- The Washington Times - Tuesday, October 30, 2001

The recent tragic deaths of two postal workers from anthrax has pushed us into the ugly world of finger-pointing.

Senate staffers appear to have received more consideration than postal workers. Like deer caught in the headlights, government and public health officials seem to be surprised every day by new anthrax developments.

Readers of my columns know I don't shy away from criticism when and where merited. In the case of the current anthrax attacks, though, recriminations are unwarranted.

Mishandling the letter sent to Sen. Majority Leader Tom Daschle's office resulted in the release of the anthrax spores into the air. Because the letter was well-sealed, it didn't seem likely that anthrax had escaped from the envelope during prior mail sorting and handling.

So at the time, the reasonable course of action seemed to be treatment of Senate staffers who may have been exposed to the airborne spores. It didn't seem likely that postal workers had been dangerously exposed by a sealed envelope.

But Surgeon General David Satcher readily admitted, "We were wrong."

No one knows exactly how the postal workers who died recently were exposed to anthrax. It's possible that the letter-sorting machinery forced anthrax spores through the paper.

The spores in the letter were milled very finely. Reportedly, some were as small as 1.5 microns in diameter. An average human hair is about 100 microns wide. Since the paper fibers of an envelope are several microns apart, the smallest spores could actually escape between them.

Any spores escaping between the fibers would also be the most readily airborne and most readily inhaled, making them the most dangerous. The now discontinued practice of blowing out the dust from the machinery could also have contributed to the airborne contamination.

This is all hindsight, though.

Experts have warned of the possibility of bioterror attacks with anthrax for years. But among all those warnings, it does not appear that the sort of attacks we are now experiencing were widely considered even by the most concerned experts.

In the aftermath of the first anthrax-related in Florida, concern still centered around the possibility of a mass attack with bulk amounts of anthrax.

It seems somewhat unreasonable to lay blame for errors made amidst events that were unforeseen and perhaps unforeseeable in the pre-Sept. 11 world.

USA Today last week subtly criticized the physicians who failed to suspect anthrax in one of the postal workers who died. The physicians apparently were insufficiently "curious, knowledgeable and determined."

In contrast, USA Today spotlighted the New York physician, an infectious disease expert, who diagnosed NBC News anchor Tom Brokaw's assistant with cutaneous anthrax. "Despite the rarity of the diagnosis, he rejected flawed test results showing no anthrax, prescribed antibiotics and pushed local health officials to notify the CDC," USA Today editorialized.

What the physician did was to consult his textbooks about the strange lesion on his patient's chest. No doubt he did terrific work, since cutaneous anthrax is such a rare disease, particularly in New York City. But this is quite different that the situation faced by the physicians treating the postal worker.

The postal worker had inhalation anthrax. The initial symptoms are innocuously flulike. There are no obvious telltale lesions. Since it's not standard procedure to ask patients with flulike symptoms where they work information that presumably would have triggered the right suspicions in the hospital physicians it's not surprising that the worker was sent home to recover.

No one in the world has the experience or expertise for flawless management of bioterrorism. Government and public health officials, physicians and other front-line public health personnel, the public, and the media have learned a great deal about bioterrorism in the last month. Undoubtedly, there is much more to learn.

In these trying times, the most we can reasonably hope for is that we learn quickly especially from our mistakes. Blame is not conducive to the learning process. Instead, it's distracting and discouraging.

Steven Milloy is the publisher of JunkScience.com, an adjunct scholar at the Cato Institute and the author of "Junk Science Judo: Self-defense Against Health Scares and Scams." (Cato Institute, 2001).

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