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Pandemic Flu Projection Says More Than Half Million Could Die in U.S.

Chart shows expected deaths, hospitalization, cases by state

June 24, 2005 - Trust for America's Health (TFAH) today released state-by-state projections that found over half a million Americans could die and over 2.3 million could be hospitalized if a moderately severe strain of a pandemic flu virus hits the U.S. Senior citizens and the elderly would be at high risk. Based on the model estimates, 66.9 million Americans are at risk of contracting the disease.

The study also found that the U.S. currently only has stockpiled 2.3 million courses and has placed orders for an additional three million courses of antiviral pharmaceuticals (produced as Tamiflu by Roche Pharmaceuticals), which would likely be available in 2006. This would be enough to cover 5.3 million Americans, leaving over 60 million who could be infected and would not be able to receive medication before an effective vaccine to combat the flu strain is identified and produced.

TFAH's numerical projections are included in a new report, "A Killer Flu? 'Inevitable' Epidemic Could Kill Millions."

"This is not a drill. This is not a planning exercise. This is for real," said Shelley A. Hearne, DrPH, executive director of TFAH. "Americans are being placed needlessly at risk. The U.S. must take fast and furious action to prepare for a possible pandemic outbreak here at home."

"The Government Reform Committee has held several hearings over the last few years to let people know that the flu is not something to take lightly," said Rep. Tom Davis (R-Va.), Chairman of the House Government Reform Committee. "TFAH's report clearly demonstrates that the emergence of a pandemic flu could exact a tremendous toll on U.S. health and economic stability. In order to identify problem areas and prioritize planning and response efforts, the Committee will hold a hearing next week on the threats posed by a potential flu pandemic."

Dr. Hearne will be testifying Thursday, June 30, before the House Government Reform Committee on U.S. preparedness for pandemic and annual flu. Some of the TFAH report's other findings include:

-- While estimates find that over two million Americans may need to be hospitalized during a pandemic outbreak, the U.S. currently only has approximately 965,256 staffed hospital beds.

-- The U.S. has not adequately planned for the disruption a flu pandemic could cause to the economy, daily life, food and supply distributions, or homeland security.

-- The U.S. lags in pandemic preparations compared to Great Britain and Canada based on an examination of leadership, vaccine development, vaccine and antiviral planning, health care system surge capacity planning, coordination between public and private sectors, and emergency communications planning.

TFAH provides a series of detailed recommendations to help ensure the U.S. is better prepared regardless of whether a pandemic occurs as soon as this year or in several years. With a crisis looming, the U.S. plan for the pandemic should be finalized and the President should designate an official with authority to coordinate the U.S. response across federal agencies. Other top-level recommendations include taking:

-- Immediate steps of outbreak tracking, stockpiling medical supplies, and developing emergency communications plans;

-- Intermediate steps of stockpiling additional antivirals and developing surge capacity plans for hospitals and health care providers; and

-- Longer range steps to increase vaccine production and the development of new technologies for vaccines.

As the highest populated state, California could be impacted the hardest, with over 60,875 deaths, 273,090 hospitalized, and over eight million infected people. With 5.3 million courses of antivirals evenly distributed among states, California could face a shortfall of over 7.4 million people infected who could not receive the medication. As the least populated state, Alaska could have 866 deaths, 4,558 hospitalized, 152,328 cases, and an antiviral shortfall of 140,263.

Potential Pandemic Influenza Deaths and Hospitalizations from a Mid-Level Pandemic Flu*

