
Noboru Hashimoto/Corbis
The
death cult Aum Shinrikyo, which used sarin gas to horrific effect in
the Tokyo subway system in 1995, had also sought to weaponize anthrax.
The White House wanted to know: How much
safer are Americans today than they were on October 4, 2001? That was
the day when a photo editor in Florida became the first reported case
of inhalation anthrax in America in decades. In what became biology’s
9/11, five letters containing less than a quarter-ounce of anthrax
total—the equivalent of two pats of butter—killed five people, infected
17, put more than 20,000 on antibiotics, and traumatized thousands
more. Decontamination alone, including at the Hart Senate Office
Building in Washington, took over three years and cost some $200
million.
With these disturbing facts in mind, and keenly aware that al-Qaida
and other terrorist groups have sought germ weapons, the White House in
2006 quietly directed the Department of Homeland Security to commission
studies from teams of researchers on what Americans had received for
the billions of dollars spent on preparing for a bioterrorist attack
since 2001. Taken together, the papers—whose contents remain secret and
whose authors have been asked by the DHS not to discuss them—constitute
what officials call the first “net assessment” to focus exclusively on
the issue. Though many of the papers were delivered to the DHS months
ago, the net assessment remains unfinished and is likely to be handed
over to the next administration, officials say. Still, its thrust is
that while the estimated $50 billion spent since 2001 on countering
bioterrorism has left us far better prepared for a bioterrorist attack,
we remain vulnerable and, in some ways, may even be losing ground.
President Bush himself is said to have privately expressed
frustration with the pace of biosecurity progress. At a meeting with
cabinet members and other senior biodefense officials in the White
House situation room on June 30, the president was briefed on yet
another internal review of the administration’s biodefense effort.
After hearing that his agencies were unlikely to complete most of their
56 assigned tasks by the end of his term in office, says one official
who was told about the meeting, Bush echoed the old Nike ad, in a
display of irritated determination: “Just do it!”
Officials and independent analysts agree
that much has been done to prepare for an attack and mitigate its
consequences. One of the most important advances is the least
quantifiable. “We understand the problem far better than we did before
the anthrax mailings,” says Kenneth Bernard, a former White House
biodefense advisor in both the Clinton and Bush administrations. “We
now see the risks and our vulnerabilities far more clearly and have
spent billions addressing them.” Scientists know much more today than
they did seven years ago about the importance of timely detection in
any suspicious outbreak of disease, for example, and about the
difficulty of delivering drugs and vaccines quickly and cheaply to
affected populations.
They also know more about the genomic structure of pathogens.
Federally funded research has vastly improved scientific understanding
of many entries in the government’s list of some 70 “select agents,”
the world’s most contagious or lethal bacteria and viruses. Between
2001 and 2008, research funding by the National Institutes of Health on
bioweapons agents increased from $53 million to $1.6 billion. At the
same time, the Pentagon more than doubled its investment in biodefense
research, to over $1 billion.
Bioforensics, too, has seen great advances. Using techniques that
hadn’t even been invented when the anthrax letters arrived in 2001, for
instance, scientists working with the FBI’s “Amerithrax” investigation
broke ground in microbial forensics, decoding the anthrax genome to
trace the powder used in the letters to a flask labeled RMR-1029 that
was stored at the Army Medical Institute of Infectious Diseases, the
military’s main biodefense lab, in Fort Detrick, Maryland.
Another source of pride is the Strategic
National Stockpile, a repository of drugs and antibiotics stored at
sites throughout the country that can be sent to any city within 12
hours. Launched nearly a decade ago under the Clinton administration,
the stockpile now contains enough antibiotics to treat more than 40
million Americans who might be exposed to anthrax, as well as other
vaccines and drugs to combat a wide range of illnesses.
One of these, smallpox, used to be a major concern. The World Health
Organization had declared the disease eradicated in 1980, but
scientists have long suspected that countries or labs might be hiding
samples of the deadly virus that could fall into terrorist hands. But
the Strategic National Stockpile has virtually removed the disease from
the list of America’s bioterrorism concerns, according to James W.
LeDuc, associate director of the University of Texas’s Galveston
National Laboratory. The number of smallpox-vaccine doses in the
stockpile has increased from 90,000 before 9/11 to 300 million today.
