Webcast Transcript
Anthrax: What Every Clinician Should Know, Part 1
(October 18, 2001)
(View the webcast on the University of North Carolina School of Public Health site.)
Segment 1 of 6
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Dr. Ed Baker (moderator):
Hello, I’m Dr. Ed Baker. I serve
as director of CDC’s Public Health Practice Program Office, and
I’d like to welcome you to this special Public Health Training Network
program on “Anthrax: What Every Clinician Should Know.” We are broadcasting
today from the headquarters of the Centers for Disease Control and
Prevention and the Agency for Toxic Substances and Disease Registry
in Atlanta, and doing this program in collaboration with our partners
at the American Medical Association and the American Hospital Association.
Participating today are physicians, nurse clinicians, and other
healthcare providers, and many other colleagues working in a variety
of settings and communities throughout the country. We appreciate
your interest in what has become an important topic for us all,
and anticipate that today’s program will help to ensure successfully
coordinated efforts between the medical community and public health
practitioners in addressing suspected anthrax exposures.
As you have read in the program fact sheet, the goal of this program
is to provide physicians, nurse clinicians, and other healthcare
providers working in private offices, hospitals, and public health
settings with an update of how to correctly recognize, test, diagnose,
treat, and report cases of suspected anthrax exposure. To accomplish
this, we have 3 main objectives for this program. First, to describe
the critical role the front line medical practitioners play as an
independent and essential part of the public health system surveillance
of anthrax exposure. Secondly, to describe the proper clinical practice
for early recognition, testing, diagnosis, treatment, and reporting
of anthrax exposure. And finally, to provide accurate and relevant
information about anthrax and the risk it poses to individuals and
the community.
We have the pleasure of having with us today the Honorable Tommy
Thompson, Secretary of the Department of Health and Human Services.
Secretary Thompson will speak to us first, followed by Dr. Jeffrey
Koplan, Director of the federal Centers of Disease Control and Prevention
and ATSDR. We have with us CDC staff members Dr. David Stephens,
Dr. Bradley Perkins, who will then present an overview of clinical
guidelines and procedures for the early recognition, testing, diagnosis,
and treatment of this condition.
Before we begin, we would like to express CDC’s gratitude to key
sponsors that have made this program possible: the American Hospital
Association, the American Medical Association, the University of
North Carolina School of Public Health. I’d also like to thank the
many public, private, subscriber, and military networks that are
assisting us in making this program available across the nation.
Thanks to all of you. And now we would like to hear from Secretary
Thompson.
Secretary Tommy Thompson:
Hello. Who is on?
Dr. Baker (moderator):
Secretary Thompson, this is Dr. Ed Baker at CDC with Dr. Koplan
and Dr. Stephens and Dr. Perkins.
Secretary Thompson:
Wonderful.
Dr. Baker (moderator):
And we are broadcasting live to our network.
Secretary Thompson:
Well, that’s wonderful. First, let me thank you all at CDC for
the job you are doing. Can I start out and then turn it over to
you, Jeff?
Dr. Jeff Koplan:
Absolutely.
Secretary Thompson:
Okay. Are the doctors and the hospital associations both on
the line?
Dr. Baker (moderator):
Yes, sir.
Secretary Thompson:
All right. Good afternoon, everyone. I am very pleased to be
with you today and I certainly appreciate the leadership that all
of you on this teleconference have taken on this very critical issue.
I first want to thank Dick Davidson of the American Hospital Association,
who has issued a wonderful call to action in which he has urged
all of you to both get back to work and also care for the needs
of patients as you continue to wrestle with illness and disease.
To me, it is exactly the right tack to take, Dick, and I thank you
for it, and the hospital association, I commend you for carrying
it out. The American Medical Association, I believe, has put out
some tremendously helpful information on disaster preparedness and
anthrax information. Both of your organizations who are on this
teleconference call this afternoon, I appreciate it and thank you
for taking your time out to hear from CDC and myself as Secretary.
