Tuesday, December 07, 2004

Hong Kong plans for bird flu

XinhuaNet is reporting Hong Kong officials are proposing a three level alert system for bird flu (influenza A H5N1) linked to a clear command and control system. No color coding is involved, an obvious slap at chromatically challenged former US Homeland Security Secretary Tom Ridge.

The alert level will be designated by the Secretary for Health, Welfare & Food upon the advice of Health and/or Agrigulture officials. The lowest response level, "alert", will be called when a Highly Pathogenic (for birds) Avian Influenza (HPAI) virus appears in the poultry population or there are human cases outside of Hong Kong. This will initiate a "simplified emergency response structure" (details not yet available). "Serious" represents HPAI in poultry or human cases locally without evidence of person to person transmission. Evidence that a mutated virus anywhere in the world is being transmitted from person to person or the designation of a pandemic by WHO will trigger the "emergency" level.

These are now proposals contained in a consultation paper put before Hong Kong legislators. It shows a heightened sensitivity undoubtedly stemming from the deaths in 6 Hong Kong residents and the culling of huge numbers of poultry when the city suffered an outbreak in 1997 that cost Hong Kong dearly. This history might explain the more advanced state of planning and the more open discussion compared to the US and elsewhere. Hong Kong officials recognize that if a mutated virus appears anywhere it will travel globally in short order.

While we fiddle with yellows and oranges for potential terrorist incidents that might or might not materialize (but if they do would affect hundreds or thousands), we won't talk openly about a potential pandemic that could kill hundreds of thousands or millions. While a bird flu pandemic is still only a potential event, shouldn't we devote as much effort and visibility to this as we do to yellow-orange-red? And if not, why not? What are we worried about: scaring people?

Wanted: Public health leadership.