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Respond to Mike:

The issue that arises with a mass bioterrorist attack is the high level of casualties that quickly overwhelm the caregivers in a mass casualty scenario. While there is a chance of terrorists utilizing a bio agent in an attempt to cause mass casualties, it is the individuals who travel around the globe and become infected without realizing it and pass through all of the safeguards into another country undetected, basically becoming the new patient zero for that country. Whatever the method is that the pandemic begins, the caregivers, medical treatment facilities and hospitals, as well as antidotes depending on the type of biohazard, will quickly be depleted. If the hazard is rare, there is also the chance that antidotes are in very limited stocks. The ability of caregivers to give continuous relief can be taxing, even when surging extra personnel at the problem, not including that sometimes caregivers themselves, when exhausted, make treatment mistakes and can become infected as well, making themselves just more candidates for spreading the biohazard even more.

Misdiagnosis is also another issue that has occurred often enough, based on a country’s history of dealing with certain diseases or pandemic outbreaks. I was working here in the Central African Republic in 2015 when the Ebola outbreak occurred in Western Africa and ended up contracting malaria. I had the malaria a week before I returned to the United States and I was never screened coming back home from Bangui, Casablanca, Paris, Atlanta and then finally Huntsville, Alabama having changed planes 4 different times and spending the night in a hotel in Paris. Once I had been home for about 3 days the full blown malaria proceeded, and I went to seek treatment at my local medical provider. Since I had been in Africa, they refused to let me enter the facility, which was understandable from other patient’s perspectives. I was directed to go to Huntsville hospital, where again I was quarantined for Ebola, not malaria, as the hospital in Huntsville did not have the ability to test properly for malaria and had to conduct research. Only after being directed to an infectious diseases doctor in Huntsville did all of the required tests get completed and the proper medications prescribed. To its credit, I had not been back to my house a hour before the Center for Disease Control (CDC) called my house to discuss with my travels, just to make sure that the findings were not an anomaly.

As with any type of mass incident, the ability to conduct mass communication briefings to the public regularly, even at 6 or 12-hour intervals, needs to be maintained to ensure that general panic does not seep into the surrounding area, leading people to begin self-diagnosing that something is wrong with them, further overwhelming the abilities of medical providers and emergency responders. “After the Sarin attacks in the Tokyo subway, medical systems were briefly overwhelmed by thousands of individuals who feared that they had the symptoms of poisoning, may who became psychosomatically ill” (Speckhard, pg. 6, 2006). Psychologically an biohazard attack creates panic and horror, and undermines the public confidence in the community, state and the nation in their ability to contain the hazard and provide the proper treatments.

The BioWatch system is being replaced with a new system called BioDetection 21, which according to James McDonnell, Assistant Secretary of Homeland Security’s Office of Countering Weapons of Mass Destruction, is supposed to “be faster and more reliable than BioWatch” (Willman, 2019). Even though there are plans to manufacture and deploy over 9,000 of the devices by 2025, there are still serious flaws in the system according to the John’s Hopkins University Applied Science Physics Laboratory that was tasked with confirming qualification tests by DHS. The new system has shortcomings by not being as sensitive in testing, allowing some biological elements to pass even if the amounts were enough to cause a pandemic. There is also the issue of false alarms, which for those of us who remember the M-8 Chemical Alarms of old, can cause serious panic at first but then begins to undermine the public’s confidence in the system if continued false alarms are the norm.

As far as improvements for states the CDC recommends improved environmental sampling methods, decision points of if and when to initiate prophylaxis, decision points for evacuation or conducting quarantine, and “additional templates for risk communication messages to the public and health care providers” (National Academy Press, 2011). While we continue to look for advances in detection and treatment for public health in defense of a bio attack, there are areas of concern that need to still be addressed in ensuring informing the public with a knowledgeable response quickly and effectively without causing further undo panic.

Mike Simmons

W/C 791

References:

National Academy Press, (2011). Biowatch and Public Health Surveillance: Evaluating Systems for the Early Detection of Biological Threats. Institute of Medicine (US) and National Research Council. Committee on Effectiveness of National Biosurveillance Systems: Biowatch and the Public Health System. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK219712/

Speckhard, A. (2006). Prevention Strategies and Promoting Psychological Resilience to Bioterrorism Through Communication. NATO Science Series. Georgetown University. DOI: 10.1007/978-1-4020-5808-0_13. Retrieved fromhttps://www.researchgate.net/publication/226524440_Prevention_Strategies_and_Promoting_Psychological_Resilience_to_Bioterrorism_Through_Communication

Wilman, D. (2019). Homeland Security replacing troubled biodefense system with another flawed approach. Los Angeles Times. Retrieved fromhttps://www.latimes.com/politics/la-na-pol-biowatch-replacement-20190215-story.html