Department of Health and Human Services

Pandemic Planning 

Update III

A Report from Secretary Michael O. Leavitt

November 13, 2006

“Our country has been given fair warning of this danger to our 

homeland — and time to prepare. It’s my responsibility as President to 

take measures to protect the American people from the possibility that 

human-to-human transmission may occur.”

— President George W. Bush

November 1, 2005 
Message from the Secretary

“We are in a race. A race 

against a fast moving, virulent 

virus with the potential to 

cause an influenza pandemic.” 

- Secretary Mike Leavitt, HHS 

March 13, 2006 

A year ago, few Americans had heard of avian flu. Today, awareness is high. There 

has been a deluge of news reports, and we’ve had not one, but two made-for-TV 

bird flu movies. This past year, a nearly forgotten word, pandemic, re-entered our 

vocabulary. And then the media moved on. 

There is a danger that as avian flu slips from the headlines, people will believe the 

threat is no longer real. But the race against bird flu has not slowed, and we are 

continuing to prepare. In fact, the highly pathogenic H5N1 avian flu virus continues 

to change, to probe our defenses. The virus has been confirmed in birds in 55 

nations. A year ago, it had been reported in only sixteen. As this report is being 

written, 256 people in ten nations have been infected and 159— 59 percent—have 

died. The number will likely have increased by the time you read these words. 

It has been one year since the President called the nation to action. I can report 

that the response has been unprecedented and the progress considerable. We 

are building a national stockpile of pandemic vaccines, antiviral drugs and other 

supplies needed to respond to a potential pandemic, and we are subsidizing state 

efforts to purchase antivirals. Thirty-three states have already placed orders. 

In June, Congress passed the President’s funding request of $2.3 billion for the 

second year of the HHS Pandemic Influenza Plan. This funding allows HHS to 

continue to develop a vaccine for the US population within six months of the first 

sign of a pandemic, come closer to our goal of antiviral coverage of 25% of the 

population, and enhance domestic and international public health infrastructure and 

preparedness. The President’s FY 2007 request also includes $352 million for HHS 

agencies to build on the implementation of the Pandemic Influenza Preparedness 

Plan through the following activities:

Expanding domestic and international 

surveillance and detection capabilities;

Improving pandemic preparedness and 

response capabilities;

Establishing a vaccine registry to assess 

vaccine distribution, safety, and efficacy 

and;

Improving our Nation’s ability to contain a 

potential pandemic influenza outbreak.

Vaccine research continues at a frantic pace. 

Vaccines have been developed for the two 

known variants of H5N1 and we have already 

stockpiled enough vaccine to treat more than 

some 3 million people. We are working with 

industry and other countries to increase vaccine production capacity at home and 

abroad. 

State and local planning has been ubiquitous. We have held pandemic planning 

summits with broad cross-sections of leadership in every state. Every state has 

drafted a pandemic plan. Many have taken their planning to county and local levels. 

Indiana, for example, recently announced that all 92 counties had completed local 

pandemic influenza response plans. 

•

•

•

•

2003 2004 2005 2006

55

78

16

36

9

1 4

152

Countries with H5N1 Avian Influenza and

Human Deaths (both cumulative)

Countries with H5N1 avian influenza in animals

Human Deaths

Through Nov 13




In August, the Department of Health and Human Services (HHS) released an 

additional $225 million to the states to enhance preparedness, further regional 

planning and hold planning exercises. In June 2006, Congress appropriated 

an additional $250 million for state and local preparedness. A portion of this 

funding will be awarded on a competitive basis for innovative approaches to 

preparedness. 

International cooperation has been 

extraordinary. At the urging of the 

President, more than 93 countries and 20 

international organizations are participating 

in the International Partnership on Avian 

and Pandemic Influenza. The NIH is 

supporting a collaboration of domestic 

and international partners in the Influenza 

Genome Sequencing Project. Genetic 

sequences are being made available to the 

entire scientific community via the internet. 

Indonesia is sharing avian influenza virus 

samples and, recently, China also agreed to 

share virus samples.

Monitoring and surveillance remains our 

first defense against the emergence of 

a pandemic influenza virus. To date, the 

Departments of Interior and Agriculture 

and state partners have tested more than 

35,000 wild migratory birds in the United States for avian flu. To date, the highly 

pathogenic strain of H5N1 has not been found anywhere in the Americas. 

