WASHINGTON – A recent test of Maryland’s readiness to respond to bioterrorist attacks produced dismal results, a Johns Hopkins University doctor told a Senate panel Thursday.
When Dr. John G. Bartlett posed a hypothetical anthrax case to Johns Hopkins Hospital’s emergency room in late February, no one could diagnose the case, no one could find the phone number to report the potential threat and the state health department took three days to call back with the right number.
One emergency room physician even thought the hypothetical patient might have the flu and should be sent home, Bartlett told the Senate Subcommittee on Public Health.
“There are virtually no physicians who have ever seen a case of anthrax or a case of smallpox,” likely agents of a bioterrorist attack, said Bartlett in his written testimony.
Because smallpox was eliminated from globe in 1976, “there are very few nurses — certainly none under the age of 55 — who know the specialized techniques required for small pox vaccinations,” he said.
Bartlett and others said it is time for the federal government to redirect bioterrorism dollars away from bureaucracy and toward the doctors and nurses who will be the first to treat such an attack — if they even recognize it.
“Where are we going to get the thousands of health care workers that we’ll need? From private practice, from HMO’s,” Bartlett said. “Maryland’s 16,000 doctors and 30,000 nurses will be our workforce, but they don’t know it yet.”
The deputy director of the Department of Health and Human Services Office of Emergency Preparedness conceded that anti-terrorism efforts initially focused on training local medical professionals to respond to chemical attacks. But William Clark said his office is now including biological threats in its training, which will be expanded from 27 to 47 cities this year as a result of increased federal funding.
That shift in focus seemed to suit Sen. Barbara Mikulski, D-Baltimore, who warned other HHS officials that she did not want to see federal money “poured into bells and whistles.” She said federal bureaucrats should get a second opinion on their proposed anti-terrorism programs from healthcare officials in the field before they put them in practice.
But planning on the local level still has a long way to go, said Dr. D.A. Henderson, director of Hopkins’ Center for Civilian Biodefense Studies. He said he has visited 46 states to talk about the potential for bioterrorism and has yet to find a single hospital or HMO with a biological threat emergency plan.
Bartlett estimated that less than 1 percent of the doctors, nurses and emergency medical personnel nationwide who would be the country’s first line of defense against a bioterrorist attack ever even consider the possibility.
And, contrary how it may appear from the test Bartlett ran in February, he and Henderson said Maryland is actually one of the better-prepared states for bioterrorism.
Maryland is one of 35 states, for example, with a central point of contact where frontline medical professionals can report unusual symptoms that could indicate a public health emergency. Those could be anything from a bioterrorist attack to the emergence of a drug-resistant bacteria.
But Bartlett’s hypothetical example showed that a central point of contact does no good if no one knows to call it or if no one responds on the other end.
“In Maryland that single number is there, but nobody knows it’s there,” he said. “That number ought to be on every hospital directory.”
Federal and state public health officials Thursday underscored the need for central contact points at the state and national levels.
“When 50 or even 20 people show up in one emergency room [with unusual symptoms], that’ll raise a lot of red flags,” said Dr. Jeffrey Koplan, director of the Centers for Disease Control. “The bigger fear is one case in Bethesda, one in Nashville, one in Spokane.”
Margaret Hamburg, assistant HHS secretary for planning and evaluation, said after the hearing that local doctors and federal officials are “really all on the same page.” But state governments will have to help if the nation is to have an effective biological threat program, which cannot be “just driven by federal dollars,” she said.