US Hospitals Have No Capacity For Terror Attack, House Survey

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Main Category: Bio-terrorism / Terrorism
Also Included In: Public Health;  Aid / Disasters
Article Date: 08 May 2008 - 3:00 PDT

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A survey of US hospitals and emergency rooms suggests they would not be able to cope with the surge of casualties that might follow a terror attack. The one day survey of 34 major hospitals was carried out by a House of Representatives oversight committee that is investigating the potential impact of plans by the Bush administration to cut Medicaid funding.

On Tuesday March 25th, the House Committee on Oversight and Government Reform carried out a snapshot survey of 34 level 1 trauma centers throughout the US.

Chairing the committee is representative Henry Waxman (Democrat, California), who said they were alarmed by what they found:

• None of the hospitals had enough ER capacity to deal with a sudden influx of victims from a terrorist attack.
• There were hardly any free intensive care beds to treat the most serious casualties.
• There weren't enough regular inpatient beds to accommodate the less seriously injured victims.

"The situation in Washington, DC and Los Angeles was particularly dire," said Waxman.

In Washington DC, he said, "There was no available space in the emergency rooms at the main trauma centers." And they found "One emergency room was operating at over 200 per cent of capacity: more than half the patients receiving emergency care in the hospital had been diverted to hallways and waiting rooms for treatment."

In Los Angeles, the survey found that:

"Three of the five Level I trauma centers were so overcrowded that they went 'on diversion', which means they closed their doors to new patients," said Waxman.

"If a terrorist attack had occurred in Washington, DC or Los Angeles on March 25 when we did our survey, the consequences could have been catastrophic," he added.

Waxman said the emergency care systems were already at breaking point with no spare capacity to deal with a sudden surge of new casualties.

He said the survey also revealed what appears to be a:

"Complete breakdown in communications between the Department of Homeland Security and the Department of Health and Human Services."

In October last year, President Bush issued a homeland security directive that requires the Secretary of Health and Human Services (HHS) to identify any barriers to public health and medical readiness that could be removed by changing regulations. The directive also requires that the Secretary co-ordinate with the Secretary of Homeland Security to maintain what Waxman describes as "a robust capacity to provide emergency care".

But Waxman said neither department was able to produce a single document when the Committee asked to see an analysis of the impact the new Medicaid regulations might have on hospital emergency surge capacity. He called the situation "incomprehensible", saying that the government has passed regulations that will take "millions of dollars away from hospital emergency rooms", without considering the effect that might have on the nation's readiness for a large emergency response.

The Committee held two days of hearings this week that included testimony from experts in national security and emergency preparedness, representatives from the medical and nursing profession, and Michael O Leavitt, Secretary, Department of Health and Human Services, and Michael Chertoff, Secretary, Department of Homeland Security.

According to a report in the Washington Post earlier today, the Cabinet members acknowledged there were gaps in the nation's emergency capacity in hospitals for dealing with a mass terrorist attack, but blocking the planned Medicaid cuts would not solve the problem. They said legislators could deal with the problem more directly by funding stockpiling of hospital beds, equipment and drugs.

Secretary Leavitt told the committee:

"There are deficiencies in our surge capacity. I just don't believe Medicaid dollars is the source of funds that ought to be directed or looked to link to that solution."

Responding to the apparently alarming results of the Committee's survey, Leavitt told the hearing that his department were planning a nationwide survey of capacity to deal with a surge that will report by the end of this year.

Leavitt said that:

"Surge capacity is about using existing assets to convert to a hospital capacity very quickly."

"It is not simply using the emergency room," he explained.

He also said the purpose of the planned Medicaid changes was to stop states using federal funds as a substitute for state funding, reported the Washington Post. He said the changes were about "states not paying their fair share".

Click here for House Committee on Oversight and Government Reform website.

Sources: House Committee on Oversight and Government Reform, Washington Post.

Written by: Catharine Paddock, PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today