Remembering 1906. And 1918.

Posted April 17, 2006

Well it’s the centennial of San Francisco’s Big One, but it’s not 1906 that the feds are thinking about — it’s 1918 when a flu pandemic killed a half million Americans and 40-50 million people worldwide. Having been humbled by Katrina, the federal government is busy attempting to lower expectations that they will be able to do much about avian flu.

The Washington Post reports:

President Bush is expected to approve soon a national pandemic influenza response plan that identifies more than 300 specific tasks for federal agencies, including determining which frontline workers should be the first vaccinated and expanding Internet capacity to handle what would probably be a flood of people working from their home computers.

The Treasury Department is poised to sign agreements with other nations to produce currency if U.S. mints cannot operate. The Pentagon, anticipating difficulties acquiring supplies from the Far East, is considering stockpiling millions of latex gloves. And the Department of Veterans Affairs has developed a drive-through medical exam to quickly assess patients who suspect they have been infected.

The document is the first attempt to spell out in some detail how the government would detect and respond to an outbreak, and continue functioning through what could be an 18-month crisis, which in a worst-case scenario could kill 1.9 million Americans.

I published my thoughts about disaster preparation here - and it’s worth a review — because as the feds acknowledge, you won’t get much help. The WaPo notes:

"…officials have warned that the federal preparations go only so far. Much is left to the states, communities and even individuals. "Any community that fails to prepare — with the expectation that the federal government can come to the rescue — will be tragically wrong," HHS Secretary Mike Leavitt said in a speech April 10.

That would have been Secretary Leavitt’s famous "keep tuna and dried milk under your bed" speech. Why is he so pessimistic? Well, because when H5N1 mutates (a question of when, not if, according to the World Health Organization and many scientists), the planet will go through what Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota called a worldwide "12- to 18-month blizzard."

To keep the 1.8 million federal workers healthy and productive through a pandemic, the Bush administration would tap into its secure stash of medications, cancel large gatherings, encourage schools to close and shift air traffic controllers to the busier hubs — probably where flu had not yet struck. Retired federal employees would be summoned back to work, and National Guard troops could be dispatched to cities facing possible "insurrection," said Jeffrey W. Runge, chief medical officer at the Department of Homeland Security.

As Katrina illustrated, a central issue would be "who is ultimately in charge and how the agencies will be coordinated," said former assistant surgeon general Susan Blumenthal. The Department of Health and Human Services would take the lead on medical aspects, but Homeland Security would have overall authority, she noted. "How are those authorities going to come together?"

Essentially, the president would be in charge, the White House official replied. Bush is expected to adopt post-Katrina recommendations that a new interagency task force coordinate the federal response and a high-level Disaster Response Group resolve disputes among agencies or states. Neither entity has been created. Analysts at the Government Accountability Office found that earlier efforts by the administration to plan for disasters were overly broad or simply sat on a shelf.

"Our biggest concern is whether an agency has a clear idea of what it absolutely has to do, no matter what," said Linda Koontz, director of information management issues at the GAO. "Some had three and some had 400 essential functions. We raised questions about whether 400 were really essential."

In several cases, agencies never trained for or rehearsed emergency plans, she said, causing concern that when disaster strikes, "people will be sitting there with a 500-page book in front of them."

The federal government — as well as private businesses — should expect as much as 40 percent of its workforce to be out during a pandemic, said Bruce Gellin, director of the National Vaccine Program Office at HHS. Some will be sick or dead; others could be depressed, or caring for a loved one or staying at home to prevent spread of the virus. "The problem is, you never know which 40 percent will be out," he said.

Will the federal response be a complete waste? Nope — it just won’t be enough. They rightly acknowledge it and we should too. In fact, the feds have put together one of the best websites I have seen on how communities, neighborhoods, businesses, and families can prepare for flu. Check it out at http://www.pandemicflu.gov/.