This book published in September 2000 suggests that we need to bring the state Public Health Departments under the umbrella of the CDC/NIH (military charters) and withhold medicines from states who do not go along to ensure that that happens. 911 provided the excuse to do that anyway
but now with the new administration and the corruption of pharmceuticals it is most likely a ploy to extort even more money for necessary drugs from the sheeple. Osterholm, is a fireman who would start fires to put out and make himself a hero for our own good. LDCM dealt directly with him during the 1990s and he personally went and lobbied the legislature boldly in front of our scheduled appointments to kill legislation that would save lives and end suffering for thousands of Minnesotans with tick borne disease. He was rewarded with his own bio-terror lab at the U of MN. And yes he is the chosen expert on ecoli and other food-borne diseases. It never ceases to amaze me that people see the corruption in other institutions but cannot see it here.
When Public Health has to compete for dollars and common sense with bio-terrorism or huge profits since 911, Public Health loses every time.
http://www.amazon.com/Living-Terrors-America-Bioterrorist-Catastrophe/dp/0385334818/ref=sr_1_2?s=books&ie=UTF8&qid=1293035332&sr=1-2Living Terrors also focuses on systems and logistics that need to be addressed. Both antibiotics and immunizations are effective in specific situations, but there are currently not enough doses to have much of an impact in the event of an attack. Civil defense preparedness is also lacking. The type of response needed for a chemical weapons release is compared with biological weapons. Early identification of the infectious disease is critical since many of the diseases appear to be similar to upper respiratory infections. Quarantine and respiratory isolation of individuals affected with smallpox is also the best initial intervention to prevent subsequent waves of infection. The more specific issue of containing patients in negative air pressure rooms is contrasted with the fact that there are only 60 such rooms in the state of Minnesota's 144 hospitals.
The associated public health issues of decreased bed capacity and physician time to devote to these issues are discussed. One of Dr. Osterholm's recommendations involves increasing the "slack" in the system. He points out that for smaller disasters, such as plane crashes, the current systems are deficient and these deficiencies would be greatly amplified in a bioterrorist attack. Many physicians have never seen a case of small pox or anthrax and would benefit from the appropriate training. Appropriate training programs exist, but don't target local health systems.
The legal responses by both local officials and federal officials as well as law enforcement are discussed. Large epidemics are inherently disruptive to public health and law enforcement systems. The authors point out how the different perspectives of law enforcement and medicine (preserve the crime scene vs. do whatever is medically necessary) can lead to non-productive and at times embarrassing conflicts during public health emergencies. They also discuss the current legal landscape as it applies to a large epidemic, referencing the work of legal scholar Terry P. O'Brien. Several
problems with the current the policies about the government response
to a terrorist event are described.