In the wake of the recent Ebola crisis, the House Committee on Homeland Security’s Subcommitteeon Emergency Preparedness, Response and Communications convened a hearing Wednesday to examine US preparedness for a bioterrorist attack.
“The risk of a biological terrorist attack to America is an urgent and serious threat. A bioattack could cause illness and even kill hundreds of thousands of people, overwhelm our public health capabilities, and create significant economic, societal and political consequences,” said subcommittee chairman Martha McSally (R-Ariz). “Our nation’s capacity to prevent, respond to, and mitigate the impacts of biological terror incidents is a top national security priority.”
Bioterrorist threat from ISIL and other terrorist organizations
In her opening statement, McSally expressed concern over the possibility that the Islamic State of Iraq and the Levant (ISIL) and other jihadi terrorist organizations could conduct a biological attack on American soil.
“ISIL is better resourced, more brutal, and more organized than any terrorist group to date,” McSally said. “We know that they have an interest in using chemical and biological weapons.”
Last year, Director of National Intelligence James Clapper warned the Syrian government might have advanced beyond the research and development stage and may have a restricted capacity to manufacture weaponized disease agents. Counterterrorism officials have worried for years since the conflict in Syria began that ISIL may be able to get a hold of these biological weapons.
Moreover, last year, a laptop belonging to a Tunisian jihadist reportedly recovered from an ISIL hideout in Syria contained a hidden trove of secret plans, including instructions for weaponizing the bubonic plague and a document discussing the advantages of a biological attack.
“The advantage of biological weapons is that they do not cost a lot of money, while the human casualties can be huge,” stated a document found on the laptop.
In October, jihadists and supporters of ISIL stepped up discussions on jihadist social media websites about the possibility and ease of using Ebola, as well as other virulent pathogens and poisons, as weapons against the US and the West, according to reports by the Middle East Media Research Institute.
Jim Talent, former Senator from Missouri and former vice-chair of The Commission on the Prevention of Weapons of Mass Destruction Proliferation and Terrorism, testified that the threat of a bioattack is “one of the greatest and gravest” facing the nation.
Talent said that at the end of 2008, the 9/11 Commission issued the report, World at Risk, which addressed the threat posed by nuclear and biological weapons. Talent and former Sen. Bob Graham (D-Fla.) gave the biothreat greater emphasis, knowing that terrorists have acquired bio-weapons in the past, and that it’s likely easier for them to secure a bio-weapon than a nuclear weapon.
The report stated, “We accept the validity of current intelligence estimates about the current rudimentary nature of terrorist capabilities in the area of biological weapons but caution that the terrorists are trying to upgrade their capabilities and could do so by recruiting skilled scientists. In this regard, the biological threat is greater than the nuclear; the acquisition of deadly pathogens, and their weaponization and dissemination in aerosol form, would entail fewer technical hurdles than the theft of production of weapons-grade uranium or plutonium and its assembly into an improvised nuclear device.”
In addition, bio-weapons can be easily transported, stockpiled, can cause more deaths than a tactical nuclear weapon, and, depending on the biological agent used, the terrorists could launch an attack and escape the area before the authorities even knew that an attack had occurred, according to Talent.
And he’s not alone. Seasoned and veteran counterterrorism officials agree that jihadi organizations appear to have a greater interest in acquiring and using biological and radiological weapons, and that Al Qaeda is known to have experimented with trying to weaponize a number of highly virulent pathogens.
In 2005, Homeland Security Today first reported that Al Qaeda had worked on plans to send squads of "bio-martyrs" who would deliberately infect themselves with a human transmittable strain of bird flu once such a strain become a human contagion or a human transmissible form clandestinely bio-engineering to be easily passed between humans, and then to spread the virus as widely around the world as they could by traveling on one international flight after another, officials said at the time. During the height of the Ebola outbreak, intelligence surfaced indicating that jihadi organizations were discussing doing the same thing with the Ebola virus.
With a long enough period of sanctuary where terrorists can plan, recruit and get together the necessary lab facilities and experts, they can isolate and weaponize. According to Talent, there are now areas, including in Iraq and Syria, where jihadists have the time and sanctuary to develop these weapons.
