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Editorials |19 April 2005

Being Prepared: Modeling the Response to an Anthrax Attack

Glenn F. Webb, PhD

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
  • From Vanderbilt University, Nashville, TN 37240.

    Potential Financial Conflicts of Interest: None disclosed.

    Requests for Single Reprints: Glenn F. Webb, PhD, Department of Mathematics, Vanderbilt University, 1326 Stevenson Center, Nashville, TN 37240; e-mail, glenn.f.webb@vanderbilt.edu.

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On 1 February 2005, Connecticut residents heard an emergency alert broadcast, beginning at 2:10 p.m. and ending at 3:10 p.m., that ordered them to evacuate the state. Fortunately, their response was minimal. A state emergency management official had mistakenly entered the wrong computer code into a weekly test of the emergency alert system, and incredulous Connecticut residents had correctly assumed that the broadcast was a false alarm. The incident illustrates several difficulties in preparing for a future catastrophe. Potential catastrophes differ in form, scale, and predictability, and each requires specific consideration of risk and preparation. If we could predict with certainty when and where a particular catastrophic event would occur, we could prepare with total commitment. Alas, to quote the physicist Niels Bohr: “Prediction is very difficult, especially about the future” (1).
In this issue, Fowler and colleagues (2) analyze the issues of preparedness for a specific potential catastrophe: a large-scale anthrax attack on a U.S. city. They focus on medical logistics and cost-effectiveness analyses of preattack and postattack strategies. Their method is decision-analytic modeling, which uses computer simulations to predict large-scale system outcomes based on assumptions about the probability of small-scale events. The model tracks individuals as they pass through various health states. Transition from one state to another is a matter of chance, as determined by probabilities derived from published studies. The mathematical modeling allows comparison of different strategies of preparation and response in terms of probabilities of vaccination, vaccination efficacy, and side effects; antibiotic therapy efficacy...
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Webb GF. Being Prepared: Modeling the Response to an Anthrax Attack. Ann Intern Med. 2005;142:667–668. doi: 10.7326/0003-4819-142-8-200504190-00016

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Published: Ann Intern Med. 2005;142(8):667-668.

DOI: 10.7326/0003-4819-142-8-200504190-00016

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2005 American College of Physicians
15 Citations

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