Homeland Security Watch

News and analysis of critical issues in homeland security

March 26, 2012

Healthcare as a national security issue

Filed under: Biosecurity — by Arnold Bogis on March 26, 2012

There is no escaping that the big news item this week will be that President Obama’s healthcare legislation is up for review at the Supreme Court.

I have my personal opinions about the law in question, but no legal expertise upon which to offer any serous analysis of the issues relevant to events this week.

Instead, I’ll leave it up to the lawyers at Lawfare to share this interesting perspective from everyone’s favorite homeland security author, Philip Bobbitt:

The consequence of these developments is that the healthcare of all persons living in America is bound together: the protection of every American is no stronger than the weakest protection of any American.  Yet the most frequent reason cited by persons who do not present themselves to hospitals for treatment is a lack of medical insurance.  Without such presentment, medical authorities are unable to accumulate the data necessary to warn of a biological attack in the timeliest way.  In the case of the anthrax attacks of 2001, the determining factor whether the victims lived or died was whether the treating physicians recognized the cause of infection.  Unalerted, many did not; their patients died.

Basically, as Benjamin Wittes of Lawfare notes, ““it can be persuasively shown that Congress could rationally have concluded that [the law] was an appropriate method of providing for the ‘common Defence … of the United States.”

So Obamacare need not depend on the Commerce Clause, but instead the fact that health care is in fact a national security issue.

I can’t argue that, never mind prove it.  But I do like the idea…

February 14, 2012

The Never-Ending Story of BioScarity Concerns

Filed under: Biosecurity — by Alan Wolfe on February 14, 2012

There have been so many terms developed over the course of the last twenty years to describe the confluence of biotechnology, warfare, and terrorism. It used to be enough to call it “biological defense” against biological warfare agents. Then we had to worry about “bioterrorism,” since we’ve had a total of two actual bioterror cases in the United States over the past 30 years. So then we started talking about “biosecurity” concerns, which seemed pertinent due to the immense chicken and pig processing factories in the United States, where their owners had to worry about losing their livelihood due to a possible invasion of a foreign animal-transmitted virus. Because of all the DHHS and DHS grants, BL-2 and BL-3 laboratories started springing up across the nation, calling for concerns about “biosurety” procedures.  As Professor Barry Kellman observes, we need to be worried about “bioviolence,” don’t we?

So I want to invent a new word, too.

I think we need to be concerned about “BioScarity” tactics, a phenomena seen when uninformed journalists and political pundits deliberately try to scare the public through technical discussions about biological diseases and the possibility that terrorists might “harvest” one to use against the public.

Yes, we have to be concerned that terrorists are sending their minions with Petri dishes into the deepest parts of Africa for the sole purpose of capturing rare and exotic species of disease, because it is just so hard to make an impact on society if you can’t cause a mass extinction event. At least, that’s what I’ve gathered from Huffington Post reporter Lynne Peeples in her article,  “Bioterrorism Funding Withers As Death Germs Thrive in Labs, Nature.”

Wow. What an attention grabber.

It’s hard to consider how the U.S. government has spent (on average) more than five billion dollars each year since 2003 on this specific topic, which is more than the Department of Defense spends on protecting its service members from all military chemical and biological warfare agents (which is currently around $1.5 billion/yr).

And nothing should stop your wandering eyes more than the term “death germs” – it’s as if every one of the thousands of biological organisms being studied out there are just waiting to break out and cause a world-wide contagion. That is, unless you considered how the annual influenza bug kills less than one percent of those infected.

You know, details like that.

Peeples makes her case for the article’s title in one aspect, which is kind of hidden. She believes that state and local public health funds have “plummeted” since 9/11, and since they are the “first line of defense,” this is a Bad Thing.

I suppose that an economic recession, combined with budget decisions by federal and state agencies to reduce the amount of money coming into their coffers, and the more relevant threat of pandemic influenza as compared to the theoretical threat of bioterrorism, has had nothing to do with this trend.

But I digress.

I’m attacking the journalist who unwittingly became the pawns of the bioterror profiteers – those people most interested in ensuring that we, the public, remain terrified of the potential of something that hasn’t happened but twice in the last 30 years. Take this paragraph in the article:

This means a terrorist may need few tools, little training, minimal money and no published blueprint to harvest a superbug and then unleash it in food, water, air or via insect vectors such as fleas or mosquitos. “As a normal person, you can collect anthrax in Texas soil or ebola in Africa by hunting down a monkey,” says Ramon Flick, chief scientific officer at BioProtection Systems Corp., which develops anti-viral vaccines. “It’s so easy to get a potential bioterror agent in your hands.”

Yes, it really is so easy.

That explains all the failed attempts by disgruntled individuals and terrorist splinter groups to develop ricin from castor beans and all of the “white powder” alarms that occur in the thousands all over the world. It’s all because “it’s so easy to get a potential bioterror agent.”

And what would a contemporary article on “death germs” be without referencing the recent attempt by Dutch scientists to examine how avian flu might mutate to a transmissible virus that could impact humans?

She waffles on the issue – it’s just so hard to judge. On the one hand, the public health benefits of understanding how avian flu might mutate are important. On the other hand, George Koblentz of George Mason University notes, “we still shouldn’t be going around making new versions” of deadly viruses without fully considering the possible implications. Modern day life is just so complicated.

