Most States Remain Unprepared for Bioterrorist Attacks, Report Finds
States have made some improvements in bioterrorism preparedness since 2001, but most remain "woefully unprepared" to respond to a bioterrorist attack or public health emergency, according to a report released on Tuesday by the Trust for America's Health, USA Today reports (Hall, USA Today, 12/15). The report is the second annual survey of state bioterrorism preparedness conducted by TAH, but the group revised the criteria since last year that made comparisons with the previous results incomparable (Baldor, AP/Bakersfield Californian, 12/14).
According to the new report, the federal government since 2001 has spent $3 billion to improve bioterrorism preparedness, but states have made "little progress" in the implementation of systems to track disease outbreaks, the preparation for widespread distribution of medications and vaccines and the provision of equipment to enable laboratories to identify and test for pathogens, USA Today reports (USA Today, 12/15). Most states also lack statewide bioterrorism response plans, and many have not adequately funded their public health systems, according to the report.
Federal bioterrorism funds decreased by $1 million per state in fiscal year 2004, and about one-third of states reduced their public health budgets, the report found (AP/Bakersfield Californian, 12/14). In addition, the report found that many states face "impending mass retirement of state public-health personnel," which "creates a challenge that is unlikely to abate in the foreseeable future" (Shelton, Orlando Sentinel, 12/15).
The report graded states on whether they met 10 criteria for bioterrorism preparedness, such as the amount of state and federal funds spent on public health, flu vaccination rates and the number of scientists and laboratories available to test for anthrax or plague (AP/Bakersfield Californian, 12/14). In addition, the report graded states on whether they have laboratories that can handle pathogens, the legal authority to order quarantines, an adequate public health workforce, the ability to track disease outbreaks electronically and plans to respond to a flu pandemic (Imse, Denver Rocky Mountain News, 12/15).
According to the report, no state met all 10 criteria, and most met only five or six. Florida and North Carolina met the most criteria at nine, and Massachusetts and Alaska met the fewest at three (AP/Bakersfield Californian, 12/14). The report found that many states "lack the resources to handle routine threats" -- such as a severe flu season -- "let alone the potential devastation of an intentional smallpox or plague outbreak," the Sentinel reports (Orlando Sentinel, 12/15).
According to the report, only six states have the ability to distribute medications and vaccines from a federal stockpile in a public health emergency; 20 states have no plan to respond to a flu pandemic; only five state have public health labs with the ability and space to address a chemical attack; and two-thirds of states do not have the ability to track disease outbreaks electronically (USA Today, 12/15). In addition, only 16 states have an adequate number of labs and only 21 have an adequate number of scientists to address serious disease outbreaks (AP/Bakersfield Californian, 12/14).
The report recommended several improvements for U.S. bioterrorism preparedness. The report said that the federal government should establish consistent, measurable standards of improvement to ensure states are held accountable for their bioterrorism preparedness.
In addition, the report said that states should conduct more drills to improve their response to bioterrorist attacks and to identify problems. The report also recommended improvements in public health services, such as systems to monitor diseases (Orlando Sentinel, 12/15).
"More than three years after 9/11 and the anthrax tragedies, we've only made baby steps toward better bioterrorism preparedness, rather than the giant leaps required to adequately protect the American people," TAH President Lowell Weicker said (Heil, CongressDaily, 12/14). He attributed the lack of bioterrorism preparedness to "public perceptions," adding, "It's easy to visualize planes going down. (But) it's far more difficult to understand matters scientific, which are far more deadly in terms of the number of people who could be affected."
Shelley Hearne, executive director of TAH, said, "Health preparedness is probably the weakest link in homeland security. Ironically, it's the one we've had the most reminders about in the past three years" (Orlando Sentinel, 12/15).
Von Roebuck, a CDC spokesperson, said that agency officials "feel comfortable that any state in the nation could respond" to a bioterrorist attack. He added that "there's been a lot of really good progress that's been made" on bioterrorism preparedness, although "there is work that still needs to be ongoing."
Lisa Speissegger, a public health analyst with the National Conference of State Legislatures, said, "It's really tough to work with a federal budget that's not consistent year to year. Public health departments are doing the best they can" (USA Today, 12/15).
Health officials for Colorado, which the report found met six of the 10 criteria, questioned the results because some of the data used was outdated. Ned Calonge, chief medical officer for the Colorado Department of Public Health and Environment, said that the state meets all 10 criteria, adding that TAH "didn't call us" (Denver Rocky Mountain News, 12/15). The report is available online. Note: You must have Adobe Acrobat Reader to view the report.
"The World" -- a production of BBC World Service, PRI and WGBH Boston -- on Tuesday included an interview with Hearne (Werman, "The World," PRI, 12/14). The complete segment is available online in Windows Media.