(00:00:00) With news from Minnesota Public Radio. I'm Stephen John security has been beefed up at three Minnesota airports with the arrival of the Minnesota National Guard guard members dressed in combat gear and armed with rifles or pistols began Manning the checkpoints this morning at Twin Cities International Airport as well as airports in Rochester and Duluth Microsoft Great Plains annual business conference stamp a a stampede to Fargo is underway. The International Conference is part workshop and strategy session for the company its employees and business partners. This is the last year the Stampede will be held in Fargo next year. It moves to Minneapolis Microsoft senior vice president Doug burgum gave the keynote speech yesterday burgum says, it will take courage to handle the economic uncertainty created after the September 11th terrorist attacks burgum says the country and the economy will recover that's not to say there isn't going to be some tough Economic Times in the next two or three quarters, but long-term I remain enormously optimistic about where the world can go and I remain normally optimistic about the role that that we as in each of us. Individuals can have and helping change the world in a positive way burgum leads the Great Plains Division of Microsoft and was president of a Fargo based software company before it was purchased three boys, attending a birthday sleepover died in an overnight house fire in Hutchinson. All three were in the fifth grade at Park Elementary School in Hutchinson authorities. Say the fire is still under investigation. The first signs of winter are creeping into Minnesota not only were temperatures well below freezing in many parts of the state Before Dawn today, but snow was reported in Baudette on the Canadian border. There's a freeze advisory for Western Minnesota tonight as for this afternoon, look for temperatures generally in the 40s across the state Moorhead is sunny skies 39 degrees. It's 38 in Duluth 48 in Albert Lea and in the Twin Cities sunshine and 47 that's news from Minnesota public radio programming on Minnesota Public Radio is supported by the Saint Paul chamber orchestra Andreas delves conducts a premier from Minnesota native Steven policy and a Beethoven symphony at the Ordway October 6th and 7th. Online at the SP co.org it 6 minutes now past 12. And good afternoon. Welcome back to midday on Minnesota Public Radio. I'm Gary eichten glad you could join us since terrorists hit the twin towers and the Pentagon on September 11th government officials have repeatedly warned Americans to be alert that a follow-up attack was possible this week Congress reportedly received an even stronger warning us intelligence officials reportedly told members of Congress that if the u.s. Strikes Afghanistan as expected the chance of another attack on us targets at home or abroad is 100% sort of Public Safety commissioner Charley Weaver says, there is no evidence of a threat here in Minnesota, but Weaver and other state officials assured minnesotans again yesterday that they are prepared to prevent or respond to a terrorist attack. If one does occur such preparations include preparations for perhaps the scariest of all prospects namely of a biological or chemical attack in Minnesota. Minnesota is usually credited with having one of Best preparedness programs in the nation but critics say we still may be woefully unprepared if an attack would occur. So what's the situation here in Minnesota? What more could or should be done joining us today here in the studio is the man in charge of the State Health Department's bioterrorism surveillance unit State epidemiologist. Harry Hull as always if you have a question about Minnesota's ability to respond to such an attack. We invite you to give us a call. Our Twin City area number here is 6512276 thousand. That's our Twin City number six five. One two, two seven six thousand outside the Twin Cities. You can reach us toll-free and that number is 1-800-218-4243 or 1-800 to for to to 828 Our Guest this our state epidemiologist Harry Hall. Thank you, sir for coming in today. Appreciate it. I'm (00:03:57) pleased to be here Gary (00:03:58) if an attack were to occur here in Minnesota is the public health system capable of dealing with it in an efficient effective. Of way (00:04:08) with the depends on what you mean by an attack are we prepared? Yes, we are prepared. Could we do more certainly can we guard against every possible attack? I mean that's just impossible, you know, some of the scenarios that have been put forward or you know, almost border on the fanciful and one of the problems that you face and just discussing. This is you're always talking about the abstract and it's we frequently get into conversations about what if you know, for example, we if you stockpile antibiotics to treat a certain infection, then the question comes up. Well, what if the terrorists then use gene splicing to create a an organism that is resistant to those antibiotics and those what if scenarios are the fanciful scenarios are hard to defend yourself against because again it is Rather than reality (00:05:09) in terms though of what is to the extent that such an attack is likely and of course, there's dispute about that. But to the extent that they're such an attack might be likely given what we know about Anthrax and smallpox and rest. We're in good shape here in Minnesota in terms of responding to those kinds of threats. (00:05:31) Well, we're in good shape certainly compared to the rest of the country where one of the most prepared states in the country when we talk about defending ourselves against a biological attack. The question always comes up, you know, will what form does that take some of the things that I've read in the newspaper for example suggest that you know, it might be somebody running around spraying something in your face or just touching you at the Mall of America something like that. That's not how a biological attack is going to Here basically, these are living organisms most of the case they have incubation period so it's going to be time after after your exposure that you're going to become ill and to Be an Effective attack. It's