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CRA Designs First of a Kind Statewide Pandemic Exercise for Utah - If Flu Pandemic Hits, You're on your Own

The Salt Lake Tribune. 09/20/2007

In just eight days, a highly virulent strain of the flu swept across Utah, sickening some 53,000 people.

Health department phones rang off the hook. Emergency rooms and intensive care units brimmed with nearly 8,000 patients. Some 760 people died.

The crisis triggered a ripple effect in Utah's economy, sending gas prices soaring to $5 a gallon and causing 30 percent absentee rates in businesses. Public officials wrestled with difficult questions. Should the state shut down schools? Churches? And how will Utah's small stock of anti-viral medications be divvied up?

Such a mock crisis unfolded this week as part of a three-day, statewide exercise testing the Utah public health system's ability to respond to a flu outbreak. At the end of it, one thing was abundantly clear: Utahns must rely on themselves, not the government, to survive a serious public health crisis, said A. Richard Melton, deputy director of the Utah Department of Health.

"The less they expect to have the government and system take care of them, the better the state will deal with the pandemic," he said.

Designed by CRA Inc., a company that specializes in homeland security exercises, the Statewide Public Health Emergency Response Exercise, or SPHERE, was the first such drill of its kind.

It included more than 350 people from federal, state, local and tribal governments, the health care industry, military, volunteer groups and the community, said Sharon Talboys, project director for training and education for the health department.

Utah's mock flu pandemic was fashioned after the "Spanish Flu" or "La Grippe" of 1918, which killed more than 20 million people - a higher death toll than that of the "Black Death" bubonic plague from 1347 to 1351.

Beginning with a flood of calls from the "public" reporting illnesses, the exercise - based at the health department's Emergency Operations Center in Salt Lake City - was made up of a series of actions.

Agencies had to quickly gather and analyze surveillance data, request anti-virals from the state and national stockpiles and initiate conference calls with other public health officials to discuss the distribution of the anti-virals, the declaration of a public health emergency and closing down public spaces.

The Utah Pandemic Flu Plan outlines most of these procedures, but acting them out even in a mock scenario proved challenging at times, Melton said.

"Clearly there were things that didn't quite work the way that we expected them to," said Melton, who noted that several changes will likely be made to the state plan and tested in smaller-scale exercises.

Among the difficulties they wrangled with was the tough ethical question of who gets the limited supply of anti-virals.

"We had some very interesting discussions during our [mock] policy meetings, both with local health departments and the simulated governor's office," he said.

Many of the same problems posed in the drill would exist if a real outbreak were to happen tomorrow - namely, the lack of anti-virals and the inability of hospitals to treat every sick person, Melton said.

"One of the things [Utahns] will need to be prepared to do is take care of themselves," he said. "It's not unlikely families will be asked to stay home from work. So, the more they had their own personal lives in order, the better Utah will be able to deal with this."

A staff of almost 50 people from the UCLA Center for Public Health and Disasters and from the University of Utah observed the exercise and will provide the health department with evaluations and recommendations, Talboys said.

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