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Show ___ TheSalt Lake Tribune_ NATION _ Sunday, October31, 1999 ’S most € is out port to ig shot, ‘id. llioween Agencies May BeGetting Where Federal Funding Is Going - Fat Off Bioterrorism Fear The Department of Health and Human Services has spent about $25million so far to providespecial training to the120 largestcities in the UnitedStates. hoping to improve the response to a chemical oF biologicalterror ick Sofar, 47 cities have a Metropolitan Medical Response S n place, and more are expected to be Hi Rush to protect against attacks leads to improper funding, some say BY ELIZABETH NEUS GANNETT NEWSSERVICE WASHINGTON — Unnerved by the deadly gas attack on the Tokyo subway and stories from high- ok also > presi level defectors aboutthesize ofthe Soviet germ-warfare program, governmentofficials flood Capitol nation against an attack by ter- Federal spending to combatall rorists wielding anthrax or botulismor smallpox. Moneynowflowslike wine ata good party. But so many people and agenciesare partaking of the largess so quickly that some ex- perts wonder whetherit is time to temporarily shut down the bar. Noone,noteven thecritics, believes the $1.2 billion allocated in e that sueda series ofreports critical of the disjointed way the money has beenallocated. “It is time to takestock, sort out what we need vs. what we have and make sure we get the right Programs funded in the right amounts.” hundredsof millions ofdollars the imount available to protect the for the he has 10WS a latch’s ordinated, and I can’t tell you that,”said Mark Gebicke, director of the National Security Preparednessdivisionof the General Accounting Office, which hasis- fight the bioterrorism threat, And Congress is listening. Lawmakers have boosted by Hill with requests for money to kind of Senate “T'd liketo tell you that all these assets are well-organized and co- 1999 to fund preparations for an uttack by a weapon of mass destruction — generally a chemical, nuclear or biological weapon,al. though a bomb aslarge as Oklajhoma City also counts — is being misspent. But with Cabinet-level agencies romthe Departmentof Justice to the Department of Agriculture suddenly awash in money that trickles clear down to local fire ind health departments,it is hard to tell exactly where it all is going, Andthat could be a problem. No central body oversees the sntire bioterrorism preparation affort. No independent agency evaluates the programs being put into place. No single office audits the spending andhas authority to re it is headed in the right diction. Some programs even mto be redundant. Critics say the fundingis based »n fear and perceived vulnerabiliy. not ona rational assessmentof | threat. While such assessents have been madein termsof 1t we mightface overseasorin lie military,little has been done to evaluate the real threatto civilians onU.S.soil. Response toa real bioterrorattack could come from all directions — local and state health and emergencyofficials, federal health ind law enforcement officials, possibly even the military and the National Guard. Chains of com- forms of terrorism continues to rise: President Clinton has asked for $10 billion in his fiscal 2000 budget, up from the $6.7 billion in 1999. Half ofit — $5 billion — goes to agencies dealing directly with national security. The military is widely considered the mostlikely target for a biological-weapons attack, fighters and other emergency personnel — how toreact quickly and safely in a chemicalor biological attack. Bin a $20 million program Congress seems eager to expand, the National Guardis creating 10 “RAID” units specially trained and equipped to respond to chemical orbiological attacks. The Justice Departmentreceived nospecific funding to deal with weapons of mass destruction-related issues in 1997, but in 2000 could get as much as $162 million. The FBI leads criminal investigations into bioterror threats or aitacks, and this year alone is investigating more than 200 threats — mostly the wellpublicized anthrax hoaxes. @ The Centers for Disease Control and Prevention this fall received $40 million to expand and improve its ability to watch for outbreaksof disease and to boost hat it is time to reassess where viet Union's bioterrorism pro- he money is going, and whether gram whodefected in 1992. “At the same time we are improving our peed of funding even has come underthe disapproving eye of the zovernment’s agency. own watchdog local health departments’ ability to communicate with each other in the