going to be done in secret. It's not going to be oh my goodness. Here comes a crop duster that spraying a fat me. It's going to be some kind of secret release. And again, that's what makes it really brings out the fear in people. So how a biological attack is going to show up is going to be suddenly a lot of people very often young healthy people who shouldn't be getting ill there's a lot of people are going to be getting ill they're going to be getting seriously ill many of them are going to die. And our emphasis has been on (00:06:59) detecting that (00:07:01) outbreak so that you can Define what it is. You can understand who's getting ill you got to identify the organism because this is not a single organism. This is not just Anthrax, but there's a very long list of agents that could be used. So in order to control it, you've got to know what that organism is. You've got to know who's at risk, you've got to define the control measures and put them in place. Now Infectious Disease Control is our bread and butter. That's what mdh does we're known nationally worldwide for our ability to detect and control infectious diseases. So we've got one of the best surveillance systems here in the country. If not in the world. We've got a excellent. Excellent. Excellent laboratory that's going to be able to analyze these agents figure out what it is, and then we're in a position to I'm bringing the national resources. If necessary. There are National Stock piles of antibiotics. There are National Stock piles of vaccines how we respond will depend on the organism how it's been spread who's been sick how many people are affected. So there's not just a simple response. (00:08:13) I want to get some listeners involved here, but one other question for you, sir. Do you think people are getting the straight Scoop from federal government officials there seem to be a lot of skepticism on Capitol Hill this week on Sunday and 60 Minutes Health and Human Services commissioner. Tommy Thompson said that by golly we're prepared for any emergency ready to go then on Wednesday on Capitol Hill. He seemed to qualify that saying well, there are some gaps and more we have to do and members of Congress who heard the testimony were skeptical even about that saying that he was simply being too. Mystic to pollyannish and that the situation is more critical than secretary Thompson has portrayed what's your reading of (00:09:04) that? Well, I'll go back to my opening statement. Are we prepared? Yes, we are prepared. There are a lot of things that we can handle are we prepared for everything under the sun? No, we're not prepared for everything under the sun. Is there more that we need to do? Yes, and that's true at the national level and at the state level. We need to move forward and have better planning. We need to have new stock piles of particular the smallpox vaccine and we need to make sure that we are in a better position to respond and that gets down to some of the the talk that's been going around of you know, how is it that we respond and there's a lot of talk about what we can do as individuals to protect ourselves gas mask, you know, should I go and get antibiotics? There's In terms of bioterrorism. There's not a lot that individuals can do we need to respond to this as a community and as a state we need to make sure that our infrastructure is strong. Who was it that responded trying to save lives when the World Trade Center was struck how many firemen how many EMTs died trying to save others in any kind of terrorism event here. It's going to be your fire your police your emergency medical responders your hospitals your Physicians and your health department. They're going to protect you to protect our they're going to protect our communities and we need to make sure that that system is as strong as possible. One of the things that I think needs to be said again. And again is that in good times we tend to get complacent and we forget neglect our Infrastructure and I think particularly from my point of view the public health infrastructure has been neglected nationally and we need to make sure it is as strong as possible so that we can defend ourselves as in the best way possible against a bioterrorism attack (00:11:11) and sort of State epidemiologist. Harry Hall is our guest this hour we're talking about Minnesota's preparedness for another attack. If one were to occur again, let me give you the number here. You might want to wait for a couple of minutes. All our lines are busy. We'll get through some calls and then some lines will clear up. We'd like to get your question on 6512276 Thousand or 1-800 to for 22828 barrier first. Go ahead Place. Yeah a number of the comments and concerns expressed as in about bioterrorism in terms of Anthrax and smallpox and such. I'm wondering if you could discuss what the state is doing to protect the food sources recently. We've had scares about hoof and mouth and mad cow disease and things like that. Are those potential biological As well and I'll listen off the phone. (00:12:00) Very the answer to your question is yes mean could a bioterrorist use foot-and-mouth disease or as a terrorist weapon certainly could be again. I guess we have to get go back a little bit and say what is the motivation of the terrorists and is to create Terror and to kill people that would cause economic disruption and so it would it could be a weapon but it wouldn't have quite the terrorists impact that killing a large number of humans would the response that we would have to have to something like foot and mouth disease there was legislation put through that was passed by the Minnesota Legislature and signed by the governor during this last legislative session giving authority to control foot and mouth disease and we'd have to undertake similar message measures or measures similar to what was done in Britain. Earlier this (00:13:00) year in terms of human diseases. Do you folks have the legal authority to deal adequately with a problem a quarantine Authority and that sort of thing. (00:13:08) Well, this is one of the things where we need to be better prepared right now. We do have a quarantine Authority where you for example, we