I would like to start by introducing Secretary Mike Leavitt, who is going to talk with you a little bit about one of the initiatives. As I think everyone knows, Secretary Leavitt has been an enormous champion of flu preparedness.

And it has really been under his leadership that we have been able to take giant strides towards really digging in, rolling our sleeves up and preparing not only the government but the entire network of communities across out country and across the world. Secretary Leavitt, we would love to hear from you.

MIKE LEAVITT, SECRETARY OF HEALTH AND HUMAN SERVICES: Thank you, Dr. Gerberding. A little over a year ago, the President mobilized the nation to prepare for a pandemic. I traveled to almost every state and territory to hold planning summits. At every level of government our plans are developing and resources have been allocated. Today we are better prepared than we were a year ago, but there is still much to do.

There is also a danger that as avian influenza slips from the headlines that people may begin to believe that the threat is no longer real. The media buzz may have died down, but the H5N1 virus hasn't.

Over the past two weeks, seven cases of avian influenza in humans have been reported and five of those people have already died. To date, more than 265 people have contracted this disease. Dozens of countries across three continents have seen H5N1 claim poultry and kill wild birds. The disease is highly pathogenic. And it continues to spread.

Now we can't be certain that the H5N1 virus will be the spark of the next pandemic. We can be sure that pandemics happen. It happened in the past and they will happen in the future. That is why we continue to take this threat so seriously. Preparedness has to involve planning at every level of government, every school, every business, every church, every civic organization, every family, every individual needs to have a plan.

To make sure that people have the information they need to have effective plans, we are releasing two initiatives today. The first, we are releasing a community mitigation guide. This document helps communities understand the appropriate steps that they need to follow depending on the severity of the pandemic. These steps can include things like closing schools, canceling public meetings, or the need to stay home for an extended period of time. By anticipating the need for these activities, we can execute them more effectively. These steps can help reduce the spread of the disease until a vaccine is available, and that means saving lives.

The second initiative I want to speak about today is a public service announcement or a PSA campaign. This will provide useful tips and it will help people know what to do about pandemic flu. It directs them to a government web site, pandemicflu.gov. There they can get more information.

We have an opportunity to become the first generation in human history to prepare for a pandemic. Let's continue toward that goal.

Now before turning back to Dr. Gerberding, I would just like to show you two of our public service announcements and I want to thank you all for your attention to this very important public health issue.

UNIDENTIFIED PARTICIPANT: Hey dad? Mom? Grandpa? I know bird flu is quite rare in humans, but could that change as the virus changes? Do the experts expect bird flu to have global ramifications? Should we be taking precautionary measures in case bird flu becomes a pandemic?

DR. GERBERDING: Well, as you can see we are reaching out into the communities and doing everything we can to alert people across the whole network that we need to prepare. CDC is one part of the front line of pandemic preparedness, but we're doing today by a number of the other partners who are working with us on these efforts.

And I would just like to acknowledge the tremendous contributions of not only my colleagues at CDC and in the Department of Health and Human Services, but some colleagues who have joined us from other very special components of the effort.

First of all, Dr. Paul Jarris, who is the CEO of the Association of State and Territorial Health Officers, is a true visionary in public health and he represents the whole governmental public health system, both local and state public health officials whose true role is on the front line.

I'd also like to introduce Dr. Carter Mecher who is a member of the Homeland Security Council, the Executive Office of the President and, Carter, you have really been behind the scenes doing the lion’s share of heavy lifting in terms of moving these guidelines through the government and we really appreciate and thank you for your leadership.

I'd also like to introduce Ms. Camille Wellborn, who is the special advisor to the Secretary of the Department of Education. I think one of the most rewarding parts of this effort has been the integration and the close working relationship with Education. And we couldn't have done that without your contribution. So I thank you very much for that leadership.

Not here today is Dr. Richard – sorry - Hatchett who is part of the National Institutes of Health. But he is the person who really first conceived some of the premises that have led to the guidance that we're bringing forward today and we want to acknowledge his intellectual property and his leadership as well.

And then finally Dr. Howard Markel is here from, where are you, thank you, from Michigan, who is one of the modelers and the scientists behind the scenes who have put together a lot of the data that have led to this effort.

On the telephone bridge we have from the Department of Homeland Security Mr. Alfonso Martinez-Fonts, who is the Assistant Secretary for the Private Sector, bringing the private sector into planning and infrastructure and protection of the things that keep society functioning is key to all of this.

And not least of all is Ms. Susan Howe, who is the Deputy Assistant Secretary for Policy in the Department of Labor, recognizing the important role that businesses and workers and employees play in all of this.

So let me start by giving just a little bit of context to how we went about trying to do the kinds of planning that communities need to protect people against flu. We have some premises. As Secretary Leavitt said, pandemic influenza is not necessarily imminent, but we believe it is inevitable. And it is not a question of if. It is a question of when. So we do have to prepare. It would be irresponsible if we didn't continue our planning efforts.

And this isn't just about H5N1 avian flu. This is about any novel influenza virus to which people have not been exposed and to which we might all be susceptible. Planning requires that a whole network is engaged. It means individuals and families. It means communities and it means the whole system of business, education, health care and government really work together so that we have a strong linkage throughout the entire network.

We are only as strong as our weakest link. When we think about preparedness, we have to think about at least four things, plans for sure. We have to think about products like anti-virals and vaccines. We have to think about people who are prepared and trained and know what their role and responsibility would be, whether it is in their family, their workplace or in their government role. But we also have to think about practice. As many of you know, CDC just finished its flu exercise as one component of practice. But what we are really thinking about today is how can we help people prepare and practice for what they would need to do in the context of a pandemic.

