[iwar] [fc:The.Anthrax.Alarm]

From: Fred Cohen (fc@all.net)
Date: 2001-10-13 15:21:41


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From: Fred Cohen <fc@all.net>
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Date: Sat, 13 Oct 2001 15:21:41 -0700 (PDT)
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Subject: [iwar] [fc:The.Anthrax.Alarm]
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Washington Post
October 12, 2001
Pg. 32
The Anthrax Alarm

Much remains mysterious about the Florida anthrax case, where exposure now 
appears limited to three workers at a single office building in Boca Raton. 
Even one death from this rare and deadly pathogen is alarming; investigators 
have yet to offer a hypothesis as to how the spores ended up on the computer 
keyboard of Robert Stevens, who died last Friday, or in the noses of two 
other workers. But quick medical and law enforcement responses in Florida 
have forestalled what could have been much wider panic. Health workers 
flagged the case early and confirmed Mr. Stevens's diagnosis within 24 hours, 
allowing the building to be sealed, the second case to be found and more than 
700 employees to be located and quickly given exposure tests and prophylactic 
drugs. Broad canvasses of Florida hospitals have turned up no new cases, 
sending at least a partially calming message to those suffering from jitters 
over strange packages or flu-like symptoms.
This is far from proving American readiness for a biological attack. On the 
contrary, Florida benefited from pilot programs that need to be extended to 
the country at large. An attack with epidemic casualties would probably 
overwhelm emergency room and hospital bed capacity in most jurisdictions, as 
flunked training exercises in a half-dozen cities have shown. Defenses 
against bioterrorism are likely to get a huge influx of cash this year; 
Congress is looking at packages that could go as high as $1.65 billion. With 
that kind of money, debates on priorities tend to deteriorate into shopping 
lists boosting funding for every program with a conceivable link to public 
health. Florida's successes point to some key elements that need to be part 
of any plan to boost readiness.
The experience underlines the importance of what happens in the first few 
hours -- detection, analysis, containment. That would be even more important 
if the biological attack agent were one that, unlike anthrax, could pass from 
person to person. The capacity for quick response needs to be spread as 
widely as possible through the country. Funding is not the only element here: 
For now, news reports and widespread edginess have created a degree of 
alertness that money can't buy. But doctors and nurses, who would be first to 
see strange ailments, do need the training to recognize them. They also need 
fast, secure ways to pass information on to health authorities; some 
jurisdictions still use regular mail for such alerts because it guarantees 
confidentiality.
Beyond that, resources should go to boosting vaccine and antibiotic 
stockpiles; to ensuring there are enough labs for testing and enough trained 
"medical detectives" ready to go into the field; and to adding to the "surge 
capacity" of hospitals, which, rather than being encouraged to maintain extra 
beds they can't afford, should have contingency plans for converting large 
spaces for use on short notice. Longer-term programs for strengthening the 
public heath system, such as training more nurses to fill an estimated 
126,000 vacancies nationwide, have a role to play, but far more emphasis 
should go to measures that enhance readiness now.
Few states are starting at zero on this kind of planning, but until now they 
have had to cobble their efforts together from multiple small programs: 
Nebraska, for instance, computerized its health alert system with money from 
the tobacco settlement. A federal overview of which states and localities are 
up to snuff is a must; this is no time for deferring too much to state and 
local autonomy.
As much as medical readiness, people need reminders that the actual 
likelihood of a successful large-scale biological attack is slim. Known 
failures, such as the multiple unsuccessful attempts by Japan's Aum Shinrikyo 
cult, suggest the technical difficulties of getting, weaponizing and 
distributing biological agents. Other panic-inducing possibilities, such as 
crop-dusters, present even greater practical barriers. A concerted effort to 
prevent panic may be able to dissuade people from depleting antibiotic 
stocks, unwisely self-medicating or otherwise undercutting the nation's best 
attempts at readiness. 

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This archive was generated by hypermail 2.1.2 : 2001-12-31 20:59:55 PST