Bush may use troops, quarantine if bird flu breaks out
President Bush said yesterday that he is considering the use of military troops to impose a quarantine in the event of a deadly flu pandemic...
WASHINGTON — President Bush said yesterday that he is considering the use of military troops to impose a quarantine in the event of a deadly flu pandemic.
Bush, in response to a question at a news conference, echoed warnings from health experts who fear a replay of the 1918 pandemic that killed an estimated 50 million people worldwide. He outlined a series of steps to deal with an illness that could overwhelm the health-care system.
The World Health Organization says an influenza pandemic is "just a matter of time." Some health officials particularly are concerned about avian flu because it seems to be extremely lethal when it jumps from birds to humans. Of 116 known cases in humans since 2003, more than half — 60 — ended in death. There are no confirmed cases of human-to-human transmission of the flu, also known as bird flu, but that could change because such viruses constantly mutate.
Bush left no doubt that he takes the threat seriously.
"I am concerned about avian flu. ... I've thought through all the scenarios of what an avian-flu outbreak could mean," Bush said. "I'm not predicting an outbreak. I'm just suggesting to you that we'd better be thinking about it."
The president gave no details on the specific role troops might play or what sort of quarantine might be invoked. The federal government's pandemic-response plan, the product of more than a year of work, is expected to be released soon.
Most public-health experts believe it is impossible to entirely isolate neighborhoods, towns, cities or regions during an outbreak of disease. Instead, "quarantines" today generally refer to a variety of strategies for identifying and limiting the movement of people who are infected with a contagious pathogen or are at high risk.
That might include screening travelers for fever and flu symptoms; prohibiting large gatherings of people, including at some workplaces; and requiring that people exposed to infected individuals stay at home until the incubation period for the illness has passed. China took these measures during the outbreak of severe acute respiratory syndrome in 2003.
"The policy questions for a president in dealing with an avian-flu outbreak are difficult," Bush said. "One example: If we had an outbreak somewhere in the United States, do we not then quarantine that part of the country? And how do you, then, enforce a quarantine? ... And who best to be able to effect a quarantine?"
He did not answer his questions but after the last one, he said: "One option is the use of a military that's able to plan and move. So that's why I put it on the table. I think it's an important debate for Congress to have."
Since the bungled initial federal response to Hurricane Katrina, Bush has suggested a change in law that would put the Pentagon in charge of search-and-rescue efforts in times of a major terrorist attack or similarly catastrophic natural disaster.
The president acknowledged that some governors object to the idea of federal control of National Guard units in emergencies. He added that as a former governor, "I understand that. ... But Congress needs to take a look at circumstances that may need to vest the capacity of the president to move beyond that debate. And one such catastrophe or one such challenge could be an avian-flu outbreak."
White House officials said Bush's fears were heightened last summer when he read "The Great Influenza," a nightmarish account of the 1918 pandemic by writer John Barry. In that outbreak, an avian-flu virus passed to humans and left a trail of death around the globe. Most victims developed an extremely virulent form of pneumonia.
Unlike a typical flu outbreak, the illness struck hardest against people in the prime of life. Jam-packed hospitals turned away patients and left many of those who were admitted without treatment. Morgues ran out of caskets. Schools, government buildings and churches closed in a desperate and futile attempt to stop the spread of the disease.
If it happens again, experts say, the death toll and economic devastation could far surpass the damage from Katrina. And some fear that the government's response could be equally inadequate.
"The entire world has a long way to go to achieve even the most fundamental levels of preparedness," said Michael Osterholm, director of the Center for Infectious Disease Research and Policy.
Bush said he is encouraging work on a new vaccine against avian flu. If the virus were to start spreading in the next year, the world would have only a relative handful of doses of an experimental vaccine. If the vaccine proved effective and every flu-vaccine factory in the world started making it, the first doses would not be ready for four months.
Bush said he used his visit to the United Nations last month to "talk to as many leaders as I could find" about the need to report outbreaks quickly.
"Obviously, the best way to deal with a pandemic is to isolate it and keep it isolated in the region in which it begins. ... We're watching it very carefully," Bush said.
He did not mention the cost of preparing for an outbreak, but health officials and members of Congress say it could cost billions of dollars to stockpile necessary vaccines, anti-viral drugs and other supplies. The Senate last week passed an amendment that added $3.9 billion to a defense spending bill for anti-viral drugs and other flu-related expenses.
"That is like trying to fill Lake Superior with a garden hose. That's just a start," Osterholm said.
Barry, who spent seven years on his book on the 1918 outbreak, said no one can know how bad the next pandemic will be until a new virus emerges. It could be a replay of 1918, or it could more closely resemble the 1968 Hong Kong flu, which caused 750,000 deaths.
"We don't know whether it's going to be a 1968 virus or a 1918 virus," Barry said. "That's frightening, without a doubt. We need to take it very, very, very, very seriously."
Details on Bush's proposal to change law were provided by The Associated Press.
When vice president of Sub Pop Records Megan Jasper isn't running things at the office, she's working in her garden at her West Seattle home where she and her husband Brian spend time relaxing.