The recent strategy laid out by the Bush Administration to prepare for a possible bird flu pandemic in the United States is one which the administration hopes it will never need.
In case of an outbreak, it has been predicted that two million Americans will die, 50 million will be infected, and 40 percent of American workers will be off their jobs.
Development of a new vaccine specific to a human flu strain, stockpiling vaccines, quarantining infected individuals, minimizing human contact, liberal leave policies, and even bringing in the National Guard are some of the 300 recommendations included in the May 2006 “National Strategy for Pandemic Influenza” implementation plan that both government and non-government agencies are being asked to consider by the Bush Administration.
The latest flu plan outlined by the U.S. government however makes it clear that there will be a limited federal role. The White House stressed the fact that although federal aid will be available in the form of 75 million doses of stockpiled antiviral drugs and 20 million doses of vaccine, local governments will have to take on maximum responsibility in fighting the flu pandemic when it does hit the United States.
Julie Sinai, senior aid to Mayor Tom Bates, City of Berkeley, said that it was important not to work in isolation when it came to pandemic preparedness.
“Although we are lucky to have our own public health office, we need to involve the county and the state at the planning level,” she said.
Sinai also added that the mayor holds frequent breakfast meetings at which emergency preparedness methods for the pandemic flu are discussed.
“The mayor has agreed to have a meeting similar to the one on earthquake preparedness with officials from the state and county level to discuss the pandemic,” she said. “Citizens need to know that in case of an outbreak they need to stay home.”
But as some officials emphasize the need to coordinate a response the threat, others suspect that a major outbreak of the flu will turn each community into its own island.
“We can no longer be in denial that we will be on our own,” said Dr. Wendell Bruner, Contra Costa County Public Health Officer.
“We have to plan for the worst and hope for the best,” he said. “According to the federal plan, localities will be on their own.”
Highlighting the fact that counties will need to fall back on their own resources, Bruner painted a grim picture in the case of a possible pandemic in Contra Costa County.
“5,000 or more will die, tens of thousands will be infected, 20,000 or more will need hospital beds,” he said. “There are presently 1,500 hospital beds in the county which are mostly already filled up ... There will be no mass vaccinations as there is no vaccine available. We are not even in the capacity to produce this vaccine at the moment.”
And Bruner said the danger might have already arrived.
“Bird flu will be in the Bay Area this year, but by that we mean that it will come to the birds,” he said. “It does not necessarily mean that the H5N1 flu strain that will infect birds will infect humans as well.”
Bruner said that some have said it is unlikely that the bird flu pandemic will move on to humans. “But there will definitely be a flu pandemic sometime and when it does occur it will prove fatal,” he said.
Of the three influenza pandemics that have occurred in the last century, the 1918 pandemic—sometimes referred to as the “Spanish Flu”—wiped out 500,000 Americans and more than 20 million people worldwide. It infected one-third of the U.S. population and average life expectancy was reduced by 13 years.
The 1957 and 1968 pandemics killed tens of thousands of Americans and millions across the world. According to the National Strategy for Pandemic Influenza, scientists believe that viruses from birds played a role in each of these outbreaks.
Bruner also said that surveillance played an important role in combating the pandemic and that World Health Organization always remains on the lookout to try and stamp out any new flu strains before it gets started.
Contra Costa County recently carried out the strategic national stockpile drill at Moffett Field as part of a mock Northern California drug receiving and distributing exercise.
Dr. Tony Iton, Alameda County public health officer, told The Planet that the county’s plan to combat pandemic flu outbreak was recently revised.
“Our plan to combat the pandemic has four different phases,” Iton said. “These are surveillance, disease control, communication and resource coordination.”
Surveillance would include monitoring whether the virus has already entered Alameda County in which case quarantining people would be of no use, he said.
“We would also look out for reported cases of influenza, test cases in labs, and work along with the county hospitals in order to spot unusual trends,” Iton said. “People who have traveled to any country with the H5N1 strain would also be closely monitored. The state veterinary and agricultural organizations will be on the lookout for H1N5 cases in immigratory and wild birds and their deaths.”
Disease control would include isolating and quarantining people on a voluntary basis and to cancel schools and public gatherings.
“Hospitals would be very quickly filled up and all health care professionals will have to be on board at all times,” Iton said.
Iton added that communication and planning was just as important.
“We are working with BART and BUSD to discuss preparedness plans,” he said. “Thirty-five to 40 percent of workforces will be effected. The death rate is going to be under 2 percent and 35 percent of the population will be made ill.”
Young adults will be the most effected in the pandemic.
Dr. Tomas Aragon, director of The Center for Infectious Disease Preparedness in Berkeley, said that if waterfowl in California were to be tested for influenza at this very moment, test results would likely be positive.
“Bird flu will spread the way regular flu does but there will be more cases of pneumonia and more deaths,” he said.
Aragon also added that there had been a summer program in Berkeley last year to train public health professionals for a pandemic outbreak but this year the focus would be on earthquake preparedness.
Linda Rudolph, Berkeley public health officer, said that the city public health office was preparing the same way every other health department was.
“The two key messages we want to send out to the people of Berkeley is that the pandemic influenza threat is real and everyone needs to work with the public health office and the city to combat it,” she said.
Rudolph also added that in the first phase of the pandemic there won’t be any vaccines or anti-virals available and that the current anti-virals available are not that effective.
“We are working with the county health department to develop a system and to get medical volunteers,” she said. “Hospitals and health care providers will be inundated. Businesses and government offices will need to figure out a plan on how to keep functioning because a lot of people will be falling sick.”