Pandemic question 'when,' not 'if'

Faith-based and community responders told to get prepared.

BY P.J. HELLER | ALBUQUERQUE, N.M. | April 23, 2007

Dr. Scott Santibanez of the CDC urges disaster responders to prepare for pandemic flu.
Credit: P.J. Heller

Warning that the U.S. is "overdue and unprepared" for a flu pandemic, disaster response organizations are being advised to prepare now much the same way they would for any major disaster.

"Just as communities plan and prepare for mitigating the effects of severe natural disasters like hurricanes, they should plan and prepare for mitigating the effects of a severe pandemic," said Dr. Scott Santibanez of the Centers for Disease Control and Prevention.

"We do think it's a time to prepare," he told attendees at the 15th annual National Voluntary Organizations in Disaster conference here. "It's not a time to panic, but it is a time to be preparing."

Santibanez, a physician trained in infectious diseases who now heads the CDC's partnership with faith-based and community organizations, said it was not a question of if a pandemic would hit, but when.

"We're walking that line between we don't want people to panic because there's no pandemic right now," he said. "But we need to prepare because at some point there will be another pandemic. We just don't know exactly when."

Santibanez said a pandemic typically occurs three times each century. The most deadly influenza pandemic in the 20th century occurred in 1918, which killed as many as 50 million people worldwide. Pandemics also occurred in 1957 and 1968.

"We know there's going to be another pandemic at some point, just because cyclically that's the way it happens," Santibanez said. "We don't know when the next pandemic is going to be. We don't know how many people it's going to affect. And we don't know if it's going to be the H5N1 bird flu that you've heard about."

That strain has shown up in birds and animals but health officials fear that if it mutates, it could spread rapidly from person to person. Some 300 human cases have been reported worldwide since 2003, with more than half of those infected dying of the disease.

"If you look at the migratory pattern of birds, it's not in North America yet, but it's only a matter of time . . ." Santibanez said. "We're not as concerned about that as much as we are about whether it mutates to spread from person to person."

The same day that Santibanez told response groups to prepare for pandemic flu, officials at the Food and Drug Administration in Washington announced it had approved the first U.S. vaccine against the avian influenza virus. The drug will be stockpiled by the government and will not be available commercially.

"The threat of an influenza pandemic is, at present, one of the most significant public health issues our nation and world faces," said agency commissioner Dr. Andrew C. von Eschenbach. "The approval of this vaccine is an important step forward in our protection against a pandemic."

The vaccine was expected to be a stopgap measure until a vaccine can be developed that addresses the specific pandemic strain of the virus.

Santibanez said that any new vaccine would not be available until six months after the start of a pandemic.

He stressed local planning and preparation was essential since help from other areas across the nation would not be forthcoming because those areas would also be coping with the pandemic. The pandemic could last six to eight weeks, as it did in 1918, or could be even longer, he said.

"All areas across the U.S. will be working on their own area at the same time," Santibanez said. "They won't be able to deploy and help out other areas that have been hit hard.

"Pandemic planning must occur at all levels of government, all sectors of society and we must develop a nationwide plan," he said. "This can't just be a government response."

Faith-based and community organizations are key elements in any plan, as are businesses, schools, and colleges, he said. An influenza preparedness checklist for faith-based and community organizations is available from the CDC.

"It's going to be a lot of different sectors working together," he added. "We need to be implementing measures in a uniform way and as early as possible."

Faith-based and community organizations will be "essential partners in protecting the public's health when an influenza pandemic occurs," according to an interim planning guide from CDC.

Among the guide's recommendations:

- Plan for ill individuals to remain at home.

- Plan for all household members of a person who is ill to voluntarily remain at home.

- Plan for the closing of schools and child care programs.

- Organizations should develop communication plans for employees who cannot come to work. They should also plan their budgets accordingly, since many rely on community giving for support. Strategies should be developed to allow people to contribute via mail, the Internet or other means.

- Develop workplace and community "social distancing measures" that limit person-to-person contact, including large gatherings.

"It's important to realize that there's no pandemic right now," Santibanez said. "It's a time to prepare."

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