Hospitals preparing for bioterror BY JOHN DORSCHNER jdorschner@herald.com

RICHARD PATTERSON/FOR THE HERALD

Hospitals in South Florida and across the nation are starting preparations for biological and chemical attacks that security experts are convinced may eventually come.

In the three months since the last of five Americans died of anthrax, thousands of South Florida hospital personnel have gone through training.

A task force for the region -- Broward, Miami-Dade, Palm Beach and Monroe counties -- believes the area's hospitals need at least $12 million to prepare.

Jackson Memorial, which would like to become the lead hospital for bioterror response in South Florida, says it needs $2 million to $5 million just for itself.

Where these funds might come from, however, is uncertain.

As a first step, Jackson trustees have allocated $440,000 to protect the sprawling hospital complex and its 337 entrances. A fence will be built around the entire facility, with gates that will be open most of the time but that can be locked quickly in event of an attack so that victims can be funneled through the emergency room and trauma center, which are getting new safeguards.

In Broward, representatives of the North and South hospital districts have sent teams to study hospitals in Israel, where medical authorities have long been prepared for such attacks.

ISRAELI MEASURES

The Broward public hospitals have already beefed up security, and they're discussing implementing many Israeli security measures, spokesman Mark Knight said. One move: installing negative air-pressure systems in isolation rooms, so that super-potent airborne toxins won't rush through the hospital's normal ventilation system and contaminate the entire building.

''In Israel, we took the worst case scenario as being the most realistic,'' said Bernd Wollschlaeger, a former Israel medical officer who is now an Aventura physician and chairman of the disaster preparedness task force of the Florida Medical Association. ''We prepared with gas masks for everyone, antidotes, decontamination powder, and I think we have to take a similar approach here, at least for the major urban areas,'' Wollschlaeger said.

FEARED NIGHTMARE

All experts fear this nightmare: Hundreds of victims of a biological attack rush to hospitals, flooding every entrance. They race down corridors hunting for the emergency room, contaminating patients, doctors and nurses. Soon, the caregivers themselves are in need of treatment, falling on cots beside the first wave of victims.

Stopping a scenario like that is not easy -- or cheap.

''This is an amazingly expensive process,'' said Richard Weisman, director of the Florida Poison Information Center and coordinator of Jackson's bioterrorism efforts.

The North Broward Hospital District has started purchasing $550 gas masks that can protect against the tiniest microbes. Full hazmat suits cost $1,500 to $4,500.

''And, boy, those suits are hot,'' Weisman says. ``We'll need multiple crews. They can only work 30 to 35 minutes, and then they need to be rotated.''

That means a lot of people need to be trained. The North Broward Hospital District, which has four public facilities, including Broward General, has trained 700 so far. Jackson has trained 1,200. Mount Sinai and Baptist have also been educating their staffs.

A key question is how big a disaster to prepare for. At the moment, Weisman said, Jackson could probably handle 300 victims of bioterrorism. ``If Jackson gets up to its highest level, it would be able to accept 1,000. That would be a Herculean task.''

But 1,000 victims aren't a lot. Disaster experts envision scenarios in which there could be hundreds of thousands injured in South Florida.

Preparing for a catastrophe of that size would involve astronomical sums. Tommy Thompson, secretary of Health and Human Services, instead recommends that each municipal area be able to accommodate ``500 acutely ill patients.''

One major problem: Preparing for a chemical attack -- many victims in one area who might have horrible skin problems -- would be far different than mail sorters who inhaled anthrax.

For hospitals, the biggest fear is a highly contagious disease, such as smallpox or hemorrhagic fevers like Ebola. ''You want to make sure that these people who come into the emergency room don't infect the rest of the hospital,'' said Barbara Russell, director of infection control services at Baptist.

How all these preparations are going to be paid for is still up in the air. At present, there's $62 million to divvy up among seven Florida regions.

The first debate will be how much each region gets. ''I've been screaming about this for months,'' said Michael Kosnitzky, a Jackson trustee. He fears that the Panhandle region may end up getting as much as South Florida, which has a far larger population.

More money will eventually filter down from Washington. In the latest federal budget, President Bush proposes spending $1.6 billion for local healthcare organizations to respond to biological attacks. That's not a lot to spread among hundreds, if not thousands, of hospitals, and in a struggling economy, administrators are not certain where they could find more money on their own.

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-- Martin Thompson (mthom1927@aol.com), February 20, 2002