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Docs at Front Line of Terror War.

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Preparing for the Unknown continued...

"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.

Before 9/11, many physicians were unaware of the signs of diseases such as anthrax and smallpox -- likely targets for terrorist use. Experts say that's now changed.

"What happened was that people went from being totally ignorant of these [bioterror] issues to being informed as to where to get information," says infectious disease specialist Jon Temte, MD, PhD, associate professor of family medicine at the University of Wisconsin.

Temte says primary care and emergency room doctors now have much better access to information about potential bioterrorist agents provided by organizations such as the CDC and the American Academy of Family Physicians (AAFP).

He says a focus group conducted among physicians six months before 9/11 showed that many felt they wouldn't recognize the signs of anthrax or know how to contact the public health department about it. But another survey six months after 9/11 showed that while some doctors said they might not be able recognize an isolated anthrax case, they would recognize a cluster of cases. And they said they knew how to contact the proper authorities.

Temte says those findings also reveal one of the major problems facing the U.S. healthcare system in addressing bioterrorist threats and other major public-health concerns.

"We have a pretty well-trained physician force across the country," Temte tells WebMD. "But the gaps ... have to do with the perspective we take. Doctors are still oriented to the individual rather than the community. I think that is a perspective that needs to change."

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