Wednesday, October 24, 2001
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Wednesday, October 24, 2001 |
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District health chief: 'No reason for panic' By MICHAEL BRACKETT Fellow citizens: There is no reason for panic, just caution. I am writing to reassure the general public that the professionals working in public health services have been aggressively addressing the terrorism issue for the past four years. With support from the Department of Defense, Department of Justice, National Health Service, CDC and a host of others, we have worked and will continue to work to improve the ability to rapidly recognize unusual diseases, improve communications between hospitals, EMS, fire, police, resource physicians, and public health. A successful response to this threat will require a coordinated team effort. We have carefully studied response scenarios. There are guidelines that cover most practical questions on the basics of handling "suspicious for terrorism" threats. No guideline can address all potential situations, so judgment on the scene, coupled with resource phone calls, will no doubt be required on some cases. The first thought in each event obviously goes to the safety of the people involved at the scene. Local professional judgment calls should always take precedent until further information is available. While no one is completely happy with our level of competency, I think that the events of the past few weeks have proven that despite determined attack, we can minimize the real threat to the general public. I am confident that our president, working with other leaders of the free world, with the forces at their command, are dealing a mortal blow to our enemy in what appears to me to be a world war on terrorism. I believe that these cowardly acts of bioterrorism on our soil are the desperate shots of a weak and dying criminal faction. While there will likely be more incidents in our future, I have no doubt in our ability to prevail. I want to emphasize that most of the current incidences of powder exposure are extremely low risk for biologic contamination. There is no reason for panic, just caution. Most scenarios are presently managed over a one-week period of time. It also takes time to determine not only if a risk exists, but of what type. Powders being tested nationwide are overwhelmingly testing as negative for anthrax, but any could be anthrax or some other biological agent. Treatment, if needed, could vary depending on the agent detected. Unfortunately, this type of substance analysis takes time, about three to four days for preliminary and three to four more days for confirmatory tests. This is usually within the window for successful use of antibiotics to prevent or treat illness. Taking antibiotics without knowing if they are needed and for what specific germ is always unwise. Generally speaking, then, time is on our side. Patient, scientific analysis will lead to wise decisions without risking lives. Each of these cases of "terroristic threat" is a potential crime scene. First, call 911. The local police may also be called in some situations to protect evidence and pursue their functions unimpeded. It is quite possible that the local police will need to call in the FBI. Only the police, sheriff, FBI or other official peace officers are able to collect evidence with proper chain of custody that will stand up in court. We want to be able to prosecute the perpetrator. It sometimes seems counterintuitive to call the police for a medical situation, but this is the case. Any trained official can work with most threats to gather evidence or to decontaminate a suspicious material by using simple protective equipment such as rubber gloves, surgical masks, and perhaps a disposable gown. This is not always an incident requiring hazardous material equipment unless the exposure of a toxic substance has been confirmed or is readily identifiable as hazardous. Cleanup in the case of powders of unknown origin should be done with water/Clorox solution of 10 to 1 ratio by trained professionals after the collection of evidence. All attempts at cleanup should be directed at preventing evidence becoming airborne. Wash with water to reduce the risk of remaining contaminant. Our duty to the "war effort" is the education and reassurance of citizens involved, both at the scene and afterward. The enemy's goal is terror. Our goal must be to thwart this attack through reassurance of the truly low risks involved and our capability to contain the event. This nation is the most capable nation in the world to deal with this threat. We have not completely covered all scenarios, but we have, by all judgments, performed well in the first battle. Compare what is going on in the rest of the world, Afghanistan, for example, with what we are dealing with, and you get a true perspective on the severity of risk. Should you have any questions, call your local health department. If unable to reach them, please call District Four Health Services at 706-845-4035. After business hours, holidays, or week-ends, you may call the Public Health Information Line to reach a nurse on-call at 1-800-847-4262. Michael L. Brackett, M.D., FAAFP District Health Director District Four Health Services LaGrange, Ga.
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