Hyping the Fear for Medical martial Law
U.S. Prepares for Possible Flu Outbreak
Closing Schools, Rationing Medicine May Be Needed if New Flu Strain Sparks Outbreak, U.S. Says
The Associated Press/August 25, 2004
Closing schools, restricting travel and rationing scarce medications may be the nation's first protections if a powerful new flu strain spurs a worldwide outbreak because it will take months to brew a vaccine, say government preparations for the next pandemic.
Specialists say it's only a matter of time before the next one strikes, and concern is rising that the recurring bird flu in Asia could be the trigger if it mutates in a way that lets it spread easily among people.
There have been three flu pandemics in the last century, the worst in 1918, which killed more than half a million Americans and 20 million people worldwide.
It's impossible to predict the toll of the next one. But estimates suggest a bad one could kill up to 207,000 Americans, says the nation's new response plan, obtained Wednesday by The Associated Press.
That's almost six times more lives than regular flu claims every year. Millions of sick patients could swarm doctors' offices and hospitals, and the country could suffer an economic and social wallop from disruption of transportation, commerce, even routine public safety.
The Pandemic Influenza Response and Preparedness Plan, to be released Thursday by the Department of Health and Human Services, stresses ways to speed up vaccine production, limit the spread of such a super-flu, and care for the ill.
It's just a first draft, open for public comment through October as the government struggles to decide exactly how to respond to the earliest signs of a pandemic.
"We recognize that we need more treatments and we need more vaccine capability," Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention, said in an interview.
"But it's also important to remember good, old-fashioned isolation and quarantine have a special role to play in any pandemic," she said. "One of the things we have to do now, before we're in the middle of this situation, is do our very best to make sure people understand what would be the first steps, why they'd be necessary, and what they can do to minimize the disruption."
Among the preparations:
The CDC is increasing surveillance so it can spot dangerous flu strains as soon as they emerge anywhere in the world, offering early warnings.
It now takes six to eight months to develop a new vaccine against the slightly different flu strains that circulate every winter. A pandemic strain would be genetically very different. Government scientists plan to create "seed viruses" as potential vaccine candidates in hopes of speeding production. And HHS is working with manufacturers to ensure fast access to supplies including the chicken eggs that flu vaccine is grown in so production could start at a moment's notice.
Four drugs can treat the flu if given soon after symptoms begin, and decrease chances of catching it. U.S. supplies of the two considered top pandemic candidates, Tamiflu and Relenza, are limited, but HHS began stockpiling some Tamiflu last year.
HHS is increasing pressure on states to prepare their own plans for dealing with pandemic flu this year, including how to free up enough hospital beds to handle the sickest patients. Last year, only about a quarter of state health departments had such plans.
Travel restrictions like those implemented during last year's SARS crisis in Asia and Canada, closing schools and restricting public gatherings, even quarantine may be necessary to limit the spread of infection, depending on where a pandemic begins and how virulent it seems.
The government is seeking input from hospitals and state health departments as it develops the plans.
Indeed, HHS is asking some big questions, such as whether the federal government should control all supplies of a pandemic flu vaccine to ensure the people who need it most get it. Recent shortages of regular flu vaccine led to price hikes and other practices that limited access by the elderly and other particularly at-risk patients.
Similarly, the government is considering rationing anti-flu drugs before a vaccine is produced, debating if doctors, nurses, police and other groups should get first doses along with the most frail patients.
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