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Preparedness:
Congressional Action
With Sen. Bill Frist (R-Tenn.)
Wednesday, July 18, 2002; 2 p.m. EDT
In January, Sens. Bill Frist (R-Tenn.) and Edward Kennedy (D-Mass.) co-sponsored the Bioterrorism Preparedness Act of 2001 in an effort to improve the nation's ability to respond to a bioterrorist attack. Signed into law in May, the bill's sponsors hope to address gaps in biodefense, surveillance systems and our public health infrastructure through substantial federal investment in research, planning and preparedness.
Sen. Frist was online Thursday, July 18, at 2 p.m. EDT to discuss bioterrorism and the government's response to the threat of biological and chemical weapons since Sept. 11.
The transcript follows.
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Sen. Bill Frist: Hello, I'm Senator Bill Frist.
It's good to be with you today, and I'm ready to answer your questions.
Lyme, Conn.:
Do you think it would be beneficial to distribute potassium nitrate to residents living near nuclear power plants?
Sen. Bill Frist: It is potassium iodide. Generally the first rule is to evacuate. However, if the tablets are available they can be taken, but offer only very limited and partial protection--just to the thyroid gland. Again, evacuation is the first priority.
No protection against dirty nuclear bombs.
Silver Spring, Md.:
Senator: How fast can medical schools readily adapt to the changes required to educate future physicians about this new reality? And do you see the changes necessary in adapting to bioterrorism and its implications for the health care world being a watershed event in medical education, a 21st century Flexner Report as it were?
Sen. Bill Frist: After anthrax hit Washington, one of my first priorities was to contact the Deans of all medical schools to encourage inclusion in curricula, both undergraduate and in residency programs, knowledge on bioterror agents and diseases. This includes prevention, preparation, and response. Medical centers have responded aggressively and appropriately to educate phsysicians and nurses.
Current challenge is to educate practicing physicians and providers around the country.
Florissant, Mo.:
Senator Frist, what steps can I take at home that are cheap or free to better prepare my family for these new threats?
Sen. Bill Frist: Develop a communication plan for family members.
Develop a destination plan for family members in the event of a bioterror event.
Identify a safe room in your home that includes telephone, water, canned food, goggles, flashlight, role of plastic tape, and an N-95 certified mask(called a respirator, costs $1.30), and first aid kit. (Do not need prophylactic antibiotics such as Cipro.)
Charlottesville, Va.:
What quantity of antibiotics will be maintained (and where) for public health officials to use in the event of a bacteriological assault? What procedures will be used for keeping these stockpiles up to date? (Obviously, this is going to require a continuous stream of money to stay current.)
Sen. Bill Frist: So called "12-hour push packs" are available to anywhere in the country within 12 hours. These include sufficient supplies to treat 1.6 million infected with anthrax, 90 million exposed to plague, 50 million exposed to tularemia, etc. This is an area federal government and CDC have done tremendous job. There is no reason to stockpile antibiotics or other therapies.
Vienna, Va.:
How will a larger agency such as the HSA agency be able to respond quickly and efficiently? Don't smaller and more flexible structures allow for quicker adaptability? It seems as though the HSA may be too bureuacratic?
Sen. Bill Frist: The purpose of the proposed Department of Homeland Security as it relates to bioterror is to improve communication and coordination. Today 22 different departments and agencies leave the system for fighting bioterror too fragmented and too inefficient. You are correct that the best and safest system is one that depends on local, in the community, surveillance, prevention, preparation and response efforts.
We are all trying to design the DHS to acheive this purpose.
Portland, Ore.:
In my OSU College of Science alumni newsletter, I read about an OSU professor who was working on "biosensors." These are devices that use living cells to detect toxins in the environment, much like the proverbial canary in the coal mine. In the presence of certain toxic substances, the cells change color.
Is this a technology the government is looking at funding? Is this practical?
It seems to me we can't always stop a terrorist with horrible intent, though folks who rent cropdusters are probably more alert now.
How much of a focus do you put on stopping bioterrorism versus detecting a bioterrorist event?
Sen. Bill Frist: Early detection and surveillance will depend in large part on common sense awareness of surroundings by every individual, but will be greatly facilitated by the very best sensor technology and science, both in the bio, physical, and mechanical fields. Government is supporting this research, and private sector is responding.
Arlington, Va.:
Have you met any terrorists? Personally? How about communists? Witches?
This legislation seems to be fear-based, and on the verge of being an Inquisition. There are far fewer bad people than you would like us to believe, and the U.S. is repsonsible for supporting and training
most of them, right?
You are handling this all wrong, Senator.
Sen. Bill Frist: More than 12 nations have had offensive biological weapons programs, including weaponization of missile warheads with smallpox, plague, and botulism (Iraq and Russia). Iraq developed robust offensive biological weapons program in 1985 and weaponized 100 bombs with botulinum during the Gulf War.
Vienna, Va.:
As I understand it, this legislation will greatly help public service agencies in both proactive and reactive planning.
I've read that the Health Alert Network and the National Electronic Disease Surveillance System are authorized under this legislation. Could you talk to these systems and the benefit they will provide to the public?
Sen. Bill Frist: You are right on target. Both of these recognize the importance of early surveillance and timely communication. In bioterrorism, Every Moment Counts, and the more rapidly one identifies and responds to a bioterror or infectious agent, the more successful in containment one is. I encourage people to lobby their government to emphasize the importance of local public health infrastructure that allows these federal programs to be effective.
Washington, D.C.:
Senator, what can the average citizen do to help the situation? How can someone who is not familiar with bioterrism, get information? Also, are there any opportunities for citizens to help in this effort and what do you suggest?
Sen. Bill Frist: Federal government is responding by increased funding (from 500 million to 6 billion dollars over a two year period), federal legislation that provides a comprehensive framework and emphasizes local control. At this juncture, the most important thing to do is to educate the American people. A basic understanding can be obtained from a book I wrote called, "When Every Moment Counts." (No profits to me!), recently released and now out in Spanish. This is written to help families understand all these issues and to protect themselves with basic information. The important thing is to avoid panic and paralysis. We need an educated public to help us make policy decisions that currently face us, such as who should be vaccinated today for smallpox.
Washington, D.C.:
Do you think that "ring vaccination" (or "ring containment," whichever the term is) is still an effective containment strategy in these days when people travel quickly and frequently, and could leave an affected area before it was known to be affected?
Sen. Bill Frist: Ring vaccination policy, which historically served us so well, must be revisited immediately. Increased mobility and methods of delivery of smallpox dictate a re-evaluation of this traditional approach.
Sen. Bill Frist: I've got to run -- we debating prescription drugs on the Senate floor right now. We're trying to make them more affordable and more accessible. Thanks so much for participating, and remember that the most important thing is to stay well-informed. Take care!
washingtonpost.com:
That wraps up today's show. Thanks to everyone who joined the
discussion.
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