When state officials learned of a probable Minnesota case of swine flu, they needed to make several key decisions and make them quickly.
But the governor, health commissioner and state epidemiologist were not making many of those calls on the fly. They were largely following a detailed plan developed specifically for this type of a potential health emergency.
Governor Tim Pawlenty says he was alerted Tuesday evening that health officials suspected a case of swine flu. The Minnesota Department of Health had a lab sample from an unidentified patient in Cold Spring, but for confirmation, it needed further tests at the Centers for Disease Control and Prevention. With a state plane at his disposal, Pawlenty made an executive decision to get the sample to Atlanta as quickly as possible.
"During those discussions, we directed that the sample be flown to the CDC, be there this morning, so that we could potentially get the results in this business day, as opposed to having it sent down starting with this business day, and getting it late tonight or tomorrow," he said.
Pawlenty says he participated in several late-night and early-morning conference calls. At about midnight, he was on the phone with the superintendent of the Rocori School District. Health officials say the patient is linked to the Rocori Middle School and the nearby St. Boniface school in Cold Spring. Pawlenty says CDC guidelines recommend closing a school when there's a confirmed or suspected case of the flu. The governor could have ordered the school closed, but he let the superintendent make the call.
"He also has authority to close the school. And he took the step and the initiative to close the middle school and sent out notification to the parents and the communities at approximately 6:00 a.m. this morning before school started," Pawlenty said.
Pawlenty says the state is well-prepared to respond to an influenza outbreak. As a member of the National Governor's Association, Pawlenty was co-leader of a task force that developed a national model on the topic. He says concerns about an avian flu threat a few years ago resulted in important upgrades at the Minnesota Department of Health and the stockpiling of anti-viral drugs.
Dr. Ruth Lynfield, the state epidemiologist, is also confident about Minnesota's plan for a health emergency. Lynfield says the state works frequently with local public health officials on exercises that prepare them for a flu outbreak.
"We have been preparing for this for almost 10 years," she said. "When we called the public health agency at 2:00 in the morning to talk about this, the person who answered the phone was someone I have worked with in the past. It was a very easy conversation because we've already worked together and established trust."
Lynfield and other state health officials have been on the phone all day following up with health care providers about the alert and reminding them to remain vigilant. They're also continuing their investigation into the Cold Spring case.
Dr. Sanne Magnan, Minnesota's health commissioner, says there's an intense surveillance effort underway statewide.
"Hospitals and doctors have been asked to evaluate patients with respiratory illness and to send those specimens to the health department for further evaluations," she said. "And any test that is found to be suspect is forwarded to the CDC for more testing and to confirm that it's this novel influenza strain."
There's no vaccine yet for the strain, but Magnan says other anti-viral drugs are effective against it. She says the state's current stockpile is 400,000 doses, with another 200,000 on the way from the CDC. If the swine flu spreads in Minnesota, Magnan and others will face one of their toughest decisions -- who gets medication and who doesn't.
Magnan says a confirmed case will ramp up the state response. But she says those next-step efforts to control an outbreak would largely rely on Minnesotans taking care of themselves and staying home if they're sick.
"It would only be in rare situations that we would ever go to mandatory quarantine or isolation."