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THE ASSOCIATED PRESS
Feds Rate Puerto Rico Unprepared For Bioterror Response
November 2, 2002
WASHINGTON (AP) -- The federal government has truckloads of medicine and vaccines ready to deploy should bioterrorism strike, but only Florida is fully prepared to receive and distribute those treatments.
Most regions have yet to figure out how they will dedicate 500 hospital beds that could be needed in an emergency, and even fewer have found rooms inside hospitals to isolate contagious patients who could be victims of a bioterrorism attack, federal officials say.
Updates to state bioterrorism preparation plans were due in Washington on Friday, and more progress is expected in what is a continual effort to get ready for a germ attack. Yet top health officials say much work remains.
That's particularly true in handling the National Pharmaceutical Stockpile. Even Florida, the one state deemed ready to receive its contents, still must conduct drills to make sure its plans will work.
``Our biggest concern is we will get to a location and a state or a city will not be ready,'' said Jerry Hauer, assistant secretary for public health preparedness at the Department of Health and Human Services.
Federal officials emphasize that states still could handle an emergency if they had to, even if they are not considered prepared.
``People ask if our state is ready to respond to bioterrorism,'' said Dr. Patricia Nolan, director of the Rhode Island Health Department. ``Let me answer in this way: Being ready is a process.''
After the Sept. 11 attacks, when the stockpile was deployed for the first time, it took New York City officials hours to figure out where to send 50 tons of general medical supplies and how to secure them, but eventually the medicine was delivered.
By Friday's deadline, states were supposed to address key questions about how they will distribute medicine, where they can provide 500 hospital beds in case of mass casualties and how hospitals will isolate highly contagious patients.
Meanwhile, states have until Dec. 1 to produce detailed plans for vaccinating their entire populations within days of a smallpox attack. So far, plans have been filed by only 20 of the 62 states, large cities and territories that are receiving federal bioterrorism money. And those plans, not yet scrutinized, may have serious holes, health officials say.
Many states admit they are far from ready.
In Kentucky, officials have not yet figured out who will deliver the shots or where to find the people to do it, said Dr. Steven Englender, the state epidemiologist. He said it could take 60,000 people at 250 clinics to vaccinate Kentucky's 4 million people over five days.
``That's the math. The practicality is something different,'' Englender said in an interview this week.
Hauer said that math could be conservative if there were an outbreak of smallpox -- a highly contagious, fatal disease. ``Five days might actually be a luxury,'' he said.
Early this year, the federal government began distributing $1.1 billion to help cities and states improve communication systems, upgrade labs, hire disaster coordinators and otherwise build up neglected public health systems. At the last progress report, in June, HHS identified several problems.
In Arkansas, officials had plans to train people to respond to bioterrorism, but not to detect disease in the first place. In Delaware, planners identified hospital beds for 250 unexpected patients, just half of what federal rules require. In Kansas, officials planned to spend $250,000 to handle the National Pharmaceutical Stockpile; federal officials said they should count on needing $1 million.
Another concern: States with budget crunches will have federal money to hire needed workers, but won't be allowed to spend it because of hiring freezes.
The most urgent issue may be the handling of the National Pharmaceutical Stockpile.
The federal government can deliver 50 tons of medical supplies to any city in the United States within 12 hours. But communities must be ready to take control of these supplies from the airport. They must have transportation and security for the supplies and a place to distribute them. They need people who can repackage huge cartons of antibiotics into individual doses.
Federal officials use a traffic light metaphor to characterize readiness for the 62 projects, which include the 50 states, the District of Columbia, the cities of New York, Chicago and Los Angeles, five territories and three associated independent states.
Just one project, Florida, is in the ``green'' category, meaning ready to go, pending a rehearsal. Its rating is ``green-minus.''
Two states -- Wisconsin and Hawaii -- are ``red-plus,'' meaning they are making little or no progress. Puerto Rico is also ``red-plus''; the Virgin Islands is ``red.'' Wisconsin officials said Friday that they have made progress since the last federal evaluation and expect their rating to improve.
Six projects haven't been reviewed yet. The remaining 51 are rated ``amber,'' meaning they are making significant progress toward readiness but aren't there yet. Among those, eight are ``amber-plus,'' 26 are ``amber'' and 17 are ``amber-minus.'' Officials would not say which states fall into each subcategory.