Plague exercise tests county capabilities

| 28 Sep 2011 | 02:16

    PATERSON-Originally described as a county-wide biohazard exercise, the "strategic national stockpile scarlet pestilence" drill on Oct. 2 was far more sobering than the coffee served by Salvation Army volunteers. The central message, delivered by state Health Commissioner Clifton R. Lacy, M. D., is that New Jersey faces future terrorist attack. "It's not a question of if, but when," he said. "We are rich in high value targets," Lacy said, speaking of the state's being a hub of the pharmaceutical industry, as well as having numerous other major objectives. He cited the financial industry, truck and railroad transportation and military bases, Newark's international airport and weapons storage facilities such as Navy Weapons Station-Earle in Colts Neck, straddling busy Route 18, and Picatinny Arsenal in Jefferson, which bills itself as the "Home of American Firepower." Picatinny's Website claims "There is no other comprehensive armaments facility like it in the country..." "New Jersey has a long history of deliberate and accidental health threats," Lacy told government officials and media representatives attending the disaster drill at Martin Luther King School. He cited the anthrax attacks following 9-11 and, most recently, a case of Lassa fever diagnosed two weeks earlier in a returning visitor to Africa. According to the Centers for Disease Control (CDC) in Atlanta: signs and symptoms of Lassa fever typically occur 1-3 weeks after exposure. The disease has a 20 percent mortality rate. Although it's a Passaic County Health Department drill, officials from other communities, including West Milford, are conspicuous by their absence. Health officials said it would have been too cumbersome "for the sake of the exercise" to have representation from other local communities. Indeed, West Milford's public safety director, Police Chief James R. Dykstra, said Wednesday, Oct. 6, that he was never informed of the "Scarlet Pestilence" exercise. The drill scenario outlines numerous patients in Warren and Monmoth Counties, and in Paterson, who became ill 48 hours after attending a sporting event at Rutgers University, New Brunswick, along with some 7,000 others. The date is Sept. 29. Eleven people are diagnosed at area hospitals and at least one student at Rutgers also is stricken. Hospital medical staffers, in conjunction with the CDC, determine the cause is pneumonic plague. Over the next 24 hours some 3,000 suspected cases are treated and 200 people have died. Under the drill scenario, the state Health Command Center is activated on Sept. 30. By Oct. 1, the state opens its Point of Dispensing (P.O.D.) sites. For purposes of the drill, the test was conducted at just one site. The state develops a suitable emergency message to describe symptoms and urge those who believe they may have been infected to go to the treatment site. It is Oct. 2 and the gymnasiums and other large public areas at Martin Luther King School have been converted into emergency facilities, primarily patient intake, where people are admitted to the school through a police cordon, then provide initial medical information to emergency medical technicians. All public access to the school has been sealed off by dozens of Paterson police stationed about a block out from the school. After initial paperwork and processing is completed, the volunteer patients proceed to medical assessment stations where they are medically assessed, or triaged. Those deemed "worried well" are sorted out from the those who may have been exposed or who are visibly sick and will be transferred to area hospitals, according to the processing procedures. Those who are believed to have been exposed will received antibiotics to begin preventive treatment. The exercise is part of an international exercise being conducted with Canada and the United Kingdom, said Lacy. With people lined up outside, officials were asked how they would prevent one prospective victim from infecting others. "We'll mask everybody outside, if we have to," said Kate Bond, the P.O.D. director and nursing director of the Paterson Health Department. Asked how many masks the P.O.D. has, she replied: "Lots." Passaic County has 12 P.O.D.s and could deploy as many as six in Paterson alone, if they were needed, explained James S. Blumenstock, New Jersey's deputy commissioner, public health protection and emergency preparedness. He said there are 400 sites capable of supporting P.O.D. operations. "We're now developing the human resources" to handle such emergencies, he said. Each P.O.D. has 80 workers per shift. Initial processing during the exercise was capable of assessing 150 people per hour, officials said. The state has 5,000 to 6,000 doses of pneumonic plague-specific antibiotics on hand, the deputy commissioner said. Although, under a worst case scenario, with a maximum of six P.O.D.s in operation in Paterson, that would exhaust existing supplies in less than six hours, he's not worried. : "What we have is a series of multiple tiers (of preparedness) in order to protect public health. Our on-shelf supplies in hospitals would be used to treat workers and those who are admitted with symptoms." said Blumenstock. "We would already have activated state supplies and concurrently would be contacting CDC to access that stockpile. As the event unfolds, the state stockpile would be used to provide additional supplies to hospitals and other clinics. CDC has a 12-hour delivery window. At the same time that supplies are en route, we send out word to counties to start setting up clinics." By the time P.O.D.s are staffed, federal backlogs would be en route, he asserted. "Our primary objective, should there be terrorist activity, is to treat those that are sick and, second, to treat those exposed." "There are multiple national stockpiles strategically secured around the country and federal inventory continuing to grow. They (the CDC) are confident they could mobilize and distribute multiple stockpiles. "PUSH PACs can be delivered anywhere in the country in 12 hours," he said. One push package is capable of treating 225,000-300,000 people. In addition, the federal government has agreements with all the U.S. antibiotic and medication manufacturers. If we need a special medication or antibiotic, the federal government has the ability to go directly to a vendor and tap materials in that vendor's possession, said the deputy director. Citing New Jersey's enviable position as host for numerous major pharmaceutical companies, Blumenstock said: "During 911 we had pharmaceutical companies calling us and asking if we needed any of their materials