Facing a Pandemic

Tom Skinner, a public affairs officer for the CDC, tells VitaDocs that the CDC believes individuals should have an emergency preparedness plan for all purposes, including the bird flubird flu, should it come.

"Remember, the confusion after Hurricane Katrina?" Woodson asks. "Multiply that -- the emptied stores, stranded people, lack of transportation, services, and supplies -- times every state and probably every continent."

You couldn't ride it out for a few weeks -- the fluflu would probably come in waves, and even come back to an area, according to Woodson.

Both Woodson and the government are operating on the assumption that a vaccine, though in the works, probably will not be ready by the time the virus got cranking. Supplies might be scanty compared with need in a genuine pandemic.

The antiviral drugs, such as Tamiflu, may or may not work against bird flu, although the government is trying to assemble 20 million doses.

Skinner warns of social disruptions if the virus starts leaping from person to person.

On the CDC's web site:

• The government urges you to plan for the overcrowding or closing of hospitals, banks, stores, restaurants, and post offices.
• Schools may be closed for extended periods.
• Parents need to think about their children's needs and possibly even childcare requirements if the parents are able to get to work.

Woodson doesn't want to be a Chicken Little, but he does foresee a scenario in which utility companies would run out of coal and hospital generators out of diesel oil -- just because there was no one healthy enough to deliver these items. "Most doctors would want to stay open," he says, "but in our office, without electricity, we would have to close the office."

Hospitals may cease to be a refuge. According to the U.S. Department of Health and Human Services, Woodson says, there are 1 million hospital beds in this country, and 100,000 ventilators. Almost three-quarters of the beds are already full at any one time. "There is no possible way the hospital system could copeno possible way the hospital system could cope," he says.

Yet in many cities and municipalities, forward-thinking planners are trying to prepare the health care system for the coming of the virus. Jeff Kalina, MD, leads the Texas Medical Center's Pandemic Flu Task Force. He also spearheaded the center's hurricane efforts for Katrina and Rita.

"We mirror the Centers for Disease Control and FEMA guidelines," he says. "We are creating a plan and when we get it, we will drill it. If there is suddenly a ground zero and Person A gives it to Person B and Person C, we will spread the word about flu hygiene [hand washing and so on]. We also will be planning to create wards [of hospital beds]. We will turn the lights on; get triage going." Probably, says Kalina, people will be sent to places other than hospitals, where vulnerable people would be more susceptible to the bug.

Skinner adds that the CDC is developing software called FluSurge for hospitals to use in their planning and detection of viral spread.