Pandemic Flu Plan Suggests a Limited Federal Role

A draft flu-pandemic response plan from the federal government says a worst-case scenario could kill as many as 2 million people in the United States. The draft Bush administration plan is an update to the $7.1 billion in pandemic preparations that it proposed last fall. The plan outlines exactly which government agency is responsible for about 300 tasks.

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JOHN YDSTIE, host:

This is MORNING EDITION from NPR News. Steve Inskeep is on assignment in Baghdad. I'm John Ydstie.

RENEE MONTAGNE, host:

And I'm Renee Montagne. The White House, today, is to release the second installment of its plan to deal with a flu pandemic. Last November, the administration put out a broad set of planning principles. Officials say the new document is a more detailed blueprint of how to keep the country running. Federal planners warn that a pandemic could put up to 40 percent of the population out of commission.

NPR's Richard Knox reports.

RICHARD KNOX reporting:

Bits and pieces of the plan have leaked out as it was being drafted. On the one hand, it sounds incredibly detailed. Companies should make sure workers are spaced at least three feet apart. Airplane crews should put masks on passengers who are coughing. Colleges should designate specific dormitories for students who are sick.

There are 300 such items on the government's new checklist. But White House officials say the government is not going to micromanage a flu pandemic. On the contrary, says Dr. Rajeev Venkayya.

Dr. RAJEEV VENKAYYA (Special Assistant for Bio-defense to President): The federal government can't do this alone. We rely upon preparedness at all levels of government, as well as preparedness at the smallest segments of society, whether those be at the community level or in the private sector, in factories and schools and even in the household.

KNOX: Venkayya is an aide to the president for bio-security. He says a central message of the new plan is that every American business should have its own detailed pandemic plan.

Dr. VENKAYYA: A plan that ensures that that business will be able to maintain continuity of its operations during times when you have a fair amount of absenteeism because people are either sick or they're at home taking care of someone else who's sick, or because they are just afraid to come to work.

KNOX: Venkayya says businesses are waking up to the need to plan ahead.

Dr. VENKAYYA: But the reality is that most businesses have yet to really look at the full spectrum of the things that they ought to put in place and plan for.

KNOX: He says, in the next few months, all federal government agencies will have final approved pandemic plans to protect their own workers and safeguard essential functions. But states and local governments should not expect the feds to call all the shots.

Dr. VENKAYYA: There are many things here that the federal government, you know, can't or would be very reluctant to mandate from above.

KNOX: For instance, there's a highly sensitive matter of who should get available anti-flu drugs and bird flu vaccine; there's certain to be a shortage, even after the government meets its stockpile targets of 80 million courses of antiviral drugs and 20 million doses of vaccine. Venkayya picks his way carefully around this issue.

Dr. VENKAYYA: The plan lays out a framework for how we think about prioritizing and allocating both vaccines and antiviral medications like Tamiflu, or Relenza. We don't lay out a list. We aren't very explicit in certain areas such as that, but what we do to communicate to states and locals, who are asking that exact same question, is how we do approach the prioritization issue, who do we think ought to be considered for prioritization.

KNOX: Dr. Michael Osterholm, of the University of Minnesota, finds that answer unsatisfying.

Dr. MICHAEL OSTERHOLM (Director, Center for Infectious Disease Research and Policy; Professor, School of Public Health, University of Minnesota): None of us want the federal government to come into our individual healthcare facilities, our hospitals, our communities clinics, wherever, and tell us how to use Tamiflu. But we're going to have to be certain that the federal government is assisting in trying to be fair to the whole country. That's going to take some federal leadership, not just recommendations or guidelines.

KNOX: Once the plan comes out, there's also sure to be more debate about what federal agency will have clear authority to lead the government's response. Congressman Rahm Emanuel, an Illinois Democrat, says there's a lot of confusion on that score right now.

Representative RAHM EMANUEL, (Democrat, Illinois): It is not a recipe for success, no matter how good the plan is. And I'm sure the plan will be good. They studied it long enough, I'm sure the plan will be good. But who's in charge? I think post-Katrina, I have real concerns about who's running the show over there.

KNOX: In hearings on Capitol Hill, the administration has already given one answer to that question: the president is.

Richard Knox, NPR News.

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