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WASHINGTON - The government forecasts massive disruptions if bird flu or some other super-strain of influenza arises, with as much as 40 percent of the national work force off the job, but it doesn't foresee closing U.S. borders to fight the spread, according to a draft of the national response plan obtained Monday by The Associated Press.

An outbreak could lead the government to limit international flights, quarantine exposed travelers and otherwise restrict movement in and around the country.

But a complete shutdown of the border would not be likely, nor would it do more than slow the pandemic's spread by a few weeks, according to the plan that is being finalized by Bush administration officials for release Wednesday at the White House.



"While we will consider all options to limit the spread of a pandemic virus, we recognize complete border closure would be difficult to enforce, present foreign affairs complications and have significant negative social and economic consequences," the 228-page draft report says.

Pandemics can strike when the easy-to-mutate influenza virus shifts to a strain that people have never experienced, something that has happened three times in the past century. The government is preparing for a worst-case scenario of up to 2 million deaths in the United States.

It's impossible to predict when the next pandemic will strike, or how great its toll might be. But concern is rising that the Asian bird flu, called the H5N1 strain, might lead to one if it eventually starts spreading easily from person to person.

So far, H5N1 has struck more than 200 people since 2003, killing about half of them. Virtually all the victims caught it from close contact with infected poultry or droppings.

The plan says preparedness for a pandemic could take years, and so significant steps must be taken immediately across all levels of government and the private sector to protect national security, the economy and the basic functioning of society.

The report aims to energize the private sector, noting that 85 percent of the systems that are vital to society, such as food production, medicine and financial services, are privately run.

Q&A: Bird flu

AFP - Getty Images
• Facts not fears
Questions and answers about avian influenza


"While a pandemic will not damage power lines, banks or computer networks, it has the potential ultimately to threaten all critical infrastructure by its impact on an organization's human resources by removing essential personnel from the workplace for weeks or months," the report says.

Telecommuting urged
Not only would sick workers stay home, but so would anyone who caring for ill family members, under quarantine because of possible exposure to the flu or taking care of children when schools shut down. The same could go for anyone who simply feels safer at home.

Included in the report's advice for employers: Have workers remain at least three feet apart or otherwise limit face-to-face contact to limit the flu's spread, including by working from home or substituting teleconferences for office meetings.

The report envisions possible breakdowns in public order and says governors might deploy National Guard troops or request federal troops to maintain order.

Last fall, President Bush announced a $7.1 billion strategy to fight the next flu pandemic, focusing largely on public health preparations — including plans to stockpile enough bird flu vaccine for 20 million people and anti-flu drugs for 81 million. So far, the stockpile contains enough vaccine for 4 million people and medication for 5 million.

This new report is Step 2, outlining how every branch of government would have to work together with federal health officials to try to contain a pandemic and minimize its damage to the economy and society. By early next month, government agencies are to release the specific steps they plan.

The report attempts to settle any turf battle within the administration, saying the Department of Health and Human Services would lead the government's interagency response effort and the Department of Homeland Security would have a secondary role to assist with the health response and non-medical support.

If a pandemic begins abroad, federal health officials are guaranteed to take certain initial steps, such as screening travelers arriving from affected areas and putting the possibly infected into quarantine. Ship and plane captains already are required to report certain on-board illnesses upon arrival, but crews would be trained to take such steps as putting a surgical mask on a coughing traveler.

Delaying the inevitable
With no border restrictions, pandemic influenza would arrive in the United States within two months of an outbreak abroad, the document estimates. But models of influenza's spread suggest that sealing the U.S. border would not only be impractical — 1.1 million people cross the nation's 317 official ports of entry daily — but it would only delay the inevitable by a few weeks, it says.

Domestically, Americans take an average of 1.1 billion trips a day — four for every person.

INTERACTIVE




The new document promises that the Bush administration will create a "toolkit" of options to help mayors, governors and transportation officials decide what, if any, restrictions on that travel would be appropriate at different stages of a pandemic. It calls mandatory quarantine a last resort, and urges planners to consider, for example, that closing a community would sever it from the delivery of groceries and other essential goods.

The military could be activated to enforce travel restrictions and deliver vaccines and medicines, the report says.

Colleges should consider whether dormitories could be used to house or quarantine the sick, and establish mandatory sick-leave policies for anyone exposed to the flu.

Repeatedly, the report stresses that government must provide accurate and timely information to citizens, who could either help or hinder flu's spread through their own actions.

"The collective response of 300 million Americans will significantly influence the shape of the pandemic and its medical, social and economic outcomes," the report says. "Institutions in danger of becoming overwhelmed will rely on the voluntarism and sense of civic and humanitarian duty of ordinary Americans."

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