WASHINGTON – Dr. John Bartlett concedes that heightened bioterrorism awareness today would keep him from repeating trick he pulled in 1999, when he posed a hypothetical anthrax case to emergency room doctors, none of whom could diagnose the case.
But Bartlett, chief of infectious disease at Johns Hopkins Hospital, said that while hospitals today might recognize a bioterrorist attack, they might not be able to handle a large-scale attack.
“If we had a big event, we wouldn’t be able to handle it,” he said.
Bartlett said that all Maryland hospitals combined have a “surge capacity” of about 1,000 bioterror patients, after which they would be overwhelmed. He said cutbacks in staff and the number of beds could cause a major problem for most hospitals, which would not have the resources to deal with a massive attack.
The Maryland Institute for Emergency Medical Services Systems has plans to deal with the patient surge from a “large” disaster, said Executive Director Robert Bass, but he acknowledged it is not geared to respond to a “catastrophic” event.
“There are pieces there, and there are pieces we still need to work on,” Bass said.
Part of the plan is monitoring the state Department of Health and Mental Hygiene surveillance system, which collects “real-time” data from 30 hospital emergency rooms every day for unusual spikes in patient volume. Of those 30 emergency rooms, nine contribute data on symptoms that could be analyzed to flag outbreaks of bioterrorism.
Using the patient volume data, MIEMSS determines whether hospitals should be put on yellow or red alert, said spokesman Jim Brown. Yellow alert signifies an overwhelmed hospital that could still accept patients; red alert means all monitored beds are full and patients should be taken to another hospital.
But Bartlett said hospitals alone cannot do the job. He said private physicians and health maintenance organizations should be brought into the planning, so they can help provide extra manpower and resources in an emergency situation.
Bass said that private physicians and HMOs would step up in the case of a catastrophic event, and that less-critical patients would be treated at nursing homes and makeshift hospitals set up in schools and large community buildings.
The catastrophic response plan is not as concrete as the other plans, he conceded, and it relies on a community response at the time of the event.
Though Maryland hospitals have taken initiative to educate staff about bioterrorism threats, Bartlett said hospitals have to work together to come up with response plans.
Individually, hospital officials said their institutions have been evaluating emergency supplies and response plans they already had in place.
Adventist Healthcare spokesman Robert Jepson, said Adventist hospitals did a full review of disaster preparedness plans and began identifying places in the community where antibiotics could be distributed if necessary. Adventist also re-evaluated security in each hospital and purchased additional hazardous- materials equipment.
Mike Hall, a spokesman for Holy Cross Hospital, said the hospital has some supplies and equipment, but there are not enough to deal with a large attack. Hall said Holy Cross also bought more protective suits and decontamination equipment.
Even with a patient-surge plan in place and efforts of individual hospitals to prepare, Bartlett said health officials must begin planning now how to care for a large number of patients at once in case an attack should occur.
“You need to figure out how you are going to be able to take care of a bunch of sick people,” he said.