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"If this thing rages for a year, all of this is academic, all of these stockpiles. Because we're going to burn through all of that. So we have to have plans," said Stewart Simonson, assistant secretary of the U.S. Department of Health. "Health care may end up looking, for a little while . . . more like the '50s. And we may run out of rubber gloves. So we're going to have to have some way for people to sterilize their hands so they can safely do things. We've got to start thinking that way, I think." Weighing on the minds of those deliberating is the fear that, while health-care workers will be desperately needed during a pandemic, some may refuse to show up for work if they feel they are not adequately protected. Ontario nurses are already raising the issue, complaining that the federal government is stockpiling inexpensive surgical masks rather than the more costly N-95 respiratory masks.

And those involved in discussions over the use of masks recognize their advice has to cover both what might be best if it is workable, and what might be an acceptable alternative if best isn't available. "It's going to be important to establish the ideal and then plan for the real event," said Dr. Michael Osterholm, an infectious disease expert who has been warning of the amplifying effect the global just-in-time distribution system will have during the next pandemic. "And the real event, we'll be seriously short of many of those essential goods and even some services that we count on on a routine basis," said Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.