Among the issues decided: Closing schools to slow the spread of disease; stockpiling masks for health-care workers; and using antiviral medicines to treat the sick, rather than to prevent illness.

01:00 AM EDT on Saturday, July 1, 2006

BY FELICE J. FREYER
Journal Medical Writer

Bodies will be piled, respectfully, in ice-skating rinks and refrigerated trucks. Relatives will be asked to identify them by photo rather than direct sight. Trained laypeople will determine that death occurred naturally, filling in for overburdened medical examiners.

Those are among the plans that health officials from seven states agreed on this week, as they considered how state governments would respond to a worldwide flu pandemic. The worst-case scenarios call for such a flu pandemic to kill 2 million Americans and 6,700 Rhode Islanders. That's more bodies than hospital morgues can handle.

Officials from the six New England states and New York met in Boston Thursday and yesterday to begin coordinating their planning for such a calamity.

"It was a very good way for the states to begin communicating about these issues," Dr. L. Anthony Cirillo, the Rhode Island emergency doctor who organized the meeting, said in an phone interview as he was returning yesterday evening.

Cirillo said consensus was also reached on these issues:

Closing schools will be an important strategy to slow the spread of disease, but when they close will depend on where the virus first shows up and how quickly it spreads.

People will not be advised to wear masks in public, because other methods such as covering coughs and hand-washing are more effective. But masks will be stockpiled for health-care workers.

Antiviral medicines will be used to treat the sick, rather than to prevent illness in the well, because there won't be enough for everyone.

Cirillo said that about 180 people, including a number of federal officials and the top health officials of three states, attended the two-day workshop. Eight working groups are examining such issues as laboratory policies and risk communication, and those groups will continue to stay in touch by phone.

The state officials will next gather in late August at the Naval War College in Newport for an exercise. After that, Cirillo said, the focus will be on communicating just as officials would if a flu pandemic struck -- not by traipsing to Boston for a "summit" but by picking up the phone. Working out the details of who will talk to whom when is part of the planning process.

Many experts consider a flu pandemic inevitable. There were three such pandemics in the 20th century, and there is no reason to think this century will be different. When a lethal strain of bird flu recently passed from birds to people in Asia, scientists became concerned that the next pandemic would soon reach our doorstep.

ffreyer@projo.com / (401) 277-7397