSIBLY CAN TO GET OUT OF THE HOSPITAL OR OTHER HEALTH CARE FACILITY AS QUICKLY AS YOU POSSIBLY CAN; the longer you stay there, the greater the risk of exposure. Advice #6 above becomes especially important - wash your hands extremely frequently while in the facility, and as soon as you have left. Also, NO VISITORS; I know this sounds like cruel advice, but why needlessly expose other people?

10) Be prepared to take more extreme measures during a pandemic. Have face masks stockpiled. Be prepared to seal oneself inside one's home and to have enough food, water, energy, medical supplies, and other essentials to ride it out for several weeks.

I am sure others can add to this list.