Emergency Medical Services (EMS) personnel

Emergency Medical Services (EMS) personnel are routinely called to treat and transport patients with infectious disease. This may include a patient with pulmonary tuberculosis or the flu. It also includes victims of a bioterrorist attack. In a biological WMD release, EMS personnel may respond to the initial 9-1-1 call(s) for a patient with a fever and rash illness long before the cause of the illness is known.
In the event of an announced release of anthrax or smallpox into a building ventilation system, exposed people may take anywhere from a couple of days (anthrax) to 7-17 days (smallpox) to become ill. These people may not need transport to a medical facility, but will need to be identified for public health information purposes so they can receive antibiotics or vaccine at a later time.
EMS may be the primary health care provider at these scenes initially and must assure that an accurate accounting of all patient contacts is made and then provide such to public health officials.
1. In such cases should the ICS be commanded by a public health official/EMS Chief/MD rather than the police and fire units?
2. To what extent should non-medical personnel/managers make medical decisions during a bioterrorist incident?

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