A Stronger Health Department Rises From 9/11 Attacks

"There was a huge spike in demand for people and supplies and equipment" related to homeland security, Natarajan said.

In addition, the Health Department was roiled by changes in leadership. In August 2004, Gregg A. Pane became the third city health director in five years. Pane, a former emergency room physician, has vowed to improve the department's handling of the anti-terrorism money.

Health Department officials say they are trying to spend the new funds carefully, investing in equipment and training that will be useful in any kind of disaster, from a hurricane to pandemic flu.

"We're not just looking at anthrax," Natarajan said.

Among the biggest outstanding jobs in preparing for a bioterrorist attack is upgrading the city laboratory. Although the lab has made improvements, it can't fully test for dangerous pathogens such as smallpox. The Health Department has agreements with federal labs to handle such crises.

Other challenges facing Natarajan and his colleagues involve humans rather than sophisticated equipment. They have been trying to improve communication with federal and local agencies after city officials learned belatedly of two bioterrorism scares last year. Neither proved dangerous.

And one of the biggest tasks is simply increasing public awareness. The Health Department is preparing an educational campaign about quarantines, which could be imposed in the event of pandemic flu or an outbreak of smallpox or plague.

"We hope to never need it," Natarajan said. "We hope all of this is an exercise in futility."