In hours, state would start setting up 935 clinics, report says
By DENNIS CHAPTMAN Last Updated: Dec. 2, 2002
Madison - A Wisconsin smallpox outbreak would trigger an emergency
plan that would likely include round-the-clock vaccinations in such large-scale
venues as the Bradley Center, State Fair Park and the Midwest Express Center, a
state report released Monday said.
The interim report, prepared for federal officials, lays out plans for how
government officials and health care providers would react to a smallpox
outbreak, the specter of which has been raised since the Sept. 11 terror
attacks.
Prepared by the state Division of Public Health, the report represents a
first step in planning for dealing with a public health emergency that could
require mass vaccination clinics to open within 12 hours of an order by the
governor.
"It would be a Herculean task, and would require a great deal of cooperation
and effort by a large number of people," said Herb Bostrom, director of the
state Bureau of Communicable Diseases.
Bostrom said the last time the state attempted to vaccinate large numbers of
people was in 1976, when officials had nine months to assemble a plan to protect
the public from the swine flu.
"Of course, we all hope and expect that this will not be necessary, but it is
an essential bioterrorism preparedness activity," Bostrom said of the smallpox
plan.
Smallpox, one of the deadliest and most contagious diseases known to man, was
eliminated worldwide in the late 1970s, and routine immunizations ended in the
United States several years before that.
The only known stocks of the virus are in secured labs in the former Soviet
Union and the U.S., but experts say clandestine supplies probably exist, and
fear that terrorists might use it as a biological weapon.
About half of the nation's 285 million people have never been vaccinated
against smallpox, and many who got shots in childhood no longer have immunity
from getting and spreading the disease, though they might be less likely to die
from it.
Report put on fast track
The state report was originally due to be filed in late 2003, but federal
officials accelerated the timeline, leaving state officials about three weeks to
prepare it. Bostrom said he expects it will undergo considerable change and
detailing in months to come.
"There is a ton of detail that needs to be filled in," he said. "The plan is
very, very, very preliminary. We have not had a chance to meet with a large
number of our partners. Some have never seen the draft."
The report anticipates a heavy demand for the vaccine if the mass clinics
were ordered into operation.
"Public demand would likely require that clinics operate 24 hours a day, so
we should plan accordingly," states the report, which was submitted to the
federal Centers for Disease Control and Prevention.
According to the report, there would have to be 935 immunization clinics set
up statewide in the event of a smallpox outbreak, assuming they were operated 16
hours a day. The emergency plan envisions 104 clinics in the city of Milwaukee,
while Waukesha County would have 63 clinics, Ozaukee County, 14, and Washington
County, 20. Local officials would determine the location of the clinics.
Officials urged consideration of mobile vaccination clinics to serve people
in nursing homes, on college campuses, or those unable to travel.
Governor would make the call
The decision to begin any mass or limited vaccinations would lie with the
governor, in consultation with state health officials. The scale of vaccinations
could partly depend on the circumstances of any confirmed case.
For example, if a sales representative with the disease continued visiting
clients around the state, a mass statewide vaccination would be needed, the
report states. If the same worker stayed home in bed, a more limited vaccination
might be ordered.
If a mass vaccination were ordered, the report states, it would take eight to
16 hours for enough vaccine to arrive from the National Pharmacy Stockpile at a
storage depot in Madison.
"Thus, clinic sites must be prepared to open mass clinics approximately 12
hours from first notification," said the report, which deleted some sections
that included references to national and state security issues.
Those who believe they have smallpox symptoms would not be directed to mass
vaccination clinics, and if those with smallpox appear at the clinics, they
would be isolated for counseling, evaluation and vaccination, the report said.
The report also includes a plan for dealing with the media and holding
briefings with local health officials to keep them updated on the status of the
outbreak and the vaccinations.
Officials assumed that groups of health professionals in each Wisconsin
hospital would already have been vaccinated against smallpox. Bostrom said a
plan for vaccinating health professionals is due to be submitted to federal
officials by Monday.
ALL INFORMATION, DATA, AND
MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION
PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS
OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR
LEGAL ADVICE. THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND
COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH
YOUR HEALTH CARE PROVIDER.
"A foolish faith in authority is the worst enemy of truth."
-- Albert Einstein, letter to a friend, 1901
"I know of no safe depository of the ultimate powers of the society but the people themselves, and if we think them not enlightened enough to exercise control with a wholesome discretion, the remedy is not to take it from them, but to inform their discretion by education."
-- Thomas Jefferson, letter to William C. Jarvis, September 28, 1820
"What's the point of vaccination if it doesn't protect you from the unvaccinated?"
-- Sandy Gottstein
"Who gets to decide what the greater good is and how many will be sacrificed to it?"
