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Alabama getting ready for pandemic flu, other disasters

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  • Alabama getting ready for pandemic flu, other disasters
    Alabama getting ready for pandemic flu, other disasters
    Associated Press

    MONTGOMERY, Ala. - Piled high on wooden pallets and dozens of blue and orange metal racks, the Saran-wrapped boxes sit like packages of goods at any bulk-club store warehouse.

    But these boxes, with their varying shapes and sizes and labels with words like "bio" and "specimen," could mean the difference between life and death for millions of Alabamians.

    The state, along with the rest of the country, is in high-gear preparations for a pandemic, stockpiling medical supplies, conducting drills and creating educational materials in hopes of lessening the devastation of a deadly flu outbreak - or whatever disaster may be coming at the hands of terrorists or Mother Nature.

    "For a while there we were focused on smallpox and sometimes we were focused on hurricanes and sometimes we were focused on biological attacks, but now we're just kind of an all-hazards approach," state emergency planner Kent Speigner said, his voice echoing in the cavernous warehouse.

    "There's about 15 scenarios of things that could happen nationally, so we're trying to be prepared for a wide range of events ... we're looking at the broad and big picture," he said. "We really don't know what's coming next."

    State Health Officer Don Williamson said the biggest concern is a lack of staff to provide pandemic-scale emergency medical services - and the ethical dilemma of who should get vaccination shots first.

    At least one of 12 practice drills suggested by the Centers for Disease Control have been conducted in all of Alabama's 67 counties and most of those have included business and community groups, said Cindy Lesinger, the health department's pandemic influenza coordinator.

    "That's still something some of our counties have to work on - getting involved with some of these groups that we haven't traditionally worked with in pandemic planning," she said. "Business was already involved in some places and the goal is to make sure we have all the seven sectors involved in planning."

    Williamson said the practice drills were successful, but the other trouble spots remain, including who should get drugs if supplies are scarce.

    Would the emphasis be on preserving individuals and thus every patient on a first come, first served basis, or would preserving society be the priority, with drugs given to essential folks first?

    "That is a major ethical decision that has not yet been reached at a national level," Williamson said.

    The state currently plans to make sure first responders and medical staff are vaccinated first, followed by individuals, with priority given to the young and old, Williamson said.

    Health and Human Services estimates say 12,975 Alabamians would need hospitalization in a mild outbreak like the 1957 Asian flu and 1968 Hong Kong flu outbreaks. A severe 1918-like outbreak, when "Spanish flu" killed 500,000 in the U.S. and millions more around the world, would mean hospitalization for 148,500 and 28,545 deaths in Alabama. An estimated 3,135 people would die in the state in a moderate outbreak.

    Williamson said he wasn't as worried about bed space in the event of a moderate outbreak because the state has 7,000 hospital beds and can quickly create about 1,200 negative pressure rooms, which create sterile hospital-like environments. Staffing is his concern.

    "It's that we don't have the health care workers to take care of all the patients that would be potentially impacted," he said.

    The state has purchased 900 portable cots that can be quickly set up in a church, school gymnasium or empty store buildings, Speigner said, and there are plans to buy about 250 more.

    Lesinger said about $1.6 million in federal funds has been received for pandemic flu planning since May and a second-phase installment of $3.4 million became available Oct. 1.

    Nearly $7 million in state funds has been appropriated to buy Tamiflu, but the state plans to use around $6 million for the 474,000 courses it has committed to buying, Williamson said.

    Alabama has 31,400 courses already in stock.

    The Tamiflu is kept in the department's original warehouse, where it can be refrigerated, but the other supplies - including 500,000 surgical masks, 300,000 syringes and thousands of cotton balls - are housed in two new warehouses that total 70,000 square feet.

    Officials are tightlipped about the location of the nondescript brick buildings for security reasons and to avoid a rush of residents going there if an emergency occurs, Speigner said.

    "Just imagine how bad that would be," he said. "We had lines of elderly people waiting outside clinics in terrible weather and that was just for the seasonal flu. Think about what it'd be like if we had four or five thousand healthy young men coming here."

    Senior epidemiologist Chris Sellers coordinates the state's flu surveillance and said 20 hospitals statewide send in their lab reports and more than 50 doctors report cases of Influenza Like Illness, or ILIs, to the department.

    Providers can input the information at the department's website or fax it in each week and the department of education also sends in its absentee information and that's used to track flu activity, Sellers said.

    Sue Adams with the ADOE said generalized pandemic plans have been given to each of the state's 131 school systems with local superintendents making changes to fit their specific needs.

    Education officials have partnered with Alabama Public Television to make school lessons available on TV if schools are closed, but those plans are still being worked out, she said.

    Williamson said the decision to close schools will be made after a meeting between State Superintendent of Education Joe Morton, Gov. Bob Riley and himself, with Riley making the final announcement to the public.

    Lesinger said individuals who care for particularly vulnerable people such as the elderly or shut-ins, must begin making their own plans for how care will be provided in a pandemic. It's nearly an every man, woman and child for themselves situation, she said.

