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After the 911 terrorist attacks, The National League of Cities conducted a preparedness survey of 456 communities and towns.
Here are their findings.
Survey Question
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All |
Cities |
Medium Towns |
Small Towns |
| Does your city have a terrorism response or prevention plan in
place? |
55% |
83% |
59% |
40% |
Has your city ever had anti-terrorism training?
In the last year?
In the last two years?
Never? |
48%
31%
12%
52%
|
85%
57%
21%
15%
|
50%
33%
13%
50%
|
32%
19%
08%
69%
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Locals who will now conduct an overall reassessment.
|
52% |
66% |
52% |
48% |
Population Key - Cities = 100,000+; Medium Towns = 10,000 - 100,000;
Small Towns = 10,000 and fewer
Officials pretty much agree on one thing, extremist assaults are
not likely over yet. In fact, as of Saturday, October 6th, experts
state there is 100% assurance of additional terrorist attacks.1
Disturbingly, we've heard the same advice over and over - rely
on the government to supply your defense if a biological or chemical
attack occurs. Like a broken record, government spokes people
like Health and Human Services Secretary Tommy Thompson stressed
there is plenty of vaccine should a bio-chem agent zap our air,
water or and/food supplies. This is simply false.
TRUTH OOZES OUT
Over the past week, the truth has filtered out sparingly. Certain
vaccines available in limited quantity, but most are in reserve
for the military and medical people. Fair enough. Both of these
allocations are completely understandable, but implying there
is adequate vaccine for everyone does no one any favors. It only
staves off panic right now.
Should a bio-chem attack occur and we anxiously await shots, can
you imagine the chaos and anger erupting once we understand "the
cure" might not be for us? Better that we grasp that truth now
than after dispersal.
The morning of October 5th, on Pueblo's 590 AM station, the 6
a.m. news stated our local health department is finally getting
inquiries - lots of them - about anthrax, smallpox and plague
vaccines. They told the public that the available vaccines are
reserved for the military. Some doctors are refusing to give shots
until they get "official word" from the federal government about
who can and who can't have them.
During Senate hearings October 3rd, officials discussed how well-prepared
the government is (or isn't) to face biowarfare. CNN broadcast
Health Secretary Tommy Thompson admission there are problems,
particularly at the state and local level, but reassured that
the U.S. is prepared to handle "any contingency, any consequence
from any kind of bioterrorism attack."
Senator Robert Byrd, D-W.Va. was heard to snort, "Will you still love me if I tell you I don't believe that?"
Secry. Thompson acknowledged the health system does have "gaps".2 A GAO Official testified our preparation is "fragmented."3 "Fragmentation" and "gaps include areas that need addressing
immediately and should have been done resolved a long time ago.
In a Newsweek poll released Sept. 29th, more than 8 out of 10 people think
an attack with biological or chemical weapons is at least somewhat
likely. Fewer than half think the government is ready to handle
one.
GAPS
1. How would hospitals cope with a huge influx - possibly tens of thousands of sick people - at one time?
A single biological or chemical attack on a U.S. city would probably
overwhelm local medical resources. What if there were more than
one? Some suggestions include military field tents which could
be set up in 72 hour to handle the masses, but would these suffice
in the dead of winter?
Tommy Thomsom says we have 7,000 doctors and medical assistance
teams throughout America to deal with an extensive assault. That
may be so, but a successful attack could be overwhelming. Joe
Zelinka, public safety program coordinator at the Council of Governments
stated we could be talking about tens of thousands of victims
which "would absolutely crush our medical system."4
One suggested solution would be to discharge other patients, but
due to rising medical costs, people in hospital already tend to
be quite ill. People are entering the hospital for frivolous reasons.
Around the country, hospitals have closed and consolidated as
they struggle to cope with rising costs. Military hospitals also
have shut down, further limiting the number of beds.
Additionally, the national nursing shortage means hospitals are
already understaffed.
2. Many physicians and labs aren't trained to recognize the symptoms
of anthrax, smallpox or plague.
Should sick people wander into their doctor's office or hospital,
how many healthy people would become infected? (Smallpox is highly
contagious once the rash appears. Health experts estimate one
person will spread the disease to at least 10 people.)
3. How would they handle administering enormous numbers of vaccines?
Most vaccines must be given very rapidly - some before the onset
of symptoms. Literally thousands of medical people would be needed
since federally supplied antibiotics were purchased and stored
in bulk. Doses for each person would have to be counted out by
hand from huge bottles.
