Most U.S. hospitals found unprepared to handle
chemical, biological attack
January 11, 2000
Web posted at: 10:24 p.m. EST (0324 GMT)
(CNN) -- Should a large scale biological or chemical
attack be launched against U.S. civilians -- the
United States has no practical contingency plan to
handle it, according to a new report published in this
week's Journal of the American Medical Association.
| MESSAGE BOARD|
Hospitals and other health care facilities are "poorly
prepared" to care for victims of such an attack, the
Terrorism experts say the probability of such an
attack on any single U.S. city is low. However, they
add, it's not so much a matter of if or when it will
happen, as it is a question of where the attack will
Terrorist activities that would affect a large number
of civilians are of greatest concern. The JAMA study's
authors looked at key elements of effective hospital
response including decontamination and triage, medical
therapy and coordination with public health agencies
and emergency response personnel.
Medical Correspondent Dr. Steve Salvatore looks at whether hospitals are prepared for a bioterrorist attack.
"I think there is a general consensus among emergency
planners and among the health care community in the
United States that our health care preparedness for
catastrophic chemical terrorism is not where we want
it to be," said Dr. Joseph Barbera of George
Five years ago, the Clinton administration spent $158
million to train firefighters, police and emergency
medical service workers in 120 cities to deal with
Experts say biological and chemical attacks shift a
large part of the burden away from police and firemen
to hospitals and health care workers.
"Our first obligation is to protect the facility,
meaning the staff, our current patients, and our
capability to take care of patients," Barbera said.
"So we need to have immediate perimeter control and to
redirect patients to where they can get what they
need, which is decontamination."
3 out of 4 hospitals unprepared
Currently, about 25 percent of 6,000 U.S. hospitals
are at some state of readiness for a chemical or
biological incident, according to the American
One such facility is New York's Presbyterian Hospital.
"We had to consider our proximity to areas that might
likely be involved," said Dr. Neal Flomenbaum, head of
the emergency department at New York Presbyterian
Hospital. "The logistics of decontaminating large
numbers of patients -- the likelihood that after a
period of time, the ground floor of the hospital could
The hospital is stockpiling large quantities of
antidotes and antibiotics in case of a bioterrorism
"There's real reason to stockpile them in a central
location," Flomenbaum said. "By central, I don't mean
in one location for the entire country, but in cities,
because the last thing you would want to do is have
them widely available in the individual facilities and
FBI declared 4 high level alerts in Dallas
Parkland Hospital in Dallas also has a stockpile of
drugs, including the antidote for sarin nerve gas,
antibiotics for anthrax and medication to relieve
The Texas facility also has a bioterrorism response
team and has trained the staff using simulated
attacks. However, hospital officials concede they
would be quickly overwhelmed.
"We could be dealing with 10 to 100 times what we've
planned for," said Dr. Kathy Rinnert, a leader of one
of the response teams.
Hospital officials said that since September, the FBI
has declared a "Level One" terrorist alert -- the
agency's highest alert level -- in Dallas four times
"While the frequency of risk is low, when an event
occurs, the casualty numbers and the mortality -- the
number of people that die -- will be very, very
large," said Rinnert.
Pentagon needed in handling catastrophe
There has been only one successful biological attack
in the United States. In 1984, the Rajneesh cult
poisoned salad bars in Oregon with salmonella,
sickening some 750 people.
"These are weapons that terrorists have had access to
for decades and yet have shunned -- and I think
they've shunned them for good reason -- that they are
not very reliable. They are difficult to weaponize,"
said Bruce Hoffman, a terrorism expert with RAND.
A 1995 sarin gas attack in a Tokyo subway killed 11
people and set off alarms in Washington.
Last year, the Clinton administration doubled spending
on federal efforts to counter such attacks, raising
the figure to $1.4 billion.
The Defense Department set up a new command designed
to help local police and disaster relief efforts --
drawing on the military's expertise in chemical,
biological and nuclear weapons.
"The Defense Department is very adept at mobilizing
and moving large numbers of people and great
quantities of equipment and materials very quickly,"
said Brig. Gen. Bruce Lawlor, commander of the Joint
Task Force. "In the event of one of these
catastrophes, those kinds of skills are going to be
Hoffman pointed out, however, that, "terrorists can
still accomplish their basic aims of fear and
intimidation just as well by using entirely
conventional weapons -- the gun and the bomb."
Even those sorts of attacks apparently were
successfully thwarted over the New Year's holiday. So
while there is reason for caution, some analysts argue
there's no need to go overboard against a threat that
has yet to materialize.
Medical Correspondent Dr. Steve Salvatore, National
Security Correspondent David Ensor and Correspondent Charles Zewe contributed to this report.
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American Hospital Association - Home Page
JAMA: Weapons of Mass Destruction Events With Contaminated Casualties: Effective Planning for Health Care Facilities
The George Washington University
New York Presbyterian Hospital: The University Hospital of Columbia and Cornell
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