Bedford Co. TN: Emergency planners brace for bird flu pandemic

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Source: Emergency planners brace for bird flu pandemic
Monday, May 19, 2008
By Brian Mosely

Also: Avian Flu: A Primer

"We're not trying to be paranoid, we're trying to be prudent."

Those are the words of Scott Johnson, director of Bedford County Emergency Agency, about the planning his department is doing to prepare for the day when the avian flu, or "bird flu", becomes pandemic.

And many experts agree -- it is not a matter of if but when a deadly outbreak of the virus will occur.

Currently, the H5N1 strain of the virus that can be passed from person to person has a 61.8 percent fatality rate.

"This could be very serious," Johnson said.

County and city leaders were briefed last week on preparation efforts by Johnson; Dr. Carl Bailey, who is the avian influenza planning project manager for the county; and Lynn Burns, emergency response coordinator for Tennessee Department of Health. Another meeting is scheduled Sept. 18.

Johnson said the state health department has devised a plan that specifies what the local responsibilities would be when an avian flu outbreak occurs. As a result, Johnson said that Bedford County has become "more robust" in planning over the past 12 months.

"We've come up with a game plan; mostly, our job is resource management," Johnson said, such as looking at what volunteer help would be available as well as facilities that would be used in the event of an outbreak.

Two years ago, Bell Buckle formed an avian flu preparedness committee to look at what would have to be done in the event of a pandemic, focusing on the needs of their neighbors and the situations in different households. The county's plan involves working with the school system, industry, retail businesses and the health department.

The county and state will have four areas of responsibility: Actual disaster management, which will be run from the EMA building on Railroad Avenue; community volunteerism; medical community awareness; and training to manage a pandemic.

"A pandemic is a completely different animal," Bailey said. The 1918 Spanish flu, the 1947 Asian flu and the 1973 swine flu are considered pandemics. Compared to the annual flu, there is a much higher risk of fatality with the pandemic outbreaks.

"Viruses replicate themselves," according to Dr. Bailey. "One thing we do know is that viruses exist for one reason only, and that's to exist." Once a virus is stimulated by an uncomfortable environment, it will adjust to it, and Bailey says one of the adjustments that the H5N1 virus has made is that it is now transmissible through human cell receptors to other humans.

"That's a big leap that no one hoped we would see," Bailey said. "That appears to be what has happened."

The latest outbreak of the deadly virus is in Pakistan. Bailey said there is no evidence that it is passed from birds to humans, but rather from person to person. The H5N1 virus is no longer just in birds, but also in dogs, along with some cat species in northern Europe, he added.

The H5N1 strain reemerged in the human population in the year 2000 in Thailand. "Since that time to date, 61.8 percent is the mortality rate that the world population has experienced in these very sporadic outbreaks around the world," Bailey explained.

The only thing that approaches that high fatality rate was the Black Plague of the Middle Ages, he added. The 1918 flu pandemic killed about 55 million worldwide in a nine to ten month period. "The U.S. lost 680,000 during that timeframe," Bailey said.

The 1918 outbreak was complicated by the fact there was no vaccine for it. But today there are medications that will "somewhat mitigate" the illness and keep the death toll down. Two companies are doing "great work" in creating a vaccine, but if the virus changes again, it would be useless.

One problem that affects Bedford County more than any other location in the state is the population of privately-owned chickens, with more than one million "backyard chickens" or "ground flocks" in the county.

Commercial poultry operations, such as those which supply Tyson, are enclosed and in a controlled environment, with the birds being vaccinated three times during their 11.5-week life cycle, and thereby pose a reduced risk.

The state agriculture department says that there is twice the commercial chicken production in Bedford County than any other county in Tennessee, Bailey explained. However, the backyard birds can average in number from 15 to 500 at any location.

Bailey said the backyard chickens have interaction with wild birds through water sources like ponds and streams, "and there is a very definite transmission route there." Bailey said that situation causes him more concern than commercial chicken operations.

During a recent briefing in Nashville, Bailey was told by the state agriculture department that the H5N1 virus has already been found in the remains of dead birds in Tennessee. The state is directly in the path of the flyover route for many birds heading south for the winter, Bailey explained.

"Those birds are the Typhoid Mary," Bailey said. "They don't get sick, but they carry it." But Bailey added that he doesn't want to panic the public, explaining that the infected birds carry a "low pathology" version of the virus, in which there is a low threat of death to humans.

Part 2 will cover what the public could expect to see when a pandemic occurs. More information about Avian Flu and pandemics can be found at www.pandemicflu.gov .

