Responding to the avian flu threat

After years of formulation, President George Bush on Nov. 1 unveiled a plan for preparing for and responding to a global pandemic unleashed by a virulent new strain of human transmittable avian flu—a pandemic that Dr. David Nabarro, the United Nation’s new pandemic czar, warned threatens the very survival of the “world as we know it.”
There’s little doubt that a global flu pandemic would be calamitous, warned Nabarro, who said in October, “We’re dealing here with world survival issues.” He stressed, “We just can’t go on approaching it with sort of business-as-usual type approaches.”
“There is no question that the consequence of a worst-case global pandemic is dire,” HSToday was told by Dr. Paul Offit, chief of the Division of Infectious Diseases and the Maurice R. Hilleman professor of vaccinology at the Children’s Hospital of Philadelphia, and author of the new book, The Cutter Incident: How America’s First Polio Vaccine Led to the Growing Vaccine Crisis .
The administration plan inherently admitted that the government is woefully unprepared today—and for perhaps years—for coping with a catastrophic pandemic. The administration said nearly 2 million Americans could be struck dead and nearly 10 million hospitalized.
The numbers were remarkably higher than previous worst-case estimates calculated by the Centers for Disease Control and Prevention (CDC). CDC had previously postulated that a pandemic in the United States would make between 40 million and 100 million people sick and kill somewhere between 89,000 and 300,000. The CDC’s best-case scenario resulted in 75,000 deaths, and a worst-case scenario left nearly 500,000 dead.
Offit and other authorities told HSToday the higher numbers seem to be recognition of the potential for a catastrophic pandemic sweeping across America.
The plan reflected the possibility of such a pandemic. Some of the proposed measures included forced rationing of vaccines and anti-viral medications; enforced quarantines imposed by the military; and draconian travel and border restrictions.
“An influenza pandemic will place extraordinary and sustained demands not only on public health and health care providers but also on providers of essential services across the United States and around the globe,” the plan said.
The plan also placed much of the burden of controlling a pandemic on the shoulders of state and local authorities. State and local responsibilities included local rationing of vaccine and drug supplies; issuing and enforcing local quarantines and closing schools; housing the sick and dying when hospitals’ surge capacity was overwhelmed; and ensuring the delivery of food, water and essential basic public services in the midst of a near-anarchic societal collapse.
Public health officials across the country said only $100 million of the $7.1 billion in proposed spending to prepare and respond to a pandemic is earmarked for state and local public health departments. They also questioned the plan’s reliance on already cash-strapped states to come up with an estimated $510 million to help pay for making enough anti-virals to treat 81 million Americans.
But even 81 million doses of the anti-viral drug Tamiflu isn’t enough, said Sen. Charles Schumer (D-NY). He pointed out that the plan provides for only 7 percent of the population to receive Tamiflu, “and that just isn’t enough. Experts agree that we should have enough anti-virals like Tamiflu to cover 40 percent to 50 percent of the public.”
The plan also did not deal with a pandemic’s effect on the transportation sector, the economy and business operations.
Administration officials say the plan represents only a start and that other segments of society that must also be addressed, such astransportation and business, will be tackled as the plan is enhanced by the input of other federal departments and agencies.
The plan also calls on Congress to pass legislation shielding drug makers from product liability lawsuits to encourage more vaccine-manufacturing capacity. The shield would cover only pandemic-related products.
At present, there are only a handful of flu vaccine manufacturing plants in the world that can produce about 450 million doses over six months, once the lethal new strain is isolated. That is enough vaccine for less than 10 percent of the world’s population. Because all but one of these flu vaccine factories are located in the United States, the plan calls for increasing domestic production. Otherwise, the United States might see only a fraction of the vaccines that would be needed in the event of a pandemic.

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The Government Technology & Services Coalition's Homeland Security Today (HSToday) is the premier news and information resource for the homeland security community, dedicated to elevating the discussions and insights that can support a safe and secure nation. A non-profit magazine and media platform, HSToday provides readers with the whole story, placing facts and comments in context to inform debate and drive realistic solutions to some of the nation’s most vexing security challenges.

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