There was a nationwide "Bioterrorism Response Exercise" a while back that was conducted in cities across the U.S. The results from this exercise were quite enlightening as to what the proficiencies and deficiencies were when it came to how the casualties were cared for. A few of the items on the "plus" side were that the first responders, EMS and hospital staff were usually adequately trained to identify persons that were contaminated with a pathogen and knew what the protocol was and the treatment for, the infected individual. Overall, the preparation studies that have been performed and the training that has been given, to date, seems to have been very effective.

During the exercise, two known items that merit mentioning occurred in Chicago. The EMS personnel picked up four "infected" persons and transported them to a hospital. While the EMS person in the back of the ambulance had a N95 mask with a Tyvek® suit, that was all he had. The back of most EMS vehicles tend to be positive pressure and do not have airflow patterns that protect the EMS worker. This could be a major problem after a few hours or a few days depending on the pathogen used by terrorists. The EMS personnel, ultimately, can be infected and not be able to report to work.

Once the "victims" arrived at the hospital, they were told that the hospital only had ten isolation rooms and eight of those were already being utilized for TB patients. Where were the bio-attack victims supposed to go now? There are under 197,000 (Source: American Hospital Association) infectious isolation (negative pressure) rooms in the U. S. We are simply not set up in any area of the country to handle mass casualties from any type of bioterror attack or even a natural local epidemic or nationwide pandemic.

In the United States, the federal and state governments have been trying to prepare for a biological or chemical attack. The first item covered with the monies that were allocated were for studies to determine the threat and ways to mitigate the effects. The second item was more studies. Then it was decided to immunize the population beginning with the healthcare workers and first responders which was an excellent idea. Then there were more studies. Then there was training for first responders who were going to be responding to a NBC (Nuclear, Biological, Chemical) attack, another excellent idea. Then there were more studies. Then there were more immunizations for more people. Good idea. Then there were more studies.

If you do a search on "bioterrorism studies" on the internet you will see more that 26,000 (depends on the search engine) returns on your request for information. The only studies that are left to do are the ones defining what measures need to be taken in a specific building, city, county/parish, or state.

There are funds being distributed through the federal Health and Human Services (HHS) department and it seems that Homeland Security is also finally allocating monies for state and local governments. There are three (3) major areas to address:

Studies on general biological and chemical attacks have been done and there are recommendations on how to minimize the effects of this type of event. The money now allocated needs to be directed to doing studies, if not already done, on how to protect the infrastructure of the specific areas affected. In other words, look at the buildings or small geographical areas and use the information to protect the buildings/personnel or area.

Engineering controls are essential for protecting government offices, emergency management centers, 911 call centers, hospitals, fire stations and any other building or areas that represent our "infrastructure". The studies have been done, immunizations are being administered, now, let’s start protecting those that will help us when we are attacked with weaponized chemicals and/or pathogens.

As budget dollars become available, all institutions should upgrade their HVAC system to incorporate air security measures. Admittedly, this is not inexpensive, but it will guarantee that the essential command, control and communications will be there to ensure we have the personnel directing disaster relief efforts without worrying about if they will actually be there in a few hours or a few days after the event has happened.

For information on how you can begin the process of protecting your facility, please go to:

This NIOSH document is an excellent resource that can help you to begin protecting your facility from attack. The measures stated in this document are quite comprehensive and will give you advice on what you should and should not do. This is probably one "study" that was well worth the money! This would represent a very good start.