Sunday, July 23, 2006

Planning now for flu pandemic

Planning now for flu pandemic

First published: Sunday, July 23, 2006

The projections are sobering. Hospital emergency rooms and intensive care units would be overwhelmed. Absenteeism in the workplace could range from 30 percent to 50 percent. Travel could be sharply curtailed, and basic necessities could soon be in short supply.

State health and emergency management officials are making preparations for an influenza pandemic that some say is overdue. The likely culprit would be a new form, or mutant, of the H5N1 avian flu virus, which in its current form is not easily transmitted between humans.

Humans who have caught avian flu have been in close and prolonged contact with infected poultry or other birds. What alarms health experts is the high death rate: Half those who contracted the virus died.

A pandemic is a global outbreak of flu caused by a new strain of the influenza virus. It's easily transmitted between humans, and can strike people of any age, at any time of year, said Dr. Sarah Elmendorf, an epidemiologist at Albany Medical Center.

Businesses have begun planning to reduce the potential impact of a pandemic. The state Public Service Commission last month held a workshop with utilities to review their business continuity plans. Banks and other financial institutions, meanwhile, are preparing ways to continue operating.

"Having the key utilities functional during a pandemic is imperative," said Debbie Drew, a spokeswoman for National Grid, which serves much of the Capital Region. "We're working to that end."

The utility has drawn up plans to continue functioning with as many as half its workers absent, she said. Its information technology department is increasing the capacity of its computers to permit large numbers of employees to work from home.

Planning began last August, and since then the utility has stockpiled medical supplies, as well as masks, gloves and antiseptic wipes, she said.

Verizon Communications Inc., the Capital Region's major provider of phone service, is preparing for a shift in data and voice traffic on its network from business centers to residential neighborhoods, as more employees telecommute to avoid catching the flu, said spokeswoman Heather Wilner.

KeyBank N.A., with more than 50 Capital Region offices and 1,600 employees locally, is working on ways to keep automated teller machines stocked, and to keep branches staffed, said Charlene Whitcomb, manager of continuity and recovery. In a pandemic, the bank might consolidate several branches in a given area into one or two to reduce staffing needs, she said.

The bank also is preparing for a surge in online and call center business, she added. And, like many businesses, it's identifying succession plans, not just for top executives, but for employees throughout the organization, to ensure workers with the necessary skills are in place.

While KeyBank and other companies say that, internally, they're in control, it's the external factors that have them worried. Will the power continue to flow? Will deliveries be made? Will the water be safe to drink? Will the Internet service providers continue to function?

With large numbers of workers telecommuting, said Whitcomb, "now, you're potentially competing for Internet resources, kids downloading music competing with" telecommuters, she said.

That's because schools will likely shut down, and students will be at home.

Business planners often draw parallels with 1918, when a pandemic killed between 20 million and 40 million people worldwide, including 675,000 in the United States.

In some ways, we're better prepared, but in other ways, the risks we face are greater than in 1918, said Kim Baker, a registered nurse who is a certified infection control practitioner in Albany Medical Center's department of epidemiology.

While international travel is far more prevalent today, worldwide surveillance systems to detect and report disease outbreaks also are more sophisticated, she said. Antibiotics to treat complications of the flu are readily available, households are smaller and we have more effective face masks and other protection.

But society also is more interdependent, Baker said, with manufactured goods, raw materials and other items coming from such places as Asia. She said supplies of chlorine, used to treat water supplies, might be exhausted within a few weeks of a pandemic's onset.

The practice of just-in-time deliveries to reduce inventory carrying costs could exacerbate the problem, Baker said.

But Amy Fires, a spokeswoman for the state Office of Homeland Security, said the availability of such critical materials as chlorine for water treatment, while provided by the private sector, would be closely monitored by government officials.

But Baker questioned how much assistance government would be able to provide.

"Hurricane Katrina was just one area of the United States," she said. "This would hit everywhere."