“In the event of a smallpox outbreak today, we would have access to
enough vaccine for every American,” LeDuc says. “It cost close to $1
billion, but it is a tremendous insurance policy.”
Yet another advance is the crown jewel of the Department of Homeland
Security’s biodefense effort: a vast research complex at Fort Detrick,
an hour’s drive from the capital, centered on the new National
Biodefense Analysis and Countermeasures Center. The NBACC already
operates in temporary offices; its state-of-the-art, $150 million,
160,000-square-foot headquarters is scheduled to be completed by March
2009. It will contain a large Biosafety Level 4 (BSL-4) laboratory,
authorized to work on the world’s most dangerous germs, such as Ebola
and Marburg, for which neither vaccines nor cures yet exist. Its 150
scientists will characterize existing biological threats—the bulk of
its research—identify future sources of potential vulnerability, and
conduct the kind of bioforensic research that was used in Amerithrax in
the event of future bioterrorist attacks.
The agency’s original plan was to operate the NBACC mostly in secret
by classifying the entire center as a Sensitive Compartmented
Information Facility (SCIF, pronounced “skiff”)—a place where
top-secret information and materials could be stored and discussed. But
the NBACC’s new director, J. Patrick Fitch, says that he intends to
operate the lab with the greatest possible transparency. “Eighty
percent of our projects and their results will be unclassified, and we
will encourage our scientists to publish,” he says. While his facility
would be “SCIFable” in an emergency, he intends to encourage as much
interaction as possible between NBACC scientists and their American and
foreign counterparts. “In such a fast-moving area,” he explains, “it’s
self-defeating to isolate yourself.”
Fitch also denies reports that the lab plans to invent new superbugs
just to see if it can be done. “Our research must be grounded in
indications of a real threat and in science,” he says. And in another
course correction, Fitch has appointed a panel of seven independent
scientists to review the lab’s work three times a year to ensure that
its research is not only safe, but in compliance with the 1972
international treaty banning the acquisition, production, and
development of germ weapons for anything other than defensive purposes.
The panel has allayed some of the concerns of Tara O’Toole, director of
the University of Pittsburgh’s Center for Biosecurity, formerly a
forceful critic of the lab and now a panel member. Fitch has made
“earnest efforts to be responsible and transparent and must continue on
this path,” says O’Toole.
Taken together, all these achievements have dramatically altered the
biodefense landscape since the anthrax letter attacks, many analysts
agree. “I don’t think there’s any doubt that we are safer today than we
were seven years ago,” said Michael Chertoff, the secretary of the
Department of Homeland Security, at a forum on September 10, though he
also warned Americans against complacency. “Getting the ship of state
to move 10 degrees to port is a big deal,” says Bernard. “You can
always show how it might have been done better. But this has been
tantamount to putting a man on the moon”—an exercise in “imperfect
incrementalism,” as one administration official calls it. “I really
don’t think we went down any major wrong roads,” Bernard ventures. “The
perfect is inevitably the enemy of the good.”
But many experts believe that the
government has taken detours from the highway to better biosecurity.
Some even question what had looked like unqualified successes. Consider
the Amerithrax investigation. The impressive scientific achievement
that enabled the FBI to trace the anthrax in the letters back to the
RMR-1029 flask has been largely overshadowed by allegations that the
bureau once again rushed to judgment in blaming Bruce E. Ivins, one of
more than 100 researchers at the Army’s biodefense lab who had access
to the flask. Ivins committed suicide before he could be indicted.
According to several analysts who attended the bureau’s classified
briefings on its investigation, the case is based largely on the kind
of circumstantial information that led the FBI to finger Steven J.
Hatfill as the likely culprit five years ago, and would have been
unlikely to hold up in court. Hatfill, who doggedly fought his
designation as a “person of interest” in the press and the courts for
five years, was recently vindicated when the FBI paid him $5.8 million
for the damage done to his reputation and career.
