Hospital leaders charged by the federal government with readying for a possible flu pandemic or other disaster warned Tuesday that they lack the money needed to properly prepare while maintaining day-to-day operations.

Bush administration officials have repeatedly stressed that governments, businesses, schools, and hospitals must all have individual plans to deal with a pandemic like the one threatened by bird flu. A national pandemic readiness plan due out this week from the White House is expected to reinforce the strategy.

“There is no way that [Washington] can respond to every home town in America at the same time” if a pandemic occurs, Health and Human Services Secretary Michael O. Leavitt told reporters Tuesday at a disaster preparedness summit sponsored by the magazine U.S. News & World Report.

But directors leading the large hospitals expected to act on the front lines of such a response say that they’ve been left largely without the financial resources needed to beef up readiness.

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Limited Resources

Concerns run the gamut of hospital operations, including increasing numbers of clinic beds, securing additional medical machines, and ensuring that personnel will show up for work during a disaster.

“The problem is, we are just good enough for what happens now,” says W. Frank Peacock IV, chairman of emergency preparedness at The Cleveland Clinic.

Peacock says his hospital would have to double its number of staffed hospital beds to be ready to treat the potentially tens of thousands of sick Clevelanders if a pandemic hit. Operating margins are too thin to allow for such a sustained increase, he warned.

“To ask any industry to double its infrastructure with no funding is really a hard row,” Peacock tells WebMD.

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Local Planning Key

The Bush administration asked Congress for $7.1 billion in funding for a national pandemic plan. But the vast majority of the money goes toward programs to speed vaccine and medicine development and to boost the capacity of the U.S. vaccine industry.

Only a fraction is targeted toward cities and states to fund preparedness. Leavitt says that the thin funding will help force communities to formulate their own plans without relying on Washington.

“The foundation of pandemic preparedness is local planning. It has to be,” says Leavitt.

But other hospital leaders say they’ve funded preparedness efforts at the expense of other functions. Edward Miller, MD, chief executive officer of the Johns Hopkins University School of Medicine, says the hospital has spent $11 million on disaster readiness, only $1 million of which came from outside of the university.

“It comes out of other programs that we’re not funding,” he tells WebMD.

Miller warns that most hospitals cannot afford extra respiratory ventilators and other medical equipment that would become essential to treat a surge in people with a respiratory illness like the flu.

“It’s nice for the secretary to say we should stockpile ventilators, but most of us don’t have the money to buy 2, 3, or 100 ventilators,” he says. “This is not a sustainable business plan.”

Vicki Running, the director of disaster planning at Stanford University Medical Center in Palo Alto, Calif., says the institution is focusing on ensuring that health workers and hospital personnel actually show up for work if a pandemic hits.

Less than half of health workers surveyed said they would report for duty during a pandemic, according to a report published Tuesday in the online journal BMC Public Health.

“Staffing becomes the No. 1 concern,” she explains.

Congress has agreed to half of the $7.1 billion requested by the White House. The administration is expected to request the second half in the coming weeks.

“I expect that Congress will respond when it’s presented,” Leavitt says.

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By Todd Zwillich, reviewed by Louise Chang, MD

SOURCES: Michael O. Leavitt, secretary, Health and Human Services. W. Frank Peacock IV, chairman of emergency preparedness, The Cleveland Clinic. Edward Miller, MD, chief executive officer, Johns Hopkins University School of Medicine. Vicki Running, director, disaster planning, Stanford University Medical Center, Palo Alto, Calif. BMC Public Health, 2006; vol 6: p 99.