25% Of Japan Could Be Infected In H5N1 Pandemic

Source The announcement Friday that the government had included a project team's proposals on measures to combat a possible outbreak of a new strain of influenza in its latest basic policy outline of economic and fiscal reforms has brought realization of these plans a step closer. The proposals, which cover measures for preventing a flu outbreak, argue that the issue should be considered as part of a crisis-management strategy by the government and emphasized the importance of crossing boundaries between ministries and agencies. But the plans stopped short of mentioning how local governments and medical institutions should respond, indicating there is still some work to be done. Bird flu, which some fear could mutate into a new strain of influenza that can be transmitted from person to person, has badly hit other parts of Asia, especially Indonesia, where it had claimed the lives of 243 people as of June 19. The government predicts that if such an outbreak occurred in Japan, as many as 32 million people, or 25 percent of the population, could be infected, with as many as 100,000 patients a day needing to be hospitalized, and possible fatalities ranging between 170,000 and 640,000. The proposals cover 60 wide-ranging items, including the possibility of having the Self-Defense Forces help Japanese return from a country where an outbreak occurs, and what the Japan Coast Guard can do to prevent those infected with bird flu from entering Japan. The project team emphasized that action is needed at the highest level, and that preventing an outbreak should be taken as seriously as contingency planning for terrorism and rioting. However, only two numerical goals requiring a budget allocation were mentioned--one on shortening the period necessary to produce a vaccine after an outbreak occurs, and one for increasing stockpiles of antivirus medicines. Other measures proposed in the package lacked detail, and it is therefore unclear if the government can allocate funds. "Under the tight budget conditions we face, I'm not sure it's feasible," one senior Health, Labor and Welfare Ministry official said. Prefectural governments, which will be responsible for actually implementing any measures, have also raised concerns over the team's work and the fact it postponed making any firm decisions on key issues, such as deciding in which order of priority vaccine stockpiles should be used. Under a 2007 central government action plan for dealing with new strains of influenza, prefectural governors can request that residents refrain from holding gatherings or even restrict the movement of residents. But there are no laws in place obliging people to comply with such a request, and although some local government heads have pressed for some sort of resolution to this problem, the proposals only cited the need for legislative action as such restrictions might infringe constitutional rights. "We'll have to deal with an outbreak without necessary authority," one local government official said. Medical institutions face similar uncertainty. Though prefectural governments are required to have hospitals set up dedicated outpatient departments for a new strain of flu, only a small number of hospitals have so far cooperated. Prof. Hitoshi Oshitani, a researcher of virology at Tohoku University, said: "Japanese measures tend to focus on preventing a virus from entering the country. We also need an approach similar to the United States, where they prioritize preventing the spread of infections, if necessary through a a combination of measures including movement restrictions, closure of schools and vaccination programs."