Bird Flu Would Ravage U.S., White House Warns

Times Staff Writer

The White House on Wednesday unveiled a foreboding report on the nation’s lack of preparedness for a bird flu pandemic, warning that such an outbreak could kill as many as 2 million people and deal a war-like blow to the country’s economic and social fabric. It urged state and local governments to make their own preparations beyond the federal efforts.

In the government’s first detailed look at the potential effects on public health and U.S. society as a whole, the report said a full-blown pandemic could lead to travel restrictions, mandatory quarantines, massive absenteeism, an economic slowdown “and civil disturbances and breakdowns in public order.”

It warned that the healthcare system -- including doctors, nurses and suppliers of pharmaceuticals -- was inadequate to meet the country’s needs in a flu pandemic. “In the event of multiple simultaneous outbreaks, there may be insufficient medical resources or personnel to augment local capabilities,” the report warned.

More broadly, state, local and tribal governments should “anticipate that all sources of external aid may be compromised during a pandemic,” it said, meaning that “local communities will have to address the medical and non-medical effects of the pandemic with available resources.”


While warning that as a last resort, mandatory travel restrictions may be necessary, such limits alone “are unlikely to reduce the total number of people who become ill or the impact the pandemic will have on any one community.”

Some observers welcomed the report’s blunt tone.

Michael Osterholm, an expert on disease control who has long warned that the nation is ill-prepared for a bird flu pandemic, praised the 234-page report as “a very important step forward.”

“This was a brutally honest but very fair ... assessment of where we’re at,” Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said in a telephone interview. He said he had no role in preparing the report.


The document includes the White House Homeland Security Council’s plan to implement a national strategy in the face of a flu pandemic, for which Congress appropriated $3.8 billion in December.

The strategy is built around three elements: preparation, surveillance and detection, and containment. And the report listed more than 300 steps that it said the administration would take, had already begun to take, or would recommend that state and local governments pursue.

In a cover letter, President Bush said the government had made “major investments in vaccine and antiviral development, research into the influenza virus, surveillance for disease in animals and humans, and the local, state and federal infrastructure necessary to respond to a pandemic.”

But the report indicated that only a bare beginning had been made thus far on preparing for the kind of large-scale, months-long disaster a flu pandemic would represent.


And critics were quick to attack what they said was the administration’s slow response.

As Frances Fragos Townsend, the president’s domestic security advisor, presented the report, Sen. Edward M. Kennedy of Massachusetts, the senior Democrat on the Senate Health Committee, issued a report of his own that chastised the administration for what it said was a failure to prepare the country for a flu pandemic.

Speaking on the Senate floor, Kennedy said the administration suffered from “competence-deficit disorder,” and said the White House report represented the third attempt to write a flu plan.

“No amount of revision can disguise the fact that other nations have been implementing their plans for years, while we are waiting to read ours for the first time today,” Kennedy said. “The United States is at the back of the line in ordering essential flu medicines, and we’re at the bottom of the international league in having a coordinated national strategy.”


There have been no verified incidences of bird flu in either wild birds or domestic poultry in North America, and spread of the disease from human to human has not been documented.

But, the report said, scientists believe birds played a role in two global influenza pandemics in the last 50 years that killed millions of people. It said that since the influenza strain known as H5N1 appeared in humans in Hong Kong in 1997, it has spread across Asia and into Africa and Europe and has infected more than 200 people, killing more than 50% of them.

For the Bush administration, the report represents an opportunity to demonstrate an effort to prepare for a potential catastrophe after the criticism it suffered for its response to Hurricane Katrina at the start of its second term, and, four years earlier, the intelligence failures that were blamed for not securing the nation against the Sept. 11 attacks.

Looking at specific demands that a pandemic would impose on the nation, the report said that workplace absenteeism could reach 40%.


To illustrate what the effect of such high levels of absenteeism could mean, Osterholm said that the oil industry had reported in one preparedness seminar that its refineries could not function if 30% of workers were absent -- a figure suggesting that a pandemic could have a domino effect across the economy.

Although praising the study for “educating the government and hopefully the public that the pandemic is not just a health emergency,” Kim Elliott, deputy director of the health policy nonprofit Trust for America’s Health, said it failed to address the cost of implementing it.

She said Congress’ appropriation covered barely half of the $7.1 billion that Bush said last year would be needed.