Answer for next anthrax attack: letter carriers

WASHINGTON — If there ever is another anthrax attack, the letter carrier may deliver your antibiotics.

Secretary of Health and Human Services Michael Leavitt on Wednesday 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 mail carrier do the job.

The government has lots of drugs stockpiled but few ways to distribute them quickly to citizens. Leavitt noted that if someone possibly inhaled anthrax, the chances of survival are best if antibiotic treatment begins within 48 hours.

The U.S. Postal Service came forward, he said, and said it has "people who every day walk to every house." Those carriers could provide "a front-end quick strike," added the Health and Human Services Department's emergency-planning chief, William Raub.

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. The carriers also would 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 U.S. 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.

Boston, Philadelphia and Seattle held experimental runs of the distribution strategy in 2006 and 2007, Raub said. 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, Minn., he said.

The postal service there will solicit about 700 letter carriers, enough to cover 20 ZIP codes, or about one-quarter of all households. The workers will be medically screened (including questions about family members), fitted with special face masks and issued a supply of the antibiotic doxycycline for their household.

Before that pilot project can begin, however, the Food and Drug Administration (FDA) must approve distribution of the drug for this purpose, which is not part of its officially approved list of uses.

Leavitt on Wednesday requested that FDA review, which may take months.

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 bioterrorist attack.

Any of them will now be able to use letter-carrier distribution. 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.

Letter carriers who volunteer for this duty would not be paid bonuses or given any other incentives, Brennan said.