Panelist Dr. Charles Bauer

Dr. Bauer's going to give the emergency department physician and hospital perspective for this problem.

Applause

Thank you Dr. Stewart and thank you all for being here tonight and all of those of you who are at the outlying sites I'm sure glad that you are here and listening to us also. This is a regional and national problem so I'm glad you all are here.

First off, I'm going to talk about the role of physicians in hospitals, but I think we have to understand we're not really talking about just physicians we're talking about all health care providers because as was said by Dr. Guerra, we are on the front line in this battle for bioterrorism. We have to be alert at all times to try to determine if there is something that we should suspect, report, diagnose and treat. So, we have to be paying attention and so with that I think we need to go back a little bit. I was asked the other day by a physician, "Why don't they do something?" And I said well so who do think they is? It's really all of us. And a lot of the they that I've been working with for a long time are sitting at the table here tonight. And we do know each other and we have been working together for a number of years, and we have accomplished some things and they have done quite a bit and if you think way back to San Antonio, and actually it was before I came to this city, but back a number of years ago in the 60s, Dr. Rockwood and a number of other people got our EMS system. And then we went on, I got here in the 80s, and in those early days, a number of us that are sitting at this same table starting working on HASMET and by the end of the 80s and early 90s we had Hasmet teams which we do have available to deal with a lot of the threats and hazardous materials.

And then now the next thing that came along in the mid to late 90s was the biochemical, nuclear terrorism and we started then back then with the getting some funds from the non? community funds and started training in Dec. of 1997.

We were about the sixth city in the country to go through a week of training that started out with law enforcement, fire, ems, first responders, the hasmet teams and the health care providers. And we trained according to train the trainer-type things for health care at that time in the areas that we are now very interested in, as a matter of fact. And there was some interest in the way we kept having our exercises and those of us who participated worked at it and we would get more equipment and we did get equipment for our first responders, our medical response teams and were trained. They do have the equipment to protect themselves which is the first thing you have to do in a situation like that. And actually I want you to know that the hospitals have been able to do quite a bit too along those efforts. Hospitals like University hospital have warm water and showers and pop-up tents and the other equipment, protective personal equipment for a number of people, to be able to deal with an incident. Other hospitals are doing the same thing. We need a lot more. Some of the things that I think Dr. Guerra was alluding to that we are going forward asking for more equipment and then also training. I asked a young man in our emergency room tonight, a technician, "Are you up to speed with wearing the equipment and the mask and the suit and he said yes and I said would you wear and go in there and do it and yes he would he said. That's good because you have to have confidence in your training and in your equipment. All of us have to have that. And I'm hoping that you have confidence in those of us who are out there to first off diagnose and suspect and then the surveillance issues, report possible disease and then pass the word on. A couple of things, the week of Sept. 11 we had an exercise planned for the city. It was a large exercise that was going to involve a lot of people, a national disaster medical system exercise that was going to involve biologicals. We didn't get around to doing that because of the events that occurred but you need to know that we were prepared to do that and we were reporting our hospital status of beds that were available on a number of things to do that. And we are prepared in many ways, now we're not perfect, but we do have a lot of the things we need and we do have antibiotics to deal with the situation locally and if we need more there is the national pharmaceutical stock pile that you heard about on the news.

And an example would be just as I was listening to over the last couple of days is that the case in Florida was on the fourth of Oct. by late on the fifth of October they realized that they wanted to give prophylactics to a number of people. That was at 5 o'clock in the afternoon on the fifth. By 5:30 in the morning of the sixth, they had the supplies the Ciprofloxacin and the people to distributed there on site in Florida so they moved fast with this to help us out so it was a coordinated effort locally and nationally.

There's many other speakers, I think I'll let them pass on there words to you. Thank you very much.