Bird flu is an ocean away and may never mutate into a pandemic virus. Still, Utah health officials are coming up with a plan, just in case — and are hoping to engage lawmakers, transportation officials and others to start planning, too.

It is estimated that a flu pandemic similar to the influenza of 1918 could kill 1.5 million Americans. "We have the ability to reduce the number of deaths. That's why we're developing a plan," explained health department spokesperson Steve McDonald.

"I don't think it makes sense for people to be scared," said Utah Department of Health epidemiologist Dr. Robert Rolfs. "But people like me should be concerned. I don't think fear that is more than just awareness of risk is appropriate, because (a pandemic) may or may not happen. But I do think we should take it seriously" so that the right decisions are made.

There's only so much the health department can do, Rolfs said. After that it's up to legislators to provide funds for vaccines, for example, and up to the private sector to help figure out how to ration those vaccines if there aren't enough to go around.

"I can't buy a stockpile of antiviral medications with my existing budget," Rolfs added.

The Utah Department of Health will discuss the current state of its pandemic influenza preparations at a meeting of its Health Advisory Council 1 to 3 p.m. Wednesday.

A Pandemic Planning Committee, made up of representatives from state and local health departments, the American Red Cross and physicians, has been meeting for more than a year to come up with a detailed strategy. Rolfs is currently condensing that plan into a public policy document.

"To make a difference, this plan has to involve the whole community," Rolfs said. Hospitals, for example, have to plan how to best care for people when there are more patients than beds. "We're at the point where we have to decide how do we engage those people. How do we engage the community in a practical way?"

What happens, for example, when so many people are out sick that there aren't enough workers to pick up the garbage or drive buses?

As part of its immunization grant to states, the federal Centers for Disease Control requires that each state come up with a pandemic influenza strategy. Even though the threat of a worldwide pandemic has been around for a while, Rolfs said, "two things pushed us to take it more seriously" — a series of emerging disease threats, including SARS and monkey pox — and, more recently, the emergence of avian flu.

Only 117 people, all of them in Asia, have contracted bird flu; 61 of these have died. Currently the virus has spread mostly between birds, and only occasionally between birds and humans — and only in cases where people have worked with poultry. The virus would have to mutate in order for it to be transmitted from person to person.

Right now it's just an avian flu, not a flu pandemic. "Those are two separate things. But people are mixing it up," Rolfs said.

The state's pandemic influenza plan is, at present, specific to bird flu but can also be used for other pandemics, he said. "We're trying to come up with something so that when the next thing comes along, we can pull (the plan) out of the closet, tweak it and make it generally applicable."

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