Federal officials say the first case of bird flu could show up in the United States in the coming weeks or months as birds migrate from overseas. President George W. Bush is expected to approve a national response plan in the next week or two laying out how agencies should respond if it were transmitted to humans.
The plan assumes a worst-case scenario that as many as 90 million people in the U.S. would become sick and 2 million would die during a worldwide flu pandemic.
It envisions people may need to avoid human contact and stay home from work, school and other large gathering places, according to officials familiar with draft. Some details of the draft, first in Sunday's Washington Post, were confirmed by officials at the White House who spoke anonymously because the plan has not been finalized.
Dr. Bruce Gellin, director of the National Vaccine Program Office at the Health and Human Services Department, said the report builds on the strategy that Bush outlined six months ago — new flu-vaccine technology and greater stockpiles of vaccines and antivirals.
The government had focused on health issues in that earlier report, but a pandemic would affect every aspect of government, Gellin said.
The response plan, assembled by the president's Homeland Security Council, lays out who should be the first vaccinated, proposes that other countries make U.S. money if domestic locations cannot operate. The plan anticipates that employees could strain Internet capacity while working from home computers.
The U.S. has had such money agreements with allies in the past in case of emergency, a White House official said, but there is no current arrangement. Congress approval would be needed for a new deal.
The Veterans Affairs Department has developed a medical exam that could be conducted in VA hospital parking lots, with those who suspect they may be infected able to get a quick exam. The program is modeled after a drive-through flu vaccination program conducted last year.
Dr. Anthony Fauci, the National Institutes of Health's infectious disease chief, said in an interview with The Associated Press last week that scientists are debating whether to vaccinate first those most likely to spread the virus, rather than those traditionally first in line for winter flu shots, including the very old, very young and chronically ill. That policy still is under debate, he said.