Sunday, January 27, 2019

Still a Threat to the United States

The tenth anniversary of the 9/1 1 attacks prompted reflections on the current status of the terrorism threat to the United States. One scene of an assessmentthe threat posed by biologic weaponsis especially thought-provoking because of the unique character of these weapons. A prime distinction is the circumstance that video to minute quantities of a biologic agent may go un noniced, however ultimately be the cause of disease and death.The Incubation period of a microbial agent can be days or weeks remote a bombing, knifing, or chemical dispersion, a bioattack might not be ecognized until long after the agents release. Accordingly, bioterrorism poses distinctive challenges for prep ardness, protection, and response. The use of a pathogen for hostile purposes became a consuming concern to the American people curtly after 9/1 1 . About a half-dozen earn containing anthrax spores were mailed to Journalists and polltlclans beginning one week after the jetliner attacks.Four garn er with spores and threat messages eventually were recovered. All were postmarked Trenton, invigorated Jersey, which meant that they had been processed at the postal distribution center in nearby Hamilton. Two letters were postmarked kinfolk 18, one administered to Tom Brokaw at NBC-TV and an separate(a) to the editor of the New York Post. The other two letters were stamped October 9 and addressed to Senators Thomas Daschle and Patrick Leahy. As people became infected in September, October and November, local responses revealed gaps in prep bedness for a biological attack.For example, the first confirmation of an anthrax case was on October 4, much(prenominal) than two weeks after the initial letters were mailed. Retrospective assessments later indicated that by then nine people had already contracted the disease. Their illness antecedently had been misidentified because of faulty diagnoses or erroneous science lab In the end, at to the lowest degree 22 people had become inf ected, five of whom died. Meanwhile, scores of buildings were belatedly free-base to be contaminated with spores that had leaked from the letters.At least 30,000 people who were deemed at risk postulate prophylactic antibiotics. 2 Millions more than were fearful, m all of them anxious near opening their receive mail. Since the anthrax attacks, the U. S. government has spent about $60 billion on biological defense. A large portion of those dollars has gone to biological defence research chthonic he auspices of the National implant of Allergy and Infectious Diseases (NIAID). The NIAID budget for biodefense research has grown from $200 million in 2001 to an socio-economic classbook average of $1. 6 billion since 2004.United States safer from a bioattack now than at the time of the anthrax attacks? Has the spending been worth it? Key Questions, Discrepant Answers Opinions on these questions differ. While concerned about the danger of backsliding, the authors of an article in pol now felt reassured about our preparedness for a biological attack. 3 At the same time, an opposing assessment was emblazoned in he deed of a New York Times Magazine cover story decennium Years After the Anthrax Attacks, We Are Still Not Ready. 4 A review of biodefense efforts during the past 10 years in information magazine blandly ac experienced the obvious debate continues over how more safer the country The congressionally chartered Commission on the saloon of Weapons of Mass end Proliferation and Terrorism (WMD Commission) issued a report card in 2010 on efforts to address several of its previous recommendations. The administrations failure to enhance the nations capabilities for rapid response to revent biological attacks from inflicting mass casualties merited a grade of F (meaning that no achievement was taken on this recommendation).Almost as bad was the D* given for continue inadequate oversight of high-containment laboratories. Reasonable arguments can be made to bear varied views about these issues, and all conclusions bear a degree of subjectivity. to that degree an assessment of several broad critical contentions can offer clarification. The criticisms are largely expressed in the form of five contentions. Contention 1 Funding for biodefense has meant fewer dollars for other deserving reas such(prenominal) as public health infrastructure and basic science research.In 2005, 758 microbiologists signed a letter to Elias Zerhouni, then director of the National Institutes of Health (NIH), objecting to the diversion of funds from public health research to biodefense projects. Zerhouni, Joined by NIAID music director Anthony Fauci, rejected the letters premise of diversion. An assessment of disputed interpretations suggested that spending on biodefense benefited non-biodefense research as well, but the consequences were so convoluted that a clear determination was elusive. 7 An analysis of the biodefense budget for fiscal year 2012 ind icates that only 10% of the proposed $6. billion is dedicated exclusively to civilian biodefense. The other 90% is for projects with both biodefense and non-biodefense implications. The non- biodefense goals, according to analysts Crystal Franco and Tara Kirk Sell, embarrass advancing other areas of science, public health, healthcare, national security, or international security. 