Are We Ready for a Bioterrorist Attack?

. Is this country prepared to handle a bioterrorist attack? Bob Schieffer and Gloria Borger talked to Senator Bill Frist, who is the ranking Republican on the public health subcommittee in the Senate and Dr. Mohammed Akhter, who heads the American Public Health Association.

DR. MOHAMMED AKHTER, American Public Health Association: I think we are fully prepared to handle a small attack like this anthrax-type things. We are on top of it.

But when it comes to a larger attack, then we are not prepared, we are short in many, many places, because we do not have an early warning system in place that will let us know that an attack has taken place and that we should take prompt action. We don't have the capacity at the local level to deal with this. The CDC [Centers for Disease Control and Prevention], our central place where people go for help, could be very much thinly stretched, and so they will not have the resources.

And I'm very pleased that Senator Frist has shown the leadership in the Senate to move this forward before the Congress, to have adequate resources allocated so we could be prepared as quickly as possible to deal with the bigger threat.

SCHIEFFER: Well, to kind of underline that, Senator Frist, what I was struck by--and I don't remember if it was Dr. Akhter or someone else, one of the other witnesses that was before your committee--but they said that 500 cases of anthrax, that if that happened, there is no hospital or contiguous group of hospitals that could handle 500 cases at once.

SENATOR BILL FRIST, REPUBLICAN-TENNESSEE: No, I think the points that need to be made . . .

SCHIEFFER: Is that true? I mean, do you agree with that?

FRIST: There's no question, if you were to use anthrax as a weapon of mass destruction--which Osama bin Laden and the terrorists have the capability to do, to my mind--If were you to use it, our system is underprepared, not unprepared, because we can respond. We've made huge progress in the last 2 years.

That's not what we're seeing now in New York or the threat you were talking about earlier here, or in Florida. The other response has been beautiful. It's been like a symphony. It's been the FBI working with the public health system the way they haven't had to in the past, with good surveillance, good communication, good laboratory response.

The problem would be is if that occurred all over the country or if an airplane flew over and exposed hundreds of thousands of people, you couldn't handle it in our public health infrastructure. You couldn't handle it at the local emergency room. I'm not sure we would have--we don't know, if it happened in several different spots--enough vaccine or antibiotics.

That's what we can do, is build that public health infrastructure, and we're doing that rapidly. We're much better prepared now than we were a year ago or 2 yeas ago. Five years ago we weren't prepared at all.

SCHIEFFER: Gloria?

BORGER: But we're talking about anthrax right now, which is something that, as you both have said, is sort of controllable. What about if there is some kind of bioterrorist attack that involves a plague, that involves smallpox?

Is that something, Dr. Ahkter that really worries you?

AHKTER: Absolutely. There are times that you can't go to sleep because you know the weaknesses in the system.

Unlike anthrax, these other diseases can spread from one person to another, and so--and we have large numbers of people. In fact, all of us in this country are not protected against smallpox. And we know from our intelligence reports that many of the terrorists could get this, have access to it through the Soviet Union through other places.

And so, the best thing we can do is to really prepare ourselves, build our capacity, educate our people, so tht we could act as promptly as we can to really contain the very first case and then provide the treatment.

SCHIEFFER: Senator Frist, we were just talking about the possibility of someone trying to infect the nation with smallpox. Is that possible or likely?

FRIST: You know, it is. And when we look at the various agents, you can say anthrax, smallpox, tularemia, pneumonic plague, you can go down a long list. And that's what's important for us in public health, in public policy to be addressing.

Smallpox has huge consequence, much more than an atomic bomb if it were released, to my mind, much more today. Why? Because unlike anthrax, it's contagious.

There was an exercise called Dark Winter planned for actually 2001 using preparedness today. And we know by introduction on that model in three different states that within 3 months it spread to 25 states, spread overseas. There are no boundaries there. About 2 million people would be dead, 5 million people sick at the end of 3 months.

That makes it alarmist.

The good news is that smallpox has been eradicated from the face of the earth. The flip side of that is that we know there is some smallpox in this country, in Russia, and possibly in other countries.

SCHIEFFER: Well, people my age, we still have our vaccination scar, because when we were little kids we got vaccinated. They don't do that anymore. Should we start doing that again, Doctor?

AKHTER: No, I don't think we're ready right now. But this is one area where we need to be working together with the intelligence community, the public health community, to see the level of threat. If the level of threat ever rises, if there is one case of smallpox, I would be the first one sitting here advocating, saying let's prepare our nation and protect our people.

FRIST: Let me say to that that we are prepared with that first step. There is no treament. Smallpox is a virus. It's contagious. It takes about 10 days. So, right now if I had smallpox, you would be infected and we'd all be going around the country infecting other people.

We have to identify those cases. We have to have better surveillance. We have insufficient surveillance. As a doctor, I've never seen a case. First responders don't even know how to recognize the rash. We have to have better communication so if it's picked up in New Orleans or down in Florida or in California, they can communicate. We have inadequate communication today. And we need better laboratories.

I say all that because anthrax we're doing a great job with. The FBI is, the public health infrastructure is. But if we have another agent that is a contagious agent, we are underprepared today.

AKHTER: Absolutely.

BORGER: What do we do, though? Here we are talking about things like a possible smallpox, bubonic plague, or whatever. What can we say to people? Not to panic people, but to tell them, okay, there are ways you can prepare for this. There are ways you can recognize this. These are the prudent things to do.

AKHTER: I think what we need to tell people is not to worry. We are looking at all possible options. We are getting ready. We are getting prepared. There is very little that an individual can do until we find the first case.

And then we are setting up communications systems. We are working all together. We will let the public know. We are gathering the vaccines. We are putting our people together. We are educating the medical community. We are strengthening public health departments. That's what people need to know.

They shouldn't be worried about it. It's us, the folks in public health community and the government, who should be worrying and building and working hard to make sure that we are ready in case the unthinkable happens.

FRIST: And, Gloria, Secretar Thompson has said he has taken criticism for being too optimistic. But he's exactly right. When we started addressing this issue 2 or 3 years ago, we were unprepared. Today, anywhere in the country we can get 10 million doses of smallpox vaccine, which is plenty sufficient, I believe, for right now. Within a year we'll be able to get 40 million doses. Now, we may need to go higher than that, but our government is working very, very quickly.

Same thing with anthrax today. It is treatable. And it is treatable with antibiotics today, and we can get 2 million doses anywhere in the United States of America within hours.

So people don't need to be stockpiling. They don't need to be buying gas masks today. Our federal government is fulfilling its responsibility. Now we need to fill these gaps that are in there at the level of public health infrastructure.

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