Health Workers Man HHS Flu Command Center

U.S. officials say it is too early to say whether the swine flu threat is receding. When the outbreak was first detected, the U.S. government was prepared. Morning Edition goes behind the scenes to the strategy center at the Department of Health and Human Services that is coordinating the medical response.

Copyright © 2009 NPR. For personal, noncommercial use only. See Terms of Use. For other uses, prior permission required.

STEVE INSKEEP, host:

It's MORNING EDITION from NPR News. Good morning, I'm Steve Inskeep.

RENEE MONTAGNE, host:

And I'm Renee Montagne.

Governments are trying to calibrate their response to the swine flu. For now, at least, the virus seems less deadly than originally feared. Schools are still closing when swine flu appears, but the Centers for Disease Control and Prevention is considering whether that should continue.

INSKEEP: The lessons of a past pandemic suggest that the spread of information may matter as much as the spread of the virus, and in a moment we'll examine the government's failure to tell the truth as the flu killed millions starting in 1918.

MONTAGNE: First we'll look at what the government is doing today. NPR's Joanne Silberner visits the strategy center at the Department of Health and Human Services.

(Soundbite of conversations)

JOANNE SILBERNER: This is the command center for the Department of Health and Human Services in Washington - rows of polished dark brown desks, bright maps projected on every bit of wall space. Everything is going pretty much as planned.

Mr. GERALD PARKER (Department of Health and Human Services): This is, I would say, at a heightened but not stressed situation.

SILBERNER: That's Gerald Parker, who supervises what's called the Secretary's Operations Center. It's designed to coordinate the federal response to any serious public health emergency. About two dozen people, some uniformed, some not, are talking or they're on the phones or checking for latest outbreak reports on their computer screens. Kevin Yeskey is the director of the Office of Preparedness and Emergency Operations at HHS.

Mr. KEVIN YESKEY (Deputy Assistant Secretary; HHS): In a nutshell, essentially we are the eyes and ears for the department's response activity.

SILBERMAN: They are taking in information from the Centers from the Disease Control and Prevention, the Food and Drug Administration, and other agencies, plus state and local governments and the media. The CDC is coordinating the public health research. The people here in this room are doing the basic bureaucratic but necessary work to make sure everyone knows what everyone else is doing across the entire government, not just HHS but other government agencies as well. And it's providing the kind of information, like the availability of tests and drugs, to policy makers who are deciding what to do next. Parker says it takes a lot of work.

Mr. PARKER: Phone calls, meetings, teleconferences, conference calls, video teleconferencing, and then face to face meetings. So we use every form of communication and tools to make sure that we have effective coordination.

SILBERNER: So with the information gathered by the center, HHS was able to issue an emergency public health declaration, giving the FDA the power to make drugs and test kits more widely available. It's calm. Yeskey says that because they've done countless mock drills.

Mr. YESKEY: We've been preparing for this and have been developing the plans and exercising the plans and trying to maintain a high level of alert for this, so when we did detect cases we'd be able to respond appropriately.

SILBERNER: There is one thing, though, that they didn't prepare for. Parker says the drills were based on a new flu starting in some far off location, not the U.S. or Mexico, and the first step was to figure out whether it could be kept from coming in.

Mr. PARKER: Nonetheless we were able to just open our playbooks and deal with the information as it was unfolding.

SILBERNER: Even with the surprise, Parker says things are going very well, better than the federal response to Hurricane Katrina. The center has more people now and it has more time to practice.

Joanne Silberner, NPR News, Washington.

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CDC Chief Urges Caution Amid 'Encouraging Signs'

A man wearing a mask makes his way down an empty street in Mexico City's Chinatown on Sunday. i i

A man wearing a mask makes his way down an empty street in Mexico City's Chinatown on Sunday. Eitan Abramovich/AFP/Getty Images hide caption

itoggle caption Eitan Abramovich/AFP/Getty Images
A man wearing a mask makes his way down an empty street in Mexico City's Chinatown on Sunday.

A man wearing a mask makes his way down an empty street in Mexico City's Chinatown on Sunday.

Eitan Abramovich/AFP/Getty Images

'Flu Shots' Blog

Get the latest updates on the swine flu outbreak.

  

See this Q&A to learn more about preventing the flu.

Swine flu continues to spread widely, but there are signs that the severity of the outbreak is starting to level off, the acting chief of the Centers for Disease Control and Prevention said Monday.

"While we're not out of the woods, we are seeing a lot of encouraging signs," Dr. Richard Besser said at a news conference in Washington, D.C. He cautioned, however, that it's still too early to declare the problem under control.

In Mexico, the country's health secretary cited an ebb in the swine flu outbreak in announcing that most businesses will be allowed to reopen nationwide this week.

Health Secretary Jose Cordova said economic activity will resume Wednesday, ending a five-day closure of nonessential businesses to stop the spread of the new virus. In Mexico City, officials said cafes, museums and libraries will reopen this week but that health officials need to finish inspecting schools before students can return to class.

Mexico still called off Cinco de Mayo celebrations Tuesday, including the biggest one of all — a re-enactment of the May 5, 1862, victory over French troops in the central state of Puebla.

More than 1,200 confirmed swine flu cases have been reported worldwide. In the U.S., the number of cases stood at 388.

Besser also said there were more than 700 probable U.S. cases, or patients who exhibit symptoms but have not been through a full battery of tests to confirm the new H1N1 swine virus. "We expect that all states will likely have confirmed cases," he said.

The CDC was still discussing whether or not a vaccine was necessary, Besser said, adding, "We are doing all of the steps that are necessary should we decide to produce a vaccine."

The agency's flu chief, Dr. Nancy Cox, said the new swine flu virus has not shown any signs of becoming more lethal.

"We haven't seen any changes that would cause alarm," she said. "The viruses are remaining very consistent."

Meanwhile, the heads of the United Nations and the World Health Organization said Monday that there are no imminent plans to raise the WHO pandemic alert to its highest level.

U.N. Secretary-General Ban Ki-moon said in New York that WHO "has no plan to raise the alert level to 6 at this moment." And WHO chief Margaret Chan also told the U.N. General Assembly that "we are not there yet." She added there is "no indication" that the situation is similar to the flu outbreak in 1918.

Phase 6 — the highest alert level — would mean that a global outbreak of swine flu is under way. WHO raised the level to 5 last week.

The virus has spread to Colombia in the first confirmed case in South America — where flu season is about to begin — and more cases have been confirmed in Europe and North America. Besser said that what now ensues in the Southern Hemisphere will be "critically important for us to understand as we think about the decisions around vaccination."

In the U.S., Maryland announced its first confirmed cases of swine flu, joining 36 other states that have reported cases.

Many schools across the country have been temporarily closed because of confirmed or possible cases of the new H1N1 virus.

But on Monday, the first U.S. school to close because of swine flu reopened. Students, many carrying bottles of hand sanitizer, returned to St. Francis Preparatory School, where 45 people had contracted the flu.

Although the new flu is transmitted by humans and not by pigs or pork products, the widespread coverage of the outbreak in the media helped drive U.S. hog prices sharply lower Monday at the Chicago Mercantile Exchange. Meat producer Tyson Foods Inc. reported that domestic pork sales had slipped.

"I saw so much price pressure [on pork] throughout the week on product as this hysteria on H1N1 was evolving," Tyson executive Jim Lochner said Monday during an earnings conference call with Wall Street analysts. "We have seen weaker demand domestically as well over this confusion."

NPR staff and wire services contributed to this report.

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