Fairfax Issues Pandemic Flu Response Plan
Nearly 700 Deaths Possible in Outbreak

By Lisa Rein
Washington Post Staff Writer
Saturday, September 16, 2006

A severe outbreak of bird flu would infect nearly a third of Fairfax County's population, killing almost 700 people and sending thousands to local hospitals, according to a new report.

The 112-page primer on how the Washington area's largest local government would respond to a pandemic that many researchers think is inevitable depicts a grim scene of sick or at-risk people in widespread isolation or quarantine, at home or in hospital beds.

As much as 40 percent of the county's workforce would be out of commission. And hospitals, nursing homes and other makeshift medical centers would have to set up temporary morgues and stockpile body bags to handle the deaths.

"Life as you see it today will not be the same," Fairfax health director Gloria Addo-Ayensu said yesterday. "We will all have to make sacrifices."

Fairfax, which has posted its response plan on the county Web site, is the region's first local government to issue a comprehensive report on pandemic flu preparations, said Addo-Ayensu and other emergency management officials.

Although the Bush administration has released a federal plan and committed tens of millions of dollars to anticipate a crisis, the details of how to respond are left to state and local governments.

Public health experts fear that avian influenza, which is spreading worldwide in poultry and has infected more than 230 people, could mutate into a virulent, pandemic strain that could spread widely from person to person, killing millions around the world.

There is no bird flu vaccine, and public health officials predict a shortage of antiviral drugs.

Fairfax, like most local governments, has planned emergency exercises; held meetings with doctors, businesses, school and religious leaders; and prepared public service announcements and publications to give residents information about a possible pandemic.

Now the county is giving its government officials, infectious disease specialists, emergency planners and first responders explicit instructions on what to do if people get sick.

"We have to look at the scenarios that are the worst-case," said C. Douglas Bass, the county's emergency management director, "and look at how we would deal with them."

Bass said the county took the unusual step of putting the response plan on its Web site "to assure the public that we are being vigilant, that we've gone through this process, and to provide a forum if they have questions."

It's largely a communications plan that dispassionately lays out military-style procedures that would be set in motion at the first sign of a pandemic. The goal is to minimize the transmission of a highly contagious virus while keeping the county government of 11,000 employees running, albeit with truncated services.

Taking its cue from federal officials, the county would track individual infections through reporting by local doctors and hospitals. Sites would be set up across the county to distribute a potential vaccine or medicine, and sick people could be forced into quarantine.

The county would communicate a series of sobering messages: A pandemic has been declared somewhere in the world, and Fairfax may soon experience illnesses and deaths. A pandemic could last as long as 18 months. And residents should practice good hygiene -- washing their hands and covering their mouths when they cough -- to prevent the spread of germs.

Many county employees would work from home, and hundreds could be diverted from their jobs in libraries, parks and other "nonessential" agencies to help with the emergency response. Critical personnel would include police and fire rescue workers and those in utilities and wastewater treatment. Heads of agencies are supposed to designate replacements who could fill in if they get sick.

And as a pandemic approached, thousands of other people would be ordered to stay home, steering clear of trains, buses, malls and other places where they would come into close contact with others.

The response could get particularly challenging in a county of more than 1 million people, thousands of whom do not speak English. As many as 51,000 of those infected would be low-income residents without regular access to medical care, the response plan says.

"Trying to do mass vaccinations, for example, would be a huge challenge," county spokeswoman Merni Fitzgerald said. "We are so big that we can't just say, 'Everybody show up at once place.' "

A flu outbreak could last six to eight weeks, with two waves over 18 months, the report says.

As more people get sick, waves of panic could spread, with increased calls to police. "Civil disturbances and breakdowns in public order may occur," the plan says. Crime could jump as police officers might be diverted from traditional duties.

And security problems could be rampant as people might fight for access to limited vaccines and medication. Health-care workers, the elderly and those with chronic illnesses would get first priority.

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