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May 05, 2006

Lucky to be Living in Seattle/King County

If the bird flu pandemic hits, we couldn’t be living in a better prepared place than here in King County.  That may be small solace if it arrives or arrives before we can be better prepared as a nation but it should serve as some measure of consolation.

A couple days ago, in a letter released in conjunction with a report entitled “National Strategy for Pandemic Influenza," President Bush said that local governments and individual communities will have to shoulder most of the burden in battling the disease if a pandemic strikes.

Given what we know about the usefulness of federal responses under this administration, this comes as no surprise.  So, lucky for us that our local officials figured out the same thing a while ago and have been planning and preparing on our behalf.

The federal government report has been helpful in articulating the situation even if it might best have been done a couple years earlier. 

Frances Townsend, the chirpy new Homeland Security spokesperson, said at a news briefing covered by the NYT: "We cannot say whether or not a human pandemic will begin."   If it does strike the United States, “the country will have a health crisis unlike any it has seen in decades”, she said.  “Under the government's plan for the worst-case possibility, a pandemic flu could cause up to two million deaths in the United States.”

The report notes: 

Pandemic influenza is different from seasonal influenza because it occurs when a new strain of influenza emerges that can be transmitted easily from person to person and for which people have no immunity. Unlike seasonal influenza, which typically affects the frail and sick, pandemic influenza could present as much risk to the young and healthy.

Moreover, the routine of everyday life would be disrupted, perhaps for months, among the sick and healthy.

A flu pandemic would severely disrupt the economy, and private businesses and government agencies should assume that up to 40 percent of employees would be absent for up to two weeks at the height of each wave of infections, the report says. Local police departments and state National Guard units would have primary responsibility for keeping order, but the military would be available to assist. 

And people would have to change the way they live and do business, perhaps for months. They might be asked to limit their travel or, in the worst case, be ordered not to travel. Such measures would give local communities more time to prepare, but they would only slow the advance of the disease.

Companies would be encouraged, if not told, to curtail meetings. Social gatherings would be discouraged. People who show any symptoms would be advised to stay home altogether.

In February, NPR highlighted King County’s bird flu preparation in a piece on “All Things Considered”.   They began by describing a bird flu simulation model prepared by the Emory University and the Los Alamos National Lab.  A researcher at the University of Washington, Ira Longini, used that and other data to predict the number of people who would be afflicted with the avian bird flu should an outbreak occur here. 

Here’s what he came up with:

Day 1
0 people sick

Day 28
31 people sick

Day 49
1,403 people sick

Day 77
57,623 people sick

Day 86 (Peak)
90,122 people sick

Day 98
36,267 people sick

Day 112
4,136 people sick

Day 126
390 people sick

Day 147
19 people sick

Day 168
1 people sick

Day 182
0 people sick

Cumulative number of people projected to contract the flu in King County, Wash., during a severe pandemic: 828,950.

With that in mind, King County and the Seattle/ King County Health Department went to work to plan for how to best meet such a calamity.  From transcripts of the NPR broadcast:

For some time now officials there have been making the rounds of health care facilities, businesses and schools, warning about the scope of a potential flu pandemic. They've also been talking about and what might be done to minimize illness, death and social disruption. Their master plan, just released, is based roughly on the deadly flu pandemic of 1918.

That plan can be found on the King County website.  The website includes a fact sheet on bird flu, resources for individual and families, law enforcement, local businesses, schools, local government agencies, healthcare professionals, additional resources from other national and international agencies such as the U.S. government, the CDC and the World Health Organization. 

The 45-page Response Plan, Version 11, is an astounding document.  It includes the purpose of the plan, assumptions about the possible pandemic, the likely phases of a pandemic, the responsibilities of the various state and local agencies, and discussions of how direction will be provided, communications maintained, schools run, people quanantined, and social distancing strategies implemented.  (Note that phrase, social distancing.  You’ll be hearing a lot about that as we begin to talk more about preparing for living with a flu pandemic.)  They talk about many aspects of the public health system and responses and then how the recovery from the pandemic can proceed.

They also have a section on maintenance of essential services, something I’ve personally been very interested in since my assumptions about the availability of services has a lot to do with my personal preparations.  Can we count on having water, even intermittently?  Electricity? Bus service?  I was reassured and incredibly impressed by the obvious thought that has gone into thinking this all through and developing agreement to it.

The Response Plan requires that government agencies and private businesses that provide essential services to the public provide and maintain continuity of operations plans and protocols for use in the different phases of a pandemic.

My hat is off to Ron Sims, King County Executive, for directing that the county take on this immense and critically important preparation and planning and to Jim Lopez, his Deputy Chief of Staff, for implementing and overseeing this plan.  I’m sure there were many more people who were critical to its development, likely including Dr. Jeff Duchin, chief of infection control for the Seattle-King County Public Health Department; Dr. Peter Houck of the U.S. Centers for Disease Control and Prevention; Chris Martin, director of emergency services at Harborview; and Carolyn Teeter, Chief of Health Operations for King County, all of whom have been mentioned in the several news reports praising Seattle/King County’s efforts so far.

When I interviewed Ron Sims two months ago, he talked about the hard decisions that public officials would be forced to make.  He mentioned the case of Seattle Mayor Ole Hanson, mayor during the 1918 pandemic, who imposed classic public health measures and was vilified even though those measures clearly saved many lives.  Hanson resigned and left town.  Sims says that he would not hesitate to make the hard decisions to save lives. 

Luckily, the planning and consensus building with relevant agencies and businesses and organizations that Sims has instituted should make all that easier if we are in the unfortunate position of having to implement them.

Posted by Lynn Allen on May 5, 2006 at 10:44 PM in Washington Culture | Permalink

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