By Susan Jarvis
October 23, 2006

The Municipal Waste Management Association (MWMA), the environmental affiliate of The United States Conference of Mayors, briefed their members on Avian Bird Flu during a conference call last week. MWMA provides quarterly conference call briefings on a wide range of topics for its members as a free member benefit. Captain Allan Ortman, from West Palm Beach, spent an hour exploring the impact of a pandemic flu on a community’s healthcare system and the community as a whole, increasing the understanding of the responsibilities of community partners and first responders, determining the adequacy of current plans to address the pandemic, identifying gaps in preparedness and promoting planning within the city.

The big question public health officials are asking concerning avian bird flu “… is not if, but when,” began Ortman. Unlike hurricanes and other disasters, communities hit by a flu pandemic will have to “… fend for themselves. All communities will be affected, so there will be no where else to turn.” Additionally, there is no known anti viral and a vaccine will not be available for six to nine months after the outbreak hits. The flu can be transmitted both directly, by breathing in droplets left over from a sneeze or cough, and indirectly as the virus can survive on surfaces like a doorknob, a hand etc. for many months.

In Palm Beach County, the predicted morbidity rate is 35 percent and the predicted mortality rate is five percent. Seventy-five percent of those affected will seek treatment. These statistics raises questions about community preparedness in terms of hospital staffing and treatment. It will most likely overwhelm both community and public health systems and poor funeral homes.

When planning for the pandemic, Otrman suggests cities ask themselves the following questions:

• When a vaccine becomes available, who should get it?

• How should the limited supply of anti-viral medicine be distributed?

• With a limited supply of medication, how should we approach reducing illness and death?

• What is the right balance of to minimize the health, economic and societal damage?

A comprehensive plan for quarantining and isolating the sick will help delay the epidemic in your community. Cities should also educate the public about a change in social norms, including increased hand washing and wearing masks.

A city immersed in an epidemic will have an impact on essential services. Ortman suggests that ten percent of your workforce will be out for many weeks. Cities need to work out agreements with unions regarding overtime and placement issues. “I guarantee city workers will not be doing their ‘ regular’ jobs,” Ortman states.