December 14, 2001
Experts Assess Officials on Anthrax
By LAWRENCE K. ALTMAN
Dec. 13 The government investigation of the deliberate spread of anthrax
received praise and criticism from officials in directly affected states and in
the postal system at a meeting here today.
The meeting was one of several held by the Centers for Disease Control and
Prevention in recent days to take advantage of a lull in the outbreak no new
case has been detected since mid-November for experts and representatives of
affected groups to discuss what went right and wrong in the investigation that
began 10 weeks ago.
Participants criticized political leaders who were not medically trained for
providing information about medical issues like the proper use of antibiotics.
But they did not name any leaders.
The criticism was polite largely because the meeting was open to reporters,
a number of participants said. They said in interviews that they would reserve
harsher comments for private discussions with officials from the Centers for
Disease Control and Prevention.
Deborah Willhite, senior vice- president for government relations of the
United States Postal Service, said the disease control centers had not usually
considered it important to put money into communications, "but it is
Referring to the confusion resulting from poor communication when anthrax
was first found in the postal system, Ms. Willhite said, "we needed one
person from C.D.C." to speak at news conferences.
Traditionally, the agency has deferred to state and local health officials
to disclose health information. But that strategy was not effective in the
recent anthrax attacks. As cases were detected in several states, there was a
critical lack of a national voice to prevent confusion, said Dr. John Agwunobi,
the Florida secretary of health.
Information giving "was too local," Dr. Agwunobi said, and
"it took too long to turn a single event in Palm Beach" into the
national threat that it was.
Dr. Agwunobi was among those who criticized the health profession's
imprecise language in reporting test results.
"We are not going to use the words `preliminary' or `presumptive'
anymore because they confused the situation," Dr. Agwunobi said, adding
that instead, "we'll use `positive or not positive,' `result or no
But state health officials also praised the disease control centers for
providing their expertise on anthrax. One Postal Service official, Suzanne
Medvidovich, senior vice president for human resources, praised the agency's
experts for their willingness to make decisions and for their availability to
inform workers about anthrax.
Corey Thompson of the American Postal Workers Union said C.D.C.
representatives regularly provided all requested information and participated
in meetings with his group.
Tim Haynes, the plant manager at the Brentwood postal station in Washington,
said there would have been more panic without the help of the agency and the
District of Columbia Health Department.
But, Mr. Haynes said, "we need a better way to communicate."
State health officials criticized the disease control centers and themselves
for not clearly explaining the uncertainty over the usefulness of nasal swabs
and blood tests in detecting anthrax cases and for delays in communicating
other critical information to the public in plain English.
During the outbreak, medical investigators were trying to gather data and
conduct tests like nasal swabs and blood tests to see if they might be
effective in detecting anthrax, Dr. Agwunobi said, although their usefulness
had not been proved.
He said blood tests turned out not to be helpful in detecting whether a person
was infected, and health officials were then criticized by patients who asked:
"Why did you draw my blood if it did not benefit me directly?"
"Where we failed was in adequately communicating to the community and
individuals involved the limitations of that mode of testing," Dr.
On Oct. 15, when an opened envelope dispersed anthrax spores through the
office of Senator Tom Daschle, visitors to the Capitol called their physicians
and health departments right away to ask whether they should take antibiotics.
But, said Dr. Matthew Carter of the Connecticut health department, he and
other health officials "did not know who to call for information."
Dr. John Eisold, the Capitol physician, said the Department of Health and
Human Services asked him to write recommendations, which he then sent to the
disease control centers.
But the recommendations were not posted on the disease control centers' Web
site until two days later, Dr. Carter said.
In a separate development today, Dr. Brad Perkins, a top anthrax
investigator for the disease control centers, said that the Department of
Health and Human Services was obtaining 220,000 doses of anthrax vaccine from
the Department of Defense.
The Centers for Disease Control and Prevention has permission from the Food
and Drug Administration to use the vaccine in experiments in preventing
infection and treating patients. The C.D.C. is seeking advice from an
independent committee on vaccine practices about its use in laboratory and
other workers, Dr. Perkins said.
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