A worldwide outbreak of bird flu could kill four times as many people as the Spanish flu outbreak of 1918.
In a worst-case scenario, up to 150 million people around the globe would die, including nearly 27,000 Coloradans.
People with severe fever, aches and difficulty breathing would overwhelm emergency rooms and doctors' offices in Colorado Springs.
During an initial wave lasting six to eight weeks, vaccines would either be unavailable or in such short supply that only hospital workers, police, public officials and other essential staff would receive them, according to emerging plans.
"Remember, it's just a worst-case scenario," says Dr. Ned Calonge, Colorado's chief medical officer.
About a week ago, hundreds of people attended an El Paso County Health Department forum intended to raise awareness of the potent A-H5N1 "bird" flu virus, or avian flu.
Attendees were told to stock up on items like canned food, beef jerky and peanut butter. They were told to buy 14 two-quart bottles of water enough to last a single person one week. They were reminded to update first-aid kits and even to keep warm clothing on hand, such as gloves, should heat become unavailable.
"If it comes, the key to handling it will be a concerted response," says El Paso County Public Health Administrator Rosemary Bakes-Martin.
Federal, state and local governments don't have the resources to handle a pandemic alone, she says, adding that everyone must take some responsibility. Businesses, for example, should plan to grant more sick time to keep infected workers out of the office. Volunteers will be needed in hospitals, neighborhoods and elsewhere.
Although the federal government recently provided $1.6 million to Colorado for flu-fighting medicines, other supplies and training, Calonge says it isn't enough to fight the worst-case scenario.
Exacerbating preparedness problems are cuts to public health departments in recent years.
In 2002, state legislators eliminated roughly $5.6 million in population-based spending that helped local health departments fund public health initiatives. El Paso County, which recently became the state's most populated county, has lost about $700,000 annually since then, Bakes-Martin says.
In addition, county commissioners cut roughly $1.2 million from the department over the past three years a situation that prompted layoffs. The department now is at a bare minimum, says Bakes-Martin.
El Paso County allocates $6.61 per resident to the health department, putting it among the least supportive counties along the Front Range. In 2005, Pueblo County spent $10.25 per resident, and Boulder County $16.30.
Should a pandemic hit, the county would likely shift workers from other areas, as it did when it reassigned food inspectors in 2003 for several months to help combat the harsh West Nile virus season.
County Commission Chairwoman Sallie Clark says the health department appears to be doing everything it can and should to prepare for a pandemic. She adds that commissioners are scheduled to review the department's budget in August.
At this time, additional cuts aren't planned, Clark says.
The virus is soon expected in North America. It will arrive from Asia via geese that migrate through Alaska and, eventually, to Colorado, Calonge says.
Yet a pandemic might result only if the virus also mutates to a strain more easily transmitted from person to person.