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Workshop on Preparing for Calamities Focuses on the Flu

By ANEMONA HARTOCOLLIS
Published: June 18, 2008
http://www.nytimes.com/2008/06/18/

Be afraid, be very afraid. There is no telling what the next disaster will be. Another terrorist attack? A steam pipe explosion like the one that shut down several blocks of Lexington Avenue a year ago? Or perhaps a pandemic flu that would cripple New York City’s economy by making people afraid to go to work or ride on subways and buses?

That was the message at a daylong workshop conducted on Tuesday by the city’s health and emergency management agencies, intended to give businesses tips on how to cope with the potential calamities.

The workshop had all the portentous, overwrought atmosphere of movies about how the world is coming to an end and everyone had better be ready, from “War of the Worlds” to the latest M. Night Shyamalan film. Only in this faux disaster, the participants — some of whom have spent years immersing themselves in the subject — were treating it with deadly earnestness.

The possibility of an influenza pandemic was the disaster du jour. Dr. Isaac B. Weisfuse, the city’s deputy health commissioner for disease control, told an audience of about 300 business people that since history repeats itself, he considers it likely that there will be a worldwide outbreak of flu, possibly a mutation of the current avian flu, sometime in the 21st century, just as there were killer disease epidemics in virtually every other century.

“Everybody in the whole state — local governments, businesses large and small, families — should be preparing,” Dr. Weisfuse told the gathering at New York University.

Just as Americans built bomb shelters and stocked them with crackers during the Cold War, the city has been stockpiling supplies to combat pandemic flu, Dr. Weisfuse assured his audience. He announced that 25 million surgical face masks — known as P.P.E.’s, short for “personal protective equipment” — are secreted in a New York City warehouse.

“I’m very proud of this collection,” Dr. Weisfuse said, showing a slide of the rows upon rows of boxed-up masks, like the treasure in an Indiana Jones movie. “We have more face masks than you could ever imagine.”

But, still not enough. The stockpile is equal to three for each of the city’s eight million residents, and epidemiologists recommend changing those face masks twice a day. “Look at all these lovely boxes,” Dr. Weisfuse said. “They’re going to be empty after about a day and a half of pandemic.”

(One audience member, who said he managed a 42-story residential high-rise, wondered how many microns of particle size the mask should be able to guard against. Dr. Weisfuse replied, in essence, that it does not mater, because the masks are so loose that some germs are bound to escape from the sides.)

In an indication of how hot the topic is, a competing workshop on preparing employers for pandemic flu has been scheduled for Thursday at the Javits Convention Center, sponsored by, among others, Roche, the maker of Tamiflu, an antiviral treatment used to treat and prevent seasonal flu.

At Tuesday’s session, city officials said they were thinking far beyond the common flu. The city has access to enough antiviral medications to give more than two million people a five-day course of treatment, a supply based on the expectation that a pandemic flu would attack about 25 percent of the population, Dr. Weisfuse said. It is up to individual businesses to decide whether to stockpile their own antiviral medications, and they run the risk of having to replace them at the end of their current five-year shelf life. There are also legal and ethical implications in determining who should get the medication if there is not enough, he said. (The government has posted some guidelines for distributing medication, with national security workers, health care workers, emergency services workers, drug manufacturers, elected officials and infrastructure workers ranking high on the list.)

The federal government has 20 million to 30 million prepared doses of vaccine, he said, which would probably be reserved for health care workers and the military.

But Dr. Weisfuse noted that this stockpile was based on the existing strain of avian flu, H5N1, which is not easily transmitted from person to person, and said the real threat would come from a mutation in the existing strain.

“We don’t know if the prepared vaccination is going to be very useful,” he said, noting that flu germs have been adept at developing drug resistance. “It may be that we’re kind of all up the creek, because we have no treatment regimens that would be effective.” Controlling a pandemic and keeping a city running at the same time is a delicate balancing act: how to keep mass transit running so people can get to work, while advising people to stay out of crowds, where flu can spread by coughing?

“We know people are more likely to walk,” Dr. Weisfuse said, “which, quite frankly, wouldn’t be a bad thing, for obesity, exercise.”

The city’s quintessential urbanness could be its silver lining.

“One of the beauties of living in New York City is that we have no big poultry production farms,” like, say, Pennsylvania, Dr. Weisfuse said, with a hint of glee.

But the city does have live poultry markets, and city officials are making plans to cull diseased birds from those markets. In any case, Dr. Weisfuse dismissed that problem as “small potatoes.”

So, someone in the audience asked, what are the chances?

“Let’s look at history,” Dr. Weisfuse replied, and then he ticked it off: pandemics in 1968, 1957 and 1918 (the worst, in which an estimated 30 million to 50 million people died).

“By that criterion,” he said, “we’re kind of due.”

 

 

 

 
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