Are We Ready?
A large-scale disaster like a pandemic flu or terrorist attack could overwhelm the nation's healthcare providers
Despite such efforts, many hospital executives say the lack of accountability standards from the feds remains a big problem. "What is missing in action is a definition for what we mean by 'prepared' for hospitals or communities," says Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University's Mailman School of Public Health.
In the end, it comes down to money. "To ask any industry to double its productive capacity with no funding is really a hard row," said the Cleveland Clinic's Peacock. Just adding decontamination showers at his hospital, Peacock noted, cost an estimated $1 million. Dan Hanfling, an emergency room physician with Inova Health System in Northern Virginia, told Congress last month that the $2.1 billion appropriated over the past five years to give hospitals a basic level of preparedness isn't nearly enough. The American Hospital Association estimates that stockpiles of pharmaceutical supplies and medical equipment, plus personal protective equipment, decontamination facilities, computer systems, and training, would cost about $11 billion.
Public-health facilities need help, too: Labs in more than a quarter of the states don't have the equipment or staff to respond to a bioterrorist attack. After 9/11, more federal funds were directed to shore up the system. But it had been neglected for so long that much of that money went toward basic upgrades, and local funding was often cut in light of the federal increases, says Nicole Lurie, codirector for public health at Rand's Center for Domestic and International Health Security.
It's not just healthcare providers who must gear up for disaster. "It's critically important that individuals in the private sector take responsible steps to prepare themselves," Department of Homeland Security Secretary Michael Chertoff told summit participants. A personal preparedness plan, plenty of canned food, and avoiding shaking hands during an epidemic can go only so far, though. "You need to be asking state and local governments what they will do," says Minnesota's Osterholm. "Demand answers beyond 'We've got it covered.'"
On Long Island, Brian O'Neill believes his hospital system can handle all but a major pandemic. But as proud as he is to show off his stockpiles of antidotes, masks, and portable ventilators, he'd be just as happy never to have to use them.
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