Monday, November 4, 2013

Preparedness Review of The Walking Dead Episode 403: Isolation

Spoiler Alert !!!!  

Hershel:  You take a breath, you're risking your life.

Synopsis:  The outbreak at the prison officially spirals out of control, with multiple people becoming symptomatic, including Sasha, Doc S, and Glen.  Tyreese becomes aggressive and angry over Karen's murder, and Rick beats him down after being punched while trying to calm him. Hershel brews up an herbal remedy to help the sick while Daryl, Michonne, Tyreese and Bob go on a run to a veterinary college for medicines that will work with humans. Maggie and Beth deal with the fact that their dad is in harm's way and may not survive.   Carol admits she killed Karen and David in an attempt to stop the illness from spreading.

Isolation is a story about control.   It's about losing control of the infection, trying to maintain control of the prison, and maintaining personal control and calm in the face of horrific suffering.  Twelve people have died of the illness and subsequent walker attack; two more have been murdered. Rick surmises that they were killed to stop the spread of the disease.

You won't like me when I'm angry.
Tyreese, meanwhile, is inconsolable and filled with rage.  He wants blood, and demands Rick immediately find the killer.   This leads to a confrontation with Daryl, who keeps calm and tries to soothe Tyreese by explaining that they have all lost someone.   When Rick attempts to further calm Tyreese, the bigger man whirls and punches him in the face.  Rick's facade of control evaporates, and he beats the admittedly bigger man silly.   Tyreese is mad, but he is not naturally aggressive.  Rick is used to handling out of control people as a deputy and touches that inner bit of savagery that helped him lead the group last year.   Daryl has to pull him off a barely conscious Tyreese.

Most of the survivors in Cell Block D, and some of their rescuers, are now confined to Cell Block A battling the illness that killed Patrick. The rest of the group (Carl, Beth, Hershel, and the smaller kids) quarantined in the administrative block to protect them from the disease.   Glen and Daryl are burying the bodies, and the Council is trying to decide what to do next.

Glen and Sasha come down sick, and Hershel says without needed medical supplies, including antibiotics, most of the ill will not survive.   There is a veterinary college 50 miles away that might have what they need, and Daryl, Tyreese, Michonne, and Bob (oh great) head out on a run to get the supplies.   On the way, they hear a garbled radio transmission and run smack into a massive pack of walkers.   There are walkers as far as the eye can see on the highway, and the car gets stuck on a pile of them as Daryl tries to reverse the car to go back the way they came.  The crew is forced to make a run for it, and Tyreese, after stewing for a moment, gets out gets starts swinging his hammer for all he is worth.   His control is gone, as is his humanity for the moment.  This is all about blind rage.  Eventually he and the rest of the group link up and they head to the college.

Meanwhile, Carl and Hershel go into the woods to find elderberries to brew elderberry tea, a natural flu remedy.   Hershel disperses the tea inside Cell Block A and gets exposed to the illness.  He is now stuck inside.  Maggie and Beth have a conversation about needing to do their jobs, and both are teetering on the edge of despair knowing their father and Maggie's husband are among those at risk.  Beth shows that she is not as hardened as previously thought, but both agree to "do their jobs."

Carol, the new Colonel Saul Tigh.
Carol and Rick work outside to get water to the sick, eventually having to go outside the wire to unclog the pump line.    Carol went outside by herself, taking what looks like a foolish risk.  This leads to a confrontation with more walkers and a narrow escape.     We've seen all through the episode that Carol has had moments of breakdown when people are not around.  She seems completely in control on the outside, but is obviously conflicted about something.  The becomes more apparent after Lizzy, one of the girls she agreed to raise, comes down sick.

Finally, at the episode's end, Rick confronts Carol about the murders.  She readily confesses in a matter-of-fact manner. The relative peace the survivors has known is shattered, perhaps for good.

