States plan for avian flu

Reuters HealthWednesday, June 7, 2006

By Carey Gillam
TOPEKA, Kansas (Reuters) - Kansans are practicing using a football field-sized tent as a portable hospital. Hawaii plans to find the sick by doing nasal swabs on tourists, and Seattle is issuing instructions on how to bury the dead.
Across the United States, local and state officials are spending millions of dollars to plot strategies for dealing with a still hypothetical - but experts say inevitable - pandemic flu crisis forecast to kill upwards of 2 million Americans.
The fears are tied to the current spread of a deadly strain of avian influenza known as H5N1 that has surfaced in Asia, Europe and Africa.
"There is no cookbook for pandemic. There is no one who says this is how this works," said Tod Bunting, who leads Kansas' emergency management operations, including the state's National Guard troops, who would be on the front lines of pandemic response. "The picture is unclear but we're just going to have to plan as best we can and then go with the flow."
The H5N1 avian influenza virus has infected at least 224 people in 10 countries and killed 127 of them, according to the World Health Organization. Experts evaluating the spread of this type of avian influenza believe it will ultimately mutate into a strain that could pass easily from person to person, sparking a pandemic that could sweep the globe in weeks or months.
The United States has not yet seen a case of H5N1, either in fowl or in a human, according to the Department of Health and Human Services. But federal officials have spent the past few months criss-crossing the country, warning of the possibilities of pandemic and pushing states to come up with plans for how to handle a deadly flu outbreak if it strikes.
'OVERDUE, UNDER-PREPARED'
"We are overdue and we are under-prepared," HHS Deputy Secretary Alex Azar told a group of Kansas emergency responders at a meeting in Topeka last week. "The more and better we prepare, the more lives we will save."
Azar said the federal government won't be able to provide a safety net if a pandemic hits. States will have to rely on their own ingenuity to provide health care, keep essential services operating and distribute food and medicines.
The state efforts have been augmented with $100 million in federal money so far, including $1.2 million earmarked for Kansas. HHS will distribute another $250 million to states later this year, according to Azar.
Taking the concerns to heart, community leaders and local and state officials have a mix of plans on the drawing board.
In Hawaii, officials at the Honolulu airport are planning to have nurses take nasal swabs of airline passengers who appear ill to screen them for the flu, and a jetload of people could be quarantined if any one passenger tested positive for the H5N1 strain, according to the Hawaii State Department of Health.
In Boston, thousands of healthcare professionals are being asked to sign up as volunteers for a "Medical Reserve Corps" who could help treat flu victims.
BURY IN THE BACKYARD
In Illinois, the DuPage County Health Department, which encompasses 1 million people in suburbs west of Chicago, last month sent out a mailer to 350,000 homes warning residents of pandemic flu and offering tips on how to personally prepare, including stocking up on food and water.
The county is also planning outreach kits to businesses, churches and schools along with a series of conferences in the fall, and it is launching a bird flu Web site.
"People are concerned and are asking for information," said DuPage County Health Department spokesman Dave Hass.
In South Carolina, representatives from all state agencies are meeting monthly with American Red Cross volunteers and other volunteer organizations to develop a plan of action.
The Muhlenberg College in Allentown, Pennsylvania is readying technology and personnel to transform the college quickly into a command center capable of handling hundreds of hotline calls should pandemic hit.
And in Washington state, the King County public health department in Seattle has warned people that if body bags and refrigerated trucks are in short supply, flu victims should be buried in backyards, provided the graves are far from septic systems.
In Kansas, where state officials estimate a pandemic would claim some 2,500 lives, military units in Topeka spent last weekend practicing an emergency setup of the state's "EMEDS" (expeditionary medical support system), a portable system of tents that was deployed for use along the Gulf Coast after Hurricane Katrina. The system is designed to accommodate 25 intensive care beds, a surgical wing and a pharmacy. Another EMEDS is on order and the state anticipates it would be critical in handling waves of flu patients.
"We have never really had a public emergency of this magnitude in our lifetime," said Bunting. "But we can rally the country to win this thing. We can do this."