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FYI This is upsetting

Health officials brace for summit
Bioterror tops list of fears for G-8

By DAVID WAHLBERG
The Atlanta Journal-Constitution
Published on: 05/02/04

SAVANNAH — Global leaders attending next month's Group of Eight summit on Sea Island might be accompanied by unwelcome guests: deadly germs, arriving naturally or through bioterrorism.

With thousands expected in southeast Georgia for the June 8-10 event, organizers fear major outbreaks of disease, or clashes between protesters and police, could overwhelm a coastal medical system more accustomed to sunburns and the occasional St. Patrick's Day brawl. But health officials say they're ready.

With $60 million in new bioterrorism funding statewide, plus the experience of the 1996 Olympic Games in Atlanta and a major coastal evacuation during Hurricane Floyd five years ago, authorities have a new strategy. They say they're pairing their traditional methods of detecting and responding to medical emergencies with a new post-Sept. 11 vigilance: Do what you normally do to combat disease, but do more of it. And assume the worst of motives.

"We plan to handle this in the same way we would with any potential outbreak," said Susan Lance-Parker, an epidemiologist with the Georgia Division of Public Health. "But we'll have a higher index of suspicion of something being done intentionally."

During the summit — which will bring together the leaders of the United States, Canada, Britain, France, Germany, Italy, Japan and Russia — federal authorities will be in charge of medical care on Sea Island. But if President Bush or other dignitaries required hospital care, they would go to Shands Hospital in Jacksonville, say officials at Shands and other area hospitals the Secret Service briefed.

Shands, a 700-bed facility 70 miles south of Sea Island, has a Level 1 trauma center capable of treating the most serious cases, said Dr. David Vukich, its senior vice president for medical affairs.

Memorial Health University Medical Center in Savannah, 70 miles north of Sea Island, also has a Level 1 trauma center. But with the international media and possibly thousands of protesters in Savannah, officials are reserving Memorial for the public, said Scott Regan, executive vice president of the 500-bed hospital.

Savannah has two other hospitals, St. Joseph's and Candler, with a combined 920 beds. All three Savannah hospitals, like many in metro Atlanta, occasionally have turned away patients recently because they have been full, Regan said. The G-8 summit could exacerbate the crowding. But officials say that in a crisis, patients with less serious conditions might be discharged and inland hospitals could provide additional beds.

Southeast Georgia Health System's 317-bed hospital in Brunswick, just across the causeway from St. Simons Island, expects to be busy. Its urgent care center on St. Simons Island, which normally closes in the evening, will be open around the clock.

Brunswick hospital officials have mounted a substantial readiness campaign, said Marjorie Mathieu, vice president for support services. They booked hotel rooms for doctors in case traffic gets tied up.

To prepare for bioterrorism, they have run decontami-

nation drills under a specially equipped tent. In case they need to fly patients to Savannah or Jacksonville, they have clearance to use medical helicopters despite federal airspace restrictions.

The prospect of mayhem near Brunswick, population 16,000, has many worried.

"We do disaster planning all the time, but this is a big unknown," Mathieu said. "The entire community is in an apprehensive mode."

As hospitals gear up, health officials are increasing efforts to detect disease — and bioterrorism. State and local health agencies will be in charge. The federal Centers for Disease Control and Prevention also will have people on hand.

Symptoms of some of the six agents the CDC lists as the top bioterrorism concerns — anthrax, botulism, plague, smallpox, tularemia and viral hemorrhagic fevers such as the Ebola virus — can take days to develop and can initially be vague. That complicates efforts to recognize the germs.

To be able to spot a cause for alarm during the summit, health officials are gathering background data on patients' most common complaints, from headaches to rashes to nausea. When the crowds arrive, the authorities will see if any conditions seem to be showing up more than usual, said Lance-Parker of the state health division. A blip in the incidence of blurred vision or slurred speech, for example, could trigger an investigation for botulism poisoning.

The $60 million in bioterrorism funds Georgia has received from the CDC in the past two years has boosted preparedness throughout the state. But officials have speeded up some improvements near the coast before the summit. Drug caches, including cyanide antidotes and potassium iodide pills to reduce harm from radiation exposure, soon will be distributed in southeast Georgia. A new biological testing lab in Waycross means samples no longer must go to Atlanta.

It is unlikely the Savannah area is one of the 30 or more secret locations that are part of Biowatch, a federal program featuring air detection devices to sniff out deadly agents. But similar efforts are set up during high-level events such as the G-8 summit, said Michael Osterholm, a University of Minnesota epidemiologist and one of the top government bioterrorism consultants.

One of the ways terrorists could wreak havoc is by contaminating food. Federal authorities will maintain tight control over food on Sea Island, testing samples for germs, said James Drinnon, director of environmental health for Georgia's East Health District in Savannah.

But it's not feasible to test all food for bacteria and viruses, and it would take days for some results. So authorities will focus more on tracking food from distributor to table, said Mike Doyle, director of the University of Georgia's Center for Food Safety.

"Testing is not going to be the solution," Doyle said. "Security is."

So is practice. During two days of drills last week, area health officials reviewed what they would do in an emergency using a mock disaster scenario: a simulated release of anthrax at a shopping mall.

After learning of the "illness" of hundreds of people during the drill, the authorities called the CDC to tap into the Strategic National Stockpile, a collection of drugs, vaccines and emergency equipment stored at 12 secret locations across the country. They converted a high school into a clinic and distributed antibiotics, questioning volunteer "patients" to determine whether they needed medication.

The drills "allow us to be more comfortable in a real emergency, whether it be anthrax or smallpox or whatever," said Dr. Diane Weems, medical officer for the Savannah health district.

The only problem: not enough "patients" showed up. Health officials only hope that's their biggest concern during the summit.