NYC Simulates Bioterror Disaster! Grades = ?

[Guest guest]

The drill was reassuring to a very worried New York

City population, however, in reality, it really proved

little.

The drill was based on an assumption that terrorists

would strike using inhalation anthrax. The drill used

police and fire cadets as patients.

It was a succes, i.e. as far as drills go.

In reality, a terrorist may not use anthrax but may

use a contagion. The contagion may have symptoms that

are unknown to clinicians. In other words, the

disease may take a toll of hundreds or thousands

before it is diagnosed and a bioterrorist event

declared.

The first line of defense will be the ER docs, lab

personnel, and first responders. It is encumbant upon

each of them to diagnose the disease immediately.

A terrorist may use a pathogen, such as VEEpox or

Ebolapox, which has never been seen in a human

patient. The symptoms will stump doctors.

The drill was successful in medicating the diagnosed

patients. If a contagion, such as smallpox, ebola,

ebolapox, plague etal is used, central medication

dispensing will not be used. Quarantine would be in

place and, patients would not be able to report to

central dispensing.

We would then need personnel to dispense medication

door to door. I am told that in a City, such as New

York City, up to 4,000 people would be needed just to

bring meds door to door.

This would be complicated by the fact that the streets

would be unpassable, even for trained personnel.

There would be personnel transporting hundreds, maybe

thousands of dead and ill. Not a very hospitable place

to be.

By this time, people will be panicing and the

complication of looters and paniced public would

require action.

One problem that previous simulation drills

experienced was the " Who is in charge " question. The

CDC, FBI, State, Local, Federal. Inter agency

fighting had created a problem for lower eschelon

workers. No one was sure who to accept as ultimate

authority.

I think that the main purpose of todays drill was to

reassure the public during this time of hightened

alert. It is Fleet Week in New York City and many

people are apprehensive expecting a terrorist to

strike.

Hearing that the bioterrorist preparedness drill was

deemed a " success " did ease some nerves of city

dwellers and visitors alike who have been extemely

unsettled since 9/11.

In reality, the drill really did not accomplish much.

The City needs to be working on a plan to use closed

military bases, such as Ft. Slocum which is an island

in Long Island sound. There are many such closed

bases that could be refurbished quickly and used to

treat victims of weapons of mass destruction. The

city also owns land on island in Long Island Sound and

the East River that could be used for make shift

morgues and for mass burial grounds for victims of a

contagious pathogen.

The VA system is also very underutilized and would be

better suited to treat bioterrorism victims.

A terrorist who is able to deliver sophisticated

bioweapons, such as ebolapox, would probably have

planned to " neutralize " hospitals in the area that

would be treating terrorist victims. Most of the New

York area hospitals would not be able to implement

high security and would be easy targets for secondary

attacks. It would be easy to neutralize hospitals by

using chemical weapons or conventional weapons.

Patients would then, have no place to be treated.

VA hospitals, many with large campuses, could be

secured realtively easy and protected by military

police. No one in or out except, already cleared

healthcare workers, and patients.

Once an event has been identified and declared, the VA

as well as the military bases that would be receiving

victims, could be isolated and implement top security.

A City hospital, already treating patients, would not

be able to provide adequate security. The hospitals

also do not have campuses and many are at street level

with underground garages.

I believe that time is running out and that an event

is imminent. Unless, we prepare now, and begin

refurbishing the VA hospitals and bases, we won't be

ready to accept patients when the need arises.

I believe that the small localized outbreak of a

mysterious illness in an isolated village in Pakistan

might, very well, be a bioweapon test.

If so, we can expect to see the same illness breaking

out somewhere in the US. Will that City or town in

the US be able to care for the victims? Will we be

able to manage the event and minimize casualities?

I think that we need to move beyond the drill that we

saw today in New York City. We need to plan and set

up the VA hospitals and closed military bases. We

also need to alert Emergency personnel to the symptoms

of created diseases. No one has seen what Ebolapox

will do to a human being. We need to assess what the

symptoms of created, altered diseases will be and

then, alert those who will be first in line treating

these diseases.

It is very sad that the human race has not progressed

beyond the middle ages. Man's inhumanity to man

continues as it has since Cain first killed Abel.

Thank you,

Doyle

Newsday.com article

City Simulates Bioterror Disaster

Drill doles out substitute drugs

By Margaret

STAFF WRITER, Staff writer Graham Rayman contributed

to this story.

May 23, 2002

If the city were hit by a biological terrorist attack,

would officials be ready to dispense mass medication

to thousands of infected people?

In preparation for such a disaster, city officials

yesterday simulated an attack and conducted a six-hour

medication dispensing drill at Pier 92 in Manhattan.

Odermatt, commissioner of the Office of Emergency

Management, said the goal was to treat and prescribe

medication to 1,000 people per hour.

" This will help us simulate a biological attack, " he

said. " In the event of an actual attack, we hope to

use this as a model and set up several medication

dispensing centers around the city. "

While federal officials recently warned of potential

terrorist attacks in the city, Odermatt said

yesterday's drill was unrelated to those warnings. The

drill originally had been scheduled for Sept. 12,

2001, the day after the World Trade Center attack.

" What we're doing is a long-planned exercise. It has

nothing to do with recent events. It has nothing to do

with 9/11, " said Dr. Frieden, the city health

commissioner. " Today is about preparedness. You can

never be too prepared. "

More than 600 police and fire cadets took part in the

simulation, playing patients requiring immediate

medical help. Health department employees asked the

" patients " about their age, sex and reactions to the

biological agent.

After questioning, the patients were directed to a

medication dispensing area, where they received

appropriate drugs. For the drill's purposes, the

prescribed medication took the form of M & M's,

Starburst fruit chews or Skittles.

One scripted conversation between a patient and a

health worker related how a disaster might affect an

infected family. A police cadet playing the role of a

head of household was asked a series of questions by

an interviewer: " Do your children appear toxic? Are

any of them having trouble breathing? Does your infant

have fever or chills? "

At a national conference of emergency management

officials, biological attacks also were discussed.

Marcelle Layton, an epidemiologist with the city

health department, explained why the agency was taken

by surprise by the anthrax outbreak.

" All of our planning had been founded on a worst-case

scenario, the release of inhalation anthrax, not cases

of cutaneous anthrax, " she said. " We were still able

to modify the program quickly to respond to it. " She

said many decisions were made on the fly because there

was " no good data " available on outbreaks at the time.

Staff writer Graham Rayman contributed to this story.

Copyright © 2002, Newsday, Inc.

=====

Doyle, PhD

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