middleofan outbreak. “We are not wasting taxpayer money,” said Ken Alibek, the former deputy director of the So- That argument frequently is used by HHSofficials in particular, as they defend increased wee | | | PAPERWoRy Miracle Flightsfor Kids Providing over 16,000 urgentflightsfor children needing critical medical a TRAILERS "RESTRICTIONS APPLY ee attention. Sarving very sick kids and tharfamilie since 1988. FREE 800 875-2772 PICK-UP 4 (LIMITED TIMEAisa “The government has a security role and the government has anintelligencerole,” said Ed Badolato,the executive directorof the International of Counterterrorism and Security Professionals. But what worries those who watch the money flying every which wayis that the infrastructure may be growing unwieldy — onto a source of easy money. And they are afraid once the money is there, it won't go away evenif the agrip. The GAOhaslooked at some of this potential duplication sloppy organization: and I TheNational Guard’s RAID units almost perfectiy replicate similar hazardous materials teams organized by the FBI, the Army and Marine Corps, and scores of fire and police departments. @ veritable alphabet soup of local, state and federal programs are on tap to help in case ofa bio- logical attack — everything froma city’s own Metropolitan Medical Response System to a network of federally funded volunteer doctors called the National Disaster Medical System. No one knows what it should cost to oulfit first responders, the police, firefighters and paramed- ics whoarrivefirst at a scene, nor what equipment really is needed. A June GAO report found that “the only piece of emergency equipment that could be abso- lutely agreed upon as necessary wasyellow cautiontape,” Gebicke said. “Lam almost overwhelmed the more we get into this by thedif. ferent groups we have set uw said Rep. Christopher Shays, R-Conn. : Source: GNSresearch Frank Pompa, Gannett News Service Preview 6:00 pm A huge estate and antiquecollection loaded with quality home furnishing and art objects from severalpalatial estates and other consignment to be sold at public auction consisting of: “Art Objects “Antiques *Oriental Rugs *Fine Furniture *Lamps & Clocks *Crystal & Porcelain *Collectibles “Paintings & Prints Seven Oaks Reception Center 6775 South 900 East - MIDVALE EMI/UNIPORT AUCTIONS Terms: Cash or check (on our approval) he is | wee / Washington D.C. Hampton Roeds* J i 8 we @ Hotiston San Antonio . Orleans = Virginia ‘Norfolk, News, Hampion “Norfolk, Virgin @ Miami \ a and other cities in the area. Outbreak Was a Model for Bioterror Attack GANNETT NEWS SERVICE WASHINGTON — Evenbefore The New Yorker magazineplanted attack of any kind, prompted by human outbreak, z00 officials called in favorsfrom friendsin the military, who ran tests on bird For example, the city closely samples. And the state had sent samples to a California lab with out telling the CDC. Separately, but nearly simulta neously, the military, the Califor. the 1993 bombing of the World Trade Center. the idea in the national subconscious, infectious disease experts thoughtthe WestNile encephalitis monitors innocent outbreaks of flu or diarrhea— and eventracks outbreak in New York City was a purchases ofanti-diarrhea medicine asan early warning system — good modelfor how a bioterrorism attack might occur. incase those outbreaks are not so innocent. appears to have happened naturally. But the stealthy wayit unfolded — in a large urban area where something could easily But the way the encephalitis outbreak was spotted could hap- The CIA says that the outbreak have been overlooked sent shivers through scientists and those assigned to watch for out breaks of any origin. Noonethinksthey will get any warning of a biological-weapons attack, despite the profusion this year of fake anthrax threats at schools, abortion clinics and government buildings. “The city was only able to de. tect the [encephalitis] outbreak as pen anywhere that doctors are paying attention. “Be prepared for the unexpected — whether it bea naturally occurring event such as a world- wide influenza pandemic or the deliberate release of anthrax bya terrot ” said Scott Lillibridge, director of the Centers for Disease Control and Prevention’s bioterrorism preparednessprogram. Whatcaught the attention of New York health officials was a call Aug, 23 from a Queenshospi- use of an tal where twoelderly patients had Layton, chief of the Bureau of symptoms. As city and state health officials sought the cause, morepatients appeared. Concerned that the still- quickly as we