None of this should make us complacent. While there is no way to know when, 

or even if, the H5N1 virus will form a variant capable of widespread human-tohuman transmission, we know that pandemics are inevitable and our efforts 

are designed to advance our preparedness to minimize the impact of the next 

pandemic when it comes.

A pandemic would impact every community in the nation over a very short period 

of time. It could last six to eight weeks and it could return in wave after wave 

with each wave lasting two to three months. There is no way to know how lethal 

an H5N1 avian influenza outbreak could be, but a catastrophic scenario — a 

2004 – H5N1 vaccine reference strain created

by reverse genetics from H5N1 virus isolated from Vietnam

April 2005 – RFP for cell-based vaccine contract issued

November 2005 – President Bush announces

the National Strategy for Pandemic Influenza

Summer 2005 – Preliminary results from H5N1

vaccine clinical trials in healthy adults aged 18-64 indicate an

immune response predictive of protection against the H5N1

September 2005 – International Partnership on Avian

and Pandemic Influenza launched

November 2005 – HHS releases

Pandemic Influenza Plan

November 2005 – WHO Global Meeting

October 2005 – Southeast Asia fact-finding mission 

led by HHS Secretary and State Department

2004 April - November 2005

Message from the Secretary (cont.)
pandemic of 1918 severity — could cause nearly two million deaths in the United 

States, and tens, perhaps hundreds, of millions of deaths worldwide. 

Public and private leaders at all levels are grappling with the enormity of keeping 

our government, our economy, and our society functioning during a severe 

pandemic. There is much for each of us to do, at home, at school, at work, and in 

the community to plan and prepare for what we hope never happens.

 As I wrote in my first report, “Preparation is a continuum. Each day we prepare 

brings us closer to being ready. We are better prepared today than we were 

yesterday. And we must be better prepared tomorrow than we are today.” 

December 2005 – Passage of the Public Readiness

and Emergency Preparedness Act (PREP Act)

December 2005 – Enrollment for clinical trials with H5N1

vaccine in healthy adults (>65 years of age) was completed

December 2005 – Convening of States

Summit, in Washington, DC

December 2005 – Release of State and Local

Pandemic Influenza Checklist

December 2005 – Release 

of Business Pandemic 

Influenza Checklist

December 2005 – First State Summit, Minnesota

December 2005 –Tabletop communications exercises with

US Departments and representatives from Canada and the UK

December 2005 –WHO Global Pandemic Communications 

Meeting in Switzerland, HHS led US delegation

December 2005

Message from the Secretary (cont.)

 Picture a graceful whooper swan, lifting from a Mongolian wetland. It 

will carry on its back a tiny, 2.3 ounce solar-powered GPS transmitter 

as it wings its way across Eurasia to its western breeding grounds. On 

the ground, an international team of scientists from the U. S. Geological 

Survey, the United Nations Food and Agriculture Organization, the 

Wildlife Conservation Society and the Mongolian Academy of Sciences 

will carefully track the swan’s migration route.

With good reason: the swan may be carrying more than its GPS 

transmitter. In 2005, large numbers of whooper swans died in parts of 

Mongolia where few poultry are present. Testing of the dead swans 

verified the presence of the highly pathogenic H5N1 virus.

Tracking the swans is just one way scientists are trying to better understand 

and document links between wild birds and the spread of avian influenza. 

Monitoring and Surveillance




January 2006 – Roughly 5 million courses in SNS stockpile

January 2006 – 6 State Summits AZ,VT, WV, RI, GA, KY

January 2006 – RFI issued on advanced

development of promising antivirals

January 2006 – RFI issued on increasing

egg-based vaccine capacity

January 2006 – Release of

Individuals and Families

Pandemic Influenza Checklist

January 2006 – Bilateral teams sent to Turkey, Armenia, 

Azerbaijan, Georgia, Romania, Ukraine and Nigeria to

assess avian flu outbreaks

January 2006 – International Pledging Conference in Beijing;

$334M in US grants and technical assistance to aid global effort

January 2006 –Tokyo WHO conference to draft WHO pandemic plan

January 2006

Monitoring and Surveillance (cont.)

