U.S. Bird Flu Plan Taking Shape

Stefan Lovgren
for National Geographic News

April 17, 2006

A U.S. national response plan is being finalized to combat a potential pandemic of avian influenza.

Expected to be approved by President George W. Bush in the next week or two, the proposed bird flu plan is the first attempt to spell out how the federal government would respond to an outbreak that threatens to kill as many as two million Americans.

The draft plan reportedly calls for the closing of schools and large gatherings. Other emergency measures include drive-through medical exams and shifting production of U.S. money to foreign sites, in the event that the usual facilities are sidelined.

The Washington Post yesterday reported details of the plan, which has not yet been officially announced.

Such a pandemic could make as many as 90 million Americans sick in a worst-case scenario, the plan warns.

Christian Sandrock is an infectious-disease expert at the University of California, Davis.

While he has not seen the draft plan, he welcomes a national preparedness strategy. But, he says, the real question is how it will be implemented on the local level.

"If they just say a certain percentage of people will be infected and you need to close schools, well, that's easily said but it doesn't mean it will work," Sandrock said.

"The key is to outline who gets the authority, how resources are going to be allocated on a local level, and how it's going to be managed locally."

Shifting Air Traffic

The H5N1 avian influenza virus—the strain that currently poses the greatest threat—is found primarily in domestic and wild birds.

(Photo gallery: The Next Killer Flu.)

Federal officials warn that the first case of bird flu could show up in the United States in the coming weeks or months as birds migrate from overseas.

The virus has yet to become easily transferable among humans. Pandemics occur when viruses mutate into forms that are easily passed from person to person and that cannot generally be stopped by the human immune system.

Still reeling from criticism over its handling of Hurricane Katrina, the Bush Administration will reportedly recommend in its plan that schools should be closed during a pandemic and large gatherings canceled.

Air traffic could be shifted to busier hubs where the flu may not have yet struck.

With as many as 40 percent of the workforce expected to be out during a pandemic, federal officials anticipate that employees could strain U.S. Internet capacity while working from home, according to the Post report.

Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota in Minneapolis, compares a potential pandemic to a worldwide 12- to 18-month "blizzard."

"Most of the federal government right now is as ill prepared as any part of society," Osterholm told the Post.

Medicine Stockpiles

The plan relies on the quick distribution of medications and a possible vaccine.

The U.S. Veterans Affairs Department has developed a medical exam that could be conducted in VA hospital parking lots to look for signs of infection.

But scientists are still debating who should be vaccinated first in the event of an outbreak—those most likely to spread the virus or those traditionally first in line for winter flu shots (generally the very old, very young and chronically ill).

The U.S. government currently has about five million courses of the antiviral drug oseltamivir (sold under the trade name Tamiflu). Federal authorities aim to secure 21 million doses of Tamiflu by the end of the year.

A recent study showed that, without any vaccines or travel restrictions in place, the U.S. would need 182 million courses of Tamiflu to combat a virus with the same transmissibility of the virus that caused the 1918 "Spanish flu," which killed 20 to 40 million people worldwide.

(See "U.S. Not Ready for Fast-Spreading Bird Flu, Study Finds.")

Sandrock, the UC Davis expert, says training for an outbreak must be done locally.

"If we out here in California don't read the [national] plan and practice it, it's going to be useless," he said. "To refer to a 500-page book the day the pandemic arrives is going to do nothing for you."

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