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Before the Committee on Government Reform, Subcommittee on the District of Columbia
United States House of Representatives

Emergency Preparedness in the Nation's Capital

Statement of
RADM Arthur J. Lawrence
Assistant Surgeon General and
Acting Principal Deputy Assistant Secretary for Health
Department of Health and Human Services

For Release on Delivery
Expected at 10:00 am
on Friday, November 2, 2001


Good morning Madam Chair and Members of the Subcommittee. I am Dr. Arthur Lawrence, Assistant Surgeon General and Acting Principal Deputy Assistant Secretary for Health of the Department of Health and Human Services (HHS). In this regard I am the head of the Office of Public Health and Science and supervise the activities of the Office of Emergency Preparedness.

Recently, the emergency response capabilities of HHS have been mobilized to assist local governments in New York, Pennsylvania, and the Washington metropolitan area address the health consequences of unprecedented terrorist attacks against the citizens of the United States. Our Department, with our partners in the Departments of Defense and Veterans Affairs, are in the best position at the national level to supplement the resources of State and local governments in mass casualty situations, regardless of their cause, as we have done continuously since September 11.

HHS is a signatory agency of the Federal Response Plan that provides a structure for federal response assistance to other levels of government when their resources are overwhelmed. In particular, our Department is responsible for leading the health and medical services emergency support function of the Plan, known as ESF 8. We are supported in that responsibility by 12 other departments and agencies. The functions that we carry out, through the Office of Emergency Preparedness (OEP), include medical services, mental health services, preventive health services, and environmental health services. All of the agencies of HHS participate with OEP in executing the functions of the Secretary of Health and Human Services under the Plan.

One of our most important assets for providing emergency health support to our citizens during disasters is the National Disaster Medical System (NDMS). NDMS is a partnership of the Departments of Health and Human Services, Defense (DOD), and Veterans Affairs (VA), as well as the Federal Emergency Management Agency (FEMA). In this partnership, more than 7000 health professionals (doctors, nurses, pharmacists, emergency medical technicians, etc) are organized into approximately 80 teams around the country to provide medical, mental health and specialized services at or near the scene of disasters. Furthermore, the System provides the capability to transport patients to other locations away from the disaster region in order to meet victims' definitive care needs, should that be necessary. Additionally, under the System, both DOD and the VA manage approximately 2000 private sector hospitals which have volunteered and can be called upon to accept patients from the disaster area who might not otherwise be able to receive care in locally overwhelmed systems.

Another resource that we can access is the Public Health Service's Commissioned Corps Readiness Force (CCRF), a group of 1400 Public Health Service Officers that can be mobilized to respond to disasters or other public health emergencies. Immediately after the attack on the World Trade Center, the Secretary of HHS, Tommy Thompson, placed these systems on their highest state of readiness to respond. And they did.

Since September 11, we have mobilized over 1300 members of NDMS, commissioned officers under CCRF, and public health professionals from the Centers from Disease Control and Prevention (CDC) to augment local resources available to respond to these calamities. For example, in New York City, we are still providing medical support for the teams working at the site of the destruction of the World Trade Center, augmenting the resources of the medical examiner to identify the victims of the attack, supplementing the nursing staff at the burn center taking care of some of the survivors, assisting the Department of Health with its public health surveillance, and providing support for the immediate crisis counseling needs that have been identified, among other activities.

In addition to continuing to support the City in response to the World Trade Center attack, we have deployed over 100 NDMS and CCRF members to assist in distributing drugs to United States Postal Service (USPS) workers to protect them from potential exposure to the anthrax that was used to contaminate letters sent to the major television networks and that passed through their mail processing centers. Today and tomorrow, these teams are back in New York to assist in distributing the pharmaceuticals that will be necessary to complete the prophylaxis of more than 5000 postal workers and contractors potentially exposed.

Similarly, we are still assisting the District government in investigating and controlling the health risks to USPS and other mail room workers and visitors in the District and surrounding jurisdictions that were exposed to anthrax that was contained in one or more letters processed through the Brentwood postal facility or the State Department Annex 32 mail handling area. In support of the District Government, we have provided the majority of the health professionals that have staffed the anthrax prevention clinics that were set up at DC General Hospital to assure that mail handlers exposed to anthrax in Washington received the necessary pharmaceuticals, in this case ciprofloxacin and doxycycline. Although we also provided these drugs to Maryland, Virginia and New Jersey for their affected postal workers, their health departments decided to make the distributions without our direct assistance.

Our Department has had a long experience with both federal, State and local governments in the Washington metropolitan area in preparing for terrorist attacks. For example, here in the Capitol our teams support the Attending Physician during major events (such as the State of the Union Address), assuring the availability of health services for Members of Congress, their staffs and visitors should a significant disaster occur. In recent weeks, we have provided continuous support to the Office of the Attending Physician in testing and providing preventive services and pharmaceuticals to Members of Congress, their staffs and visitors to areas affected by the release of anthrax in the Congressional mail system.

Likewise, we have worked with all of the Washington area jurisdictions to create a National Medical Response Team that can supplement the available resources in any one of the jurisdictions (Montgomery County, Prince Georges County, Arlington County, Alexandria or Fairfax counties, or the District) should there be the release of a chemical weapon. Sufficient antidotes are stockpiled here to treat 5,000 victims, using a team that can respond within 90 minutes of activation. Now we are in the final stages of completion of a plan, expected within two weeks, for the distribution of pharmaceuticals in the District in the event of a biological attack directed against the general population.

These most recent events have not been the initiator for our local actions. In fact, we have been working with the governments in Maryland, Virginia and the District since 1995 in strengthening public health responsibilities. We are looking forward to continuing these close working relationships.

Thank you, Madam Chairman, for the opportunity to testify today. I would be pleased to address any questions that you or Members of the Subcommittee may have.

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Last revised: November 6, 2001