Pandemic plans miss key questions

http://www.mlive.com/columns/aanews/index.ssf?/base/news-1/1145889806152250.xml&coll=2

Pandemic plans miss key questions
Monday, April 24, 2006

In the next few days, the federal government is expected to release another flu pandemic response plan, this one designed to guide the behavior of federal agencies in case of a disaster. According to a recent briefing, preparations include plans to print money abroad if U.S. mints cannot operate; to close cafeterias and cancel meetings; and even to define what, exactly, the federal government's basic functions are. Some agencies at the moment list as many as 400 "essential tasks'' in their emergency plans, an unrealistically high number.

This is all very well, as far as it goes. But neither this plan nor any previous one has honestly confronted the central question of any pandemic: what to do with hundreds - or hundreds of thousands - of sick people. No one has produced an effective flu vaccine. Until someone does, any contagious flu virus - or bioengineered virus - will make many people ill. And neither America's hospitals nor any other part of the medical system is ready to deal with them.

True, there are plans for mobile medical units, and there have been rudimentary attempts to define and measure the nation's "surge capacity.'' But most of America's 5,000-odd hospitals are unprepared. More important than shortages of equipment like ventilators and beds is the shortage of medical staffers. In a pandemic it will be impossible to provide traditional hospital care to everyone. But even makeshift military field hospitals will require minimally trained staff.

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