have somebody who has tuberculosis and it's not taking the medicines and is spreading the disease to others we can take them to court and force them to take their medicine or if necessary put them in a hospital and make them take the medicine until they're not infectious. But that is for one person at a time if we had a bioterrorism attack where we have thousands of people exposed who might be at risk of spreading to others. We don't have time to take people to court one by one we've got to act immediately. So right now we are having our lawyers review the quarantine Authority proposed legislation, and we're going to have to get in some to some pretty heavy discussions with the Just later in the governor because this also gets into the area of individual rights and civil liberties and we have to be able to strike that balance between the individuals rights and the right of society to protect itself (00:14:14) Kathy your question. Yes. I am as a person just living out here in the general population. I would feel better. If I knew what the truth that I'm sorry the two threats were to us as far as biological and chemical warfare, you know, the side effects of the or the signs that we would see if you know down the road if they had done something in what we could do about that. Okay. I'll take my answer off the air. Thank you. Okay, that's a good question because we're always told by the government now be alert. Well, what are we supposed to be alert (00:14:45) for Kathy? I agree with me that this is a very good question and part of the complexity answer is that there are literally hundreds of Agents. That could be used in a biological warfare or biological terrorism event. The common thread of all of them is that they are chosen as Weapons because they make people really sick and they kill a lot of people. So the Common Thread is if you wake up in the morning, you've got a scratch in your throat. Do you need to worry that you've been exposed to biological weapons? And the answer is no if you've been if you are infected with the biological weapon organism, you're going to be sick really sick high fever short of breath as far as the most common organisms are concerned Anthrax would be fever shortness of breath smallpox is going to be very high fever and a rash. That would be a parent. Your face and then on your hands. It's a very characteristic rash. It looks a little bit like chicken pox. But to the expert it's not plague typically would cause swelling of the lymph nodes in the groin, but when it would be used as a biological weapon would actually be in the lungs that would cause high high fever shortness of breath coughing up blood. Tularemia is another one that would cause a pneumonia again shortness of breath high fever. And the last one is botulism which would in turn induces paralysis. Whether or not individuals should be getting up every morning and wondering about every possible symptom that they might have looking in the mirror and saying is this pimple smallpox. That's a very I think it's almost a self-destructive kind of thing because it really just breeds fear and worry and it's just going to wear you down really really quickly. And again people are afraid right now and I think that we have to recognize that the events in New York and Washington really Upset our sense of balance our sense of equanimity our sense that things were safe. And now we're looking in saying well, what are these threats and biological warfare is particularly worrisome because it's invisible. There are these little things that are going to come and get (00:17:40) you. Let me ask you this. Dr. Holly if somebody does feel poorly and let us say 4 Points of discussion that they have somehow been infected with one of these horrible diseases are the doctors the health professionals here in Minnesota. Do they know enough about this where if you walked in they wouldn't say all you've got the flu go home take care of yourself. Would they be able to identify it right away as something other than kind of a relative regular old malady? (00:18:13) Well, one of the things that I meant to say earlier is if you're infected with the biological warfare agent, if you're sick with one of these agents, you're going to be sick enough that And I want to go to the hospital. It's not a question of waking up and saying GMI sick. You're really sick. We've put a lot of information out to the medical community. There's a lot of information that's available to them. As soon as the terrorist attacks occurred on September 11th. We sent out an alert to all the hospitals advising doctors of the basic symptoms, but one of the difficulties here is that a lot of Laboratories are not equipped to analyze these specimens. They need to be sent to us. And so again, we're getting back to our basic responses that we have to make Physicians aware that when they're seeing something unusual like this. They need to call the health department. They need to get us involved in need to get the expertise. They're both our laboratory and our clinical expertise to look at these patients and see if we can sort out what's going on. (00:19:20) Given the state employees striked you have enough folks to deal with any problem that might occur. (00:19:25) Well our situation is that we've got more than half of our staff out and it's we're struggling but what we've done is we've got a lot of our long-term work down and we're focusing in on making sure that we can respond to any potential outbreak now last night when we got the word about five o'clock of this Anthrax case down in Florida and it wasn't clear what was happening. We were concerned about it our staff were here until the middle of the evening last night. We sent out a health flirt, but it's a stretch in the event of a real bioterrorism event. We're going to have to pull in a lot of staff from the rest of the health department. And one of the things that I was encouraged about was in a quote in the Pioneer Press this morning from the strike captain. are building saying, you know, if something like this really happens the staff are going to come back in and I'm happy to see that they feel that way because we've got a lot of very