 

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Re: Bedford Co. TN: Emergency planners brace for bird flu pandemic

Source: http://www.t-g.com/story/1406157.html
Bird flu's potential impact could be massive
Tuesday, May 20, 2008
By Brian Mosely

Previously: Officials brace for possible flu pandemic

Bedford County Emergency Management Director Scott Johnson and Avian Influenza Planning Project Manager Dr. Carl Bailey have been examining what difficulties the county will likely face in the event of an Avian Flu pandemic.

The pair stressed they do not want to frighten the public about what an outbreak of the deadly virus could mean, but encourage preparedness for everyone -- no matter if they are involved in government, business, civic groups or just protecting their families.

Social isolation

A pandemic is an epidemic that covers a wide geographic area and affects a large portion of the population, like the 1918 Spanish flu outbreak.

The 1918 flu pandemic, commonly referred to as the Spanish flu, was first found in the United States, appeared in Sierra Leone and France, and then spread to nearly every part of the world, according to Wikipedia.

It was caused by an unusually severe and deadly influenza strain. Many of its victims were healthy young adults, in contrast to most influenza outbreaks, which predominantly affect juvenile, elderly, or otherwise weakened patients.

The Spanish flu lasted from March 1918 to June 1920. It is estimated that anywhere from 20 to 100 million people were killed worldwide

When that occurred, America was still mostly an agricultural society, and travel was comparatively limited.

Today, people interact with each other socially a great deal more, Johnson said. Because of this, officials say "social isolation," or staying at home, is one of the best ways to stop the spread of the virus.

In such an event, the county would close schools and any kind of excessive public gatherings to keep people apart.

"When you get within that magic 36-inch distance (from another person), you transmit it," Bailey said.

Bailey corrected the assumption that the reason so many people died in 1918 was the quality of medical care.

"The medical ... is no better or worse than it was ... but we do have many more things in place to alert the public," he said, adding that by the time people were aware there was a pandemic in 1918, it was already well underway.

Johnson said that typically when flu or virus outbreaks occur, administrators would shut down schools for just a few days to let the bug die out.

But the time frame for a pandemic is much longer, Bailey explained. According to the Centers for Disease Control, local planners should prepare for three waves of the virus, each lasting from eight to 16 weeks.

Economic damage

Bailey said the single biggest issue right now is working with industry in the county. When meeting with the heads of these companies, Bailey asks what would happen if they came in on a Monday morning and 15 percent of their workforce was gone.

"By Tuesday, it's 20 percent and by Thursday it's 35 percent ... gone. You've got no people to produce wages," Bailey said. He also referred to a recent economic study that looked at how long businesses could survive without cash flow. Only large businesses would be able to cope for 12 days without cash flow, Bailey said.

However, the small businesses would have to close their doors and could possibly never reopen.

"The economic damage to this county, if we really don't get it together, would be far and away the worst damage we would suffer," the doctor said. "The death, the grief, the loss will happen. That we will get through ... our 130 pastors will be tasked to the limit."

But it could take years to recover from the economic impact. Bailey said he's "ruined many a chicken dinner meeting with community groups" by relating these painful facts.

"I try to wake these people up, but I also tell them that there is light at the end of the tunnel," Bailey said. "Just don't get near anyone and you won't transmit it."

Mobility means danger

Bailey says because of the change of our mode of living, with much more mobility, things are considerably different than during the 1918 pandemic.

"Medicine has not changed that much -- there was no vaccine then and there is none now," Bailey said, but people are less than six hours away from an international airport and access to any part of the world.

"There's an enormous number of issues that federal and state agencies are working with regarding what to do if a pandemic hits somewhere," Bailey said, giving an example of someone flying into Nashville from an overseas outbreak and then driving to Shelbyville an hour later.

"You begin to think about all those situations," Bailey said, calling it a "Pandora's box." Just one example to ponder is the number of 18-wheelers that move through Shelbyville each day.

"How many trucks have to arrive here on a daily basis to feed us? What would happen if trucks didn't show up for three days? All of our stores would have no food on the shelves. It's a horror story."

On our own

Johnson said in a normal disaster response, the event is extremely localized. But in the occurrence of a pandemic, "everything you read from the federal government, to the state, city and county is 'don't expect any help' from the federal government or the state because everybody is going to be in the same boat."

When there is a large local disaster, such as a tornado or other event, counties can rely on mutual aid from neighboring areas, but in the case of a pandemic, everyone will have their hands full.

