Responding to bioterrorism.(Guest Editorial)

My experience with the nation's first anthrax case taught me that we must better prepare our medical systems to respond to bioterrorism. Only through extensive training can we become prepared.

Most communities are ill prepared to handle a bioterrorism event. A recent Rand Corp. survey found that fewer than half of all U.S. hospitals and local health departments have a formal bioterrorism response plan in place. Worse, fewer than 40% of those that do have ever tested their plans.

Until local health departments develop and test their own response plans, effective response is not going to happen. Plans mean nothing unless you test them.

The anthrax letters of October 2001 demonstrated the extent to which biological agents used by a terrorist can produce fear and panic in communities.

In fall 2001, there were 22 cases of anthrax in the United States. Five people died. Media coverage was continuous and often inaccurate. Mail delivery was disrupted in New Jersey, New York, and Washington, D.C. Anxiety was brought to nearly every home in the nation via the U.S. Postal Service. Up to 40,000 people took an antibiotic until supplies of the drug ran out in some parts of the country. The government offered immunizations to postal workers, but only 5% accepted.

The public health system didn't react much better. Hospitals, physicians, and health departments were besieged with inquiries about what people and organizations should do about these events, but were very poorly prepared to answer.

Medical laboratories were overloaded. In Palm Beach County, Fla., where I direct the department of health, we had four lab oratories working 24 hours a day, 7 days a week for almost 2 months to handle the overload. It took 2 days to ...