WEDNESDAY, May 3, 2006 (HealthDay News) -- Details released Wednesday on the U.S. government's flu pandemic preparedness plan outlined the strategy's finer points while focusing on a "worst-case" scenario.
The document also stressed that in the event of a pandemic, local communities must be prepared to protect themselves and not rely solely on the federal government.
But the plan's focus on a worst possible outcome could backfire in unexpected ways, some experts said.
"It's heavily based on the most-severe-and-unlikely-catastrophe-imaginable scenario," said Dr. Marc Siegel, author of Bird Flu: Everything You Need to Know About the Next Pandemic, and clinical associate professor of medicine at New York University School of Medicine in New York City.
"I'm concerned about it not taking into account the fear component, and the more we talk about the worst-case scenario, the more fear we have," he said.
"Some people reading this could become alarmed if, for example, there was a limitation placed on international flights or if their movements were limited to be sure they weren't incubating the disease," added Dr. Pascal James Imperato, chair of the department of preventive medicine at SUNY (State University of New York) Downstate Medical Center in New York City. "But it remains to be seen whether any of that would ever be put into effect, " he said.
And, alarmed or not, people should be familiar with most of the plan's recommendations. "A lot of these details have been broadly discussed for quite some time," Imperato said.
The federal government's $7.1 billion National Strategy for Pandemic Influenza was announced Nov. 1 and included three parts: preparedness and communication; surveillance and detection; and response and containment.
The current document, posted Wednesday on the White House's Web site, marks the third and final part of the overall plan.
Fears of a worldwide flu pandemic are focused on the H5N1 bird flu virus, which has infected about 200 people since 2003, killing about half of them. So far, all infections have passed from infected birds to humans, usually through sustained, close contact with the animals (for example, on poultry farms).
However, experts are concerned that the virus -- which is more virulent than other flu strains -- could mutate into a form that is easily transmitted between humans.
The long-awaited final chapter of the government's preparedness plan paints a worst-case picture of a flu pandemic that could cause up to two million deaths in the United States. Also, as many as 40 percent of American workers could be off the job for up to two weeks, the plan said, and disruptions could last for months.
Officials stressed that local communities would have to take the lead and not expect rescue from the federal government.
To mitigate both the deaths and damage from any outbreak, the federal plan outlined a policy of restricting domestic travel, including reductions in non-essential travel, with mandatory restrictions as a last resort. Travelers would have to be screened when they left any country that was experiencing an outbreak, and then screened again as they arrived at U.S. airports. The number of airports accepting international flights would be limited, ill travelers would be isolated, non-ill travelers and crew would be quarantined, and all passengers would be given antivirals.
The plan also calls for alternating offices and schedules to limit contact between employees. Offices should be disinfected regularly, people should not shake hands, and co-workers should maintain distances of at least three feet apart.
Such declarations may backfire by sowing panic, Siegel said, and that could cause some people to pay less heed, not more, to safety precautions. "What is crucial is isolating sick people and reporting cases," he added.
Finally, the plan also calls for expanding national stockpiles of vaccines and antiviral medications, in addition to poultry vaccines.
For some, though, the focus on stockpiling was also misguided.
"It's heavily stockpile-centric but that's not a surprise," Siegel said. "What's concerning to me is that these are perishable items, they'll have to be thrown out in three to four years, and we're not even sure how effective this vaccine is. The strain that eventually emerges may actually not be sensitive to this vaccine."
Resources would be better spent on updating the vaccine manufacturing system, which currently relies on outdated techniques, he said.
On a more positive note, Siegel added, the plan did include provisions for vaccination of birds and for safeguarding bird handlers. "I love that," he said. "This whole plan could have come out with nothing geared towards birds."
"This plan underlines the need to differentiate long-term improvement in preparedness vs. sending the public an erroneous message that something is imminent," he added. "That means learning a new language to convey risk, and this plan has not learned that language."
More information
For more on bird flu, head to the U.S. Centers for Disease Control and Prevention.