    "This is really going to be a matter of self-responsibility. The bottom line message is, the government wants to help, the state wants to help, but no one can help everybody at the same time," she said. "It's up to you to prepare."

  • #2
    Re: Alabama getting ready for pandemic flu, other disasters

    Drill will simulate flu pandemic

    Saturday, July 21, 2007

    The Alabama Department of Public Health has scheduled an exercise at Garrett Coliseum in Montgomery on Tuesday to simulate an outbreak of pandemic influenza. The one-day drill will simulate a situation in which large numbers of people become ill. Only the sickest patients will be sent to the hospital, and home care will be stressed. An alternative care site also will be set up to care for influenza patients who have no caregivers. Finally, the exercise will demonstrate the distribution of antiviral medications to priority groups.

    The Montgomery City-County Emergency Management Agency, Alabama Hospital Association, Alabama Department of Public Safety, local hospitals, American Red Cross, volunteers and health department staff from the Anniston, Mobile, Montgomery and Selma regions are participating.
    "In the beginning of change, the patriot is a scarce man (or woman, and brave, and hated and scorned. When his cause succeeds, the timid join him, for it then costs nothing to be a patriot."- Mark TwainReason obeys itself; and ignorance submits to whatever is dictated to it. -Thomas Paine


    • #3
      Re: Alabama getting ready for pandemic flu, other disasters

      State has plan to deal with bird flu outbreak

      By Paul W. Sullivan

      The state health department has 500,000 doses of antiviral medicine on hand in case a mu*tation of the bird flu hits Ala-
      bama, according to a state health official.

      Another 700,000 treatments would arrive in the state within days of the declaration of a flu epidemic, said Cindy Lesinger, pandemic influenza coordinator for the Alabama Department of Public Health.

      However, the success of the antiviral medicine against an outbreak of the bird flu vaccine would not be as effective as a vaccine, which could take months to develop.

      State Health Officer Dr. Don Williamson said there is no ef*fective vaccine for the bird flu now because any virus striking people would be a strain of the influenza called H5N1.

      Any mutation of H5N1 would need to be identified before a vaccine could be developed, he said.

      Williamson made the com*ments during a public health de*partment-sponsored drill de*signed to mimic a flu outbreak. State and local health officials took part in the statewide exer*cise Tuesday with Garrett Coli*seum serving as a staging ground for part of the program.

      Health workers treated vol*unteers posing as flu victims. They also communicated with hospitals and health officials across the city and state to test how the health system would handle a sudden epidemic.

      "The exercise is done to iden*tify gaps in the process," Wil*liamson said.

      The antiviral doses would be used to treat people with the new flu strain, those with symp*toms, and Alabamians filling important positions who would need to stay healthy to treat the sick, and maintain public serv*ices,Williamson said.

      Medical workers would be administered the medicine in the hope that it would be effec*tive, Williamson said.

      The medicine would be dis*pensed while a vaccine was be*ing produced, a process which could take up to six months, he said.

      The coliseum itself might be a location where flu victims too sick to stay at home could re*ceive treatment when hospitals become overwhelmed.

      Hospitals would quickly be overburdened if a new type of bird flu strikes, Williamson said. He described a possible scenario in which a traveler from overseas might bring the flu to America.

      That would likely mean the first outbreak would occur in a metropolitan area giving the state some time to prepare for the onset of the sickness.

      Avian influenza is a strain of flu that mainly infects migrat*ing birds, waterfowl, poultry and some wild birds. It's very contagious among birds, and can make some domesticated birds sick. Infected birds shed influenza virus in their saliva, nasal secretions and feces.

      All influenza viruses have the ability to change, or mutate. Scientists are concerned that if the H5N1 virus mutates, it could infect people. If this occurs, many people will likely catch the virus because nobody would have immunity against the new strain of influenza. The result would be a worldwide outbreak of the disease.

      In that case, medicine distri*bution points and treatment areas would be set up across the state to dispense medicine and treat the overflow from hospi*tals. Public gatherings and schools schedules would be af*fected as well, Williamson said.

      He said studies of different actions taken by officials in Philadelphia and St. Louis in wake of the 1918 flu outbreak show an aggressive approach to limiting large gatherings of peo*ple can save lives.

      More than 250 cases of avian influenza have been reported in Asia and Europe, according to the Centers for Disease Control and Prevention. Most of the cases have resulted from people coming in contact with infected poultry, or surfaces contaminat*ed with secretions from the birds.

      The 1918 flu outbreak led to high levels of illness, death and economic loss. Experts predict a pandemic flu will likely occur again and enormous numbers of people will be affected. "Individ*uals need to prepare themselves and their family," Lesinger said.

      She said on average, pandem*ics hit every 40 years. With the last coming in 1968, she said America is due.

      A disruption of utility and other services could have a re*sult similar to what happens during a major hurricane, she added.