Dr. Donald A. Henderson
When asked by U.S. Health and Human Services Secretary Tommy G.
Thompson to chair an advisory commission on bioterrorism, Dr. Donald A.
Henderson didn't pause to set up an office or even a desk as he began
meetings at HHS with top health officials.
Henderson, 73, has felt a sense of urgency about preparing for the
unthinkable
— an urgency only now shared by much of the nation
— since
the mid-1990s, pressing his case before Congress, the CIA and World
Health Organization.
While Henderson, former dean of faculty of the Johns Hopkins School of Public
Health, has said that a biological weapons release is not a likely
event, he says the risk is not zero. And he was concerned enough about
the possibility to establish the Hopkins center for biodefense studies
in 1989.
"He's been the pioneer in the civilian world for trying to combat
bioterrorism," said James Campbell, an infectious disease specialist at
the University of Maryland.
As he hurries to come up with a coordinated medical and public health
strategy for responding to a bioterrorist attack, he says the effort
will not be easy or quick.
"We'll get better and better and better prepared," Henderson said in a
phone interview yesterday. "But to really rebuild the public health
system — which is a fundamental part of this
— will require personnel,
training and planning. It's going to take a number of years."
He said it would be several years before the public health system
reached even a "reasonable" level of preparedness. It is now a network
of 50 state and 3,000 local public health agencies, which Henderson said
shouldn't even be called a "system," because it isn't coordinated in any
meaningful way.
"It's not terribly able to respond," he said.
For instance, most hospitals are stressed by outbreaks of influenza and
not able to handle even 25 to 50 acutely ill patients at a time. An
outbreak of anthrax could require a hospital to tend to 500 people.
Hopkins, Henderson said, is one of the few hospitals in the nation with
a plan for treating large numbers of patients.
What's more, many county and city health departments do not have 24-hour
emergency phone numbers, and their officials are not equipped with
pagers, cell phones or computers, he said.
In testimony before a Senate panel this week, Henderson, a science and
technology adviser to President Bill Clinton and the first President
Bush, said: "If we are to detect and rapidly identify a new health
problem, public health officials must be available 24 hours a day, seven
days a week, to take calls from clinicians reporting cases which may be
suggestive of ... a bioweapons-related disease. This is not possible in
most areas of the country."
The bioterrorism council, which will advise Thompson, will consist of
public health officials from county to federal levels, hospital
personnel, university doctors and researchers, even medical ethicists
and lawyers.
Aside from overhauling the public health system, Henderson says, his
council will also focus on development of vaccines and antibiotics.
Of the deadly agents that could be used by terrorists, Henderson says,
anthrax is the most likely, but smallpox the most devastating.
Henderson spent 11 years leading the World Health Organization's
campaign to eradicate smallpox. When the last case was tracked down in
Somalia in 1977, it became the only infectious disease ever to be
completely wiped out. Smallpox samples are still kept in some
laboratories, and there is a fear that some could fall into the wrong
hands.
Although Americans haven't been routinely vaccinated against the disease
since 1972, there is enough smallpox vaccine left - up to 15 million
doses - to handle a moderate-size outbreak, Henderson said. The Centers
for Disease Control has stepped up its effort to deliver 40 million more
doses, but production could take up to three years.
Most counties are not equipped for mass vaccinations, since they haven't
engaged in such a process since delivering the oral polio vaccine in the
early 1960s, Henderson said.
He has tried to calm some of the post-Sept. 11 hysteria, advising
against buying gas masks, which he says are more likely to suffocate
people than save them, and stockpiling antibiotics, which he says are
only useful if you have the right one.
Still, he has urged Congress, as soon as possible, to send an additional
$1.4 billion to $1.6 billion to the states for bioterrorism defense, on
top of the $350 million the federal government is already spending this
year on bioterrorism.
"It is difficult for me to exaggerate the deficiencies of our present
public health capabilities," he said.