By Chris Gearon

WASHINGTON, Aug 23,2000
(Reuters Health)

The US healthcare system is "ill-prepared" to handle an epidemic caused by a biological attack, and a "robust" public-private strategy is needed to help protect Americans from the growing threat of bioterrorism, a biological defense expert told a gathering here on Tuesday.

"The threat [of bioterrorism] is inarguable and it will grow," Dr. Tara O'Toole, deputy director of the Johns Hopkins University Center for Civilian Biodefense Studies said at a forum on biological terrorism sponsored by the Center for Strategic and International Studies. "The consequences are so potentially calamitous."

"The life sciences are going to be the most important industry this century...When we create an opportunity to [develop] a new drug or vaccine we also have the ability to create a more powerful weapon," Dr. O'Toole said. "The consequences of a biological weapon attack would be an epidemic."

Dr. O'Toole said that it would take a multipronged strategy between federal and state governments and the private sector to protect the US from biological weapons unleashed by either rogue nations or vengeful individuals.

Such a strategy, Dr. O'Toole said, needs to include: investing $30 billion over 10 years into biodefense research and development by the US government; preparing the healthcare system to respond to epidemics; and bolstering public health capacities to detect, track and contain epidemics.

"We need to engage the genius of universities and pharmaceutical firms," Dr. O'Toole added. She urged the federal government, using incentives, to collaborate with university researchers and biotech and pharmaceutical companies so that vaccines, antibiotics and antivirals can be developed to combat growing biological threats.

American physicians are not trained in recognizing anthrax, smallpox or bubonic plague, Dr. O'Toole said. These are among the pathogens most likely to be used in a bioterrorist attack, as they are highly lethal and not treatable. Furthermore, no definite lab tests exist for identifying these contagious diseases, outside a few highly specialized laboratories.

American hospitals, financially strapped in recent years, have not been put to the test of mass casualties. Last winter's influenza season stressed hospitals throughout the nation, with some inner city hospitals having to send patients to other facilities. "Even a handful of highly contagious patients would cause havoc in a hospital," Dr. O'Toole said.

The lack of communication between the medical community and the public health system is a further barrier preventing the recognition of an outbreak and the ability for public health officials to contain and track an epidemic.

Dr. O'Toole said that a concerted strategy to enhance the nation's biological detection and response system will save lives and reduce suffering. Furthermore, the US would become a less attractive target for bioterrorism if the nation beefed up its detection and response system. At the same time, the overall medical system would be enhanced, Dr. O'Toole argued.

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