Moreover, while there is no doubt that Ivins had psychological
problems that ultimately prompted his suicide, his attorney and family
say that being subjected to such intense federal scrutiny was also
partly to blame. And those who worked most closely with the eccentric
scientist at Fort Detrick have openly challenged the bureau’s claim
that Ivins was the perpetrator. Critics have called for more
congressional hearings and even an independent commission to examine
the entire Amerithrax investigation. In any event, the controversy over
the case highlights the continuing difficulty of
“attribution”—identifying the source of an attack so that its sponsors
can be punished and future strikes deterred—even in an age of
sophisticated bioforensics.
Some scientists—though they’re in the minority—view the
proliferation of high-containment, top-security labs as a liability.
Government officials like Anthony S. Fauci, the National Institutes of
Health official who heads biodefense research, maintain that there was
a critical shortage of such labs in 2001 and that the expansion will
eventually result in better diagnostics and next-generation drugs. But
Elisa D. Harris, a biosecurity expert at the University of Maryland,
warned in the New York Times that the increase of high-containment labs
and undertrained personnel was creating the very threat that it was
intended to thwart. “The correct response to the anthrax letter
attacks,” agrees Richard H. Ebright, a biochemist at Rutgers, “should
have been to curtail the number of people and institutions with access
to the deadliest agents and to dramatically increase security
surrounding such research.”
Keith Rhodes, chief technologist at the Government Accountability
Office, also warned Congress last October that the nation was at
“greater risk” because of the increase of BSL-4 labs from five before
2001 to 15 today. His agency estimated that at least 15,000 technicians
were working with dangerous pathogens in BSL-3 and BSL-4 labs—the vast
majority of them for the first time—and that, though no one knew
exactly how many public and private BSL-3 labs were in operation, the
number was “surely in the thousands.” Moreover, he added, articulating
a more widely shared concern, though 12 federal agencies were involved
in some aspect of biological research, no single agency was responsible
for monitoring the labs and managing the risks. While most of the
scientists in the field welcome the additional lab capacity, they do
worry about the lack of direct federal oversight and insufficient
safety and security standards at these new labs. “We have not wildly
expanded over what we need,” O’Toole says. “But we do need better
training and to ensure that the labs and people in them conform to
rigorous standards.”
As for the Strategic National Stockpile,
its drugs will help combat bioterrorist attacks only if they can be
delivered and distributed rapidly enough—and at present, the government
doubts that they can be. “When we began in 2001, we could get
antibiotics to people in 2.5 weeks,” says a senior official. “Today it
takes four days, but that’s still not good enough. We need to do it in
two days. We’ve moved mountains, but not enough of them.”
Among the recommendations that President Bush endorsed in the June
meeting was a proposal to support additional testing of drug and
vaccine delivery by mail and other methods. For example, instead of
using mainly public buildings as PODs (points of distribution), as New
York and other cities currently plan, government might also use large
commercial enterprises like Wal-Mart. But even then, who would
administer the drugs after an attack? A federal scheme in 2003 to
inoculate half a million health-care workers against smallpox foundered
after Washington failed to provide guarantees that workers who fell ill
because of the vaccine would be compensated; only 40,000 workers
volunteered to be vaccinated, 8 percent of the target.
Supplying the Strategic National Stockpile is another challenge.
BioShield is a multibillion-dollar fund to encourage the development of
vaccines and other drugs for the stockpile. But major pharmaceutical
companies have proved reluctant to develop drugs whose main customer
would be the government, fearing that the market for such drugs is
likely to be limited, absent an attack, and that research costs
wouldn’t be recouped. As for smaller firms, the government was forced
in 2006 to cancel its contract with VaxGen, a biotech start-up that had
never produced a vaccine before. VaxGen was to help supply 75 million
more doses of a safer, second-generation anthrax vaccine, but
repeatedly missed its deadlines.
Even if drugs can be manufactured sufficiently and delivered
promptly, they depend on our ability to detect an attack in the first
place. In a project called “BioWatch,” Washington has deployed
equipment in more than 30 cities to sniff out deadly germs in the
air—but because the sniffers’ filters must be checked manually and
transported to labs for diagnosis, detecting the germs can take up to
36 hours. New York City has been testing six automated sensors that
detect the existence of an unwelcome pathogen more quickly—the only
such units yet deployed in the nation. “We want to know when something
happens as soon as it happens,” says Dani-Margot Zavasky, an
infectious-disease specialist who advises the NYPD on WMD-related
medical issues.
