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Responding to Bioterrorist Smallpox in San Antonio

Altarum Institute, PO Box 134001, Ann Arbor, Michigan 48113-4001
Altarum Institute, 3737 Broadway, Suite 205, San Antonio, Texas 78209
University of Texas Health Science Center at San Antonio and South Texas Veterans Health Care System, 7400 Merton Minter Street, San Antonio, Texas 78229
george.miller{at}altarum.org
steve.randolph{at}altarum.org
pattersonj{at}uthscsa.edu

We used discrete-event simulation to help the San Antonio public health and acute medical care communities to plan their response to a bioterrorist attack. The analysis, based on a scenario positing an attack with aerosolized smallpox, indicated the resources and strategies needed for an effective response. We found that a mixture of public-health measures designed to stop the spread of the disease would form a more robust and effective response than any single measure. However, unless the attack is very small, the public-health system is unlikely to be able to prevent a surge in demand for acute care that will require community-wide coordination of resources, a definitive patient-triage policy, and temporary treatment practices. The San Antonio communities are integrating our recommendations into their plans.

Key Words: health care: epidemiology; simulation: applications

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