Details Emerge on Government Pandemic Flu Response Plan

President Bush this week is expected to approve the government's national pandemic influenza response plan, a draft of which details how federal officials would detect and respond to an outbreak and continue functioning through a potential 18-month crisis, the Washington Post reports. The 240-page draft document identifies more than 300 specific tasks for federal agencies, and federal officials working on the plan say it "continues to evolve," according to the Post (Connolly, Washington Post, 4/16).

The plan is based on a worst-case scenario that assumes as many as 90 million people in the U.S. would become sick and two million people would die in a pandemic. The report is based in part on the strategy Bush outlined in October 2005 (Pickler, AP/South Florida Sun-Sentinel, 4/17). Some of the plans outlined in the report include the following:

• The Department of Treasury could produce currency in other countries if its U.S. mints could not operate.
  


• The Pentagon is considering stockpiling millions of latex gloves due to concerns about acquiring supplies from Asia.
  


• The Department of Veterans Affairs could employ drive-through medical exams to quickly assess patients who think they have been infected by the flu.
  


• To protect the 1.8 million-strong federal workforce, the Bush administration could use its stockpile of medications, cancel large gatherings, encourage schools to shut down and move air traffic controllers to busier hubs.
  


• Retired federal employees could be called back to work, and the National Guard could be sent to cities facing possible "insurrection," according to Jeffrey Runge, chief medical officer of the Department of Homeland Security.
  


• The U.S could send medical teams and supplies abroad to help contain the first cases and introduce "travel restrictions to help stamp out that spark," Runge said.
  


• The U.S. Department of Agriculture would stagger shifts, close cafeterias, cancel face-to-face meetings and establish a 24-hour employee hotline to provide medical advice and work updates.
  

According to the Post, some agencies are "far along in preparing for a deadly outbreak," but "[o]thers have yet to resolve basic questions, such as who is designated an essential employee and how the agency would cope if that person were out of commission." In addition, "critical decisions" have yet to be made, such as "how much vaccine would be needed to immunize against a new strain of avian influenza" and "who should have priority for antiviral drugs," the Post reports.

Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said, "Most of the federal government right now is ill-prepared as any part of society." He said progress has been made, but the government is nowhere near prepared (Washington Post, 4/16).

California Department of Health Services officials said counties across the state, including Los Angeles, "have nowhere near the capacity" needed to treat the hundreds of thousands of residents who might require medical care in the event of a large-scale flu pandemic, the Los Angeles Times reports.

In March, Los Angeles County released results of a 2005 survey that found that 67% of hospitals in the county did not have plans for handling a flu pandemic. Only three out of five hospitals reported having extra supplies of gloves, masks, gowns and Tamiflu, an anti-flu medication.

To contend with a potential pandemic, Los Angeles County is creating a reserve volunteer medical registry of doctors, nurses and respiratory therapists who could be called for duty, Kay Fruhwirth, assistant director of the Los Angeles County emergency medical services agency, said. Nearly 600 retired doctors and nurses already are part of a reserve corps.

In addition, Los Angeles County is identifying "surge capacity" facilities such as schools, gymnasiums and community centers that could house and feed affected patients (Lin, Los Angeles Times, 4/17).