Can world avoid flu pandemic?

Kerry Fehr-Snyder
The Arizona Republic
Oct. 4, 2005 12:00 AM

Infectious-disease specialists in Arizona and around the world are planning for a flu pandemic they call inevitable - if not this year, then soon.

But whether their plans can stem a worldwide flu outbreak is doubtful, critics say.

The reasons:

• A tiny national stockpile of anti-viral medication to treat those already sick or exposed to a pandemic flu strain.

• An insufficient supply of effective vaccines.

• A lack of capacity at Arizona hospitals to handle a big surge of critically ill patients.

Estimates of the potential worldwide death toll from a flu pandemic today range from 5 million to 150 million, according to the United Nations. In the United States, a pandemic could kill 89,000 to 207,000, the Centers for Disease Control and Prevention says.

The most likely source of a pandemic flu now is a virulent bird flu that has killed dozens in Asia who handled infected birds.

State officials have been working on a pandemic flu response for five years, but their plan, like the federal draft plan so far, is skimpy on details. However, the U.S. Department of Health and Human Services is finishing a more detailed plan to be unveiled as early as this week. It may request billions of dollars more from Congress.

Scientists fear the lack of a thorough plan will leave officials and citizens as ill-prepared as the victims of Hurricane Katrina.

"We're way off where anyone thinks we need to be," said Kim Elliott, deputy director of the Trust for America's Health, a non-profit group based in Washington, D.C.

In Arizona, for example, health officials have not stockpiled anti-viral medication because of the cost.

"We don't have the budget or the capacity to have a stockpile of such medication in the state," state epidemiologist David Engelthaler said.

In the event of an outbreak, vaccine and anti-viral medication would be allocated on a priority basis, according to Arizona's draft plan. But the plan doesn't detail criteria.

Among its few specifics, the plan cites several strategies to detect and control a flu pandemic, including:

• Discharging all but critically ill hospital patients to make room for flu patients.

• Expanding mortuary services to handle the dead.

• Ramping up state health lab testing to identify flu pandemic strains.

• Isolating and quarantining residents who are exposed to the virus or are ill from it.

State health officials say they're doing the best they can but may need to ration resources.

"There's a lot of discussions about the ethical use of public health resources during an emergency," said Engelthaler, who helped engineer the state pandemic flu plan.

Setting priorities ahead of time is difficult, especially for the distribution of anti-viral medication and vaccines, said Will Humble, the Arizona Department of Health Services' chief of public health preparedness.

"The whole key to this thing is, it's just like a forest fire. You've got to put it out quickly," Humble said. "Pandemic flu is always an A-list thing with us as far as public health preparedness because viruses from the beginning of time have been nature's Number 1 terrorist."

Don't panic, plan. There are a lot of things you can do to protect your family from this lurking killer. Flu Wiki is the place to start and the place to share your wisdom. Working together makes us stronger. Collaborating means we won't just survive, we'll thrive.

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Posted by Melanie (Bump in the Beltway) at 10:00 PM