It will be cost effective. It must involve national, state, regional and local organizations, agencies and officials. As the perceived threat has mounted and the federal government has responded with funds, bioterrorism defense has become a growth industry. Yet, no single office with the necessary authority has clearly taken the lead, either within the Department of Defense or the federal government. Therefore, interagency collaboration has become even more important.
Excellent leadership facilitates necessary collaboration.
The fundamentals of what is needed in a hospital or medical center facing a spike in the patient load following an attack is application of the standard principles of medicine with which the professional and support staffs are already intimately familiar. But our health-care providers have not seen the diseases caused by many of the threat agents. Training, planning and drills must prepare physicians and staff for mass-casualty patient management, respiratory support for unusual numbers of patients, distribution of medications or support of the local government in vaccination programs. Engineering staffs must be taught to establish improvised containment in patient rooms or suites. Traditional first-responders and public and military leaders must understand rather complex technical and biological issues in order to effectively balance cost and benefit in preparation and response.