What will Americans do if bird flu strikes?

According to a recent poll most Americans would comply with government orders to avoid work, school or other public places in the event of a flu pandemic.

In a telephone survey conducted by Harvard researchers, it was found that it would be, initially at least, relatively easy for public health officials to convince most people to temporarily adjust their daily life in order to halt the spread of bird flu during a threatened pandemic.

But, the researchers caution that such compliance would be sorely tested within weeks as wages were lost, and food shortages and demands for medical attention spiraled.

Robert J. Blendon, the author of the report and a professor of health policy at the Harvard School of Public Health, says the big question is, how are essential services to be provided if the the public cannot move about in a normal way?

The survey queried more than 1,700 U.S. adults and 90 percent said they would postpone air travel and avoid public venues like movie theatres and shopping centers if asked by public health officials; 94 percent said they would be prepared to stay home for 7 to 10 days to help authorities control the spread of the disease.

However one in four adults says there is no one to care for them at home if they became sick and more than one-quarter of respondents said they would lose a job or business if they had to stay home for 7 to 10 days.

Only one-third thought they still would get paid if they missed work.

Federal, state, and local officials have been planning for the possibility of a flu pandemic since bird flu began infecting humans in Southeast Asia in 2003.

According to the World Health Organization the H5N1 bird flu strain has to date killed 151 people and sickened another 256.

Almost all cases have been as a result of close contact with diseased poultry but there is worldwide concern that the virus will ultimately mutate and acquire the ability to transfer from human to human triggering a pandemic.

A pandemic could kill millions in a short space of time.

A great deal of time and money has gone into developing an effective bird flu vaccine against the H5N1 strain since 2004 and there is no certainty that any which are developed will be effective against the virus as it mutates.

Vaccine manufacturers would need at least six months to make enough vaccine for all Americans and experts are skeptical that such a vaccine will be available to protect against either the first or second wave of an epidemic.

This essentially means that such basic measures as hand washing and social distancing are likely to be the most effective ways of stemming an outbreak in its early stages.

It is hoped the survey will alert government officials to consider early on how to provide essential services in particular for low income citizens.

One of the lessons of Hurricane Katrina was that poor residents are much more vulnerable when disaster strikes and chaos can ensue when people believe their government is not helping them.

Federal guidelines for pandemic planning issued last year, appears to leave the detailed planning for hospital services, school closings, and emergency response in the hands of state and local planners.

But experts say few hospitals have planned for the surges in patients that would probably turn up for medical attention in the first wave of a pandemic, and few have stockpiled filtration masks or other medical supplies.