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Southern Calif. hospitals may not be ready for bird flu

By Troy Anderson Staff Writer
Pasadena Star-News (California)
Copyright 2006 MediaNews Group, Inc. and Los Angeles Newspaper Group, Inc.

As health officials announced Friday the first evidence of Avian influenza spreading person to person, Southland experts said they are growing increasingly alarmed that cities and hospitals are drastically unprepared for a possible pandemic.

Hospital officials, in particular, are concerned that federal preparation is not adequate as birds carrying the virus come closer to the United States, said James Lott, executive vice-president of the Hospital Association of Southern California.

“We have an opportunity here in California to have hundreds of thousands of people infected by the bird flu when it does arrive and insufficient funding and planning has been done to prepare California to deal with this level of a catastrophe,” Lott said.

“The fact the governor is stepping up to the plate with a proposal to add $400 million to the budget to prepare California is testament to the fact that the federal government’s response has been inadequate.”

Gov. Arnold Schwarzenegger unveiled the plan Friday, proposing the extra funds to help the state’s health system prepare for disasters by purchasing mobile field hospitals, antiviral drugs, ventilators, protective equipment and other supplies.

Lott said the funds will help, but the federal government needs to provide far more.

In January, U.S. Health and Human Services Secretary Mike Leavitt came to Los Angeles and said the federal government would provide $100 million for pandemic flu preparations, including $6.7 million for California and an additional $2.9 million for the county.

But Lott said Friday, “We’ve seen very little of that funding. We’ve seen very little come to the front lines.”

Carol Meyer, director of the county’s Emergency Medical Services Agency, said none of that money is going to private hospitals.

“Where do think the patients are going to go?” Meyer asked. “There was also nothing for emergency medical services. Who do think is going to be responding?

“We think there needs to be some emphasis on hospitals because they are going to be overwhelmed.”

Adm. John Agwunobi, assistant secretary of health for HHS, said another $250 million will be provided to the states in the next few months.

Earlier this week, Leavitt announced Congress had approved the president’s 2006-07 emergency funding request of $2.3 billion to prepare for a pandemic. An undetermined amount of those funds will go to states and counties.

Agwunobi said that’s on top of more than $6 billion in bioterrorism funds the federal government has provided to states and counties since 2001 to increase hospital surge capacity and enhance public health.

“The funding is ongoing for health infrastructure and hospital surge capacity,” Agwunobi said. “I want to stress, however, that pandemic influenza preparedness is not only the responsibility of the federal government.

“As we travel the nation, we’re urging local and state governments and the federal government to come together in partnership in investing, planning and preparing for a pandemic.”

Currently, Lott said hospitals in the state have 35,000 ventilators, but estimate they would need 350,000 to effectively deal with a pandemic.

“We could have more people hospitalized than we’ve ever had before,” Lott said. “Each of the mobile hospitals have 400 beds apiece. So we’ll have surge capacity.

“But we’ve got hundreds of thousands of people in nursing homes who are going to be highly at risk, children and other people with compromised immune systems. So we’re looking at huge numbers of patients we’ll have to have ventilators for.”

County Public Health Officer Dr. Jonathan E. Fielding said that in the event of a pandemic, staffing would be the biggest challenge.

“We already have a nursing shortage,” Fielding said. “So if a substantial portion of the workforce was ill or had to take care of loved ones who were ill, I think we’re going to have significant stress in terms of being able to staff the existing hospitals, let along surge capacity. It’s not like we’ll be able to draw substantial numbers of people from outside the area.

So far the virus has killed tens of thousands of birds and 130 people in Asia, Eastern Europe and Africa. But experts are concerned that it could mutate into a form easily transmissible among people.

On Friday, World Health Organization officials said they had the first evidence that the bird flu virus had mutated and spread from person to person within a family in Indonesia.

Health experts said the spread was limited to the family and the genetic change does not increase the threat of a worldwide pandemic.

“There has been no evidence of significant person to person spread, but the more this spreads around the world it makes us incredibly concerned about the possibility of a mutation,” Fielding said.

Meanwhile, although Canadian officials reported last week that a goshing had tested positive for the H5N1 virus, officials said Tuesday the bird did not die of the highly pathogenic strain of bird flu found throughout Asia, Europe and Africa.

In Alaska, U.S. Fish and Wildlife spokesman Bruce Woods said officials are continuing to test birds for the virus coming over the Asian-Australian flyway.

“I think that probably the closest it is now is in Russia, Vietnam or Cambodia,” Woods said.