How to Minimize Illness After the SHTF

A woman blows her nose while sick in bed.
The flu, COVID, and RSV are joined by a mysterious outbreak of pneumonia that is hospitalizing children.

Catching a cold, getting the flu, puking your guts out, or having problems at the other end of the system is no fun when we have access to modern medicines and chicken soup. Imagine what it will be like after the SHTF. Or, consider what might happen if you or your child has an ear infection, strep throat, or a minor injury becomes infected and there is no clinic or physician to see them. Without our modern system of medicine, that could spell trouble or possibly even death.

Now imagine a scenario in which the water purification plant isn’t running and you are collecting drinking water from a natural source. You are eating an assortment of foods you are not used to, and you cook your meals over an open fire. When it grows cold outside, you have to pile on more blankets because the furnace doesn’t run. All of these scenarios can cause sickness or exacerbate it, and all are likely to be present after a major disaster. That’s going to complicate treatment.

As with many things, the best approach is not to get sick in the first place. That means drinking clean water, eating healthy food, and staying protected from the elements.

The biggest contributor to illness after the SHTF is dirty water and a lack of waste management.

Contaminated Water

The weeks and months after a flood, an earthquake that destroys a city, or another humanitarian disaster see many illnesses. These are often brought on by a lack of clean water, the presence of too much untreated human waste, and/or presence bodies of animals and humans both in the water and rotting on land.

Your best chance to avoid this is to have a source of clean water or a way to purify water. In our case, our water is from an underground spring and never sees the light of day, so it should remain pure even in the advent of nuclear fallout. Just in case, however, we have filters and replacement elements for the filters. Because I believe in the layered approach to prepping we have large gravity-flow filters where you pour water into the top and it seeps through filters and comes out the bottom. We also have multiple varieties of pump filters where you can pump water from a wild source like a stream or pond and the pump forces the water through a filter. Then we also have small devices like sports bottles and life straws.

If these devices are not available, you can boil your water, but that won’t remove chemical contaminants or fallout.

Beyond Drinking

Clean water for drinking, cooking and washing your hands can help you avoid cholera, typhoid, dysentery, diarrhea, and illnesses caused by parasites in the water, including intestinal worms, giardia, and cryptosporidiosis. Water can also carry E. Coli and other bacteria from fecal matter or decaying flesh.

You should also be prepared to supply water to your livestock even if there are no utilities. Animals are better prepared for drinking water from wild sources, but the cleaner their water, the better. Ensure you give them fresh water at least daily. They may need more in hot weather and you may have to break their ice during the winter.

Bottled water and other forms of stored water are good for short-term emergencies, such as power outages or to throw in the car when bugging out, but unless you have large storage tanks, it is impractical to store sufficient water for a lengthy emergency. You must have a renewable source and a way to filter or otherwise purify it.


We all know germs spread disease, often bacterial or viral. Hopefully, we all know that cleanliness can prevent the spread of these germs. What you may not know is that germ theory was not widely accepted until the late 1800s and a lack of cleanliness contributed to the spread of illnesses before that time. Let’s not slip backwards. Wash your hands whenever they are dirty and especially before eating or preparing food. After working with animals or animal products, wash your hands and your face. Don’t wear your farm boots into the house. Aprons and coveralls were invented for a reasons, use one when doing dirty work.

Clean your cooking and meal-prep areas, dishes, and utensils, too. If you eventually run out of soaps, you can make your own. If your spray bottles of cleansers run low, you can make your own using diluted bleach. It may smell worse than your preferred cleaner, but it will kill germs and decontaminate the area, and that should be your primary concern.

Cleaning yourself, your bed linens, and your clothing will also minimize disease and infestations of lice, bedbugs, and fleas. If you can’t shower or bathe in your post-SHTF world, at least wash your face, and take a sponge bath. At a minimum, clean your pits, crotch, butt, and feet every other day. Brush your teeth. Change your socks and underwear daily, if possible, and try to give your footwear a day off a couple times a week so it can dry out. This will help you avoid mold and other fungal infections.

This may not sound very important in the early days of a disaster, but it will become increasingly so as you run out of clean clothes and start to stink and itch.

Proper Waste Disposal

Waste includes human waste, food waste (which we will call garbage) and trash, which is packaging and other non-dangerous materials. Today, you may flush the first and wrap everything else up in a plastic bag for someone else to handle.

After the SHTF, you will have to handle it yourself. Compost as much of your food waste as possible or feed it to your chickens, goats, pigs, dogs or other animals. If you have trash, burn it in a burn barrel.

There are multiple blog posts and videos about making a bucket sanitation system, which usually include separate buckets for feces and urine. This is a fine approach and you should consider it.

I prefer burial. If you have a gravity-fed septic system, it will work for several years but at some point will clog up. You may lengthen its service life by using your toilets only in bad weather and using the great outdoors the rest of the time. We’re not talking about going behind a bush and dropping your drawers. That might work once or twice, but for any length of time, you need a more serious system to dispose of human waste.

I prefer a pit toilet or a trench toilet. (A trench is shallower and you lengthen it as needed, filling it in behind you as you “go.”) The concept of keeping urine and fecal matter separate can apply to a trench system as well as a bucket system and may reduce the smell.

I recommend you search online or find a military manual for treating waste in the field. Even an old guide from WWII should be sufficient, as shovels have changed little in the past 80 years.

Be careful to avoid contaminating your water source, your neighbor’s water source, or your garden.

