States lag in
bioterror response

Hawaii and 19 other states
meet six of 10 criteria for
readiness for a germ attack

WASHINGTON » States that routinely deal with hurricanes and other natural disasters are better prepared than others to handle bioterrorism, but overall the nation is struggling to develop plans for public health emergencies.

Hawaii falls short in four areas States were ranked by the Trust for America's Health based on their preparedness to face bioterrorism risks, as evidenced by meeting 10 criteria picked by the trust. Hawaii met six of the criteria but fell short in these areas: » Hawaii has failed to achieve "green" status for the Strategic National Stockpile, which means the state is inadequately prepared to distribute vaccines and antidotes in an emergency. » The state reports insufficient laboratory capabilities (facilities, technology and/or equipment) to fully respond to a chemical or bioterrorism threat. » Hawaii does not have enough laboratory scientists to test for anthrax or plague in the event of such an outbreak. » Hawaii is among two-thirds of the states that fail to track disease outbreaks electronically by national standards. Failure to track the information can cause serious delays in reporting information, making early warning of disease threats difficult. Source: Trust for America's Health

Hawaii was ranked in the middle among states based on criteria assessing their readiness.

Florida and North Carolina, both familiar with evacuating residents and distributing emergency aid, received top rankings in a study by the private Trust for America's Health. Alaska and Massachusetts got the lowest ratings despite infusions of federal aid designed to improve emergency responsiveness.

Overall the report found that states are slowly becoming better prepared to handle bioterror, but most still lack statewide response plans. Federal planning money is declining.

The report echoed fears voiced by Health and Human Services Secretary Tommy Thompson, in announcing his resignation this month, that he couldn't understand why terrorists haven't attacked the country's food supply because it would be "so easy to do."

The review also follows a year in which the country faced a shortage of flu vaccines, normally a routine protection against a known problem.

Combating bioterror is the weakest link in homeland security, said former Connecticut Gov. Lowell Weicker, now president of Trust for America's Health.

"We're not ready, and I see no excuses as to why we shouldn't be," said Weicker, who served three terms in the Senate. He said that while the report focuses on bioterror, it also shows the country is ill-prepared to deal with daily public health emergencies, from childhood asthma to West Nile virus.

The report issued yesterday found only six states adequately prepared to distribute vaccines and antidotes in emergencies, but it named only three of them: Florida, Illinois and Louisiana.

The report graded states on whether they met 10 criteria, including such elements as the amount of state spending and federal aid allocated to public health, flu vaccine rates and the number of scientists and laboratories available to test for anthrax or the plague.

No state met all 10 criteria, and only Florida and North Carolina met nine of the 10. Most states met five or six criteria.

Hawaii was among 20 states to score a six. But state Health Director Dr. Chiyome Fukino said Hawaii is taking steps that should result in the state scoring a 10 when the 2005 report comes out.

States such as Florida have spent money on training and built an effective infrastructure to deal with public health emergencies, said Shelley Hearne, executive director of the Trust for America's Health.

The report concluded that basic bioterror detection, diagnosis and response capabilities are not in place, and the country has a long way to go to protect the public from such attacks.

A common problem was lack of money. Federal bioterror aid was decreased by about $1 million per state in 2004, and about one-third of the states saw their public health budgets decline.

The most significant failure among the states was the lack of adequate public health labs and laboratory scientists to handle serious outbreaks.

The report found only 16 states have enough labs and 21 enough scientists.

Handling an influenza pandemic, especially considering this year's shortage of flu vaccines, would be a problem for at least 20 states that have no public response plan in place.

Earlier this fall, U.S. health officials began scrambling for flu vaccine when British authorities shut down the British operations of U.S.-owned vaccine maker Chiron Corp. after finding contamination at a Liverpool plant.

Spokesman Von Roebuck of the Centers for Disease Control and Prevention said the agency is doing comprehensive assessments of how well-prepared states are, but will not release a detailed report. Instead, he said the CDC is working with the states to help development of response plans.