Staffers Critical of Anthrax Response

Posted February 28, 2005 at 6:21pm

In a focus group conducted by the RAND Corp., Senate staffers affected by the 2001 anthrax attacks on Congress gave high marks to the Attending Physician’s office but said they ultimately lost confidence in public health officials because they delivered inconsistent and disorganized messages during the crisis.

“The [Centers for Disease Control and Prevention] would say things, or there would be an announcement from the Public Health Service,” one Senate staffer is quoted as saying. “You always left every meeting more confused than when you went in.

The study, titled “In Their Own Words, Lessons Learned From Those Exposed to Anthrax,” was published in the March 2005 edition of the American Journal of Public Health. The study was commissioned to help authorities learn how to better deal with health care emergencies.

Researchers gathered their information through in-depth discussions with both postal workers and Senate employees who were exposed to anthrax in 2001 when biologically tainted letters containing the deadly bacteria were mailed to then-Sen. Tom Daschle (D-S.D.) and several other Members of Congress.

Thirty-six postal workers from the Brentwood facility in Northeast Washington were placed into four focus groups, while one focus group included seven staffers who worked in the Hart Senate Office Building, which was closed for months for cleanup after the mailed anthrax was discovered.

The conclusions were similar among both types of workers.

“Both groups made statements noting that the CDC and the District of Columbia health department provided very little useful information,” the report said, adding, “both groups expressed negative opinions, and particularly mistrust, of many of the sources of information, such as from the USPS and the CDC, although the underlying reasons for mistrust differed by location.”

One of the anonymous Senate staffers said: “My impression throughout this was that the Capitol [physician’s office] … was truly concerned about us, versus the CDC or other people who were just like, ‘Isn’t this a fascinating laboratory test.’”

Overall, Senate staffers said they received the bulk of their information from the Attending Physician’s office, with additional information coming from military or Navy personnel, coworkers or friends, and to a lesser extent, the media and the Internet.

But more than half of the Senate staffers in the focus group remarked on a “general absence of information” and roughly a quarter complained about a lack of clarity and “poor quality of information.”

Other frequently cited problems included a lack of organization on the part of those who delivered the information; a feeling that information about treatment options was not complete; and inadequate information about side effects and potential interactions between prophylactic antibiotics and other drugs.

Overall, some 600 employees in the Hart Building were advised to take 60 days of preventive antibiotics after their potential exposure to anthrax, but earlier studies show that not everyone adhered to the medical advice.

According to a 2002 study in Emerging Infectious Diseases, a journal published by CDC, approximately 64 percent of those working at Brentwood and 58 percent of Senate workers completed their course of antibiotics. The rest did not.

At least some of the Senate staffers agreed with many Brentwood employees who claimed that they were not treated with the same respect that Capitol Hill staffers received.

“They gave [us] preferential treatment because [we] were in Congress,” one Senate staffer said. “And if that was readily apparent to us, it was probably apparent to the community — people living in D.C. and Virginia and Maryland also. That was a tragedy, because they waited so long to close the Brentwood facility.”

Janice Blanchard, a RAND researcher and lead author of the report, said in a statement said the study’s findings “underscore the needs to develop better ways [to] deliver direct, consistent and accurate information to different groups during a health care emergency.”

The Senate’s handling of the anthrax crisis, for instance, provided a good example of how officials can more effectively manage an incident of bioterrorism, the authors of the report concluded.

“The identification of an advocate (the Capitol Physician’s Office), as well as networking with individuals who took responsibility for informing others, seemed to help Senate workers cope with events,” the study concluded.

Brentwood employees, the study noted, did not have a similar network upon which to rely and instead turned to the media and the constantly changing information flowing from the U.S. Postal Service, the CDC and the District of Columbia’s health department.

Other ways that focus group participants suggested to improve the effectiveness of communication included: developing consistent messages across all groups; relying on already established leaders within the community to communicate crisis information; involving exposed individuals in the making of a strategy for intervention, treatment and communications; and considering the diversity of the individuals affected when devising a communication strategy.

“Get the most recent studies of everything … and then admit, we’ve never seen this before and this is the best recommendation that we can give you based on all these other studies,” said one Senate staffer who participated in the focus groups. “But feel comfortable in saying we don’t know. Because that’s always more reassuring than hearing conflicting information from people, because then you don’t believe anything.”

Senate staffers included in the study were recruited through an e-mail announcement sent to those who work in the Hart Building. While Brentwood employees received $50 for their participation in the study, Senate ethics rules precluded such payment. Instead, the staffers were served lunch.