We’re all gonna die: GovExec.com reported yesterday that the Health and Human Services Department has awarded a Project Bioshield contract for two radiological countermeasures. Remember Project Bioshield? Herr Prez mentioned it in his 2003 State of the Union speech and Congress passed the bill in 2004. The PB supposedly “provides new tools to improve medical countermeasures protecting Americans against a chemical, biological, radiological, or nuclear attack.”

Specifically, HHS is spending $21.9 million on a five-year contract awarded to Akorn Inc., which is expected to deliver 390,000 doses of Ca-DTPA (Pentetate Calcium Trisodium Injection Sterile Solution) and 60,000 doses of its Zn-DTPA (Pentetate Zinc Trisodium Injection Sterile Solution). Hameln Pharmaceuticals GmbH of Hameln, Germany, developed the drugs.

The Federal Drug Administration approved the drugs for treatment of acute radiation exposure in 2004. According to the FDA, they are appropriate for very specific contamination situations:

Until today, there had been no approved drug products for the treatment of internal contamination with plutonium, americium, or curium.

Remember the old days of duck and cover? I do, along with the recurring nightmares of nuclear annihilation that were my childhood companions.

Internal contamination with plutonium, americium, or curium can occur through a variety of routes including ingestion, inhalation, or direct contact through wounds. The goal of treatment with Ca-DTPA and Zn-DTPA is to enhance the removal of these radioactive contaminants and therefore the risk of possible future biological effects including the development of certain cancers, which may occur years after exposure.

Release of plutonium, americium and curium could occur from laboratory or industrial accidents; or through terrorist attacks using a radiation dispersal device (RDD), commonly known as a “dirty bomb.”

This is just a small part of Project Bioshield, which also calls for stockpiling the following:

• 75 million doses of a second generation anthrax vaccine that was supposed to become available for stockpiling beginning in 2005.
• New medical treatments for anthrax directed at neutralizing the effects of anthrax toxin.
• Polyvalent botulinum antitoxin.
• A safer second generation smallpox vaccine.

The number of doses of Ca-DTPA and Zn-DTPA ordered by HHS is based on a threat assessment of the medical affects of a nuclear or radiological attack by the Homeland Security Departmentand the interagency Weapons of Mass Destruction Medical Countermeasures Subcommittee. Under the contract, 500,000 more doses of each drug can be purchased, if needed.

Here’s how the FDA describes treatment with the drugs:

Ca-DTPA and Zn-DTPA should not be administered simultaneously. If both products are available, Ca-DTPA should be given as the first dose. If additional treatment is needed, treatment should be switched to Zn-DTPA. This treatment sequence is recommended because Ca-DTPA is more effective than Zn-DTPA during the first 24 hours after internal contamination. After the initial 24 hours, Zn-DTPA and Ca-DTPA are similarly effective. Ca-DTPA and Zn-DTPA are usually administered into the blood stream, however in people whose contamination is only by inhalation, Ca-DTPA or Zn-DTPA can be administered by nebulized inhalation.

The main side effect of Ca-DTPA is the loss of certain essential nutritional metals such as zinc, which can be replaced by taking oral zinc supplements. Although Zn-DTPA may also decrease the levels of certain nutritional metals, the effect is less than with Ca-DTPA. In addition, breathing difficulties have been noted in some individuals treated by inhalation therapy with these products.

These drugs would be used to treat acute radiation syndrome, which the Centers for Disease Control and Prevention describe this way:

Acute Radiation Syndrome (ARS) (sometimes known as radiation toxicity or radiation sickness) is an acute illness caused by irradiation of the entire body (or most of the body) by a high dose of penetrating radiation in a very short period of time (usually a matter of minutes). The major cause of this syndrome is depletion of immature parenchymal stem cells in specific tissues. Examples of people who suffered from ARS are the survivors of the Hiroshima and Nagasaki atomic bombs, the firefighters that first responded after the Chernobyl Nuclear Power Plant event in 1986, and some unintentional exposures to sterilization irradiators.

How you get ARS is to get a heaping helping of radiation. How you get over it is less clear. While these drugs can help rid the body of contamination by three radioactive isotopes, there’s still skin, tissue and bone damage to recover from.

The CDC describes the progress of ARS this way:

The four stages of ARS

• Prodromal stage: The classic symptoms for this stage are nausea, vomiting, as well as anorexia and possibly diarrhea (depending on dose), which occur from minutes to days following exposure. The symptoms may last (episodically) for minutes up to several days.
• Latent stage: In this stage, the patient looks and feels generally healthy for a few hours or even up to a few weeks.
• Manifest illness stage: In this stage the symptoms depend on the specific syndrome and last from hours up to several months.
• Recovery or death: Most patients who do not recover will die within several months of exposure. The recovery process lasts from several weeks up to two years.

While that may sound pretty bad, the U.S. Nuclear Regulatory Commission offers some handy advice on how to avoid getting ARS. The NRC begins by mapping out a likely dirty bomb scenario:

Basically, the principal type of dirty bomb, or Radiological Dispersal Device (RDD), combines a conventional explosive, such as dynamite, with radioactive material. In most instances, the conventional explosive itself would have more immediate lethality than the radioactive material. At the levels created by most probable sources, not enough radiation would be present in a dirty bomb to kill people or cause severe illness. For example, most radioactive material employed in hospitals for diagnosis or treatment of cancer is sufficiently benign that about 100,000 patients a day are released with this material in their bodies.

However, certain other radioactive materials, dispersed in the air, could contaminate up to several city blocks, creating fear and possibly panic and requiring potentially costly cleanup. Prompt, accurate, non-emotional public information might prevent the panic sought by terrorists.

A second type of RDD might involve a powerful radioactive source hidden in a public place, such as a trash receptacle in a busy train or subway station, where people passing close to the source might get a significant dose of radiation.

A dirty bomb is in no way similar to a nuclear weapon. The presumed purpose of its use would be therefore not as a Weapon of Mass Destruction but rather as a Weapon of Mass Disruption.

In the event that you should be unlucky enough to have your afternoon disrupted by a Weapon of Mass Disruption, the NRC offers guidance on the appropriate post-disruption actions to take:

What People Should Do Following an Explosion

• Move away from the immediate area–at least several blocks from the explosion — and go inside. This will reduce exposure to any radioactive airborne dust.
• Turn on local radio or TV channels for advisories from emergency response and health authorities.
• If facilities are available, remove clothes and place them in a sealed plastic bag. Saving contaminated clothing will allow testing for radiation exposure.
• Take a shower to wash off dust and dirt. This will reduce total radiation exposure, if the explosive device contained radioactive material.
• If radioactive material was released, local news broadcasts will advise people where to report for radiation monitoring and blood and other tests to determine whether they were in fact exposed and what steps to take to protect their health.

Remember the old days of duck and cover? I do, along with the recurring nightmares of nuclear annihilation that were my childhood companions. Well, this here Project Bioshield sound like it holds about as much protection as my first-grade school desk.

First, the program assumes that DHS will be able to get the doses of the anti-radiation drugs to the affected areas. Well, I remember finding out my FEMA ice was in a truck in Maryland when I needed it in Miami following Hurricane Wilma. Same idiots in charge, same outcome this time.

Plus, the plan assumes the radioactive materials used will be similar to those used in a conventional nuclear weapon, not a dirty bomb made with whatever left-over medical waste or stolen yellow cake uranium the bomber could find. the drugs, provided they could get them to you on time, might not do you a damn bit of good.

This appears to be part of a typical Bush administration plan — bold initiatives that sound good in a speech, but are imminently impractical in the real world.

DUCK AND COVER!