For years, we’ve been warned: At some point, influenza will turn on us.
Without warning, it will switch from a familiar, annual virus into one that triggers a worldwide epidemic.
Over the past two weeks, health officials, both in Washington and around the world, worried that this prediction was about to become reality.
A never-before-seen type of influenza, a hybrid of swine, bird and human flu, was causing people in Mexico to become sick and die. Then similar cases were reported in California and Texas.
Oddly, the virus was springing up at what typically is the end of flu season. And unlike seasonal flu, there was no vaccine ready to help people fend off this new version.
Officials at all levels reached for their plans on dealing with a major flu outbreak. Those plans, finished in 2007, were spurred by bird flu cases, which at the time officials thought could trigger a pandemic.
Swine flu has provided the first real test of those plans. Health officials said the last two weeks have allowed them to learn, seeing what works and what would need to be changed if a full-fledged pandemic hit.
So after years of planning and drills, did the plans work when put to the test?
“I think the value of those plans is being shown,” said Dr. Ann Marie Kimball, a professor of public heath and medicine at the University of Washington.
“What you saw our local health officials doing was revising the steps they were taking in light of the information they were receiving,” she said.
That led to a change in school closure policy, first adopted by health officials in King and Snohomish counties about a week ago and later adopted as a national model.
Schools will no longer be closed when a single swine flu case is reported. Instead, parents can be a first line of defense against flu spread, officials said, by keeping sick kids home.
That sort of agile change in response is what you hope to see, Kimball said.
“What you didn’t want to see is people taking a plan off the shelf and doing it exactly like the plan said no matter what,” she said.
As of Sunday, the number of confirmed cases in Washington had grown to 128. In addition to the 24 in Snohomish County and 89 in King County, people in Clark, Thurston, King, Skagit, Whatcom and Spokane counties have become ill.
Nationally, the virus has spread to 44 states, with 2,532 confirmed cases and three deaths, including one of a man in Snohomish County.
Although Snohomish County’s flu plan has generally worked well, “the devil is in the details,” said Dr. Gary Goldbaum, chief health officer for the Snohomish Health District.
Budget reductions have forced the health district to cut programs and staff, he said. Flu planning is just one example.
“We’re short on resources,” he said. “We’re not deep enough to manage a severe incident for very long.”
Money woes have also caused Snohomish and King counties to make different decisions on buying extra anti-viral medications, which can slow and weaken some strains of the flu.
King County spent $2.7 million to buy enough anti-viral medication to treat about 190,000 people in a severe outbreak, said James Apa, a spokesman for Public Health — Seattle &King County.
Extra stocks of anti-virals weren’t purchased in Snohomish County. Instead, the county relied on anti-virals provided by the federal government. The supply is enough to treat about 4,000 people.
“I think that was a very prudent decision,” Goldbaum said. “We don’t know what pandemic strains will be sensitive to these drugs.”
Up to this point, the anti-viral drugs have been effective in slowing the spread of swine flu. And although there were scattered reports of temporary shortages, by the middle of last week, there were no problems getting prescriptions filled in Snohomish County, he said.
Once the virus passes, public health agency and county officials plan to discuss what they can learn from this brush with a flu scare, Goldbaum said.
With all the planning, though, some people wonder how this bug could spread so far so fast.
“There are more bugs than people,” said Mary Selecky, health secretary for the state Department of Health. “They adapt and change quicker than we can catch up with them.”
Flu viruses change every year, which is why the formula in seasonal flu shots is adjusted annually.
Health officials had to make decisions based on information that was changing quickly, sometimes by the hour. “We were dealing with a virus in real time — it is here,” Selecky said.
So far, the swine flu virus has been relatively mild, she said, sickening many but killing few.
Still, it has provided health officials with important lessons on handling future flu pandemics, she said.
“It gives us an opportunity to learn.”
Sharon Salyer: 425-339-3486, salyer@heraldnet.com.
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