County officials can help prepare for influenza pandemic
The nation’s newspapers report the progress of avian influenza in Asian and European poultry populations almost daily. Scientists worldwide are concerned that the avian flu virus may mutate into a virus capable of transmission not only from bird to human, but also from human to human. We don’t know for sure whether this will happen, and we can’t predict when it might happen. But people are worried.
If this situation of uncertainty sounds familiar, it is because the same situation exists with respect to potential emergencies caused by terrorists. Counties have been working on preparedness for biological, chemical and nuclear terrorism for several years, knowing that a threat exists, but not knowing the magnitude or the likelihood.
However, the costs of being unprepared for an unthinkable event are so high that all governments have recognized their responsibility to develop plans and build response capabilities. Whether the cause of a serious disease outbreak is a bug that is released intentionally, or one like influenza that occurs naturally, makes little difference in what county governments must do to prepare.
Preparedness for pandemic influenza does not require a whole new effort or set of plans. Rather, it requires looking at existing emergency preparedness plans and capacities, adding what would be necessary for an influenza pandemic, and conducting exercises. Moreover, in the course of improving pandemic preparedness, counties will also be improving their abilities to respond quickly and properly to any emergency that threatens human health.
Pandemic would last months
If an influenza pandemic occurs, it will occur in many places at the same time. The period of high threat and a large incidence of illness and death will last for many months. County health departments manage small outbreaks of infectious diseases, such as meningitis or tuberculosis, all the time.
The challenge of a pandemic will be in scaling up strategies to stop the spread of disease, along with strategies to care for people who are sick, to a degree that modern governments have not previously faced.
We are not starting from scratch. County health departments have been working to improve bioterrorism and public health preparedness for several years. They have even learned some useful lessons from real-life events, such as the influenza vaccine shortages that have plagued many communities, and they have used routine flu clinics as opportunities to exercise plans for larger-scale events. The most effective local plans are incorporated into overall local emergency management plans and the planning process has included all governmental first responders, as well as hospitals and the medical community.
Quarantine may be necessary
Response to such a large-scale outbreak will engage the entire emergency response system in a community, as well as the entire private sector. It will be necessary to isolate the sick from contact with others and take care of them. It may also be necessary to impose and enforce quarantine measures, which would restrict the movement of people who may have been exposed to the disease so they can’t unknowingly infect others.
In the worst case, county officials may have to consider carefully whether to close schools, cancel public events, and shut down public transportation in order to minimize disease spread.
Hospitals will be severely challenged because it is likely that the number of beds and the amounts of equipment now available will be insufficient to meet demand. Communities must therefore plan how to increase their medical surge capacity in a pandemic situation.
If antiviral drugs and vaccines are available, there must be plans and methods for distributing drugs or administering shots on a large scale. It is likely that there won’t be enough to meet the demand, so there must be plans for getting them to persons with highest priority. Volunteers will be needed to supplement the existing health care and public health workforce.
The challenges in managing public panic and large predictable needs for psychosocial support will be great. The frail elderly and disabled persons will need a higher degree of service and support if their regular support systems fall apart under the duress of a pandemic. Government and health care employees that fill essential functions will have grave concerns about the health of themselves and their families that must be addressed.
What you can do now
County officials will play central roles in such a scenario, particularly in educating the public and leading by example. There are many things you can do now to help your county become better prepared for pandemic influenza.
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Talk to the health department that serves your jurisdiction and learn the status of pandemic influenza planning. Ask if you can help engage partners that will need to be involved in responding to pandemic influenza, such as schools and businesses.
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Investigate whether the necessary legal authorities that the county government may need to contain a pandemic are in place.
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Ask about plans for maintaining essential county government services in the face of a pandemic.
The federal government is looking for ways to produce better antiviral drugs and effective vaccines. Vaccines in particular will be the most essential weapons for fighting a pandemic. However, all the vaccines in the world will not help if county governments are not ready, with pre-planned logistics, trained personnel and necessary equipment, to get the shots into their citizens’ arms. There is no substitute for robust local preparedness.
More information on pandemic influenza can be found at www.pandemicflu.gov.
(Donna Brown is the government affairs counsel for the National Association of City & County Health Officials. Carol Moehrle, is the director of the North Central District Health Department, Nez Perce County, Idaho, and a NACo Board member.)
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