dedicated very competent employees and our hearts are out with them in this difficult time. (00:20:39) We should clarify by the way that Anthrax case in Florida turns out was just one of those isolated cases was it there? Is there any evidence that it was part of some plot or anything? (00:20:50) Well, the thing is that this man got sick on Sunday. And it was identified yesterday yesterday morning is anthrax. And you know, if there was a biological terrorist attack using Anthrax, most of the cases are going to come one two, three, four five day certainly a less than a week after the attack. And if this was in fact a bioterrorist attack, we would be seeing a lot more cases at this point in time. The fact is that the North Carolina Health departments in the Florida Health Department's the man was in North Carolina when he started to get sick. They have been searching all across the state to see if there are other people who might have Anthrax in the answer is no so how this man got Anthrax is still under investigation. Is it a biological terrorist event? No. Okay. (00:21:48) Deb's on the line from Elk River with a question. Go ahead. Yep. Hi. My question is basically in reality. How likely are how easy would it be for someone to use biological weapons we've talked about the fear so How likely would it be doesn't seem to be any consensus about that is there (00:22:07) not again some of these scenarios that are put forward or clearly fanciful some of them are based in reality what I can tell you is that getting these organisms in a form that would be useful for biological terrorism is quite difficult. It's not something that you can Brew up in your bathtub and then spread all over the place. In fact that if I can use Anthrax as an example, there was this cult in Japan. I'm Shimmer Shimmer EQ right that they spread nerve gas in the Tokyo subway, but what's not generally appreciated is that they also had tried to use Anthrax to make people ill they grew up a bunch of Anthrax and then dumped it off the top of the building and it all fell to the ground and nobody got sick. So you really have to have a very high degree of technical expertise to pull this off properly Randy your (00:23:13) question. Yes, how much and I don't do we have to let's say a specific disease like smallpox and what do we have and how many people could be inoculated and are some of these antibodies any good anymore? (00:23:30) Okay, you've got a number of questions there Randy. Let's start with the last one first smallpox vaccination was stopped in this country in 1972. So if you were born in 1971 or before you're likely to have a smallpox vaccination scar on your shoulder, the question is are you still protected from that and the answer is that the protection Fades over time? And it's likely that most people who are vaccinated 30 years ago are not going to be fully protected against smallpox. The question is will they be more likely to survive and there's some data to suggest that they would be more likely to survive but still would get the infection how much smallpox vaccine do we have against smallpox is is a viral disease. There's no antiviral or antibiotic age. Is that we know would be effective against an end. So our first line of defense is smallpox vaccine there currently is a stockpile of 7 million doses that is available. This is vaccine that has been was manufactured 25 years ago. So it's been sitting around for a while. There are some people who've raised the question about whether or not that would still be effective in the should be there is also a federal government program to creating new smallpox vaccine using current technology that program has been accelerated since the September 11 events, and they're aiming to have a stockpile of 40 million doses. One of the things that I would have to say about smallpox though is that I actually worked in the who smallpox eradication initiative working in Bangladesh at the beginning of my career. And smallpox was not controlled through Mass vaccination smallpox was controlled through a strategy that we call surveillance and containment which is identifying cases and vaccinating everyone around them. So that is the thinking behind the strategy behind the stockpiling of vaccine. I think that we even when there is new vaccine available. It's unlikely that we're going to have mass vaccination programs. It's going to be maintained as a stockpile. The other thing that has to be said to about smallpox is that the incubation period is on the order of two weeks. So if we have somebody running around exposing people, the first wave of cases is going to happen two weeks after that event occurs the then there's going to be another two weeks. And so there's an element of time here a time to respond the time to find out who's been infected at a time. To vaccinate people and that I think has been not put forward in the discussion. There is a time element that needs to be considered. This is not going to be something that's going to spread through the country in a matter of (00:26:42) days quick question before we break for news or follow up there. Dr. Hall your predecessor. Michael Oster home is talked, of course a lot about this and he has suggested that given the small relatively small supply of smallpox vaccine best thing to do with the existing supplies until they can be built up is to make sure that First Responders the police the fire the doctors and the nurses and so on around the country have access to this vaccine. So at least they can deal with people if there is an attack and without killing themselves in the process, does that make sense to (00:27:17) you whether yeah that that makes a lot of sense but they're going to be the first ones vaccinated when the attack comes because you know again sick people are going to go to the hospital the (00:27:29) But won't they have already been infected by then if they don't if they aren't vaccinated before that was sick people show up. (00:27:38) The 7 million doses the question is how many you know what percentage of the Medical Care staff in this country? We would we vaccinate with that and if we used up all of our vaccine Supply vaccinating those staff right