Agencies Offer Resources for Boosting Emergency Preparedness
Peggy Eastman · Emergency Medicine News · 2003
Hoping to prevent the stunning lack of U.S. preparedness against terrorism that occurred Sept. 11, 2001, the federal government and medical organizations have been providing a veritable cornucopia of materials and guidelines on counterterrorism. The amount of material available is staggering, but a few agencies and web sites distill the information into manageable bites. One emergency physicians might check out is the National Academy of Sciences' new web site for first responders at www.nap.edu/firstresponders. This site is specifically geared to emergency personnel, and includes a collection of links to guide visitors to credible, science-based information on counterterrorism. “The attacks were unprecedented, we had little scientific evidence to work with, and yet our changing practices based on evolving knowledge were seen as mistakes.” Dr. Julie L. Gerberding It also features a search engine of more than 3,000 web pages of related material. “This site is a great search tool for people like me who are looking for accurate, publicly available information about responding to biological agents or other threats,” said Charles Werner, the deputy fire chief for Charlottesville, VA. Smallpox Guidelines A new smallpox plan was sent to state and local health departments by the Centers for Disease Control and Prevention this past September, and the document plan is a major step forward in federal preparedness and communication, officials said. Speaking in Washington shortly before the release of the smallpox guidelines, CDC Director Julie L. Gerberding, MD, readily conceded that at the time of the terrorist hijackings on Sept. 11, 2001, communication between the CDC and state and local medical personnel was not as good as it should have been. “The attacks were unprecedented, we had little scientific evidence to work with, and yet our changing practices based on evolving knowledge were seen as mistakes,” she said at the 21st Annual Science Reporters Conference sponsored by the American Medical Association. “As a result, scientists were reluctant to make decisions until they gathered all the data.” Now, Dr. Gerberding said, things have changed, and “we operate very much on a ‘learn-as-we-go-theme.’” Since Sept. 11 a year ago, she said the CDC has put a high priority on communication. The CDC now uses the Health Alert Network, a high-speed Internet connection for local health officials and first responder agencies to provide access to the CDC's prevention recommendations, practice guidelines, surveillance, and laboratory and disease data. Dr. Gerberding said the network is capable of reaching all 50 states and 6,000 local health departments at the same time. “We now have best practices we can apply from the lessons we learned after 9/11 and the anthrax outbreak,” said Dr. Gerberding. “We are developing new methods for rapidly detecting, evaluating, and reporting suspicious health events that might indicate covert terrorist attacks.”TableMoney helps. Before the tragedies of Sept. 11, the CDC had a budget of $120 million annually for terrorism, she said. This year, CDC was given $918 million, which the agency distributed to state and local health departments to improve their emergency preparedness programs, largely for better laboratories and detection systems and for improving surveillance systems that might indicate covert terrorist attacks.Figure: Dr. Julie L. GerberdingBioterrorism On the private side, the AMA recently released Bioterrorism: Guidelines for Medical and Public Health Management (AMA Press, 2002), a comprehensive 244-page guidebook on biological weapons. The book covers inhalational and cutaneous anthrax, smallpox, plague, botulism, tularemia, hemorrhagic fever viruses, and large-scale quarantine following biological terrorism. In his foreword to the guidebook, Anthony S. Fauci, MD, the director of the National Institute of Allergy and Infectious Diseases, noted that preparation for the next bioterrorism attack occurs on two major fronts: intelligence and law enforcement activities to prevent an attack, and medical and public health activities to prepare for, respond to, and lessen the impact of an attack. The CDC can deliver guidelines, surveillance, and disease data to all 50 states and 6,000 local health departments at the same time Dr. Fauci also cited the need for ongoing biomedical studies to provide first responders, including emergency physicians, with the best means of diagnosing and treating illness caused by terrorists. “A robust commitment to basic and applied research is essential to the development of the essential tools — diagnostic tests, therapies, and vaccines — needed by physicians, nurses, epidemiologists, and other public health professionals to control an outbreak of disease caused by a bioterrorist,” he wrote. The Institute of Medicine (IOM) of the National Academy of Sciences also published Preparing for Terrorism: Tools for Evaluating the Metropolitan Medical Response System Protocol (National Academy Press, 2002). This 310-page report is dedicated to Ray Downey, the chief of rescue operations in the Fire Department of the City of New York, who served on the committee that wrote the report and died while leading rescue efforts at the World Trade Center on Sept. 11. The report covers community emergency management and available federal assistance, federal efforts to increase state and local terrorism preparedness, preparedness indicators, and communication among key players in emergency preparedness.