Washington-area officials prepare for possibility of flu pandemic

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Washington-area officials prepare for possibility of flu pandemic

By BRETT ZONGKER, The Associated Press

Dec 17, 2006 12:01 AM

WASHINGTON - School buses in Fairfax County could be used to pick up

pandemic-flu victims, who might be steered to alternative clinics

rather than overcrowded hospitals. Health officials there also plan to

conduct a " tabletop " exercise next month to test their ability to

quarantine people showing signs of the disease.

But like many involved in pandemic-flu preparation, the Washington

suburb is struggling with a number of unanswered questions: Would

there be enough vaccine and antiviral drugs if the plague actually

strikes? Would enough nurses, doctors and utility workers show up to

work critical jobs? And would coordination efforts in the private and

public sectors pay off in a populous region that is home to the

federal government?

Most Washington-area health officials readily acknowledge that things

wouldn't go exactly as planned. They know well that many governments

were overwhelmed during the 1918 flu pandemic that killed more than

600,000 Americans and nearly shut down the nation's capital.

" In a disaster, during such situations, things can't be perfect, " said

Dr. Gloria Addo-Ayensu, Fairfax County's health director.

Local officials say they want people to prepare for the possibility of

a pandemic, however remote. And they have made it clear they want to

have their plans - and stockpiles - in place before it's too late.

The District of Columbia, for example, is collecting more than 2.5

million masks for police, health-care workers and others. And D.C.,

land and Virginia health officials plan to purchase the full stock

of antiviral drugs allowed under federal guidelines, which are based

on population.

But many states aren't doing enough to prepare for health emergencies,

including a flu pandemic, one report suggests. The study, released

last week by the Trust for America's Health, ranked land and the

district at the lower end of the scale. Virginia, however, was among

the 14 best-prepared states for a health emergency, including a pandemic.

" We've come a long way, " said Dr. Kaplowitz, a top health

official in Virginia. " We're not there yet. "

The report found both land and Virginia would run out of hospital

beds within two weeks of a moderate pandemic outbreak. Although the

district was in slightly better shape for hospital space, it failed to

score points in several other areas, including flu vaccination rate

for adults over 65.

land and D.C. officials disagreed with some of the report's criteria.

" They're not measuring perhaps the most important thing, which is

actual experience, " said Dr. Gregg A. Pane, D.C.'s chief health

officer. " The national capital region and D.C. Department of Health,

in particular, have probably more experience standing up for various

disasters or potential problems than any place in the United States. "

land should have received extra points for its extensive drills

and exercises, said Dr. Marsha Davenport, a medical epidemiologist for

the state's Department of Health and Mental Hygiene.

land, Virginia and some local health departments have run mass

vaccination drills to practice quickly dispensing antivirals and

vaccine. Health officials across the region also are working to

prioritize the distribution of medication, vaccine and equipment.

" We all are dealing with the reality that there will be shortages of

antivirals, of vaccine, as well as some essential equipment, " said Dr.

Ulder J. Tillman, Montgomery County's health director.

The discussion about a vaccine assumes that one will be available to

treat the avian-flu strain that has killed humans but has yet to pass

easily from human to human and may never become a pandemic. But

researchers are rushing for a solution to prevent a pandemic in case

the virus ever makes that final leap.

" If we can prevent people from getting ill and having some of the

complications, then we can potentially avert that or make the pandemic

no worse than a seasonal flu type of illness, " said Dr.

, an assistant professor at the University of land School

of Medicine who is leading an avian flu vaccine trial for the National

Institutes of Health.

Both public and private-sector officials are worried about employees

who would be absent because they are ill, tending to sick family

members or afraid of catching the flu. In Prince 's County,

officials are addressing this concern by working to " cross-train "

employees so they can serve different functions.

" We would lose approximately a third of our workforce at a time, " said

Gwendolyn Clerkley, the county's acting health officer. " We may be

asking people to do jobs they are not accustomed to doing. "

The workforce shortage would likely extend to other critical

industries - many of which have made their own plans. Verizon, for

example, has been looking at ways to keep the dial tone operating in

the event of a pandemic. But it acknowledges that high absence rates

and possible quarantines could present problems.

" While by and large the network keeps running, you need to still

apportion your resources for people to move out and about, " said Mark

Marchand, a spokesman for Verizon's corporate center in Basking Ridge,

N.J. " We need to be able to make sure if there are quarantines or

whatever, that we can maintain those kinds of services. "

A unique challenge for Washington-area health officials is the sheer

amount of coordination required in a dense region with 5 million

residents, more than 20 localities and dozens of federal agencies.

" One day (former Federal Reserve Chairman) Alan Greenspan's office

called, " said Pane, the district's chief of health. " They're just very

concerned about this problem, and the Federal Reserve has done a lot

to keep the economic backbone of the country running. "

The district's pandemic plans read like a laundry list. Along with

stockpiling, city officials are trying to improve coordination with

localities, embassies, the sonian, the World Bank and many others.

The city is working with hotels and building managers to encourage

people to shelter there rather than rush to hospitals. It also is

involved in a pilot program to mine the Medicaid database to identify

where vulnerable citizens are located.

Tabletop discussions and exercises to test emergency communications

have involved federal partners, the military, area hospitals and

regional leaders from land and Virginia.

" It was very good to be able to see whose plans maybe didn't intersect

very well with somebody else's plans, " said Beverly Pritchett, senior

deputy director for the D.C. Emergency Health and Medical Services

Administration. " We learned a lot from that before the day was out. "

Despite the plans, there are concerns that some important steps will

not be taken.

For example, local officials would be in charge of closing public

schools, if necessary, to quell a pandemic. But private schools have

been forgotten during past emergencies, said Gibbs, spokeswoman

for the Archdiocese of Washington, which operates Catholic schools for

33,000 students in the area.

" What we've been really trying to do over the last five years is make

sure we're on the radar screen, " she said.

Smaller localities are also working to prepare for a pandemic, but

some are behind the larger, more urban jurisdictions.

For example, Calvert County, Md., says it's making progress. But Dr.

, the county's health officer, said planning in the county

of 90,000 residents is in " a fairly embryonic form. "

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