Federal Health Officials Discuss President Bush's Flu Pandemic Plan, Including Vaccine Supplies, During Congressional Hearing

HHS Secretary Mike Leavitt on Wednesday during congressional hearings announced details about the federal government's 396-page plan for preparing the U.S. for a possible flu pandemic, one day after President Bush outlined the plan in his $7.1 billion funding request to Congress, the Baltimore Sun reports (Bor, Baltimore Sun, 11/3). According to CQ HealthBeat, the HHS plan is the "medical and public health component" of the proposal announced by Bush on Tuesday (CQ HealthBeat, 11/2). The HHS plan "lays out a wide array of suggestions of how state and local health departments can marshal scarce resources and manpower" but "declines, in most cases, to tell them exactly what to do," the Washington Post reports (Brown, Washington Post, 11/3). The plan calls on governments to improve preparedness plans for keeping "utilities working, medical facilities staffed and hospitals secure," the Wall Street Journal reports. It also asks state and local officials to consider such issues as how to distribute antiviral drugs and vaccines and whether employees placed in quarantines will be reimbursed for lost pay (Lueck, Wall Street Journal, 11/3). It provides guidance on what doctors should do if they believe a patient has a new form of influenza, how hospitals can limit the spread of infection and what home caregivers can do to protect themselves. The plan also addresses such issues as health care worker morale in what could be a yearlong public health crisis and how individuals should prepare for possible quarantines and other restrictions.

Specifics
The plan recommends that workers in vaccine and antiviral drug plants receive vaccines first, followed by medical professionals, public health workers, individuals older than age 65 with chronic illnesses other than hypertension, and individuals between the ages of six months and 65 years who are at risk for complications. The plan says states could adjust this list based on their needs. The document also recommends that hospitals stockpile an eight-week supply of masks, gowns, gloves, "morgue packs" and other necessary items and says individuals should consider having enough food to remain in their home for 10 days (Washington Post, 11/3).

Travel Restrictions, Isolation
A section of the HHS plan titled "Managing Travel-Related Risks of Diseases" provides recommendations to state and local governments on "travel-related containment strategies that can be used during different phases of an influenza pandemic," the Washington Times reports (Howard Price, Washington Times, 11/3). In the event of a pandemic, the U.S. could resort to travel restrictions, quarantines and isolation, the plan says. Local health officials could isolate ill patients and quarantine those exposed to flu patients, the plan said. Other options for states include closing schools and banning other public gatherings (Sternberg, USA Today, 11/3). Local governments also could establish "snow days" to keep individuals at home and prevent them from spreading infection during a pandemic (Washington Post, 11/3).

Vaccine Industry Improvements
Leavitt during his congressional testimony on Wednesday also discussed improvements to the vaccine industry (Washington Times, 11/3). The largest spending item in Bush's plan is $2.8 billion for research into cell-based vaccine manufacturing techniques. NIH already is working with the vaccine industry to use new cell-culture technology -- instead of the traditional method using chicken eggs -- to develop enough vaccine to immunize all U.S. residents within six months of the inception of a pandemic. Companies developing cell-based production techniques include Chiron, Sanofi-Aventis and Solvay (Kaiser Daily Health Policy Report, 11/2). Leavitt said it likely will take four to five years for the U.S. to have the production capacity to manufacture the necessary amount of vaccine to inoculate the entire population within six months of the beginning of a pandemic (Washington Times, 11/3).

States' Responses
Many state and local officials said they support the national strategy and have begun making their own plans, but others expressed concern that the funding earmarked for their efforts in Bush's plan is insufficient, according to the Wall Street Journal (Wall Street Journal, 11/3). The plan earmarks $583 million for states and local governments to prepare emergency plans to respond to an outbreak of flu. In addition, it calls for states to purchase 31 million of the 81 million courses of antiviral medications that will comprise the national stockpile. States will be responsible for 75% of the cost of that purchase (Kaiser Daily Health Policy Report, 11/2).

Response
According to the New York Times, the plan drew a "mixed reception" from Congress, as some senators raised questions about the delay in its release, along with its "spending priorities" (Harris, New York Times, 1/3). Anthony Fauci, director of NIH's National Institute of Allergy and Infectious Disease, said a pandemic is unlikely to occur in the upcoming flu season but stressed the importance of preparation (Washington Times, 11/3). Leavitt said, "Think of the world as a vast forest susceptible to fire. With a pandemic, it only takes a spark to create a pandemic" (Baltimore Sun, 11/3).