Bird Flu Alarm

2006-02-03-Bird Flu Would Overwhelm U.S.

Understanding Avian Influenza

2006-02-03-Bird Flu Would Overwhelm U.S.

U.S. flu experts are resigned to being overwhelmed by an avian flu pandemic, saying hospitals, schools, businesses and the general public are nowhere near ready to cope.

Money, equipment and staff are lacking and few states have even the most basic plans in place for dealing with an epidemic of any disease, let alone the possibly imminent pandemic of H5N1 avian influenza, they told a meeting on Thursday.

While a federal plan has been out for several weeks, it lacks essential details such as guidance on when hospitals should start to turn away all but the sickest patients and when schools should close, the experts complained.

"There is no way at this time that we can even plan for this epidemic," said Dr. Roger Baxter of the University of California San Francisco and associate director of the Kaiser Permanente Vaccine Study Center.

"We could be easily overwhelmed," Baxter told the meeting organized by the Infectious Diseases Society of America, the Society for Healthcare Epidemiology of America, the Centers of

Disease Control and Prevention and the National Institute of Allergy and Infectious Diseases.

"A lot of our facilities are old, with no isolation facilities," Baxter said.

H5N1 avian influenza has swept through flocks across Asia and into Europe, killing or forcing the culling of 200 million birds. It sometimes infects people and has infected 161 documented patients, killing 86 of them.

Experts say the virus is mutating steadily and poses the biggest threat yet for a long-expected global influenza pandemic if it acquires the ability to pass from person to person.

The world has not seen a flu pandemic since 1968, and that one was mild by most measures. The global public health system has crumbled as people enjoyed the respite from disease, experts say.

Now they are scrambling to fix it up, but say it is too big a job to do it quickly.

Dr. Dan Hanfling, director of emergency management and disaster medicine at the Inova Health System in Falls Church, Virginia, said hospitals in the Washington, D.C., area would be flooded with patients with nowhere to put them.

"There are going to be many, many people coming to the hospital because they are worried they may have been exposed," Hanfling said.

If there was just a 10 percent infection rate, that would mean 500,000 sick people in the Washington, D.C., area, Hanfling calculated. Some models assume that 20 percent of these people would need to be treated in hospitals.

"We are talking about finding 100,000 places," Hanfling said. "We have 7,800 staffed beds."

And hospitals are already filled to capacity with everyday illnesses.

"We'll still have heart attacks. We'll still have strokes. We'll still have babies to deliver," Hanfling told the meeting.

He cited one survey that showed only 66 percent of health care workers would show up for work if they thought patients might infect them. And an expected 25 percent could be out sick themselves, or caring for sick family members.

Dr. Trish Perl, president of the Society for Healthcare Epidemiology of America and director for infection control at Johns Hopkins Hospital in Baltimore said she did a quick estimate of how many masks, for instance, a hospital would need to get through a pandemic outbreak.

A protective face mask is standard equipment for use in caring for patients with respiratory disease such as flu.

A 600-bed hospital would need 1.6 million masks to get through six weeks ? and that is assuming the hospital eases up on rules requiring workers to wear a fresh mask at each encounter with each patient, Perl said.

Understanding Avian Influenza