Two days after the unveiling of President Bush’s federal
proposal to prepare the country for a potential pandemic of avian
flu, California’s Assembly of Health Committee brought
together a panel of experts and state public health officials at
UCLA to discuss how ready the state is for a possible outbreak.
The panel, headed by Assemblyman Hector De La Torre, D-South
Gate, co-chairman of the committee, discussed topics including the
probability of an outbreak of avian flu among humans, vaccination,
hospital capacity, and cooperation among different levels of
government.
Sandra Shewry, director of California’s Department of
Health Services, called avian flu the “biggest health
challenge of our time,” because it has the potential to
develop into a pandemic.
Shewry said the state’s core infrastructure for dealing
with an outbreak of avian flu is already in place. Its strengths
include awareness and attention from public officials, a
multifaceted vaccination plan, a process of reviewing the
prioritization of who should receive the vaccine, and a lab in
Richmond with the advanced technologies needed for research and
testing.
The state’s No. 1 weakness, she said, is the surge
capacity of the state’s hospitals, which would be overwhelmed
by the number and duration of hospitalizations in the case of an
outbreak.
Shewry also said California, like many other states, faces the
problem of anti-viral medication shortages.
The state has already ordered 70,000 doses of the anti-viral
drug Tamiflu, but the drug is expensive, and a larger stockpile is
not immediately available.
Bush’s federal proposal offers to help provide 50 million
courses of the drug, but the state still has the financial burden
of purchasing 31 million more, Shewry said.
Anti-viral drugs and surge capacity are only two of the seven
elements she said that are crucial to the state’s
preparedness, but they are the areas California needs to improve
the most upon. Other elements are planning, surveillance,
vaccination, disease-control measures and risk communications.
Shewry said a pre-qualified list should be compiled of
physicians and nurses who would be willing to lend a hand in an
emergency.
The state is also working on a hot line and multilingual
campaign that would allow about 350,000 people to simultaneously
reach a telephone message system with instructions or the most
updated information in an emergency, she said.
At the county level, Jonathan Fielding, Los Angeles County
health officer, said that officials have already begun efforts to
delay the spread of bird flu into the United States through the Los
Angeles International Airport and the city’s several
seaports.
He pointed out that it would be unrealistic to try to prevent it
altogether.
Los Angeles differs from California’s other 57 counties in
that it receives funding directly from the federal government for
use against bio-terrorism and pandemics.
Fielding said that this money would go toward expanding hospital
capacity, increasing health-care personnel, and improving
communication among law enforcement, medical centers and the
general public.
Fielding acknowledged the importance of Bush’s plan, which
would concentrate most of its funding on vaccine supplies, and
provide states with some funding for local preparedness. He added
that the $100 million to be given to the state out of $7.1 billion
“doesn’t jive with the reality that most of the
response to an actual pandemic would be local.”
Scott Layne, associate professor of epidemiology at the UCLA
School of Public Health, testified on behalf of the intellectual
community and its most recent findings.
Layne, who has studied avian flu for eight years, explained that
avian flu is a strain of influenza virus that has decimated poultry
flocks in Asia, and has resulted in more than 60 human deaths.
The growing concern among experts is the chance that bird flu
will mutate into a human pathogen and trigger an influenza
pandemic.
World Health Organization officials say the current situation is
the closest the world has come to experiencing a pandemic since
1968, the end of the last influenza pandemic, called Hong Kong Flu,
which caused about 34,000 deaths in the United States.
Layne referred to WHO’s three criteria that must be met in
order for an outbreak to be considered the start of a pandemic:
There must be an emergence of a disease new to a population, the
agent must infect humans and spread easily, and the agent must be
able to spread easily among humans, he said. So far, avian flu
meets only the first two of these conditions.
Most experts agreed that avian flu will eventually spread to
North American and Californian birds, most likely through Alaska.
Because California is the ninth-largest poultry-producing state,
and the industry employs around 25,000 people, “this will
make our consumption of poultry change. Worker-safety issues will
arise,” Layne said.
He said the chances that the flu will mutate into a human
pathogen are small.
“I venture the educated guess of 10 percent or
less,” Layne said.
The probability of an actual pandemic may seem disproportionate
to the actions taken by all levels of government.
“The risk is so tiny,” said Jo Ann Dawson, director
of Primary Care at the Arthur Ashe Student Health and Wellness
Center, who was present at the meeting.
She said she understands, however, that the danger lies in the
fact that there is a risk at all.
“The thing is the potential. It hasn’t happened yet
““ and that is the worry,” she said.
If a patient did have the appropriate symptoms of bird flu and
history of exposure and showed up at the Ashe Center for treatment,
she said, the patient would be sent to the UCLA Medical Center,
where respiration could be monitored and the pathogen could be
contained.
University of California officials would call the local police
and issue a warning from there.
“We may be called upon to make really quick
decisions,” Layne said. “The key to guiding these good
decisions is information.”