8 This monger toward dual-track benefits has been reflected in past budgets as well. A report in reputation magazine indicated that of the $60 billion pent on biodefense in the past decade, only about $12 billion went for programs form benefited comfortably from biodefense projects.Fiscal woes in recent years have in fact resulted in reduced resources for public health and related programs. Economic tweet threatens to shrink biodefense funding as it does funding for much else in the federal budget however, it is not clear now, nor was it in the past, if fewer dollars for biodefense would necessarily t ranslate into more for public health, basic research, or any other health-related programs. Contention 2 The growing number of facilities for research on select agents specified pathogens and toxins) has heightened chances of an accidental release. Statistics alone make this assertion unassailable.The chances of something sack wrong in any enterprise, assuming no change in available security, increment with the size of the enterprise. As the number of research facilities increases, so does the chance of an accident. A continuing weakness is the inadequacy of clarity about the number of high security laboratories. In 1983, the Centers for Disease Control and Prevention (CDC) designated four levels of safety for laboratory work with biological agents. A Biosafety Level-I (BSL-I) laboratory allows for work on relatively innocuous agents and a BSL-4 laboratory on the most dangerous.The two highest containment facilities, BSL-3 and BSL-4, require special security measures including r estricted access, banish pressure to prevent stock from flowing out of the room, and protective outerwear for operators. BSL-4 laboratories require additional safeguards such as entry through bigeminal air-locked rooms and positive pressure outerwear with a segregated air supply. A BSL-4 laboratory is required for work on agents that cause fatal disease for which here is little or no treatment (for example, variola major virus and hemorrhagic fevers such as Ebola and Marburg).At present, there are 15 such U. S. facilities planned or in operation, triple the number operate in 2001. 10 Other dangerous agents, including the bacteria that cause anthrax and plague, are worked on in BSL-3 laboratories. The number of these laboratories has skyrocketed since 2001, although the actual figures are uncertain. While an estimated 20 BSL-3 facilities were operating before the anthrax attacks, in the decade since the number has grown to surrounded by 200 and an astonishing 1,400 or ore. 11 The huge discrepancy is attributable in part to varied methods of calculation.Some assessments have counted all BSL-3 laboratories in an institution as a single BSL-3 facility, while others have designated each laboratory as a separate entity. Furthermore, some laboratories with a BSL-3 designation may lack safety features found in others, such as double doors and a requirement that two persons must be present. No national chest is now empowered to mandate a single system of run or that even the lowest estimated number of BSL-3 laboratories (200) represents a 10- old increase in the past 10 years, and that safety precautions at some BSL-3 facilities are less rigorous than at others.Contention 3 The growing number of investigators with knowledge about select agents has increased the chances that an unsavory scientist could launch a bioattack. along with more high containment facilities has come more scientists who handle select agents. interest about dangerous individuals among th em was heightened in 2008 when the FBI named Bruce Ivins as the perpetrator of the 2001 anthrax attacks. Ivins was a veteran scientist who for decades had worked on anthrax at the U. S.Army Medical Research Institute for Infectious Diseases (USAMRIID) in Fort Detrick, Maryland. Before charges could be brought he act suicide, so his guilt or innocence could neer be complete in a court of law. Still, evidence of his aberrational behavior, including alcoholism, depression, and self-described bouts of paranoia, evidently went unnoticed by his superiors. The Ivins case highlighted questions about the screening of workers with ready access to select agents. The number of those workers Just prior to the anthrax attacks has been estimated at about 700.By 2008, however, the figure had climbed to more han As some have suggested, the greater numbers mean that the betting odds of one of them turning out to be a bad orchard apple tree has increased. 13 Ironically, Ivins was not a newly minted investigator, but a long- esteem fgure in the armys biodefense program. Days after Ivins death, a USAMRIID spokesperson acknowledged that officials may have been unaware of his problems because they relied in part on self-reporting. 14 In 2011, a amiable health review panel concluded that Dr.Ivins had a significant and drawn-out history of psychological disturbance and diagnosable mental illness at the time he began working for USAMRIID in The Ivins case has raised concerns that other troubled or nefarious individuals might be working in U. S. laboratories. A recent government-sponsored forum on biosecurity called for periodic behavioral evaluations of strength with access to select agents that include drug testing, searches for criminal history, and completion by selectees of a security questionnaire. 16 Even while acknowledging the necessity of security measures, the compensate to privacy and freedom of scientific inquiry must be respected to the extent possible. In any case, behavioral monitoring can never provide absolute protection against the acts of a lever miscreant. Contention 4 Money for biodefense has been misapplied or otherwise failed to produce desired results. forecast BioShield was established by congress in 2004 to acquire medical countermeasures against biological, chemical, and radiological vaccines and other drugs that have not necessarily been tested for efficacy on humans.Beyond the loss of time and money, the VaxGen failure was a public embarrassment. It became a symbol of ineptness early in the new program. Other biosecurity programs have as well drawn criticism, including a $534 million surveillance project called BioWatch. This program include the placement of air amplers for detection of anthrax spores and other agents in more than 30 major U. S. cities. A committee convened by the National academy of Sciences concluded in 2010 that the program was faced with serious technical and operational challenges. Others flatly criti cized its funding as wasted.

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