University’s ‘what-if’ planning for bird flu in sync with new CDC guidelines

Recently released U.S. government guidelines for combating a potential avian flu pandemic closely resemble response strategies that have been under development by Harvard planners since October 2005.

Both the Centers for Disease Control (CDC) guidelines – available online at http://www.pandemicflu.gov/plan/community/community_mitigation.pdf – and Harvard’s ongoing “what-if” planning say that the best protection against a flu pandemic would be “social distancing,” or limiting contact with people who are sick, and attending to personal hygiene, in particular, hand washing.

The CDC guidelines – developed to help U.S. communities create their own plans if there is a pandemic in the coming years – call for keeping people from congregating in buildings where the virus can spread easily from person to person. Specific actions would include closing schools, canceling public gatherings, instituting work leave policies, greatly increasing telecommuting, and isolating those who catch the virus and their close contacts.

“It’s no surprise that Harvard’s response mirrors the CDC guidelines; public health experts have long realized that an avian flu pandemic would require the use of social distancing measures,” said David Rosenthal, director of University Health Services (UHS), and a member of the University’s Incident Support Team (IST) that has been drafting potential responses to the avian flu. “If a pandemic occurred, the disease could spread far and fast with devastating consequences while we waited for an effective vaccine to be developed. The best protections would be the old standbys – limiting contact and attending to personal hygiene, especially hand washing.”

University officials stress that planning is being carried out only on a “what-if” basis, not because Harvard has information that a pandemic is imminent. Avian influenza, or “bird flu,” remains a disease that mainly afflicts birds. The World Health Organization as of Feb. 6 had recorded 272 cases of humans catching bird flu, from close contacts with infected fowls, and 166 deaths.

What concerns public health planners is the possibility that the deadly H5N1 subtype of avian flu could mutate to a form easily spread from human to human, and that people would have no natural immunity to it. The most effective treatment – a vaccine to keep people from catching the avian flu – could take a while to develop and distribute, and no one knows whether antiviral medications would be effective.

The CDC report did not address the use of face masks because CDC researchers are still investigating whether they would be effective in stopping transmission of the flu virus. Joseph Griffin, the University’s director of environmental health and safety, noted that federal law requires training and fit-testing of face masks when an employer issues them to frontline employees, and that some of that training is going on now at Harvard as a purely precautionary measure.

UHS’s Rosenthal said that in the event of a pandemic, very few Harvard personnel would perform the types of duties that would put them in close contact with infected people and require the use of face masks. “It would be health care workers, police officers who were helping to transport sick people, cleaning service employees in buildings that housed sick people, and others who came in direct contact with ill members of our community.”

The CDC guidelines identify schools, including colleges and universities, as a primary concern because students study and live in such close quarters. At Harvard, members of the IST and 29 local emergency management teams (LEMTs), which have responsibility for Schools or units of the University, have been working in subcommittees to develop plans should it become necessary for the University administration to suspend classes and close dormitories. Not only would University officials have to facilitate the orderly decampment of students; they would also need to make provisions for those students who could not return to family homes.

Other IST subcommittees have been planning how to aid telecommuting; provide for services that cannot be shut down, such as care of laboratory animals; provide shelter, food, and security for those students and employees who remain on campus; ensure security for vacant University buildings; determine essential roles of University personnel and how those will be filled if employees cannot work; guarantee payroll continuity; and develop lines of communication with local, state, and federal officials.

“We are working hard to plan for an event that we don’t think will happen soon, and that we sincerely hope never happens,” said Tom Vautin, associate vice president for facilities and environmental services at Harvard and the coordinator of the IST. “The best policy is to prepare for the worst, and then we will be ready no matter what happens. The planning we’re doing already is paying benefits, because it is helping us to better manage everyday, local emergencies in a more coordinated fashion.”