WASHINGTON, Sept. 13 (UPI) -- The federal government has doled out more than $1 billion to state and local health departments to improve their abilities to respond to a bioterrorist attack but much of the country -- especially in rural areas -- remains woefully unprepared, experts told United Press International Friday.
Health departments and emergency personnel at the city level will be the first to respond to an attack involving biological or chemical weapons, much the way they were first on the scene with the Sept. 11 attacks and the anthrax mailings last fall, making it essential they be adequately prepared so the number of casualties is limited and the spread of disease contained.
Charles Pena, senior defense policy analyst at the Washington-based think tank Cato Institute said, "I don't think our local health authorities are in any real position to respond to a bioterrorist attack.
"It's still not clear that local authorities are prepared to deal with anthrax," which after the mailings last October became not just a hypothetical threat but a real one, he added.
Stephen Prior, a biochemical weapons expert with the Arlington, Va.-based think tank, the Potomac Institute for Policy Studies, said: "We've made great strides since Sept. 11, and our level of preparedness and awareness is much better. The problem is that we had such a long way to go that it is absolutely the case that we are not yet prepared."
Ed Thompson, a member of the newly created Council on Public Health Preparedness, which advises the federal government on how to prepare for bioterrorism and other health emergencies, said "There are state and local health departments that no doubt have not taken this as seriously as others have."
Thompson, who also serves as state health officer for the Mississippi State Department of Health, said, "Some health department are better prepared now than others," but he declined to name specific locales or states.
Major metropolitan areas such as New York City, Los Angeles and Washington, D.C., have "well-coordinated plans" and are "well protected," said Mohammad Akhter of the American Public Health Association. But he noted, "If an attack happened in some rural area, there are inadequate resources to mount a good defense."
One way of monitoring whether local health departments have adequate plans in place is to assess their response to the more than 400 anthrax hoaxes that have occurred around the country since the anthrax mailings last fall.
"(However) there's not an official monitoring system in place," said George Benjamin, secretary of the Maryland Department of Health and Mental Hygiene and a member of the Council on Public Health Preparedness.
Bill Pierce, spokesman for the Department of Health and Human Services, maintained the agency "works with local health departments and gets feedback from them about how they responded."
A source at the Centers for Disease Control and Prevention in Atlanta, the agency charged with formulating a national plan for responding to bioterrorist attacks, told UPI, "Unless CDC is called in by the local health departments, we may not even know about (specific incidents)."
The source, who asked not to be named, noted, "CDC heard about a recent incident -- in Nashville in which former Vice President Al Gore received a letter that was initially suspected of containing anthrax -- from a CNN news report."
Part of the requirement for receiving the federal grant money was that state and local health departments had to produce a detailed bioterrorism response plan. This included an accountability program to monitor how the departments progressed in their implementation of the plans, the CDC source said.
He conceded, however, there is "no requirement for local health departments to detail to CDC how they responded" to any of the anthrax hoaxes.
Thompson said emergency personnel responding to anthrax hoaxes in his state have a "fairly organized system" that "worked well." But he said there were "instances where it stumbled."
Benjamin said "it's too early" for health departments to be fully prepared as many still are implementing or developing their bioterrorism response plans. This includes hiring new response personnel, putting in place better communications systems, acquiring new equipment and educating personnel about biological and chemical weapons.
In addition, health departments have started conducting drills for responding to biological and chemical weapons attacks. Maryland has conducted several drills and hospitals in the Washington, D.C., area also have done several, Benjamin said. They have also conducted "several communications drills" in which they sent out false attack alerts "to see who responded just to make sure that everybody had the right phone numbers" and were aware of the appropriate response they should take.
"We're better than we were a year ago but we still have a ways to go," Benjamin said. "We will clearly be better prepared to respond in a universal manner, but we're not yet prepared to vaccinate the whole country for smallpox, for example."
A nationwide vaccination program may be a concern should the United States may invade Iraq, which is suspected of having biological weapons.
Some experts fear Iraq could launch bioterrorist attacks against the United States or other countries as retaliation. Israel already has begun vaccinating against smallpox, apparently spurred by fear Iraq could launch an attack against them.
"The Iraqi threat did not go away when we stopped the United Nations weapons inspections," Prior said. "That was a number of years ago and one must assume that they have made progress in that direction. Therefore, Iraq poses a larger threat than they did during the Gulf War."
Thompson agreed. "Iraq underscores what we're doing," he said. "It simply reminds us that we cannot wait, that we have to move forward as rapidly as we can."
