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Cleveland
Epidemiologists Help CDC in Assessing Bioterrorism
(from the Plain Dealer, 11/06/01). Regina McEnery An international group that includes a team of epidemiologists from Cleveland will be helping public health authorities battle bioterrorism. The Society for Medical Decision Making, an eclectic group of 1,000 whose goals seem more suited to the board room than the emergency room, have turned to computer models, cost analyses and sensitivity tests to tackle complicated questions about biological agents. The Centers for Disease Control and Prevention accepted the society's offer of help amid a rapidly evolving anthrax investigation that has raised a host of medical issues ranging from who should be tested and vaccinated to the reliability of anthrax detection tests. Since its founding in 1979, members of the society have acted as independent consultants to advisory panels representing public and private agencies. Their expert opinions have helped determine when women should get an annual mammogram or when a toddler should be vaccinated against the virus RSV. Last month, a New York City internist and society member showcased a computer model that spit out realistic estimates on how many beds, ventilators, vials of antibiotics and health care workers a hospital needs to counter a biological weapon like anthrax. But its current assignment is the society's first group project, and the assignment is an urgent one, said Dr. Joel Tsevat, president of the society and director of outcomes research at the University of Cincinnati Medical Center. "In many cases, we'll have to do our analyses in hours or days, rather than weeks or months," Tsevat told society members in a soon-to-be published newsletter. Though infectious disease experts generally give the CDC high marks for its handling of the anthrax cases, a series of conflicting statements from Health and Human Services Secretary Tommy Thompson and Homeland Security Chief Tom Ridge created confusion during the initial phase of the crisis. Some believe it raised the public's anxiety even further. And even as the first peer-reviewed articles on anthrax attacks await release, some as soon as mid-November, a dearth of reliable data on anthrax remains a huge barrier for public policy makers on the front lines of the investigation. "The state-of-the-art is not certain," acknowledged Dr. Randall Cebul, a professor of medicine and epidemiology at Case Western Reserve University's School of Medicine. Cebul, who also directs the Center for Health Care Research and Policy at MetroHealth Medical Center, said he and five Cleveland researchers are among about eight groups that have formed since late last week. A California team is evaluating the reliability of anthrax detection. Cebul's group met yesterday. He said his group wants to establish diagnostic and treatment guidelines for people who seek medical services for flu-like illnesses. The issue is an important one for physicians because the early symptoms of inhalation anthrax have included headache, chest pains, chills and fever. "We need increased vigilance for biological agents and to simultaneously use health care resources intelligently," Cebul said. � 2001 The Plain Dealer. Used with permission.
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