4. Vaccination protocol
Vaccination issues have yet to be resolved. Some say only people
who have had contact with the sick should be vaccinated, while
others say that entire cities where smallpox was found would need
inoculations.
There is a lack of standard operating procedures or signed agreements
in place with private air cargo and land transport to move the
stockpiles to contaminated areas.
5. Problems with federally stored vaccines
Areas of concern involve whether or not the vaccines could be
stolen, storing conditions are too hot rendering them ineffective,
outdated product which should have been rotated (sound familiar?)
and poor tracking systems which show vaccine in stock which isn't
and vice versa. You can read the details of these Senate hearings
at http://www.house.gov/reform/ns/web_resources/briefing_memo_may_1_2001.htm
6. How well is your own community prepared?
Local governments have much of the initial burden to furnish medical
treatment after an attack. Local public health systems will have
to provide patient care, immunizations or prophylactic drug treatments
for exposed groups, deal with fatalities and decontaminate the
environment.
Don't wait until an event to find out how well prepared your community
is. Ask! Phone or visit your state and local emergency preparedness
departments.
Start with your city, county and state government officials; they
can direct you to the specific people in charge. Check with the
local health department and hospitals to see what disaster plans
are practiced. Call the city and/or county's emergency management
team to see what measures are in place. Be polite, but be persistent
until you are satisfied with the answers. You, the public pay
their salary, so they owe you an honest answer.
October 11th, Stan and I attended Pueblo County's public preparedness forum which discussed localemergency readiness measures. Representatives participated from both hospitals, the FBI, Office of Emergency Management, the school district, police and sheriff's departments, Pueblo's Chemical Weapons Depot, Pueblo County Commissioners and the fire department. They
claim our community is better prepared thanmost for good reason.
Since our area hosts a weapons depot, the government funded a
$4.5 million emergency preparedness program with state-of-the-art
capabilities a few years ago. For that reason, as we heard a number
of times at this meeting, Pueblo is "ahead of the game."
The CDC has set forth certain Procedures for State and Local Public Health Officials in case of a bioterrorist attack. In broadstroke, pictured right
is the blueprint. For more details, click on the link above.
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SMALLPOX VACCINE
One radio talk show host in Colorado Springs last week mistakenly
told everyone to quit worrying about smallpox if you had been
vaccinated as a kid. Well, "as a kid" is more years ago than most
of us want to remember and that vaccination quit being effective
three years after it was given. Some studies show the antibodies
to be present for five to ten years, but even so, even those who
received the recommended single-dose vaccination as children no
longer have immunity. "People vaccinated before 1972 lost most
of their immunity within 10 years."5
Since these shots ceased in the 70s, it's safe to say none of
us are protected against smallpox now. There can be severe side
effects to the smallpox vaccine and it's not available to the
general public.
In researching this disease, conflicting information popped up.
This is what the CDC states for treatment.
"In people exposed to smallpox, the vaccine can lessen the severity
of or even prevent illness if given within 4 days after exposure...
There is no proven treatment for smallpox but research to evaluate
new antiviral agents is ongoing. Patients with smallpox can benefit
from supportive therapy (intravenous fluids, medicine to control
fever or pain, etc.) and antibiotics for any secondary bacterial
infections that occur."6
This is what Johns-Hopkins says about treatment:
"Treatment of smallpox is limited to supportive therapy and antibiotics
as required for treating secondary bacterial infections. There
are no proven antiviral agents effective in treating smallpox."7
Early treatment is vital. By the time symptoms show - generally
within 12 days, treatment is much less successful and is fatal
30% of the time.
Currently the U.S. has 15.4 million doses of the smallpox vaccine
available and the World Health Organization has about 500,000.
Another 40 million doses are on order and should be ready by the
end of 2002.
ANTHRAX VACCINE
While the anthrax preventative vaccine is about 93% effective,
it takes 18 months to complete the series of shots. It is in too-short
supply and reserved for the military. As of October 5th, the sole
manufacturer of the military's anthrax prevention, BioPort Corporation
still can not meet FDA standards for production. BioPort has not
made a single dose of anthrax vaccine since 1998.8
Anthrax usually is susceptible to penicillin, doxycycline, and
fluoroquinolones.
According to Tommy Thompson, the nation's health secretary, there
are enough antibiotics for anthrax in a federal stockpile to treat
2 million people for 60 days.9
Until the pharmacies manufacture much more of these defense agents,
one would be wise not to count on receiving a vaccine.
