Pandemic plans ready in Eastern Iowa: Health officials plan for the worst, but don’t expect it

Don't expect mass vaccinations, cots stretched across school gymnasiums or quarantine orders as Iowa's public health system faces the H1N1 flu.

Those plans exist.

Health experts, however, don't envision such extreme measures being needed anytime soon to combat the virus, commonly called swine flu.

“This is nothing to panic over,” said Tricia Kitzmann, deputy director of Johnson County Public Health. “We're prepared for this. We're ready for this. We've been planning for this for years.”

Plans in Linn and Johnson counties include what would happen in a worst-case scenario, akin to the 1918 pandemic that killed up to 40 million people worldwide.

Sites, including schools, are identified in both counties for “surge” capacity - where patients would go if hospitals become overcrowded. They are not publicly identifying those sites at this time.

Both counties have stockpiles of several hundred cots that could be used in such wards.

In Johnson County, health care workers from Mercy Iowa City, the Veterans Affairs Medical Center and University of Iowa Hospitals and Clinics would rotate staffing such wards.

Curtis Dickson, director of Linn County Public Health, said plans are under way in Linn County for a medical corps with health care volunteers and retirees for staffing.

As it stands, the likelihood of rolling out any cots is slim, Dickson and Kitzmann said.

Rather than a 1918-type pandemic, both public health officials want employers, parents and others to prepare for weeks of inconvenience.

Parents could need to stay home taking care of ill children and miss more work if they, too, become sick.

Recommendations call for staying home until one is fever-free for 24 hours without the use of fever-reducing medications.

Seasonal flu typically hits the elderly hardest. But the H1N1 virus is disproportionately affecting children and young adults. Up to half of the work force could be absent during an outbreak.

Dickson said the most vital measure employers can take is to allow sick workers to stay home.

The virus is highly contagious, and some fear a mutation could make it more deadly.

Should that happen, quarantine or isolation orders that force people to stay at home or at a specified location could be issued, said Kitzmann, who added that such orders are extremely rare.

An H1N1 flu vaccine should be ready by October, but mass immunization clinics are unlikely, at least in early stages. Rather, Dickson said, flu shots initially will be allotted in small increments.

Federal H1N1 vaccines go to the Iowa Department of Public Health, then on to local health departments. Information should come this week on Iowa's supply.

In Linn and Johnson counties, those first shots will go to pediatricians, ob-gyn doctors and others who see pregnant women, young patients and other priority groups. The vaccine is free, but offices may charge an administration fee.

Although considered a priority for seasonal flu, adults over age 65 may have immunity from past exposure to a similar flu and won't be first in line for the H1N1 vaccine.

Seasonal flu shots don't provide protection against the H1N1 strain, but are encouraged for staying healthy.

Antiviral drugs, such as Tamiflu, can make the illness milder, but Dickson and Kitzmann said those should be reserved for people at highest risk of becoming seriously ill.

Doctors should not prescribe antivirals for everyone who asks, and stockpiling is discouraged. Stockpiling face masks to wear in public - a measure that proved ineffective in Mexico's H1N1 outbreak - is also discouraged, Dickson said.

The only stockpiling Kitzmann recommends is making sure people have ample supplies of food, tissues and over-the-counter medications, so sick people won't have to leave home.

Public health departments work together in regions to prepare for emergencies. Region 6, which includes Linn, Johnson and a dozen surrounding counties, contains one-third of the state's population, said Julie Stephens of Linn County Public Health.

Stephens' new role as emergency preparedness and disaster recovery specialist points to the time and dedication put into preparation efforts.

She is getting H1N1 information to churches, businesses, schools and the public.

Thousands worldwide have been infected, and 593 have died in the United States, including one Iowan.

Better vaccines and antiviral drugs should keep the pandemic in check, Dickson said.

“It's not a 1918 episode,” he said. “We need to keep things in perspective.”