White House Plan Defers Leadership In Bird-Flu Fight

By David Brown
Washington Post Staff Writer
Thursday, May 4, 2006

The Bush administration plan for an influenza pandemic released yesterday hinges on sharing authority with global agencies such as the World Health Organization, and, at the opposite end of the spectrum, with governors, mayors and school superintendents.

The 227-page road map acknowledges that the federal government cannot -- and should not try -- to fully manage the response to an event that is likely to start overseas, eventually take hold in even the smallest U.S. communities, and last for months.

"The impact of a severe pandemic may be more comparable to that of war or a widespread economic crisis than a hurricane, earthquake, or act of terrorism," the authors of the plan wrote. "The center of gravity of the pandemic response will be in communities [and] the support the federal government can guarantee to any state, tribe or community will be limited."

At the same time, the road map -- developed to support an equally voluminous pandemic "strategy" unveiled in November -- lays out an ambitious agenda of more than 300 tasks for federal agencies, along with a timetable for completing them.

They include such tasks as helping improve a flu laboratory in Singapore and encouraging new cell-based vaccine-making technology in this country; devising plans to route all international flights to just a few U.S. airports during a pandemic; and helping local jurisdictions come up with plans for canceling school and triaging patients at hospital emergency rooms.

Nevertheless, many crucial questions about the government's response remain unanswered in the "Implementation Plan of the National Strategy for Pandemic Influenza."

They include how officials would decide who should get limited supplies of vaccine and antiviral drugs; whether the government would dip into those domestic supplies to help contain a foreign outbreak; at what point to trigger mass treatment of U.S. citizens in an effort to contain the virus here; and how travel and border-crossing might be limited.

"We recognize that we cannot make these decisions in a vacuum and must consult with our international partners to ensure that we adopt a consistent approach," Frances Fragos Townsend, President Bush's assistant for homeland security and counterterrorism, said at White House briefing.

The document anticipates that a flu pandemic would probably come in two or three global waves, each lasting about three months; in any given community, an outbreak would last six to eight weeks; at least one-third of the population would become ill, and workforce absenteeism could peak at 40 percent.

Mortality in the United States depends on many variables; the report assumes there could be 200,000 to 2 million deaths.

A pandemic on the scale of the Spanish flu that circled the world three times in 1918 and 1919, killing at least 50 million people, could result in the loss of 5 percent of the U.S. gross domestic product, according to Congressional Budget Office estimates cited in the report.

The administration's plan appeared to reflect the lessons of the severe acute respiratory syndrome outbreak of 2003 and the response to Hurricane Katrina last summer.

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