Bird flu planning discussed

TACOMA – More than 1,000 emergency planners from government, hospitals, schools, tribes and the military gathered in Tacoma on Friday to plan for a virulent viral pandemic.

“We don’t believe this is about ‘If,’ ” said Gov. Chris Gregoire. “We believe this is about ‘When.’ “

Three times in the last century, pandemics have swept the globe. They’re far more deadly than typical flu. The 1968 Hong Kong Flu, according to the World Health Organization, killed a million people. The 1957 Asian Flu killed 2 million. Worst of all was the 1918 Spanish Flu – now believed to have started in Kansas – which killed 40 million to 50 million people.

“This is not a disease that looks like seasonal flu. This is a devastating human illness,” said Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention.

Given the regularity of these vast, deadly epidemics – 10 in the past 300 years – public health officials are trying to quickly get ready for the next one.

“We are so much better prepared than we were even three or four years ago,” said Alex Azar II, deputy secretary of the U.S. Department of Health and Human Services. “People should not panic. People should be getting prepared.”

An outbreak would have dramatic effects, health officials say. Sick truckers and panic buying would lead to bare supermarket shelves. Schools would empty. With hospitals overwhelmed, health officials would set up triage centers in church basements and community centers. One Homeland Security official warned Friday that terrorists could try to take advantage of the chaos to launch strikes here. And unlike a normal natural disaster, no one expects waves of kindly civilian volunteers to rush to afflicted areas.

The good news is that the much-talked-about “Avian Flu” is not a human pandemic at this point, Azar and other health officials said. Although it’s killing millions of wild birds, it has killed fewer than 200 humans so far.

Most of those fatalities lived in close contact with poultry. Gerberding related the sad tale of a little boy in Vietnam whose pet chicken got sick. The heartbroken boy carried his chicken around, caring for it and trying to nurse it back to health. Both soon died.

But the unusually deadly Spanish Flu is thought to have mutated from a bird virus. So health officials are keeping close watch on the bird flu, which is expected to appear in the United States with migrating birds later this year.

“This is, so far, a bird disease,” Azar said.

It’s also mutating quickly. The viral strain detected in Vietnam just a couple of years ago changed by the time migrating birds carried it to Eastern Europe.

“That’s why you have to get a new flu shot every year. It constantly evolves,” Gerberding said.

Whenever a true pandemic emerges, federal health officials have set up teams to rush to any global outbreak and try to quell it with quarantines and drugs. It’s a strategy that Azar compared with trying to stamp out a spark in a tinder-dry forest.

They’re also stockpiling millions of doses of anti-viral drugs. The government has 5.5 million doses of Tamiflu stored, with another 12.4 million doses ordered. The government is also buying nearly 2 million doses of a second anti-viral drug. A tough challenge, Azar said, is setting up a distribution system to get the medicine to people within 36 hours after infection.

“We are basically buying this drug (Tamiflu) as fast as the manufacturer can make it,” said Gerberding.

The feds have started spending billions of dollars on a three- to five-year effort to dramatically speed up vaccine production once the new virus develops. Azar said the current system, which uses fertilized chicken eggs, cannot make the 300 million doses that America would need.

In the meantime, the government plans to stockpile 20 million doses of the viral strain thought most likely to evolve into a pandemic. Many of those doses would go to health workers, in hopes they provide some protection.

“There’s a possibility that a pandemic might not break out for years. Some will accuse us of crying wolf,” he said. “That is a risk we’re prepared to take.”

Mary Selecky, secretary of the Washington State Department of Health, is one of many health officials who want the feds to also stockpile mechanical ventilators. The virus fills infected people’s lungs with fluid, making it hard to breathe. The CDC estimates that tens of thousands of people, if not hundreds of thousands, will need ventilators during a pandemic outbreak.

Selecky said some parts of rural Washington have only one or two of the machines per county.

Much of the preparation must be local, federal officials said. Local health authorities have quarantine powers. They’re closest to potential victims.

Gregoire said that individuals and families must also prepare. In a pandemic, a large percentage of workers and schoolchildren would likely stay home. Some would be too ill to work. Others would be caring for family members. Health officials might order non-essential workers to stay home to prevent spreading the virus.

“We want our families to be thinking about how to do that and be prepared to really stand alone,” said Dr. Kim Thorburn, director of the Spokane Regional Health District.

Although face masks are of limited effectiveness in a pandemic, Gerberding said the government is stockpiling masks. They’re best at preventing already-infected people from touching their nose and mouth and spreading the virus, she said.

Gregoire said that Washington must be especially well-prepared. Thousands of people fly here daily from Asia, home of the first of the human bird-flu cases.

The state is urging businesses to develop plans to keep critical functions going with skeleton crews. Selecky said some are setting up ways to do payroll and bookkeeping from remote sites.

“We need to keep an economy going,” said Gregoire. “If 30 percent of a work force is out, how do you keep that shop open?”

Dr. Richard Raymond, undersecretary for food safety at the U.S. Department of Agriculture, said Friday that if bird flu does arrive in America, consumers shouldn’t worry about eating poultry. USDA vets examine the birds before slaughter, he said. And the avian flu kills so quickly that a large number of birds would likely die en route to the slaughterhouse and raise questions, he said.

Also, he said, cooking kills the virus.

“All you have to do is cook your bird to 165 degrees,” he said.