AFTER WORKING on its pandemic flu plan for 14 years, the federal government might have been expected to come up with a full blueprint of how the country would prepare for and respond to an epidemic comparable to the one that killed 20 million worldwide in 1918. But that is not at all what President Bush unveiled this week. The report includes recommendations for acquiring flu vaccines and improving the process of making them, but it states that it is not an ''operational plan," and it leaves in doubt who will be in charge if the lethal H5N1 strain of avian flu suddenly mutates and becomes easily transmittable from person to person.
That has not happened yet and might never. Still, the fear of this possibility has pushed the administration to put forward a plan that has been long in the making but remains short on specifics. ''New Orleans had a plan, too," is the dismissive but not unfair reaction to the report of Dr. Nils Daulaire, president of the Global Health Council.
Congressional staffers who have studied the US plan compare it unfavorably to those of other nations. Those other plans have detailed descriptions of the steps that different levels of government would take in the event of a major outbreak. The administration damns itself with its statement from the plan: ''It is unlikely that there will be sufficient personnel, equipment, and supplies to respond adequately to multiple areas of the country for a sustained period of time."
By all means, the United States should acquire stocks of any avian flu vaccine that is available and of antiviral medications like Tamiflu. But congressmen and state health officials have criticized the plan for expecting that individual states will be responsible for supplying almost half of the national store of antiviral drugs. This could result in harsh disparities if some states simply lack the means to buy the medication.
The plan calls for $100 million for state and local health departments to draw up their own flu plans. But at the same time the administration is proposing a $130 million reduction in funds these same departments get from Washington for preparedness work.
The plan also fails to learn lessons from its smallpox vaccine program of two years ago, when many healthcare workers refused to take the vaccine unless the government promised them compensation for any debilitating side effects. This time, too, the plan includes no provision to help anyone adversely affected by a vaccine.
Republican Senator Arlen Specter of Pennsylvania is one of the plan's strongest critics. He has called on Health and Human Services Secretary Michael Leavitt to come up with more information. The country is far from prepared for a viral Katrina.