This year, in the United States, biologists from the Departments of Interior and 

Agriculture and their state partners have tested more than 35,000 wild birds for 

the presence of H5N1. 

This testing has revealed the presence of low pathogenic H5N1 and other avian 

viruses in several states this fall. These low pathogenic viruses are common 

to wild fowl, and are very different from 

the highly pathogenic H5N1 circulating 

in parts of Asia, Europe and Africa. To 

date, highly pathogenic H5N1 has not 

been found in the Americas. 

The testing is critical to provide an early 

warning should the highly pathogenic 

H5N1 virus be brought here by migratory 

birds. Early detection creates the 

opportunity to take precautions to 

prevent the spread of the deadly virus. 

Highly pathogenic avian influenza (HPAI) 

strains have been found and eradicated 

three times in the United States: in 

1924, 1983 and 2004. No significant 

human illness resulted from any of these 

outbreaks.

HHS is investing resources in international surveillance and response to assist 

other countries in detecting a pandemic influenza outbreak early. These 

resources will help other countries prepare for an influenza pandemic to 

minimize and contain the impact of a pandemic, should one occur.

Should people become sick, it is critical to be able to quickly confirm whether 

or not they have been infected by the H5N1 virus. A reliable, rapid diagnostic 

test is needed for epidemiologic assessments, traveler screening and clinical 

care. The CDC is currently studying proposals for the development of such a 

test, and expects to award contracts later this year.

H5N1 in wild birds

H5N1 in poultry and wild birds

H5N1 in humans
January 2006 – First state summit with signing of a 

Planning Agreement, Vermont

February 2006 – 11 State Summits CT, IA, MA, 

FL, OH, NV, DE, AL, MO, NE, MD

February 2006 – Enrollment in a pediatric H5N1 vaccine 

clinical trial (children aged two to nine years) was completed

February 2006 – Laboratory

assay for diagnostic testing of avian

influenza A/H5 approved

January 2006 – Release of Faith-based & Community

Organizations Pandemic Influenza Checklist

January 2006 – Release of School Disricts (K-12)

Pandemic Influenza Checklist

February 2006 – Risk Communications Preparedness

Workshop hosted by CDC in Thailand

February 2006 – Meeting with UN Coordinator for avian

and pandemic influenza on how to best assist UN efforts

Jan 2006 February 2006

Research 

The Armed Forces Institute of Pathology has been collecting pathological 

specimens since 1862. It holds some 2.5 million specimens. Exactly one of them, 

a lung specimen from an Army private who died in 1918, had genetic material for 

the virus that caused the 1918 Spanish Flu pandemic.

Applying genetic sequencing, pathologists at the Institute were able to replicate 

the genetic code of the deadly virus. Scientists were then able to reconstruct a 

virus containing all eight 1918 flu virus genes. 

Unlike typical seasonal flu, which strikes hardest at the very young, the elderly 

and those with compromised immune function, the 1918 flu disproportionately 

killed young people in the prime of life. Scientists wanted to know why. 

Mouse studies provided clues to the answer.

“We clearly see a dramatic and uncontrolled immune response in the mouse 

lungs as early as one day following infection with the reconstructed 1918 

virus,” said Michael G. Katze who led the research team. The virus may have 

turned the Army private’s immune system against him. If true, people in their 

prime of life, with the strongest immune systems, were most at risk.

Of particular concern is that in the limited number of human cases identified to 

date, we are seeing similar human mortality patterns associated with the current 

highly pathogenic H5N1 virus.

Genetic sequencing promises to energize the race to understand avian flu. 

Surveying and comparing how the virus strains circulating in poultry are changing 

could alert researchers to an imminent pandemic. It could also help them to select 

a strain to target with a vaccine. With the 1918 virus sequenced, scientists can 

compare genetic sequences and perhaps determine what makes one strain more 

lethal than another and what makes one strain more contagious than another.

The genetic sequence of each influenza virus is more than 13,000 letters long. 

The Influenza Genome Sequencing Project, an international collaboration 

supported by the National Institute of Allergy and Infectious Diseases, has set up 

a production line, growing different virus strains, isolating their genetic material, 

and then sequencing them one by one. The project’s goal is to sequence 500 to 

1000 strains a year. With the sequences of over 1650 human and avian isolates 

made available in less than two years since its inception, the project has proven 

successful so far.




