Bioterrorism defense improving one year since anthrax attacks

? A year after the first anthrax-tainted letters were dropped into a New Jersey mailbox, the nation is vastly better prepared to face bioterrorism. Yet experts agree that major holes remain in communications, emergency planning and staffing, and many fear the country’s resolve could fade along with memories of the attacks.

There have been no arrests and there are officially no suspects in the criminal investigation into the attacks-by-mail, which killed five and sickened 18. While the investigation appears stalled, efforts to prepare for the next attack have moved steadily forward.

Members of a hazardous materials team wait outside the West Trenton post office in Ewing, N.J., in this Oct. 25, 2001, file photo. A year after the first anthrax-tainted letters were dropped into a New Jersey mailbox, experts worry that, even if the money is available, there aren't enough trained epidemilogists, lab technicians and other public-health experts to do the work needed.

“Public health has always been the poor stepchild. It’s never received the dollars, it’s never received the attention,” said Health and Human Services Secretary Tommy Thompson. “One of the good consequences of 9-11 is we now have the resources available to build the public-health system.”

Much work remains.

An expanded National Pharmaceutical Stockpile is loaded with medicines, vaccines and supplies, ready to land a cargo plane with 50 tons of material in any city within hours. But many communities have no plan for transporting those supplies to the public.

States have new money to hire public-health workers, but there is a dearth of talent for hire.

While cities are now focusing on the threat, experts worry there is still no efficient way to get medical information to the doctors on the front lines.

Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention, described a “mosaic of preparedness.”

“In some areas, certain aspects are absolutely gold standard and others have a ways to go, and in a neighboring district it might be just the opposite,” she said Wednesday.

Despite the limited scale of the anthrax attacks, the public health system was severely taxed under the weight of investigating hundreds of false alarms, testing more than 120,000 environmental samples and distributing antibiotics to thousands of people who may have been exposed to the bacteria.

“Last fall was a tragic dry run,” said Dr. Michael Osterholm of the University of Minnesota, who advises HHS on bioterrorism. “That was horrible, but we all know what it could have been had the same amount of anthrax been put into air intake systems.”

The long-neglected public health infrastructure the people and systems who guard the community’s health got an unprecedented, rapid infusion of dollars, nearly $1 billion. “I can’t remember a time when money went out that quickly,” Osterholm said.

Yet he and other experts are concerned states will fail to put up their own money to finish the job or, worse, will cut back existing state spending now that the federal dollars have arrived. Some want Washington to ensure that the states spend the money wisely, something HHS has pledged to do.

A small community of experts had long argued that the country was vulnerable to bioterrorism, but their warnings received little attention before last fall. Now experts fear that as memories of the anthrax attacks fade, attention to solving these problems may, too.

Osterholm hopes people stay a little scared. He points to the fire department at the Minneapolis airport. There’s never been a fire there.

“But tonight could be the night,” he says. “We have to understand today can be the day that the next shoe drops.”