Inside the War Room: Amid Many Unknowns, An Avian Flu Battle Plan Emerges Here

The conference room in the basement of Pitt’s housing department was suitably grim for the task. With its laminated table obliquely wedged in an airless chute, there was no historic vista or architectural grandeur to distract.

But the mission that April day in 2006 seemed monumental in its own right: Work with 20-some University administrators to devise a plan for action should avian flu, then emerging sporadically and deadly in scattered locales across Asia and eastern Europe, morph into a pandemic that threatens Pitt’s people and campuses.

At first it seemed like a fair fight, with some of the best medical expertise in the world, internationally renowned faculty researchers, versatile communicators, and a score of experienced administrators coming to bear against a virus targeting birds halfway around the world.

But after weeks of research, the mining of the expertise of our best and brightest, and several very impressive flow charts, here’s what we didn’t know:

What would the virus be after mutating from the one that now infects birds and only rarely humans mutates to one easily transmissible from one human to another? How virulent would it be—would it sicken like the seasonal flu, or kill? How fast might it spread? Would there be enough time before it comes our way for vaccines to be developed?

Where in the world would it start—in Indonesia, or in Oakland? How many people might get sick? If we dispersed our campus population, how would they get home? What if “home” is Singapore?

Would classes continue? Would the University’s computer system still run if key personnel weren’t working? Who supplies food if our food suppliers are shut down because of sickness?

Can we learn anything from the flu epidemic of 1918? Hasn’t the state of medicine come so far that we’ll undoubtedly be safer than in that earlier episode? But doesn’t the frequency of air travel make us less safe?

That was just the start of what we didn’t know—and what we slowly came to realize, may not be knowable.

Through dozens of sessions, most of them led by Pitt’s Environmental Health and Safety Director Jay Frerotte, a perfect combination of John Wayne confidence and Mr. Rogers sensitivity, we struggled to think about the unknowable. Slowly—painfully—a strategy began to evolve.

Other universities around the country were also devising their strategies, and all were sharing. The pool of information was expanding, and so was our creativity: We may not have known a lot about the bug, but we knew people, planning, decision-making in rational organizations, and the uniqueness of Pitt.

One thing that was growing clearer: In the event of a pandemic, every area of endeavor on our five campuses would be affected and every department would have to react. Our team of 20 pandemic planners soon grew to 60 as we reached out in concentric circles to more areas of campus life and the greater community.

Sixteen months later, a summary of the resulting plan has been placed on Pitt’s Web site: www.pitt.edu/avianflu/plan.html. It is a framework for a plan, actually, that will be adjusted as new and better information about the virus becomes known.

Some of the missing details on how Pitt will respond will be added as complex questions are answered over time. But the advance planning, even if imperfect, should allow for a smart, fast, and comprehensive reaction to any infectious emergency. Perhaps this would not have been possible if the messy, persistent, intimate, and generous tangling of experts had not occurred in a war room too small to flee. Now we hope to clutter that room even more by adding a small shelf upon which will rest an avian flu plan that Pitt will never, ever, have need to open.