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the people sending those anthrax-infested envelopes know what they’re doing: infecting first the media, the retinal nerve of democratic perception, before turning to the pols. A nervous press means a nervous public. What’s striking about the initial round of white-powder letters is the sophisticated consideration of media dynamics and demographics: the ultra-tabloid Sun, the ultra-respectable New York Times old-media Tom Brokaw, dot-com Microsoft.
A few things about the anthrax scare need to be said. Should the number of cases or the distribution of spores grow more widespread, the greatest danger comes not from the easily treatable disease but from the long degradation of America’s public health infrastructure.
For the past 20 years, Republicans and Democrats alike have regarded public health, and any excess capacity in the health care system, as an insult to the free market. In large cities, public hospitals have been closed and privatized and community clinics converted to bottom-line-driven HMOs. Understaffed and underfunded city and state health departments track illness with out-of-date computer software 10 per cent of local health departments don’t even have e-mail. Last year, the federal government spent less than $50 million on improving state and local public health infrastructure — a piddling amount when spread among 50 states.
“One of the responses to financial pressures has been to cut out excess capacity,” MD Tara O’Toole of the Johns Hopkins Center for Civilian Biodefense Studies testified in July before the Senate’s internal security subcommittee. “The entire hospital in virtually every town in this country, whether it’s the Johns Hopkins Medical Center or a small rural hospital, is basically now functioning on “just in time’ models.”
Simply put, today’s public health system has no surge capacity. After a devastating fire in a high-rise building, the Maryland secretary of health conducted a study of hospitals’ preparation for a large number of people needing ventilators, a likely scenario in a biological attack. Though Maryland is home to a major city, sprawling suburbs and two major medical centres, officials found only about 100 ventilators statewide.
The political culture has left public health so far behind that official Washington seems to have taken little notice of the near-complete absence of the nation’s top medical officials from the media as the anthrax cases spread. Remember Surgeon General David Satcher? A quick Nexis search reveals only two mentions of Satcher in the scare’s first five days.
Remember the Centers for Disease Control? Doctors nationwide are complaining that the CDC and its director, Dr. Jeffrey Koplan, are offering only scant information about the detection and treatment protocols for anthrax. For days, the public’s only information came from Attorney General John Ashcroft and HHS Secretary Tommy Thompson — and from Thompson it was often misinformation that infuriated medical professionals.
The Bush administration seems to be applying the same extreme strictures on medical information that it’s enforcing at the Pentagon. Researchers say off the record that everyone at CDC is terrified of talking.
Johns Hopkins’s Tara O’Toole puts it this way: “It is normal in a criminal investigation to withhold information. But this is not a normal situation. The public is panicking. People need information desperately. If there is anything we have learned from past disasters, it is that people do better with more information, even if it is disturbing information.”
What makes today’s anthrax outbreak distinctly threatening is not the sadism and criminality of the attacks. It is the speed with which panic can spread through a mass medium that is itself the centre of attack — amid a political culture that for 20 years has refused to regard public health as a bottom-line indicator of national security.
From The Nation
