PROVIDENCE -- Planning for one-time disasters such as tornadoes, flood or fire is one thing, but planning for a pandemic flu outbreak is quite another, says Dr. David R. Gifford, head of the state's Health Department.

Governor Carcieri has asked Gifford to form and take charge of a "Pandemic Flu Working Group" that will finalize the state's plan for preventing and responding to an outbreak of pandemic influenza in Rhode Island. Carcieri has asked for a report by Dec. 20, Gifford said.

Carcieri also authorized a state stockpiling of flu vaccines, and purchase of "as much of the anti-flu medication Tamiflu as possible."

The governor issued his request a few hours after President Bush unveiled a $7.1-billion plan yesterday to prepare for such a pandemic, or universal outbreak of the flu.

Carcieri said public health and emergency management officials have been working for months to update Rhode Island's plans for dealing with a potential outbreak of pandemic flu.

The Health Department "has already increased surveillance of influenza cases, acquired technology to test for avian flu, developed plans to acquire flu vaccines, and created a directory of Rhode Island's health-care workers so we can better communicate in the event of an emergency. But we must do more."

The working group will include the state's Health Department, Emergency Management Agency, Department of Environmental Management, Office of Health and Human Services, the National Guard, and the Department of Administration.

Gifford said the group will bolster plans for informing the public on how to prevent the spread of a pandemic flu, "how to make sure we have capacity to treat people who are sick, and what to do with people who die."

The goal will be to ensure that the Health Department's plan for a pandemic, and the EMA's general emergency operations plan "dovetail well."

Federal money from Mr. Bush's plan will allow the state to examine, for example, what was learned from Hurricane Katrina, and determine "whether we have any missing holes," Gifford said. Katrina made clear "that some of the historical things we thought would be effective were not effective."

Much of the emergency planning to date involves a potential disaster that "is in a confined geographic location and is sort of self-limited, such as a fire, a tornado, an explosion or even an isolated infection," said Gifford.

Resources from outside the state would be available in such discreet or one-time events, but in a pandemic flu, "the resources from outside will be less available, because everyone will be suffering from this," Gifford said.

If the infection follows the historic course of other pandemics, "it will come in waves of six to twelve weeks, rather than a discreet thing like an explosion, where it happens and then it's over," said Gifford.

And unlike hurricanes, which destroy infrastructure, "a pandemic flu doesn't affect our infrastructure, but does affect our most valuable resources, which is people," Gifford said.

Many people would be dying in a short period of time, "which would overwhelm the current system," he said. Patient overflow could not be sent to other states for treatment, as occurred during the Station fire. The challenge is to build the capacity "to handle that surge of people who are sick."

A pandemic flu occurs "because an existing influenza mutates in a way that makes it significantly different from the previous strain," Gifford said.

But so far, "avian flu has only been transmitted in rare circumstances to humans. We have not seen that sort of mutation that allows the [avian]flu to spread from human to human. Once it starts spreading from human to human, that's when it's likely to have a pandemic. It's a very different flu."

Dr. Timothy Flanigan, head of the infectious diseases departments at Miriam Hospital and Brown University, said he and other infectious disease experts at Brown have been asked to advise the working group.

Flanigan said avian influenza "is a very severe flu-like illness, with very high fevers, with pneumonia and shortness of breath and cough and severe dehydration. Normal influenza can cause pneumonia as well, but avian influenza is much more virulent." It can also cause liver inflammation.

"Avian influenza is enormously challenging, because there is the specter of a terrible pandemic that could lead to awful suffering and loss of life. This will occur if the current H5N1 avian influenza mutates so it can easily transmit from person to person," said Flanigan.

"This has not happened yet, and it probably will not happen, thank goodness. But even though it probably will not occur, there is still a significant chance that mutation could occur," said Flanigan, "and if it does, it will require all of the health sector, as well as almost every other sector in our community, coming together to help fight this illness."

Dr. Christopher Hannafin, state veterinarian, said his department has been working "full bore" for years to prevent spread of avian flu.

He said his office will recommend to the working group "that they include in any of their public education the message that it's mandatory to report avian influenza in poultry and migratory birds."

JOIN A LIVE CHAT with Dr. David Gifford, director of the Rhode Island Health Department, today at 1 p.m. to discuss the possible threat of a pandemic here and what the state is doing to prepare. Plus, find out more about avian flu and share your concerns, at:

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