Preparedness Discussion

Sanitation, proper hygiene, and the threat of illness is always a consideration in a survival situation.    The illness that swept the prison is suspected to be a form of the influenza virus by the survivors, but truthfully no one knows.    There are no labs or ways to test the theory, so Hershel and Doc S are really just taking a guess.   These types of bugs can sweep through a facility like this under the best of circumstances -- as a father, I know what happens when an illness hits a modern school -- so there was really no way an outbreak could have been prevented.   The surprise is that it took almost a year to happen.

Some basic biology:  illnesses like this are caused by either viruses or bacteria.   Viruses are smaller than a single cell, and are untreatable by antibiotics. Bacteria are treatable with antibiotics, but only certain drugs are effective against certain microorganisms.  Further, some bacteria have developed a resistance to all but the most potent medicines.   These drugs come with side effects as well.   The Sanford Guide to Antimicrobial Therapy is a good resource for more information regarding these drugs and their effects.  Just get a magnifying glass out, as  it is printed in a tiny type size.

Let me preface my next statement with the following qualifier:   I am not a medical professional.  I am not a pharmacist.   I have a layman's knowledge of biology, anatomy, and pharmacology.  I urge you to do your own research in this matter. Always consult with a medical professional when considering taking a drug of any sort.

Hershel is correct in that many of the drugs used for animals are the same drugs used in humans.    Please see this post at that covers this topic fairly well (again, do your own research).  The topic of survival antibiotics has been covered extensively on James Wesley Rawles' Survival Blog here, here, and here as well.

Antibiotics don't automatically turn to poison when a magical date passes, but some drugs, such as the -cycline family, might become toxic (see  this post about the hazards of antibiotics).  Hershel should know what he is looking at, so hopefully the group can get something to help the situation.

Tea for two.
The scavenging group should be looking for saline bags and IV equipment as well.  Rick and Carol's constant battle during the episode to obtain fresh water is not just busy work.    Patients with fever, vomiting, and heavy perspiration are at risk of dehydration.   They should also be searching for fever reducing medications like ibuprofen and acetaminophen, which can help control fevers.  Hershel's use of an old herbal remedy deserves mention here as well.   Elderberry extract is a traditional flu remedy that has some scientific backing, and in a long term collapse scenario,  everything must be considered.

For more information regarding survival medicine, another good resource is the Dr. Bones and Nurse Amy web site,

The interpersonal dynamics of the people who are still healthy take front and center throughout the episode.   Rick is trending back into a leadership mode, but the brutality that made him so effective earlier last season still lurks just below the surface.  Tyreese is out for blood, and refuses to help do anything but find Karen's killer, but when Sasha becomes sick, he realizes that he cannot help his dead girlfriend, but he can help Sasha.   Hershel wants to help the sick, and puts himself at risk to do so.  At least one third of the the population is dead, with many more sick or dying, and everyone is being tested.   People have to do what they can over events they can influence.

Finally, there is the shocker that Carol killed the two in the cells.   She admits it as a matter of fact, then moves on.   The episode ends on that note, but I am sure it will be explored in the next one. What would you do in her situation if you thought you could save lives by killing two of your group? 

This review is already long, but here are a few more observations:
  • How are they sterilizing their water?   If the group is pulling that water straight out of the pond and drinking it, they should have all died of cholera by now.  Likewise with the rain catchment system.  It all needs to be boiled.
  • All the patients' cell doors should be closed and locked, with Hershel having the key.  This controls the threat of walkers via expiration.
  • Where is Bob's AR clone from Episode 401?   Maybe he realized without a rear sight it was a load.  Just like him.
Preparedness Lessons for Episode 402:
  • Hygiene, sanitation, and hygiene.
  • Simple infections that are treatable with a dose of antibiotics can kill after a disaster when resources are limited.
  • Everyone will be tested in a survival situation, and everyone has to contribute, because there will come a time when the "old reliables" in your group might be incapacitated or dead.

Next week:  Rick and Carol go on another supply run.  Alone.   Last time someone went out alone with Rick he put a knife in Shane's chest.

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