Analyzing the U.S. Flu Plan

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Health and science correspondent Richard Knox talks to host Michele Norris about President Bush's plan to prepare the nation for pandemic flu and compares it to efforts in other nations.


Now joining us for some analysis of the president's plan is NPR's Richard Knox.

Richard, you've been covering pandemic flu for months. Is this the plan that experts have been hoping to hear from the White House?

RICHARD KNOX reporting:

Well, I think it's fair to say it's a start on that plan that they've been hoping to hear. And as recently as a month ago when some drafts began to leak out, people in the health-care field were not very happy. So I think people are beginning to think that there's been a lot of progress made. But it's not the plan. Tomorrow we'll have a 300-plus-page plan for public health response that's supposed to come out from Health and Human Services. But people I talked to today said the president's speech is a good first start for a country that's been kind of slow off the mark compared to places like, say, Great Britain.

NORRIS: So the president didn't get deep into the details, but he did outline three key elements. The first was detecting an outbreak quickly, before it spreads from one country to another. Do experts think that's realistic?

KNOX: Well, it's not only realistic to do, but it's crucial because we won't have a prayer of coping with a pandemic unless we identify it early. The great hope is it can be identified and stamped out at the source, but the next best thing would be to slow it down a bit in order to make time for developing more drugs, more vaccines. And that should be doable. It doesn't involve new technology; it does involve a lot of training at the front lines. And front lines means places like rural Vietnam, Cambodia, Laos, Indonesia. Doctors and health workers at these front lines have to be thinking pandemic flu whenever they see a cluster of people with severe respiratory symptoms. And it's really just a question of how fast this grassroots surveillance can be geared up, but people think it can be done.

NORRIS: Well, it seems like that sets the stage for a certain amount of confusion. The president called for a surveillance system inside the US. So how do people tell the difference between ordinary seasonal flu and a dangerous pandemic strain, especially now that the flu season is upon us?

KNOX: Yeah, you're right, that's going to be very confusing, and I think we can probably expect false alarms. Now within the United States, since there is not any H5N1, which is the viral strain that people are very worried might become the pandemic strain, flu is probably ordinary flu. It's going to be much more confusing and problematic in those parts of the world where there already is known H5N1 and there have been human cases. Nobody wants to pull the trigger on a big pandemic response, you know, if it's not true. That could be disastrous economically. And if it happens more than once, then the credibility of public health officials is going to be in tatters. People are just going to have to understand, if they can, it's going to take some time to sort it out when it happens.

NORRIS: We heard the president today talk about stockpiling antiviral drugs. Is that feasible?

KNOX: Well, it's not clear where the Bush administration is going to find Tamiflu at any price right now. Roche is the company that makes it--is said to be ramping up production. We don't know how much and by when. So there's a lot of confusion, a lot of uncertainty about just how much of the drug can be stockpiled and, secondly, how much we really need. I think we can look for more detail from the government on how they think they're going to do it.

NORRIS: You mentioned the government, Richard. Is the public health-care system in the States prepared to deal with this?

KNOX: That's an easy answer: No. There's just a whole lot of situations--everybody's been waiting for the federal plan. But, you know, there's not enough capacity in the hospitals, the communications systems and the lines of--chains of command to who's going to do what when--a lot of stuff really needs to be worked out.

NORRIS: NPR's Richard Knox speaking to us about President Bush's plan for dealing with a possible flu pandemic in the United States. Richard, thank you so much.

KNOX: You're welcome.

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