U.S. Response: Focus Should Shift to Public Health System, Experts Say

Bioterrorism discussions should focus on strengthening the public health system and preparedness rather than on antibiotics or vaccines, according to some health experts (see GSN, Sept. 28).  “For bioterrorism, the No. 1 inadequacy, if you rank them, is the inadequacy of our public health infrastructure.  This is a product of about 15 years of neglect,” said U.S. Senator Bill Frist (R-Tenn).

Many problems face the U.S. public health system, according to the New York Times.  Doctors are poorly trained to recognize symptoms of possible biological warfare agents, such as anthrax, which can resemble the flu.  Many hospitals lack necessary equipment, in some cases even tools like fax machines, to receive or report information in an emergency.  Government agencies cannot agree on what diseases are the biggest threats -- with the Centers for Disease Control listing smallpox as a major risk and the FBI not even placing smallpox on its list.  Two important health positions, commissioner of food and drugs and director of the National Institute of Health, remain unfilled.

While a number of federal agencies have established bioterrorism response teams and there has been steady improvement in laboratories on testing and identifying biological agents, it is a patchwork set against the larger arena of cities, states, and counties all with their own reporting requirements and plans (Sheryl Gay Stolberg, New York Times, Sept. 30).

U.S. Health and Human Services Secretary Tommy Thompson has said that the United States is prepared in the event of a biological attack. “We’ve got to make sure that people understand that they’re safe.  And that we’re prepared to take care of any contingency, any consequence that develops from any kind of bioterrorism attack,” Thompson said.  There are eight staging areas around the country that are each stocked with 50 tons of medical supplies including vaccines, antibiotics, gas masks and ventilators, that can be moved to the site of a biological attack within hours, according to Thompson.  There are also 7,000 trained medical personnel ready to respond, Thompson said (Associated Press/Salon, Sept. 30, 2001).

Some public health officials agree that the United States is better prepared than it was three or four years ago, but worry that improvements still need to be made in identifying when a biological attack is under way.  “We are not going to have a bomb fly out of the sky and land on somebody so that we can say, ‘Look, there’s a bomb, and we are all dying of anthrax,’” said Asha M. George, who studies bioterrorism for the Nuclear Threat Initiative.  “It is most likely going to be a covert release, and people will get sick and go to their hospitals, and the public health system will have to pick up on this,” George said (Stolberg, New York Times).

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