March 2006 – 19 State Summits SC, SD, ND, WY, WI, PA, IL,

NC, VA, IN, PR,CO, UT, ID, TX, NM, OR, CA and the Virgin Islands

March 2006 – Results published demonstrated that inactivated 

H5N1 vaccine induces immune responses in healthy adults

March 2006 – Release of Medical Offices and Clinics 

Pandemic Influenza Planning Checklist

March-April 2006 – FDA approves 

Relenza for the prevention of Influenza 

A and B in adults and children

March 2006 – Release of Home Health Care Checklist

March 2006 – Pandemic flu supplemental

guidance sent to states

March 2006

March 2006 – Release of Colleges and Universities ChecklistMarch 2006 – Release of Child Care and Preschool Checklist

March 2006 – RFP issued for advanced

development of antigen sparing technologies

Vaccines and Vaccine Production Capacity 

Vaccines are the time-tested means for preventing influenza. HHS is committed 

to developing the technologies and creating the vaccine production capacity 

that pandemic preparedness requires.

First, HHS is investing in development of pre-pandemic vaccines – vaccines 

against currently circulating H5N1 avian influenza virus strains using 

conventional egg-based production methods. The situation is that the H5N1 

avian influenza viruses continue to change – yielding families of closely related 

new strain variants, technically known as clades. The expectation is that the 

pre-pandemic vaccine developed from an H5N1 clade 1 virus will provide at 

least partial protection against new virus strains. It is, for now, the best vaccine 

defense we have; and so we are stockpiling it. We currently have sufficient 

H5N1 clade 1 vaccine courses on hand to vaccinate some three million people.

In response to the emergence of a second clade of H5N1 avian influenza 

viruses during 2005-2006 in Asia and Europe, HHS is moving forward with the 

development of H5N1 clade 2 vaccine candidates and the manufacturing of 

H5N1 clade 2 vaccine stockpiles. Depending on availability of vaccine seed 

stocks and production yield, we expect to have another five million courses of 

H5N1 clade 1 and clade 2 vaccines stockpiled in 2007.

Second, HHS committed over $1 billion during 2005 and 2006 for advanced 

development of cell-based influenza vaccine production methods. This 

investment will make possible a more flexible alternative to egg-based 

production methods. It sets the stage for the modernization and expansion of 

domestic production capacity that must occur if the US is to be able to acquire 

300 million treatment courses of a human vaccine within six months after the 

emergence of a pandemic virus.

Third, recognizing the need to expand egg-based vaccine production capacity 

along with cell-based capacity, HHS in July 2006 sought proposals to adapt 

existing egg-based manufacturing facilities for emergency production of 

pandemic influenza vaccine. Contracts are expected to be awarded this 

December.

Fourth, HHS is moving forward with advanced development of ways to make 

vaccines more efficient. The use of vaccine additives called adjuvants could 

potentially extend U.S. pandemic influenza vaccine supply several-fold and 

“WHO and international 

experts believe that the world is 

now closer to another influenza 

pandemic than at any time 

since 1968, when the last of 

the previous century’s three 

pandemics began” 

–Dr. Margaret Chan

Director-General Elect

World Health Organization

December 7, 2005


March 2006 –Order of 16.2 million courses of Tamiflu

and 3.9 million courses of Relenza

March 2006 – States receive initial grant funding

for pandemic preparedness

March 2006 April 2006

April 2006 – 7 State Summits TN, AK, WA, HI, LA, MI, 

and the District of Columbia

April 2006 – Government leaders from the

Freely Associated States and Pacific Territories

participate in the Hawaii and Guam summits

April 2006 – Computer model examines strategies to

mitigate potential US flu pandemic

April 2006 – FDA issues guidance for industry on 

diagnostic devices to detect influenza A viruses

April 2006 –WHO issues guidelines

for humanitarian agencies

Vaccines and Vaccine Production Capacity (cont.)

thus decrease the time required to achieve our manufacturing capacity target. 

