02 October 2001
Text: Senator Frist Assesses Bio-terrorism Threat to U.S.
(There are steps U.S. can take now to minimize risk, he says) (2630)
The potential damage of a bioterrorism attack is "huge," but Americans
"need to put the threat of bioterrorism in perspective," according to
Senator William Frist (Republican of Tennessee).
"The overall probability of a bioterrorist attack is low," Frist said
in an October 1 Senate address.
At the same time, "it is clear that we are highly vulnerable in the
event such an attack takes place," said Frist, a member of the Senate
Health, Education, Labor and Pensions subcommittee on Public Health
and Safety.
"The consequences of such an attack, whether it is with anthrax,
smallpox, tularemia, pneumonic plague, nerve agents or blister agents,
is huge," said Frist, the only member of Congress who is also a
doctor.
According to Frist, the United States can take steps immediately to
diminish the threat of bio-terrorism by developing a "comprehensive
biodefense plan capable of preventing a bioterrorist attack."
Prevention should be a "primary goal," said Frist, a member of the
Senate Foreign Relations Committee. "We want to keep biological
weapons out of the hands of people who are intent on destruction."
According to Frist, the United States should prepare what he termed
"an effective response plan."
Frist said the United States should build up its capacity for
"consequence management" -- or "crisis management" -- after an assault
takes place.
"We are working very hard over the course of this week on how much
money should be put into this effort. We had a good first step last
year in the Public Health Threats and Emergency Act," said Frist, who
helped author that legislation.
"I am very confident that the American public will be very well served
by this body and by the administration as we look at this critical
area of biodefense," he said.
Frist, who sits on the Senate Budget Committee, complained that
America's public health infrastructure "has been woefully and
inadequately underfunded over the last really 15 years to two
decades."
In a bioterrorist attack, Frist said, "you have to diagnosis, you have
to have good medical surveillance, you have to be able to assimilate a
response team, and you have to do in it a rapid fashion."
"That is done through our public health system," he said.
Besides fire fighters and police officers, Frist said, the first
responders to such an attack have to include "physicians, nurses, and
the people who are managing the public health systems today."
Most physicians, he went on, "have never been trained to recognize
smallpox or to recognize the pneumonic plague that affects the lungs
or to recognize tularemia or the various types of food poisoning."
"When you see 100 cases of flu, you do not even think about pneumonic
anthrax. So we need better training," Frist said.
"We must make sure that there is coordination at the State level and
then at the Federal level and then across the Federal level, and that
there is appropriate coordination without duplication," Frist said.
Following is the text of Frist's October 1 speech to the Senate from
the Congressional Record:
(begin text)
THREAT OF GERM WARFARE AND BIOTERRORISM
Senate
October 01, 2001
Mr. FRIST. Mr. President, I rise to discuss an issue based on my
observations over the past week, an issue clearly on the minds of many
people, and that is the potential threat of germ warfare and
bioterrorism. Over the weekend, there was a lot of discussion through
the various media outlets about our broad vulnerability to terrorism
in the United States of America, in part based on intelligence and in
part based on the events of September 11.
Over the last week, many people have rushed to obtain antibiotics and
gas masks to prepare for the threat of bioterrorism or germ
warfare--the threat that is posed by germs, bacteria--if viruses fall
into the wrong hands. Many people are concerned that given the
powerful destructive ability of some of these viruses, they could (be)
used in a way that threatens not only all Americans, but all of
civilization.
A lot of people called me over the weekend, recognizing my interest in
this topic and recognizing I had participated in passing a bill called
the Public Health Threats and Emergency Act which was passed in the
year 2000.
People have asked if the threat of bioterrorism is real? The answer is
yes, it is real. In fact, we have already seen the destructive use of
bacteria by people in this country. In 1984, there was an outbreak in
Oregon of salmonella poisoning from which over 700 people suffered
some illness. This outbreak was caused by members of a religious cult
placing living bacteria in the salad bars of 10 different sites across
the State.
