An eight-week outbreak of avian influenza in Hawai'i could overwhelm the state's healthcare system, killing 1,000 people and sending 5,000 people to hospitals for acute care, a health official told state lawmakers yesterday.

"The effects of a large hurricane, tsunami or other natural disaster would pale in comparison," said Toby Clairmont, the emergency program manager for the Healthcare Association of Hawai'i, which represents hospitals, long-term care, home-care and hospice providers.

The estimate, based on a planning tool from the federal Centers for Disease Control and Prevention, assumes 25 percent of the state's population would be infected and there would be one casualty surge during the outbreak.

State House lawmakers held an informational briefing to discuss the potential impact of the bird flu on the Islands. The Lingle administration has asked for $15 million to stockpile antiviral drugs and create a data management system to monitor illnesses.

The deadly flu has been limited mostly to people who come into contact with infected poultry in Asia. But it has raised fears of a pandemic if a subtype of the virus emerges that can be easily transmitted by people. There is no vaccine to protect people from the bird flu, but antiviral drugs such as Tamiflu and Relenza may reduce its severity.

Clairmont said state officials and healthcare providers are storing equipment and supply caches at hospitals, creating mobile treatment centers on O'ahu, Maui, Kaua'i and the Big Island, and building a state cache of medical supplies and equipment. The state hopes to have special medical and disaster response teams, along with emergency teams at hospitals, ready for an outbreak within 45 days.

Increased screening of travelers at airports might help prevent the flu from entering the Islands now, since outbreaks have been mainly isolated to people infected by birds in Asia, but will likely not be an effective barrier if a strain of the virus spreads rapidly among people, health officials said. Federal authorities have the power to quarantine travelers who might be infected and officials have designated Gate 34 at Honolulu International Airport as a possible quarantine site.

"I think it's the weak link and what troubles me the most," state Rep. Kirk Caldwell, D-24th (Manoa), said of the risk at airports.

People who become sick with the flu but are not hospitalized likely would be asked to stay at home, raising questions about how they would receive food and medical care. The state also would have to decide who gets antiviral drugs from the stockpile, especially if the outbreak is larger than anticipated.

"We do have some daunting operational challenges," said Linda Rosen, deputy director for health resources administration at the Department of Health.

Clairmont, asked if his estimates were too alarming, said the threat is real. "We're talking about 5,000 patients," he said.

Reach Derrick DePledge at ddepledge@honoluluadvertiser.com.