Our goal is all of this is to make sure that we do everything we can to save lives. Now we all know that if a pandemic virus emerged, the first thing we would try to do is completely extinguish it or quench it. But that might not be realistic given the speed with which virus can move around the world.

So, the next best thing we can do is to try and slow down the spread and buy some time. The best way to protect people is of course a vaccine. But we are not likely to have an effective vaccine in the first six months of a pandemic. So we have to put our heads together and figure out what can we do in the first six months before the pandemic virus vaccine is available.

We have looked at a lot of information to try to decide what things might make sense for the community for the few weeks that a pandemic is rolling through or threatens to affect them. We have looked primarily at the experience of the last three pandemics.

There has been extensive investigations on a city-by-city basis to look at what do the communities do to protect their citizens, which communities had the worst problem, which communities had the least problem, which communities had the slowest onset of flu cases, so that we could try to get a sense of what seemed to work in 1918 or in previous pandemics.

We have also modeled looking at what we know about seasonal flu transmissions, what we can assume about the transmission of a pandemic virus with various degrees of estimators. And we have been able to draw some important conclusions. One important conclusion is that the earlier you initiate an intervention, the more likely it is to make a big impact.

We have also looked at what we do know about seasonal flu and what we know about interventions that help slow down or prevent seasonal flu in ordinary years.

We have also used some common sense. We have pulled together some experts, really the best experts, not just in government, many of whom are here today, but experts in a multitude of fields and scientific endeavors and perspectives. And I think most importantly in this process, we have listened to people.

We have conducted focus groups and we have tried to understand what citizens are concerned about, what they might do, how long they might be willing to do it and what some of the barriers might be that would prohibit them from being able to do it effectively.

There will be more steps in the future. We are already investing about $5.2 million in research to help us characterize which interventions seem to be most effective, particularly during seasonal flu. We are doing more modeling of course, more sophisticated modeling with more perspectives. We are exercising and we will be seeing local and state governments and their community stakeholders doing a great deal of exercising throughout the next many months.

One of the important investments that we are making with the funding to the states is to provide a set of objectives and criteria for practicing preparedness efforts and response efforts, and we will be requiring that that focus specifically in part on these kinds of community interventions.

We are going to learn from that. One of the important things that we will learn is what looks feasible? Are the things that we are recommending things that communities really can do? What barriers would need to be overcome? What is the down side? What can we learn when people really set out to try to implement them?

And again, we will be asking for input from the public. As people understand what does this mean for my family or my house or my workplace, they are going to have a lot of questions and they are going to bring insights and perspectives that we just don't have right now. We can't anticipate everything. So we will be learning from them.

All this learning means that we have to be prepared, that whatever we are using as a planning tool today is very likely to have to be updated. So you will notice that the guidance that we are talking about starts with a very important word. That word is interim. And we mean something very specific when we say interim.

We mean that this was our best effort right now, pulling everything together what we have looked at. But we fully expect that as we learn more we are going to need to update this planning tool and we will do our best as important updates become relevant to provide refreshed guidance and make that available with information about why the updates were necessary.

I am not going to spend a lot of time going into detail about all the aspects of what is in the document, but I do want to hit a few highlights. One very important, and I think, new concept that we introduced in this planning is the concept that not all pandemics are equally severe and that we can use what we know about epidemiology to create a severity index.

So by that we mean, a pandemic that does not move very fast from person to person, or does not have a very high fatality rate would likely be a fairly mild pandemic. One of our recent pandemics was very mild. And the kinds of interventions that we might recommend in that setting wouldn't be the full court press that we would use if we were dealing with something more serious.

On the other hand, we know in 1918 for example, we had a pandemic that not only moved with extraordinary speed from person to person and around the world, but it also had an unusually high mortality rate. We would categorize that as a category 5 pandemic.

And we use the word category because there is an analogy here to the hurricane analogy. Everyone knows what a category one hurricane is. Everyone understands what a category four or five hurricane is. And we have embedded in our minds some understanding of the difference in severity, of a different level of planning that might be required and the different harm that could come from these kinds of different scenarios.

So as we try to develop protection measures for the community that match up well with the severity, we had to make some assumptions, but we also relied on the models to really help us determine what would likely slow down the spread of a pandemic and save lives.

I have a graphic that I think illustrates what our goal is with all of these interventions. What we are trying to do is take a situation, particularly in a severe pandemic that looks like this, with a very high peak and a very early peak of cases in any given community and spread that curve out over time so there is a lower peak as well as perhaps a total reduction in the number of cases, certainly in the number of cases at any given time.

This is an important goal because it will help save lives. But it will also help decompress our health system and the tremendous burden that a pandemic would place on hospitals and outpatient clinics and intensive care units.

But it may also result in an overall ability of us to sustain society, to continue to have our economies moving, our businesses operating and the critical infrastructure in our communities able to protect citizens and provide for their security and their essential functions.

So this slowing down and buying time is a key principle. We don't expect that we would be able to protect everyone. We don't expect that there would be no mortality or no deaths or no impact from any pandemic. But we do believe we can make a difference and these planning measures are designed to do that.

So, category one planning measures are really those that we would think of using with any infectious disease. Category one would include keeping your hands clean, because we know that viruses can be spread from person to person by touching someone or something that is infected and touching your mucous membrane or your eye or your nose or you