Homeland Insecurity

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While he praised the nimbleness and skill of the public-health network, the system had been through a tense fire drill. It had taken a week and a half to nail down the diagnosis of anthrax at NBC. At first the baby believed to have been infected at ABC News was thought to have a spider bite. Testing at the CDC lab in Atlanta was delayed for 14 hours after a 1-hr. power failure. Most health-care workers have never seen a case of anthrax, though they are learning what it looks like fast. Many of the national Emergency Response Network's 100-odd public-health labs, flooded with suspicious samples to test, had to learn to do triage: the disease detectives at the CDC were reportedly coaching other labs on how to assess the risks and decide which substances to test first. They also alerted health officials to watch for the signs of other diseases, like plague (fever, cough, chest pain), smallpox (flulike symptoms and rash) and botulism (drooping eyelids, difficulty swallowing, blurred vision). While there was "no evidence" of the threat of any such diseases, says acting deputy director of the National Center for Infectious Diseases Julie Gerberding, "we do live in an era when those threats can become a reality."

At CDC headquarters, cots were set up and meals were brought in to make researchers more comfortable as they worked around the clock. Eighty people arrived at a Staten Island, N.Y., hospital fearing they had been exposed on a ferry. "It was a mob mentality," a doctor said. Clinicians tried to reason with people, explaining that their odds of being hit by a car while running to the ER are far greater than their chances of contracting anthrax. "We've been testing a lot of Sweet'N Low, drywall dust, sugar and talcum powder," said Kathy Barton, chief of public affairs for Houston's department of health and human services. "When we think we get the public calmed down, something else cracks down in Washington or New York and it heats up again."

In Washington the consensus was that public-health officials were equipped to handle a couple of dozen cases of anthrax spread by envelope but not a couple of million spread by a crop duster. A 1993 report by the now-defunct Congressional Office of Technology Assessment showed that a broad dispersal of anthrax spores over a major city could cause 3 million casualties. Another report estimated that a smallpox release could kill 40 million. But Bush's budget this year allocated just $345 million for bioterrorism preparedness. Congress had passed legislation asking for $1.4 billion, and now that number is considered too low. Last week Thompson publicly asked for an extra $1.5 billion, and the final number could be more than three times that. The money would be used to boost drug stockpiles, train local health workers to respond to an emergency and improve the testing facilities at labs. Many today have no fax machine, let alone a computer link to the CDC.