Recently, both GlaxoSmithKline and Novartis announced results of studies 

demonstrating that adjuvanted vaccine produced possible protective immunity 

at substantially lower doses of antigen than did unadjuvanted vaccine. HHS is 

encouraged by these findings. Moreover, HHS currently is reviewing contract 

proposals for further development of such dose-sparing technologies.

Fifth, HHS is looking to the long-term, beyond current strain-specific influenza 

vaccines, with a view to fostering development of a “universal vaccine” – one 

that provides broad-based, cross-protective immunity against 

multiple virus strains.

A universal vaccine would protect against viruses resulting 

from antigenic shift (significant changes in viral proteins) that 

historically have been associated with influenza pandemics as 

well as those resulting from antigenic drift (small changes in viral 

proteins) associated with seasonal influenza. 

Although this is not a new concept, the prospect is receiving 

increased attention because new technologies have made 

important pre-clinical studies possible. NIH is currently working 

to bring such vaccine candidates through the discovery and 

proof-of-concept stages. Successful development of a “universal” influenza 

vaccine would mean that you would need only one flu shot to protect you for 

many years (possibly for life). This, in turn, would mean that we could stockpile 

the universal vaccine – thereby making influenza pandemics things of the past.

The United States is not alone in the quest to establish an adequate influenza 

vaccine supply. The World Health Organization (WHO) has taken a significant 

step forward in the global effort by publishing the Global Pandemic Influenza 

Action Plan to Increase Vaccine Supply. The United States has provided $10 

million to WHO to support other countries as they develop sustainable programs 

for vaccines to counter H5N1 or other novel influenza viruses that can infect 

humans. 


May 2006 – HHS awards contracts totaling more

than $1 billion to develop cell-based influenza vaccine

May 2006 –Release of National Strategy for Pandemic

Influenza: Implementation Plan

April 2006 May 2006

May 2006 – Department of State establishes Avian

Influenza Action Group to coordinate US international effort

May 2006 – Release of Long-Term Care and

Other Residential Facilities Checklist

April 2006 – NIH researchers model interregional 

spread of influenza through United States as described 

by virus type, size of population and commuting rates and distance

April 2006 – HHS provides assistance to

Bangladesh and India to enhance planning for a

potential influenza pandemic

Antiviral Drugs

Antiviral medications are principally used to treat influenza infections, lessening 

the impact of a virus after an individual has been infected. Under certain 

circumstances, these drugs can also reduce transmission of the virus or even 

prevent infection. Two antiviral drugs are effective against the H5N1 virus in 

laboratory testing. Tamiflu, manufactured by Roche Laboratories, is administered 

as a course of capsules or liquid that is taken orally. Relenza, manufactured 

by GlaxoSmithKline, is administered by an inhaler. Both work by blocking 

the ability of the virus to multiply beyond the infected host cell. 

Antivirals are an important part of our nation’s Strategic National Stockpile 

(SNS) against pandemic flu. A total of $782 million was allocated this 

year for the purchase of antivirals. The goal is to have 26 million courses 

of antivirals on hand by the end of 2006 and a total of 50 million courses in the 

SNS by the end of 2008. The Federal stockpile, in addition to State purchases of 

31 million courses of antivirals, will ensure that we have enough antivirals for 25 

percent of the population.

We are on target to meet those goals. Sixteen million courses of antivirals have 

already been warehoused, and we will have 36 million courses on hand by March 

2007. 

In addition to these direct purchases, HHS allocated $170 million 

to subsidize state purchases of an additional 31 million courses of 

antivirals. These were apportioned based on population, with HHS 

paying 25 percent of the cost. Thirty-three states have already 

placed orders. Four states plan to make unsubsidized purchases 

above their allocation; only four states do not plan to take full 

advantage of the subsidy program. To date, states have ordered 

more than eight million courses. All stockpiled antivirals must be 

reserved for use in a potential pandemic; they may not be used to 

treat seasonal flu.

States know their delivery systems best, and are responsible for 

the intrastate distribution of antivirals in a pandemic. To help them, HHS joined 

with the Healthcare Distribution Management Association (HDMA) to develop a 

model distribution plan. This was completed in August, and the HDMA is now 

working with states to help them adapt the plan to their specific situations. Those 

plans will then be reviewed by HHS and the Department of Homeland Security.