Don’t Ignore Minor Injuries

Do you know anyone that neglected a cut or scrape and ended up with a serious infection? Something as simple as a bug bite or minor puncture wound can become septic and lead to blood poisoning and other deadly outcomes. For this reason, you should clean, disinfect, treat and cover all open wounds, even if they are small. I use hydrogen peroxide to clean the wound and then apply triple-antibiotic ointment and a bandage. If the area becomes rad or painful in a day or two, I soak it in hydrogen peroxide for five minutes several times a day. This usually does the trick

Bandages can be commercial Band-Aid type bandages, a piece of gauze held in place with tape, or gauze under a few turns of vet wrap. If you bandage someone up, change their dressing at least daily. You should also change the dressing if it becomes saturated with fluid from the wound. When changing the dressing, consider whether the wound needs to be dosed with hydrogen peroxide again to fight a growing infection or just a reapplication of antibiotic ointment. I lean towards hydrogen peroxide treatments for the first two or three days.

While I have never heard of a hangnail or a paper cut becoming septic, minor wounds like blisters on your feet or a bad splinter can. Treat your feet well, wear two layers of socks to minimize blisters (a thin inner layer or sock liner under a thicker sock), and use moleskin if you develop any hot spots inside your shoes. Better yet, break in your boots and shoes before you need to bug out.

You should also disinfect thoroughly any bites from animals, as their mouths can harbor multiple bacteria. This includes both wild animals and domestic ones.

Medical Supplies

Make sure your medicine cabinet is full of things like hydrogen peroxide, rubbing alcohol, acetaminophen and ibuprofen, antibiotic ointment, bandages, gauze, vet-wrap, sports tape, a thermometer, anti-itch lotions, antifungals (get the ones to treat athletes foot), an anti-diarrheal, an antihistamine, oral rehydration salts, and other common OTC meds. Finger splits, ace bandages, slings and an old-fashioned hot water bottle are also useful for treating injuries in people not used to physical labor. Your tactical first aid kit should include a tourniquet, compression bandages, and a chest seal to treat gunshot wounds.

If you or a group member has medical training, you can store a stethoscope and blood-pressure cuff, an oxygen monitor, a basic surgical kit, sutures, and antibiotics. If you are a doctor or nurse, then go to town and buy and stockpile whatever you think you will need to treat injuries and illnesses after a disaster.

Keep in mind that you won’t be evacuating anyone to a trauma center, the cardiac unit, or even to an orthopedic specialist. Any medical care they receive will come from you and your supplies. Plan accordingly.

Avoiding Disease Vectors

Quarantining sick people has a long and successful history. While it didn’t work during COVID, this is probably because health officials outside of China didn’t quarantine sick people; they tried to lock down everyone.

If the disaster you face is an epidemic, or if an epidemic is a secondary disaster on the heels of a major disaster, avoid contact with anyone or anything that could carry the illness. This is likely people, but it could well be animals. For example, rodents can carry diseases and you can catch some respiratory diseases from their dried feces. If the bird flu evolves, you could catch it from domestic or wild birds. Even mammals could give you a disease, as about 60 percent of known infectious diseases are zoonotic, meaning they originated in or can be transferred by animals.

Having “plagues” after a global catastrophe would not surprise me. While the lack of air travel post-SHTF would slow transmission of diseases originating in African village or Chinese wet markets, we need to remember that the black plague and small pox both traveled through Europe for years.

The best solution if there are no vaccines may be isolation. Don’t expose yourself to strangers and you won’t be exposed to any disease they carry or vermin they harbor.

Terminal Illnesses

If someone has or develops a serious illness such as cancer, heart disease, or even diabetes, there is little you can do to save them in a post-SHTF world with no modern medicine. You can look to herbal or homeopathic medications or dietary changes, but there won’t be any infusions, radiation, double-bypasses, stents, or insulin available.

Likewise, serious injuries will be difficult or impossible to treat in a survival situation. This is why avoidance is so critical.

In most cases, all you can do is make the victim comfortable during their last days and reassure them they are not alone.

Stay Healthy

Among the best ways to stay healthy after a global disaster is to drink clean water, eat healthy food, and avoid overdoing physical labor it to the point of injury. If possible, don’t let yourself get too cold, too tired, overheated or dehydrated, or too stressed.

Be careful and don’t rush. Watch where you put your feet. Follow common sense safety guidelines, like wearing a safety line, having someone stabilize your ladder, and wearing eye protection. Don’t chop wood without safety-toe boots or use a chainsaw without Kevlar chaps. Keep your appendages away from moving parts. There may be no second chances and we’ll being going back to peg legs instead of advanced prosthetics, ao

Be careful and don’t rush. Watch where you put your feet. Follow common sense safety guidelines, like wearing a safety line, having someone stabilize your ladder, and wearing eye protection. Don’t chop wood without safety-toe boots or use a chainsaw without Kevlar chaps. Keep your appendages away from moving parts. There may be no second chances and we’ll being going back to peg legs instead of advanced prosthetics, so look before you leap.

What is a minor injury today could turn into a life-threatening one in a world where doctors are scarce, hospitals are closed, and the dentist uses a pair of channel locks to pull teeth.

Note: The author is not a medical or healthcare professional and the above is not medical advice. It simply reflects preparations and plans the author has taken or plans to take to minimize and treat illnesses and injuries during and after a disaster or SHTF situation. Consult a medical professional for your healthcare needs whenever possible.