November 26, 2001
Cleland, Barnes talk bioterrorism at Emory
By Michael Terrazas firstname.lastname@example.org
U.S. Senator Max Cleland (D-Ga.) wants to pass legislation to help America
deal with the threat of biological and chemical warfare. In order to assess
the current state of readiness in the public health system, he wanted
to talk to people on the front linesand even ahead of the game.
Cleland held a Nov. 19 roundtable to discuss bioterrorism in the auditorium
of the Nell Hodgson Woodruff School of Nursing, and some of public healths
heaviest hitters were on hand to contribute. Participating in the discussion
were Emorys own James Curran, dean of the Rollins School of Public
Health; Jeffrey Koplan, director of the Centers for Disease Control and
Prevention; Kathleen Toomey, director of the Georgia Division of Public
Health; and Phil Jacobs, chairman of Friends of CDC, an organization dedicated
to lobbying for adequate funding for the federal agency. Joining the roundtable
toward the end was another guest of some repute, Georgia Gov. Roy Barnes.
National homeland defense begins and ends at the state and local
levels, Cleland said. As we work to shore up our preparedness
on the national level, it will be our first responders, our emergency
room doctors and our fire and police forces who will be the ones on the
front lines. They must have the best training, resources and information
to successfully prevent a bioterrorist threat from becoming a tragedy.
Cleland has authored a piece of legislation, the Public Health Emergencies Account-ability Act, that would clarify the chain of command in a crisis such as that caused by a bioterrorism attack.
Currently, Cleland said, federal law is unclear as to which agency would
assume authority in the event of such an attack, but Clelands bill
would provide some marching orders.
The bill would put the Federal Bureau of Investigation in charge in case
of an attack, but the secretary of Health and Human Services would retain
the authority to declare a public health emergency, at which
point the CDC would begin calling the shots. But whoever is in charge,
Cleland said, most important is that both law enforcement and public health
agencies work together to deal with a crisis.
As for the new Department of Homeland Defense, headed by former Pennsylvania
governor Tom Ridge, Cleland said the fledgling agency would be hard-pressed
to comprehensively manage a government response in such an event.
I wish Tom Ridge the best of luckhes a fellow Vietnam
veteranbut hes got 18 people, Cleland said. How
can 18 people oversee 70 federal agencies? I dont know. Pray for
Koplan spoke of the importance of communication between the CDC and local
health departments, which would be the first line of defense against a
biological or chemical attack. The recent discovery of anthrax in Florida,
Koplan said, was due to the diligence of a local health official in Palm
Beach County, who made a preliminary diagnosis and then quickly sent specimens
to CDC for confirmation.
The state of public health in America as a whole is only as strong
as its weakest link in the local health departments, Koplan said.
Koplan estimated that CDC had studied barely 200 cases of anthrax in
the 55 years before Sept. 11, and just 18 of those were inhalation anthrax.
We have learned things every day during this crisis, he said.
Curran commented on Clelands belief that Atlanta, as one of the
countrysand, thus, the worldspremier centers of
public health, should be viewed as a model for other cities in preparing
Nobody knew what it meant to be the public health capital
of the world until Sept. 11, Curran said. Public health
is the pulling together of everything we do as a society to ensure health,
both in times of emergency and more normal times.
Toomey said Atlanta, and DeKalb County particularly, have a leg up on
much of the country in planning for terrorist attacks for a couple reasons.
First, DeKalb has been working with CDC and Toomeys office for more
than a year to develop a bioterrorism response plan; and second, the city
is building off preparations made for the 1996 Olympic Games.
Toomey added that communication is critical in a crisis, and adequate
resources must be directed toward improving communication for the public
health system. She said roughly 60 local health departments across the
state are not yet connected to CDCs online system, but they should
be by early 2002.
What has really emerged from the events of Sept. 11 is the fact
that the public wants a single, credible source for health information,
Toomey said. Discordant messages can lead to confusion.
Jacobs spoke of the deplorable condition of much of CDCs
laboratory facilities and the drive to increase the agencys federal
funding. Before Friends of CDC was created, Jacobs said, the agencys
annual facilities budget was $30 million. The first year the group began
lobbying on CDCs behalf, that number jumped to $60 million. Last
year it stood at $175 million, and Jacobs said he hopes to secure as much
as $300 million in FY03 to upgrade CDC labs.
Barnes, who arrived at the event just as the floor opened up for questions, echoed Jacobs sentiments. Without a significant investment from the federal level, Barnes said, we run the risk that this agency will not be able to provide the critical support we all need. This needs to be done, and it needs to be done now. I can think of no higher priority.