Although an attack using biological agents or weapons is a low probability, high consequence event, “When you keep running risk and the risk continues to grow, even gradually, eventually the bullet is in the chamber,” Talent said.
On August 14, 2013, Homeland Security Today Editor-in-Chief Anthony Kimery and former CIA WMD counterterrorism unit chief Charles Faddis appeared in "Biopocalypse," an episode of the SyFy Channel TV series, "Joe Rogan Questions Everything." The segment dealt with bio-terrorism, designer-hybrid pathogenic threats and unregulated DIY-bio genetics labs from out of which could emerge unregulated designer/hybrid pathogens.
US response to Ebola outbreak highlights lack of bio preparedness
The recent Ebola outbreak—the deadliest in history—has claimed the lives of over 10,000 and infected over 26,000, according to the Centers for Disease Control and Prevention (CDC). With no cure and a mortality rate as high as 90 percent, the Ebola epidemic serves as a grim reminder that even with the advent of modern medicine, the spread of deadly infectious diseases is not relegated to history.
The World Health Organization (WHO) has been criticized for its slow response in the early months of the outbreak. Recently, WHO admitted to boggling the Ebola response, and released a list of lessons learned as well as suggested reforms for moving forward.
"The Ebola outbreak that started in December 2013 became a public health, humanitarian and socioeconomic crisis with a devastating impact on families, communities and affected countries,” WHO said in a statement. “It also served as a reminder that the world, including WHO, is ill-prepared for a large and sustained disease outbreak.”
Like WHO, the United States also mishandled the Ebola outbreak, calling into question US bio preparedness, both for terrorism and pandemics or other emerging infectious diseases. McSally stated that bureaucracy, as well as a leadership vacuum, prevented an effective response to the crisis.
“Even after the Ebola response we cannot seem to identify the federal official who has the responsibility and authority to coordinate the dozen or so senior officials with responsibility for biological preparedness and defense,” McSally said. “It’s just baffling.”
Earlier this month, Homeland Security Today reported that the post-9/11 Commission Blue Ribbon Study Panel on Biodefense arrived at the consensus that the government does not have a good answer to the question of who would be in charge if America was beset by a biological or chemical weapons attack.
"The federal government has stated that a public health disaster or pandemic is one of the top strategic threats our country faces," said Dr. Kenneth Bernard, a former biodefense official in the Clinton and Bush administrations. "Yet, we were still largely unprepared for the Ebola outbreak this year. We’re not managing our leadership properly."
Panel co-chair Tom Ridge said a “leadership vacuum” plagues response efforts – especially the response to a large-scale, mass casualty biological or chemical attack, which most public health and emergency public health authorities agree the US isn’t prepared for handling or mitigating.
"Biological and chemical threats are among the most sinister our nation faces," Ridge said. "Terrorist groups have voiced their desire to obtain and use biological and chemical weapons. The Ebola crisis revealed significant gaps in US public health and medical preparedness. We must consider our current ability to defend against such threats and provide for the health and welfare of our citizens."
The Blue Ribbon Study Panel on Biodefense plans to issue recommendations for changes to US law and policy later this year.
In addition to lack of leadership, the US has also failed to effectively manage and oversee its inventory of pandemic preparedness supplies, including protective equipment and antiviral drugs.
In October, Homeland Security Today reported that by failing to implement controls to monitor its stockpiles, the Department of Homeland Security (DHS) cannot be certain whether it has too little, too much or ineffective supplies for its personnel, especially those who will be needed on the front lines of a large-scale mass casualty attack or event.
For example, the stockpile contained 4,982 bottles of hand sanitizer, 84 percent of which is expired, and the Transportation Security Administration’s stock of pandemic protective equipment included about 200,000 respirators that are beyond the 5-year usability guaranteed by the manufacturer.
The glut in supplies means millions of dollars wasted on unnecessary drugs and equipment that need to be replaced in order to be continuously prepared. During a House Committee on Oversight and Government Reform hearing, Rep. John Mica (R-Fla.) said, "We spent millions of dollars for a pandemic … We don’t know the inventory, we don’t know who’s got it, and we don’t know who’s gonna get it.”