now, then the rest of the population would still be vulnerable. I think that we need to work with our surveillance and containment approach that is going to be most likely to control an outbreak or a an event should it occur. (00:28:20) I guess this hour is Minnesota state epidemiologist, Terry Holland. He has come by this hour to bring us up to date on how prepared a Minnesota is to deal with a follow-up terrorist attack if there is such a thing specific Focus this hour mean being So does Public Health System again? If you'd like to join our conversation give us a call here at 6512276 Thousand or one eight hundred two, four two two eight two eight we get to more of your questions in a couple of minutes right now. Let's catch up on the latest news headlines here Stephen John Stephen. Thank you. Gary British Prime Minister. Tony Blair says any military response against Afghanistan should be targeted and not directed at the Afghan people Blair as in Pakistan today where he met with the country's leader and praised his decision to back the u.s. LED anti-terrorism campaign newly unsealed court documents reveal details of a cell phone call by a victim on one of the hijacked jets that collapsed the World Trade Center in the call a flight attendant says the hijackers were Middle Eastern had knives and had wounded some passengers a rather rare rebuke for Israel from the US. The White House is criticizing Israeli Prime Minister Ariel Sharon for accusing the Bush Administration of appeasing Palestinians to bolster Arab support for the war on terrorism. Spokesman Ari Fleischer calls Sharon's Men's unacceptable the house easily approved a 170 billion dollar overhaul of farm programs today. The bill did not include a proposal by Urban lawmakers and environmentalists to shift billions in crop subsidies into conservation programs. The Senate agriculture committee is expected to start writing its version of the bill this month Wells Fargo is buying Banks and other businesses in 7 States owned by Minnesota Twins owner Carl Pollard and his family Wells Fargo is purchasing banking companies with nearly six billion dollars in assets. The deal includes 36 Marquette Bank and Marquette Capital Bank locations in Minnesota Minneapolis police shot and wounded a man on a North Side Street this morning after authorities say he held a gun to the head of another man and shot him both men were taken to hospitals police say the victim was severely wounded by the suspect but the suspect received a non-life-threatening won't no officers were hurt in the shooting as a freeze advisory for Western, Minnesota for tonight. Day look for mostly cloudy skies in the north with a chance of rain or snow showers partly cloudy in the South. It will be cool with highs mainly in the 40s today lows tonight dropping into the 20s to low 30s right now in the Twin Cities 47 degrees Gary. That's the latest from The Newsroom. All right. Thank you. Stephen 25 minutes before one o'clock. This is midday on Minnesota Public Radio in our guest. This hour is Minnesota's State epidemiologist. Harry Hall. He is in charge of the State Health Department's bioterrorism surveillance unit. And he's joined us this hour to talk about just how prepared Minnesota is in case there is another terrorist attack and one that would affect Minnesota in some direct way. Now, we should note that state officials say there's been no evidence of a threat here in Minnesota, but preparations continue just in case something does happen. Lots of callers on the line with questions for Harry Hall Leslie your next go ahead place. Yes. Thank you all the discussions so far have dealt with After the fact incidences after people who become ill or started dropping dead what plans do we have looking out for five six years as far as starting to vaccinate the population in general for certain things. Well talking about smallpox again, I understand the short-term situation of containment and then dealing with that then but what are we doing as far as long-range (00:32:00) planning with the question is what which of these agents we actually have effective vaccines for in which would vaccination being an effective strategy. There is an anthrax vaccine for example, but it takes five or six Doses and it's produced in very limited Supply and that's reserved for the military and it's felt that that that antibiotics are much more effective way of controlling that as far as smallpox is concerned again, there is the research going on on creating a new vaccine using modern technology the Maxine was not perfectly safe. I mean one of the reasons why vaccination is stopped was that there were a handful of people who died every year from that from that particular vaccine the plans right now are to maintain a stockpile of smallpox vaccine, but I'm sure that there will be a broader discussion as that new vaccine becomes available whether we should go back to routine vaccinations and I think part of that will depend on the events of the next couple of years because that vaccine will not be available for a couple of years. So that will be an ongoing discussion. (00:33:13) If somebody along the way decided by golly, you know, these threats are so serious. What we really need here is a crash program. Let's spend what it takes to beef up get the get the vaccinated vaccines ready get the public health system ready to go. Would that make any difference is that the kind of thing where if you can just put some money and time into it and everything will be taken care of fairly quickly or is it a really a (00:33:36) long-term? Well, the answer to both of those questions is yes, I mean more and more money and more pressure will help move things forward and that is what is happening. Now, if you follow the news carefully, you'll see that the research program has been accelerated. But unfortunately some of these things just take time. I mean some of the studies that are required to show that a vaccine is once it's been created is safe number one and number two effective take time because you've got a administer it to volunteers wait for them to respond and then do the Laboratory Testing that's that's necessary. So there's an element of time