The day before, a Seattle Post-Intelligencer article cited the "woeful level of preparation for bioterrorism nationwide."
And on Sept. 26, the Atlanta Journal-Constitution quoted former Sen. Sam Nunn, D-Ga., as saying, "America is most vulnerable today to a biological or chemical attack."
To read these and other stories, it's natural to ask: Are we in imminent danger of an attack by killer germs? And are the nation's health agencies prepared for an epidemic?
While it's vital that emergency rooms and family physicians be able to recognize an outbreak, and while hospitals and health agencies must have cohesive plans for dealing with thousands of infections, the reality is that there is no bulletproof vest to protect us against disease.
The real predicament is that we can't stop a determined terrorist from mastering the intricacies of unleashing a germ. And there is no plan of action that can keep a germ from killing.
"The terrorist has a number of weapons at his disposal," says Dr. Henry Siegelson, an emergency physician at WellStar Cobb Hospital who has trained Atlanta hospital personnel to recognize signs of a possible biological attack. "But we only have a limited capability to respond. We only have a certain number of paramedics and firefighters and nurses and physicians and hospitals."
It is unreasonable to think we should build hospital wards and hire staff who would serve no purpose except to wait for an attack that might never come. In the event of an extremely successful biological attack -- however unlikely one is -- we cannot expect to prevent all casualties. We can only plan to keep the casualties down.
Most scientists and health officials bracing for biological warfare have narrowed a terrorist's likely arsenal to two major threats: anthrax and smallpox. Neither of them is easy to morph into weapon form, yet each would present its own horrific set of challenges to those trying to stop it.
Anthrax grows like yeast, and a well-funded terrorist with spores in hand could cultivate more fairly quickly. "It's not rocket science, but it does require some specialized skills," says Jeanne Kwik, a Johns Hopkins professor and fellow at the university's Center for Civilian Biodefense Studies.
Kwik points out that anthrax, easy as it might be to grow, is difficult to disperse in the air and almost impossible to spread through water supplies. "UV radiation from sunlight can kill a lot of the bugs," she says. "And water treatment centers are designed to remove biological agents."
If sunlight failed to kill anthrax, the spores would have to remain in a dense cloud so that a person breathed in enough of them. And the spores would have to be nourished to a very specific size, Kwik ways. If they're too big they can be coughed out. If too small, they might fail to infect you.
In the case of a successful anthrax attack, the first people to show symptoms -- in a few days or a few weeks -- would appear to have the flu, then would die in a day or two of respiratory failure or shock. More would surely follow. Anthrax is not contagious, but it does carry a 90 percent fatality rate without early antibiotic intervention.
If, upon the initial deaths, there was a mad dash to pharmacies and shelves were immediately cleared, the government would tap into eight massive stockpiles of antibiotics and vaccines, Secretary of Health and Human Services Tommy Thompson said on Sunday's "60 Minutes." One of the stockpiles is in a Buford Highway warehouse, according to Dr. Bill Waugh, a Georgia State University professor and terrorism consultant to the Federal Emergency Management Agency.
But the number of deaths would likely outnumber the number of people who could be saved, even if the supplies were dispatched within hours. Antibiotics must be administered before symptoms of anthrax appear. An analysis by the Office of Technology Assessment of the U.S. Congress estimated that 130,000 to 3 million deaths could occur following the release of 100 kilograms of anthrax over Washington D.C., according to the Center for Civilian Biodefense.
In order for a terrorist group to get its hands on so much anthrax, it would have a hard time cultivating it from an infected animal, where the bacteria usually occurs, or from a manmade vaccine, according to Kwik.
The group would likely have a much easier time getting it from Iraq, Iran or North Korea, which are believed to have amassed biological weapons, Kwik says. More than a dozen other countries are rumored to be experimenting with deadly germs. Some may have been leaked from the former Soviet Union's dismantled biological weapons programs.
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