Flu Outbreak Plans Draw on Warning Model Used for Hurricanes
CDC on Thursday issued new guidelines to help states, businesses, families and local communities plan their responses to a flu pandemic, the McClatchy/Houston Chronicle reports. The guidelines are based in part on a "pandemic severity index" developed by CDC that "ranks outbreaks in terms of expected deaths and is modeled after the hurricane warning system that the National Weather Service uses," the McClatchy/Chronicle reports (Pugh, McClatchy/Houston Chronicle, 2/2).
Under the pandemic severity index, the 1918 flu that in the U.S. killed 2.2% of those infected would be considered a Category 5. Pandemics in 1957 and 1968 that had case-fatality ratios in the U.S. of 0.5% would be classified as Category 2 outbreaks (Brown, Washington Post, 2/2).
A Category 5 virus in 2007 would kill an estimated 1.8 million U.S. residents, while a Category 1 outbreak would kill about 90,000, according to CDC (Russell, San Francisco Chronicle, 2/2).
The CDC guidelines are "considered critical" to slowing the flu spread in a pandemic during the months before a vaccine would become available, the Los Angeles Times reports (Chong, Los Angeles Times, 2/2).
In the event of a Category 1 pandemic, the guidelines recommend that infected people stay at home until they are no longer contagious and be treated with antiviral drugs if they are available.
In a Category 2 pandemic, which likely would kill between 90,000 and 450,000 people, or Category 3 pandemic, which likely would kill between 450,000 and 900,000 people, the following measures also should be considered: voluntary quarantine of households with sick individuals, dismissal of school students, postponement or cancellation of large public gatherings, such as sporting events and concerts, and the encouragement of telecommuting and staggered work schedules to avoid overcrowding of public transportation.
CDC recommends that in the event of a Category 4 pandemic, which could kill 900,000 to 1.8 million people, or a Category 5 pandemic, schools and child-care programs should be closed for up to three months. In addition, the gathering of children and teenagers in the community should be restricted (Los Angeles Times graphic, 2/2).
Communities should begin considering ways to continue providing services such as transportation and meal service to particularly vulnerable groups such as the elderly and people who live alone, according to the report (McNeil, New York Times, 2/2). State and local governments would have the authority to decide when to take specific measures.
The guidance, "notably, did not suggest restricting travel" because its authors "believe that if a pandemic's effects can be blunted or spread out over time, the essential functions of the economy may be able to continue largely unchanged," the Post reports (Washington Post, 2/2).
CDC Director Julie Gerberding said the agency deliberately copied the hurricane warning system because "[e]veryone knows what a Category 1 hurricane is, everyone knows what a Category 4 or 5 hurricane is and ... the different harm that could come from these kinds of different scenarios" (Neergaard, AP/South Florida Sun-Sentinel, 2/1).
Gerberding said that without immediate access to a vaccine, the next best response to a pandemic would be "to try [to] slow down the spread and buy some time" (Los Angeles Times, 2/2). Gerberding added, "Pandemic influenza is not necessarily imminent, but we believe it's inevitable. And it's not a question of if, it's a question of when, so we do have to prepare."
HHS Secretary Mike Leavitt said, "The disease is highly pathogenic and continues to spread. That's why we continue to take this threat so seriously" (McClatchy/Houston Chronicle, 2/2).
Martin Cetron, director of global migration and quarantine at CDC, said, "At the very onset of a pandemic, we're going to be stuck to deal with this without our best countermeasure, which would be enough vaccine for the whole population. We have to recognize that we're going to face the first wave of this without (vaccines)" (Manning, USA Today, 2/2).
NPR's "Morning Edition" on Wednesday reported on the guidelines. The segment features comments from Cetron; Jeff Duchin, chief of communicable disease control, epidemiology and immunization for Seattle & King County Public Health; and Thomas Inglesby, chief operating officer for the Center for Biosecurity at University of Pittsburgh Medical Center (Knox, "Morning Edition," NPR, 2/1).
Audio of the segment is available online.