The Bush administration assumes that a deadly bird flu pandemic is coming.
The worst-case scenario is a repeat of the Spanish flu outbreak of 1918 that infected more than one in four Americans and resulted in the deaths of about 675,000 in this country alone.
Secretary of Health and Human Services Mike Leavitt said today that he must assume that a similar outbreak is coming soon. The problem, he said, is "we don't know if we are at 1905 right now, or 1917."
Scientists say that the influenza strain known as H5N1 that is infecting birds in various parts of the globe now may never make the leap from bird-to-bird transmission to human-to-human transmission that could lead to a catastrophic outbreak.
If so, the fear of a bird flu pandemic may be misdirected, but that does not mean we shouldn't be be prepared.
Leavitt said history should be the guide. Some pandemic -- whether it is H5N1 or another virus -- is virtually inevitable.
"There were 10 pandemics in the last 300 years. Three in the last 100 years. There is no reason to think the 21st century will be different," Leavitt said.
When and whether a pandemic comes, the Bush administration knows that many Americans will get their information from news outlets. With that in mind, the White House is holding briefings with reporters who are likely to play a key role in that coverage.
At a briefing today at the White House with reporters from the TV networks, Leavitt and Secretary of Agriculture Mike Johanns discussed their plans to "flood the zone" with information to media outlets when and whether a pandemic occurred.
Leavitt and Johanns discussed how the virus was being tracked now, in bird and poultry populations in the United States and around the world. They walked through some hypothetical examples.
While preparations are being made for various potential scenarios, Leavitt said there was no way to avoid some period of time when a pandemic would not be well contained and many people could get sick and die.
"The first six months of the pandemic, we're not going to have a vaccine," he said. That is because once there is a human-to-human outbreak, a vaccine that works against that strain of flu will need to be identified, manufactured and delivered.
Leavitt pointed out that one critical part of the response to a pandemic was not being handled by the federal government: distribution of vaccine and treatment. That important step is being passed to local governments.
The federal government has held about 55 summits with local authorities around the country. More meetings and war game-type exercises are being planned.
With local authorities in charge of the all-important distribution of medicines, how to prioritize who gets vaccine and treatment first? Who should go to the front of the line: the elderly, the sickest, the young, health-care workers or the military?
"This is a delicious conundrum," Leavitt said, acknowledging it was a "hard problem." He pointed out that any pandemic was likely to last about a year or a year and a half before it petered out. The country needs to be prepared to handle other disasters during that time too, Leavitt said.
"We could have four to five hurricanes during a pandemic, a bio-terror incident, natural disasters -- all during a pandemic. We need to preserve our capacity to respond" by keeping the military and other first-responders healthy and able to work, Leavitt said.
The government has established and is updating a Web site with more information about the flu pandemic: www.pandemicflu.gov