Awareness of the need to plan is apparently increasing among Capital Region businesses. A session in April sponsored by the Chamber of Schenectady County had to be canceled because of a lack of interest. More recently, though, the Saratoga County Public Health Department held an evening session that drew between 50 and 80 people, said Terry Stortz, the department's prevention team supervisor.

And a meeting of the Capital Region chapter of the Association of Contingency Planners two weeks ago attracted several dozen people.

Most agencies say they're prepared, but they'll depend on guidance from state and federal health officials.

"We have teams that are set up on a nationwide basis that are set to respond to emergencies such as a pandemic," said Paul Varville, federal security director for the Transportation Security Administration at Albany International Airport. "We'd be mostly just helping out. Guidance would be from the health officials."

Pandemic planning "is being worked on largely with the State Emergency Management Office and the Health Department, and we would take direction from them if there was an event that occurred," said Jennifer Post, a spokeswoman for the state Department of Transportation.

The Health Department has expanded capabilities to test for influenza viruses at its Wadsworth Laboratories, and it has stockpiled medicines. Officials declined to permit a photographer to visit either location.

Health care facilities could be overwhelmed by a pandemic, said Scott Heller, director of the Regional Resource Center for Emergency and Disaster Preparedness, based at Albany Medical Center.

"It doesn't take much to see how stressed the health system is now in this country," he said. "What are some of the innovative ways we can expand capacity? We're working with 30 to 50 percent fewer employees."

Baker, of Albany Med's department of epidemiology, said hospitals would postpone elective procedures to increase capacity. Nevertheless, hospitals could face bed and equipment shortages.

Elmendorf, the Albany Med epidemiologist, told contingency planners at their meeting that pandemic patients would take up 63 percent of hospital bed capacity, 125 percent of intensive care unit capacity, and 65 percent of hospital ventilator capacity.

Developing a vaccine would take four to eight months, she said, and only 5 million doses a week could be produced.

"We don't know when it will come until it comes," she said. "When it gets here, it's going to take weeks to months for it to run its course."

In the meantime, travel may be disrupted, quarantines may be put in place, and people will be encouraged to stay home and isolated from others.

"One of the things we've been promoting is social distancing -- don't go out to the mall," said Stortz of the Saratoga County Public Health Department. Any large public gatherings, particularly indoors, might be discouraged, she and others said.

In workplaces, employees might have to be separated and face-to-face contact limited, said Deborah Taylor of SunGard Availability Services, who also spoke at the contingency planners' meeting. The Wayne, Pa.-based company helps businesses keep their data networks and systems operating.

What's not known is how the financial markets might react.

"Large Wall Street investment and financial firms have been urged to have plans in place," Taylor told the planners.

Depending on the pandemic's severity, the nation might see a decline in its gross domestic product of 1.5 percent to as much as 5 percent, or about $200 billion to $700 billion, according to the Congressional Budget Office. The World Bank has estimated the global cost to the economy at about $800 billion, Taylor said.

A separate study by the Centers for Disease Control in Atlanta estimated total impact on the U.S. economy at $71.3 billion to $166.5 billion, excluding disruptions to commerce, and the number of deaths at 89,000 to 207,000.

KeyBank's Whitcomb said pandemic preparations are reminiscent of some of the efforts bank officials made to prepare for Y2K, when worries about computer failures led to equipment upgrades and a host of contingency plans.

Unlike Y2K, however, there's no point in time when we know the danger will have passed.

"We don't know when the pandemic will start -- tomorrow, next year, 10 years," said Albany Med's Baker. "Preparations should be made, not because it's imminent, but because the cost of not preparing will be great." Anderson can be reached at 454-5323 or by e-mail at

Pandemic's death toll Three influenza pandemics in the past century have claimed thousands of lives in the United States: 1918: 675,000 deaths 1957: 70,000 deaths 1968: 34,000 deaths Seasonal influenza strikes 5 percent to 20 percent of the U.S. population annually, and kills about 30,000 people each year. Source: Albany Medical Center

All Times Union materials copyright 1996-2006, Capital Newspapers Division of The Hearst Corporation, Albany, N.Y.


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