Copyright 2006 The Morning Call, Inc.
By ANN WLAZELEK
Morning Call (Allentown, Pennsylvania)
A local hospital is considering buying a modular MASH-like unit capable of isolating and treating as many as 100 infected patients.
A Lehigh Valley-based world supplier of medical oxygen is exploring ways to continue production even if a pandemic flu sickens 80 percent of its work force.
And area public health officials have produced a DVD to help individuals and groups prepare for widespread illness.
Regardless of the likelihood that a virus killing birds and some people in Asia will cross the ocean and mutate into the next North American plague, local businesses, health care organizations and public officials are preparing for the worst.
Air Products and Chemicals, Lehigh Valley Hospital and the Allentown and Bethlehem health bureaus are among those taking cues from 9/11, SARS and Hurricane Katrina. They are deciding not to wait for the federal government to swoop in for the rescue, because needs will be immediate and could exceed the feds’ capacity.
And those groups are not alone in the region in getting prepared. Sanofi Pasteur, a worldwide vaccinemaker, is making an avian flu vaccine in Swiftwater for national stockpiles. Muhlenberg College is readying its Allentown campus for transformation into a communications command center capable of answering hundreds of hotline calls. And state and regional leaders are testing their plans with drills — the next one for emergency and medical personnel is Tuesday in Bethlehem.
“Everyone is taking a look at their emergency operation plans,” said Vicky Kistler, an Allentown Bureau of Health manager and regional health and medical task force coordinator. “Hopefully we are learning from Katrina that we can never be prepared enough.”
No one can predict if the H5N1 strain of virus that kills birds and has killed more than 125 people in 10 countries will affect Americans, said Bill Koch, the “homeland security chief” at Air Products and Chemicals in Trexlertown. However, the world is overdue for some type of widespread killer flu, he said.
The 20th century had three, including the Spanish flu of 1918 that killed 20 million to 40 million people. The Asian flu of 1957 and Hong Kong flu of 1968 each killed another 1 million to 4 million people.
“There will be another pandemic,” Koch said, echoing the warnings of medical scientists around the globe. “It’s just a matter of when.”
For hospitals here and across the country, the buzz word in preparing for a pandemic is “surge,” how to expand the number of beds available quickly and for weeks or months at a time without disrupting other patients.
LVH’s chief of infectious diseases, Dr. Luther Rhodes, said hospital officials are looking at tractor-trailer-sized modular units that can be driven onto the property off Cedar Crest Boulevard to isolate and treat contagious patients. Such units are sometimes referred to as MASH, or Mobile Army Surgical Hospital, units. Similar units were employed in the rescue and evacuation of residents from Louisiana during Hurricane Katrina, Rhodes said.
While Rhodes has testified before Congress in favor of the National Guard providing such modules in partnership with the hospitals, he said no deal has been struck, so LVH is proceeding on its own “because we have to.”
St. Luke’s Hospital and Health Network plans to convert a patient wing into an isolation unit for contagious patients instead of buying MASH trucks or tents, according to Alan Lynch, director of network safety and security.
Officials for the Fountain Hill-based network also ordered supplies difficult to obtain at high volumes in an emergency, such as surgical masks, respirators and gowns. Equipment alone could cost $250,000, he said.
St. Luke’s is evaluating ways to immunize staff in rapid fashion for the coming influenza season in the fall and to arrange for food, shelter and peace of mind for employees who might have to stay at the hospital during a pandemic.
Plans are being made for families and pets, said Dr. Jeffrey Jahre, chief of medicine and infectious diseases at St. Luke’s. “If an employee’s mind is at home, he or she won’t be able to stay here.”
Jahre said St. Luke’s is following national guidelines and not stockpiling Tamiflu, an anti-viral medicine that might or might not work against a pandemic flu.
“We always have enough on hand for patients and staff who would become infected, but are not collecting itfor weeks at a time,” he explained. “If all hospitals did that, there wouldn’t be any Tamiflu.”
Sacred Heart Hospital in Allentown hopes tents purchased in 2003 with state grant money will suffice for temporary decontamination or isolation of the sick. The staff conducts a drill each year.
