For the coterie of national security wonks who have warned for years that the crumbling U.S. public health system makes an inviting stage for the dark arts of germ warfare, the scene at a closed hospital near the Capitol on Tuesday must have felt like grim vindication.
On a day when public health officials from Health and Human Services Secretary Tommy Thompson on down were promising to spend millions rejuvenating public health, 2,000 postal workers lined up at D.C. General Hospital to get an allotment of the antibiotics that might have saved their two murdered colleagues.
D.C. General, an enormous brick complex near RFK Stadium, was shut down in June after serving impoverished southeastern Washington, in one form or another, for 195 years. Although a skeletal emergency room remains open, vast wings of the hospital are closed, its windows cracked and broken like superannuated Moscow dormitories. On Tuesday, police shooed hordes of reporters away from the doors while Red Cross volunteers passed out crackers and soft drinks.
Many of the postal workers, who got 10 days' worth of Cipro, said their superiors had urged them not to talk to the press. Some worried about getting sick while others expressed confusion about why they were getting antibiotics without first being tested for anthrax.
"They told me three days ago I was going to be tested," said a 51-year-old mail carrier whose route is in Georgetown. "Today's what? Tuesday. We should have been tested long before."
In fact, none of the postal workers were tested Tuesday. Fearful of more deaths and sickness, officials decided it was better to medicate than to wait for accurate test results that might take a few days to arrive.
"They said there was no reason to get tested because they were giving us medicine to prevent us from getting anything. If they prevent," said postal worker Gordon Garrison, "they don't have to diagnose."
With the whoop of ambulance sirens as soundtrack, it was an icky day in our nation's capital, despite the Indian summer. The White House got its first anthrax scare, though a minor one. Secret Service employees found anthrax on a mechanical mail-opener at a military base where White House mail is opened.
Anthrax panic even found its way into my son's backpack in the form of an alarming informational leaflet from the D.C. Department of Health, distributed to all schoolchildren. Its most trenchant bit of advice was to "resist the human urge to rush to a person you believe has been exposed" to anthrax.
At a noon news conference, Mayor Anthony Williams confirmed that postmen Thomas L. Morris Jr., 55, and Joseph P. Curseen, 47, died of toxic shock from anthrax exposure after being misdiagnosed and sent home early from a Maryland hospital.
Two other postmen were hospitalized with anthrax in serious condition at a Northern Virginia hospital, and 16 other D.C.-area hospital patients are under observation for possible anthrax symptoms. Most had worked at the Brentwood mail distribution center, where postal workers who handled the anthraxed letter to Tom Daschle stayed at their jobs until this week.
The comparison to Congress, which recessed last Thursday for five days, was odious. "Basically," said Charlie, a Gaithersburg, Md., postal worker who refused to give his last name, "I think they just wanted us to deliver the damn mail."
Barely audible over the snarl of reporters, the Centers for Disease Control's Rima Khabbazz tried to explain the missteps of the team of 40 epidemiologists investigating the Washington outbreak. Khabbazz' comments pointed to the basic problem with handling this outbreak: the lack of precedent.
Based on the Florida and New York anthrax cases, Khabbazz explained, there was no reason to suspect that the anthrax-tainted envelope received in Sen. Tom Daschle's office would have leaked in the Brentwood distribution center that handled it.
On Thursday, Postmaster General John Potter had even held a news conference at Brentwood to say there was only a "minute chance" that anthrax spores had escaped into the plant.
"We make recommendations based on the best science available at the time," said Khabbazz. "The paradigm shifted at Brentwood."
On Saturday, after Leroy Richmond became the first Brentwood employee confirmed ill with anthrax, CDC officials gave prophylactic antibiotics to his workplace neighbors. But Morris and Curseen apparently worked hundreds of feet away.
One theory is that high-pressure air nozzles used to clean mail-sorting gear may have whisked clots of anthrax spores across the sealed room. Or there may have been another letter. "We haven't ruled anything out," Khabbazz said.
It wasn't until Monday that bacteria from 29 swabs gathered at Brentwood had been allowed to grow -- and 14 came back positive for anthrax.
By then, the blood of Morris and Curseen was boiling with anthrax poisons.
Who are the next victims? Could the Daschle letter, a reporter asked, have rubbed onto other mail, including some that continues to arrive at our houses this week? Khabbazz, humbled by previous errors, let out a big sigh. "There is science," she said. "There is science. We don't fully understand the situation."
Brentwood employees began going on antibiotics Saturday. Postal workers from 36 post offices that do business with the center got their drugs starting Monday night. They were given a 10-day supply of Cipro and told not to drink milk or alcohol with it. If the bug turns out to be susceptible to older antibiotics like doxycycline or amoxycillin, the postal workers may later be switched to those drugs, according to CDC officials, who are following the recommendations that an expert panel published in 1999 in the Journal of the American Medical Association.
Williams and the officials around him took a pass on making recriminations for the failure to protect the lost postmen, although Williams did get in a jab at Congress by saying that "anyone, no matter what they look like or where they work, deserves the best treatment."
"The most important thing is to maintain confidence in the public health system," added Ivan Walks, D.C.'s chief public health official.
"The enemy is not public health or the D.C. government or the CDC," said Deborah Willhite, a vice president of the Postal Service. "The enemy is the murderers who sent the letters."
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