Bioterrorism: Are we ready?

When the unthinkable becomes thinkable

When the unthinkable becomes thinkable

September 09, 2002|by KEVIN CLAPP

Want to know how much credence John G. Newby gave to the idea of Washington County being brought to its knees by a terror attack last year?

About as much as the NFL would to playing the Super Bowl at North Hagerstown High School.

Unh-uh. No way. Not going to happen.

This from a guy - a physician with a healthy respect for the destructive power of anthrax, plague or smallpox - who had attended seminars about biological weapons a decade prior to Sept. 11, 2001.

If he didn't see the need to safeguard against them, why should anyone else?

"In my mind it was really theoretical," Newby says. "I didn't see any need to do it. We live out in the country. What's the probability of something happening out here?


"You just don't think of it. Who would've thought, other than Tom Clancy in that book of his, thought of flying a 747 into a significant building? It was just unthinkable."

Unfortunately what's unthinkable to some, even most, represents a holy grail for others.

So think of biological weapons in terms of Goldilocks and the Three Bears.

Anthrax and similar agents are a one-shot strike, unable to be spread from person to person; too cold.

Viral infections such as Ebola and Marburg work rapidly, within days, to decimate victims, and can't be transmitted through the air; too hot.

But smallpox, easily transmitted from person to person with a lengthy (21 day) incubation period? Just right.

Post 9-11, Newby, M.D., director of laboratories for Washington County Health System, discusses bioterrorism as if he were reading the phone book or reciting a grocery list.

Unflinchingly. Methodically. Calmly.

"If you really want to create panic and a significant terroristic event, then smallpox is your weapon of choice," says the chair of the health system's bioterrorism task force. "If you can get it. And that's the question - we don't know if it's available. We haven't seen inklings it's out there. It's a theoretical possibility, but it's the one that gives us the most sleepless nights."

Too hot. Too cold. Just right. Welcome to the new world.

For all the tragedy and heartbreak associated with Sept. 11, at least one good thing came of the infamous actions on that now-infamous date. Emergency and health care professionals embraced a call to arms, bracing for the possibility, however remote, of a biological attack against the Tri-State region.

Cooperation between hospitals, EMS, fire, police and other emergency agencies is up; hospital employees have willingly hopped aboard. Instead of waiting for federal and state guidelines, regional health care planners have worked independently to prepare themselves.

There have been obstacles. Guidance from state and federal entities has been slow in coming. Preparedness, in the form of equipment and training, costs money, requiring creative solutions in a snug fiscal environment.

Yet as the first anniversary of 9-11 approaches, those in the know are secure in the knowledge that they are prepared. Measures to be taken are not stuck on a shelf, ready to be dusted off only when biological weapons are used.

Instead, these plans also apply to events much more likely to impact Tri-State residents, from massive Interstate car wrecks to farming accidents to industrial spills.

"In this area, there are a lot of disasters that are unlikely but much higher on the list than a bioterrorism attack," says Thomas Anderson, M.D., an emergency room physician at Chambersburg (Pa.) Hospital since 1986.

"I think if something like that did happen, we have a plan, put it in place and do the best we can," he says. "Bioterrorism exposure would certainly add dimensions to a disaster you wouldn't have with a pile-up on the freeway, but the same principles hold true."

Yes, decontamination and isolation protocol must be followed when bioweapons are involved, but the basic tenets of providing care - diagnosis and treatment of patients - remain the same.

Still, plans exist in their present form for two reasons: What transpired in New York, Washington and Shanksville, Pa., a year ago Wednesday; and anthrax scares last fall along the East Coast.

Funny thing is, Newby doesn't worry about Hagerstown's proximity to D.C. or Baltimore. What gives him pause is being a stone's throw away from Camp David and Site R, the secret installation near Waynesboro, Pa., also known as the underground Pentagon.

"When you think of cities our size, probably our risk factor for another city of 40,000 is probably 10 times a city in Iowa of the same size," unless, he says, it's located next to a military installation. "The probability of us really seeing a universal smallpox epidemic is remote, but it's remote, which is why in this day and age it's prudent to plan and prepare for it."

Planning for the worst

It would be perfectly reasonable to conclude that 9-11 + anthrax scare = bioterrorism preparedness plans.

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