Patient Rights and Emergency Procedures

Hypatia

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In my novel, an epidemic has killed about 200 million worldwide over the past five years. A handful of government agents knows that some of the survivors have psi powers. They want to create a database of survivors. Would they face trouble with patient's privacy laws?

Also, in the event that several hundred people suddenly died in one area, what would be emergency procedures? National guard called in, bodybags? They would want to do autopsies, but there wouldn't be near enough room in local morgues to preserve the bodies.
 

mirandashell

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Ah, the mention of NG puts this in America. But it would be helpful if you'd made that more obvious.
 

lbender

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I'm not sure about the privacy laws. What I am sure about is, in emergencies, such as 200 million dying from an epidemic, a lot of those laws might be set aside "in the interests of national security" to fight the epidemic. They set aside laws now for much stupider reasons.
 

Raventongue

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Depending on when this is set (modern? future?) the laws might have changed anyway.

Relax: there's been a whole fictional epidemic. You're allowed to make little things up too.
 

jclarkdawe

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In my novel, an epidemic has killed about 200 million worldwide over the past five years. A nice high number. You'd think it would be high enough, but the daily death rate is over 150,000. That works out to 55 million per year worldwide. Present world population is 6.84 billion and 200 million is only about 3% of that figure. In other words, you need to add another zero. Even at 2 billion, that would still leave nearly 5 billion survivors. A handful of government agents knows that some of the survivors have psi powers. Hell, with 6.6 billion survivors, some of them probably have all sorts of powers. They want to create a database of survivors. Would they face trouble with patient's privacy laws? Database of survivors in civilized countries could be as simple as who is still paying taxes.

Also, in the event that several hundred people suddenly died in one area, what would be emergency procedures? National guard called in, bodybags? Mass burials, no body bags, just big bulldozers. They would want to do autopsies, but there wouldn't be near enough room in local morgues to preserve the bodies. Why would they want to do autopsies?

Change your numbers and think through what percentage of the world's population you want to survive.

Best of luck,

Jim Clark-Dawe
 

Bing Z

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Originally Posted by Hypatia
In my novel, an epidemic has killed about 200 million worldwide over the past five years. A nice high number. You'd think it would be high enough, but the daily death rate is over 150,000. That works out to 55 million per year worldwide. Present world population is 6.84 billion and 200 million is only about 3% of that figure. In other words, you need to add another zero. Even at 2 billion, that would still leave nearly 5 billion survivors.
Jim, for the first time in the history of mankind, I have to disagree with you. AIDS/HIV is termed a pandemic (widespread epidemic) and the death toll is just 25 million from 1981 to now. SARS only killed 775 people over two years and the WHO and all the infected countries were so panic. I think an epidemic that causes 200m lives/5 years, obviously on top of the 55m/year other deaths, will induce massive horror.

But yeah, I think to maximize terror the epidemic can be centered in North America (eeeeek) and/or the trend uprising geometrically (like, 1st year death toll was 5m, last year it was 120m.)
Also, in the event that several hundred people suddenly died in one area, what would be emergency procedures? National guard called in, bodybags? They would want to do autopsies, but there wouldn't be near enough room in local morgues to preserve the bodies.

I don't have a clue if they will do massive autopsy. If they can't handle the whole thing, they may cut a piece (if they know which part to cut) and store in the freezer. Chances are the Dover Air Force Base Mortuary will get involved. The top priory should however be containment and human/citizen rights will be nonexistent at this stage. Depending on how widely spread it is, the county/state or even the entire nation may be under curfew.
 

jclarkdawe

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Originally Posted by jclarkdawe
In my novel, an epidemic has killed about 200 million worldwide over the past five years. A nice high number. You'd think it would be high enough, but the daily death rate is over 150,000. That works out to 55 million per year worldwide. Present world population is 6.84 billion and 200 million is only about 3% of that figure. In other words, you need to add another zero. Even at 2 billion, that would still leave nearly 5 billion survivors.
Jim, for the first time in the history of mankind, I have to disagree with you. AIDS/HIV is termed a pandemic (widespread epidemic) and the death toll is just 25 million from 1981 to now. SARS only killed 775 people over two years and the WHO and all the infected countries were so panic. I think an epidemic that causes 200m lives/5 years, obviously on top of the 55m/year other deaths, will induce massive horror.

More people should disagree with me. You're right that any disease that causes 200 million deaths would cause massive horror. And if that was all the OP was going for, I wouldn't have a problem. And it would produce some massive changes in our behavior.

But for the massive changes that the OP appears to want to introduce, I don't think it will be enough of an impact. The Black Death appears to have killed roughly a third to a half of the world's population. It did cause some long-term changes and some very massive temporary changes.

I don't think a 3% drop in the world population will cause many significant changes. I think it's well within the amount that we can tolerate without changes to the infrastructure.

Best of luck,

Jim Clark-Dawe
 

Cath

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I don't think a 3% drop in the world population will cause many significant changes. I think it's well within the amount that we can tolerate without changes to the infrastructure.
I think it would depend who's affected. 3% of the world's population might not cause significant change. Make that affected group educated, affluent, vocal, and networked and it's a different game.
 

Hypatia

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Okay, my first post wasn't very clear. By "survivors" I meant the few who had symptoms and lived, not the majority who never show symptoms even after being exposed.