The ``bio'' part of biogerm warfare or biochemical warfare is the
living organism, and that is what was inserted in the salad bars that
caused the illness of about 700 people. We know germ warfare has been
used, so the threat is real.
But before people attempt to respond to this threat by rushing out and
buying items, we need to put the threat of bioterrorism in
perspective. The overall probability of a bioterrorist attack is low.
I do not know exactly what that number is. In fact, we cannot put a
specific number on it, but the overall probability of a terrorist
attack using biology, bacteria, living organisms--is low. However, it
is increasing. It is now our number one or number two threat, and, at
least to me, it is clear that we are highly vulnerable in the event
such an attack takes place.
The consequences of such an attack, whether it is with anthrax,
smallpox, tularemia, pneumonic plague, nerve agents or blister agents,
is huge. Why? Because we are ill equipped. We are unprepared. However,
in saying that, we have to be careful that we do not become alarmists.
People will have nightmares, will not sleep at night, and the response
should be the opposite.
We need to recognize there are things we can do right now, first and
foremost, to develop a comprehensive biodefense plan capable of
preventing a bioterrorist attack. Obviously, prevention should be our
primary goal from the outset. We want to keep biological weapons out
of the hands of people who are intent on destruction. At the same time
we can be prepared--if these germs and agents fall in the hands of a
potential terrorist--by preparing an effective response plan. Third,
is the response, an area called consequence management, crisis
management after such an assault takes place.
Yes, the threat is real, but very low--a tiny probability, but
growing. Why do I say growing? Because on September 11 we witnessed a
calamity the likes of which have never been seen before in the history
of the world. It was unexpected and unfathomable--using planes as
bombs. We know those events were carefully planned out over a period
of years in a very sophisticated way that was obviously well financed.
Therefore, I will say it is growing because we did not expect it, and
because it has occurred several years after Khobar Towers and after
the attack on the USS Cole. So there is an increasing threat of
calamity and destruction.
This threat is rising, secondly, because of scientific advances in
areas such as aerosolization. People talk about anthrax and how you
cannot really aerosolize it--that is, breaking it down into defined
particles so it can be inhaled into the lungs--because 10 years ago we
tried to do it and could not do it. However, over the last 10 years
there have been huge advances in this technology. Today we use
nebulizers in hospitals to aerosolize particles to get medication deep
into the lungs. We did not have that technology 10 to 15 years ago,
but the technology has been developed.
Take perfume, for example. When one goes through a department store,
one can smell the perfume around. The technology of aerosolization has
progressed rapidly over the last 10 to 15 years. What we thought could
not be done 10 or 15 years ago can be done today because of advances
in technology.
Another example is airplanes spraying chemicals. They say: Oh, those
crop dusters cannot do it, but there are some dry chemical crop
dusters that might be able to spray agents.
I have mentioned these examples because science has changed and what
we could not do years ago can be done today.
In addition, the scientific expertise related to biochemical warfare
is there. A lot of people don't realize that during the 1980s, well
after a general pact in 1972 was agreed upon by really the world, the
Soviet Union set out in a very determined and aggressive way to
develop biochemical weapons. The number one goal of this project was
the development of pathogens that could kill. This was not a little,
secret project. This project involved as many as 7,000 scientists
whose professional being, through the 1980s in the Soviet Union, was
to develop these pathogens and effective mechanisms for their
delivery.
With the fall of the Soviet Union 13 years ago, those scientists all
of a sudden became unemployed. With no employment available in the
former Soviet Union, those scientists have gone elsewhere in the
world. We do not know where they all are, but we do know that they
spent their entire professional life studying how to develop the
biochemical weapons that threaten us today.
I say that because it is not beyond the realm of possibility that
those scientists can be either hired or bought. All of this is in the
public record, and, again, I want to be very careful because I do not
want to be an alarmist. On the other hand, people need to realize that
from the technology and the scientific standpoint, the expertise is
out there.
The third area, and the reason why I say the risk is rising compared
to 10 years ago, is that the United States today has emerged as the
sole superpower of the world. Without the Cold War and the sort of
balances and the trade-offs and the push and the pull, the United
States has become the target of many people who resent us, who do not
like us, who are jealous of us, and a lot of that fervor today will
hit the surface, or was hitting the surface more than 10 or 15 years
ago in the middle of the Cold War.