did astute clinician,” said Marcelle Communicable Diseases in New York, Quickly is also a relative term: From the first call to the city health department to initial diag nosis, il days elapsed. The diag nosis proved wrong, and a new one was made 12 days later. The second diagnosis, of West Nile encephalitis, came because a pathologist at the Bronx Zoo had n trying to figure cut since July whyexotic zoobirds andlocal birds alike were dying. The z00 investigation was moving on a parallel track to the human out break, and they took several weeksto converge. New York is widely considered the same baffling neurologicai undiagnosed illness was spreading, the city sent an e-mail message to all hospitals a week after the first cases appeared, telling them to report anyone with similar symptoms. The CDC wason thecase that weekend,andlocal, state andfederal scientists arrived at a diagno sis St. Louis encephalitis — on Sept. 3. The numberof cases was growing, and public fear contin: ued. But in general, everything seemed undercontrol. But with the CDC busy with the nia lab and the CDC cameup with a new diagnosis, announced Sept 23: West Nile encephalitis, a less virulent cousin of St. Louis encephalitis. Now,doctors think it might be another virus altogether; in the Oct. 8 edition ofLancet,they saidit might be a newlydetected strain of encephalitis virus, but still a rela tive of West Nile. Asof October's end, health offi cials reported 56 casesof encepha litis in people and seven deaths. Knowingthe precise diagnosis earlier would not have changed anything the city or its doctors did; the remediesstill would have been to treat the symptoms and spray neighborhoods with pesticide. Butit did point out the lags that can occurin aninvestigation and proved a timely reminderthat an answer may not be instantly forthcoming if a man-made out break should occur. The New York incident may be as good as sur veillancegets. “Tt went pretty well,” said Col Edward Eitzen, a physician and chief of the operational medicine division of the Army's Medical Roan Institute of Infectious Diseases. “When something like this eed especially if it’s < major event with lots and lots of casualties, nobody expectsit to go perfectly.” among the most sophisticated in planning aresponseto terrorism NEW MEDICATIONS STUDIED Save on your ReUPnaisery with Sofa Biz Great Prices, workmanship , and dynamic fabrics. Taking part in an investigational research study Js an excellent opportunity to learn more about a chronic illness and how to treatit. Call for an DO YOUR CHEEKS HURT WHEN TOUCHED? appointment. 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SusTai Oklahoma Fort Worth 4 @ Datias /AIR DUCT CLEANING ag ® Kansas City Albuquerque knowledgeofinfectious disease.” CUhes TRUCKS “ aust eos demonstrated in recent years,” said Denise Koo of the CDC's epidemiology programoffice. In addition, it is the government’s job to worry about things threat evaporates. sponders” — paramedics, fire- | rorist attack has been clearly “It’s an easy way for federal agencies to get dollars now, so they jump on the bandwagon,” Gebickesaid. “Wesee quite bit of duplication. Somebody's gotto get million-plus program to provide moneyto train a city’s “first re- 4 Sacramento the nation’s vulnerability to ter- allocationin just three years. Amongtheplaces the money is going: HHHS has a 3-year-old, $25 Portland “Concern aboutbioterrorism is not newto usin public health, but chargeofthe medical aspects of a mand are being designed, but they complicated; whether they ild hold in a real emergencyis unanswered question. Some experts are saying in ink tank articles, op-ed pieces iid testimony before Congress (he effort matches the threat. The anti-terrorism scene — on what they concedeis a low-probability but high-impactevent. and that everybody has latched bioterror attack, has seen a 3,000 percentrise in its anti-terrorism 21996 @1997 4 1999 spending bytheir agency — a relatively new entry on the modern But other agenciesare gettinga boost. For example, the Depart- ment of Health and Human Services (HHS), which would be in (GO @ ) established ee lectures are held at The University of Utah Neuropsychiatric Institute, 501 Chipeta from 7:30-9:00 p.m. As part of our continuing commitmentto bring thefinest and most recent developmentsin health care to the community, For additional information call 583-2500. ASTHMA Participants with asthma receive up to $380 for participating in an investigational research drug study. 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