Moreover, according to Talent, the lack of sufficient medical countermeasures (MCMs) in our Strategic National Stockpile, and the lack of a system to quickly develop and produce MCMs during a crisis is the number one concern in US preparedness for a bio attack.
Talent stated, “The recent Ebola virus outbreak highlighted that unless countermeasures are immediately available, including diagnostics tests that can be used by clinicians who are evaluating suspected cases, therapeutics to treat cases and vaccines to protect health care workers and others at risk, we are left with fairly primitive means to respond to and contain such events.”
However, “The list of bio-threat agents for which we should have diagnostics tests, therapeutics and vaccines for is about a dozen. To date, our stockpile contains countermeasures for only three or four,” Talent said.
Public health and emergency preparedness
As the largest port of entry in the US, New York City activated “a highly detailed, coordinated and expensive multiagency and multijurisdictional effort” in response to increasing cases of Ebola in West Africa last year.
Preparedness efforts included development of detailed plans for disease surveillance by the health department, investigation of hundreds of suspect cases, extensive staff training at each of its eleven hospitals to be prepared to receive and screen individuals potentially exposed to the disease, and the designation and readying of Bellevue Hospital as the primary New York City Ebola treatment center.
New York City also engaged the community by distributing over 100,000 “Am I at Risk?” palm cards and holding over 115 public events to discuss public health concerns.
Marisa Raphael, deputy commissioner of the Office of Emergency Planning and Response for the NYC Department of Health and Mental Hygiene, testified that federal funding played a critical role in the success of the city’s response to the Ebola crisis.
Raphael also stated, “The greatest danger to our progress is the decline in federal emergency preparedness funding.”
Homeland Security Today reported just last week that, as Western counterterrorism and intelligence officials worry about the increasing potential for an Islamist jihadist group or inspired individual to carry out a chemical, biological or radiological mass casualty attack in the United States, combined federal, state and local public health spending has fallen below pre-recession levels at $75.4 billion in 2013 — or $239 per person ($218 adjusted for inflation) compared to $241 per person in 2009, according the new Trust for America’s Health (TFAH) report, Investing in America’s Health: A State-by-State Look at Public Health Funding and Key Health Facts.
Adjusting for inflation, TFAH said, “public health spending was 10 percent lower in 2013 than in 2009.
Public health and emergency preparedness funding for New York City has decreased 35 percent from its peak in Fiscal Year 2005, which has led to a 47 percent reduction in our public health preparedness and response workforce. Raphael said, “The erosion of a skilled, dedicated workforce including epidemiologists, laboratory technicians, and preparedness planners threatens to compromise our ability to detect and respond to disease outbreaks.”
As Homeland Security Today earlier reported, the federal funding cuts have not affected New York alone.
“We cannot afford to let our guard down. We must remain vigilant in preparing for any potential mass casualty event. Yet, year after year, we see less and less funds going to the people who and departments that are responsible for preparing for a public health emergency,” TFAH Deputy Director Rich Hamburg told Homeland Security Today.
Although New York demonstrated a high level of public health and emergency preparedness during the Ebola crisis, other large US cities remain vastly unprepared. Many do not access to the amount of funding or resources granted to New York. But beyond New York, hospitals in most major metropolitan cities are inadequately prepared for a surge of people infected with a highly contagious pathogen, a problem Homeland Security Today has reported since 2004.
University of Arizona College of Medicine Interim Dean Dr. Chuck Cairns said at the hearing thatTucson and Phoenix could not respond to a biological threat such as Ebola the way a city like New York can “I don’t think Tucson and Phoenix would have that same experience or resources," he said.
“Generally speaking, federal budgets designed to support public health and health care system preparedness and response capabilities must be increased and sustained, this is as true for New York City as it is for localities nationwide, particularly dense urban centers,” said Raphael.
Editor’s note: Read Homeland Security Today Senior Contributing Editor Peter Marghella’s recent report, When the Crossroads of Health Care and Public Health Never Meet.