U.S. Better Prepared for Bioterrorism Attack, Health Officials Say

WASHINGTON —  After 11 months of preparing for the worst, the nation’s top health officials sought Tuesday to assure Americans they are much safer from a bioterrorism attack than they were a year ago.

At the same time, they said, much remains to be done to prepare the nation for a smallpox, anthrax, plague or other bioterror attack that government officials are convinced is all but inevitable.

Mindful that the coming Sept. 11 anniversary retrospectives will turn an analytical eye on what the government has done to protect Americans from future terrorist attacks, government health officials in Washington and Atlanta, headquarters of the Centers for Disease Control and Prevention, touted their accomplishments and highlighted some of the remaining challenges.

“We are much better prepared than the American public thinks we are,” Tommy G. Thompson, secretary of Health and Human Services, told reporters after addressing the first meeting of his public health preparedness advisory council.

“We will continue to do as much as we can as fast as we can,” Dr. Julie Gerberding, director of the CDC, said at a teleconference in Atlanta. “We are scaling up, speeding up and streamlining.”

Indeed, an alphabet soup of government agencies at federal, state and local levels has worked with uncommon speed and coordination--and a tenfold increase in federal funding--to prepare for a bioterrorism attack.

The integration of public health agencies and private health care providers at all levels is critical because “bioterror agents don’t recognize borders and they don’t recognize ZIP codes,” said Robert A. Malson, president of the District of Columbia Hospital Assn.

Among the concrete results of the year’s work are improved communication networks, modernized laboratories, health care workers who are better able to recognize the symptoms of a bioterror attack, stockpiles of antibiotics and vaccines that can be delivered anywhere in the country within 12 hours, plans for hospital isolation rooms and off-site treatment areas, and strategies to vaccinate as many as 1 million people in 10 days.

“If we can prepare for the worst, we ought to be able to handle anything less than that,” said Dr. Lisa Rotz, chief epidemiologist for the CDC’s bioterrorism preparedness and response program.

In some cases, however, preparation will require difficult, somewhat political, decisions.

While Thompson praised his department for arranging to have more than 209 million doses of smallpox vaccine by the end of the year, the government has not yet decided who should be vaccinated, or when.

The issue is critical because smallpox, a highly contagious disease, is considered the most serious bioterrorism threat, and vaccination is effective in preventing it--even after a person has been exposed to the virus if no symptoms have developed. At the same time, the vaccine itself poses risks, especially to people with compromised immune systems.

Public health officials have been anxiously awaiting a final smallpox vaccination decision for more than two months, ever since a national advisory panel recommended limiting preventive vaccination to the health care and emergency response workers who would be most likely to treat victims of a smallpox attack.

Thompson said Tuesday he had submitted his recommendation to the White House, and hoped there would soon be a decision.

“Many of these decisions are going to be incredibly tough, and there is no absolute right or wrong,” said Michael T. Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy. “We’re going to have to hang together and help the community understand the decision.”

Public health experts agreed that the nation’s preparedness effort had benefited from a shared sense of urgency.