Florida Is Only State Ready for Bioterror

— -- Only Florida Deemed Prepared for Bioterror

W A S H I N G T O N, Nov. 1 — The federal government has truckloads ofmedicine and vaccines ready to deploy should bioterrorism strike,but only one state is fully prepared to receive and distributethose treatments. Federal officials say that while states have made considerableprogress in preparing for bioterrorism, much work remains. "Our biggest concern is we will get to a location and a stateor a city will not be ready," said Jerry Hauer, assistantsecretary for public health preparedness at the Department ofHealth and Human Services. Even Florida, the one state deemed ready to receive the NationalPharmaceutical Stockpile, still must conduct drills to make sureits plans will work. Federal officials emphasize that states still could handle anemergency if they had to, even if they are not considered prepared.After the Sept. 11 attacks, when the stockpile was deployed for thefirst time, it took New York City officials "several valuablehours" figuring out where to send 50 tons of general medicalsupplies and how to secure them — but eventually the medicine wasdelivered, said Steven Bice, who runs the program for the Centersfor Disease Control and Prevention. Today was the deadline for states to report progress inpreparing for bioterrorism. Key questions asked by HHS included howthey will distribute medicine, where they can provide 500 hospitalbeds in case of mass casualties and how hospitals will isolatehighly contagious patients. Most regions are not prepared to dedicate 500 beds in anemergency, much less the 1,500 beds that they are supposed to havein place by next year, Hauer said. Even fewer communities haverooms in place inside hospitals that could be used to isolateinfectious victims of bioterror attacks. Meanwhile, states have until Dec. 1 to produce detailed plansfor vaccinating their entire populations within days of a smallpoxattack. So far, plans have been filed by only 20 of the 62 states,large cities and territories that are receiving federalbioterrorism money. And those plans, not yet scrutinized, may haveserious holes, health officials say. Many states admit they are far from ready. In Kentucky, officials have not yet figured out who will deliverthe shots or where to find the people to do it, said Dr. StevenEnglender, the state epidemiologist. He said it could take 60,000people at 250 clinics to vaccinate Kentucky's 4 million people overfive days. "That's the math. The practicality is something different,"Englender said in an interview this week. Hauer says that math could be conservative if there were anoutbreak of smallpox — a highly contagious, fatal disease. "Five days might actually be a luxury," Hauer said. Early this year, the federal government began distributing $1.1billion to help cities and states improve communication systems,upgrade labs, hire disaster coordinators and otherwise build upneglected public health systems. At the last progress report, inJune, HHS identified several problems. In Arkansas, officials had plans to train people to respond tobioterrorism, but not to detect disease in the first place. InDelaware, planners identified hospital beds for 250 unexpectedpatients, just half of what federal rules require. In Kansas,officials were planning on spending $250,000 to handle the NationalPharmaceutical Stockpile; federal officials said they should counton needing $1 million. Nearly one in three states failed to show how they would workwith bordering states, and about half the states failed to includeIndian tribes in planning. Jack Pittman, administrator of public health preparedness at theFlorida Department of Health, agreed that working with tribes is aproblem. "We've invited them to formally sit with us on advisorycommittees. To this date they have not taken us up on that," hesaid. Another concern is states with budget crunches will have federalmoney to hire needed workers, but won't be allowed to spend itbecause of state hiring freezes. The most urgent issue may be the handling of the NationalPharmaceutical Stockpile. The federal government can deliver 50 tons of medical suppliesto any city in the United States within 12 hours. But communitiesmust be ready to take control of these supplies from the airport.They must have transportation and security for the supplies and aplace to distribute them. They need people who can repackage hugecartons of antibiotics into individual doses. Federal officials use a traffic light metaphor to characterizereadiness for the 62 projects, which include the 50 states, theDistrict of Columbia, the cities of New York, Chicago and LosAngeles, the territories of American Samoa, Guam, NorthernMarianas, Puerto Rico and Virgin Islands, and three associatedindependent states: Marshall Islands, Micronesia and Palau. Just one project, Florida, is "green," meaning ready to go,pending a rehearsal. Two states are "red," Wisconsin — HHSSecretary Tommy Thompson's home state — and Hawaii, meaning theyare making little or no progress. Also red: Puerto Rico and theVirgin Islands. Six projects haven't been reviewed yet; the remaining 51 arerated "amber," meaning they are making significant progresstoward readiness but aren't there yet. For instance, some state plans relied on the National Guard, butHHS pointed out that the Guard might be unavailable in anemergency, said Bill Raub, who is reviewing state plans for HHS.