I believe you are both organizations that are doing outstanding
work.
The Department of Health and Human Services, which is the agency
which I lead, is the lead federal agency for the public health response
to any biological or chemical attack. We are working vigorously
with our federal partners to coordinate domestic preparedness, and
I believe we are doing as good a job as can be under the circumstances,
and I hope to continue to do so with your support and partnership.
We moved the bioterrorism preparedness efforts into my immediate
office upon my being selected as Secretary of Health and Human Services.
I appointed Dr. Scott Lillibridge of the Centers for Disease Control,
one of the nation’s leading experts on bioterrorism, to head the
Office for National Security and Bioterrorism. His office is on
my floor in the HHS building right across from my office. I have
also assembled a team of experts from throughout the Department
of Health and Human Services and other federal agencies that are
working 24 hours a day, 7 days a week in a conference room a few
steps from my office to coordinate the intel that is coming in,
as well as the department’s activities in responding to the public
health needs. I announced several weeks ago that I was creating
an advisory committee that was going to be headed by Dr. D.A. Henderson
(as all of you know, he is the physician who led the successful
fight to eradicate smallpox), and he is on board almost on a daily
basis. The president has now requested an additional 1½ billion
dollars to combat terrorism to strengthen our ability to prevent
and respond to a bioterrorism attack. The request is, of course,
more than a sixfold increase of the current budget. A big share
of that is going to be for the purchase of pharmaceuticals, namely
the antibiotics that deal with anthrax but also 509 million dollars
to speed the development and purchase of 300 million doses of smallpox
vaccine.
We are going to also add 4 more push packs to the current 8. We
have 400 tons of pharmaceutical supplies right now. This will raise
it by an additional 200 tons and we will then be able to have even
closer response time to locales throughout the country. We are also
putting in 88 million dollars in partnerships to assist at the local
level and to strengthen laboratory analysis, as well as to strengthen
the local needs, which of course I think have been largely underfunded
for several years. I also believe (and I’ve asked Congress—this
is my request, it’s not the president’s, and not in the president’s
package), I have also requested that at least one federally funded
epidemiologist who has graduated from the Epidemiology Intelligence
Service Training Program at CDC be placed in every state health
department and every regional office. We are also putting an additional
50 million dollars in to strengthen our metropolitan medical response
system, and we will go from 97 communities to 122. These are the
things that I think are pertinent to our discussion today, but I
know that you have questions that you may want to ask of me, or
more particularly and probably more importantly, of that of CDC
led by Jeff Koplan. I would like to just add that I think CDC has
just done an exemplary, fine job throughout this whole thing. I
can’t tell you how much I appreciate their support and partnership
and the professionalism by which they have conducted their work.
And I also want to thank all of you for your efforts and so on.
Now I have got a request and am looking for some help, and that
is, at the present time we have had 6,000 requests that have come
into our state health departments and our laboratories, and they
are just overrun by requests and analysis of stuff that has been
sent and so on. They’re so overwhelmed that I am wondering how we
might be able to use your associations to assist us in trying to
reduce this number and also be able to help our other laboratories.
I throw that out because it just came to my attention that the state
labs are really stretched thin at this point and time, and I am
trying to figure out a way how we might be able to buttress them
and help them get the necessary resources they need. We may have
to go in and get some extra money—I don’t know, but I appreciate any comments.
I also would ask of your associations, please try and knock down
this fear factor that is epidemic across America. As professionals,
you know that anthrax can be treated and treated very effectively
by antibiotics. We have to somehow get the American public to understand
that. I’ve been trying, but I need your medical professionalism
to assist me to accomplish this.
So with that, I will now be more than happy to turn it over to Jeff
Koplan for his remarks and then we will open it up for questions.
Once again, before I do, I would just like to take this opportunity
to thank the American Hospital Association and the American Medical
Association for being such wonderful partners in this very perplexing
and troublesome time in our country’s history. Jeff?
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