Hospitals better prepared for attacks

By Emily Richmond

Monday, Sept. 16, 2002 | 11:05 a.m.

At the Las Vegas Valley's 11 major hospitals earlier this month, a grim message flashed on computer monitors in the emergency rooms -- students at Clark High School were having trouble breathing, and a suspicious vapor was believed to be the cause.

At University Medical Center workers hustled to set up portable decontamination showers -- purchased after the terrorist attacks a year ago but never used.

Sunrise Hospital's emergency services manager made sure the pulmonary specialists had been paged and that the brand-new biohazard suits were within easy reach. Health professionals at St. Rose, Desert Springs and Summerlin hospitals also heard the alert and were ready to offer help, if needed.

"We used to have to wait to get a call from the paramedics saying they were bringing in a bunch of kids," said George Jones, Sunrise's director of public safety. "Then we would just have to stand by and twiddle our thumbs, not knowing what we needed to do to get ready. Not anymore."

While it may have been nothing more than a pepper spray prank that emptied Clark High School Sept. 5, county health officials say the incident demonstrates how they've stepped up preparedness for the worst-case scenarios -- a biological or chemical attack.

In June Nevada was promised $10.5 million in federal funds to boost disaster preparedness. The new computer hookups for the emergency broadcasts, along with the decontamination showers and biohazard suits, were paid for using some of that money, officials said. The funds also went toward training health care professionals to recognize symptoms of anthrax, smallpox and other possible germ warfare weapons.

The new alert system is less than a year old and allows operators at the joint emergency services dispatch center to relay updates from the field to area hospitals, paramedics and emergency teams. The system can also be used to relay detailed lists of potential symptoms that may denote exposure to a particular pathogen.

If the episode at Clark High School had escalated, the county's Emergency Operations Center would have likely been activated, said Jim O'Brien, emergency management manager. From there county officials would direct everything, from communications to coordinating help from state and federal agencies, O'Brien said.

Since the Oklahoma City bombing in 1995, Clark County has coordinated emergency preparedness plans among local, state and federal agencies, O'Brien said. But in the past year the number of training exercises and simulations has been increased, and a committee now meets regularly to discuss regional responses to potential threats, O'Brien said.

Hospital officials say they've already learned valuable lessons from the training exercises. This summer, during a simulation of a chemical attack at a shopping mall, emergency room workers were overwhelmed by the so-called "walking worried," said UMC's director of public safety, Ruben Gurrola. People without symptoms of injury or illness demanded treatment, tying up medical personnel and delaying response to actual victims, Gurrola said.

"We realized we have to create a level of confidence where the end result becomes a comfort zone for the public," Gurrola said. "We need to reassure people now that we're prepared, we have a plan and we'll handle the situation appropriately."

Dr. Donald Kwalick, chief health officer for the Clark County Health District, said his agency still will receive about $4 million from the federal grants for bioterrorism preparedness. That includes $2 million to build a testing lab capable of handling potentially deadly pathogens.

Currently specimens can only be tested at the state's lab in Reno, Kwalick said. The Las Vegas Valley is the only major metropolitan area that does not have such testing facilities within a 100-mile radius, Kwalick said.

It's an improvement, Kwalick said, "that was needed long before Sept. 11. The tragic events of that day put the spotlight on some serious gaps in our nation's public health services."

But what the county still doesn't have is an electronic network for doctors, paramedics and other health-care professionals to immediately share news of threats, outbreaks or other incidents, Kwalick said. Under the existing system health professionals are supposed to report any unusual cases, but that can sometimes take days, Kwalick said.

"We're still operating with a passive response system," Kwalick said. "We need a survelliance network that is up and running on a real-time basis."

A proposed system would be able to instantly alert everyone from paramedics to school nurses and tell them to watch out for specific symptoms of suspicious illnesses, Kwalick said.

Exactly when the instant electronic system could be in place isn't known. In the meantime officials rely on e-mails and fax alerts, Kwalick said.

"We are getting the information out there quickly already, but we know it could be done even more expediently," Kwalick said.

Kwalick said the biggest stumbling block to a speedy response is still firmly in place -- Nevada's quarantine laws. As the regulations stand, Kwalick would have to get a court order to quarantine anyone suspected of carrying an infectious disease. In the event of a bioterrorism attack, which could involve thousands of people, Kwalick would still need to get each person's name on an individual court order.

Legislation is making its way through Congress that could give more power to states to enact quarantines in the event of a bioterrorism attack.

Kwalick said his office was notified by the Clark County School District about the incident at the high school but found no reason to investigate. Minor incidents are left to the public safety agencies of each city or town, Kwalick said.

The Clark County School District's emergency response protocol was followed at the high school "to the letter," said Jim Artis, manager of information services for the district's facilities division. A hazardous materials team was called, as well as School Superintendent Carlos Garcia, Artis said. Hospitals and the Board of Health also were alerted.