Disease, quarantine and pests when hospitals are gone

Five habits stop most outbreaks: clean water only, hand washing, separating waste from water and food, isolating the sick early, and keeping records. Quarantine new arrivals for 14 days if you can, and keep it humane.

Part of Day Zero, the plan for an AI-related crisis that gets out of control. Why it exists. General information, not medical advice: how these guides are reviewed.

When there are no hospitals, infectious disease is usually the largest killer after the first weeks: dirty water, crowding, bad sanitation, dead bodies left unburied, rats, lice and mosquitoes. Most of it can be prevented by habits, not medicine.

The five habits

1. Clean water only. Boil or filter and treat every drink and every cooking and washing source (water guide).
2. Wash hands with soap or ash and water after the toilet, before food, after caring for the sick.
3. Separate waste from water and food. Latrines downhill and far from wells; cover food; keep flies off.
4. Isolate the sick early: a separate room, one carer, a bucket for waste, no shared plates.
5. Keep records: who is ill, since when, symptoms. A pattern (many people with diarrhoea in two days) means the water or food is the cause: stop that source at once.

Quarantine

• New arrivals stay apart for 14 days if you can, in a separate shelter, with food left at a distance.
• Anyone with fever, a cough that is getting worse, a rash, or vomiting and diarrhoea is kept separate until it is clear what it is.
• The carer wears a cloth mask and gloves if available, washes hands and clothing, and does not care for others the same day if possible.
• Quarantine only works if it is fair and humane: people who are isolated get food, water, company at a distance and respect. If they are punished, people will hide illness.

Common killers and what helps

• Diarrhoea (cholera, dysentery, typhoid): oral rehydration solution, safe water, rest. Dehydration kills, not the germ (medicine).
• Respiratory illness (flu, pneumonia, tuberculosis): ventilation, distance, rest, fluids, warmth; keep the sick away from babies and the old.
• Wounds and tetanus: wash with clean water, remove dirt, keep clean and dry. Tetanus vaccination before it happens is the only real protection, so keep it up to date.
• Measles, whooping cough and others: only vaccination prevents them. Keep vaccination records safe and, where you can, vaccinate before.
• Malaria and other mosquito-borne illness: nets, long sleeves at dusk, drain standing water.
• Lice and fleas carry typhus: wash clothes hot, change and air bedding, cut hair if infested.

Pests

• Store food in metal or thick plastic with lids, off the floor.
• Burn or bury rubbish every day. Do not leave food scraps.
• Cats, traps and clean habits protect stores from rats more than poison.

The dead

• Do not leave bodies in the open near water or homes. Bury at least 30 metres from water and 1.5 metres deep where possible; bury those who died of disease quickly, with gloves, and wash after.
• Mark graves and keep a record of names and dates. Grieving properly matters for the living.

Animals

• Do not eat animals that died of unknown illness. Cook meat and eggs through. Wash hands after handling carcasses.

Review status: not yet checked by a named professional. Read how these guides are reviewed and check anything medical or dangerous with a qualified person where you can.