States, cities and businesses should not expect to be rescued by the federal government if a flu pandemic strikes, warns a draft of the latest national response plan, one already under fire from critics who say federal preparations are moving too slowly.
On Wednesday, the Bush administration will update the $7.1 billion pandemic preparations it proposed last fall, an incremental step that basically outlines exactly which government agency is responsible for some 300 tasks.
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"This would really be a road map," White House spokesman Scott McClellan said Tuesday. "It will cover both the government and nongovernment actions that are being taken to plan and prepare for any potential pandemic."
A draft of the document, obtained Monday by The Associated Press, provides little new information on government preparations — but instead offers an acknowledgment that even the most draconian steps would almost certainly fail to keep a flu pandemic from penetrating U.S. borders.
The messy medical reality is that people can spread flu a full day before they show symptoms, meaning even shutting U.S. borders against outbreaks abroad offers no reassurance that a super-strain isn't already incubating here.
The government is preparing for a worst-case scenario of up to 2 million deaths in the United States.
Once a pandemic begins, expect massive disruptions with as much as 40 percent of the work force off the job for a few weeks at a time, even if the government slowed the spread by limiting international flights, quarantining exposed travelers and otherwise restricting movement around the country, the document says.
"Local communities will have to address the medical and nonmedical impacts of the pandemic with available resources," the draft warns, because federal officials won't be able to offer the kind of aid expected after hurricanes or other one-time, one-location natural disasters.
A flu pandemic instead would roll through the country, causing six to eight weeks of active infection per community.
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. Those businesses must ensure that power stays on and food is shipped even if 40 percent of their workers are absent because they're ill, caring for sick relatives or other pandemic upheaval.
But the report doesn't actually put anyone in charge of checking whether vital businesses are heeding these warnings.
Few are, suggests a survey that found 66 percent of mid- to large-sized companies have made no preparations, said former Health and Human Services Secretary Tommy Thompson, whose new Deloitte Center for Health Solutions conducted the survey.
Businesses and local governments need specific instructions, he said.
"Everybody is asking, 'Well, we want to do something. How do we do it?'" said Thompson, who heard those questions Tuesday while addressing pandemic preparations at a Michigan law-enforcement conference. "We've got to be much more specific."
The incremental plan was drawing complaints Tuesday that despite months of dire talk about the threat of a pandemic, the Bush administration hasn't accomplished enough.
"Other nations have been implementing their plans for years, but we're reading ours for the first time now. These needless delays have put Americans at risk," complained Sen. Edward Kennedy.
Influenza pandemics strike every few decades when a never-before-seen strain arises. It's impossible to predict when the next will occur, although concern is rising that the Asian bird flu, called the H5N1 strain, might lead to one if it starts spreading easily from person to person.