[Congressional Record (Bound Edition), Volume 147 (2001), Part 11]
[Senate]
[Page 15104]
[From the U.S. Government Publishing Office, www.gpo.gov]




            PREPARING FOR BIOTERRORISM . . . WHAT TO DO NEXT

  Mr. AKAKA. Mr. President, I rise to address a subject on which I 
recently chaired a hearing in the Governmental Affairs Subcommittee on 
International Security, Proliferation, and Federal Services concerning 
what the Federal Government is doing to better prepare our communities 
for an act of bioterrorism.
  Mr. Bruce Baughman, the Director of Readiness and Planning for the 
Federal Emergency Management Agency, FEMA, testified on terrorism 
programs, the newly established Office of National Preparedness, and 
FEMA's plans to enact a nationally coordinated plan for terrorism 
preparedness. Dr. Scott Lillibridge, the first Special Assistant to the 
Secretary of Health and Human Services, HHS, for National Security and 
Emergency Management, discussed the current and future bioterrorism 
preparedness and response programs within HHS.
  They were followed by two expert witnesses, whose testimony and 
experience were very helpful in laying out what the country should be 
doing, on a national, State, and local level, to respond to 
bioterrorism.
  Dr. Tara O'Toole, of the Johns Hopkins University Center for Civilian 
Biodefense Studies, discussed the nature of the threat and the 
challenges facing response efforts. As she aptly noted, ``nothing in 
the realm of natural catastrophes or man-made disasters rivals the 
complex response problems that would follow a bioweapon attack against 
civilian populations.''
  Dr. Dan Hanfling, a physician in the Emergency Department at Inova 
Fairfax Hospital, and an active member in regional disaster response 
planning, shared his views on the ability of local emergency rooms to 
respond to biological agents. He explained how, with emergency room 
overcrowding and ambulance diversions, emergency departments and 
hospitals are operating in a `disaster mode' from day to day.
  Throughout the hearing, I heard three recurring concerns that must be 
addressed to prepare properly for bioterrorism. First, the medical and 
hospital community is not engaged fully in bioterrorism planning. 
Second, the partnerships between medical and public health 
professionals are not as strong as they need to be. And, third, 
hospitals must have the resources to develop surge capabilities.
  All three will require long-term efforts to correct these problems. 
However, I believe that we can make considerable progress with some 
simple measures that can be implemented quickly.
  First, we need to improve awareness of the threat among the medical 
community, thereby increasing engagement with physicians and hospitals. 
Dr. O'Toole suggested Congressional support for curriculum development 
for medical and nursing schools. Such support would require funding for 
the development of biological weapon and emerging infectious disease 
curricula, which could be shared to educate, train, and retrain medical 
professionals.
  Second, FEMA must ensure that our medical and hospital communities 
have a place at the table in the planning and implementing of 
bioterrorism programs. Both Dr. Hanfling and Dr. O'Toole emphasized the 
necessity of involving the public health and medical communities in 
response planning for all acts of terrorism. The medical community is 
always called upon for assistance in disasters by traditional first 
responders. For acts of bioterrorism, they become the first responders. 
This will require funding to provide physicians, nurses, and hospital 
administrators the resources and time to attend meetings, training 
sessions, and planning activities.
  Third, we can also enhance the surveillance and monitoring 
capabilities of the local and state public health departments. This is 
crucial in order to detect outbreaks as early as possible. One step in 
accomplishing this would be to include veterinarians in current 
monitoring and surveillance networks. Dr. Lillibridge and Dr. O'Toole 
agreed that the veterinary community can offer many things to the 
bioterrorism effort.
  For example, most physicians do not have clinical experience with 
likely bioterrorist agents, such as plague, anthrax, and small pox. 
However, many veterinarians have field experience with anthrax and 
plague. Veterinarians could also help in detecting unusual biological 
events because many emerging diseases, such as West Nile Virus, appear 
in animals long before humans.
  Dr. Lillibridge said HHS is considering some options to actively 
engage the animal health community. I would suggest creating a senior 
level position within the Centers for Disease Control and Prevention 
responsible for communicating and coordinating with the veterinary 
associations, local and State animal health officials, and practicing 
and research veterinarians on a routine basis. I hope that HHS will act 
quickly in determining the best course of action.
  These three actions can help move bioterrorism response forward. Will 
they solve all the problems we face? No. But with Congressional 
leadership, FEMA's coordination, and HHS's implementation, we should be 
able to improve awareness and engagement by the medical and hospital 
community. We can also expand partnerships between the medical, public 
health, and veterinary communities. These are small steps to tackling a 
problem which, at times, may seem daunting and overwhelming.
  Our bioterrorism preparedness effort will be helped by developing new 
activities and communicating with other interested parties. I look 
forward to working with the different stakeholders in their efforts to 
prepare our communities for a possible act of bioterrorism.

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