Mass Graves Prepared for U.S. Citizens

State prepares for bioterrorism
Executive orders give governor additional powers


The state of Colorado could seize antibiotics, cremate disease-ridden corpsesand, under extreme circumstances, dig mass graves under executive ordersdrafted for use in the event of a bioterrorism attack. Eight of the executive orders have been drafted since mid-2001 by the Governor's Expert Emergency Epidemic Response Committee.


The 19-member panel advises Gov. Bill Owens on measures to prevent or reducethe spread of disease after a bioterrorism attack. It was formed in 2000 -well before the Sept. 11 attacks and the anthrax scares - as part of a law that laid out the Colorado governor's powers during emergencies.Owens hasn't signedany of the draft executive orders yet, and there's a good chance they'll never be needed, said Mark Estock, bioterrorism program coordinator at the state health department.


"We hope and pray that these cataclysmic events never come,"Estock said. The nightmare scenarios include planes flying over a stadium and releasing anaerosolized germ, such as smallpox or plague, that infects thousands of people. "But should they come, we're going to be able to say to the citizens of Colorado,'We're ready, and this is what we're going to do.'


"Other states have requested copies of Colorado's orders to use as models, Estock said."They contacted us because they've heard we have a good statute in place, so Ithink it's fair to say that Colorado is looked to as a leader in bioterrorism preparedness," said Lt. Gov. Jane Norton. The former executive director of thestate health department chaired the epidemic-response committee until she took over as lieutenant governor in January. Most of the eight draft executiveorders would temporarily suspend various state regulatory statutes so emergency workers and health officials can act quickly after a bioterrorism event.


One draft order empowers the state to commandeer pharmaceuticals from drugstores and warehouses after an attack. The federal government would immediately send in antibiotics and other medicines from the Centers for Disease Control and Prevention's National Pharmaceutical Stockpile, but until that shipment arrived, Colorado healthworkers would be forced to rely on local supplies."If it was the crop-duster-over-Coors Field scenario, we might want to get the stuff right into the hands of the people going out to work with those patients,"Estock said.


Three of the orders suspend licensing and pharmacy laws to allow emergency responders to dispense drugs and immunize victims.


Another would allow hospital emergency rooms to close their doors to bioterrorism victims when they reach capacity. Currently, federal law requires hospitals to evaluate every patient who shows up at their emergency rooms.


After a bioterrorism or chemical attack, field decontamination and triage areas might be set up near ground zero. Victims would processed, sorted, then sent to assigned hospitals. "In the event of an emergency, we may have to triage patients so they don't overwhelm the hospitals," Estock said.


Under another draft executive order, mental health patients could be removed from treatment facilities so their beds could be used by bioterrorism victims.


Another order would suspend statutes pertaining to death certificates and burial practices. "The funeral codes say that a dead body is to be handled by a funeral home and that you must notify the next of kin and give preference to the religious practices of the next of kin," said Deputy Attorney General Renny Fagan, a member of the governor's advisory committee. "But in a biological event or in a mass-casualty event, it may not be practical to follow that law," Fagan said.


Infected corpses might have to be isolated at temporary morgues to prevent the spread of disease, Estock said. In certain situations, mass cremations or burials might be required. "I don't want to come across as saying the state's going to make this decisionto do mass cremations and ruin the lives of families. That's certainly not the intent," Estock said. "But it (the executive order) just gives us maximum flexibility."A ninth executive order, pertaining to quarantines, is being prepared.

State and local health officials already have statutory authority to quarantine people with contagious diseases. The draft executive order would extend those powers so they could be applied "on a broader basis than usually occurs in public health," Fagan said. Colorado health officials will test their ability to respond to a bioterrorist eventthis summer in a statewide exercise, Estock said.