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Under a flu outbreak, will U.S. quarantine?

Two experts discuss the possibility of entire towns being sealed off

There's a growing fear of a bird or Avian flu virus. It has killed at least 60 people in Asia in the past two years, and could become a worldwide pandemic, with predictions ranging from the possibility of 100,000 to two million people dead in this country. 

At the White House last week, the president talked about the real possibility of imposing a quarantine.

"If we had an outbreak somewhere in the United States, do we not then quarantine that part of the country and how do you then enforce a quarantine.  One option is the use of a military disable the plan and move, and so that's why I put it on the table," President Bush said.

But is using the military the best way to deal with it and would it mean that neighborhoods would literally be sealed off

Greg Evans, director of St. Louis University's Institute for Biosecurity and Dr. William Schaffner, chairmen of Vanderbilt University's Department of Preventive Medicine, joined MSNBC's Dan Abrams on Tuesday's 'Abrams Report' to discuss whether a quarantine could work.

To read an excerpt of their conversation, continue to the text below. To watch the video, click on the "Launch" button to the right.

DAN ABRAMS: All right, Dr. Schaffner, let me start with you.  Look, you are hearing the president there talking about the real possibility of a quarantine; you're saying it won't work?

DR. WILLIAM SCHAFFNER, VANDERBILT UNIVERSITY:  Well I think it'll be very hard to make it work.  Certainly initially we want to diagnose the imported cases very quickly and institute a voluntary quarantine of their contacts.  But we are going to get repeated introductions and influenza spreads much more rapidly than SARS.  So the notion of kind of walling off a neighborhood or something like that is unlikely to be very, very effective.  It really hasn't worked for respiratory disease like influenza in the past.

ABRAMS:  This is what the president had to say about isolating it.

-- Begin video clip -- BUSH:  Obviously, the best way to deal with a pandemic is to isolate it and keep it isolated in the region in which it begins.  As you know, there has been a lot of reporting of different flocks that have fallen ill with the H5N1 virus.  And we have also got some cases of the virus being transmitted to person and we are watching very carefully. -- End video clip --

ABRAMS:  Dr. Evans, if this becomes as serious as it sounds like it might, do you think quarantine may be the only option?

GREG EVANS, ST. LOUIS UNIV. INSTITUTE FOR BIOSECURITY:  Yes, I think quarantine is one of the only tools that we have.  It's how that quarantine is carried out.  I'm not certain that using the military to actually cordon off a city is the right way to handle it.

ABRAMS:  Why not?

EVANS:  Well because I don't think it will work.  I mean American people won't stand for it.  But you can use the military in an effective way.  You can have people quarantined, mandatory quarantine in their homes and the military then has responsibility for bringing food, water to the homes of the people that are quarantined and then at the same time can make sure that the people are under quarantine.

ABRAMS:  How do you deal with the fact that the military people are going to be bringing food, et cetera, are going to be then exposed to the virus?

EVANS:  Well I mean that is true but they can take protective actions.  I mean someone is going to have to and you can't quarantine people without providing them with provisions.  Is that a possibility?  I mean there are protective measures that can be taken.

The military certainly is in a position to learn what those protective measures are using masks and other type of protective clothes and would probably be the best group to be able to do this.  We have no other large-scale group that would be able to serve this function during a quarantine.

ABRAMS:  Michael Leavitt, the health and human services secretary said this: "It will require school districts to have a plan on how they will deal with school opening and closing.  It will require the mayor to have a plan on whether or not they're going to ask the theaters not to have a movie, et cetera."

You wouldn't disagree with that, Dr. Schaffner, would you?

SCHAFFNER:  Oh absolutely not.  In fact we encourage it.  There is going to be a federal plan, there are state plans, local plans.  Indeed my own institution has a plan and we have drilled it further, and so, I think it will be very important to put the emphasis on local public health and local security folks, the local municipalities to control the introductions.  I think the military can be terrifically helpful in moving vaccine and moving drugs from point to point around the country.  I don't think they are going to be terribly useful going door to door.  There are just not going to be enough of them.

ABRAMS:  Dr. Evans, are we going to really see thousands of Americans dead because of this?

EVANS:  Oh yes, I think that there's no doubt.

ABRAMS:  Really?  No doubt?

EVANS:  There's no doubt if this comes about, there will be thousands of Americans dead.  However, what we want to do is reduce the number that are going to die.  I mean some people are going to die.  There's no question about it.  I don't believe that the local authorities, particularly what we have seen after Katrina, are in a position to be the most effective individuals to actually carry out the logistics of quarantine and isolation. I think that we have to have a federal response to do this.

ABRAMS:  And Dr. Schaffner, I was reading a 'Men's Health' article today.  They were saying that young people could be the ones who are most at risk, at least based on the 1918 flu?

SCHAFFNER:  Well that was the 1918 flu.  We have had two other pandemics in '57 and '68 in which that was not the case.  We will just have to see.  In any event, Dr. Evans is correct, if we have a pandemic, it will have a major impact on our society, and we would all work, federal and local, to mitigate that impact.

Watch the 'Abrams Report' for more analysis and interviews on the top legal stories each weeknight at 6 p.m. ET on MSNBC TV.