WASHINGTON – Every county in Maryland has an emergency plan that coordinates responses to crises from natural disasters to chemical accidents. But biological terrorism is a scenario few have even contemplated until now.
While state officials began to prepare three or four years ago for a biological attack, and began phasing that plan in about a year ago, that planning is just now beginning to filter down to the county level.
“We have a general idea of what we need to do up here, we just haven’t completed the plan yet,” said Eric Cvetnick, a resident nurse with the Garrett County Health Department who deals with communicable diseases. “Our pants are down, so to speak.”
Many counties said they do not have a specific bioterrorism response plan and would be forced to rely on the state and federal governments if an attack occurred.
“For us to be responsive, a local health department or a county would have to have an awful lot of resources from the state or federal government,” said Carroll County Health Officer Larry Leitch.
Phil Taylor, director of emergency services for Queen Anne’s County, agreed that smaller counties lack resources and would need help to implement their plans.
“The state might be OK,” he said. “Frankly, if the bad thing happened here, the first call I would make would be to the state. We’d be strictly reactionary.”
Taylor said most of the emergency response personnel in his rural county are volunteers.
“We don’t have a major airport here, we don’t even have a hospital,” he said. “There’s more cornfields than Cadillacs. We rely on our national defense to keep the bad guys out.”
Taylor and others predicted that a bioterrorist would likely strike an urban area first and the larger jurisdictions in the state seem to be farther ahead on a response, both in terms of planning and resources.
Montgomery County became concerned with the threat of bioterrorism four years ago, and incorporated a mock bioterrorist attack in an emergency response drill last November.
“You’re never as prepared as you want to be, but we’re been working on this for three years now, and we’ve been working hard,” said Richard Helfrich, a senior administrator in Montgomery County’s Public Health Services.
Since that November scenario, Helfrich said the federal government has set up a stockpile of “hundreds of thousands” of medications and supplies that would be accessible to counties throughout the state in the event of an actual attack.
While urban areas might be more likely targets, rural counties know they have to be prepared. Ed Birkmire, director of environmental health and chairman of the local emergency planning committee in Kent County, said terrorists could really scare Americans by striking rural areas, which are assumed to be safe.
Birkmire said Kent County does not have a solid plan for dealing with bioterrorism in place, “but we’re working on it.”
Julie Casani, the Department of Health and Mental Hygiene official in charge of the state’s bioterror response plan, said people should not be too concerned if their county does not have a plan. She said the state will monitor health trends and notify the counties of any possible outbreaks.
Detection and early notification are the first line of defense against bioterrorism, and can allow for relatively simple treatment. The state has a system to monitor potential outbreaks of biological agents, and lines of communication between the state and the counties means that even small jurisdictions would know if anything happened.
That communication is vital: Leitch said local medical personnel might not recognize a biological agent if the outbreak starts in a rural area.
“If the doctor doesn’t diagnose it immediately, the patient could be in trouble. You don’t have a lot of time research to identify it,” he said.
Taylor said educating doctors and nurses is the key to combating a biological attack, and that the state has been fairly good at making education available.
“Education is really one of the only weapons we have in our arsenal, and probably our best weapon,” said Taylor. Casani said there are a lot of training programs scheduled for the next six months throughout the state.
“The good news is that for a lot of biological agents, the antibiotics are common and they are out there,” Casani said.
But some, like Charles County, do not have a stockpile of those medications. They said their first response to a report of a disaster would be to call in help.
“One of the negatives about the whole thing, we have to rely on other counties or the state or the even federal government,” said Don McGuire, director of emergency services for Charles County. “We need the equipment and the training, then you could put the plan into place.”
McGuire said the state has done a good job getting together resources as well as plans and equipment. He said they have identified everything, but now is the time to implement it.
“The state or the feds have to come up with the funding,” McGuire said. “Don’t give us another mandate. We don’t have the funds to do what we need to do.”
But Montgomery County’s Helfrich offered encouragement to smaller counties.
“We do a lot of stuff on a shoestring, and we do a lot of stuff on virtually no money,” he said, adding that good planning takes cooperation from every angle that would be involved in an attack.