Sat, Feb 03, 2007 - Page 9 News List

A scenario of a US avian flu outbreak raises some dire questions


This is not a real article. This is an exercise.

Patient Zero in the 2007 avian flu pandemic died at 9:25 on Wednesday morning.

It caused little fuss in the war room of the US Centers for Disease Control and Prevention (CDC) when it was announced.

In part, the death was expected -- there had been hints of what was coming in this first avian flu drill to involve the whole agency. Patient Zero was a fictional 22-year-old Georgetown University student who had just returned from visiting his family in Indonesia. The object of the drill was to determine how the CDC would respond in a real epidemic.

So for the agency, the patient's death was beside the point; what was important was the diagnosis of avian flu. The question for Julie Gerberding, the agency's director, and her staff was whether it marked the beginning of a full-blown pandemic.

How many of the student's 10 roommates had he infected? How about the 40 others on the Georgetown swim team? One of them appeared to be dying in New York after a swim meet at Columbia University. And the woman in Chicago who had died after being on his plane from Jakarta -- were they all linked?

This was the CDC's first "full functional [internal]" avian flu exercise, meaning that virtually everyone at its headquarters here was involved in some way, including about 100 people packing the operations center, where banks of computers and phones faced a wall full of television screens.

A major threat

There has never been a case of avian flu reported in the US, and it has not mutated into a pandemic strain. But it killed more people last year in Asia than it did in 2005 and in 2004, and public health experts consider it a major threat.

Four reporters, from the New York Times, the Washington Post, The Associated Press and The Canadian Press, were allowed in to watch the exercise (and even to comment on how well CDC public affairs officers played reporters during a mock news conference).

"This is new for us," Gerberding said. "A lot of people feel it's really high-risk to let the press look inside the sausage factory while the sausage is being made."

Instead, she said, she decided to stand the scrutiny even if mistakes were seen, partly to prod states and localities to conduct similar drills, and partly because news coverage of such a crisis "can make or break your credibility, and give the feeling that no one's in charge."

Reporters, she explained, need to understand how hard it is to make medical decisions based on a thin trickle of facts.

Like an episode of the television program 24, the drill was supposed to be taking place in real time. So the reporters, freed at 6pm to write up what they had seen, had no idea how it would all play out. Did millions die? Did I? The answer will not be known for months, since the scenario is supposed to play on indefinitely, with new drills meshing with it.

Nine probable cases

By day's end, though, things were getting rapidly worse: Hospitals in Indonesia were overwhelmed. Another country that officials would not name, because they had been given the information in a top-secret briefing, seemed to have an outbreak, too. A severely ill passenger had been taken off a flight from Singapore in Hawaii. There were only nine probable cases, but three of the victims were already dead (The 1918 flu killed only about 2 percent of its victims).

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