Hawai'i health officials have begun implementing parts of a statewide pandemic-flu preparedness plan, including the re-establishment of an emergency medical clinic at Honolulu International Airport, one of the first places in the state the flu may show up.

The state Transportation Department this month began seeking a new provider of medical services at the airport. Part of the facility's requirements would be to help DOT officials train staff, educate the public, evaluate passengers who may arrive in Hawai'i with symptoms of a new flu strain and, when necessary, provide emergency medical treatment.

The airport facility and its flu- preparedness duties are just one aspect of what health officials say is the first implementation stage of a sweeping plan approved last year to mitigate the local effects of a possible worldwide outbreak of a killer flu strain.

"We've done the plan, and now we're doing the heavy lifting of putting it into place. Execution is the difficult part," said Dr. Paul Effler, the state's chief epidemiologist.

Unlike the airport facility, much of the other work is being done out of the public eye by public health planners, government officials and, increasingly, local business leaders. Once a worldwide flu outbreak is identified, a big part of the plan calls for businesses and individuals to take extra precautions to ensure the health of their employees and to keep the economy running as smoothly as possible.

"Our whole idea has been to develop a plan that would minimize any disruption to our business in the event of an outbreak," said Ray Trombley, corporate business continuity manager for Bank of Hawaii, one of the first Hawai'i companies to develop a comprehensive strategy for dealing with a pandemic.

20,000 VISITORS EACH DAY

A pandemic is any disease outbreak that spreads over a wide geographic area and affects a large proportion of the population. In 1918-1919, for instance, an influenza pandemic killed between 20 million and 40 million people worldwide and about 500,000 in the United States. Health officials fear that a similar outbreak today could spread far more quickly around the world and cause even more deaths.

In November 2005, Hawai'i became the first state to screen incoming passengers on a voluntary basis for signs of bird flu or other viruses. The state, with about 1.3 million residents, has about 20,000 airline passengers every day.

The Honolulu airport lost its emergency medical provider late last year when a contract with The Queen's Medical Center was not renewed. Since then, police, fire and trained airport personnel have been the primary providers of medical services while the state seeks a new clinic operator, said DOT spokesman Scott Ishikawa.

"The primary responsibility is to provide emergency medical care at the airport in the event of an accident or disaster," Ishikawa said.

But the DOT's new guidelines also will require the company to assist the state in meeting its pandemic preparedness goals by collecting disease data and diagnostic specimens, and enacting preventive measures and treatments. State officials hope to have the new service in place by April, Ishikawa said.

Meanwhile, Health Department officials have made significant progress in implementing other parts of the plan approved last summer, Effler said.

DRUGS STOCKPILED

Among the accomplishments so far, according to Effler: the stockpiling of enough anti-viral drugs to treat at least a quarter of the state's resident and visitor population, development of a laboratory capability in Hawai'i to test for avian and other flu strains, an improved system to have doctors report early signs of a severe flu outbreak, and an increasing effort to take anti-flu planning beyond the government and into the business and education communities.

"Many of the things that should be done in a pandemic are the same ones that are prudent to do now" to reduce chances of getting a less severe seasonal flu, he said. The winter flu season in Hawai'i has been relatively mild so far, in part because there are more than adequate vaccine supplies available, he noted.

"We need to start changing the etiquette so that things like covering your mouth when you cough, washing your hands, and not showing up for work when you are sick become second nature right now," he said.

REDUCING CONTACT KEY

If a pandemic flu does strike, social distancing — reducing the number of people gathered in different places — will be a key element in containing it, Effler said.

At the Bank of Hawaii, which has about 3,000 employees, officials have already developed individual preparedness plans to cover almost 40 branches and other business units. The plans rely heavily on reducing contact between essential employees during an outbreak, Trombley said.

"Our No. 1 goal is to control the spread of the infection," he said.

The bank's plans include quickly implementing restrictions on all-but-essential business travel, limiting group meetings, updating security procedures, expanding leadership succession lists and dispersing staff.

Reach Mike Leidemann at mleidemann@honoluluadvertiser.com.