Tuesday, November 6, 2001

NEW YORK (AP) Amid the horror of the September 11 attacks, Dr. Dan Wiener had an even more horrifying thought.
As he watched nearly 100 shocked, soot-covered victims of the World Trade Center collapse rush through a hospital emergency room door normally used only by ambulance drivers, he wondered what the awful effect would be if they were carrying contagion from a biological or chemical attack.
Now, St. Luke’s-Roosevelt Hospital Center in Manhattan is building a door over that entrance and revamping security. It is also developing a rapid-screening process for anthrax, buying new protective suits, planning for more decontamination showers and training an additional 100 staffers in coping with a bioterrorism attack.
“We think with a different mind-set now,” Dr. Wiener said.
“In a way, you always knew some sort of a bioterrorism attack could happen” said Dr. Wiener, the hospital’s chairman of emergency medicine. “But now that possibility is more real, and we’ve been adding a whole new level of expertise.”
Hospitals traditionally have done some planning for accidents such as plane wrecks or building fires, and for hurricanes or other natural disasters. But, experts say, they are not ready for a major chemical, biological or nuclear attack.
“On a grand scale, hospitals are ill-prepared to deal with bioterrorism or chemical attacks,” said James Snyder, a microbiology professor at the University of Louisville in Kentucky and the author of “The Anthrax Vaccine: A Question of Safety. “We just never thought it would happen. We had a false sense of security.”
Hospitals say that equipment and training for such an emergency would cost billions of dollars at a time when they are already struggling with financial losses and shortages of equipment, nurses, pharmacists and lab technicians.
A third of the United States’ 4,900 hospitals lost money last year. More than 300 have closed since 1990.
The American Hospital Association is seeking $11.3 billion from Congress for more drugs, protective clothing and decontamination showers, among other things. But large amounts of money aren’t forthcoming.
The Bush administration has proposed $1.5 billion to fight bioterrorism, with about $50 million earmarked for hospitals. A bioterrorism bill sponsored by Sens. Edward M. Kennedy, Massachusetts Democrat, and Bill Frist, Tennessee Republican, has been whittled down to $1.5 billion from $10 billion. A $7 billion proposal by House Democrats has no Republican support.
James Bentley, senior vice president for the hospital association, acknowledged that many industries are asking for government help in connection with the attacks, and the threat of more terrorism.
“But the nation has to ask itself: Would it rather bail out the airlines or have a safe community?” he said.
The association recommends that city hospitals be prepared to treat up to 1,000 people for 24 to 48 hours. Smaller hospitals should be ready for 200 patients.
“We’d be overwhelmed by 100 patients,” said Kris Roce, chief executive of Ohio-based Forum Health, which runs hospitals in Youngstown and Warren. “Even if I could open 100 extra beds, I wouldn’t have nurses to staff them.”

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