that's involved here that we can't get (00:34:21) around. What about State funding for your program here and all the local programs across the state of Minnesota as the federal government debates how to deal with this. Is there a need for significant increase in state funding? Beef up Minnesota's Public Health System. Well right now (00:34:41) we're money to beef up State Health Systems is under consideration at the federal level and that will be Alpha but we're also reviewing exactly what we need in anticipation of a legislative discussion about what the state can do. There are some things that require no funding for the quarantine and law that we already discussed is one example, there are some things that require a little bit a little bit of funding. I mean, for example, our computers went down earlier this week in our internet access was down for a day that's been fixed. But we need to have what we would call a redundant system so that we've got multiple access to the internet and in times of emergency because that's one of the ways that we get it messages out to everybody as well as getting information in And then there are things that are going to be more expensive having the staff to work with every hospital in the state to make sure that they've got an appropriate preparedness plan because where are these sick people going to go? You know, most of them are going to need to be in the hospital got to make sure that we can have a broader training program for Physicians to help them recognize that recognize these diseases (00:36:03) do most local hospitals have such a plan. Now, are they ready to go in case of an emergency (00:36:09) today? They're they're ready to some degree because they are required to have emergency plans. But the the a true bioterrorism event is much different than for example, even having a 747 crash out of the out of the airport here and we're looking at thousands of casualties and that's going to require a different response. And then the other element that has to be thrown in here to is. Again, depending on the agent if it can be spread from person to person then people who are ill are going to need to be not just hospitalized but quarantine at the same time and we'd have to select certain facilities to put those people (00:36:52) in hand. So your question, please first of all that I'd like to preface this by and get your response as well. I suspect just kind of listening and I'm kind of a News Junkie anyway, but from what I've understood the chances of an individual actually, you know dying, you know should something like this happen is probably on the on the same the same categories may be getting struck by lightning when you think of the millions of people that are in the US and how this thing would would move throughout the population, but then also just just listening it really I really have Hesitancy, I mean the numbers just don't don't make sense. If there's you know 7 million doses out there. You said that the medical staff themselves would eat up or use this 7 million doses. So if something like this were to occur, I think we have to look at reality that you know, a lot of people would be affected. You know, we heard Tommy Thompson yesterday talking about were ready to respond. Whatever that means and I think that you know as public policy folks talking to the public we're so used to kind of dancing around things. There's sometimes and I think this is one of them where you just have to be straightforward with the public and say the chances of an individual, you know of you actually getting affected in this happening to you is small but I'm not hearing what what am I to do, you know sitting in Maplewood here if MPR breaks in And says there appears to be you know, some type of a biological attack and I think that's really what people need need to know to calm a little bit is well. What exactly should I do? Should I you know Run for the country should I you know barricade myself, you know, let's talk about that a little bit. Alright, thanks hands. Okay, so we break into our programming Harry Hall and announce that our worst nightmares have come true. Here's to be an attack here in the Twin City metropolitan area. What should folks in Maplewood do when they get that news? (00:39:14) Right? Will the I was just listening to you and I was remembering the was that the 1930s the war the world? Well, basically this is a want to be clear that this is not occurring right now right in care for somebody who just turned yeah tuned in but relax. Part of the difficulty Hans and I hear you very clearly you want to know what to do and part of the difficulty is that it's going to depend on what the agent is and how its transmitted. For example smallpox can be spread from person to person and in that situation again, depending on how many people have been exposed how many people are currently sick. We would want to impose a a fairly broad quarantine and that means taking people who have who are sick putting them in a place where they would not come into contact with others or only come into contact with people who are already vaccinated that would be our vaccination of the medical staff. And then we would also want to identify all the folks who have been exposed to this individual and are potentially incubating if it's Very quickly after the exposure we would want to vaccinate them, but they would have to be quarantined so that they would not be exposing others. If it's Anthrax again, if you've been listening to the news, you know that Anthrax is not spread person-to-person. And then our Primary Response is going to be identifying people who have been exposed and getting antibiotics to them so that they would not come down with illness or identifying sick people and getting them into Medical Care as quickly as possible so that we can keep the number of infected individuals Down Under the number of people who died from the infection down to a minimum. (00:41:20) So it depends. (00:41:22) Well it does it does (00:41:24) let me ask you this is our communication systems up it up to Snuff. Now you folks apparently even beat the CDC in terms of getting out a warning on September 11 that there could be a