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See excellent post by DarkSyde, interviewing Dr. Tara Smith. This Science Friday follow-up expands on some of her points about H5N1.

Did you know that flu experts met in Washington this week and took stock of the situation? The conclusion, after evaluating what's going on here and abroad, is that we're not ready if it should ever get here.

U.S. experts expect to be overwhelmed by bird flu

WASHINGTON, Feb 2 (Reuters) - 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.

The Feds agree. HHS Secretary Mike Leavitt is touring the country (he was in CT yesterday), explaining about the disastous 1918 flu and warning that if (and when) a pandemic strikes the US, and you're not prepared, there's no cavalry coming from DC.

Rell and Leavitt signed a resolution at Thursday's event to affirm the
state and federal governments' commitment to work together on pandemic
planning. Local officials who attended the conference also were
directed use its lessons as they create or revamp their own
municipalities' preparedness plans.

But the details include a $1 million grant to prepare all of CT. That works out to be around $32,000 per CT's acute care hospital, and  if you think that's enough to solve this problem (if nothing else, that'll buy enough tamiflu to treat 10,000 of CT's 3.5 million citizens), I've got a bridge in Brooklyn to sell you. The Feds know this, and that's why they're warning citizens to consider stockpiling food and water in the event services are disrupted.

Why would services be disrupted? Well, the planning assumptions are that 40% of the workforce would be ill, and half of those would seek hospital care. That means a big hit to our just-in-time economy, which is not designed for such an event. The workers who maintain infrastructure for water treatment plants and bring and distribute food into cities might be affected. Cities typically have a weeks worth of chlorine and a week's worth of food on supermarket shelves. what happens if they can't be replenished?

But isn't that just "fearmongering"? That's a term some of the skeptics like to use, and there are skeptics. However, even the skeptics agree on several points: some day there will be a pandemic, they just don't this it's the current H5N1 that'll be the problem. And they also agree, for the most part that pandemic praparation is a good thing. What they emphasize is that the H5N1 virus in the news is a difficult virus for humans to catch in its current form, and that it needs to go through some significant mutations in order to move from an avian flu to a pandemic flu. Their focus is on vigilence in the hen house, by making sure the poultry that can get H5N1 are monitored, vaccinated (there are bird vaccines) and (if necessary) culled.

But even that is a big deal. H5N1 in CT would cost the state $193 million in lost commerce if the largest egg producer were shut down by culling chickens. And the cost to developing countries where poultry has to be culled now (Turkey, SE Asia and Iraq) is enormous, a cost they can't afford.

Something else has been happening as well. The virus has continued to mutate, picking up abilities that make it ever so slightly easier to infect humans. The assertion by the skeptics that 'it just won't happen' is nonetheless being challenged by virologists, epidemiologists and public health docs all over the world. It may, indeed, not happen but that's an unknown and not a fact. In the meantime, new cases are reported every week, and the Iraq cases have to give one pause. It's a war zone. Imagine if the next international WHO team sent in to asess, treat and control an outbreak is either kidnapped or blown up. Is that 'fearmongering'? Ask the ABC News team.

Back home, as the prep message makes its way from Leavitt to state leaderts to local leaders, the message is heard, but heeding it is difficult.

County health officer Ulder Tillman discussed local efforts, which
include a disease hot line and quarantine orders in case of a flu

The county is also planning a session with area businesses to establish
crisis plans in the event that a pandemic affects a large number of

Council President George L. Leventhal took issue with Tillman's
recommendations that residents stockpile up to 30 days of food and
water in case of a flu quarantine.

``I have half an acre of land that I live on. Where am I going to put
all these gallons of water?" said Leventhal (D-At large) of Takoma
Park. ``I don't think it's reasonable to ask people to give up a
portion of their living space when they have no room."

Asked by Councilman Michael L. Subin (D-At large) of Gaithersburg
whether any county building or agency had taken the same precautions,
Tillman said no.

In the end, we have a situation just like pre-Katrina. Something might happen and we don't know when. if it does happen, we need to be prepared, not just now but 10 years from now. And if you're going to prepare, best plan for a cat 5 storm, not a cat 3. And just because you can't remember such an event in your lifetime doesn't mean it hasn't happened, or that it won't happen again. So you'd best get used to calm, rational planning. Don't call it 'fearmongering'. Call it experience.

Crossposted to The Next Hurrah

Originally posted to Daily Kos on Fri Feb 03, 2006 at 05:32 AM PST.

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