CEO SUMMARY: In both New York City and Washington, DC, widespread publicity about exposure to anthrax generated a steady volume of test requests. Clinical labs in both cities adopted similar management strategies to deal with the sudden public interest in anthrax testing. One common step was to send detailed information about anthrax testing to physician clients, source of many anthrax test requests.
CLINICAL LABORATORIES in both New York and Washington, DC found themselves doing lots of anthrax tests in recent weeks.
“The first anthrax cases in Florida didn’t cause much of a reaction around Washington, DC,” said Jack Bergstrom, Executive Vice President at American Medical Laboratories, Inc. (AML), located in the Washington suburb of Chantilly, Virginia. “But that all changed following the discovery of anthrax in the letter mailed to Senator Thomas Daschle’s office (D-South Dakota) on October 15.
“Beginning on that date, we began to see a regular flow of specimens with a request by the referring physicians to rule out anthrax,” he continued. “There was also a noticeable increase in calls from the public requesting information about anthrax testing.”
AML’s experience mirrors that of most labs offering lab testing services in both Washington, DC and New York. Concerns about anthrax sparked three specific responses from the general population.
One, labs began to get a steady volume of phone calls from the public requesting information about screening tests for anthrax. Two, office-based physicians began referring specimens to labs accompanied by a request to rule out anthrax. Three, certain government agencies and private companies contacted labs to request that designated staff members be screened for anthrax.
“Inquiries and requests for anthrax testing picked up immediately after the news of the anthrax-infected NBC assistant,” noted Elkin Simson, M.D., Medical Director of the Center for Clinical Laboratories at Mt. Sinai Medical Hospitalin Manhattan. “In particular, a number of patients began showing up at our emergency department.
Lab Scheduled Extra Hours
“Our laboratory responded by extending the hours that we would do testing,” he said. “In fact, our microbiology laboratory was temporarily staffed on a 24/7 basis during the initial phase of this concern.
“We sent information about anthrax to the clinical staff and it was posted on the Web sites of both the health system (www.msnyuhealth.org) and the medical school (mssm.edu),” continued Dr. Simson. “Specimens come to us from the emergency department, the hospital, and affiliated clinics. Clinical specimens come to our lab. Environmental specimens are referred to public health labs.”
Although anthrax-contaminated sites were generally found in New York City and New Jersey, residents on Long Island also had concerns. “When the news broke about the discovery of anthrax in Tom Brokaw’s office at NBC, the very next day we got cultures from doctors asking us to rule out anthrax,” stated Pat Lanza, President of Sunrise Medical Laboratories, Inc. in Hauppauge, New York.
Meetings With Lab Staff
“The interesting thing that happened next was that some of our employees became concerned about potential exposure,” she added. “We conducted a series of meetings with each department and reviewed the points about anthrax testing and safety procedures. We also discussed procedures for handling mail that appeared suspicious.”
In the days following the initial disclosures about anthrax discoveries in New York and New Jersey, Sunrise fielded a call from an occupational medicine facility. “They inquired about the details of testing up to 500 employees of a local post office,” noted Lanza. “Days later, that number was raised to 2,500 employees.”
Even as more anthrax-contaminated sites were identified in New York and New Jersey, the nation’s attention quickly shifted to Washington, DC. In recent weeks, the number of contaminated mail rooms and offices in government buildings climbed steadily. Residents in DC, already living in a high-profile target for terrorism, began keeping close tabs on the anthrax situation.
Steady Flow Of Phone Calls
“Because government buildings are likely targets for terrorists, our lab’s proximity to the nation’s capital puts us close to anything that happens,” stated Chuck Krambuhl, AML’s Executive Vice President of Employee and Client Relations. “Not only did we start getting a steady flow of phone calls from individuals with questions about anthrax testing, but patients were walking into our service centers and asking phlebotomists to educate them about anthrax testing. We also discovered that calls about anthrax were coming into different departments of the laboratory.
“Once we recognized this situation, our management strategy was to create an ‘anthrax information center’ and direct all requests to this newly-designated team,” explained Krambuhl. “We changed the telephone prompt for callers to the lab, giving them an option to switch directly to our anthrax information resource center. Couriers and staff at the patient service centers referred questions to this phone resource. We also sent a special ‘Lab Alert’ to our clients, informing them of basic procedures for ordering anthrax tests.”
In response to the anthrax contamination, some government agencies and private companies contacted AML to arrange anthrax screening for their staffs. “We’ve cooperated in these efforts,” noted Bergstrom. “In some cases, several hundred people were screened.
“Normally, this is a category of lab testing which is typically quiet,” added Bergstrom. “Operationally, our normal operating procedures allowed us to handle this unplanned increase in testing in a timely fashion.”
Calls Come Into LabCorp
At Laboratory Corporation of America, Inc., the situation has been similar. “We’ve certainly gotten inquiries and calls requesting information about anthrax,” stated Pam Sherry, Senior Vice President of Investor and Public Relations at LabCorp.
“We sent detailed information to our clinician and staff about anthrax testing and employee safety. Like many other labs, we test only clinical specimens. Environmental specimens need to be sent directly to the appropriate public health laboratories,” she noted. Sherry also confirmed that LabCorp has done screening programs for public and private organizations that had reasons to request such testing.
The bioterror attacks using anthrax reveal how quickly laboratories become an important resource for the affected communities. The experience of clinical laboratories in New York City and Washington, DC demonstrates that most labs already have in place the basic management procedures necessary to react effectively to this level of biological attack.
At the same time, the reality of this rather modest bioterror attack forces laboratories throughout the United States to contemplate a more fearful question: what happens if there is a wide-scale biological attack, affecting thousands of people? Can individual laboratories effectively respond?
Labs Beware: Coming Soon Home Tests for Anthrax
PREDICTIONS ARE THAT RETAIL STORES will have over-the-counter test kits for Anthrax as early as Thanksgiving.
These are non-invasive test kits to be used for determining whether anthrax is present in the environment, such as in a letter or in an air conditioning system. As a non-invasive test, these kits are exempt from most government regulation.
Vital Living Products, Inc. of Matthews, North Carolina may be first to market with such kits. Already, Ace Hardware Corporation has announced it will sell the $25 kit in its nationwide chain of 5,100 stores. Other national retailers are also expected to stock the kits.
Nationwide surveys indicate that as many as half the people polled would buy a home test kit for anthrax. Because these types of kits are designed to detect for the family of Bacillus bacteria (of which Bacillus anthracis is a member), some experts point out that a high number of false positives can be expected.
THE DARK REPORTadvises that clinical laboratories should maintain a watchful eye on how consumers respond to the availability of home test kits for anthrax. Worried consumers, after using their home test kits, will definitely include clinical laboratories in their search for information and follow-up testing.