problem right by a whole hour yet getting trying to send out word to folks around the state of Minnesota. But some of them never got the message (00:41:40) apparently. Well, there are a few people who didn't get the message. That's true. But by and large, you know 99% did and that's that's pretty darn good. Do they know what to do? Well that what we told them to do was to be alert that for the possibility of a bioterrorism attack. That's number one. We gave them a listing of the kind of symptoms that we would expect to see that an advisory to let them know that if they were starting to see people with that they needed to contact us immediately and get us involved. Hmm. (00:42:14) So you're confident that at least the alert system is working and and the information we (00:42:19) Conforth as long as your (00:42:20) computer's don't break down (00:42:22) right but we do have backups. We when our computers went down. We actually sent out what we call broadcast facts all across the state letting them know that our computers were down. (00:42:34) Okay Lisa your next go ahead Place. Hi, my name is nurse at a local Twin Cities Hospital. I'm just curious to see how the planning is going. You mentioned a little bit earlier about the planning between hospitals and maybe possibly infectious disease positions and so forth about alerting staff to the types of symptoms and starting a plan or a more complete protocol for this type of thing, and I'm just going to take my answer off the air, but I just wanted you to talk a little bit more about (00:43:07) that. Right Lisa. I think that that's a that's a great question. You know, one of the difficulties with bio terrorism is that until September 11th. It was hard to get people people's attention. You know, they tend to say well we've got other things that are more important since then we've got a lot of requests for educational opportunities where we can talk to Physicians directly and Hospital staff about these diseases and the system and how they would participate in that system. We've also been approached by the hospital Association saying that they need to work with us collectively as opposed to just individual hospitals working with us. So that is helpful. And so I think that we're going to be able to move forward some of our ability to move forward though is compromised because a huge percentage of our end of our staff are out on strike at this point in time and It's going to take time to get all these plans together and we're hopeful that that can take place. We're well, let's just say we're hopeful that the strike can be settled soon (00:44:20) is the hospital system. Is there enough capacity in the hospital system to deal with a true emergency be whether whether it's a bioterrorism attack or something else seemed to just two years ago. If I remember right? We had a little worse than normal flu season and all the hospitals as I recall in the metro area were filled to overflowing remember the nurses mentioning this spring that the the system was stretched to the limits. There was a fellow testifying on Capitol Hill this week about bioterrorism. He was saying that the hospital system would degenerate into chaos. I believe as the court. I mean is there enough are the hospital's capable of dealing with something like this? (00:45:06) The I would just say that our hospital system has been the capacity of the hospital system has been reduced and our ability to respond would in fact be stretched, but we also have to remember that the hospitals are not just taking care of the sickest patients at this point in time. You know, there is there are voluntary procedures going on at this point in time. And certainly we would have to restrict access to voluntary surgery elective surgeries and postpone those kinds of things but the capacity the hospital system, you know, they're running close to full most of the time right now. (00:45:51) Is there anything that can be done about that to build some some some capacity into the system put that back in without driving healthcare costs through the roof. (00:46:02) Well, that's the serious debate. I mean the There has been a hospital capacity that is closed down. But keeping that in a ready Alert state making sure that we've got enough nurses and Physicians janitors health care aids Ward clerks to man such a system that's going to cost money. And we as a society need to think about that and I think that your flu analogy is absolutely right, you know, when we have an average flue system or an average flu season the Health Care system is stretched to its capacity when we get the serious flu season. We're going to be pushed our absolute limits Gordon your comment, please (00:46:50) thank you. I would just like to add to this excellent information the need not only for by a logical chemical attack, but for communities and being born in 1920 and st. Paul, I remember many cry. These were people bend it together like in World War two of their local Air Raid Warden and so forth and to me as a Lutheran pastor and chaplains, we have to prepare people spiritually socially and psychologically not to Stampede to be willing at there's a limited amount of vaccine to say the young get it first and just like in the World Trade Center the people didn't Stampede down the stairwells, they helped each other but I think a mindset has to be continually upgraded and that's why I would like to suggest you know monthly or quarterly meetings and the community level to just keep people dialoguing and interacting so that they don't panic and let fear overwhelm them and get a perspective (00:47:57) on it. Nice card Gordon. That's a great comment. I really like it. I mean when I was talking with the news different A reporter and a couple days ago. He said, well should we all go out and go into bomb shelters? And the answer is well, if you really want to provide yourself absolutely absolute protection against chemical biological warfare or against terrorist bombs and whatever you can go into your bomb shelter and live there for the next 20 years. But guess what you miss your life in the process and I think that we do have to band together. We do have to support our public