Air Products is in the forefront of pandemic planning because it is a global company employing workers in three of the countries where bird flu has infected chickens and people. Senior managers decided in November to develop a plan that addresses employee health needs, assuming some would get sick and others would need protection.
The plan supplements a longstanding corporate strategy that addresses the loss of an office or building to disaster, as was the case with Hurricane Katrina in New Orleans.
They also didn’t want to wait until employees got sick, as with SARS, another deadly upper respiratory illness prevalent in Asia and Canada three years ago.
The plan calls upon employees to report the first signs of a virus, such as a fever and body aches, even before a diagnosis. Every department obtains enough masks, hand sanitizers and medicines for each worker. Employees are encouraged to get annual seasonal flu shots to prevent confusion with the avian flu, which can occur at any time. Plant and department heads determine which employees can do their jobs at home using laptop computers or at remote sites, should that become necessary. A health response officer at each site will assess the level of risk and follow recommendations.
The company’s pandemic planning operates on the assumption that a plague would come in three waves, each six to eight weeks in duration. Maintaining operations with a 20 percent absentee rate is fairly routine during peak vacation periods, said Koch, whose formal title is global director of process integrity.
A 50 percent or 80 percent absenteeism rate “makes ‘em think,” Koch said. Thirty-six Air Products’ plants make oxygen, nitrogen and other gases vital in this country and others. Koch said top managers are grappling with the question: “We can lose one but how many more?”
“And the demand for things like medical oxygen will probably increase” in a pandemic, he said. The challenge is for plants in China, Thailand and Indonesia to finish their plans by the end of September and for the rest of Air Products to finish by the end of 2006.
Smaller businesses need to prepare too and are invited to an information meeting the week of June 20 at Lehigh Carbon Community College. Scott Lindenmuth, Allentown’s emergency management coordinator, said most employers need to be educated about how the flu might spread and identify tasks that need to resume.
“We probably wouldn’t cut grass or pave streets,” he said of the city’s need to plan for continuity. “But if those employees are healthy, they might be able to help with security or transportation.”
Pennsylvania has been preparing for pandemic flu since 1999, according to state health officials. Last year the governor asked officials to keep tabs not only on humans contracting flu-like illnesses but also poultry, because experts say birds will likely get sick first. No birds in the United States have so far been identified with the H5N1 strain. The Department of Agriculture conducts more than 240,000 tests a year on chickens and other birds — more than any other state, according to Michael Huff, the Department of Health’s “pandemic guy,” or director of community health systems.
Huff said Pennsylvania’s pandemic flu plan is divided into seven work categories: disease detection, isolation and quarantine, vaccine distribution, command and control, work force, communication and local government.
To help local individuals, school groups and others learn what they can do to protect themselves and what they might be asked to do in a flu pandemic, the Allentown and Bethlehem health bureaus collaborated on a DVD that will be free, no longer than 15 minutes and feature local emergency responders.
It tells people how to get informed with the latest flu news, get ready to stay in their homes with enough food, water, batteries for a week or more, get ready to leave their homes and to get involved in personal and community updates on preparedness.
Kistler, of the Allentown health bureau, said the DVD is expected to be presented to the public Sept. 12 and followed with six months of community education.
FLU TERMS
What is bird flu? A virus that naturally infects wild birds. The H5N1 variant is deadly to chickens and other fowl and can be transmitted from birds to humans. No birds in the United States have so far been identified with H5N1 strain.
What is pandemic flu? A deadly human flu that often starts with birds and causes a global outbreak, or pandemic, of serious illness. The disease can spread easily from person to person because of little natural immunity. There currently is no pandemic flu.
Source: U.S. Centers for Disease Control and Prevention
PANDEMIC PLANNING
June 16: Government summit on pandemic flu preparation in Pennsylvania, at the Scranton Hilton Convention Center in Scranton. Open to the public. Federal, state and local leaders will present information on pandemic flu and the status of the state plan.
June 20-25: “Get Ready 2006" comprehensive regional health and safety symposium, at Lehigh Carbon Community College, Schnecksville. Seminars and forums for health care workers, first responders, police, teachers, and the public. A workshop on June 24 will focus on helping families prepare for emergencies.