Like a special forces team without a target, the biggest
problem for doctors on the front lines of healthcare today is not knowing where
the enemy lurks or how it may strike. For a healthcare system responsible for
handling the aftermath of terrorism in its many forms, preparing for the
unexpected in the post-9/11 world is an unprecedented challenge.
After the attack on 9/11, emergency room personnel in New York
City anxiously awaited injured survivors from the World Trade Center. Weeks
later, physicians and healthcare providers across the country faced a deluge of
worried patients who feared they might have been exposed to anthrax spores. And
earlier this year, a thwarted "dirty bomb" plot had doctors rushing for
a refresher course in treating radiation exposure.
As these events have shown, unmasking a terrorist attack can be
as simple as reporting a suspicious rash to the local health department. But at
the same time, hospitals have to be prepared for something as complex as mass
hysteria and a rapid influx of casualties.
That means doctors and healthcare providers have now joined the
ranks and are an integral part of the country's defense in the war against
terrorism. And they're finding that the learning curve is both steep and
Preparing for the Unknown
"Hospitals across the country are looking at ways of
becoming prepared, but there are a lot of problems," says emergency room
physician Howard Levitin, MD, of St. Francis Hospital and Health Centers in
Indianapolis. "Number one, no one has really defined what preparedness
Levitin recently completed a study of the nation's healthcare
system's ability to respond to a bioterrorist attack. It was funded by the
Agency for Healthcare Research and Quality (AHRQ) -- the research arm of the
Department of Health and Human Services.
"For example, the media often reports that hospitals aren't
prepared for bioterrorism. Well, if you look at the anthrax cases that occurred
in October, I'd say we were well prepared," says Levitin. "It's not a
big effort to take care of a few additional sick patients, and that's what we
saw during the anthrax events."
"If we define preparedness as being prepared to take care
of tens and hundreds of patients, then hospitals are not prepared, and it will
be difficult to ever be prepared because they have a hard time meeting the
patient load they see every single day," Levitin tells WebMD. "We can't
handle the flu, let alone think about handling a bioterror event."
Before last fall, Levitin says federal domestic preparedness
programs for healthcare professionals focused on how to deal with large-scale
biowarfare with high numbers of casualties.
Bioterror: Spotting the Signs
The biggest difference between biological agents and
conventional weapons of war is that the germs that cause potentially deadly
diseases can spread long before any telltale signs appear, making them
virtually impossible to detect before the damage is already done. And the first
to respond to a bioterrorist attack is likely to be a healthcare provider
rather than a police officer or firefighter.