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States must lead if pandemic hits country, U.S. official says


The nation's top health official said yesterday that Maryland and other states preparing for an avian flu pandemic can take a lesson from Hurricane Katrina: It won't be anything like that.

In contrast to Katrina, an hours-long storm that devastated communities in two states, pandemic flu could sweep the nation and linger for a year - making it "logistically impossible" for the federal government to take the lead in public health efforts.

Instead, Michael O. Leavitt, secretary of the Department of Health and Human Services, told hundreds of health professionals and planners attending a Maryland "pandemic flu summit" that states must be self-sufficient in flu preparedness.

"Any community that fails to prepare with the expectation that the federal government will come to the rescue is tragically wrong," Leavitt said during a conference at the Maritime Institute of Technology and Graduate Studies in Linthicum.

He also called on families to consider how they will provide for themselves. "It's important for people to have some water, a storage of food," he said.

Families also should consider storing enough prescription drugs to last more than a week, while parents think about who would care for their children if schools were closed and they must report to work.

Leavitt announced a federal outlay of $1.8 million to help the Maryland Department of Health and Mental Hygiene prepare for pandemic flu. The money is part of a $300 million appropriation to be distributed to states over the coming year. The state can expect another installment later this year, Leavitt said.

Maryland is awaiting guidance from the federal Centers for Disease Control and Prevention on how to spend the money, said Dr. Diane L. Matuszak, director of the state's Community Health Administration. But she said the state needs to prepare myriad details, including the criteria for closing schools and plans for keeping utilities and other essential services running when many workers are out sick.

Leavitt said states also should not count on other states to help them cope.

"If the state of Maryland was asked to go to another state to help, it is unlikely you could go," he said. "You'll be dealing with the same thing."

Gov. Robert L. Ehrlich Jr. said the state understands that it must provide for most of its needs. "We understand our job is the dominant job," he said. "Any other expectation is false."

Public health authorities worry that an avian flu strain that has sickened and killed millions of domestic and migratory fowl in Asia and Europe could trigger a human pandemic like the one that killed upward of 40 million people worldwide in 1918 and 1919.

Since 2003, the so-called H5N1 strain has killed at least 91 people, almost all of whom contracted the virus from birds. But scientists warn that a simple genetic change could enable the virus to pass from person to person - the ingredient necessary for a human pandemic.

Many health experts have warned that hospitals don't have enough beds, respirators and other essential equipment to handle the possible surge of patients needing care.

Dr. Michelle Gourdine, Maryland's deputy health secretary for public health services, said the state's hospitals have the capacity for 10,000 patients. But officials have worked with long-term care facilities, including nursing homes, to accept 2,000 to 7,000 patients.

"No one can predict with certainty the amount of surge capacity we need," Gourdine said. "It's not going to be perfect. No one has a crystal ball."

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