Five years after 9/11 and the anthrax attacks, will pills protect us?
By Matthew Halverson
Illustration by Matt Kindt
On October 15, 2001, with the country reeling from 9/11 and descending into a mail order–anthrax panic, Tom Brokaw shook a bottle of pills at the end of his NBC Nightly News broadcast and uttered four little words that blurred—ever so slightly—the line between journalism and prescription medicine: “In Cipro we trust.”
Today, the federal Centers for Disease Control and Prevention is echoing Brokaw’s proclamation in St. Louis, with one addendum: “In you ... we’re not sure we trust.”
Earlier this summer, the agency launched a pilot program here that involved distributing about 4,000 “MedKits” full of ciprofl oxacin and doxycycline (another antibiotic commonly used to treat the bacteria that cause diseases like anthrax and plague) to households in St. Louis and St. Charles counties to test whether everyday citizens can keep such remedies around the house and save them for the appropriate occasion. They’ll collect the kits in stages over the next several months and determine who prematurely popped the pills and who didn’t. Bruce Clements, director of the Center for Emergency Response and Terrorism in the Missouri Department of Health and Senior Services, is looking forward to reviewing the results. “The thing that we’re concerned about is that maybe people will get a runny nose and say, ‘Oh, instead of going to my doctor, I’ll just get out that kit. It has antibiotics in it,’” he says.
Though the results will inform national policy, the program raises an important question at home: Five years after 9/11, how prepared are we for a terrorist attack, particularly of the germ-warfare variety?
“We’re on a continuous incline,” says Mike Williams, director of communicable disease control for St. Louis County. “We’re much better prepared than we were five years ago.” He points to initiatives like the CDC’s MedKit program (which may ultimately only benefit first responders) and a proposed method of distribution whereby the mailman would carry antibiotics door to door as progress in the search for quick responses to an attack. But if an attack were to come tomorrow? You’d be standing in line at your local high school gym, holding one hand out for your Cipro and the other over your mouth. “It would be fraught with the kinds of complications that mass clinics have: long lines, congestion, traffic jams,” Williams says. “It wouldn’t be pretty, but we could treat everyone in time.” (Don’t panic yet: Tests conducted in June 2005 revealed that the county could increase distribution from 200 people per hour to 800 if staffers dropped the “tell me about your symptoms” routine and just started doling out the pills.)
East of the county line, early detection is the focus of the most recent bioterrorism-preparedness developments ... but you won’t exactly hear them referred to that way. City health director Bill Kincaid seems excited about launching a new “biosurveillance system” this fall that will monitor increases in suspicious symptoms at city hospitals in real time and presumably speed identification of potential outbreaks, but spotting influenza is his focus for the time being.
“We plan to use the current flu season—from October to April—as a warm-up for pandemic,” he says. When pressed about where bioterrorism ranks in the city’s list of priorities, he’s only slightly more specific: “Preparedness in general is high on our list. Bioterrorism is certainly out there. We think it’s a real threat, or we wouldn’t be spending money trying to put systems in place that would deal with it, but we can use these systems every day to do our job better.”
And as New York throws up its hands at having its $207 million in anti-terrorism funding cut to $124 million (St. Louis’ is now $9 million) Greg Evans, director of the Institute for Biosecurity at the Saint Louis University School of Public Health, says that the real concern is where the money is being spent. “There’s still a need for developing newer, more innovative educational programs around the whole area of bioterrorism,” he says. “Right now, it’s become very difficult to get funding for that.” Where’s Tom Brokaw when we need him?
