The 4 Most Likely Ways You Can Die If the SHTF

The subject of survival in a long term disaster goes beyond having stockpiles of beans, bullets, and band-aids. Those that do survive during a long term emergency will no doubt be tried and tested with a great many things. One of those trying scenarios is dealing with death.

Zombie attacks seem to be a prevalent theme for preppers to prepare for. In fact, the CDC has even posted a preparedness article on how to ward off zombie attacks. While I believe these zombies will likely take the form of substance abusers, mental patients, chronically ill or diseased, and desperate individuals whose basic needs have not been met, they will die out in the first few months of an onset of a  major disaster, and their presence will rarely be an issue in a long term situation.

In reality, a majority of those that will die during a long-term disaster will be from illnesses brought on by acute respiratory infections due to cramped living conditions, poor water conditions (or lack of), or bacterial infections from wounds. If we survive a major disaster, America would become a third world country and the aftermath of such a scenario will be similar to those living in Africa, Ethiopia and India.

Illness Due to Poor Water Conditions

Typically, any diseases that are brought on by lack of sanitation and hygiene are controllable and preventable. In a disaster where water sources are compromised, people within a 50-mile radius could be adversely impacted by illness and disease if just one person incorrectly handles water or incorrectly disposes of waste.  Contaminated water, poor sanitation and/or lack of hygiene leads to diseases such as Hepatitis A, viral gastroenteritis, cholera, Shigellosis, Typhoid, Diphtheria, and polio. If these diseases affect enough people, an epidemic will ensue.

Dehydration and diarrhea are also water-related matters to contend with. Those without adequate water conditions and/or are suffering from the disease brought on by poor water conditions could quickly dehydrate. These types of illnesses typically affect at-risk populations such as children, the sick and the elderly. Young children, in particular, are at high risk for diarrhea and other food- and waterborne illnesses because of limited pre-existing immunity and behavioral factors such as frequent hand-to-mouth contact. The greatest risk to an infant with diarrhea and vomiting is dehydration. In addition, fever or increased ambient temperature increases fluid losses and speeds dehydration. Having knowledge beforehand on how to properly clean drinking water and food, and the symptomatology and treatment of these types of diseases can prevent further outbreaks from occurring.

Recommended preparedness items: water filtration systems, water purification tablets, chlorine granules, bleach, electrolyte or rehydration powders, anti-diarrhea medicines.


Malnutrition from either improper water conditions or from lack of nutrients is also a large killer amongst those in impoverished communities.  Medical experts say there is a symbiotic relationship between malnutrition and diarrhea.  Malnutrition increases the severity of diarrhea while diarrhea can cause malnutrition. Either way, prevention for both of these health issues is key.

Those that are malnourished are more susceptible to illness and disease. Individuals who are malnourished will also be vitamin deficient and their health is likely to regress further. Those who survive from malnutrition are permanently affected by this disease and may suffer from recurring sickness, faltering growth, poor brain development, increased tooth decay, reduced strength and work capacity, and increased the chance of chronic diseases in adulthood. Adult women with this condition will give birth to underweight babies.

Recommended preparedness items: dietary supplements, vitamin powders, seeds for sprouting or  seeds for fresh vegetables and fruits, survival bars, knowledge of alternative means to attain vitamins

Acute Respiratory Infections

Upper respiratory infections (URI) will also be a leading cause of death in a long term disaster. Upper respiratory infections include: colds, flu, sore throat, coughs, and bronchitis can usually be cured with additional liquids, rest and nourishment. Allowing the illness to exacerbate will lead to secondary infections such as bacterial pneumonia. The germs from pneumonia are easily spread from an infected person to others by coughing or sneezing or through close contact. A major concern about respiratory infections is that there are many drug resistant strands of viruses, bacterias, and diseases (including tuberculosis), that regular medicine will not cure.  In a long term disaster situation, many could perish.

To properly prepare for this type of medical situation, learn about the more prevalent viruses and bacterias in your country and how to prevent them in order to provide a healthy living environment in a long term situation.

