Bird Flu Alarm

2006-05-03-US flu report predicts chaos

Understanding Avian Influenza

2006-05-03-US flu report predicts chaos

A White House report on pandemic flu paints a grim picture of the social and economic chaos that could overtake the country in a serious outbreak, including widespread illness and 40% absenteeism, potential school closures and travel restrictions.

Experts contacted by USA TODAY praise parts of the 227-page plan, which is expected to be released today. But they say it places too great a burden on states and includes recommendations, such as quarantine of potentially exposed air travelers, that are not feasible.

USA TODAY obtained a copy from a source who had direct knowledge of the plan's preparation.

The report says the government is committed to expanding a stockpile of anti-virals and developing a vaccine, but it reiterates the message that disasters are local events and require local responses. "The center of gravity of the pandemic response will be in communities," it says, and federal support will be limited.

The approach that "communities will be on their own" is a concern, says Jeffrey Levi, director of Trust for America's Health, a public health advocacy group.

"Where you live shouldn't determine whether and how you are protected," he says. "It should be the same policy across the country ? who will be prioritized for vaccines or anti-virals, whether schools will be shut down."

Rajeev Venkayya, special assistant to the president and senior director for biodefense, would not comment on details of the plan but says, "Our responsibility is to lay everything on the table so we can have a candid conversation."

The plan is a follow-up to a strategy President Bush outlined in November.

No one knows when a pandemic will occur, but experts fear that a bird-flu virus that is now spreading across the globe could spark one should it mutate and develop the ability to spread easily among people. The plan provides some idea of what could happen if a pandemic does occur:

? At work, employees would be advised to avoid hand-shaking and maintain a 3-foot distance from co-workers. Flexible work hours and telecommuting would be recommended.

? Schools and public transit facilities may close.

? Closing the border would be difficult, but airline travel may be restricted. Ill passengers could be isolated and fellow travelers quarantined.

That part of the plan may not be feasible or effective, says infectious-disease specialist William Schaffner of Vanderbilt University in Nashville. "There will be many people who have a bit of cough, and will we be able to isolate people with symptoms and quarantine the others? I don't know if we have facilities for it."

But, he says, the plan realistically makes it clear that once a pandemic strain of flu begins to spread from person to person anywhere in the world, it might be impossible to contain. "They've told everyone ... they cannot keep the hurricane offshore," Schaffner says. "The hurricane will make landfall."

Understanding Avian Influenza