State

Projected Dead

Projected Hospitalized

Number of Cases

Number of Cases Without Tamiflu

Alabama

8,886

38,591

1,079,789

994,263

Alaska

886

4,558

152,328

140,263

Arizona

9,223

39,675

1,138,742

1,048,547

Arkansas

5,350

22,660

630,705

580,749

California

60,875

273,090

8,067,075

7,428,119

Colorado

7,192

32,978

973,161

896,081

Connecticut

7,054

29,932

817,465

752,717

Delaware

1,507

6,560

182,895

168,409

District of Columbia

1,155

4,974

132,241

121,767

Florida

35,737

142,386

3,663,486

3,373,318

Georgia

13,655

62,912

1,871,561

1,723,323

Hawaii

2,446

10,571

296,651

273,154

Idaho

2,279

10,157

302,558

278,594

Illinois

23,720

103,738

2,973,962

2,738,408

Indiana

11,817

51,711

1,466,027

1,349,910

Iowa

6,233

26,090

713,106

656,624

Kansas

5,373

22,946

654,335

602,508

Kentucky

7,930

34,748

977,031

899,645

Louisiana

8,334

37,148

1,087,942

1,001,771

Maine

2,651

11,333

310,513

285,918

Maryland

9,958

44,500

1,273,572

1,172,698

Massachusetts

13,136

56,038

1,529,313

1,408,183

Michigan

19,622

86,005

2,443,473

2,249,937

Minnesota

9,304

40,786

1,171,387

1,078,607

Mississippi

5,362

23,531

682,625

628,558

Missouri

11,274

48,240

1,350,515

1,243,546

Montana

1,804

7,787

219,703

202,301

Nebraska

3,441

14,697

414,218

381,409

Nevada

3,243

14,455

419,202

385,999

New Hampshire

2,333

10,301

293,177

269,956

New Jersey

16,980

72,791

2,013,212

1,853,755

New Mexico

3,244

14,504

432,438

398,186

New York

37,701

162,490

4,534,307

4,175,165

North Carolina

14,987

65,637

1,856,296

1,709,267

North Dakota

1,371

5,795

160,221

147,530

Ohio

23,197

99,979

2,796,583

2,575,078

Oklahoma

6,833

29,376

829,273

763,590

Oregon

6,724

29,047

810,872

746,646

Pennsylvania

27,185

112,658

3,004,915

2,766,910

Rhode Island

2,234

9,263

246,857

227,305

South Carolina

7,474

32,983

940,045

865,589

South Dakota

1,559

6,599

184,493

169,880

Tennessee

10,875

47,678

1,342,050

1,235,752

Texas

35,124

160,648

4,859,834

4,474,909

Utah

3,393

15,906

514,787

474,013

Vermont

1,185

5,213

147,245

135,582

Virginia

13,104

58,872

1,683,499

1,550,157

Washington

10,910

48,610

1,402,591

1,291,498

West Virginia

4,049

17,014

453,947

417,992

Wisconsin

10,620

45,842

1,292,419

1,190,053

Wyoming

915

4,086

119,936

110,436

U.S. TOTALS

541,433

2,358,089

66,914,573

61,614,573

* Projections are based on CDC's FluAid 2.0 program. The estimated deaths are for a pandemic strain three times more lethal than the 1968 pandemic, on which the default FluAid numbers are based. The hospitalization rate is three times the default 1968 rate. The "Dead" and "Hospitalized" numbers represent the"most likely" FluAid projection at a 25% rate of contraction. The "Number of Cases" is the projected number of residents contracting the flu, based on a 25% rate of contraction. State population numbers are from FluAid, using U.S. Census data gathered in 1999. Updated population data were not used to ensure consistency with estimated "Dead" and "Hospitalized" numbers. "Number of Cases Without Tamiflu" is based on state-bystate proportional distribution of the 5.3 million courses of Tamiflu ordered or currently in U.S. federal government possession. For example, California, with approximately 12% of the U.S. population, receives 12% of the Tamiflu in the above projection.

TFAH's analysis, based on the estimates of the severity of the current strain circulating in Asia, follows warnings issued by the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) about the severity of the pandemic, "killer flu" threat. The projections are based on a modeling program developed by the CDC using WHO estimates that approximately 25 percent of countries' populations could become infected and descriptions of the severity of the strain as likely to be in the range between the levels of the extremely severe 1918 influenza pandemic and the relatively mild 1968 pandemic. Some scientists believe the current avian flu strain is on the more severe side of the possible range. The more mild and more severe estimates are also included in the appendix of TFAH's report. TFAH's calculations and related flu materials are available online at: http://www.healthyamericans.org

Trust for America's Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.

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