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Health agency gets $9.7 million to fight bioterrorism
by Bruce Landis, THE PROVIDENCE JOURNAL
Mar. 25, 2003

The federal money also will be used to keep the public better informed during health crises, to avoid the kind of panic that followed 1998's meningitis outbreak.

PROVIDENCE -- The state will use $9.7 million it's receiving from the federal government to beef up its ability to detect and deal with bioterror and chemical warfare attacks, at the same time strengthening its basic public health system, a state health department official said yesterday.

Robert J. Marshall Jr., assistant director of the Department of Health, said the money will go to staffing, training, laboratory, computer and communications equipment and other costs as part of an escalating federal and state effort.

The department is also preparing to keep the public better informed during health emergencies, to avoid the kind of panic that followed a meningitis outbreak in the state in 1998.

The result should be a public health system that is both able to deal with the specific dangers of biological and chemical terrorism, and to better do its regular job of detecting, reporting and controlling diseases, he said.

Marshall said the project ranges from his department to the state's hospitals, emergency services such as police, fire and rescue, city and town administrations, and doctors, clinics and medical laboratories. It includes hiring 39 more staffers at the health department, and helping the state's hospitals prepare to add, for example, beds for 500 extra patients in case of an attack by a contagious disease.

It's a grim job, but Marshall said it also amounts to "a huge opportunity for the health department to improve its ability to protect public health in Rhode Island."

Financing for public health antiterrorism measures has sharply increased, Marshall said, from less than $1 million in 1999 to $8 million this year to the $9.7 for the fiscal year beginning Sept. 1. Nationally, the federal government will spend $3.5 billion this year.

The grants were announced Thursday by U.S. Sen. Jack Reed and the U.S. Department of Health and Human Services.

Marshall said the state's program is focused on these main areas, most of which are already under way:

Planning and training.

That includes getting ready to distribute to cities and towns and then to local clinics the contents of emergency shipments from the National Pharmaceuticals Stockpile, run by the Centers for Disease Control and Prevention. The stockpile contains materials such as antibiotics that fight anthrax infections.

The prospect of biological attacks, Marshall said, means lab technicians need training to do tests. Doctors and other medical professionals need training, too, he said.

"Most of these diseases, [almost] nobody who's practicing medicine now has ever seen," he said. He mentioned smallpox.

The department has run three statewide drills involving other agencies so far, and many more in-house drills, Marshall said.

Improving laboratories.

The state is upgrading its laboratory to detect the exotic diseases of biological warfare, and also chemical warfare agents.

To enable the handling and identifying of dangerous diseases, the state is building a new, high-security laboratory within the existing state laboratory on Orms Street, Marshall said. He said the improvements in equipment and training will let the lab distinguish between anthrax and pneumonia, for example, and between smallpox, the extremely contagious epidemic disease nearly eradicated 30 years ago, and chicken pox.

Marshall said he expects the next set of grants will also let the state add the ability to detect chemical warfare agents, such as nerve gas, to its laboratory.

Epidemiology.

The state is strengthening its ability to discover cases of diseases, particularly unusual and dangerous ones, to detect the pattern of cases quickly, and to respond. That means learning of cases reported by hospital emergency rooms, clinics and health-care laboratories, and then identifying the cause and tracing persons who had contact with the infected victim to prevent it from spreading.

Speed is essential, Marshall said, because each new case can infect many persons, causing a "huge escalation" in cases. Some of the money, he said, is being used to hire more epidemiologists at his agency.

A Health Alert Network.

This system, partly built now, will work 24 hours a day, 7 days a week, to link local health agencies, such as hospitals, laboratories, and police, fire and rescue personnel, with the state health department and then to national institutions, such as the CDC, Marshall said. It will include a combination of e-mail, Web sites and radio.

Marshall said that will allow two-way communication -- for example, reporting of clinical findings at hospitals to the state and the CDC, and communication of health alerts from the CDC to state and local agencies.

Part of this effort, Marshall said, is buying new radios to solve a frequent problem: local emergency radio systems that can't communicate with each other or the state. Similarly, he said, some money will go to make sure all communities have around-the-clock Internet access.

Another element will establish backup systems, for example, arrangements for data transmission by radio in case the Internet fails.

The goal, he said, is "to make sure we have access to this information no matter what happens, whether this building [the health department headquarters on Smith Street] exists or not, and whether we can go to work here or not."

Many improvements will have everyday advantages, Marshall said. For instance, the Internet network linking cities and towns to his agency should allow citizens to get birth and death certificates from their local town or city clerks, rather than having to go to the state health department.

Risk Communication.

Marshall said his department and other agencies are working on communicating with the public during the kind of disaster that could follow a biological attack. It wants to avoid what happened during an outbreak of meningitis in 1998, when parents crowded doctors' offices seeking vaccinations for their children, clinics ran out of vaccine, and panic followed. The result, he said, was "gridlock in the health-care system" to the point that sick children couldn't get care.

The health department has been conducting focus-group sessions to discover what Rhode Islanders want, he said.

They want to know where to go and what to do when frightening things happen, he said, and the health department is getting organized to tell them.

The first sign of that will come in a few weeks, when the agency sends a mailing to 500,000 Rhode Island households. That will be followed by more publications -- newspaper inserts or brochures -- to let the public know what the department is doing, and what to do in an emergency. 

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