U.S. Urges States to Prepare for Bird Flu

Health and Human Services Secretary Mike Leavitt urged each state on Monday to prepare for the possibility of a deadly bird flu pandemic by holding its own planning summit within the next four months.

During a daylong meeting of about 200 state and federal health and emergency planning officials, Leavitt said it was time to move “from ethereal plans to community action” that would include local policies for distributing lifesaving medicines, closing schools, restricting travel and giving accurate information to the public to head off panic.

Leavitt acknowledged that the feared worldwide contagion might not occur soon, but said it was better to be prepared. He noted that even if no pandemic emerged, the nation would gain by modernizing its vaccine industry, the cornerstone of President Bush’s $7-billion pandemic preparedness plan.

Some state officials at the meeting were skeptical about added costs and shifting priorities. Dr. Susan Allan, Oregon’s public health director, cautioned against what she called “the disease-of-the-month plan.”

“I do have a concern about the focus on a single disease, when other diseases may pose an equally severe risk,” she said. “I’m afraid that everybody will drop what they’re doing on other [health issues] and a lot of good activity will be undercut.”

Iowa health director Mary Mincer Hansen criticized a feature of Bush’s plan that calls on the states to bear a substantial share of the cost for purchasing antiviral drugs. These medicines are not vaccines, but can help ease severe flu symptoms and, in some cases, prevent infection.

Calling on the states to buy antiviral drugs “is doing a disservice to us,” Hansen said. “We need a national stockpile.”

Arizona and Minnesota will be the first to hold state summits later this month. California has not scheduled a meeting, a Health and Human Services official said.

Federal officials also distributed, to a mixed reception, a 63-item checklist to guide state health planners. Some welcomed guidelines from Washington, but others said they would prefer to set their own priorities.

Leavitt said mobilizing state and local governments was crucial to the success of any national plan. Without them, federal health officials can’t “put pills in the palms” of patients, he said.

A virulent strain of flu among wild and domestic birds in Asia has recently emerged among birds in Europe, but the H5N1 virus has not developed the ability to pass easily from one human being to another. The Centers for Disease Control and Prevention says the human cases involving that virus -- more than 100 since 1997 -- have occurred among individuals who were in direct contact with infected birds or contaminated surfaces.

Dr. Julie Gerberding, head of the CDC, told the gathering that it was “probably more likely than not that [the H5N1 virus] won’t evolve into a pandemic.”

Leavitt said “there is a better than 50% chance” that there will be no pandemic.

But if it did happen, 90 million Americans could get sick and 209,000 to 1.9 million could die, according to federal estimates. “Society is going to hold us responsible for what we did during this time,” Leavitt said.

Despite the administration’s sense of urgency, Bush’s pandemic plan has run into controversy in Congress. Some fiscal conservatives are insisting that the president’s request for emergency funding be paid for with cuts in other programs. Meanwhile, provisions to exempt the vaccine industry from liability in lawsuits are gaining ground, but lawmakers have neglected the issue of a compensation fund for those harmed by vaccines.

HHS officials say they are hoping to get the controversies resolved before Congress breaks for Christmas.

If the H5N1 virus emerges in the U.S., officials said it might be in the West, as migratory bird routes from Asia and North America intersect near Alaska. But John Clifford, a senior Agriculture Department veterinarian, said that wouldn’t necessarily be a cause for alarm about human health. Any infected birds and flocks that came into contact with humans would be killed, he told the meeting.