But the Department of Homeland Security has rejected the city’s
appeal for more units, which last September led police commissioner
Raymond W. Kelly, for whom counterterrorism is a religion, to berate
BioWatch’s “anemic budget” and the “low priority” that the federal
government places on biosurveillance. (Amy Kudwa, a DHS spokesperson,
counters that the department’s investment of almost $400 million in
BioWatch proves its commitment to the detection effort.)
Then there are the federal government’s
bureaucratic mistakes. Numerous officials, advisors, and independent
analysts criticize what they say is the government’s lack of emphasis
on the personnel needed to staff labs, produce drugs, and create and
operate detectors and other expensive technology. “It is our passion
for things, for quick technical fixes, gadgets and more labs, better
detectors, that obscures our real needs and vulnerabilities,” says
Colonel David R. Franz, a former commander of the defense lab at Fort
Detrick. Federal budgetary decisions have reflected this bias, health
officials complain, with cuts almost invariably targeting not equipment
but nurses, lab technicians, and other “first responders” critical in
the immediate aftermath of an attack.
Complaints about the government’s episodic focus on biosecurity are
also common. While Washington threw money at biosecurity soon after the
anthrax letter attacks, it took the White House almost three years to
produce a “blueprint” for the nation’s future biodefense program—and
that blueprint mandated that the net assessment be completed in four
more years. Further, the White House didn’t lay out a strategy for
public health and medical preparedness for catastrophes until last
October, O’Toole says. “Although we’re in better shape than we were
before the anthrax attacks, biosecurity no longer seems to have
national priority,” says Richard Falkenrath, the NYPD’s deputy
commissioner for counterterrorism, who previously coordinated
biodefense in the Bush White House.
A lack of coordination among federal agencies in biodefense
preparations is another problem, critics say. The federal government
has no single, central oversight to ensure that its departments’ many
grants are financing research likely to result in useful drugs,
vaccines, and equipment. It has, in sum, no obvious way to determine if
the billions allocated to biodefense are being spent wisely. “There is
clearly a need to rethink how we would respond to a major terrorist
event,” says Penrose “Parney” Albright, a former senior defense
official and national security expert, “and for a biodefense management
system that sets requirements and oversees agency programs to ensure
they are responsive to those needs.”
Stories about federal turf battles abound, too—in particular, the
dysfunctional split between the Department of Health and Human Services
(DHHS) and that younger, bureaucracy-bound behemoth, the Department of
Homeland Security. At a conference in Baltimore last August, scientists
from the Centers for Disease Control and Prevention, a notoriously
independent fiefdom within DHHS, disclosed that they no longer had
confidence that the BioWatch monitors would detect the presence of
germs other than anthrax and plague—a concern that they had not
previously shared with Homeland Security, which is responsible for the
monitors.
And two key papers in the net assessment—one by Robert P. Kadlec, a
physician who is now the White House’s senior director for biological
defense policy, and another by Albright—say that America remains
vulnerable partly because its early plans rested on unrealistic
assumptions about the federal government’s role in responding to
bioterrorism. “After the anthrax mailings, we initially thought that
because all crises are local, our states and high-value-target cities
would be able to manage a serious or sustained attack if they received
enough federal dollars to help them prepare,” says an official privy to
the ongoing debate in Washington. “We now know, as Hurricane Katrina
demonstrated, that the federal government would have to take the lead
in a true bioterror emergency.”
But the feds aren’t yet prepared for taking that lead. While they
are ready to deliver an emergency supply of vaccine from the stockpile
to a state, say, they still have no plans in place to deploy the army
or order governors to send the National Guard to help with distribution
of the vaccine. DHS officials say that they have “plans and guidelines
in place” to help cities respond to bioterrorism, but city officials
call these plans vague and “nonoperational.”
Two of the papers written for the “net
assessment” discuss New York City in particular, and their conclusions
are apparently grim. One, a 50-page study of New York’s response plans
and its “decision sequence” in the event of an attack, was written by
Edward Hamilton, a former New York deputy mayor, and Terrance Leighton,
a scientist at Children’s Hospital Oakland Research Institute in
California. According to experts who described the study, it found that
despite New York’s extensive plans and preparations, the city would be
severely challenged by a major anthrax attack and would have difficulty
recovering.
