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US Public Health Workers May Not Work in Flu Pandemic

A new study shows that Americans might not be able to count on public health workers, if an influenza pandemic strikes. Researchers find that nearly half of public health employees would be unlikely to work during a major flu outbreak.

The Bush administration is preparing a national plan to respond to a pandemic, if bird flu adapts to human transmission, but the study indicates that public health workers might confound the arrangements.

Researchers at the Johns Hopkins University in Baltimore and Ben-Gurion University of the Negev in Israel interviewed more than 300 public health workers in three counties in the mid-Atlantic U.S. state of Maryland. They chose these counties because they are comparable in size to those served by the vast majority of the nation's public health departments.

Johns Hopkins physician Daniel Barnett gives the startling main finding:

"Forty-six-point-two percent of the workers surveyed stated they are unlikely to report to duty during an influenza pandemic," he said. "That is almost half of the public health workforce."

Barnett says only one-third of those surveyed even felt knowledgeable about the public health impacts of a flu pandemic.

The findings are similar to a larger survey done last year among 6,200 New York City public health employees, half of whom said they would be unwilling to report to work during an untreatable infectious disease outbreak.

A breakdown of the data in the Maryland study shows that doctors and nurses were more likely to say they would report to work, while technical and support staff, such as clerical workers, were the least likely. Barnett says this is because technical and support personnel do not perceive themselves as important as clinical staff, but he says their perception is wrong.

"This is critical, because people who answer telephones, people who perform the basic computer technician activities, for example, in health departments, are really the glue that will keep the public health infrastructure running during an influenza pandemic," emphasized Barnett.

The researchers say current U.S. pandemic preparedness plans take into account some health personnel shortages, due to illness from influenza, but Barnett says public health workers are clearly not prepared for a crisis.

"I think, we need to reassess how we are doing training for public health workers in the United States, addressing willingness to respond as a variable in our curricula, not just knowledge and skills," he said. "We cannot assume that, just because we are training people in skill sets, that they will take those skill sets and willingly apply them."

Barnett's study appears in the April issue of the journal BMC Public Health.