Letter carriers may deliver antibiotics during bioterror attack

During the cold war the U.S. Post Office devised plans for continuing to deliver mail after an all-out nuclear attack on the United States. That was farcical, but current plans of the Post Office for doing its job during disaster are more serious. The service is making plans to be able to deliver deliver antibiotics to protect people from anthrax. The Washington Post’s David Brown writes that Health and Human Services (HHS) secretary Mike Leavitt the other day proposed a solution to one of the bigger challenges in responding to an anthrax bioterrorism attack — how to deliver protective antibiotics to tens of thousands of people overnight. The tentative answer: have the mailman (and -woman) do the job.

As an incentive to the letter carriers — who would be volunteers — the government would issue them in advance an antibiotic supply large enough to treat themselves and their families. They would also be accompanied by police officers on their rounds. “We have found letter carriers to be the federal government’s quickest and surest way of getting pills to whole communities,” Leavitt said.

The strategy has the full support of the Postal Service and its unions, spokesmen said. “Letter carriers are on the street six days a week. They are constantly helping out as just part of their job, and this is taking it one step further,” said Drew Von Bergen of the National Association of Letter Carriers. “Anytime this country has any kind of crisis, it is the Postal Service that is out there first,” said Postal Service spokeswoman Sue Brennan.

Boston, Philadelphia, and Seattle held experimental runs of the distribution strategy in 2006 and 2007, said William Raub, Leavitt’s science adviser. In Philadelphia, 50 carriers, each accompanied by a city police officer, reached 55,000 households in less than eight hours.

Based on those tests, the strategy was deemed practical and will be put in effect on a trial basis next year in Minneapolis and St. Paul, he said. The Postal Service there will solicit about 700 letter carriers, enough to cover twenty Zip codes or about one-quarter of all households. The workers will be medically screened (including questions about family members), fitted with N95 face masks, and issued a supply of the antibiotic doxycycline for their household. If successful, it may be expanded to encompass the entire Twin Cities area, said Jude Plessas, a Postal Service official.

Since 2004 the federal government has funded the Cities Readiness Initiative, which is helping 72 urban areas make plans to distribute drugs to a target population within 48 hours of a bioterrorism attack. Any of those cities will now be able to employ the letter carrier distribution strategy. The federal government will not force them to adopt it, as disaster planning is principally a job for state and local governments.

The federal government has enough anthrax antibiotics in the Strategic National Stockpile to treat 40 million people for 60 days. The medicine is cached in 12 sites around the country. Sixty days is the maximum amount of time a person exposed to airborne anthrax spores might have to take medicine to prevent the inhalational form of the bacterial infection, which is rapidly fatal if not treated.