And even though staff are responding well to the H1N1 outbreak, Margo Lalich, the interim Clatsop County Health Department co-director, warned the Clatsop County Board of Commissioners that her department is one employee away from catastrophe.

"We are responding exceptionally well to the H1N1 outbreak," she said Wednesday. "In our Health Department right now, if we lose one more person our program will shut down. We are at absolute minimum capacity."

Her dire warning came during a work session before the Board's regular meeting in the Judge Guy Boyington Building Wednesday.

Working behind the scenes, even without an outbreak of H1N1 "swine" flu Clatsop County Public Health and Human Services Department employees respond to reports of communicable diseases every day.

The H1N1 virus, which appeared last spring and quickly spread worldwide, remains in the population and is spreading again with the return of the traditional flu season this fall and winter.

After health officials realized the virus was endemic they began making preparations for a pandemic (or a widespread epidemic of infectious disease).

Lalich said that the county's Board of Commissioners acts as the board of health for the county.

As such it should be prepared to declare a health emergency, or a pending health emergency, should the need arise.

Lalich told the Board that the county is not under immediate threat. A declaration would only be necessary if hospitals ended up implementing their emergency management plans for a pandemic, then reached patient capacity.

"It's really what the county's capacity is to manage those cases," she said.

H1N1 vaccines have begun arriving in the county and health workers are distributing them to those who are most vulnerable.

Meanwhile, there's a growing shortage of seasonal flu vaccine. It's possible additional shipments of the vaccine won't arrive on the North Coast until November.

In a successful program just completed, Lalich had received a grant to provide seasonal flu vaccine clinics for elementary school children for free. The cost of the program was $25,000, of which the grant only paid $3,000.

The county applied for and received the grant from the Oregon Public Health Preparedness Program to conduct the clinics, which were aimed not only at vaccinating children against the seasonal influenza virus but also at allowing health department officials to test their plans for dealing with pandemic disease outbreaks or other public health emergencies.

Lalich said she'd like to see the county's part-time health officer, Dr. Tom Duncan, be more involved in preparedness planning.

As state revenue for the Health and Human Services Department has dwindled, it has had to cut back on staff