Just in time for a supper: Biowar Wednesday! Judge Alice Hill starts us off with an argument for a coordinated defense against pandemics.
Although every U.S. president since Bill Clinton has developed policies to tackle the threat posed by deadly pathogens, at their core those biodefense efforts have left the nation dangerously vulnerable. Biodefense, like other catastrophic risks, requires a comprehensive approach, and currently we lack that.
Sounds like a no-brainer, right? The Center for Disease Control put forward a plan in 2004 but its appraisal of the American medical battlespace is bleak because it hasn’t changed:
Terrorist incidents in the United States and elsewhere involving bacterial pathogens (3), nerve gas (1), and a lethal plant toxin (i.e., ricin) (4), have demonstrated that the United States is vulnerable to biological and chemical threats as well as explosives. Recipes for preparing “homemade” agents are readily available (5), and reports of arsenals of military bioweapons (2) raise the possibility that terrorists might have access to highly dangerous agents, which have been engineered for mass dissemination as small-particle aerosols. Such agents as the variola virus, the causative agent of smallpox, are highly contagious and often fatal. Responding to large-scale outbreaks caused by these agents will require the rapid mobilization of public health workers, emergency responders, and private health-care providers. Large-scale outbreaks will also require rapid procurement and distribution of large quantities of drugs and vaccines, which must be available quickly.
That’s from 2004. Use of diseases in war has been around for millennia. The good old days were filled with folks keeling over and dying due to illnesses we would consider an annoyance today. For much of the world, they remain vulnerable to the worst of it, while our dependence on medicine, clean water and various anti-bacterial soaps may leave us more vulnerable than our great grandparents. With new tools to modify the genes of diseases, and the availability of education, what mischief might be wrought?
Consider the CDC’s recommendations from their 2004 plan and ask where we are today.
U.S. public health agencies and health-care providers will be prepared to mitigate illness and injuries that result from acts of biological and chemical terrorism.
Public health surveillance for infectious diseases and injuries — including events that might indicate terrorist activity — will be timely and complete, and reporting of suspected terrorist events will be integrated with the evolving, comprehensive networks of the national public health surveillance system.
The national laboratory response network for bioterrorism will be extended to include facilities in all 50 states. The network will include CDC’s environmental health laboratory for chemical terrorism and four regional facilities.
State and federal public health departments will be equipped with state-of-the-art tools for rapid epidemiological investigation and control of suspected or confirmed acts of biological or chemical terrorism, and a designated stock of terrorism-related medical supplies will be available through a national pharmaceutical stockpile.
A cadre of well-trained health-care and public health workers will be available in every state. Their terrorism-related activities will be coordinated through a rapid and efficient communication system that links U.S. public health agencies and their partners.
I don’t mean to beat a dead goat, but what is your biodefense?