Published July 5, 2006
County-level planning underway for pandemic flu
Worst case scenario would overwhelm
emergency workers and health facilities, say local and state officials

Speaking at a pandemic flu planning meeting last week, state officials said it's been made pretty clear, if a widespread deadly flu strain strikes the United States, it's every community for itself.
Lois Bryant with the Pickens Health Department opened the meeting at Appalachian Tech June 26, by saying the county must continue planning what to do locally should a worldwide epidemic of deadly influenza occur.
"In a pandemic, there would be no help offered by the state to Pickens County," she said. "We need to look at what we can do in case of an outbreak."
The meeting included representatives from county government, emergency management agencies, the city of Jasper, law enforcement agencies, utilities, the media, grocery stores, the hospital and charitable groups.
Closing the meeting, Commissioner Robert Jones, who is the head of the recently created Pandemic Flu planning group for Pickens County, said they will begin meeting regularly to assess what can be done here.
Cherie Drenzek, chief epidemiologist with the DHR division of public health, provided an overview of pandemic flu to start the meeting.
She said pandemic flu and bird flu are often used as synonyms, but that is inaccurate. She said bird flu is a reservoir from which a pandemic flu (worldwide outbreak) could start.
She said the current "unprecedented outbreak" of the bird flu, known scientifically as H5N1, is being reported throughout Asia, across Europe into England and down into Africa.
The virus has resulted in 228 cases in humans, which lead to 130 deaths, and this is very troubling to researchers, said Drenzek.
"Usually bird viruses stay in birds and people viruses stay in people," she said.
While very deadly, the current flu strain doesn't move readily from person to person. In fact, Drenzek said it's unclear how many times, or if ever, the virus has been transmitted person to person. In the past month, a closely watched situation in Indonesia has given the appearance of person-to-person transmission among a family.
Drenzek said there is a checklist of conditions necessary before a worldwide influenza outbreak as often cited by researchers could be possible. At this point every box but the last, rapid human-to-human transmission, has occurred. "For two years we've been holding at the same spot. When will we check that box? No one knows," she said.
Drenzek said there is no way to know when or if a deadly flu pandemic could start, but scientists believe the threat is urgent enough to begin planning now.
The virus, as it exists now in birds, is extremely troubling for many reasons, not least of which is the current 57 percent death rate among humans who have contracted it, Drenzek said. She also noted the current form of the virus doesn't respond to medications commonly used to treat the flu.
But the virus will continue to alter its own form as it develops. Drenzek said influenza viruses are rapid transmitters, but "very poor proofreaders."
They change quickly, but into different forms, she said.
She said there are small changes each year, which is why we need new flu shots every year. But the possible pandemic would be a "big change."
The fact that it would be a virus unlike any ever seen before would mean no natural immunity among anyone. That would make it easy to spread and hard to fight off.
Potential deaths should this virus morph into something more easily transmitted run somewhere above a 30 percent mortality rate. Both Drenzek and later speakers said if it moves into humans, the entire world would see a devastating number of deaths.
Based on a question later in the meeting, some people who contract this flu might not be affected much worse than they would be by a severe case of yearly flu. But the disease could also kill quickly with blood filling the lungs.
Ron Hernandez, a district emergency coordinator for the state, said, "Even though this is a worldwide threat, you need to plan locally."
There won't be unaffected areas, so there won't be anyone to call for help, he said.
Hernandez used Hurricane Katrina as an example of how an area had no local plans in place and waited on the federal government to send aid, a tragic mistake.

 Both Hernandez and Drenzek said they are hoping and praying the pandemic never hits, but eventually there will be disasters, and this planning for community self-reliance will prove valuable in any number of situations.
Hernandez said the government is stockpiling funds to create vaccines, but until the flu changes into a final form, there is no way to create a vaccine.
"The thought is there will be a delay to get a vaccine," he said. "It could be four to six months to build one. You must see the virus to be able to build one." Hernandez said overall strategy to limit deaths is by "social distancing"; essentially keeping everyone, even the sick, at home.
Hospitals would be so overwhelmed it would pointless to look at getting people there for treatment, he said. The plan is to create "in-home help kits" which could be used in conjunction with phone lines for medical advice.
Pickens Emergency Management Agency Director Layne Arnold asked about the logistics of creating a phone line and the likelihood people will still call 911 and demand ambulance service.
"With the projection of three million deaths in Georgia, based on history we won't get 3 million calls, we'll get nine million," Arnold said. "People will be showing up at the hospital any way they can get there. There is no way we can respond to that many calls."
A EMA staff member from Gilmer County said they operate with more than 80 percent volunteers. If a disaster like this occurs, many of them will likely not report for work, further compounding the situation.
Hernandez acknowledged concerns relating to emergency workers. He said planners are very aware that the plan for in-home help kits, phone lines and social distancing won't be popular.
"If the answer is 'there is no help.' Then the answer is 'there is no help,'" he said. "We don't like that in this country. We want the government to come."
As part of the meeting, many of the representatives from organizations and business were asked to consider different scenarios.
Among those who spoke was Superintendent Mike Ballew of the Pickens school system. He said schools will be shut down. The facilities, with whatever food is on hand in cafeterias, could be put into general community use.
Hernandez said closing schools is an important part of the social distancing plan, but it would not be effective unless parents also stay away from other gatherings and keep kids at home.
Speaking on behalf of county government, Commissioner Jones noted the county already has emergency plans. He viewed the real threat coming with the loss of electricity, which would lead to a water outage and communication difficulties.
"Things could snowball and really get out of hand in a hurry," he said.
Judy Shaw, from Piedmont Mountainside, said one initial problem is they would be limited to what supplies they had on hand. She said they will need to work with the main Piedmont hospital on plans and details.
Robert Payne of Amicalola EMC said this is a different type of disaster than they usually plan for. In most cases it's the infrastructure they worry about, but here it would be personnel. He said the power company should be able to deliver electricity even with a greatly reduced staff as many employees currently working on new projects could be re-assigned to keeping the power flowing.
A representative of the IGA grocery store in Foothills Shopping Center said as long as trucks can move on the interstates, they will be able to remain open and supply food. He said most people already have a few days of food stored at home, and he was confident they could have a store supplied and opened before lack of provisions became an issue.
Commissioner Robert Jones asked if the experts could provide home checklists of provisions families should keep on hand at all times to use during whatever emergencies might arise. He said he would like to see public education used to help prepare people for general disasters.
Hernandez said at this point public education is the number one issue communities can address. He said there is already a lot of information available at www.pandemicflu.gov
He reiterated an earlier point, that he "is praying this pandemic never strikes," but believes all communities will benefit from having good local emergency plans in general which don't, rely solely on the state or federal governments.
"Is it really this doom and gloom scenario?" he said. "We don't know, but planning is a good thing."