On the Front Lines of a Bird-Flu Pandemic

Madeleine Brand talks with Eddie Hedrick, an epidemiologist and the emerging infections coordinator for the Missouri Department of Health, about how people on the front lines of a potential avian-flu pandemic should be prepared to respond.

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And how will local governments implement the plan? Eddie Hedrick is here now. He's the state of Missouri's emerging-infections coordinator. Welcome to the program.

Mr. EDDIE HEDRICK (Emerging-Infections Coordinator, Missouri Department of Health): Well, thank you.

BRAND: Now, in the event of an outbreak, you'll be on the front lines. And from what you know of this federal plan, does it give you what you need?

Mr. HEDRICK: This is the second part of a strategy that's been developed on a national level. One of the problems when you develop a plan for dealing with something of this magnitude is you want to make sure that everybody in the country, internationally as well, is consistent in their approach to it.

And what these documents do is give us an approach that we can hand down to states, and then from the states down to local communities so that we're all on the same page.

BRAND: Well, has your state come up with a plan of its own?

Mr. HEDRICK: Oh, yes. We've been working with the federal government since 2004 in developing state plans. These are sort of your ratcheting down in terms of this is coming down to the how-to for everything. Again, we have to have national strategies before we can have local strategies. And what they're doing is honing down on some of these things.

A good example is, how do you distribute the vaccine? Once a vaccine would become available, who would be the priority groups? That has to be consistent across the country, otherwise we'd have chaos, so...

BRAND: And who would it be in Missouri?

Mr. HEDRICK: Well, the priorities would be whatever the federal government hands down to us. And then they have put together a priority list that would start off with people like healthcare workers would be first in line to get the vaccine. And for obvious reasons. Without them, you don't have anybody to take care of persons who are ill. They've got a list that's about, oh, a page and a half long of how that would be prioritized.

BRAND: The president's plan says the states are responsible for quarantining in the event of an outbreak. How will you do that?

Mr. HEDRICK: Well, I think that this word gets bantered about quite a bit. We're talking more of community containment measures, which are voluntary in nature. We'd ask people who are sick to stay home. There wouldn't be enough resources available to enforce that kind of thing.

So a large part of this is how do you educate the public ahead of time so they'd understand what would be necessary on their part. We would have to have structures in place to help them so that they wouldn't put others at risk while they're coming to get those things.

For example, at the supermarkets, you might use a system where people would call in and we would put things together in packages and have them ready for them when they got there so they wouldn't have to be face to face with large numbers of people. There's all kind of innovative approaches to this being evaluated right now.

BRAND: Do you have enough money?

Mr. HEDRICK: Well, never do we have enough money. The federal government has given us in Missouri for the first phase of our planning process $1.89 million. That money is primarily 85 to 90 percent of it going to local communities to help them develop their plans.

One of the things in this national plan that's very clear is that in a pandemic, the federal government and the state government is unlikely to be much help, because we will be affected the same way that local communities will.

So we can help right now in getting prepared for something like this. But in an actual pandemic, everything's local. So what we're trying to do is get that money to those local communities so they can enhance their planning process.

BRAND: Eddie Hedrick is emerging-infections coordinator for the Missouri Department of Health. Thank you for joining us.

Mr. HEDRICK: Oh, you're welcome.

BRAND: And you can learn how to protect yourself and your family from a potential flu pandemic. There's that and much more on the avian flu at our Web site, npr.org.

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