Administration Plan For Flu Pandemic & tv coverage

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Bush Administration Unveils Plan For Federal Involvement In Flu

Pandemic

Article Date: 08 May 2006 - 2:00am (PDT)

The U.S. health care system will not be able to meet the country's

needs in the event of a flu pandemic, according to the government's

official pandemic flu plan released Wednesday, the Los Angeles Times

reports (Gerstenzang, Los Angeles Times, 5/4). The 227-page document,

divided into nine chapters, provides a list of actions federal

departments must complete as a pandemic spreads; makes predictions

about the effect of a pandemic; and makes recommendations for state

and local governments, as well as businesses (, New York Times,

5/4). The report cites avian flu, specifically the H5N1 strain, as a

potential source for the next pandemic, although it has not at this

time mutated into a form that is easily transmissible between people.

The report says even if the H5N1 strain never becomes a global

threat, " another novel influenza virus will emerge ... and threaten

an unsuspecting human population " (Allday, San Francisco Chronicle,

5/4). The plan estimates that a flu pandemic, likely to start abroad,

would probably spread in two or three global waves, each lasting

about three months. It predicts an outbreak would last six to eight

weeks in any given community (Brown, Washington Post, 5/4). The

report estimates that one-third of the U.S. population could become

infected, two million people could die, 40% of employees could be

absent from work during the height of an outbreak, and $600 billion

in income could be lost across the country (New York Times, 5/4). The

report says, " In the event of multiple simultaneous outbreaks, there

may be insufficient medical resources or personnel to augment local

capabilities. " The report adds that state, local and tribal

governments should " anticipate that all sources of external aid may

be compromised during a pandemic. " It also says that local

communities " will have to address the medical and nonmedical effects

of the pandemic with available resources. "

Pandemic Plans

The report says the federal government's strategy in the event of a

pandemic is based upon three elements: preparation, surveillance and

detection, and containment. It lists more than 300 steps the federal

government would take, has already begun to take or would recommend

that states and local governments take (Los Angeles Times, 5/4). It

also lists a timetable for completing those tasks. The plan says the

federal government cannot and should not try to fully manage the

response to a pandemic. The report states, " The impact of a severe

pandemic may be more comparable to that of war or a widespread

economic crisis than a hurricane, earthquake, or act of terrorism. "

It adds, " The center of gravity of the pandemic response will be in

communities, (and) the support the federal government can guarantee

to any state, tribe or community will be limited. " The plan gives

responsibility to the World Health Organization to be in charge of

managing global issues. It says WHO " represents the linchpin of

international preparedness and response activities. ... During a

pandemic we will rely upon it to be a highly visible and credible

coordinator of the international response. " The plan adds, " [W]e will

rely upon the WHO to confirm sustained human-to-human transmission of

a novel influenza virus, " and that decision will trigger the global

and domestic response (Washington Post, 5/4).

Domestic Response

The report says HHS will conduct the federal health and medical

response, while the Department of Homeland Security would be

responsible for coordinating the federal operations and resources

(New York Times, 5/4). Federal responsibilities listed by the plan

include supporting containment efforts abroad to limit arrival of a

pandemic in the U.S.; guidance to state and local governments and

other entities on measures to protect against a pandemic; changes

in " monetary policy " to lesson economic damage; obtaining and

distributing vaccines and antiviral drugs; and hastening research to

develop drugs and vaccines (Reichard, CQ HealthBeat, 5/3). The

government has a goal of stockpiling 75 million antiviral medications

for humans and 110 million doses of vaccine for poultry (Rockoff,

Baltimore Sun, 5/4). The plan expresses hope that there will be

enough vaccine to treat 20 million people, in addition to other

medical supplies and medications to give some protection while

manufacturers create a strain-specific inoculation.

Additional Measures

The report says the goal is to slow the progress of transmission of

the flu, beginning with screening international travelers for signs

of infection and quarantining potentially sick passengers. As the

pandemic spreads throughout the U.S., people will be asked to stay

away from crowds and to cancel nonessential travel. In addition,

patients' families would be temporarily isolated, while schools in

affected communities would close. Employers would be requested to let

people telecommute and regularly clean buildings (Neergaard,

AP/Atlanta Journal-Constitution, 5/4). The government will not close

the nation's borders but likely will limit the number of airports

that accept international flights and carefully screen travelers (New

York Times, 5/4). In addition, the government plans to help local

governments develop plans for canceling school and triaging patients

at hospital emergency departments (Washington Post, 5/4). The report

says, " Plan for the possible reduction or loss of income if you are

unable to work or your place of employment is closed. Stock a supply

of water and food " (CQ HealthBeat, 5/3).

