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Jewish World Review Nov. 1, 2001 / 15 Mar-Cheshvan 5762

Morton Kondracke

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How You Can Fight Terrorism -- WHAT Mayor Rudolph Giuliani advised New Yorkers, highest-level Bush administration officials should tell all Americans: get your flu shot.

And for the same reason: When flu season hits, Americans could start clogging hospital emergency rooms, fearing they are suffering from anthrax.

Hospitals would have a terrible time handling the flu crush and could miss people with anthrax, who'd die if not treated. So getting a flu shot is one simple way ordinary Americans can fight terrorism.

One problem is that there's not enough vaccine to go around, but Sen. Bill Frist (R-Tenn.) told me he's considering adding money to his bioterrorism bill to make sure 200 million doses are available.

Surgeon General David Satcher last week urged citizens to get flu shots, but the message needs to be delivered at a higher level - by Health and Human Services Secretary Tommy Thompson, Homeland Security chief Tom Ridge or officials at the White House - and repeatedly.

Giuliani, with typical showmanship, delivered his message by rolling up his sleeve and getting his flu shot in public. It's something Thompson should consider and Members of Congress, too.

One knowledgeable HHS official, explaining that drug companies don't have an adequate amount of flu vaccine on hand, said HHS could push for more to be produced, much as it is doing with the antibiotic Cipro and vaccines for anthrax and smallpox.

The federal Centers for Disease Control and Prevention's national immunization program estimates that, without a push, 79.6 million doses of flu vaccine will be available this year, up from 70 million doses last year.

"Right now we recommend that people with health risks get flu shots, and we encourage others to do so," one HHS official said, "but we ought to recommend it for everyone to avoid confusion with anthrax."

The first symptoms of anthrax resemble flu - fever, sweating, loss of energy and muscle aches - but untreated inhalation anthrax quickly causes severe breathing problems, shock and death.

Even though only a few cases of inhalation anthrax have been diagnosed, causing three deaths, some emergency rooms in the Washington area have been jammed with people demanding Cipro.

Some patients have become irate when told by physicians that taking Cipro as a preventative measure is not advisable because it has side effects and can leave one vulnerable to germs that develop resistance to antibiotics.

The Washington hospital scene could be duplicated all across the country this winter if the population isn't inoculated against the flu.

Meantime, to deal with the real anthrax threat, the former top health official at the Pentagon, Dr. Sue Bailey, recommends that the Defense Department release anthrax vaccine to inoculate postal workers and others who may have become exposed to anthrax spores.

And another ex-official suggested that unused bandwidth on the electromagnetic spectrum currently assigned to the military but not being used could be converted into a link between federal homeland security officials and state and local health agencies.

According to Bailey, some postal workers are being given only a 10-day supply of Cipro, while others are getting a more-effective 60-day supply, as are Congressional staffers who might have been exposed.

Those getting only 10 days' worth of the drug would not be adequately protected if they inhaled anthrax spores. The anthrax would outlast the Cipro in their systems and they could die.

Those with 60-day treatments would be protected against anthrax immediately, she said, but might become vulnerable to a new anthrax attack at a later time.

U.S. military personnel are put through a six-shot vaccination regimen, but Bailey said that exposed postal workers would be safe if they received a 30-day supply of Cipro and three doses of the vaccine over a four-week period.

Now an NBC News consultant, Bailey recommends that if the postal system comes under sustained attack, the government should consider inoculating all postal workers.

HHS officials said that not enough vaccine exists at the lone company producing it, the Bioport Corp. in Lansing, Mich., and that Bioport's supply has not passed Food and Drug Administration clearance.

But Bailey, who oversaw military anthrax vaccinations during the Clinton administration, said she is confident that Bioport's vaccine is safe and effective, and called for its use with informed consent from patients.

Meantime, communication between Washington and hundreds of state and local health departments could be improved with a direct channel, such as unused military frequencies now being sought after by private telecommunications companies.

Homeland security and bioterrorism obviously are new challenges for the government and the citizenry - ones that the Bush administration shouldn't be faulted for not having mastered in a few weeks.

But the administration should take suggestions from the outside, especially from Rudy Giuliani. In fact, when the mayor leaves office, President Bush should offer him a big job.

JWR contributor Morton Kondracke is executive editor of Roll Call, the newspaper of Capitol Hill. Send your comments by clicking here.

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