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Preparations for a global flu pandemic, which many experts believe is overdue, have begun but the grisly details are horrific and the number of sick could quickly overwhelm the health care system.

Needed supplies of even common medical supplies such as surgical masks and gloves are in doubt, not to mention the syringes needed for an as-yet undeveloped vaccine and costly mechanical ventilators.

The H5N1 avian flu virus that has infected flocks on at least three continents and killed 91 people could be the virus that experts fear will mutate into a highly pathogenic form that kills hundreds of millions of people in a matter of weeks or months.

In Seattle, public health officials are weighing the ramifications of hospitals overwhelmed by hundreds of thousands of sick people and the need for thousands of body bags.

"We talk about how people should bury their dead in their backyards, how far from the septic systems," said Dorothy Teeter, director of the King County public health department in Seattle. "In case you're wondering, it's $20 apiece for high-quality body bags. In New Orleans (after Hurricane Katrina) they had to double-bag bodies."

Refrigerated trucks will be needed to ship and store food and medicines and will not be available for corpses, a mistake made by federal authorities who commandeered trucks after Katrina, said James Caverly of the U.S. Department of Homeland Security.

Communicating the truth will be important to deter civil unrest, several experts told the conference. Up until six months ago, the Department of Health and Human Services was planning privately for a pandemic but saying little publicly, said communications consultant Peter Sandman.

The shift may be due to President George W. Bush reading John Barry's "The Great Influenza," an account of the 1918 influenza pandemic during which government assured the public that it was just another seasonal flu outbreak, Sandman said. At the time, Barry said many communities were brought to a near standstill, with people afraid to talk to each other or care for the sick.

"When you mislead people, when you over-reassure people ... they feel less trusting, and they behave much worse," Sandman said.

Conference participants from corporations, interest groups, and government met to discuss revising just-in-time supply concepts in order to stockpile, shutting down and restarting facilities in pandemic-hit countries, and cross-training employees and bringing back retirees to replace a significant portion of their employees that might become sick, decide not to come to work, or die.