The Anthrax Letters: The Attacks That Shocked America by Leonard A. Cole Page A

all accounts, the public health effort was remarkably successful. Doctors and hospital staff cared for the surge of patients with few hitches. Layton retrospectively sorted out her feelings:
    When you’re in the midst of an emergency, I mean you’re so focused. I didn’t see the physical destruction. We couldn’t even watch it on TV because our reception went down. I saw the hole in the first tower and that’s the last thing I remember seeing. My memory is just full of a nonstop effort to get things organized in an extremely chaotic situation and not fully comprehending what was going on.
     
    During that day, Layton and Joel Ackelsberg, the city’s deputy commissioner responsible for coordinating a bioterrorism response, reminded each other that at some point they should talk about the threat of a germ attack. The first chance came in the early hours of the next morning. “At 2 a.m., four or five of us, including a couple of people from the CDC, met here in my office,” Layton said. “We started talking about what we needed to do to be on the alert for any bioterrorist event.” In cooperation with the CDC, they planned for heightened surveillance at the 29 hospital emergency departments in New York City and for getting the word to “our medical and laboratory communities to report any unusual cluster or disease manifestations.”
    Then, 4 weeks later on October 12, came the 3 a.m. phone call from Jeffrey Koplan. The fact that someone in New York had contracted skin anthrax, apparently a victim of bioterrorism, further shocked the country. In truth, the city was better prepared to cope than many other communities. Local police, firefighters and medical people had all participated in mock attacks. Still, confirmation of a skin anthrax case came as a surprise. “All our efforts in the past several years had been focused on the expected covert release of an aerosolized agent, so we were focused on an inhalational outbreak,” Layton said. The manner of delivery was also a surprise. No one expected that the threat letters were a likely way to cause disease.
    Later that day the city issued a statement under the heading: “Health Department Announces Anthrax Case in New York City.” The text explained that an NBC employee had contracted cutaneous anthrax. Although labeled an “alert,” the statement seemed almost reassuring: “The employee has been taking antibiotics since October 1 and is doing well.”
    But the Florida anthrax incidents and the attack on the World Trade Center had just occurred and New Yorkers were shaken. Mayor Giuliani echoed the U.S. Postal Service’s warning that people should not open suspicious packages, such as those without return addresses. The NBC studios had been sealed, and internal mail delivery was halted at CBS, ABC, CNN, and the Associated Press. Judith Miller, a New York Times reporter, had received a threat letter containing powder. Although the powder proved to be harmless, it intensified the sense of siege. From the Washington Post :
    And at the New York Times , where police sealed the building for several hours, employees stuck outside broke into tears and phoned family. Rhonda Cole, a senior sales executive at the newspaper, returned from a meeting to find the building locked down. For the first time, the cumulative events of the past weeks took a toll. “I’m shaky. I’m weak,” said Cole, as she stood behind a police barrier on Broadway and watched hazardous-materials crews walk into her building. “Now I’m afraid. It’s where I work. After a while, it’s too much.”
     
    The confirmed anthrax case was that of Erin O’Connor, a 38-year-old assistant to Tom Brokaw at NBC. She remembered first seeing a sore on her chest on September 25. By the time she visited her doctor on October 1, the oval-shaped lesion, about an inch long, had become ulcerative. The lymph nodes in her neck were swollen, and she was feeling weak and tired. Dr. Richard Fried, her Manhattan