Re: Missouri Prepared, But Still Concerned About Possible Pandemic Flu Outbreak
http://www.kctv5.com/Global/story.asp?S=5823521
Missouri has pandemic flu plan but acknowledges gaps
JEFFERSON CITY, Mo. -- Missouri health officials believe they're ahead of other states in preparing to respond to a pandemic flu outbreak but acknowledge shortcomings, notably a lack of enough health workers or beds to manage a barrage of sick people.
A chief concern is how to ensure adequate staffing by doctors, nurses and other medical professionals at a time when officials estimate a third of the population could become ill _ a statistic that doesn't exempt the people who care for the rest of us.
"It's not even just a simple matter of beds, it's a matter of staffing beds as well," Missouri Hospital Association spokesman Dave Dillon said. "That may become even more of a critical problem as workers become sick."
Drills show that there won't be enough medicine to go around, and that agencies need to keep practicing to be prepared for the influx of people who would need help in a pandemic, said Bert Malone, acting deputy director of the Kansas City Department of Health.
"
There's a lot of challenges. Do we have enough volunteers, do we have enough vaccine, do we have enough antivirals to accommodate the huge number of folks who would be impacted? Frankly the answer to that is no," he said.
Another issue is figuring out the
chain of command if drastic steps such as closing schools and malls or canceling sporting events or bus routes are required.
"Normally when we are in some sort of health situation, it is managed locally. Locals know their own communities best, and they make those decisions best," said Aaron Winslow, chief of the Office of Emergency Coordination in the Missouri Department of Health and Senior Services.
"However, we also have concerns about being able to maintain statewide consistency. We're working very hard on the issue at the state level."
Missouri has received $6.1 million in federal money for pandemic planning, and has spent about $1.8 million of that so far, mostly distributed to local agencies for things such as gloves and masks to protect police, emergency workers and other first responders in a pandemic or other health crisis.
Missouri officials have conducted several
drills of their pandemic plan, he said, including an exercise in Springfield in June that focused on delivery of antiviral medicines to respond to a pandemic strain. The state health department, state emergency operations center, volunteers, public health officials and local emergency officials and police were involved.
Several internal drills within the state health agency also have been performed, along with 30 to 40 around the state, Winslow said.
Eventually, all of the more than 100 local public health agencies statewide will conduct an exercise, he said, which could be anything from using a flu shot clinic to practice a pandemic response to a full-scale exercise involving various community groups.
Another challenge is that Missouri lacks enough hospital beds to handle a flood of infected patients, he said.
"We
don't have enough surge capacity. Hospitals are a business, and they don't leave several hundred or thousand extra hospital beds waiting around for that. The hospital beds match the need of the customer," he said.
Winslow estimated that up to 35 percent of the population could become ill in a pandemic, and many could need hospitalization. So the
state is looking for alternative sites, such as churches or schools, where it could set up beds to care for the sick.
Kathryn Hadlock, hospital preparedness program manager in the state's Center for Emergency Response and Terrorism, said trailers are placed throughout the state equipped with cots and other supplies to distribute in a major health emergency, but workers would be the big concern.
"We do not have enough resources to care for the number of patients we would expect to have in a pandemic event," she said.
Missouri has 13,796 licensed, staffed hospital beds, she said, and nearly all of them are in use at a given time from regular patients. A pandemic flu could bring a crush of patients for weeks, with a peak estimated at nearly 5,300 admissions a week.
Part of Missouri's planning to handle the load includes developing a state-level registry, in conjunction with a national one, of health professionals willing to volunteer in a disaster or public health emergency, but it's not in place yet.
Hospitals also could cancel elective surgeries to free up space and staff and pull some administrative staff into patient care if needed, Hadlock said.
Another concern is
making sure health care workers are willing to volunteer. Part of that means
ensuring they would have protection from legal liability should something go wrong if they respond in a pandemic, Malone said.
The biggest problem in a pandemic, Winslow said, is the lack of a vaccine when one strikes, which means government officials must rely on fall-back measures, from
encouraging commonsense steps like hand washing and staying home if you're ill to broad-scale measures such as closing public gathering spaces to minimize a disease's spread.
