Review:  Hawaii’s plan was last updated in December 2005.

 

It is tightly linked to the WHO staging system. Declaration of phase 4 triggers a number of actions including confiscation of antivirals from pharamacies. Community quarantine is possible. Work quarantine for essential workers (SARS in Toronto as the model). Reasonable force authorized for non-compliant people. Restricted movement of sections of the community. Restriction on use of private vehicles and closure of roads possible.

 

The plan is relatively serious. What’s interesting is that all this is based on a mild pandemic with a .3% CFR. This CFR was recommended by the CDC Pandemic Influenza Planning Conference held in Denver Colorado in February 2005.

 

So, it appears that the official CDC recommendation to States is to prepare for a mild pandemic. This is built into the Flu-Surge program that states are encouraged to use for planning purposes. In contrast, another group with HHS has created a Pandemic Influenza Tabletop Exercise Package in 2006 that encourages planning for a CFR of 5%. Obviously states that use the Flu-Surge program will be much less prepared for a severe pandemic than states the use the HHS Tabletop Package. What I wonder is: Do all state governors know about the 5% figure from the HHS Tabletop Package? If they do, why aren’t they urgently updating their plans?