THE CURRENT STATE OF HOSPITAL ... Hospital security is challenged
'fhomas E. Terndrup
Sarah D. Nafziger
INTRODUCTION The concept of using naturally occurring organisms as weapons is not new. History has documented numerous attempts at biological warfare (Table 73.1). Only in the past several years, however, has the health care community become aware of the growing threat of a biological weapons attack. For many, the first notice carne with the October 2001 bioterrorism attack, in which anthrax was spread through the U.S. postal system, resulting in 18 cases of anthrax with five fatalities. This attack, along with the 2003 outbreak of severe acute respiratory syndrome (SARS), further demonstrated the underpreparedness of the United States health care system to respond not only to bioterror attacks, but also to other highly transmissible emerging infections.
THE CURRENT STATE OF HOSPITAL PREPAREDNESS Limited data indicate that most hospitals are inadequately prepared to deal with attacks by weapons of mass destruction, including bioterrorism. A large-scale bioterrorism drill performed in Denver, Colorado, simulating aerosolized plague attacks resulted in over 3,000 simulated casualties within 4 days (1). One of the most valuable insights from this drill was that the systems and resources currently in place are inadequate to manage the stress of a large-scale bioweapons attack. . Fonunately, much of what should be done in anticipation of a biological attack is also applicable to any public health disaster or infectious disease outbreak, making these expensive but necessary preparations "dual-use" in nature. In contrast to preparation for chemical spills or terrorism (where preparation relies largely on prehospital hazardous material teams and equipment, immediate treatment in the streets, and cordoned-off crime scenes), Preparation for biological terrorism relies much more on
education, a robust public health system, and broad interagency collaboration. Not only must hospitals prepare to deal with the consequences of bioterrorism, they must also take measures to reduce their vulnerability as terrorist targets. As the epicenter of community emergency response, hospitals are valuable and often extremely vulnerable assets. While many public buildings have secure perimeters and require visitor searches, most hospitals have no such security measures. Hospital security is challenged
