If a deadly flu virus spreads across the entire globe — a scenario becoming more and more likely, experts say — medical care will be only one of the many challenges Hawai'i will face.

"Think about SARS, or post-9/11, when transportation was basically shut down," said Sarah Y. Park, deputy chief of the state Health Department's disease outbreak control division and chairwoman of the state's pandemic flu preparedness working group. "We're five hours out from the closest land mass, and that's by plane. Only about 5 percent of our industry is agricultural."

Food and other items will be in short supply, she said, and the problems won't stop there.

The state has a Pandemic Influenza Preparedness & Response Plan, which concentrates on medical care as well as surveillance, testing and quarantine.

The Health Department will get $11.3 million for medicine and supplies to be used if there is a pandemic, under an emergency appropriation bill that Gov. Linda Lingle signed yesterday.

But state officials say more needs to be done.

One initiative, launched this week, is a public awareness campaign featuring a Web page with tips on how residents can prepare and updates on avian flu cases in Europe and Asia.

Another push will involve working with others — including utilities, other state agencies and businesses — to further prepare.

With that goal in mind, the Health Department, which is taking the lead in state pandemic flu preparation, is sending out about 300 invitations for the mid-June meeting on O'ahu, Park said.

"We're calling it the 'Pandemic Flu Preparedness Working Meeting,'" she said, "because we want everyone to understand they'll be working. We won't just be giving them information."

The idea is to get the experts talking about the possible scenarios, and how to best deal with the problems likely to arise in the event of a pandemic or other emergency, she said.

Perhaps most importantly, the participants need to think beyond their own expertise, and decide how to help one another, she said. After the meeting, participants are expected to communicate the information to their peers.

"We (at the Health Department) don't know all of the answers," she said. "We can take care of healthcare and infection control, but food supplies and drinking water are out of our scope. We can't take on security, tourism, banking and utilities."

The number of participants was limited to 300 in order to facilitate discussions, she said. The focus will be on statewide and O'ahu concerns, but Neighbor Island participants have been invited with hopes that they will then host other meetings in their counties.

"We're also hoping to invite everyone back later," she said, "to see what other ideas they might have had."

State officials know 25 percent to 30 percent of the population could be affected by a pandemic, and other parts of society will be crippled and further planning is needed, Park said.

"If the sanitation workers all get sick," she said, "or the hotel workers are afraid to come to work, who will do their jobs? If we don't collect the garbage, other health issues could arise."

Problems with public transportation and communications could bring all other services to a halt, she said. All the respirators in the state won't help the sick if there is no electricity to run them.

School officials must decide when canceling classes is appropriate, she said, and how children will be educated if the classroom is no longer an option.

"I've even heard of scenarios where ATM machines ran out of cash," she said.

These are the types of problems the state Health Department wants business, community and state and local government officials to address.

Reach Karen Blakeman at kblakeman@honoluluadvertiser.com.