Local: Cities, Counties Must Plan Own Fight...

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Cities, Counties Must Plan Own Fight Against Bird Flu Pandemic

May 30, 2006
By Lashawndra Dockery

(AXcess News) Washington - The day will come when hospitals will reject patients, schools will close, movie theaters will shut down and people will be quarantined in their own homes. At least that is what health officials foresee when the bird flu comes to the United States.

The bird flu, or avian influenza, which has killed people directly exposed to diseased poultry in several countries, but has not yet spread from person to person may yet do so. Even so, the National Association of County and City Health Officials has started planning a response to an outbreak that could affect millions of people.

"Whether we have the pandemic today or in a week or in the next five years, we have to be prepared," said Marty Fenstersheib, a health official in Santa Clara County, Calif.

The Advance Practice Centers, a part of NACCHO, made up of local health departments, has been discussing public health preparedness. Three jurisdictions – Santa Clara County and Seattle and King County, Washington – have the most advanced plans, and officials from those places came here last week to assure the public that health officials are thinking about what to do.

Fenstersheib said it's important to plan for a local response because, when the pandemic hits, all of the responses will be local.

"Mutual aid from the state or federal government is highly unlikely, and we are not planning on that mutual aid," Fenstersheib said.

Von Roebuch, a spokesman for the Centers for Disease Control and Prevention, said the federal government will eventually help local government, but he wasn't sure how soon.

"When it does come, the federal and state aid will be pushed in different directions, so it's important for local counties to be prepared and have a plan of action," Roebuch said.

Dorothy Frost Teeter, interim director and health officer of Public Health in Seattle and King County, said that developing a working relationship with local businesses, who may see up to 40 percent of their workers sick at the same time, is important.

"We need to educate businesses and listen to what they have to say," Teeter said.

Fenstersheib said there will not be a vaccine for six to eight months after the pandemic hits.

Fenstersheib said community involvement in planning is important, and APC will provide tools and guidance.

"Although the pandemic will not stop, this preparation will save lives," Fenstersheib said.

One challenge is finding alternative means of support and health care for individuals who are sick. Hospitals have already expressed concern about not having enough space for influenza victims as well as people with other illnesses.

"Hospitals are not the way to go," Fenstersheib said. "The hospitals have told us that most of the beds are occupied now. There are still going to be people sick from heart disease and stroke. ... Given the number of people that will become ill, we will run out of hospital beds within three weeks."

APC has suggested other ways to provide health care. Home isolation is one of them. Families will care for the sick at home, in quarantine.

"Families have to understand and be prepared to take care of their family members," Fenstersheib said. "They need to separate the sick from the well, know when to wear gloves and masks and even the opening of windows. They need our guidance to know how to hydrate their family members and making sure that they have their medication."

Another plan is to create influenza care centers in convention centers or hotel ballrooms.

Fenstersheib said influenza care centers would be for those who don’t have to go to a hospital but can't be taken care of at home. He said that the influenza care centers would be for intermediate care and have small staffs.

"They will be able to hydrate people with an IV and even get antibiotics for secondary infections. Oxygen can be administered," Fenstersheib said.

Fenstersheib said APC has already recruited 400 volunteers, most doctors and nurses, to staff intermediate care centers.

"Hospitals will be the last place we consider. They have highest level of care and staffing. The hospitals have told us please keep people away from our emergency rooms," Fenstersheib said.

Fenstersheib said “social distancing," or canceling large gatherings and closing public institutions, is another tool to fight a pandemic.

"Closing schools is the largest issue we will be talking about," he said

Christine Craig, editor of the 21st Century Science and Technology magazine, said, "The local health department and businesses are doing an admirable job in figuring out a plan, but if the pandemic disease flows like in Southeast Asia, very quickly, this is going to be a horrible disaster.

Source: Scripps Howard Foundation

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