STATE BRACES FOR PANDEMIC CLOSING SCHOOLS, WEARING MASKS PART OF DRAFT PUBLIC FLU-EMERGENCY PLANS.

Byline: Harrison Sheppard Sacramento Bureau

SACRAMENTO - California would take steps as drastic as closing schools, limiting public events and asking people to wear masks in public to cope with a possible bird flu pandemic under a draft plan released Wednesday by state health officials.

No cases of avian influenza have been reported in the U.S., and the flu is not known to spread between humans. But health officials worry that the virus could mutate, launching a worldwide pandemic on a scale not seen since Spanish flu killed up to 50 million people in 1918.

A normal flu season might result in 35,000 to 40,000 deaths nationwide, while a pandemic could kill that many people just in California, officials said.

``In California alone, scientists estimate a pandemic could cause approximately 35 percent of the population to become ill,'' said state Department of Health Services director Sandra Shewry. ``An influenza pandemic could be the greatest public-health challenge of our times, disrupting all aspects of society and our health care system.''

California health officials already have requested more money for this year and next to implement coping strategies and stockpile up to 270,000 doses of antiviral medications, although there is no vaccine yet for the bird flu, health officials said.

Under the draft plan, state officials would activate a series of emergency procedures in the event of an outbreak, including working with local health officials to increase capacity and staffing at health care facilities, identifying and quarantining potential cases, and communicating with the public.

Depending on the severity of the outbreak, the state also would invoke ``social-distancing'' measures such as limiting mass gatherings. That could include closing schools, shopping malls and some businesses; cancelling concerts and sporting events; and urging people to wear medical masks and avoid public transportation.

Schools should already be forming closure plans in the event of a public- health emergency, officials said.

State officials also would establish a Disaster Policy Council with top emergency and health officials to make high-level decisions.

Some elements will be implemented regardless of whether a pandemic occurs, including reinforcing to the public good health practices - like covering one's mouth when sneezing, washing hands and stockpiling supplies such as bottled water, canned food, batteries and flashlights for an extended stay at home.

One of the biggest challenges health officials foresee is a lack of capacity at hospitals. In Los Angeles County, for example, hospitals already are struggling to handle a growing number of patients.

``We're OK with dealing with contagious diseases, but not in huge numbers,'' said Jim Lott, executive vice president of the Hospital Association of Southern California. ``The problem is a numbers problem; it's not a medical problem.''

Lott said waiting times in Los Angeles County hospital emergency rooms average around seven hours for nonemergency care and as high as 12 hours during a normal flu season.

Nine emergency rooms or hospitals with ERs have closed in the past 2 1/2 years in Los Angeles County, Lott said, lowering the number to 78 hospitals with emergency rooms. Those hospitals are operating at 80 percent capacity, close to the recommended maximum of 85 percent, he said.

One out of every four hospitals on average is closed to ambulance traffic because of capacity problems, he added.

Shewry said state officials are aware of the problem and hope to begin addressing it through this new plan.

``A large part of our planning effort, and something we're putting a very high priority on this year, is working with our partners in the counties to document what capacity do we have to bring up our health care delivery system, to exceed the capacities we have today,'' Shewry said.

``And to come back to the Legislature and to the governor and say this is where we see the gaps, and these are the targeted changes we need.''

Another element of the plan - which updates a pandemic flu plan released in 2001 - is monitoring the state's bird population.

Food and Agriculture Secretary A.G. Kawamura said health officials tested 100,000 birds in 2005, sending screeners to poultry farms and bird markets throughout the state.

Avian influenza has not been detected in the California bird population.

So far, known cases of human infection in Asia and Europe generally have involved those who came in close contact with sick birds.

Kawamura noted that proper food handling and cooking should destroy all viruses, including bird flu.

Gov. Arnold Schwarzenegger is seeking to add $46 million to the current year's budget for natural and man-made disaster preparedness, and $60 million next year.

``The governor considers emergency preparedness to be among his highest priorities as governor and he is committed to ensuring that California is as safe and prepared as possible,'' said state Health & Human Services Agency Secretary Kim Belshe.

``The governor recognizes that emergency preparedness planning and response is the responsibility of all Californians. It is the responsibility of employers, schools, families, individuals and, of course, government. Each of us has a very important role to play.''

Harrison Sheppard, [phone]

harrison.sheppard(at)dailynews.com

INFORMATION

The California Department of Health Services draft Pandemic Influenza Preparedness and Response Plan can be found at www.dhs.ca.gov. Health officials will take public comments on the plan and issue a final version in the spring. Comments can be submitted through Feb. 15 by e-mail to panflu(at)dhs.ca.gov or by using the ``Making Comments'' link on the Web site.

Flu information from the federal government is available at www.cdc.gov and www.pandemicflu.gov.

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