Wednesday, September 2, 2009

D.C. Area Officials Coordinate Flu Fight:

Planners Use Post-Sept. 11 Response To Cut Through Jurisdictional Jumble

By Michael Laris
Washington Post Staff Writer
Wednesday, September 2, 2009

Top officials from Maryland, Virginia and the District met Tuesday to coordinate plans for fighting the swine flu, taking advantage of a structure set up after the Sept. 11, 2001, terrorist attacks to try to sharpen the region's response to outbreaks expected this fall.

The governors of Maryland and Virginia joined D.C. Mayor Adrian M. Fenty (D) and Homeland Security Secretary Janet Napolitano on a day when President Obama said "every American has a role to play in responding to this virus."

Each jurisdiction is shaping its own plans for dealing with the H1N1 virus as students return to school and the end of summer leads into flu season. But officials said the jumble of jurisdictional lines in the region demands particular vigilance in what might seem the most mundane of tasks: communicating.

"These borders are permeable. I didn't have to show my passport when I entered the District today," said John M. Colmers, secretary of Maryland's Department of Health. "You have people who may work in a school in the District but live in Maryland, and the other member of the family works in Virginia. So you've got to figure out ways of talking with one another" and smoothing possible jurisdictional complications. One example: making sure that health workers who commute to another state can get vaccinated where they work so it's easier to make sure everyone in a hospital or other setting is covered.

Health workers are among five groups of people at the top of the federal priority list for the vaccine, which local officials expect to begin receiving in mid- to late October. The others are pregnant women, people 6 months to 24 years old, family members of or people who work with children less than 6 months old and some people with chronic health conditions.

At each opportunity, officials from the local level to the White House have sought to hammer home a stable of basic precautions: wash hands frequently, sneeze into a sleeve so you don't wipe germs on everyone you touch, stay home if you're sick.

At an Alexandria elementary school Tuesday morning before the meeting with officials from the other jurisdictions, Virginia Gov. Timothy M. Kaine (D) got some lessons in hand-washing, and the state's top health official outlined emerging plans for a months-long H1N1 flu vaccination campaign this fall.

With cameras capturing every dribble and splash, a line of children from Samuel Tucker Elementary School showed the governor how to soap up. In perhaps the most responsible bout of hand-washing ever pursued by someone who's not a TV surgeon, a student named Michelle lathered up while silently running through her ABCs to make sure she continued long enough. Another student shared the old paper-towel-on-the-faucet-handle trick.

"I never heard that one before," Kaine said.

Virginia Health Commissioner Karen Remley said health and schools officials are still hashing out decisions on the state's vaccination program. They expect to be offering voluntary shots or nose sprays once they get doses of the vaccine from federal health officials. Schools, health departments, doctor offices and malls are among the places where health workers will be set up, she said.

Similar plans are also being put in place in Maryland and the District. In Maryland, for instance, there are more than 1,000 registered vaccination distribution points, most of them at doctor offices. Officials said a map of the sites will be released shortly.

Remley said every Virginian who wants the vaccine will be able to get it within two or three months after it becomes available. But she, Kaine and others repeatedly sought to discourage a general rush in the first few days the vaccine is available.

Remley said she planned to wait until November to get vaccinated. Other healthy people who are at lower risk should also think about their neighbors and wait a while, she said. "This really is a time for us to function as a community," she said.

Officials also say people should get a regular flu shot, available now, both to stay healthy and so that they know their symptoms are the swine flu if they end up getting sick later in the year.

Beyond issues of vaccine stores and timing, the conversation among some budget-strapped officials Tuesday turned to money. Maryland Gov. Martin O'Malley (D) said there have been deep cuts in states such as his, but he's encouraged by the federal assistance and cooperation he has seen.

"These cuts to public health and local health departments do affect our public health response," O'Malley said, "and at the same time, the truth remains that we have to find a way to accomplish this mission of a mass vaccination nonetheless. Fortunately, we have partners in the federal government that are helping us to do that."
Fenty said the region has proven capable of coordinating its efforts since 2001.

"Our region is as prepared as any I think you'd find anywhere in the country or anywhere in the world," Fenty said. "We're going to keep striving to make sure that, as much as possible, we've got an airtight plan should anything happen and we need to communicate and resolve something."

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