'Every family needs a plan': If a flu pandemic develops around the world, each community will have to cope on its own

As bird flu infects more people in Asia, federal officials visit Rhode Island with a sobering message about the possibility of a killer virus crippling the nation.



06:47 PM EST on Saturday, January 14, 2006
BY FELICE J. FREYER
Journal Medical Writer



WARWICK -- If a flu pandemic develops around the world, each community will have to cope on its own, Michael O. Leavitt, U.S. secretary of health and human services, warned Rhode Island officials yesterday.

The entire nation will be affected, so the federal government will not be able to marshal help from other areas. "Every community will have to rely on its own resources," Leavitt told an overflow crowd of hundreds of Rhode Islanders at the Crowne Plaza hotel.

"Every state needs a plan. Every tribe needs a plan. Every school, every business, every church, every family needs a plan," Leavitt said.


Leavitt's visit to Rhode Island was his fifth stop in a tour he plans to take to every state to push for action on pandemic-flu planning. He spoke unflinchingly of what would happen if there were a worldwide pandemic like the Spanish flu of 1918, which killed 40 million people.

"Pandemics are world-changing events," he said. A flu virus of similar strength to the 1918 flu would sicken 90 million Americans and kill 2 million. Even the healthy would be affected, because there would be fewer people able to stock grocery shelves, deliver fuel oil, care for the sick or provide other services.

If a pandemic arrives, Leavitt said, "We're not going to be able to stop it. Our preparation is to try to limit its impact.

"We may be the first generation in human history . . . that has had the opportunity to do something about it in advance."

All states, including Rhode Island, are preparing action plans for coping with such a pandemic. In Rhode Island, the plan calls for dividing the state into 10 regions, with one hospital assigned to coordinate health-care efforts in each.

SCIENTISTS HAVE BEEN worried about the possibility of an influenza pandemic because in Asia, and most recently in Turkey, a lethal strain of bird flu -- called H5N1 -- has passed from birds to people, killing about half the people known to have been infected. Experts worry that this flu virus may mutate into one that is easily transmissible from person to person. It has genetic similarities to the 1918 virus and causes the same symptoms. People would have no immunity to this new virus, and a worldwide pandemic would result.

Another reason to fear a pandemic, Leavitt told yesterday's gathering, is that it is inevitable. There were 10 pandemics in the past 300 years and 3 in the past century. There is no reason to believe that the 21st century will be any different, he said.

Pandemics have shaped the history of human life, Leavitt said, from an unknown illness that quickly wiped out a quarter of the population of Athens in 430 B.C. to the Black Death in medieval Europe. "It completely reshaped the culture, economics, politics and history of that continent," he said.

Leavitt read newspaper accounts of the 1918 epidemic in his hometown of Cedar City, Utah, and in Providence, where 50 people were dying each day.

"Local preparedness is the foundation of pandemic preparedness," Leavitt said. While the federal government may be able to provide stockpiles of antivirals, or maybe even a vaccine, local governments will have to figure how to distribute it.

WITH CURRENT TECHNOLOGY, a vaccine takes six months to produce, and it would be impossible to produce enough for everyone. But new methods are in development, Leavitt said.

"We have to learn to talk about this in a way that informs but does not inflame," he said. "We need to inspire people to prepare but not to panic."

"The good news here is that everything we do in preparing for a pandemic will improve the health and safety of our nation," he added. Preparedness for a pandemic will establish systems that will help with other disasters.

The state Health Department estimated that at least 500 people attended the event, with some watching on closed-circuit TV in the lobby. The invited were people representing health care, energy, social-service agencies, education, government agencies, philanthropies and emergency responders.

Earlier yesterday morning, Leavitt held a private meeting with 38 community leaders, including members of the congressional delegation, Governor Carcieri, Lt. Gov. Charles Fogarty, Attorney General Patrick Lynch, the presidents of two hospitals and three health insurers, and Providence Journal executive editor Joel Rawson.

Carcieri and Leavitt signed a resolution setting goals for pandemic flu planning. Leavitt also announced that Rhode Island would receive $762,000 in federal aid toward the effort.