SARS Could Overwhelm U.S. Healthcare

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WASHINGTON, April 9 (UPI) — Despite the increase in bioterrorism preparedness across the United States, the country’s public health system still has major gaps and could be overwhelmed if there is a significant increase in cases of severe acute respiratory syndrome, experts testified before Congress Wednesday.

“The outbreak of severe acute respiratory syndrome has not infected large numbers of individuals in the United States, but it has raised concerns about the nation’s preparedness should it, or other infections, reach pandemic proportions,” Janet Heinrich, director for public health issues at the General Accounting Office, testified before the House Government Reform Committee.

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The GAO issued a report Monday about efforts of public health agencies to prepare for a bioterrorist attack that found gaps in preparedness still remain. Shortcomings specifically related to SARS included that many hospitals lack the capacity to respond to large-scale outbreaks of infectious respiratory diseases.

“Most hospitals lack adequate equipment, isolation facilities, and staff to treat a large increase in the number of patients for an infectious disease such as SARS,” Heinrich said.

If cases of the disease were to increase markedly in the United States, “it could get out of control because not all hospitals are as well equipped or as well-trained as others,” she noted.

To date, there are 149 suspected cases of the illness in the United States and no deaths from the disease. Globally, more than 2,700 people have come down with SARS and 106 have died from the disease.

Dr. Margaret Hamburg, vice president of biological programs for the Nuclear Threat Initiative, shared Heinrich’s view.

The United States is “inadequately prepared (to respond to disease outbreaks) … we must do more,” said Hamburg, who served on a panel of disease experts, convened by the Institute of Medicine, that wrote a report in March about the threat of emerging infections as the SARS epidemic was just being recognized.

The IOM panel concluded the United States and other countries should do more to battle the emerging threat of infectious diseases because of the devastating global ramifications of illness outbreaks.

“SARS is a wake-up call” and “is not an isolated phenomenon,” Hamburg said, noting other new diseases will likely emerge in the future.

“The best defense against any outbreak is a robust public health system,” she said.

Dr. David Goodfriend, director of the Loudon County (Va.) Health Department, which in February treated the first suspected SARS case in the United States, said bioterrorism preparedness efforts had made their response to the mysterious illness more effective.

At the time, SARS had not yet been recognized as a syndrome but the health department was aware of reports of atypical pneumonia. Due to their bioterrorism preparedness, they already had plans in place for isolating patients and quickly notifying the state health department and the Centers for Disease Control and Prevention, which benefited their response to the suspected SARS patient, Goodfriend said.

However, health officials still lacked other critical elements for responding to an outbreak of either a bioterrorist attack or an emerging disease like SARS, he said.

Although there were provisions for transporting patient specimens to the state health department, there were no protocols in place for getting those specimens to the CDC during the weekend, he said.

In addition, the health department lacked the capacity to handle a major influx of respiratory cases and would have experienced difficulty isolating patients if there had been a larger outbreak, he said.

Copyright 2003 by United Press International. All rights reserved.

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