What would we do in a bioterror emergency?

By DAVID HULSE

DRILL SCENARIO: Last weekend you and your family had a big shopping day at a mall in Westchester County. As you’re driving home the following Friday, the car radio airs a news story about health authorities reporting that an infectious bacterial agent called Tularemia was discharged as an aerosol somewhere in the same mall on the same day you were there. Some people have become ill and the disease could be fatal if untreated.

You feel okay, but then you begin to wonder if last night’s bout of diarrhea was only from the old leftovers in the refrigerator. You start thinking about every ache and pain.

The radio recommends that people who visited the mall that day go to a special clinic set up by county health authorities.

LOCH SHELDRAKE, NY — Volunteers playing the parts of sick and/or worried residents filled the Sullivan County Community College Field House Tuesday as county health officials staged a rehearsal to practice their response efforts in a biological terror emergency.

Sullivan County Manager Dan Briggs said he was proud of the public response as more than 100 people took time out to help about 60 emergency response staff members on hand. “I think it’s a great thing that so many people would give time out of a summer day to do this,” he said.

The drill, in this case, created a point of distribution (POD) for anti-bacterial agents to be given to those in need of them. The POD scenario is the result of another chain of events.

In this case of Tularemia, local emergency rooms would have reported an increase in patients with flu-like symptoms within three days of the attack and the federal Centers for Communicable Diseases would have been notified. On the following day, an investigation team would have examined the mall and state and federal emergency agencies would be responding to requests from neighboring counties.

Tularemia would be identified as the cause.

By the fifth day, drugs would arrive from the Strategic National Stockpile for distribution at a POD. In a triage setting, people coming to the POD are interviewed to see if they are truly at risk.

Tularemia, normally passed by ticks, is not communicable from person to person, so only those who were in the mall would be in danger. Those found to be infected would be sent for treatment and those at risk would be given the necessary medicines. Those not at risk would be given an explanation of why not, “so everyone leaves feeling better,” said Carol Ryan, Director of Public Health.

In a real biological terror emergency the problems could vary greatly. Ryan said more than one POD would be set up to make the drugs more convenient and to avoid traffic problems. “Traffic is my real worry. You really don’t want 75,000 people trying to reach the same place at once,” she said.

Some of the emergency logistics, including traffic control, would come from the county’s emergency operations center, which County Emergency Coordinator Dick Martinkovic said is initiated at Sullivan County Airport in the case natural disasters, bio-chemical terrorism, or major fires, accidents and other incidents.

Jeanette Gil, the emergency planner at Sullivan County Public Health, said the county has a standing biological terror planning team. Planning for this drill took some four months and involved the assistance of the sheriff’s department, the state police, county emergency management, the Catskill Regional Medical Center, the college, and BOCES. In addition to public health workers, the staff at the drill includes a combination of retired and active health professional and volunteers. “Those whose duties include emergency response are working on the clock, but others are their own time,” Ryan said.

One of the most important results of the drill, is for residents to learn that “we have the capability and a plan to do this,” Ryan concluded.