U.S. PLANS INADEQUATE FOR 1918-TYPE PANDEMIC DOCTORS SAY ALL HEALTH SYTEMS WOULD STUMBLE.

Byline: Troy Anderson Staff Writer

Unsettled by the possibility of a global influenza pandemic, California and Los Angeles County health experts have prepared plans to deal with a potential outbreak, officials said Wednesday.

Plans include coordinating with federal agencies to receive and distribute antiviral drugs and other medicines; increasing poultry and human surveillance; and expediting testing of suspected cases to try to keep any outbreak in check, officials said.

Still, Dr. Jonathan E. Fielding, the county's health officer, warned that none of the nation's health systems is adequately prepared for an outbreak.

``We have a whole pandemic flu plan and meet every two or three weeks,'' Fielding said. ``We've looked at the capacity of hospitals and tried to understand what kind of surge capacity exists.

``But I have to be clear that I don't think any public health agency I know of is adequately prepared ... because there is not a vaccine available yet to provide to the public.''

Other local health officials concur that in a pandemic, the number of sick people would quickly exceed hospitals' capacity to care for them.

Dr. Brian Johnston, a member of the board of trustees of the California Medical Association and former president of the Los Angeles County Medical Association, said there is no question that both public and private health care systems are inadequate to respond to a flu pandemic.

``Presently, we have a hard time just dealing with Friday and Saturday nights,'' Johnston said. ``Our emergency rooms are jammed, patients wait hours to get into the ER and days to go from the ER to a bed upstairs in our hospitals. That has been true for several years.''

So far, there have been about two dozen suspected cases of Avian flu in California, but tests have come up negative on all of them.

But in December, the World Health Organization warned that the current bird flu could mutate and trigger a worldwide outbreak that could kill up to 7 million people and infect billions more.

Researchers at the U.S. Centers for Disease Control and Prevention have estimated that a pandemic could kill up to 207,000 people and sicken an additional 20 million to 47 million in the United States.

In comparison, about 5 percent to 20 percent of the U.S. population is infected each year with more common strains of flu, which kill about 36,000 people, including 1,000 to 1,500 in Los Angeles County.

World Health Organization officials said they couldn't predict when such a pandemic might occur, but recently reported increasing numbers of human avian flu cases in Southeast Asia.

Although no vaccine is available yet, an inactivated human vaccine is undergoing human clinical trials in the United States.

``Unfortunately, there is no vaccine available now at any price,'' said Howard Backer, interim state public health officer. ``They are developing prototypes and experimental vaccines. It sounds to me, from recent pronouncements, that they are increasing the development of various types of vaccines and will stockpile some of these. California will get its population-based share.''

Fielding said the most potentially effective antiviral drug is Tamiflu and the U.S. government aims to buy a large amount but, he added, there are order backlogs, and some nations have been placed on two-year waiting lists.

The United States has about 2 million doses in its national stockpiles and expects to have 6 million shortly, Backer said. The nation has ordered a total of 20 million doses.

``There is nowhere near enough to reach a significant percentage of the population,'' Fielding said. ``There would be prioritization.''

Troy Anderson, [phone]

troy.anderson(at)dailynews.com