Not only are URI’s a concern but other air-borne diseases such as tuberculosis will likely fester during a long term scenario. In regular non-SHTF times, treatment for tuberculosis requires 6-12 months of medication.  In a long term emergency, chances of surviving tuberculosis are slim. The best way to prevent tuberculosis is adequate nutrition, vitamin D and living in a properly ventilated shelter.

Survival groups that have multiple people living under one roof will only increase the likelihood of passing air-borne infections and diseases to one another. In addition, those in an at-risk group (elderly, immuno-deficient, infants) are more likely to catch illnesses.  If a survival group is sharing a home, an infirmary or sick room should be prepared for those who have fallen ill.  Isolating the person who is ill will limit exposure to the other members of the group. Adequate nutrition, water, rest, good sanitary practices and ventilation of the home is essential in curbing this.

Recommended preparedness items: decongestants, expectorants, upper respiratory medicines, antibiotics (for secondary and bacterial infections), knowledge on medicinal herbs, prepare a sick room at your survival homestead

Infections From Wounds

Open injuries have the potential for serious bacterial wound infections, including gas gangrene and tetanus, and these, in turn, may lead to long term disabilities, chronic wound or bone infection, and death.  Antibiotics will be few and far between and will be more precious than gold.  Without proper medicines, antiseptic and knowledge on proper medical procedures, many will die of bacterial infections.  Learning medical skills, gaining knowledge on natural medicines and alternative medical antiseptic (i.e., Dakin’s Solution) before a disaster occurs could help people survive from wound infections. Also, ensuring the area that you treat medical emergencies is clean and as sterile as possible may also prevent bacterial infections.

Recommended preparedness items:  stock up on maxi pads for wound absorption, gauze, celox, antibiotics, suture needles and other basic first aid supplies.

Additionally, consider developing the following skills: basic first aid class, sign up for EMT classes in your community, an off-grid medical care class such as those offered by onPoint Tactical. Also, consider investing in books such as When There is No Doctor and When There is No Dentist..

These illnesses (provided above) have impacted countries all over the world. This illness and conditions, coupled with unsanitary living conditions such as substandard sanitation, inadequate food and water supplies and poor hygiene, make disaster-affected people especially vulnerable to disease. These illnesses will affect us no matter what part of the world we live in, what socioeconomic status we currently hold, and no matter how prepared we think we are.

Understanding what can happen and being prepared when it does is absolutely essential. The last thing we want to do when a serious condition arises is to panic. Preparing your supplies, developing your skills and educating the rest of your family and preparedness group on how to prevent, identify and counteract these serious conditions will provide a significant boost to your ability to survive if the worst happens.

Recommended Readings:

Patriot Nurse: 5 Diseases that Will Explode WTSHTF

Prevention and Management of Wound Infections

Water, Sanitation, and Hygiene in Emergencies

The Prepper's Blueprint

Tess Pennington is the author of The Prepper’s Blueprint, a comprehensive guide that uses real-life scenarios to help you prepare for any disaster. Because a crisis rarely stops with a triggering event the aftermath can spiral, having the capacity to cripple our normal ways of life. The well-rounded, multi-layered approach outlined in the Blueprint helps you make sense of a wide array of preparedness concepts through easily digestible action items and supply lists.

Tess is also the author of the highly rated Prepper’s Cookbook, which helps you to create a plan for stocking, organizing and maintaining a proper emergency food supply and includes over 300 recipes for nutritious, delicious, life-saving meals. 

Visit her web site at for an extensive compilation of free information on preparedness, homesteading, and healthy living.

This information has been made available by Ready Nutrition

Originally published June 29th, 2011
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14 Responses to The 4 Most Likely Ways You Can Die If the SHTF

  1. STW says:

    In short, the things that killed people in the past may kill you in the future.

  2. John Russell says:

    Some of this stuff can be vaccinated against, like tetanus, and polio, and veternarian powdered antibiotics will last for years, you know.

