L.A. SIMULATES AN OUTBREAK OF THE BIRD FLU UNDERFUNDING, CONFUSION OVER ROLES AMONG ISSUES.

Byline: TROY ANDERSON Staff Writer

At first, officials report a single suspected human case of the bird flu in Los Angeles. By the fourth day, that person has died and officials begin scrambling to decide what to do.

No vaccine will be available for months and there is only a limited supply of antiviral medications. By day seven, officials start closing schools and employers are confronted with rising absenteeism.

By the 25th day, about 3,700 people have died in Los Angeles County, 59,000 residents are infected and the National Guard is called out to keep order.

That hypothetical scenario unfolded Wednesday as health experts and business leaders held their first broad exercise designed to prepare for a bird flu pandemic in the Los Angeles area.

``L.A. became the kind of epicenter of the pandemic and it moved across the United States,'' said Dr. Jonathan Fielding, the county Department of Public Health director, said after the exercise. ``I think we handled it as well as could be expected.''

But even as experts worked to develop emergency plans, they warned that little money has been provided and there is still confusion over the roles of federal, state and local governments during a pandemic.

``(We) have a tremendous amount of confusion over roles -- which leads to paralysis of action in many instances, or overlap, or strategies that just don't get completed because no one knows who in fact is supposed to do exactly what,'' said Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University.

First discovered in Asian poultry in 1999, the avian virus has since infected millions of migratory and domesticated birds and at least 140 people.

In its current form, avian flu can be transmitted to people only through contact with infected birds. Scientists, however, believe it's only a matter of time before it mutates into a strain that can spread among humans.

Since late last year, the federal government has given local and state governments $325 million to prepare for a flu pandemic, including $24 million for California and an additional $10 million for Los Angeles County.

But Redlener said the U.S. health system needs $1 billion for annual maintenance and $5 billion to increase capacity and purchase ventilators just to be able to handle a flu pandemic.

Sandra Shewry, director of the California Department of Health Services, said the Legislature has provided $200 million to purchase mobile field hospitals, 9.1 million doses of anti-viral medications and 2,500 ventilators.

``It's not something you want people to worry about every day, but you don't want them to forget about it,'' said Fielding. ``They've heard about it so much, we're concerned people may say that's last year's issue. We don't want that to happen. We want people to understand, it's not a question of whether it will happen. It's a question of when.''

In California, a flu pandemic on the scale of the 1918 pandemic could infect up to 30 percent of the population and result in nearly 200,000 deaths.

Redlener said hospitals would be overwhelmed with patients, many who would need intensive care and ventilators that are now in short supply.

``No community in America has ever experienced anything that we might see in terms of pediatric fatalities and illnesses that really paralyze the community's ability to function emotionally and effectively in any kind of a disaster,'' Redlener said.

``Hopefully, Katrina, 9-11, anthrax and the other things we've experienced in these last few years will become true wake-up calls and not just snooze alarms that they've been so far.''

troy.anderson(at)dailynews.com

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