- The Washington Times - Friday, December 20, 2002

Regional governments have been thinking about smallpox for some time now, both in preparation for the president's recent pronouncement on inoculations, and the need for regional coordination in case of a smallpox attack. The latter is especially critical, since the D.C. region makes both natural target and, considering it's many jurisdictions, a national nightmare for responding to such an emergency.
So far at least, regional governments seem to be taking the proper preparatory steps for both vaccination planning and post-attack coordination. However, both will bear continued close watching, since the consequences of failure are so high.
Shortly before the president's announcement, the governments of D.C., Virginia and Maryland each submitted pre-attack inoculation plans to the Centers for Disease Control and Prevention (CDC). While there were some variations, they all followed a tiered approach. In the first phase, expected to start in late January, the vaccine will be given to individuals on designated smallpox response teams and hospital-care providers. Federal officials hope they will be completed in about 30 days. In Maryland, that will cover about 5,500 people, in Virginia, nearly 13,000, and in the District, 3,000 to 5,000. In the second phase, which will begin after the first is completed, smallpox inoculations will be given to health-care workers and emergency responders police officers, firefighters and rescue workers. Federal authorities hope it will take no more than three months, after which the smallpox vaccine will be offered to the general public.
In Maryland and the District, first-phase plans seem better developed. A Virginia official characterized the state's plans as "a work in progress." The D.C. government is even more advanced in planning, in part because of last year's anthrax attacks. Well before the president's announcement, Dr. Michael Richardson, senior deputy director of the D.C. Health Department, had said, "It's a foregone conclusion we are going to vaccinate people." According to Dr. Richardson, vaccinations could begin this month, and preparations in the District are so far along that even the inoculation of the D.C. populace could take as little as 120 days.
However, as Dr. Richardson noted, regional planning for a smallpox emergency is a far more difficult proposition, since response teams and jurisdictions will cover all levels international, federal, state, regional and local. To properly integrate the response, he said that he and his staff have had multiple meetings with the many entities involved. None of the regional representatives anticipate turf battles. We certainly hope they are right, since public assurances don't always translate into life-saving practices.

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