Biodefense becomes O'Malley's top priority

Mobilization: City's stepped-up medical preparedness has benefits that will outlast current crisis.

October 07, 2001

GOVERNMENTS are notorious for their lethargy and lack of urgency. That's one reason Baltimore Mayor Martin O'Malley has glommed onto the current national crisis as a justification for stepping up the city's all-around emergency preparedness.

He has called in all the chief executives of area hospitals to make sure they have disaster plans to cope with bioterrorism. Paramedics and emergency rooms now monitor patients for any symptoms of smallpox or anthrax, which are regarded as the most likely biological weapons.

Snaring experts from the Baltimore-based Johns Hopkins Center for Civilian Biodefense Studies, he has become the U.S. Conference of Mayors' point man on increasing nationwide preparedness.

"I think the only responsible thing for any mayor of any major city is to make sure his city is as prepared as you can possibly be," he says.

Until the Sept. 11 attacks on the World Trade Center and the Pentagon, these kinds of measures would have seemed bizarre.

Even now, some critics say Mayor O'Malley is overreacting. After all, the U.S. has experienced only one documented case of bioterrorism, the 1984 contamination of several Oregon salad bars with salmonella.

The audacity of the Sept. 11 attacks changed all that. No form of terrorism now seems unthinkable. One fear is that terrorists might try something like the 1995 nerve-gas attack in the Tokyo subway system, which killed 12 and injured 5,000.

During a U.S. Conference of Mayors teleconference moderated by Mr. O'Malley, Dr. Tara O'Toole of the Johns Hopkins biodefense center appeared particularly concerned that Russian scientists might sell their expertise to terrorists. The Soviet Union manufactured several tons of smallpox weapons in the 1970s at a time when the natural occurrence of that disease was being eradicated.

Because smallpox has flu-like symptoms, Baltimore-area hospitals now report any noticeable changes in admissions.

The federal government stockpiles 15 million doses of smallpox vaccine, but in a disaster, local authorities would have to be prepared to handle the crisis for the first 48 hours.

Efficient organization and an advance game plan are needed even after the federal vaccine arrives, because it is transported in huge quantities on 747s. The vaccine would need to be repackaged and distributed locally, Dr. O'Toole said.

"Could a city's water supply be poisoned?" she was asked. Possible, but unlikely. A more likely scenario would be the poisoning of a public place like a shopping mall with aerosol weapons.

Since Sept. 11, key nerve centers in Baltimore have tightened security. Jersey barriers, for example, now create an additional perimeter in front of the city's police headquarters. Baltimore Street, which runs along its rear, now is closed to traffic.

Such precautions were a natural for Edward T. Norris, Baltimore's top cop. He was a high-ranking New York police officer in 1990, when Jewish Defense League leader Meir Kahane was assassinated, and in 1993, when terrorists bombed the World Trade Center.

If a bioterror attack were to occur, police and firefighters wouldn't be in the first line of defense. The burden would fall on hospitals and public health agencies. Baltimore, more than most other cities, has recognized this.

The preparedness measures will have long-lasting benefits that are not related to terrorism. The authorities will be better able to cope with all kinds of disasters.

Because of the absence of any real threat in the past, the United States has not paid much attention to biodefense.

An exercise this summer at Andrews Air Base that simulated a smallpox attack (with former Sen. Sam Nunn playing the president) was an exception.

All this is now changing. The U.S. mayors' Emergency Safety and Security Summit that will be held in Washington Oct. 23-25 is just one example.

Much more needs to be done. The federal government should increase its stockpile of vaccines and antibiotics so it can contain simultaneous outbreaks in several cities.

Better diagnostic tools to quickly identify anthrax, smallpox and other biowarfare agents also must be developed.

Let's hope that none of this is needed in Baltimore or in any other U.S. cities. But in the aftermath of Sept. 11, this country must be ready for anything.

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