Unanswered Questions

According to the Washington Post, " many crucial questions about the

government's response remain unanswered, " including how health

officials would determine who should receive the limited supplies of

vaccine and antiviral drugs; whether the government would use those

domestic supplies to help contain a foreign outbreak; the point at

which officials should begin mass treatment of U.S. citizens in order

to contain the virus here; and how travel and border-crossing might

be limited. Frances Fragos Townsend, President Bush's assistant for

homeland security and counterterrorism, said, " We recognize that we

cannot make these decisions in a vacuum and must consult with our

international partners to ensure that we adopt a consistent approach "

(Washington Post, 5/4). In addition, the plan does not account for

how flu pandemic efforts would be paid for. According to

Levi, director of Trust for America's Health, the plan acknowledges

that the response to a pandemic could go beyond the financial

resources of government agencies. The report cites President Bush's

$7.1 billion funding request for preparedness but does not address

how to pay for services that would be needed after a pandemic

strikes, according to Levi (Manning/, USA Today, 5/4).

Reaction

The report is " a very important step forward, " Osterholm,

director of the Center for Infectious Disease Research and Policy at

the University of Minnesota, said. He added, " This was a brutally

honest but very fair ... assessment of where we're at " (Los Angeles

Times, 5/4). However, Sen. Kennedy (D-Mass.) said the

administration's efforts for the report were inadequate, adding that

the U.S. preparations are running behind those in other countries. "

He said, " A flu plan that doesn't say how to distribute vaccine is

about as useful as a hurricane plan that doesn't say how to rescue

people " (Baltimore Sun, 5/4). Josh Sharfstein, commissioner of the

Baltimore Health Department, said the plan was welcome but

offers " new expectations without new resources. " He said the plan

asks local governments to deal with a big increase of hospital

patients, care for more patients at home and spend millions of

dollars on antivirals. Irwin Redlener, director of the National

Center for Disaster Preparedness at Columbia University,

said, " There's a disconnect between the rhetoric about what's needed

and the resources on the table. This is the mother of all unfunded

mandates. " Schaffner, chair of preventive medicine at

Vanderbilt University, said that the plan was " realistic " in advising

against shutting the borders and that cities and states need to be

prepared. He said, " Localities cannot rely on the feds to be the

cavalry that rides over the hill to rescue every U.S. town and city

from pandemic influenza " (New York Times, 5/4).

Supplemental Funding

In related news, the Senate voted on Wednesday to add $289 million to

establish a compensation fund for victims of experimental vaccines

and other products designed to combat possible pandemics such as

avian flu, CongressDaily reports. The measure passed 53-46, with 11

Republicans breaking party lines to vote for the addition to the $109

billion fiscal year 2006 emergency supplemental spending bill (HR

4939), which includes funds for the Iraq and Afghanistan wars.

President Bush has threatened to veto the measure if it comes out of

a House-Senate conference greater than $94.5 billion (Cohn/Heil,

CongressDaily, 5/3).

A copy of the report is available online. Note: You must have Adobe

Acrobat Reader to view the file.

Broadcast Coverage

Several broadcast programs reported on the avian flu plan:

ABCNews' " World News Tonight " : The segment includes comments from

Cilluffo, director of Washington University's Homeland

Security Policy Institute, and Townsend (Raddatz, " World News

Tonight, " ABCNews, 5/3). Video of the segment is available online.

NPR's " All Things Considered " : The segment includes comments from

Townsend (Knox, " All Things Considered, " NPR, 5/3). The complete

segment is available online in RealPlayer.

NPR's " Day to Day " : The segment includes comments from Laurie

Garrett, senior fellow for global health at the Council on Foreign

Relations (Brand, " Day to Day, " NPR, 5/3). The complete segment is

available online in RealPlayer.

NPR's " Day to Day " : The segment includes comments from Eddie

Hedrick, an epidemiologist and the emerging-infections coordinator

for the Missouri Department of Health and Senior Services

(Brand, " Day to Day, " NPR, 5/3). The complete segment is available

online in RealPlayer.

NPR's " Talk of the Nation " : Guests on the program included D.A.

, scholar at the Center for Biosecurity at the University of

Pittsburgh; Joe Neel, science correspondent for NPR; and Dorothy

Teeter, director and health officer for public health in King County,

Wash. (Conan, " Talk of the Nation, " NPR, 5/3). The complete segment

is available online in RealPlayer.

PBS' " NewsHour with Jim Lehrer " : The segment includes comments from

Townsend (Suarez, " NewsHour with Jim Lehrer, " PBS, 5/3). The complete

segment is available online in RealPlayer.

In addition, Townsend is scheduled to answer questions about the plan

in an " Ask the White House " chat on Thursday at 1 p.m. ET. A

transcript of the chat will be available online.

http://www.medicalnewstoday.com/medicalnews.php?newsid=42835