servants. We do have to make sure that our communities are strong because we are all in this together. So thanks a lot for your comment. (00:48:43) Is there any way as a practical matter? I don't know that this falls into the Into the purview of the state epidemiologist. Maybe it does. Is there any way to control panic in a situation like that? Gosh, I mean on September 11th all of a sudden you found people in lined up for blocks just to buy gasoline. They had apparently panicked worried that they might not be able to drive their car the next day. Well this of course would the pales in comparison to the to this threat. Is there any way to control (00:49:15) that? Well, yeah, it is appropriate to ask me that in the end. The answer to fear is information and courage and I think that when people understand with the what the threats are that they have knowledge that they can face uncertainty with resolution and I think it's important to recognize that there also have been some folks out there who are out there stirring up panic and I think that the terrorists Us to be panicked that's why they're called terrorists because they use Terror to shut down societies to make us stop living our lives and I go back again and again to Franklin Roosevelt beginning of World War II what we have to fear is fear itself. If we're afraid sometimes our emotions can take control of us and lead us to have a lead us into panic and that is destructive. What we have to do is be as knowledgeable as possible to make sure that our communities are strong as possible to build bonds with other people and get through this together and not let Terror interrupter (00:50:28) lives in terms of personal preparation. Does it make sense to get a gas (00:50:34) mask? Well, if it's going to make you feel better it might but is it going to protect you? It's very unlikely that it would again. The scenario is to that these things would be released in secret. It's not going to be a crop duster flying over the State Fairgrounds. So in order to protect yourself, you need to be wearing a gas mask all the time, you know, (00:51:00) what about apparently a lot of people have gone out and bought these antibiotics which apparently he could have some benefit in dealing with (00:51:11) Anthrax. Well, it could have but again we have very large National stockpiles in terms of it and frankly in terms of the quantity of antibiotics that you had that you're going to have. Most people have a very small stockpile in might get them through a day or two, but it's not going to be enough and if you've been exposed to Anthrax, you actually need to be taking the antibiotics for a couple of months because the You bation period can be 40 50 days. (00:51:38) Is there any point in following the Israeli lead and constructing sealed rooms in our homes? (00:51:46) Well, that's sort of what I was talking about. You can go and spend the seal in and spend all your time in a sealed room. But you know part of the issue here is when a bioterrorist attack comes are you going to know it and the answer is most likely not it's going to only going to be when a number of people are getting kind of be getting sick. (00:52:06) We have a new office White House Office of Homeland Security Now, do you think that that's an important step forward in terms of trying to improve our our ability to respond to any kind of threats or is this just another layer of (00:52:23) bureaucracy? I don't have a clear idea yet of what Homeland Security is going to be about now, you have a personal reaction that I don't like the name because of some of the similarly named offices in some repressive countries that have not Serve the People well, and the question is what can we You to make ourselves as secure as possible. But at the same time making sure that we maintain our freedoms because again the terrorists hate our freedom and so we have to make sure that we don't give away our freedoms for security. You know, we do need to have better security. I'm hopeful that the office of Homeland Security will focus in on what are our needs and strengthening the national public health infrastructure is a tremendously important needs. So hopefully funding for the for that public health infrastructure will come as a result of their efforts (00:53:27) and just to wrap up here people are going to hear more about this subject. How likely I mean should they really get stirred up about this just go about their lives and let things fall where they may (00:53:42) well I think the people need to go about their lives, you know, the there are some people who think that this is highly likely there is some intelligence activity to say that people that some evil countries are evil people are you are experimenting with these things but again, there's a difference between experimenting and actually using them and some of the scenarios are going to have the potential of being like the Germans using gases during World War one where the gases are where it actually comes back and gets you in the (00:54:16) process. Thank you, sir. Appreciate your coming in today. Thank you Minnesota state epidemiologist. Harry Hall joining us this hour to talk about Minnesota's state of preparedness. If in fact there were a follow-up terrorist attack that would affect hear that. The state of Minnesota if you missed part of this conversation, by the way, we will be re broadcasting this program at nine o'clock tonight here on Minnesota Public Radio. I'd like to thank all of you who've been listening this hour, especially those of you who called in or try to call in with your questions and comments care a fig and Chu has produced our program this week with help from Gabrielle Zuckerman Tasha Rosenfeld, Randy Johnson and Genaro Vasquez programming on Minnesota Public Radio is supported by Exo Communications offering voice data and web for business XO not just talk information available eight six six eight six nine 96 96 or on the web at EXO.com. Hello, I'm Deborah. Bear this week on sound money. We'll look at the real estate market and what you need to know about long-term care insurance plus your call Saturday morning at 10:00 and Sunday afternoon at 5 on Minnesota Public Radio.