Reprinted with the permission of The Kansas City Kansan By Ben Embry October 17, 2001

The war against terrorism was clearly on the minds of law enforcement, emergency response and health care professionals Monday at the University of Kansas School of Nursing in Kansas City, Kan.

Kansas City, Mo., Mayor Kay Barnes was worried. If you received a small pox vaccine as a child, she asked, would the inoculation still provide protection in the event of a biological attack?

What's our state of preparedness in dealing with biological or chemical attacks at sports complexes or other venues with large gatherings of people? asked U.S. Rep. Dennis Moore, D-3rd District.

Discussing those issues and many more were Michael Selves, Johnson County Emergency Management director, Kansas City, Mo., Fire Department Chief Richard Dyer, Louie Wright, representative of the International Association of Firefighters, and Federal Bureau of Investigation Supervisory Special Agent Jim Keily, who spoke with about 300 area emergency preparedness officials. The open-panel discussion, hosted by Moore and Missouri Congresswoman Karen McCarthy, D-5th District, also included area emergency health officials Dr. Rex Archer, Kansas City, Mo., health director, Dr. Matt Gratton, Kansas City, Mo., medical director and Ruth Schukman-Dakotas, KUMC director of safety administration.

"In the wake of the Sept. 11 attacks, it is important for our national and community to assess the state of preparedness for responding to terrorism, particularly biological or chemical attacks," Moore said. "We are bringing together officials from both sides of the state line to discuss how our area can prepare for a possible attack and what we can do at a federal level to help in that effort."

He added that federal, state and local officials needed to think outside of the box to counter terrorism. He said that it was important to scrutinize the plans in place dealing with a chemical or biological threat to assess where we are and how to prepare.

"If things are not perfect now, it's not the end of the world," he said. "But we have a lot of work to do."

One of the chief concerns, Selves said, was establishing an overall framework for emergency response units to handle a biological or chemical attack.

"Everybody needs to be reading from the same sheet of music," he said. "We need to work together."

Under the Metropolitan Medical Response System, Dyer said, the KCFD had been working in conjunction with the Mid-American Regional Council to address equipment and training needs in order to fashion a city-wide plan in the event of chemical or biological attack.

But with local government cutbacks, he said the federal government needed to step in and provide adequate fiscal resources for local agencies involved in MMRS, including the fire department, police department and health department personnel. In addition, Dyers suggested the creation of a single point of contact on the federal level to reduce bureaucratic red tape.

"If we address all of this, I think we can get prepared," he said.

Speaking on behalf of firefighters nationwide, Wright voiced his concern over the preparedness of local fire departments.

Local fire departments all over the country, he said, are not prepared to adequately respond to an attack.

"We know that it will require substantial national participation. But national assistance needs to be effectively distributed at the local level," Wright said.

Wright cited the need for tighter restrictions in transportation regulations. He said that Kansas and Missouri are two of the least regulated states when it comes to transporting chemical or biological agents.

"Maybe we need more licensing," he said. He also suggested putting locators on trucks transporting toxins so that dispatchers could be alerted immediately if a driver went off course.

Infectious diseases is an area of particular concern for health officials.

"The government's primary job is protecting its citizens," said Rex Archer, KCMO health director. "Unfortunately, when it comes to infectious diseases, we have not been doing an adequate job." He said infectious diseases that are picked up hospitals kill over 1,000 New Yorkers a day.

Despite the death toll from infectious diseases, Archer said hospitals and local health departments are woefully underfunded.

"Under national security measures, we need to rethink this," he said.

Archer stressed the importance of early detection in chemical or biological warfare, noting that it can be days or even weeks before an attack is detected. As a result, he said a monitoring system needed to be put in place to look for "surges" in pharmaceutical sales that could indicate an attack.

"Public health departments have not had experience responding to emergencies very rapidly," he said. "But we need to be able to respond to a biological or chemical attack within hours, or even minutes."

To improve response times, Archer said at least 12 more field staff and $1 billion in funds would be necessary to handle an outbreak.

Echoing Archer's sentiments, Domenic Serrone, KCFD deputy chief, pointed out that the KCFD was equipped to handle only 500 to 1,000 victims in the event of an attack. But, he said, one of the best ways to protect citizens is to protect the infrastructure.

"The more we deter these things, the less likely these events are to occur," he said. "If the infrastructure fails, the city fails."

And, according to Dr. Matt Gratton, emergency medical services director of Kansas City, the city "has a very good EMS plan in place." But, he said, there is room for improvement.

He said the state of readiness for a chemical attack had improved over the years. He noted that a few years ago only one hospital was prepared to deal with a hazardous materials incident, compared to eight hospitals today.

"However," he said, "they would be prepared to respond to only a small number of patients and would be rapidly overwhelmed."

In terms of biological readiness, there is a 24-hour duty officer available to respond to any reports of an attack, Gratton said.

For the city to be better prepared, he listed off a number of proposed improvements, including computerized linkings of doctor's visits with local health departments, enhanced laboratory capabilities and increased funding to implement EMS plans.

Gratton also stressed the need for a general template of action that all agencies could use in responding to a chemical or biological attack.

"How are we doing in terms of public education?" Moore asked.

"The worst this we can do right now is giving contradictory recommendations," Dyer said. "We need to have a federal template as soon as possible."

On the health care front, Schuckman-Dakotas cited three areas in need of improvement: time, staffing and funding. She pointed out that there was not enough time to adequately train staff, a crippling shortage of nurses and insufficient funding.

"Is health care prepared?," she asked. "Partly, we are. Could there be improvements? Yes."

Moore said the open-panel discussion had been a good starting point for developing a comprehensive response plan to a biological or chemical terrorist attack.

"We're better off than I thought we might be, " he said. "But we need to stay ahead of the curve, not behind the curve. We need to prepare for the worst and hope for the best."