[ OUR OPINION ]

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Hawaii needs
to prepare more
against bioterrorism

THE ISSUE A new report says Hawaii and most other states are ill-prepared for a bioterrorism attack or other health emergencies.

HAWAII received mediocre marks in its preparation for responding to bioterrorism and other health emergencies. That is not good enough, since the ultimate grade will be in human lives lost to chemical warfare or new strains of influenza. State officials should strive to close gaps in response plans to make residents less vulnerable.

The nonprofit Trust for America's Health gave more than two-thirds of the states a score of 6 or less out of 10 indicators of adequacy. Hawaii was among 20 states with a score of 6. Deficiencies in Hawaii include a shortage of laboratory scientists and the lack of a publicly available plan in place to confront the outbreak of a new lethal strain of influenza, called "pandemic flu."

In announcing his resignation, departing Health and Human Services Secretary Tommy Thompson called pandemic flu "a really huge bomb out there that could adversely impact on the health care of the world."

Paul Effler, the state epidemiologist, spoke earlier this year of a "dramatic improvement" of the public health system's ability to respond to emergencies. He said threats from SARS, dengue, West Nile virus and avian flu had been "a warning shot" to improve that ability, but Hawaii comes up short in the report's state-by-state analysis of such programs.

Hawaii does not meet national standards in use of the Internet to collect disease outbreak information, according to the report. It says that could cause serious delays in reporting and create difficulty in rendering rapid or early warning of disease threats.

The state has performed well in dealing with seasonal flu, increasing vaccination of senior residents to 76.4 percent last year from 73.9 percent in 2002. However, a pandemic flu hitting the islands could result in 1,142 deaths and nearly 5,000 people hospitalized, according to model estimates.

In a survey this fall by the Association of Public Health Laboratories, Hawaii was among 34 states to report that it lacked sufficient laboratories and staff to handle "infectious agents that may cause serious or potentially lethal disease as a result of exposure" by inhalation.

All states have had to cope with a reduction in federal funding for bioterrorism aid. Such federal aid to Hawaii this year totaled $9.2 million, down by more than $1 million -- the average for all states -- from 2002, but was able to find ways to avoid reducing the state's budget for public health, according to the report. Achieving the goal of a perfect score of 10 next year will be difficult without sufficient federal assistance.