DAY FORTY SIX:Oct. 26:
Blustery winds and near-icy cold air couldn't dampen what is now the longest running urban fire in US history. The only sites that have burned longer than Ground Zero are coal mines.
Yesterday's job fair drew more than 10,000 people, forming a line that stretched four blocks along 7th Avenue from Madison Square gardens. Just five days ago the Gardens was the site of a huge, televised rock n roll concert to raise money for the victims of the September 11 calamities. It seems that the dollars raised on Saturday might have been doled out to the jobless at the same site on Thiusday, sparing the problem of finding secure means for transporting the celebrity-inspired cash.
As it is we have no idea where those millions of dollars raised in benefits and donations have gone; certainly not to Ground Zero assistance. Poor New York.
And poor CDC, which is taking the fall for lives lost due to anthrax exposure in Washington. It now seems that the FBI has been concealing information not only from the public and media, which in a criminal investigation is their right, but also from the CDC and Health and Human Services, which in a public health crisis seems not to be their right. In today's Newsday I wrote:
"Only the FBI and the institute reportedly knew that the anthrax spores in Washington were capable of drifting invisibly in the air, and engineered to infect human lungs. So the CDC's assurances to the Postal Service appear to have been based on inadequate information. " See: http://www.newsday.com/news/health/ny-usbiot262431924oct26.story
It seems apparent that anthrax exposures are now occuring through two different means. First, there are those who are contracting cutneous or inhalational anthrax as a result of exposure to the contents of a poisoned enveloped that was mailed directly to their office or building. And, second, there have been exposures due to cross-contamination in the U.S. Postal Service, resulting from spores leaking from envelopes at central postal sorting centers and then adhering to other mail, or to the machinery and air particles inside the postal facilities.
CDC Director Dr. Jeffrey Koplan said his agency is assuming that all inhalational exposures fall in the first category of direct exposure to an anthrax-containing envelope. Which would mean that at least three such envelopes were mailed in Washington DC. It is generally believed, based on monkey studies, that a dose of 8,000 to 10,000 anthrax spores must be inhaled to produce disease. In contrast, less that 5 percent of that dose is sufficient to cause a cutaneous infection of the skin: dose is the reason for singling inhalational exposures out as those involving direct contact with a contaminated envelope.
Tests indicate that spores have been found in the central postal distribution center at Brentwood Road, and at some of the postal substations that receive Brentwood mail. A total of 22 substations were being scrutinized for cross-contamination yesterday. And wherever spores were found, Koplan said, the CDC felt the prudent course was to place all postal employees on a ten day course of prophylactic medicine, pending nasal swab test results and further study to determine if any were actually infected. So the list of people taking Cipro under CDC guidelines is rapidly expanding to include thousands.
How far could it go? The CDC is now testing nongovernment addresses serviced by Brentwood mail delivery, including businesses. Could we end up testing every single home, shop, restaurant and business in four or five zip codes? All because of a handful of anthrax-laced envelopes?
What about Embassy Row? It turns out it, too, receives mail from the Brentwood Road central distribution station. Might there be spores inside the German Embassy? The British? Or how about this for a twist: anthrax spores in the Saudi Arabian Embassy? Or Qatar? Egypt?
Quite publicly HHS is now preparing for a possible Plan C on the part of the terrorists, involving smallpox. Nobody knows whether the perpetrators of our national anthrax hysteria have possession of smallpox viruses, but HHS thinks a release of that organism would constitute the worst case scenario. Thus, it is hastily contracting for manufacture of 300 million doses, "so that every American will know there is a dose with their name on it," HHS Sec. Thompson said yesterday.
The international fear of smallpox has risen such that the World Health Organization this week digitized their old 1970 manuals, complete with gruesome color photos, and posted them on the Internet. Check it out: http://www.who.int/emc/diseases/smallpox/slideset/index.htm
I found myself dwelling today on this scenario: The USA purchases 300 million doses of smallpox, about 100 million of which will be on hand by March or April 2002, according to Thompson. Somebody unleashes smallpox in the USA. A massive vaccine campaign starts. HHS demands manufacturers speed up production and priority sell all vaccines to HHS -- to AMERICA. All over the world airports and ports shut down. Panic sets in. There is a global outcry demanding vaccine. The US government insists its supplies are for Americans, only. Sporadic cases, carried by travelers, crop up all over the world and spread. WHO is assigned the burden of control, ALL OVER AGAIN. But it's a different world now. The Cold War political environment that permitted unorthodox control procedures -- including vaccination at gun point in many countries - has vanished................
Are they ready? Have global health leaders talked about this? Has Washington, the State Department, considered the difference between stockpiling vaccines for the good of the American people versus the international perception, were such a horrible crisis to occur, that the US was hoarding cures at the expense of the lives of 5.6 billion people?
We are forced to contemplate such horrors because of less than a dozen envelopes, delivered by the US Postal Service.
Be well. Stay safe. Stand defiant.
Laurie Garrett
