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2001 Anthrax Attacks Highlight Needed Improvements in Public Health Response, GAO Says By Mike Nartker WASHINGTON — Congressional auditors have found through interviews with public health officials that the response to the 2001 anthrax attacks, which killed five people, demonstrated that further improvements were needed to better respond to future incidents, according to a U.S. General Accounting Office report released yesterday (see GSN, June 26). The GAO report, based on interviews with officials from the Health and Human Services Department and Defense Department as well as state and local officials, comes two years after the first reports of anthrax infections in the eastern United States (see GSN, Oct. 10). Those infections, caused by a still-unsolved act of biological terrorism, demonstrated areas of improvement for U.S., state and local officials concerning biological response, the report says. According to the report, the U.S. Centers for Disease Control and Prevention was “challenged” to both coordinate the federal response to the anthrax attacks, which occurred in five states, and to help support state and local response efforts. The CDC has acknowledged that it was more effective in aiding state and local efforts than in managing the overall public health response, the report says. It also says that the anthrax attacks demonstrated the CDC’s difficulties in managing the large amounts of information that was coming into the agency at the time and in communicating with public health officials, the media and the general public. The report also notes, however, a number of efforts initiated by the CDC following the anthrax attacks to better prepare for a future act of biological terrorism. For example, the agency has restructured its director’s office, enhanced the agency’s communication infrastructure and has worked to develop a database of information and expertise on biological weapons agents, the report says. It also notes that the CDC has increased its collaborative efforts with other agencies, such as establishing a permanent liaison to the FBI. In an attached response to the report, Dara Corrigan, Health and Human Services acting principal deputy inspector general, outlined a number of efforts her department took outside of the CDC both during and following the anthrax attacks. For example, during the attacks the office of the Health and Human Services secretary established an ad hoc emergency operation center to help coordinate the efforts of all department assets, Corrigan wrote. Following the attacks, Health and Human Services undertook a number of “significant actions” to improve preparedness for a future act of biological terrorism, such as creating the Office of Public Health Emergency Preparedness and accelerating the acquisition of antibiotics for the National Pharmaceutical Stockpile, she wrote. In its report, the GAO also said that the anthrax attacks demonstrated a lack of available treatments and vaccines against the disease. In addition, the attacks also indicated that many doctors did not have the training to recognize and respond to anthrax, which rarely occurs in the United States, according to the report. Congressional auditors also found through interviews with state and local public health officials both areas of strength and of needed improvement in their response to the anthrax attacks, according to the report. For example, state and local officials said their planning efforts had helped in enacting a rapid and coordinated response and that their response had benefited from previous experiences, such as other public health emergencies or training exercises, the report says. It also says, however, that the officials acknowledged that they had not recognized the level of coordination that would be needed across public and private entities involved in responding to the attacks and that they had difficulties in reaching local doctors to provide them with “needed guidance” In addition, the report says, state and local public health officials also said that the capacity of their workforce and of their clinical laboratories had been strained by the attacks. They also said that their responses would have been “difficult to sustain” if the attacks had been more extensive, the report says. In a press statement yesterday, Senate Majority Leader Bill Frist (R-Tenn.) praised the GAO report and the progress made in improving national preparedness against future acts of biological terrorism. “Today’s report effectively contributes to our base of knowledge about the anthrax attacks and the public health response — helping us understand what worked and what didn’t, and detailing what has been accomplished since that time to better prepare the nation against this threat,” said Frist, who commissioned the report. “The anthrax attacks two years ago demonstrated that much work was needed to prepare our nation against the threat of bioterrorism. I commend [Health and Human Services] Secretary [Tommy] Thompson and the [Bush] administration for their aggressive efforts to build on our experiences and better prepare the nation against these deadly threats,” Frist said. Earlier this week, however, Senator Joseph Lieberman (D-Conn.) criticized what he described as a lack of progress in improving biological terrorism defenses. In a press statement Tuesday, Lieberman said the United States continues to lack effective countermeasures against anthrax and that emergency response personnel still lack needed funding. “The casualty potential of a biological attack is far greater than any other mode of terrorist attack we have seen to date and the administration’s progress has been negligible,” Lieberman said. “We clearly are not prepared for a serious bioterror attack. And we need to undertake bold, new steps to get ready,” he said.
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