Bush Issues Medical Emergency Directive

President and Mrs. Bush arrive back on the South Lawn of the White House in Washington, Wednesday, Feb. 7, 2007, after a trip to Shenandoah National Park in Luray, Va., to attend a roundtable meeting on the National Parks Centennial Initiative. At center is Interior Secretary Dirk Kempthorne. (AP Photo/Ron Edmonds) (Ron Edmonds - AP)

WASHINGTON -- President Bush issued orders Wednesday for how federal medical personnel should respond to a nuclear, radiological, biological or chemical attack, saying authorities should focus on threats that can be dealt with medically.

An attack using any one of those weapons "could cause mass casualties, compromise critical infrastructure, adversely affect our economy, and inflict social and psychological damage," according to the order.

The directive points out that the primary goal is to prevent such an attack, "but we must be fully prepared to respond to and recover from an attack if one occurs."

It says it is not feasible to stockpile medicine and equipment against every possible threat. However, it says the priority must be on threats with a potential for a catastrophic impact on public health that have the greatest potential to be handled medically.

"We are moving heaven and earth to prevent" an attack, Homeland Security spokesman Russ Knocke said. He called the directive a playbook for how the federal government will respond and coordinate in providing medical treatment in case prevention fails.

Under the plan, authorities will focus on acquiring medicines and equipment that already exist and are proven approaches, and on pursuing long-term research to "get ahead of the curve," said Knocke.

Of all the possible threats, the biological agents offer the greatest opportunity for medical treatment and care.

Meanwhile, a report from the Homeland Security Department's internal watchdog criticized the effectiveness of its "BioWatch" program _ hundreds of air-sniffing sensors in at least 30 metropolitan areas intended to provide early warning of a chemical or biological attack.

The inspector general found that the department had not properly enforced or monitored the Environmental Protection Agency and the Centers for Disease Control and Prevention, which are also involved in the program. But it noted that Homeland Security had taken action to resolve the issues, and "we consider the recommendations resolved and closed."

Problems with filters, laboratories and fieldwork might cause cross-contamination of samples, which could jeopardize the department's ability "to protect the populace of the United States or to prosecute suspected perpetrators," the report said.

In some cities, the devices test the air 24 hours a day for traces of anthrax, smallpox and other deadly germs. New York, Boston and Washington have installed the monitors in major train and subway stations to sample the air for chemical poisons or explosive gases.

Environmental agencies also have been given portable air sensors that can be driven around in vans or carried by hand, though the sensors test only for about 20 different microbes and toxins.

In January 2003, the department rolled out the $129 million BioWatch program, relying on the Environmental Protection Agency and other agencies to run it. It was created out of concern that terrorists might aerosolize a biological agent and spread deadly biological pathogens.

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Associated Press writers Ben Feller, Kevin Freking and John Heilprin contributed to this report.