Antiviral Stockpile

Goals Progress

81 Million

12/2008

36 Million courses ordered

26 Million 10/06/06

12/06/06

16 Million courses on hand

10/31/06
May 2006 – 7 State Summits MS, OK, NJ, KS, NH, MT, and 

Tribal Leaders

June 2006 – Secretaries Leavitt of HHS, Norton of DOI, and Johanns of

USDA hold national briefing with print, wire, broadcast and 

news media outlets on US preparations for avian influenza

May 2006 – Congressional Budget Office report on

possible macroeconomic effects and policy issues in 

preparation of potential influenza pandemic

May 2006 June 2006

June 2006 – HHS Secretary addresses health ministers of 

Central America on pandemic preparedness

June 2006 – CDC issues updated 

Interim Guidance for Laboratory 

Testing of Persons with Suspected 

Infection with Avian Influenza A 

(H5N1) virus in the US

May 2006 – HHS Secretary addresses the World Health Assembly on pandemic flu

preparedness

Stockpiling Other Supplies

HHS has also purchased equipment for the national stockpile. Purchases to date 

include 73.1 million N95 respirators (with an additional 31.8 million on order) and 

37.4 million surgical masks (with an additional 14.1 million on order), as well as 

face shields, gloves and gowns.

HHS has allocated $25 million towards ventilator procurements. Studies are 

underway to determine the most appropriate types of ventilators to stockpile 

for response to a pandemic influenza event. SNS ventilator procurements are 

projected to occur in 2007-2008.

State and Local Preparedness

There is a video on www.pandemicflu.gov that models how a flu pandemic could 

spread across the United States. The model advances roughly two days per 

second. Forty-four seconds into day 85, virtually every county in the country is 

bright red, meaning more than three percent of the population is ill. If the flu is 

highly contagious, that happens in 64 days, and more than half the population 

will ultimately be affected.

What this says is that every state, every county, every community will be 

affected, and they could be affected over a short period of time. There would 

be little opportunity to shift resources from one part of the country to another, 

highlighting the priority of preparedness at all levels and by all sectors of society. 

How you and your community will fare in a pandemic will depend in large part on 

planning and preparations that are put in place today at the state and local level.

That message is well understood. From Alabama, where the Poarch Band of 

Creek Indians and all 68 counties have conducted pandemic planning summits, 

Antiviral Drugs (cont.)

10

“The fact that New York is a 

major gateway to the nation 

and one of the world’s most 

densely populated cities 

means the possibility of 

a pandemic flu, however 

remote, is one that we must 

take seriously” 

–Michael Bloomberg

Mayor, New York City
CERC Tabletop Assumptions

Susceptibility to the virus will be universal

50% of those sickened will seek outpatient-care

Communities should expect multiple waves of infection

Outbreak in each community will last 6-8 weeks

Need for credible information will be vast

•

•

•

•

•

June 2006 – USAID announces $5 million award to

enhance international efforts to track avian influenza

June 2006 – USDA trains foreign scientists on avian

influenza diagnostic testing

July 2006 – New York City Summit

June 2006 July 2006

June 2006 – Congress passes $2.3 billion funding for 

pandemic preparedness

July 2006 - Contract awarded for

 $165,943,000 in antiviral drugs

June 2006 – Indonesia holds H5N1 influenza expert

consultation

July 2006 –Arkansas Summit

to Oregon, which has conducted on-site assessments of the preparedness 

activities of every local health department, state and local governments are 

taking the threat seriously. 

Every state has at least drafted a pandemic plan. The National Governors 

Association, with HHS funding, has launched a major initiative to help states 

with issues such as public health preparedness, continuity of government, and 

maintaining the central functions of society during a pandemic. This endeavor 

will include a year-long series of regional tabletop exercises. Pandemic flu 

exercises have already been held in more than a dozen states, and Michigan 

alone has held eight. Connecticut has held eight editorial board meetings to 

establish, as they put it, a foundation of trust between government and the 

media. Idaho has planned for handling garbage removal and other public works 

when services are not available. And so it goes. 

The planning effort has been encouraged and supported by HHS. In August, 

based on initial state plans, I released an additional $225 million to support 

these tabletop and benchmarking exercises. In 

addition, HHS and CDC are delivering a Crisis and 

Emergency-Risk Communications (CERC) course, 

presenting and applying proven tools and approaches 

to the communication of crisis information.

