WASHINGTON – Employers should have plans to keep workers at least three feet apart, colleges should consider which dormitories could be used to quarantine the sick, and flight crews should have surgical masks to put on coughing travelers under a draft of the government's pandemic flu plan obtained by The Associated Press.
The Bush administration forecasts massive disruptions if bird flu or some other super-strain of influenza arises in the United States. A response plan scheduled to be released at the White House on Wednesday warns employers that as much as 40 percent of the work force could be off the job and says every segment of society must prepare.
"The collective response of 300 million Americans will significantly influence the shape of the pandemic and its medical, social and economic outcomes," says an undated 228-page draft version of the report that had not been finalized. "Institutions in danger of becoming overwhelmed will rely on the voluntarism and sense of civic and humanitarian duty of ordinary Americans."
An outbreak could lead to a variety of restrictions on movement in and around the country, including limiting the number of international flights and quarantining exposed travelers. But the government does not foresee closing U.S. borders to fight the spread of flu, in part because it would only slow the pandemic's spread by a few weeks and because it would have such significant consequences for the economy and foreign affairs.
It's impossible to predict when the next pandemic will strike, or how great its toll might be. But concern is rising that the Asian bird flu, called the H5N1 strain, might lead to one if it eventually starts spreading easily from person to person.
So far, H5N1 has struck more than 200 people since 2003, killing about half of them. Virtually all the victims caught it from close contact with infected poultry or droppings.
The government is preparing for a worst-case scenario of up to 2 million deaths in the United States.
With no border restrictions, pandemic influenza would arrive in the United States within two months of an outbreak abroad, the document estimates. But models of influenza's spread suggest that sealing the U.S. border would not only be impractical — 1.1 million people cross the nation's 317 official ports of entry daily — but it would only delay the inevitable by a few weeks, it says.
Ship and plane captains already are required to report certain on-board illnesses upon arrival, but crews would be trained to take such steps as putting a surgical mask on a traveler who is coughing.
The new document calls mandatory quarantine a last resort, and urges planners to consider, for example, that closing a community would sever it from the delivery of groceries and other essential goods.
The report aims to energize the private sector, noting that 85 percent of the systems that are vital to society, such as food production, medicine and financial services, are privately run.
Not only would sick workers stay home, but so would anyone who was caring for ill family members, under quarantine because of possible exposure to the flu or taking care of children when schools shut down. The same could go for anyone who simply feels safer at home.
Included in the report's advice:
_Employers should have workers remain at least three feet apart or otherwise limit face-to-face contact to limit the flu's spread, including by working from home or substituting teleconferences for office meetings.
_Colleges should consider whether dormitories could be used to house or quarantine the sick, and establish mandatory sick-leave policies for anyone exposed to the flu.
The report envisions possible breakdowns in public order and says governors might deploy National Guard troops or request federal troops to maintain order. The military also could be activated to enforce travel restrictions and deliver vaccines and medicines, the report says.
Last fall, President Bush announced a $7.1 billion strategy to fight the next flu pandemic, focusing largely on public health preparations, including plans to stockpile enough bird flu vaccine for 20 million people and anti-flu drugs for 81 million. So far, the stockpile contains enough vaccine for 4 million people and medication for 5 million.
This new report is Step 2, outlining how every branch of government would have to work with federal health officials to try to contain a pandemic and minimize its damage to the economy and society. By early next month, government agencies are to release the specific steps they plan.
The report attempts to settle any turf battle within the administration, saying the Health and Human Services Department would lead the government's interagency response effort and the Homeland Security Department would have a secondary role to assist with the health response and non-medical support.