Officials who had read the papers said that neither New York nor any
other American city had plans that could manage a true catastrophe. The
city would struggle to distribute drugs and transport public health
emergency workers, since contamination would probably close its
subways. The city has no decontamination plans; decontaminating
skyscrapers would be a forbidding challenge; and there are no federal
standards on how clean an area must be before it can be reoccupied. “No
locality can set such standards,” one expert says. “This is yet another
federal function that has not been done, and it is not trivial.”
The Hamilton-Leighton study builds on earlier work by Lawrence Wein,
a Stanford University business school professor. In 2003, he calculated
that a large aerosolized anthrax attack in New York might result in
100,000 deaths, even if early cases were successfully diagnosed and
drugs quickly delivered and taken. Two years later, he calculated that
decontaminating New York by traditional methods could cost well over
$20 billion and take 314 years. Wein has also argued that current plans
for distribution of antibiotics from PODs could result in delays
costing up to 10,000 lives a day.
In a new study for the net assessment, experts say, Wein urges the
government to consider distributing antibiotics before an attack, or
after one, through a variety of alternative methods—including by mail
to people’s homes, the approach he endorsed in his earlier work. The
government could encourage postal workers to come to work—a recent DHHS
study predicts absentee rates of some 40 percent during a severe
pandemic—by guaranteeing them and their families early doses of
antidotes. New York officials, however, doubt that drugs could be
delivered by the postal system; they fear that postal workers would
stay home regardless, and that New York would be unable to provide
sufficient security for those who did show up.
One bright spot is that New York has bolstered the federal BioWatch
initiative by investing heavily in its own biological surveillance
programs. The city electronically monitors everything from
over-the-counter drug sales to hospital entries to emergency-clinic
visits, says Isaac B. Weisfuse, New York’s deputy commissioner of
public health, and the city’s 6,000-person health department is widely
regarded as among the nation’s best. But technologically speaking, most
public health networks lag a decade behind New York’s and can afford
neither the technology nor the personnel in which the city has invested.
The challenge grows larger each day as the
biotech revolution spreads skills and knowledge around the globe.
Margaret Hamburg, a physician who served in senior health posts in the
federal government and in New York City, calls the explosion of
biotechnology “frightening.” In a speech last September, she speculated
on a variety of weapons, some already existent and others still being
researched, that foes might deploy one day: aerosol technology to
deliver infectious agents more efficiently into the lungs; gene therapy
vectors that could cause a permanent change in an infected person’s
genetic makeup; “stealth” viruses that could lie dormant in victims
until triggered; and biological agents intentionally engineered to be
resistant to available antibiotics or evade immune response.
Those who regard such weapons as permanently beyond terrorists’
capability should bear in mind that techniques that were theoretical
just a decade ago can now be performed by high school chemistry
students. Recent research by former Navy secretary and now Barack Obama
advisor Richard J. Danzig drives the point home. While it was known
that Aum Shinrikyo, the Japanese group that released nerve gas into the
Tokyo subway in 1995, had experimented with botulism and anthrax and
had sought to obtain Ebola, scientists once believed that the group’s
efforts to weaponize anthrax had failed because it had relied on a
harmless vaccine strain. But Danzig’s recent interviews with cult
members in Japan suggest that over a decade ago, Aum nearly succeeded
in making a benign strain lethal through genetic modification. “No one
should take comfort in Aum’s failure,” said Hamburg. “The tools of
biotechnology have jumped light-years since then.”
Hamburg’s observation underscores the ongoing need for intelligence
about America’s rivals and enemies—in fighting bioterrorism, an ounce
of prevention really is worth a pound of cure, and our first line of
defense against a devastating biological attack is still the
intelligence community, whose knowledge of what is being cooked up in
foreign laboratories remains inadequate. “In bioterrorism,” warns
Franz, “intentions are more important than capabilities.”
Should an attack occur, there is no question that our capacity to
respond, while improved, would still fall short. “What we’ve been
trying to prepare for is obviously unprecedented,” says one senior
official. “Pandemics are tough enough, and for those there are
precedents—the 1918 flu and even seasonal outbreaks. It’s so much
harder to prepare for something you’ve never experienced. You’re
obviously going to make some mistakes.”