Web Exclusives:Features

July 7, 2002:

Preparing for the worst
Senator Bill Frist '74 looks at bioterrorism

If you are a worrier, you might not want to read Senator Bill Frist '74's book on bioterrorism, When Every Moment Counts: What You Need to Know About Bioterrorism From the Senate's Only Doctor, published this year. In it, he details the most likely agents of bioterrorists, including anthrax, smallpox, and plague. And he looks at how terrorists could distribute chemical weapons and contaminate our food and water supplies. It's not a pretty picture.

As Frist says in his book, "bioterrorism is now a reality in the United States." And he predicts that bioterror attacks are a virtual certainty in our nation's future. "It's no longer a question of if but when and where and how," he writes. The nation's experience with anthrax last fall proves our health-care system was not prepared. "Gaps in our public health system — the result of 20 years of neglect and underinvestment — became glaringly apparent," writes Frist, whose own Web site http://frist.senate.gov/offers information on bioterrorism and links to related sites. "What we were discovering was that even the information from the best medical scientists and public health specialists [about anthrax] in the United States was wrong. Dead wrong."

In an easy-to-read, question-and-answer format, Frist addresses the issues that are on most people's minds about the various biological and chemical agents that terrorists might use. He devotes a chapter to each of the most likely known biological terror agents, discussing symptoms, how public health officials would likely deal with an outbreak, what countries have supplies of the agents, and whether cures or vaccinations are available.

Smallpox poses a dangerous threat, writes Frist. Last winter, he notes, the military held an exercise called Dark Winter that simulated a smallpox outbreak in the U.S., starting with 20 cases in Oklahoma City. Within two months, "there would be an estimated 3 million smallpox cases and up to 1 million deaths" and the disease would have spread around the world.

What would be the impact of a botulism attack? Frist answers: "A large outbreak could quickly overwhelm the number of available ventilators, critical care beds, and skilled personnel." Iraq, Iran, North Korea, and Syria are "believed to be developing botulinum toxin as a weapon."

You get the idea.

What can you do to help prepare for another attack? Develop a disaster plan and assemble a disaster kit, including water and canned food to last three days, change of clothing, respirators for each family member, flashlight, cash, sleeping bags, medicines, and plastic tape to seal windows — so that your family could be self-sufficient for several days after an attack. Frist recommends determining a family meeting place outside your neighborhood in case you can't get home and designating a "safe room" in your house, with a radio and telephone in case officials tell the public to shelter at home.
Many experts believe that the U.S. is more vulnerable to an attack of our food or water supply than any other kind of bioterrorist attack. Writes Frist: "Our food is particularly vulnerable to a potential biological attack, primarily because of inadequate government oversight. Only one percent of all food imports are properly inspected."

Agroterrorism — the use of biological weapons against animals and crops —wouldn't cause human sickness and death but it would disrupt our food supply. "The economic impact of agroterrorism could be staggering," he writes.

On the brighter side, our water supply seems to be fairly protected from a bioterrorist attack because it would require "truckloads of biochemical agents that would be difficult to produce and relatively easy to spot." And "any biological agent put in the water at its source would be so diluted that it would have no effect by the time it came out of your faucet."

By the time I got through reading about all the possible threats and how "underprepared" our nation is to deal with a biological or chemical attack, I felt numb. "Today we remain highly vulnerable," writes Frist, who outlines all the tasks ahead for our federal, state, and local officials, including hiring more FDA inspectors, making sure that scientists from the former Soviet Union's bioweapons programs don't sell their services "to the highest bidder," and improving the communications systems between our public health officials and health-care providers. Frist states that "One in five public health offices does not have e-mail. In this high-tech age, many public health offices still collect information on disease outbreaks by having doctors send in postcards."

Frist tries to reassure readers: "In our federal, state, local, and private health systems, we have all the pieces we need to wage an effective defense against bioterrorism. We just need to coordinate those pieces in a seamless way." In the end, he sounds confident that the U.S. can meet the challenges ahead.

We'll see.

By K.F.G.