Also, the hundreds who die in one area have no signs of the epidemic, or any other indication of cause of death. (It was a telepathic attack). So autopsies would be desirable.
 

shaldna

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In my novel, an epidemic has killed about 200 million worldwide over the past five years.

In a world with approx 7 billion people, 200 million over five years is not a lot to be honest, especially if it's a worldwide thing. If they were all in the same location - America, central Europe, then the panic would be much greater because it's essentially the whole population gone then.

But it depends on the needs of your story - is this a disease they are trying to keep under wraps? Is there a reason? I mean, if it's a disease they don't want the public knowing about, and people are dying of it in high enough numbers to cause concern, then 40million people a year is a lot, for sure.


A handful of government agents knows that some of the survivors have psi powers. They want to create a database of survivors. Would they face trouble with patient's privacy laws?

Well, there's supposed to be doctor/patient confidentiality, but it depends on the context of your story.


Also, in the event that several hundred people suddenly died in one area, what would be emergency procedures? National guard called in, bodybags? They would want to do autopsies, but there wouldn't be near enough room in local morgues to preserve the bodies.

How big is the area? I mean, if it's a city with a million residents then that's very different to a small town of a thousand people.

Jim, for the first time in the history of mankind, I have to disagree with you. AIDS/HIV is termed a pandemic (widespread epidemic) and the death toll is just 25 million from 1981 to now. SARS only killed 775 people over two years and the WHO and all the infected countries were so panic. I think an epidemic that causes 200m lives/5 years, obviously on top of the 55m/year other deaths, will induce massive horror.

But you don't see people who died from AIDS being buried in a mass grave, do you?

The thing is, while people in general might freak out - like they did with Swine Flu the other year - for the most it's not going to have a huge, devestating effect. To use your AIDS example - that's 25 million people in 31 years, that's about 750,000 people a year (give or take, it's early and my brain is struggling). It's no doubt a MASSIVE problem. But pick an average guy off the street - how many people does he know who died of it?

This is the point where the panic should set in - if folks are faced with an illness in a very close way - a friend, a family member etc, then they are more likely to panic and worry over it. 200 million people worldwide is not really enough for everyone to know someone who has contracted the illness, to to be effected by it enough.

AIDS is interesting in the context of the point I made above about how localised the illness is - AIDS is a much bigger problem in some areas than others - so, in countries like Botswana, or Lesotho where around 25% of the adult population has AIDS it's a much bigger problem, more urgent and more troubling than in a country like Finland, where 0.03% of the population has it.


Okay, my first post wasn't very clear. By "survivors" I meant the few who had symptoms and lived, not the majority who never show symptoms even after being exposed.

Also, the hundreds who die in one area have no signs of the epidemic, or any other indication of cause of death. (It was a telepathic attack). So autopsies would be desirable.

As a side note - you should try watching the BBC series 'Survivors' - it was a 1975 series which has been remade in the last five or so years. It's about a flu-type pandemic which kills a lot of people.
 

bellabar

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When the number of deaths overwhelms the local morgue it is feasible to utilise abbatoirs and butchers. They have the refrigeration etc setup immediately available. I remember reading about this happening IRL but I can't remember where, perhaps in the Australian bushfires of a couple of years ago.
 

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In my novel, an epidemic has killed about 200 million worldwide over the past five years. A handful of government agents knows that some of the survivors have psi powers. They want to create a database of survivors. Would they face trouble with patient's privacy laws?

Given that government agencies nowadays seem to have zero respect for privacy rights, I don't think anyone would blink at such a database. All they have to do is wave the "national security" flag and anything goes.

Also, in the event that several hundred people suddenly died in one area, what would be emergency procedures? National guard called in, bodybags? They would want to do autopsies, but there wouldn't be near enough room in local morgues to preserve the bodies.
Unless the cause of death was very clear (e.g. a terrorist bombing) then autopsies would be mandated. And even if the cause of death was clear, holding the bodies for identification would be mandated, too. How it gets handled really depends on the situation. A terrorist/attack situation is quite different to an earthquake/disaster, which is again different to a potentially infectious disease.

How big an area? How many local hospitals and labs? Can the bodies be transported out of the area for autopsy? Working on an emergency/overtime basis, there's no reason someplace like, say, Detroit metro couldn't handle an extra 200 autopsies in a week.
 

Hypatia

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Thank you to everyone who has commented. I wasn't thinking of an apocalypse exactly, just enough to get people panicked.

The bodies would all be at one boarding school, maybe 250. Now I'm thinking that even identifying the bodies would take too long (since the one missing student is the killer). A database of epidemic survivors would be very helpful in figuring out who is responsible.
 

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Holy crap, that is one efficient killer!
 

jclarkdawe

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250 bodies is not a big storage problem. The government will rent a refrigerated trailer, and maybe a second one. You bring it to the site and load it up. The body bag situation is not much of a problem, but even if you run out, you go down to Wal-Mart, buy the big lawn bags, and use two.

I'm not sure what the ID problem would be, unless the disease caused massive disfigurement. Students nearly always have a picture ID as part of their school record. Most of the students shouldn't be any problem to ID.

But even if you have to go to dental and DNA, you can probably process about 80% of the bodies within a couple of weeks. Usually in mass casualty situations, most of the bodies are identified fairly quickly.

Best of luck,

Jim Clark-Dawe