"We have to be prepared to be on our own," Johnson said. "Federal officials have been real good saying that since Katrina." Counties in Tennessee are in various stages of planning, with some counties "not doing anything," Johnson mentioned.

"You know you're never going to be totally ready," he said.

Bailey said he's been working in emergency management for decades and has always heard from the federal government that if people can hold out for 72 hours in a given situation, help will be on the way.

"This is the first time we have heard in repeated meetings and briefings that there will be no help available. You will truly be on your own," Bailey stressed.

As a result, many civic and faith-based groups would be turned to for help during a pandemic. A plan is being worked out with assigned duties for each organization. But no matter how proactive they are with their planning, Bailey admits they will not be able to save everyone.

Bailey has contacted all the churches in the county, which will then recruit people from their congregations to become the workforce for emergency management, from very minimal-risk tasks such as telephone work to a high-risk job such as delivering food to an infected family.

"The most important thing we can do is prepare as much as we can," Bailey said.

 

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Re: Bedford Co. TN: Emergency planners brace for bird flu pandemic

Source: http://www.t-g.com/story/1437893.html

Bedford EMA commended on bird flu plan
Wednesday, June 18, 2008
By John I. Carney

A bird flu pandemic could create disastrous consequences, not only in the potential loss of life but in the devastating economic impact, according to Carl Bailey of Bedford County Emergency Management Agency.

Bailey spoke to Bedford County Board of Commissioners' rules and legislative committee Tuesday night; the committee asked that he make a presentation to the full commission in the near future.

For example, Bailey said, a flu serious enough to close a small business with limited cash flow for 7-10 days could overwhelm it and leave it unable to re-open.

A pandemic refers to a massive outbreak of disease over a large area. There were three influenza pandemics in the 20th century: a 1918 outbreak that left 51 million dead, a 1954 outbreak that killed 2 million, and a 1973 outbreak that left 1 million dead.

Bailey said he never hears experts use the word "if" when talking about another pandemic. It's generally accepted that there will be a pandemic at some point. The question is not "if" but "when."

Lynn Burns, emergency response coordinator for Tennessee Department of Health, also spoke Tuesday night. He said a pandemic could occur in three to four waves over two years and that Tennessee's projected death toll would be 38,000.

The current concern is about the so-called "bird flu" virus, called H5N1. It's present in birds and can be transmitted from birds to humans. As it adapts to changing conditions, it could become a Type A virus, easily spread from one human to another.

Bedford County, because of its large poultry industry, is at particular risk, said Bailey. More commercial fowl are raised in Bedford County than the next two Tennessee counties combined. Some are in poultry houses, but there are also a large number in backyard flocks. In addition, he said that fighting birds -- imported as "exotic birds," since cockfighting is illegal -- can come from infected areas of the world and aren't inspected in the way agricultural birds are. Bedford County also is located in the path that many birds take from Canada south.

Most disasters -- a tornado or even a hurricane -- are somewhat limited in the geographic area they cover, allowing federal and state officials and private charities to bring a focus of relief and support. But Bailey said officials have told him a pandemic will be so large in scale that individual communities can't expect support from outside.

"We will be on our own," said Bailey.

Among those humans who have gotten the bird flu from birds, there is a high mortality rate.

There are limited medical responses to a bird flu pandemic. Right now there's no vaccine; there is promising research being done, said Bailey, but then again there's no guarantee the flu won't become resistant to a drug or vaccine after it's in use.

The key to stopping the flu will be stopping the social interactions through which it is transmitted.

"We want to keep people isolated," Bailey said. "That's the only success story."

The first step to that may mean closing schools -- possibly for an extended period of time. That could create child care problems for some of the emergency and medical workers who will be most needed during a pandemic. Bailey is working with area churches to develop volunteer programs that could help provide child care in the event of a pandemic. Other ways volunteers could help might include "meals on wheels" or medicine delivery programs to allow people to stay at home as much as possible.

A pandemic could cause massive absenteeism at area factories and businesses. Bailey said a factory could see 35 to 40 percent absenteeism for up to eight or nine weeks.

Bailey has already begun making contact with human resources personnel for the county's largest employers, and recently spoke to a local association of HR managers.

Burns commended Bedford County EMA for its proactive approach to the crisis and said it has been "by far the most progressive in taking this bull by the horns, and trying to wrestle with it."

He said Bedford County is the only county in the state with a comprehensive plan for working with industry in the event of a pandemic.

The rules committee asked County Mayor Eugene Ray to schedule Bailey to speak on the issue to the full commission on a night when there are no quarterly department reports which might take up time.