Dr. Fay Boozman said, "While the events of September 11 were tragic and heartbreaking, Americans woke up to the fact that our country is vulnerable to people who will make the ultimate sacrifice in order to wreak havoc and destruction. Therefore, as a society we have to strengthen our emergency response capabilities. We are grateful to the President, the U.S. Department of Human Services and the Centers for Disease Control and Prevention for enabling us to do so. Many of our colleagues at the ADH have been working diligently for the past three years on bioterrorism efforts. Other state agencies have been tireless in their response as well. These funds give us a golden opportunity to capitalize on this work and make it even better."

The Arkansas Department of Emergency Management has presented programs on terrorism in every county in Arkansas to address citizen's concerns. In addition, the agency has completed annexes to the State Emergency Operations Plan on terrorism and animal disease, a potential bioterrorism threat. W.R. "Bud" Harper, director of ADEM said, "The ADH and ADEM are working closely to coordinate funds dedicated to terrorism response to make sure they address the needs of Arkansas' first responders. Our main goal is to make sure that firefighters, law enforcement, emergency medical responders and hospitals have the training and equipment they need to respond quickly, safely and efficiently."

In September 1999, the Centers for Disease Control and Prevention awarded the Health Department a $601,905 grant to begin working on bioterrorism strategies. The focus of the grant was three-pronged: establish a Health Alert Network that would electronically link colleagues in local health units on a statewide basis; increase the surveillance capacity of the department to recognize a disease outbreak; and strengthen the public health laboratory system with regard to bioterrorism. Many colleagues at the ADH were responsible for accomplishing these goals. Dr. Joseph Bates, Dr. Suzanne Lea and Terence Sutphin -- key players in this effort -- include the following as some of the highlights:

• Developing a Health Alert Network and installing a statewide video conference system at 11 sites


• Upgrading the ADH laboratory with equipment to enable it to test for biological agents such as anthrax


• Expanding field staff involved in outbreak investigation teams and hiring an epidemiologist to oversee the bioterrorism component

Dr. Bates said, "The Department has done wonders in the last three years to prepare for a bioterrorist event, but anthrax illuminated how much further we need to go. This funding and our partnership with other state agencies and organizations will help to realize that dream."

Dr. Fay Boozman has appointed Jerry Hill of the Health Department Leadership Team to coordinate the State's bioterrorism plan and be the project director. Hill said, "This is a massive effort on the part of state government to coordinate this response, but in the event of a real emergency, this is exactly what we would have to do. Many different organizations, agencies and private businesses would have to come together quickly to save lives. This grant will enable us to plan how to do this and get the wheels rolling in this direction."

Some of the critical steps in the Bioterrorism Preparedness Plan include:

• Establishing an advisory committee to include: representatives from state and local health departments and government; emergency management agencies; emergency medical services; police and fire departments; emergency rescue workers and occupational health workers; other health care providers, including university, academic, medical, and public health; community health centers; Red Cross and other voluntary organizations; and the hospital community (to include Veterans Affairs and military hospitals).
  
  "Arkansas has already done much in the way of planning and working with the Arkansas Department of Emergency Management, our local hospitals and physicians statewide, the Army, the Arkansas State Police, and other agencies, because of Arkansas Nuclear One in Russellville, the Pine Bluff Arsenal and the recent anthrax scares." Dr. Boozman says. "Even though we work so well as a statewide emergency team, there are still gaps in the system these funds will help fill."


• Developing a plan and identifying personnel to be trained to receive and distribute critical stockpile items, and manage a mass distribution of vaccine and/or antibiotics on a 24/7 rotation.
  
  "Think about the logistics of immunizing thousands of people in a very short time. We all know that we have to sometimes wait a bit just to get a flu shot. Imagine a crisis situation in which time is of the essence," says Dr. Boozman.


• Develop a plan to receive and evaluate urgent disease reports from all parts of the state on a 24 hour a day, 7 day a week basis.
  
  "If groups of people start simultaneously showing up in emergency rooms with the same symptoms, we need a system that can instantly report this data to the Health Department. That's how we can recognize an outbreak and intervene," says Dr. Boozman.


• Develop a plan that ensures that 90 percent of the population is covered by the Health Alert Network -- a communication system that provides for around the clock flow of critical health information between hospital emergency departments, state and local health officials, and law enforcement.
  
  "Communication is the critical element in any disease outbreak. Our Bioterrorism Command Center logged over 700 anthrax calls from physicians, hospital administrators, the police and the general public from October 15 through November 30. It is imperative that key players in emergency response -- the Arkansas Department of Emergency Management, doctors, hospitals, the National Guard, the police and others -- be linked electronically so that critical information is disseminated in the most concise and efficient manner possible," Dr. Boozman says.