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The Honolulu Advertiser
Posted on: Sunday, November 13, 2005

Hawai'i forces take aim at bird flu

By AUDREY McAVOY
Associated Press

Rear Adm. Robert Hufstader, chief medical officer at Pacific Command headquarters, addressed a Pearl Harbor seminar last month. He wants to educate people to guard against a flu pandemic.

SPC. TIM MEYER | Pacific Command public affairs

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CAMP H.M. SMITH — U.S. military leaders in the Pacific have accelerated efforts to prepare for a possible human flu pandemic by stockpiling antiviral drugs and warning troops to be vigilant about cooking poultry and washing their hands.

This week, officials at the Hawai'i-based Pacific Command plan a workshop to test how ready they are to cope with a pandemic that could put them on the front lines of a global outbreak.

They hope the drill will expose deficiencies so they can remedy them before any real-life crisis hits.

The Joint Chiefs of Staff has ordered all the military's nine combat commands to work on anti-flu strategies. But the Pacific Command, with some 300,000 troops around the region, could face a flu challenge more urgently than others.

The highly contagious H5N1 strain of avian flu has killed at least 63 people in Southeast Asia since 2003. The virus hasn't been known to easily jump from person to person, but experts fear that it may mutate and start doing so, possibly triggering a global influenza pandemic. There were three such outbreaks in the last century.

Rear Adm. Robert D. Huf-stader, chief medical officer at the Camp Smith headquarters of the Pacific Command, said he wants to educate people so they can prepare themselves.

Like many health officials, civilian and military, Hufstader wants to avoid inciting panic.

He said the H5N1 strain of avian flu may never mutate into one easily transmissible between humans. Or if it does, it may do so over time and become less virulent.

Still, Hufstader said, the military wants to be ready for an infectious disease outbreak that could kill millions.

Coping with a flu pandemic would be more difficult than responding to last December's Indian Ocean tsunami, which killed or left missing some 230,000 people across 11 nations, he said.

"The tsunami came and happened, and no one could stop it — and then we all tried to pick up the pieces and deal with the aftermath," Hufstader said in an interview. A flu pandemic would be "an evolving thing that we'll try to identify as quickly as possible and work very hard to mitigate."

Hufstader said the military's infectious disease research labs in Jakarta, Indonesia, and Bangkok, Thailand, were part of an international network with the World Health Organization that was trying to quickly spot any H5N1 virus mutations.

It is unclear whether the military would put its hardware to use to help civilians if a pandemic breaks out. Its helicopters and ships, and its ability to move them quickly, give it capabilities not held by health organizations and other government agencies.

After the tsunami, a U.S. Navy aircraft carrier reached Indonesia within days of the disaster to deliver food and aid to thousands of victims. The U.S. later sent one of its hospital ships to provide badly needed medical care.

Hufstader said the military is still discussing whether the Pacific Command would have any role in quarantining patients or cordoning off areas where there have been outbreaks.

In the meantime, the Pacific Command has been building up its stockpile of Tamiflu pills, the medication viewed as the best available defense against a possible pandemic. The Pacific Command expects its supply to reach 6 million doses by February, or about one-fourth of the U.S. government's stockpile of 23 million.

Hufstader said leaders have not determined how they will use the drugs. In the event of a human pandemic, however, Hufstader said, nurses and doctors treating flu patients would likely be prescribed doses to protect them against contagion.

Experts say the military may also be given higher-priority access to any vaccine that scientists develop to battle a human mutation of H5N1.

Dr. Robert Kim-Farley, a professor of epidemiology at the UCLA School of Public Health, said the military's job to defend the nation created legitimate reasons for this and for ensuring that the armed forces had enough Tamiflu.

He said members of the armed forces would have a higher chance of contracting and transmitting the disease because troops live in close quarters in the field. He said many World War I soldiers caught the Spanish flu in the trenches during the 1918-19 pandemic.

The U.S. military could help other countries by dispatching a hospital ship to help overwhelmed local medical personnel, Kim-Farley said. Or it could help transport vaccines to remote areas.

Hawai'i and Alaska are the only states inside the Pacific Command's area of responsibility, which extends from the U.S. West Coast to the east coast of Africa. So the command's role on the home front would be limited.

In general, any assistance that the armed forces may give to state and local governments would also be limited by the law — in particular the Posse Comitatus Act of 1878, which prohibits the military from acting as law enforcement.

Although President Bush said after hurricanes Katrina and Rita that he was exploring ways to expand the Pentagon's role in major disasters, there is no consensus in Congress and among governors on how that should be done.

Montana Gov. Brian Schweitzer, among the harshest critics of the idea, accused military leaders of being on the path for an "end-run coup."

A flu pandemic, spread rapidly by international travel, may override such concerns, however. Experts say the flu could even take out local police officers, hurting the ability of communities to respond.

"It's conceivable that the scope and scale of this catastrophe, of this disaster, would be one in which traditional lines of involvement of authority might have to be flexible because so many lives could be at stake," said Leonard Marcus, the codirector of the National Preparedness Leadership Initiative at Harvard University.

He said, though, that the first thing the military would have to do in a pandemic is take care of its own.