Should avian flu reach Minnesota in pandemic proportions, the governor could close schools, cancel Vikings games and force businesses to close. And people could be asked to quarantine themselves to their homes for as many as eight weeks.
"I hope we're not panicking the general public," a Pennington County official said Tuesday during a state Health Department teleconference. "Let's be very cautious to the public what we can and cannot do."
But the so-called "bird flu" is making its way around the world, and could reach North America by year's end, said Dr. Ralph Morris, state Health Department local public health administrative supervisor in Bemidji.
It means the time to start educating the public is right now, he said, as about a dozen people in Bemidji joined 45 sites across Minnesota in the interactive television briefing.
"The H5N1 virus will be here probably by the end of this year, and the more education we do prior to that, the better," Morris said.
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The briefing, for county commissioners, mayors and school superintendents, told of federal and state efforts to prepare for a major pandemic event, and also to stress how important local governments are to carrying out the actions needed to contain a pandemic.
"Disasters are local," said Kris Ehresmann of the Health Department's Infectious Disease Epidemiology, Prevention and Control Division. Local governments are the front line, and often face "yoyo," she said, defining it as "you're on your own."
"During a pandemic, all aspects of government plan to provide support, but they will be stretched to the limit with a national event," Ehresmann said. "it's best to plan for 'yoyo' no differently than other natural disasters that affect infrastructure, except with this, human infrastructure is affected."
State epidemiologist Dr. Harry Hull said the best thing local governments can do is focus now on comprehensive plan for the county.
"Your plan should include maintaining essential services," Hull said. "You need a coordinated county response, not just with public health but also the sheriff, human services and other offices."
County boards should also review health planning efforts, he said, such as contingencies of where people will be sent when the hospital is full to capacity.
"You should also promote planning to businesses and schools," he said. "They will be seriously impacted with a true pandemic."
While there has been no sustained human-to-human transmission of the bird flu, the H5N1 virus in four months has spread to 37 nations on three continents, with 175 people infected and 96 of them dying, according to a U.S. Health and Human Services report issued this week. Most of the dead were exposed to infected poultry.
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HHS defines pandemic flu as a "virulent flu that causes a global outbreak, or pandemic, of serious illness. Because there is little immunity, the disease can be spread easily from person to person."
Should a pandemic flu strike, as many as 30 percent of the workforce could be laid up, said Aggie Leitheiser of the state Health Department's Office of Emergency Preparedness. And state officials are estimating that of every 1,000 Minnesotans who are infected, two to 20 will die.
While Hull noted the Pennington County official's concern over creating a public panic, planning needs to proceed -- if not for the avian flu, then for the next one.
"If avian flu is gone, then there is still a risk with another flu," Hull said. "These events occur three or four times a century, and we're overdue. We have to do planning for avian flu, because of the prospect of another pandemic flu or bioterrorism. All can affect our communities severely."
Leitheiser likened it to a fire department -- people want to know there is one and that firefighters are trained but hope to never call one.
"The foundation of risk communications shows that the public does better if it is told ahead of time, and it can build into options," she said.
Should the H5N1 virus mutate into one that can be easily transmitted human-to-human and set the stage for a pandemic, "can we afford to be complacent?" Hull asked.
Without thorough planning, "we would be substantially behind the 8-ball," he said. "Can we afford to not be prepared?"
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The federal government's role includes research and development, Ehresmann said, including finding a way to reduce the time needed to develop vaccines from six months with an egg-based vaccine to something less with cell-based vaccines.
HHS said $3.3 billion will be spent this year, with $1.78 billion on vaccine development. The federal government is also doing active surveillance for the avian flu.
"The state will be involved in purchasing and distributing vaccines and finding ways to get materials throughout the state," Ehresmann said. "But local agencies are really critical. It is the local folks who will get the vaccine into someone's arm."
In early stages, quarantining will be helpful, she said, but eventually when a pandemic breaks out, the best that can be expected is "social distancing," such as closing schools and businesses and canceling events where people gather.
"We would need to encourage people to stay at home," she said.
Local officials need a plan to continue government operations, to continue services to those who are quarantined, build lists of volunteers to help with health care needs during a pandemic, and be able to stockpile and distribute items such as protective masks for health care workers.
State law gives the governor a lot of leeway in making emergency decisions, including canceling sports events or closing businesses, but an emergency declaration lasting longer than 30 days would need legislative approval to continue, Leitheiser said.
Gov. Tim Pawlenty's supplemental budget released Tuesday includes $10.5 million a year for three years for state avian flu efforts, from a surplus in the state's Health Care Access Fund, she said. The monies will help with local government planning efforts.