One of the major planning challenges surrounds 

community-based public health interventions 

such as school closure and travel restrictions, and 

encouraging people to stay at home, out of the way of 

the virus.

With funding from HHS, the Institute of Medicine recently conducted a 

workshop on the role of community-based mitigation strategies during an 

influenza pandemic. Workshop participants were asked to assess how well 

existing computer models can predict the effectiveness of various communitycontainment procedures. They also examined how well such interventions 

worked during previous disease outbreaks, and discussed the potential 

consequences of community containment in a pandemic. Their report is 

expected by the end of the year. 

State and Local Preparedness (cont.)

11
Communications

A Harvard School of Public Health survey released at the workshop explored 

potential community and personal impacts. The encouraging news was 

that a large majority of people surveyed said they would follow public health 

recommendations even if doing that requires major changes in their lives. 

Almost all would stay away from other people if they were infected with a 

pandemic flu; 85% said they would isolate the entire family if any one member 

became ill. 

But while the survey revealed resolution, it also exposed vulnerabilities. Almost 

one in four (24%) said they would have no one to care for them if they were sick 

at home. Roughly the same number (26%) said they would experience severe 

financial problems if they missed even seven to ten days of work, and a majority 

(57%) said they would be in financial trouble if they missed one month of work.

Workshop participants were asked to assess how well existing computer models 

can predict the effectiveness of various community-containment procedures. 

They also examined how well such interventions worked during previous 

disease outbreaks, and discussed the potential consequences of community 

containment in a pandemic. 

In early 2007, a team of pandemic flu experts and communicators will tell meetings of senior news executives that human-to-human transmission of H5N1 

has been identified in a village overseas. Later in the day, they will be told the 

disease has spread across a region overseas. And finally, they will be told that 

human cases have been reported in the United States.

The announcements will be fake, part of an exercise to test how the media – and 

the experts – will respond should the day come when similar announcements 

have to be made for real. The two sides will work through the challenges of getting and reporting timely, accurate information. 

One challenge is how to keep the public informed, without undue alarm, in 

situations where there is high interest and little new information, situations that 

could develop, for instance, while waiting for the results of confirmatory testing. 

The exercise will be repeated in six other cities, reaching national, regional, 

Hispanic and African-American media.

State and Local Preparedness (cont.)

12

“More than three-fourths of 

Americans say they would 

cooperate if public health officials 

recommended that for one month 

they curtail various activities of 

their daily lives.”

–Harvard School of Public Health

October 20, 2006

Aug 2006- Quick Diagnosis of Flu Strains Possible

with New Microchip Test

Sep 2006- FDA Issues Guidance to Industry for 

Developmemt of Cell-based Viral Vaccines

August 2006 September 2006

Aug 2006- New York State Summit

October 2006- California purchases $3.9

million of courses of antivirals

October 2006
The www.pandemicflu.gov Web site continues to grow both in recognition 

and depth of content. More than 1700 Web sites around the world link to the 

homepage alone. The site, managed by HHS, provides one-stop access to all 

federal avian and pandemic flu information. Visitation closely tracks news and 

other media coverage of avian and pandemic flu developments.

Translation into Spanish and other languages is significantly expanding the site’s 

reach. Roughly half of all content is now available in Spanish with translation of 

the entire site due to be completed in December. Selected information is being translated into additional languages; the Pandemic Flu Planning Checklist 

for Individuals and Families has been translated into Arabic, Amharic, Chinese 

(traditional), Farsi, Oromo, Russian, Somali, and Vietnamese.

Functionality of the Web site is also growing with the addition of video feeds. 

Initial implementation are the addition of video clips with HHS and other department experts to augment Questions & Answers. The site offers the capability 

of live-streaming video should developments warrant and on-demand video 

features will be added in the near future.

Public service announcements will be released early in 2007 to direct people 

to www.pandemicflu.gov and to 1-800-CDC-INFO as sources to help people 

“Know What To Do About Pandemic Flu.”

Communications (cont.)

“You have to alarm people 

because until people are 

sufficiently alarmed they’re 

not going to listen to what 

has to happen.”

–Ted Koppel

Meet the Press

December 25, 2005

13