Systems cannot combat flu pandemic, health officials say

The American health care system does not have the information infrastructure needed to effectively combat a flu pandemic, leading health experts said Wednesday.

The heart of the problem is not tracking influenza but getting critical information on outbreaks to doctors and local emergency responders and then back to crisis planners, Tara O'Toole, director of the Center for Biosecurity at the University of Pittsburgh, said at a Capitol Hill panel sponsored by Trust for America's Health.

"Right now we have a very clunky system to allow the medical [community] to communicate," O'Toole said. Digital patient data would help alleviate the problem by letting doctors quickly transmit and share information about illness. "Electronic health records are a matter of national security," she added.

Health experts are now warning of an inevitable flu pandemic based on the virus H5N1, which has devastated Asian chicken populations and infected 117 people who had direct contact with sick animals, according to the World Health Organization. Sixty of those people died. The 50 percent death rate is unprecedented in modern history, O'Toole said. By contrast, the 1918 Spanish flu killed only 2 percent of those infected.

The key to good communication about any spreading epidemic is accurate information, Jeff Duchin, chief of communicable disease control at the University of Washington, said in an interview with National Journal's Technology Daily.

"One of our challenges is to sort through the large amount of information coming across our screens to find out what is reliable," Duchin said. For example, recent news of a viral resistance to Tamiflu, a treatment for the flu, proved to be false. "You really can't put a lot of stock in a single report," he said.

Most epidemiologists depend on the Centers for Disease Control and Prevention for updated alerts. "Then you need to get the information to the front lines with doctors and hospitals," Duchin said.

Internet bulletin boards with backup systems on secure Web sites would help, he added, but many local responders work outside cyberspace. "A lot of folks are hard to reach," he said. "Not everyone is on the network."

Duchin said the footwork and relationship-building need to occur before a health crisis. "It's pretty old-fashioned; you have to put people on the ground [to establish trust]," he said.

Unfortunately, experts agree that local governments have little money for such planning, and consequently little work has been done to prepare for a pandemic flu outbreak. "Hospitals are not well-integrated into disaster preparedness plans," O'Toole said. "They are not ready."

Scientists are closely watching for changes in H5N1, which is now only two amino acids from being able to transmit itself from person to person. Experts also agree that containing such a pathogen is nearly impossible given modern travel habits.

"A quarantine is not going to work in containing this flu," O'Toole said.

Instead, government officials and health workers are hoping they can spot a pandemic early and slow the disease through the use of limited anti-viral drugs if it occurs this winter. "We must act now to get prepared," she said.