Hurricanes inspire rankings of flu outbreaks

WASHINGTON — The government will grade the severity of the next flu pandemic just like forecasters grade hurricane strength — with a ranking system unveiled Thursday to help states determine when they should take increasingly strong steps to combat the flu's spread.

At issue are old-fashioned infection-control measures that may help slow the spread of the next worldwide outbreak of a super-flu until vaccines become available, steps that range from home quarantine to closing schools and postponing sporting events.

But those measures can increase a pandemic's economic fallout and even have unintended consequences. Closing schools, for example, can keep adults home from work to care for children. And it doesn't help if older kids go sneeze on each other at the mall.

The new guidelines, from the federal Centers for Disease Control and Prevention, don't tell states what infection-control steps to take — and make clear that rushing to implement them could do more harm than good.

Instead, the new "pandemic severity index" suggests when a super-flu's threat becomes great enough to justify gradually escalating those strategies.

The top example: Just as coastal communities don't evacuate for a Category 1 hurricane, schools shouldn't close for a Category 1 flu pandemic. But if the next pandemic appears to be a super-lethal Category 5, the guidelines recommend states close schools for up to three months.

"Not all pandemics are equally severe," Dr. Julie Gerberding, the CDC's director, said Thursday in unveiling the new guidelines.

"Everyone knows what a Category 1 hurricane is, everyone knows what a Category 4 or 5 hurricane is and ... the different harm that could come from these kinds of different scenarios," she explained.

It is advice that states, grappling with exactly how drastic their pandemic preparations should be, have been awaiting anxiously, said Dr. Robert Stroube, Virginia's health commissioner and president of the Association of State and Territorial Health Officials.

"You kind of plan for the worst, but the odds are it won't be," Stroube said.

Utah health officials got their first look at the 108-page document Thursday afternoon and it will take some time to see how Utah's plans, being developed by a governor's task force and multi-agency collaboration, fit in, said Susan Mottice, an epidemiologist in the Utah Department of Health.