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Hospitals Prepare for Bioterrorism

By THERESA AGOVINO
.c The Associated Press


NEW YORK (AP) - Amid the horror of the Sept. 11 attacks, Dr. Dan Wiener had
an even more horrifying thought.

He watched nearly 100 shocked, soot-covered victims of World Trade Center
collapse rush through a hospital emergency room door usually only used by
ambulance drivers. And he wondered what the awful impact would be if they
were carrying contagion from a biological or chemical attack.

Now, St. Luke's-Roosevelt Hospital Center in Manhattan is building a door
over that entrance and revamping security. It is also developing a rapid
screening process for the anthrax, buying new protective suits, planning for
more decontamination showers and training an additional 100 staffers in
coping with a bioterrorism attack.

``We think with a different mindset now,'' said Wiener.

``In a way, you always knew some sort of a bioterrorism attack could happen''
added Wiener, the hospital's chairman of emergency medicine. ``But now that
possibility is more real, and we've been adding a whole new level of expertise
.''

Hospitals traditionally have done some planning for accidents such as plane
wrecks or building fires, and for hurricanes or other natural disasters. But,
experts say, they are not ready for a major chemical, biological or nuclear
attack.

``On a grand scale, hospitals are ill-prepared to deal with bioterrorism or
chemical attacks,'' said James Snyder, a microbiology professor at the
University of Louisville and the author of ``The Anthrax Vaccine: A Question
of Safety. ``We just never thought it would happen. We had a false sense of
security.''

The hospitals say that equipment and training for such an emergency would
cost billions of dollars at a time when they are already struggling with
financial losses and shortages of equipment, nurses, pharmacists and lab
technicians.

A third of the United States' 4,900 hospitals lost money last year. More than
300 have closed since 1990.

The American Hospital Association is seeking $11.3 billion from Congress for
more drugs, protective clothing and decontamination showers, among other
things. But large amounts of money aren't forthcoming.

The Bush administration has proposed $1.5 billion to fight bioterrorism, with
about $50 million earmarked for hospitals. A bioterrorism bill sponsored by
senators Edward Kennedy, D-Mass., and Bill Frist, R-Tenn., has been whittled
down to $1.5 billion from $10 billion. A $7 billion proposal by House
Democrats has no Republican support.

James Bentley, senior vice president for the hospital association,
acknowledges that many industries are asking for government help in
connection with the attacks, and the threat of more terrorism.

``But the nation has to ask itself: Would it rather bail out the airlines or
have a safe community?'' he said.

The association recommends city hospitals be prepared to treat up to 1,000
people for 24 to 48 hours. Smaller hospitals should be ready for 200
patients.

``We'd be overwhelmed by 100 patients,'' said Kris Roce, chief executive
officer of Ohio-based Forum Health, which runs hospitals in Youngstown and
Warren. ``Even if I could open 100 extra beds, I wouldn't have nurses to
staff them.''

Forum Health has spent about $30,000 to purchase new two-way radios and add
additional drugs. The hospitals had an operating loss of $5 million last
year, and can't afford to buy more protective suits that can cost $260 each
or decontamination showers that can cost $500,000 to install, Roce said.

``Buying equipment is a good insurance policy, but how practical is it?'' he
said. ``What is the likelihood that someone will hit Youngstown, when there
are bigger cities near us like Cleveland or Pittsburgh?''

OSF Saint Francis Medical Center in Peoria, Ill., spent about $60,000 to
purchase some four portable decontamination showers and hazmat suits. But its
stocks of antidotes for biological and chemical weapons, such as the Atropine
used for treatment of mustard gas victims, is limited.

``You try to spend money as wisely as you can,'' said Dr. George Hevesy,
chairman of the hospital's emergency department.

Like most hospitals, OSF has distributed information to doctors on how to
identify conditions such as smallpox and anthrax. In a government-run mock
disaster test four years ago in Denver, 3,000 people ``died'' from the
plague, in part because it took more than 18 hours to diagnose the highly
contagious disease.

Dr. Stephen Cantrill, associate director of emergency at Denver Health
medical center, said he believes the experiment left his city better prepared
than most. Colorado passed a law requiring hospitals to have a certain level
of drugs on hand because it took longer than expected for Federal supplies of
medicines to reach the institutions.

The confusion from the trial prompted area hospitals, police, firefighters
and emergency workers to realize they needed better coordination.

``I think we'd do better now,'' he said. ``But you can't be prepared for
everything.''

AP-NY-11-05-01 1429EST

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