U.S. Flu Plan: Expect Chaos

posted: 03 May 2006 05:04 pm ET

WASHINGTON (AP)—A flu pandemic would cause massive disruptions lasting for months, and cities, states and businesses must make plans now to keep functioning—and not count on a federal rescue, the Bush administration said Wednesday.

"Our nation will face this global threat united in purpose and united in action in order to best protect our families, our communities, our nation and our world from the threat of pandemic influenza,'' President Bush said in a letter to Americans noting the release of an updated national pandemic response strategy.

Bush last fall proposed a $7.1 billion plan to prepare for the next worldwide outbreak of a super-strain of influenza. Wednesday's report updates that plan, an incremental step that basically outlines exactly which government agency is responsible for some 300 tasks, many already under way.

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Can't stop it

Even the most draconian steps, such as shutting down U.S. borders against outbreaks abroad, would almost certainly fail to keep a flu pandemic from spreading here, the report acknowledges—and thus it outlines more limited travel restrictions that would be used instead.

Influenza pandemics strike every few decades when a never-before-seen strain arises. It's impossible to predict when the next will occur, although concern is rising that the Asian bird flu, called the H5N1 strain, might lead to one if it starts spreading easily from person to person.

"I should make clear from the outset that we do not know if the bird virus we are seeing overseas will ever become ... a pandemic,'' said Frances Townsend, Bush's White House homeland security adviser.

But if that happens, "we will take immediate action to prevent or to slow the spread of the infection,'' she added.

If a human outbreak of any super-flu strain occurs abroad, the United States will work with international health officials to try to contain it in the country of origin.

But if it escapes and begins a worldwide spread, the report makes clear that the main goal will be to slow that spread, giving time for the nation to brew protective vaccine, dispense stockpiles of critical medical supplies—and limit the almost inevitable economic and social chaos.

What to expect

In a severe pandemic, up to 40 percent of the work force could be off the job for two weeks, the report estimates. Because 85 percent of the systems that are vital to society—food production, medicine and financial services—are privately run, the administration aimed to use the new report to energize businesses in particular to start planning how they will keep running under those conditions.

"No less important will be the actions of individual citizens, whose participation is necessary to the success of these efforts,'' Bush added.

A flu pandemic would roll through the country, likely causing six to eight weeks of active infection per community.

"Local communities will have to address the medical and nonmedical impacts of the pandemic with available resources,'' the report warns, because the federal government won't be able to offer the kind of aid expected after hurricanes or other one-time, one-location natural disasters.

The report assumes a worst-case scenario of up to 2 million U.S. deaths. But Townsend sought to downplay the perception that chaos will consume the nation.

"The whole purpose of planning ... is to take the fear out of it, so there's no chaos,'' she said.

Within a year, federal health officials should approve states' individual pandemic plans, it says.

What to do

For businesses, the report encourages setting clear, non-punitive sick-leave policies to limit the possibly infected from staying at work, and using alternate offices, work-at-home and "snow days'' to minimize employee contact. Also, it advises regularly cleaning offices—flu can live on hard surfaces for 48 hours—as well as not shaking hands and keeping co-workers at least 3 feet apart. [What individuals can do]

But the yard's-distance advice assumes that flu only spreads in the large droplets of coughs and sneezes; tiny droplets that stay suspended in the air for long periods can spread it, too.

"We depend on everyone outside of the government to take this as seriously as we do,'' Townsend said.

The incremental plan already was drawing complaints that despite months of dire talk about the threat of a pandemic, the administration hasn't accomplished enough.

"Other nations have been implementing their plans for years, but we're reading ours for the first time now. These needless delays have put Americans at risk,'' said Sen. Edward Kennedy, D-Mass.

Stage 0 to 5

Regardless of what causes the next pandemic, the 227-page plan outlines some steps federal officials would take at different stages.

The country currently is in Stage 0—worrisome flu strains are circulating in birds. Stage 5 would be widespread U.S. cases. In between, U.S. health officials would help world authorities try to detect and contain any potential pandemic-triggering outbreaks abroad.

The main defense: Screening travelers from affected countries and diverting or quarantining flights that arrive with possibly ill patients aboard.

But people can spread the flu for a full day before they show symptoms.

Trying to meet and quarantine lots of planes, "I'm dubious, No. 1, that just physically that's feasible. And, No. 2, I frankly wonder exactly what degree of effectiveness can be expected by that,'' said Dr. William Schaffner of Vanderbilt University, an adviser to the government on flu vaccine.

People must understand that "the hurricane cannot be kept offshore,'' he added.

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