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Bird flu? Bay area has plans ... just in case

Packed hospitals, closed schools, canceled events: If an outbreak crept in, here's what you might see..

By LISA GREENE
Published January 24, 2006

They hope that if it ever hits the Tampa Bay area, a flu epidemic would start slowly - scattered cases here and there.

But just in case, health and emergency officials are planning for the worst: a world where hospitals have no more room for the sick, and not enough healthy workers to care for them. Schools would be closed and football games canceled as food supplies dwindle and medicines are rationed.

They all hope that such a widespread outbreak will never happen.

But the recent spread of deadly bird flu from Southeast Asia to Turkey has given new urgency to planning for the possibility of a worldwide epidemic, or pandemic, whether of bird flu or of some other new strain to which people have no immunity.

"We don't know when it's coming, and we don't know if it's coming," said Doc Kokol, spokesman for the Florida Department of Health. "But we do know that we want to prepare for any eventuality."

In some ways, planning for such an event has become almost routine for Tampa Bay leaders after years of near-constant hurricane threats. Flu might be easier to prepare for: no evacuations. No flood worries. No buildings at risk of collapse.

In other ways, it could be far more difficult - and more deadly. A flu pandemic could sicken people in the Tampa Bay area for several weeks. Estimates are that more than 19,000 people in Florida could die, along with potentially millions worldwide.

Florida could be just one of many places struck at the same time.

Planning has stepped up across the country, from federal to local health departments.

In Florida, the state recently got $4.6-million in federal funds to update its pandemic plan, which state health officials discussed in Tampa just last week.

In the Tampa Bay area, local health and emergency officials have met with leaders at hospitals, school districts and large companies to prepare.

Some of the companies studying the subject might surprise you.

"We've been attending meetings with the CDC," said Shannon Patten, a spokeswoman for Publix grocery stores. "We're doing everything we can to make sure we are prepared."

Publix has critical reasons for needing to plan. Company officials want to safeguard their chicken supply if domestic birds become infected with bird flu (although the virus is killed by cooking). As a large employer, it could have many sick workers, making it harder to get food delivered and keep shelves stocked.

If such a pandemic comes here, health experts hope, and expect, that the Tampa Bay area wouldn't be ground zero for the outbreak. If bird flu were already widespread elsewhere, it's more likely a local epidemic would start quietly, with a few residents getting sick after traveling to an affected area.

"I think we have a good chance of mitigating or limiting a true pandemic influenza outbreak," said Dr. Doug Holt, infectious disease professor at the University of South Florida and director of the Hillsborough County Health Department.

The keys, Holt said, would be learning from others' experience and acting fast here.

At first, health officials would try to contain the outbreak by isolating the few who are sick and possibly quarantining their friends and relatives who had been exposed. Those first groups might also get antiviral medicine, such as Tamiflu.

Even though the drug would likely be in short supply, giving it to the first people to get sick might stop the outbreak. If not, health officials hope they could at least slow the spread.

Such a slowdown could save many lives, Holt said, by giving vaccinemakers more time to create a vaccine and produce a large supply.

But if the disease were to spread further, emergency workers would have to take other steps. At some point, a broad outbreak would make quarantines less effective, as well as hard to enforce.

Then health officials might move to a strategy they call "social distancing," or limiting contact between people.

Children would stay home from school. Public events would be canceled. Businesses might be asked to have many workers stay home.

Companies from Raymond James to Tampa Electric would expect to have staffers working from home - an option that's much easier these days, said TECO spokesman Ross Bannister. But not for everyone.

"There are some aspects that are somewhat automated, but there's a very strong human element in the production and delivery of electricity," Bannister said. "We can't store it in a container somewhere. Electricity has to be ready when a customer needs it."

However, TECO does have emergency low-staffing plans, and could call in staffers from different shifts to replace sick workers, Bannister said.

Hospitals would face the greatest challenge. At Tampa General Hospital, Dr. John Sinnott has a photo of the hospital during the 1957-58 flu epidemic. Patients were being treated on the front lawn.

Plans call for quick decisions to be made in Tampa General's emergency room. As patients enter, anyone with flu symptoms - a cough, high fever and low back pain - would be sent to a separate area, so others wouldn't be exposed. Workers caring for them would wear face shields and other protective gear.

Other hospitals have similar plans. Elective surgeries would be canceled, and some patients might be sent home early. At St. Joseph's Hospital in Tampa, the north wing would be reserved for flu patients.

"We know the sheer volume would be the biggest challenge," said spokeswoman Lisa Patterson.

Hospitals might run out of ventilators as more patients develop breathing problems. Health and emergency officials in Pinellas and Hillsborough have bought extra ones.

Hospitals also may run out of room, period. Gayle Guidash, preparedness planner for the Pinellas County Health Department, said she expects hospital workers to get creative.

"They could put people in hallways, use conference rooms, find other ways to take as many people as they can," she said.

But at some point, Pinellas might open up a temporary facility to treat flu patients, Guidash said. Hillsborough also has considered such an option, for treating people or for examining possible cases.

In Hillsborough, Holt wants to keep the genuinely ill away from those who only think they're sick - because crowding into a waiting room is the best way for them all to be exposed.

People would be given detailed information on flu symptoms, Holt said, and urged to evaluate themselves before coming in.

"We need to be giving good advice, what (treatment) they can do in their own home, and when they involve doctors and medical assessment," he said.

[Last modified January 24, 2006, 04:32:11]