When Secry. Thompson was asked what ordinary citizens should do
to avoid an outbreak, well, judge the advice for yourself:
"I would strongly tell Mr. and Mrs. Citizen ... be very vigilant.
Be very vigilant about your activities. And anything suspicious,
and any kind of cold or anything mysterious dealing with your
body -- illness or infections of rashes or coughing -- get to
a doctor. And ask that doctor if he or she knows anything about
smallpox, anthrax, botulism.
"I would not suggest that they buy a gas mask. I would not suggest
they go out and buy a lot of (antibiotics). I would strongly just
urge them to be more alert than they have in the past."10
PLAGUE
Though there are other biologicals that could be used in a terrorist
attack (see our newsletter Part 3) bubonic plague rounds out the
most likely trio. Early treatment of pneumonic plague is essential.
Plague is almost 100% fatal if not treated within a day of the
onset of symptoms. While there is no vaccine against plague, several
antibiotics are effective, including streptomycin, tetracycline,
and chloramphenicol.
Without supplying specific numbers, MSNBC reports that the government
has antibiotic tablets, streptomycin and gentamicin, stored with
millions more available from pharmacies.
Prophylactic antibiotic treatment for 7 days will protect persons
who have had face-to-face contact with infected patients.
The CDC's National Pharmaceutical Stockpile program (NPSP) states
the following regarding their priorities for acquiring and maintaining
adequate supplies of vaccine and disease treatments.
"Expert panels convened by CDC prioritized the following biological
agents: smallpox, anthrax, pneumonic plague, tularemia, botulinum
toxin and viral hemorrhagic fevers. Because anthrax, plague and
tularemia can be effectively treated with antibiotics that are
immediately available, purchasing these products for the NPSP
formulary was given first priority. The NPSP also has a cache
of vaccine available to address smallpox threats."11
If this advice works for you and you're comfortable with level
of protection, great! However many people have asked what measures
they personally can take. Some folks want gas masks, etc. but
don't have a clue what to look for. Hopefully this information
on the following pages will give you adequate pointers.
Continue
References:
1Source: '100-percent chance' of another attack
http://www.cnn.com/2001/US/10/05/ret.terrorism.threat/index.html
2Change needed to combat bioterror threat
http://www.cnn.com/2001/US/10/03/rec.bioterrorism/index.html
3U.S. Is Still Vulnerable To Attacks, Experts Say Numerous 'Targets
of Opportunity' Cited
http://www.washingtonpost.com/wp-dyn/nation/specials/attacked/A13976-2001Oct5.html
4Where Would You Put All The Sick?; October 5, 2001;
http://www.washingtonpost.com/wp-dyn/articles/A8296-2001Oct4.html
5A Common Sense Guide to Being Prepared; http://www.time.com/time/2001/underthreat/unhysterical/index.html
6CDC's Bioterrorism FAQ; update October 5, 2001; http://www.bt.cdc.gov/DocumentsAPP/faqs.asp
7Center For Civilian Biodefense Studies
http://www.hopkins-biodefense.org/pages/agents/agentsmallpox.html
8 Military's Sole Supplier of Anthrax Vaccine Still Can'tMake
It; October 6, 2001; http://www.nytimes.com/2001/10/06/health/06VACC.html
9Defending Against An Attack
http://www.msnbc.com/news/638301.asp
10Are We Safe?
http://www.cbsnews.com/now/story/0,1597,313043-412,00.shtml
11National Pharmaceutical Stockpile
http://www.bt.cdc.gov/DocumentsAPP/national_pharmaceutical_stockpile.pdf
Other References:
Bioterrorism Preparations Vary Widely
http://www.contracostatimes.com/partners/nf/prepare_20011005.htm-CBS
Bioterrorism Interactive-http://www.cbsnews.com/htdocs/mass_destruction/biochemical/framesource.html
Seeking a Treatment for Terrorism, Health Agencies Step Up Preparations
for Biological Attack; October 5, 2001; http://www.washingtonpost.com/wp-dyn/articles/A8296-2001Oct4.html
Facts about: Anthrax, Botulism, Pneumonic Plague, Smallpox http://www.bt.cdc.gov/DocumentsAPP/facts_about.pdf
CDC's Agent List
http://www.bt.cdc.gov/Agent/Agentlist.asp
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