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Northcom branches out to fight flu link

Peterson Air Force Base - Military commanders called together government emergency-response officials recently for a brainstorming session at this Cold War base turned headquarters for homeland defense. But rather than dirty bombs or suicide attacks, they wanted to talk flu.

Convinced that pandemic influenza inevitably will strike inside the United States, military leaders contend the failure of civilian agencies after Hurricane Katrina could happen again. It's an example of how U.S. Northern Command military forces charged with homeland defense quietly are assuming broader, non-traditional roles.

Those perched around conference room tables here knew the latest worst-case scenario assessments too well: pandemic flu could kill as many as 2 million Americans.

The recent spread of the H5N1 bird-flu virus to birds in Africa and southeastern Europe, just as birds begin seasonal migrations, has piqued concerns the virus could mutate to spread from birds to humans and among humans. Experts say that could touch off a global pandemic.

At the meeting here, civilian officials could only dream of acquiring the beds, vaccines, ventilators and worldwide outbreak-detection data available in the military system. Health and Human Services officials say these military assets could more than double the national capacity of 970,000 staffed beds and 100,000 ventilators.

But Northcom chiefs emphasized: the military system would treat soldiers, veterans and their families first.

Northcom spokesman Lt. Cmdr. Sean Kelly said military capacity figures "aren't available yet, but we do not believe we'd be able to double the national capacity."

Yet, spurred by President Bush during his recent visit here, Northcom officials are preparing to:
* Share early-warning data on outbreaks with civilian health authorities.
* Inspect passengers at airports and seaports for signs of flu.
* Slow travel and help police communities short of attempting fullblown quarantines.
* Move medicines to hard-hit areas and victims to clinics for treatment.
* Back up civilian doctors by working shifts at overloaded hospitals.
* Possibly share vaccines, beds, and ventilators.

"This thing could hit next week, for all we know," said Col. Joseph Bassani, Northcom's chief of planning.

While defense once meant mobilizing armed forces to confront foreign armies and control turf, homeland defense forces over the past year participated in activities ranging from border control to firefighting.

On Monday, Northcom convened military and National Guard leaders to talk about how to handle hurricanes this year.

Bush has said the military would play an important role in responding to pandemic flu. Bush also said that "the best way to deal with a pandemic is to isolate it in the region in which it begins," and suggested Congress debate quarantines.

Civilian response leaders here - representing diplomatic, environmental protection, emergency management and transportation agencies - welcomed the prospect of military support.

Military forces "have assets we don't have. They move tons of equipment every day. They're also the best at planning," said Lynn Slepski of the U.S. Public Health Service, now serving as a senior health advisor in the Department of Homeland Security.

Compared with civilian hospitals that often are hard-pressed to meet non-crisis needs, the military's medical system can treat thousands of soldiers in critical condition at once. Fixed and mobile clinics give a "surge capacity" that civilian health officials in cities such as Denver are struggling to arrange.

After Hurricane Katrina, military doctors and nurses treated hundreds of victims. Helicopters evacuated victims to the 500-bed USS Bataan floating hospital.

Military medical teams track disease outbreaks by testing tissue and blood samples at surveillance centers in Egypt, Kenya, Indonesia, Thailand and Peru.
Meanwhile, civilian hospital emergency rooms turn away as many as 500,000 people a year, according to recent studies.

The new defense budget includes millions of dollars to prepare for pandemic flu, including streamlined vaccine production.

If pandemic influenza strikes, the military likely will be needed to stabilize communities and enable an effective response, said Colorado College professor Andrew Price-Smith, author of "The Health of Nations," an authority on pandemic threats to the economy and security.

U.S. communities aren't as cohesive as in the past, and "the fragmentation in the government response evident in Katrina is, unfortunately, likely to be replicated during a pandemic," Price-Smith said. "Do we rely on the military to make up for the diminished capacity in various states? Unfortunately, we are going to need their resources. The question is: How much can the military assist?"

Government worst-case scenarios suggest pandemic flu could infect 90 million Americans, with half needing medical treatment. Up to 40 percent of workers would stay home, and the economic impact could match that of a major recession, according to a new Congressional Budget Office assessment.

The pandemic flu in 1918-19 killed more than 500,000 Americans and 50 million worldwide.

The problem, military leaders told civilians here, is that military facilities likely would be overwhelmed, too.

These exist primarily to serve soldiers and their families, and they'd be treated first in a pandemic, said Navy Adm. Timothy Keating, chief of Northern Command, in an interview.

"Our job in the Department of Defense is principally to fight and win the nation's wars," Keating said. Tens of thousands of soldiers deployed in Iraq and Afghanistan "need to know that their families are being taken care of. That's a significant effort." But "simultaneously, or as soon as we can," military forces would mobilize "to stabilize and ease human suffering," Keating said.

Military planners said soldiers would not attempt large-scale quarantines. Quarantine "really isn't effective with influenza, because influenza is so contagious," said Dr. Tanis Batsel, Northcom's chief of preventative medicine.

Americans likely would stay home anyway, she said. "Most convincing will be that people are going to be dying. Everybody will know somebody."
Soldiers instead would screen travelers at airports, and perhaps restrict movements of those who are infected.

Homeland defense officials also plan an aggressive public information campaign: Vaccinate. Follow cough etiquette. Wash hands. Avoid large groups. Reach out to the homeless and infirm.

By calling civilian emergency planners together, Northcom hoped to encourage agencies "to come up with requests for assistance" as soon as possible, Batsel said.

Then military chiefs can review them and "give a reality check."

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