Are you ready?
Duct and cover? Government advice on terror and safety triggers both panic and skepticism
4 How about the hospitals? Have they made improvements since the anthrax scare?
The good news is that most have added responses to a biological, chemical, or nuclear attack to their disaster plans. "We are substantially improved from where we were 18 months ago," says James Bentley, a senior vice president at the American Hospital Association. Many medical workers have received training now to recognize the symptoms of smallpox, anthrax, nerve agents, and poisons, and most hospitals have antibiotics, antidotes, and other medications available. Hospitals have coordinated with emergency response teams, participated in drills, and established backup communication plans.
The bad news is that there's still a long way to go. Preparing for a potential onslaught of victims is complex and expensive, and basic changes will take years. Hospitals need more protective suits and more decontamination equipment, but $30,000 "decon tents" are out of reach for many hospitals. Installing isolation facilities and modifying ventilation systems to prevent the spread of disease are even pricier. So even with improvements, no one knows if hospitals could deal with mass casualties. "We're reasonably prepared," says Stephen Cantrill, associate director of emergency medicine at Denver Health Medical Center. "But if I had to treat 700 people, how would I do that?"
Smaller hospitals face even greater challenges. Some are working together on regional plans, so if one emergency room is full, victims can be sent to another. What will it take to get everyone up to snuff? Money and time. The AHA is hopeful the federal government will come through with planned hospital funding of almost $500 million. And future hospitals will most likely be designed to specifically address the new threats.
One technological enhancement that could help is RSVP, for the Rapid Syndrome Validation Project. Physicians enter patient symptoms, such as fever or diarrhea, into a computer, and within seconds a screen pops up, plotting similar, recent cases on a regional map. Public-health workers currently use the inexpensive, Web-based system to review this data and detect outbreaks in 23 clinics in California, New Mexico, and Texas. A national healthcare company is poised to license the program, created at Sandia National Laboratories, which would extend its use to thousands of clinics, doctors' offices, and emergency rooms in every state.
With Josh Fischman, Dana Hawkins, Katherine Hobson, Katy Kelly, Nancy Shute, Marianne Szegedy-Maszak, Kenneth Terrell and Kevin Whitelaw