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Federal flu pandemic plan worries local public health

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Mike Osterholm, with the Center for Infectious Disease Research and Policy at the University of Minnesota, says he's worried about a flu pandemic's effects on the global economy. He says there needs to be a plan in place to make sure critical products and services continue. (MPR Photo/Tom Scheck)
U.S. Health and Human Services Secretary Mike Leavitt is making Minnesota the first stop in a nationwide tour to mobilize health officials to get ready for a possible pandemic of bird flu. If a massive outbreak occurs, Leavitt is telling state and local officials that they may be on their own. That worries some public health officials who say the federal government is shifting too many responsibilities to them.

St. Paul, Minn. — Federal, state and local health officials are discussing the possibility of a flu pandemic because a deadly strain of bird flu is spreading across Asia and Europe. Everyone who caught the virus was in direct contact with birds but the concern is that the bird flu will mutate from its existing strain and spread from person to person. If that happens, a pandemic will likely occur.

Minnesota state epidemiologist Harry Hull says if the pandemic reaches Minnesota is could overwhelm the state's existing health care system.

"If we have a massive outbreak, we can't rely on assistance from the federal government," Hull said. "Local communities will not be able to rely on extensive support from the state health department because we're going to have to be assisting everyone at the same time."

The Bush administration has proposed $7.1 billion in federal money to prepare for such an outbreak. The money will go to vaccine research, create a stockpile of antiviral medication and improve disease surveillance.

U.S. Health and Human Services Secretary Mike Leavitt is travelling the country discussing the plan and encouraging preparedness.

Washington County Public Health Director Lowell Johnson says he's pleased the Bush administration is talking about the issue but says a federal plan has to include enough money for local public health agencies to prepare.

It tells states and local communities to do something. It says you have to have a plan, and this is going to be a bad situation so you need to plan for it. But they don't really get into detail. Plan how? What are you supposed to do?
- Gregory Evans, director of biosecurity at St. Louis University

"We can't just go day to day with kind of a skeletal system and hope that we can flip a switch and all of a sudden have a robust system to respond to a crisis," Johnson said."

Johnson says public health officials are already struggling to meet the current demands of disease surveillance. He says they need more training, laboratory space and people to prepare for an outbreak. Others, like Gregory Evans, say the federal government needs to take a greater role.

"We're pushing things off to the states, pushing things off to the local communities because the federal government is unwilling to bite the bullet, Evans said.

Evans, the director of biosecurity at St. Louis University, called the federal plan a "good start," but says it's undefunded. Evans is also troubled that the federal government is expecting states to pay for the bulk of the medicine needed to fight a flu pandemic. He says that could cause problems for poorer states with tight budgets. Evans also says the federal plan doesn't provide enough direction.

"The problem with it is it lacks the details and the specifics," Evans said. "It tells states and local communities to do something. It says you have to plan and this is going to be a bad situation so you need to plan for it. But they don't really get into detail. Plan how? What are you supposed to do?"

Michael Osterholm, with the Center for Infectious Disease Research and Policy at the University of Minnesota, says he isn't surprised that the federal government is encouraging states and local government to shoulder much of the burden if a pandemic occurs. He says there's no other option if every major city and state is dealing with an outbreak. Osterholm says he's worried about pandemic's effects on the global economy. He says there needs to be a plan in place to make sure critical products and services continue.

"Part of what we have to do today is start moving ahead and hope that the pandemic is years off not days or months off," Osterholm said. "That will allow us enough time to ensure that critical medical supplies, food supplies and other things that we need are going to be more available during a pandemic than they would be right now if it were to hit today."

Several weeks ago, Gov. Pawlenty and state health officials announced that if a a highly contagious form of bird flu were to strike Minnesota, they would enact a plan that includes closing public places like schools and some businesses.

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