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    Monday, September 23, 2002

    Smallpox Vaccine Update: The federal government is sending its plan for dealing with a smallpox attack out to state health departments today. As The Bloviator pointed out last week, all preparedness is local:

    At the first hint of a smallpox case, the CDC in Atlanta would begin dispatching emergency teams to the area to confirm the outbreak and begin vaccination.

    Yet the suspicion that terrorists would strike more than one location "would require us to be in many, many places simultaneously," one federal planner said. "That would completely deplete our assets."

    Instead of sending its staff to every corner of the country, the CDC plans to ship the vaccine and let states handle inoculation, Osterholm said. The National Pharmaceutical Stockpile, he said, "can be at any hamlet in this country in 12 hours." Officials have not said how much it would cost or how it would be paid for.

    HHS has received assurance that even if air traffic were halted, as it was immediately after the Sept. 11 attacks, planes transporting vaccine would have clearance. Vaccine would be delivered in waves much the way a grocery store receives its weekly shipment of milk in batches.

    This reliance on local health departments to carry out the plan is more than a little worrisome. Not all public health departments are created equally, and many of them are little more than well child and sexually transmitted disease clinics. Last week, I got an inkling of what ours is probably doing with their bioterrorism money. I received a slick package on preventing falls in the elderly. It came in a nice folder with nice, glossy handouts and reminder cards for patients. Normally our health department provides handouts on xeroxed sheets, and it never presents them in a package like this. I could be wrong, but I have to wonder where they suddenly got the money for public relations.

    Ross is right, too, about the need for a more centralized approach to public health in the event of a bioterrorist attack. The CDC needs to educate the rest of the nation’s physicians about bioterror threats. They could do this by educating the state health departments and charging them with holding local educational conferences for physicians on how to recognize and respond to a bioterrorist attack. So far, nothing like this has been done.

    Me First: Yesterday’s New York Times Magazine’s “Endpaper” made a curious argument for preferential smallpox vaccination in Native Americans. Even though many (but by no means all) Native Americans live in remote, rural, and less populated areas where they would be at lower risk of contracting the disease in the event of a bioterror attack, the writer feels they deserve priority over other ethnic groups because they were devastated by the disease two hundred or more years ago. Well, we’re all equally vulnerable now. And we all deserve the opportunity to protect ourselves against the disease, regardless of ethnic group.

    posted by Sydney on 9/23/2002 06:43:00 AM 0 comments


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