So, the threat is real: low probability but rising.
Let me just close on an issue that has to be addressed, and that is
this whole field of vulnerability. Why are we so vulnerable today? We
have heard recently that the Federal Government has worked
aggressively and compared to 4 years ago, there has been enormous
improvement at the Federal level. We are investing money that was not
being invested 4 years ago. We are organized. We have 12-hour push
products that allow us to very quickly could get antibiotics and
vaccine, although not enough vaccine. We have a delivery system that
could be mobilized very quickly. All of this is good.
We also know that at the Federal level we are not nearly as
coordinated as we should be. Treasury, Defense, Energy, and Health and
Human Services are all doing something, but according to the GAO
report that came out last week, we need better organization and better
coordination to eliminate the duplication and to eliminate the
possible conflicting messages that are sent from the Federal level.
So, we can coordinate better.
I am delighted that Governor Ridge has taken on this overall
responsibility because that is the first step toward better
coordination.
What really bothers me, when I say the vulnerability is high in spite
of low probability, is that our public health infrastructure has been
woefully and inadequately underfunded over the last really 15 years to
two decades.
If there were a bioterrorist attack using germ warfare, what would
happen? Basically, you have to diagnosis, you have to have good
medical surveillance, you have to be able to assimilate a response
team, and you have to do in it a rapid fashion. That is done through
our public health system. The difference between conventional weaponry
and bioweaponry is that bioweaponry requires first responders that are
not just the firemen and the policemen, which are so critical and
whose courage was so well demonstrated 2 1/2 weeks ago, but in
addition the first responders have to be the physicians, nurses, and
the people who are managing the public health systems today.
Most physicians have never been trained to recognize smallpox or to
recognize the pneumonic plague that affects the lungs or to recognize
tularemia or the various types of food poisoning. They have not been
trained. When you see 100 cases of flu, you do not even think about
pneumonic anthrax. So we need better training.
We have underfunded the public health infrastructure. Communities of
fewer than 25,000 people are being served by public health units of
which fewer than two-thirds have fax machines or an Internet
connection. The ability to communicate between public health units
once something is suspected or identified between the public health
entities is absolutely critical. This communication infrastructure, at
least from my standpoint, as a physician, as someone who has dealt in
treating the immuno-compromised host through the field of
transplantation for 20 years before coming to the Senate, is totally
inadequate today.
There are four other things that we can do. The bill that we passed in
this body last year, the Public Health Threats and Emergency Act, is a
good first step. It addressed this prevention, it addressed this
preparedness, and it addressed this third category of consequence
management.
Unless we support our public health infrastructure, we cannot minimize
the vulnerability that is out there today by training those first
responders, by making sure that coordination at the local level among
various entities is intact. This coordination is not there today
because we have underinvested. Finally we must make sure that there is
coordination at the State level and then at the Federal level and then
across the Federal level, and that there is appropriate coordination
without duplication.
I will simply close by saying that now is not the time for individuals
to go out and hoard antibiotics or to buy gas masks. Now is the time
for us to come together and develop a comprehensive biodefense plan
that looks first at prevention to make sure we have the adequate
intelligence, the appropriate research in terms of viruses, in terms
of vaccines, and in terms of methods of early detection; second to
look at preparedness, to make sure we are stockpiling the appropriate
antibiotics, that we have a sufficient number of vaccines, which we
simply do not have today but we are working very hard to get; and
third that our consequence management and crisis management could
handle what is called the surge product, the rush of people to
emergency rooms, in a straightforward way.
I am very optimistic. We are working very hard over the course of this
week on how much money should be put into this effort. We had a good
first step last year in the Public Health Threats and Emergency Act. I
am very confident that the American public will be very well served by
this body and by the administration as we look at this critical area
of biodefense.
(end text)
(Distributed by the Office of International Information Programs, U.S.
Department of State. Web site: http://usinfo.state.gov)
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