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09 Jan 2003

Source: Washington Post, February 1, 2002.

U.S. Doles Out Bioterrorism Funds

Region Receives $54 Million for Public Health Effort

By Spencer S. Hsu, Washington Post Staff Writer

The federal government released the first installment of the $1.1 billion targeted for hospitals and state and local health agencies, including $54 million for the Washington region, to help transform the overlooked science of public health into the country's first line of defense against bioterror.

Around the nation's capital, for instance, District officials propose converting D.C. General Hospital into a contagious-disease quarantine center; federal and local planners are updating the logistics of rushing up to 15 million doses of smallpox vaccine into the region within 12 hours; and the Army is working with area universities to expand a medical surveillance system to detect a covert germ attack.

In ways visible and otherwise, states and communities from coast to coast are bracing local health networks and hospital workers to respond to nuclear, chemical or biological assaults. The government has called on the nation's governors to draw up plans to prepare hospitals to handle "mass-casualty incidents," track suspicious diseases, expand laboratory capacity and increase communication among the health industry, local health officials and federal agencies.

"We recognize that we have not as a country, nor as a District nor as a state, invested the necessary, scarce resources in our local and state public health systems," Health and Human Services Secretary Tommy G. Thompson said at a George Washington University news conference, where he appeared with Mayor Anthony A. Williams (D) and Wyoming Gov. Jim Geringer (R).

"We now have an opportunity to build a viable, vibrant strong . . . system that will prepare and protect our citizens for any attack that may come," he said.

The Health and Human Services Department released $200 million, with about one-eighth going to hospital emergency planning and most of the rest to public health agencies. The next $800 million will be released once states turn in public health plans March 15. The population-based awards range from $70 million for California to $6.5 million for Wyoming.

The District, counted as both a state and the seat of the federal government, will ultimately receive $12 million. Maryland will receive $19 million and Virginia $23 million. The money is part of a $2.9 billion bioterrorism package signed last month by the president, and Thompson said more will come in 2003.

"We do not sleep well at night," said D.A. Henderson, director of the U.S. Office of Public Health Preparedness. "We are afraid we will have another event. There are just too many other things that are threatening out there."

Across the region, planning for terrorism slowly gained momentum during the last decade, but September's strike at the Pentagon and October's anthrax crisis jolted public health officials into moving faster.

Government and hospital planners opened up 100 hospital beds in the Washington area for victims of the Pentagon attack. But they are now drafting contingency plans for a World Trade Center-scale calamity or an attack even larger that could create 10,000 or even 100,000 casualties, public health officials said.

The capital, of course, has long been seen as an potential target. The federal government has piloted several initiatives locally since 1996, stockpiling drugs and training emergency medical response teams, for example, and recruiting groups of specialized doctors and nurses.

The federal government has lately expanded the vehicle fleet of a 120-member National Medical Response Team, based at two Arlington County fire stations and staffed by Washington area firefighters and rescue workers. The team is equipped to treat up to 5,000 victims of a biological, chemical or radiological weapon. Thompson said similar teams are being organized and funded to cover 122 U.S. cities.

The U.S. Centers for Disease Control and Prevention is leading a task force of county, District and Maryland and Virginia state governments to speed emergency medical supplies to the capital region.

The U.S. Public Health Service keeps a portion of the National Pharmaceutical Stockpile, a 50-ton cache of medical supplies, at an undisclosed suburban Washington location. The supplies are supposed to be deployable within 12 hours of a crisis. The government is increasing the number of such stockpiles from eight to 12 nationwide, aiming to deliver up to 12 million anthrax treatment doses.

And the Walter Reed Army Medical Center has contracted with the George Washington University School of Public Health and the Johns Hopkins Center for Civilian Bioterror Response to develop a Washington Metropolitan Public Health Assessment Center, linking trauma centers, health clinics and schools to detect unusual symptoms. Federal health officials seek to develop a health alert network to link health officials overseeing 90 percent of the population.

The District is considering a plan to expand the number of 2,880 private hospital beds in an emergency. The government is studying an association proposal to mothball the abandoned D.C. General Hospital building as an isolation ward that can be activated with up to 400 beds in an emergency, D.C. Health Department Deputy Director Larry Siegel said.

For clinicians and hospital workers, advances in medical surveillance, antidote delivery and mobile medical resources are crucial. But they say that more must be done to improve communication between health care players, increase hospital capacity and anticipate disease outbreaks.

"There are all these systems that have been in existence, but there hasn't been a lot of coordination or collaboration between these systems," said Christopher Wuerker, chairman of emergency management at Washington Hospital Center, one of the region's three major hospitals.

Virginia, Maryland and District officials are working to create a single communication system among the jurisdiction's hospitals, said Lynn Frank, chief of Montgomery County's Public Health Service.

Hospitals are also working to balance their economic needs with government demands. "The issue is, if you get sick, you have to recognize that people go to the hospital. They go to their doctor," said Bob Malsen, chairman of the D.C. Hospital Association. "Private hospitals need to be recognized as the first responders."

Staff writer Avram Goldstein contributed to this report.