  3. Brandyn Aldag says:

    Beeswax is a good alternative to petroleum jelly, so long as it is clean.
    Plant Oils  and Cocao Butter have always been good for treating wounds. These three together are pretty much the main ingredients to Neosporin, so long as the plant oils are rich in Vitamin E.


  4. Tom Hargrave says:

    The real issue is that so many of us are dependent on our social ifrastructure that most are doomed if the SHTF. Why? Just look at your grocery store shelves – 90%+ comes from somewhere else in the country or somewhere else in the world. Also, there is not enough food on your local grocery store store shelves to feed everyone for more than a few days.

    Just last year we were impacted by the tornados that hit North Alabama. The stores that could open only accepted cash because the net was down and people were lined up all the way to the back of the local Publics waiting to check out. When I saw this the solution to me was easy. I picked up a friend of mine and we headed to a larger town that was at least 50 miled outside of the local disaster area and we bought everything we needed.

    But this was just a local Huntsville AL disaster and within another week everything was OK. With a real national disaster, by week 2 or week 3 everyone but a few will be out of food. In another 2 weeks organized gangs will be out steeling what food they can find. And it will get worse from there.  

    • JayJay says:

       I picked up a friend of mine and we headed to a larger town that was at least 50 miled outside of the local disaster area and we bought everything we needed.

      As a truly prepared person, I don’t have to leave this house for ANYTHING!!

  5. kbow says:

    im a nurse of sixteen yrs and a combat medic 0f 10 well as paramedic.remember kiss keep it simple stupid.stock up on the basics iodine alcohol peroxide bandages benadryl tylenol and asprin a big one for heart pts and people with circulation problems.recomend if you are on reguler meds you should try to get at least a 30 day supply ahead.simple face mask and gloves.tape and plastic in case you need to seal your house or a room.have a decontamination area or at least a plan.the better thought and prepared you are the better your chances.and by all means dont shoot your mouth off to everybody about what you have unless you want to have to shoot them later.

    • jayjay says:

      I have over 6 years of supplies and food; at 6 years I stopped counting.
      And I’m STILL making another trip to Sam’s Tuesday for more with a friend.

      I started 3 years ago.   

      • John says:

        That’s just dandy but not everyone has the money to buy that much extra food. Some do good to feed their families NOW

  6. Tess, Great advice but too overlooked by many in the preparedness movement (preaching to the choir here I know). The small scratch or cut I get when working on projects that I don’t even know how I got them has to get immediate attention in a long term SHTF scenario. 
    As STW put it, “In short, the things that killed people in the past may kill you in the future.” I bought three boxes of eye pads from an estate sale Sat. for less than two bucks. Hopefully I’ll never need them, but they can be used for many situations.
    Stuff growing in the yard/woods have been life savers for plenty of generations. The time to practice is now.
    Keep doing the stuff!

  7. Ben Smith says:

    So in a nutshell, disease, starvation, disease and disease.
    A better, more accurate list of four would be dehydration, starvation, exposure and infection, not necessarily in that order.

  8. bustattmovec says:

    Yes, the folks that die off in the first few months will not be an issue for the long term, that is true. What I would be concerned about are the folks that don’t die off. These are the one who are smarter, stronger, more resourcsefu, battle hardened, and in the long run, could pose an issue for your team.

  9. John says:

    So basically this is a list of what happens to totally unprepared people.

  10. bruce steger says:

    An antiseptic that has been used on farms for animals for 80 years is Blue Coat that in a pinch we can us it as well. It is superior to iodine in that it is also a bactericide as well that uses indemnable ink to put it’s medicine deep into the wound and will not wash off for a few days. I have used it to treat ring worm (the regular treatment wasn’t working) and on a brown recluse spider bite. I had no side effects from it and both wounds healed quickly! Besides food, water treatment/filters, firearms, clothing and backpacks this Blue Coat Antiseptic is what I have ready!

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