"Preparing for the worst case"

Before she died on Oct. 23, 1918, my grandmother had been a healthy young woman of 26 and the mother of two children, one of them my father, then 5 years old. Her name was Naomi Goodwin Atwater, and the nightmare that killed her and as many 50 million other people worldwide was the Spanish flu.

That personal connection with a deadly virus makes me sit up and take notice whenever there's a new report about avian flu in the media. With the virus now found in birds and causing deaths in parts of Asia and Africa, scientists are racing the clock to develop a vaccine (no mean feat, since the virus has already mutated twice since it was identified and may well do so again).

Meanwhile, in an attempt to be ahead of the curve if an epidemic (local outbreak) or pandemic (worldwide outbreak) should strike, Colorado hospitals are conducting joint planning with other emergency medical service providers and local fire and law enforcement agencies. Cindy Thistel, an infection prevention and control specialist with Centura Health's 12-hospital system, says the hospitals and first responders are "figuring out how they could function as a team" if large numbers of people became seriously ill at the same time.

They are exploring numerous difficult questions, including:

How can hospitals maintain "access control" if many people are sick? Thistel's answer: "We may have to take the temperature of staff and visitors when they enter to make sure they're not sick."

How can the flow of food, equipment and medications into the hospitals be ensured if transportation systems are disrupted? "We're working on that."

If significant numbers of hospital workers are sick at once, who will feed and provide basic care for hospitalized patients? "Very likely, family members will have to be involved."

Will health workers, worried about their own safety and the safety of their families, show up for work? "Hospitals may provide anti-viral medication not only to staff members, but to their families as well, so that health providers can go to work without worrying about those at home."

And how will health workers care for their children if child care centers are shut down? "Some hospitals are talking about providing child care on site."

In addition to joint planning to answer such questions, individual hospitals and agencies are holding drills to test their own internal preparedness. For example, Littleton Adventist Hospital recently conducted a drill to see how quickly doses of "medication" could be distributed

Public education is a big part of the work being done by area hospitals and their partners. The Tri-County Health Department and Littleton Adventist Hospital, for example, are working together to produce educational materials and to plan a media campaign that will let people know what to do and where to go for help in a crisis. Health departments across the state will be responsible for handing out oral anti-viral medications, and Red Cross sites will be set up in community locations to provide assistance.

But citizens shouldn't depend totally on others. In the case of a serious flu outbreak, authorities may impose "social distancing" to keep people from gathering in large groups. Schools, businesses, public transportation, sporting events and places of worship will likely be shut down, either by the authorities or by illness among workers.

Authorities say people should make their own preparations. Keep some money on hand, stock up on pain- and fever-reducing medications, and have enough food and water to last for a week or more (banks, gas stations, pharmacies and grocery stores may all be closed). For more information about ways to protect yourself and those you care about, visit pandemicflu.gov.

So far there hasn't been a single reported case of avian flu in the United States, so there's no need for panic. But in the words of Edgar Marcuse, M.D., chairman of the National Vaccine Advisory Committee from 1994-1998, "The pandemic clock is ticking. We just don't know what time it is."

Maybe not, but we know it's time to get with it, Colorado.

Susan Thornton (smthornton@aol.com) served 16 years on the Littleton City Council, including eight years as mayor. She writes on suburban issues on alternate Thursdays.

http://www.denverpost.com/opinion/ci_4191309