Speaker: Government doing little to prepare for next pandemic

By Wally Kennedy Participants at the Pandemic Planning Conference at Missouri Southern State University learned that they are pretty much on their own when it comes to planning for the next killer flu.



“The federal government should be doing more research to answer many of the questions that you have when planning for the next pandemic," said keynote speaker Gregory Evans, director of the Institute for Biosecurity at Saint Louis University. “Since that is not happening, you really need to do as much at the local level as possible to get ready. We have to depend on ourselves and not expect the feds to be there for us.”



The federal government has known about H5N1, the virus that causes bird flu and the most likely culprit for the next pandemic, since 2003, Evans said. But, he said, the government is suffering from what he described as “preparedness paralysis.”



In addition, he said, the public has become complacent because the H5N1 virus has not grabbed headlines of late.



“This is a very bad virus and one we need to worry about,” Evans said. “H5N1 continues to spread, and eventually it will get to the United States. The more it spreads, the more opportunity it has to mutate (into a virus that spreads from human to human).”



He said experts think the mutation that will allow the virus to spread from human to human is likely to occur in Asia, but no one knows where that mutation might occur. He pointed to historical evidence indicating that the Spanish flu of 1918-19 that killed 500,000 people in the United States started in Kansas and was spread to Europe by soldiers in World War I.



“Nearly half of those killed were healthy adults between the ages of 18 and 44. H5N1 attacks the young, too,” he said. “Since 2003, there have been 278 human cases of H5N1 and 168 deaths. That’s a death rate of over 50 percent.”



Evans pointed to face masks as an example of the research that needs to be done. He said the use of face masks was encouraged when a recent SARS outbreak occurred in China.



When the outbreak of severe acute respiratory syndrome unfolded, only those with the disease were encouraged to wear the masks to avoid spreading the virus. As a result, wearing the mask became an indicator that a person had the disease, and because of that, no one would wear them, he said. In response, health officials encouraged both well and ill people to wear the masks. That decision, he said, was somewhat effective in curtailing the spread of the disease.



Evans said the federal government, particularly the Centers for Disease Control and Prevention, has not provided guidance on the type of face masks that should be used, the proper use of them and whether local health departments should be stocking a supply.



School officials, he said, also need to know the absentee threshold for the closure of schools.



“We don’t have a threshold for closing schools,” he said. “Is it 30 percent of students and teachers absent, or is it something else?”



Doug Domer, an assistant superintendent in the Joplin R-8 School District, said his district has been concerned about a lack of direction.

"We are basically on our own in determining when to close schools," he said.



Domer said that in the most recent flu season, the absentee rate approached 20 percent. He said it is likely that schools would be closed if the absentee rate for teachers and students reached 30 percent.



“It’s scary to think about,” he said.



Dan Pekarek, director of the Joplin Health Department, said information presented Thursday will be available on a Web site that is being developed, www.jascoflu.com.



“Everything we can get our hands on about pandemic flu will be going on that Web site,” he said. “It will be one-stop shopping.”





Flu fatalities

Each year, the flu kills about 36,000 people in the United States. About 200,000 are hospitalized, and most of them are elderly. With a pandemic, there could be 2 million deaths and 10 million hospitalizations, said Gregory Evans, a public health expert at Saint Louis University. The nation has 1.5 million intensive-care beds available.



Wally Kennedy writes for The Joplin (Mo.) Globe.