This is how they will lock down the population.
The people will be scared.
The army will be called out.
Everybody will be Quarantined................
washingtonpost.com
U.S. Details Response to Smallpox
Cities Could Be Quarantined and Public Events Banned
By Justin Gillis and Ceci Connolly
Washington Post Staff Writers
Tuesday, November 27, 2001; Page A01
If bioterrorists attack the United States with smallpox virus, health
authorities could impose measures as drastic as banning public events,
halting regional transport and placing entire cities under quarantine,
according to a draft federal plan released yesterday.
The plan, by the Centers for Disease Control and Prevention, calls for
stepped-up awareness by doctors, health officials and the public to be able
to detect any outbreak of smallpox, a disease officially eradicated from
the planet 21 years ago -- and to be able to respond quickly enough to stop
it before a pandemic can sweep the nation.
Prompted by the terrorist attacks of Sept. 11 and the anthrax scare that
followed, the plan is the federal government's most detailed description
since 1972 of how authorities might respond to an outbreak of smallpox.
Overall, the plan drew praise from several experts yesterday.
However, one aspect of the plan drew immediate criticism from some state
health officers. The CDC has vaccinated 80 to 100 of its employees against
smallpox so they can respond to an attack, but the draft plan rules out any
broader campaign to vaccinate state workers, who might be the first to
respond to an outbreak.
In making that judgment, the CDC noted that vaccine supplies are limited.
It said the federal government could rush vaccines to a state and inoculate
state employees as soon as an outbreak is confirmed. Vaccination is
effective even after exposure to the smallpox virus, if given within a few
days.
"The point is that this vaccine works once exposed, so those people who
would go out and respond to a confirmed case would in fact be vaccinated
essentially as they're going out the door," said Harold Margolis, senior
adviser for smallpox preparedness at the CDC. "At that point, they are
protected."
But several state health commissioners said yesterday the plan does not
take into account the worst-case scenario: simultaneous smallpox attacks in
multiple cities, overwhelming the CDC. In such an event, they said,
unvaccinated state nurses and state police would be on the front lines
trying to contain the epidemic.
"You need to go in and talk to the person who has smallpox" to identify
contacts, said Georges C. Benjamin, Maryland's health secretary, who is
president of the Association of State and Territorial Health Officials.
"That process starts at 3 o'clock in the morning. That process doesn't
start 24 to 48 hours later, when the team gets there from Atlanta [where
the CDC is located]."
In an attack on multiple cities, "CDC in their role as the cavalry will
simply not be able to go to all those places," said Leslie M. Beitsch,
Oklahoma's health commissioner and chairman of a state health officers'
association task force on bioterrorism. "If we can't have our first
responders protected, then we risk chaos and panic."
The state health officers are expected to press the CDC to reconsider its
decision, if not now then in the next few months, as more smallpox vaccine
becomes available. At the moment, supplies are limited to an aging national
stockpile of about 15 million doses in Pennsylvania. The government has
asked companies to re-launch production of the smallpox vaccine, aiming to
build a stockpile of 300 million doses in a year.
Although the CDC plan would permit large-scale quarantine, that would be a
last resort, employed only if other control measures were failing. The
heart of the plan is the classic "ring vaccination" strategy used to
eradicate smallpox a generation ago.
That strategy depends on quickly spotting a case of smallpox, isolating the
initial patients, and identifying and vaccinating others who might have
caught the virus from them. Public health workers would continue to
identify possibly infected people by considering ever-larger rings of
people centered around the earliest cases.
"The main thing you want to do is try to get as much vaccine used in the
place where it's going to do the most good -- that is, around the contact
of a case and around the families of those contacts, so if they do come
down with a disease, there's a barrier around them," said Donald A.
Henderson, who led the global campaign that eradicated smallpox and who is
now director of health preparedness at the federal Department of Health and
Human Services.
Local officials would try to locate people thought to have been exposed on
a train or at a sports stadium, Henderson said. Should locating them prove
impossible, he said, health officials would be forced to consider a broader
vaccination program, such as inoculating a large group -- even a whole city.
If early control efforts fail or an initial outbreak is sufficiently large,
still more aggressive measures might be necessary, the plan says. In the
most extreme case, federal and state authority would be used to erect a
"cordon sanitaire" -- a sanitary ring -- around a city or other large area.
Control of a big outbreak "may require suspension of large public
gatherings, closing of public places, restriction of travel" and other
measures, according to the plan.
The last smallpox case in the United States occurred in 1949, and the last
naturally occurring case in the world occurred in Somalia in 1977. The
eradication of the disease, which the World Health Organization declared in
1980, is considered to be one of medicine's greatest achievements.
But as a result of the disease's eradication, vaccination has stopped. No
one under 30 is immune to the disease, and older people who were vaccinated
as children are believed to have only limited immunity.
Although a CDC lab in Atlanta and a Russian lab in Siberia are the only
official repositories of the virus, many experts fear a handful of
countries, such as Iraq and North Korea, may have secret stashes that could
wind up in terrorists' hands.
A single case of smallpox would be an international health emergency of the
highest order. The CDC plan makes clear that if an attack occurred in the
United States, avoiding mass panic would be a challenge.
"In the event of a bioterrorism event involving smallpox, the level of
threat perceived by the public -- whether real or imagined -- may be
extreme," the guidelines warn. "In these circumstances, state and local
health officials should be prepared for a high level of demand for vaccine
by the public." |