I honestly wonder about the quotes attributed to the “biosecurity experts” in this article, whether they are really that naïve to believe that more funding for public health and a global biosurveillance center will somehow allow us to avoid a “biological Chernobyl” caused either by Mother Nature or terrorists.

I don’t believe in any way that there were any intelligence indications of a “second event” after 9/11 that would involve biologics, as D.A. Henderson is quoted to say. If Ellen Gurksy believes that there is an “insidious erosion” of biodefense funding, then I kind of wonder about the continued federal funding for all of the public health and biodefense programs at DHHS, which haven’t decreased since 2003.  I think that if your mindset is like Scott Lillibridge, that we have to be “ready for anything,” then we’ll bankrupt the federal budget for threats that don’t exist yet, while ignoring all of the many other public health hazards that kill tens and hundreds of thousands of Americans every year.

I’ll just end this by noting, you can’t expect medical experts alone to advise us on how the U.S. government should protect the public from the potential threat of emerging infectious diseases and biological terrorism.

They’re really not good at developing realistic proposals that can be integrated into the practices and efforts of the larger homeland security enterprise. Their myopic focus on a singular threat without regard to threat source, funding constraints, regulations and authorities, doesn’t help us move forward.

We need a more objective and less sensationalistic view to address this real concern.

 

October 31, 2011

Test anthrax vaccine on children: A bad biodefense policy idea

Filed under: Biosecurity,WMD — by Alan Wolfe on October 31, 2011

I was surprised, last week, to see this story in the Washington Post about the efforts of a working group of the National Biodefense Science Board. Seems that, back in April, the board decided to examine whether children should receive the standard anthrax vaccine in the event of a wide-area anthrax attack on the nation. Although it’s not explained well in the story, it is assumed that this would be a post-treatment administered under emergency matters after an attack, rather than as a pre-treatment.

“At the end of the day, do we want to wait for an attack and give it to millions and millions of children and collect data at that time?” said Daniel B. Fagbuyi of Children’s National Medical Center in Washington, who chaired the group. “Or do we want to say: ‘How do we best protect our children?’ We can take care of Grandma and Grandpa, Uncle and Auntie. But right now, we have nothing for the children.”

Yes, oh who will think of the children? As the article explains, the vaccine has been tested for safety for the military, but it doesn’t explain that the vaccine’s efficacy is sometimes in question. Critics of the vaccine note that it hasn’t been tested against humans who have been exposed to a weaponized form of anthrax. And that’s true. There have been animal models that show the airborne vaccine should be both safe and efficacious for humans. And all of our researchers and veterinarians who work with anthrax use the vaccine, without any losses. Both the airborne vaccine and the natural form of vaccine work in the same way on the human body. So we’re pretty sure it’s a very good vaccine.

But back to the children. Medical experts and emergency responders have always been concerned about the “sensitive population” and how they are treated in the event of an emergency. Yes, it’s possible that an anthrax vaccine developed for adults might be too powerful for children or have detrimental side effects. We don’t know. But the chance of a wide-area anthrax attack affecting thousands, let alone “millions and millions of children,” is almost zero. Close enough to zero to not worry about it.

Except for this National Biodefense Science Board.  They decided, on a vote of 12-1, that in fact, we do need to have the vaccine tested on children in order to prepare for that day that is “not a matter of if, but when.”

“We need to know more about the safety and immunogenicity of the vaccine as we develop plans to use the vaccine on a large number of children in the event of a bioterrorist’s attack,” said Ruth L. Berkelman of Emory University, a panel member.

Now these are smart people. I don’t doubt their sincerity or intelligence. I do question their common sense and rationality. The absolute possibility of a transnational terrorist attack involving kilograms of anthrax to cause such an event are just insignificant compared to the storm of controversy and outcry if the US government starts testing the anthrax vaccine on kids.

It doesn’t matter if the side effects of the anthrax vaccine are far less severe than nearly any other vaccine. It doesn’t matter if the U.S. government has been using this vaccine for over a decade and has literally millions of health records to study. The critics will argue that the government hasn’t proven the vaccine’s efficacy for adults, let alone children. And they’d be right, technically; but it still works. This is a lousy argument.

The recommendation to test the vaccine for use on children is just wrong.

Any sensible mayor or governor would suggest that the appropriate risk-management approach would be to plan and resource for the widespread use of Cipro or other antibiotics on the population, to include children and other sensitive population types, as a first course of action. And then if, and only if, an actual anthrax attack occurred, the parents would be asked if they want to take the chance on the vaccine – and sign a release form for its use. It needs to be explained that this is a post-treatment, and without its use, the affected patient may die a very horrible and sudden death. This testing is unnecessary because the scenario too remotely theoretical.

It’s really that simple. How our community responds to bioterrorism is too important to be left to the doctors. Let’s get some public policy analysts involved and make better decisions.

 

October 18, 2011

Flunk the Graders, Not the Country

Filed under: Biosecurity,WMD — by Alan Wolfe on October 18, 2011

Last week, former Senators Bob Graham (D-FL) and Jim Talent (R-MO) released an assessment of the U.S. government’s preparedness for a biological terrorism event. The timing of its release, so near to the Hollywood drama “Contagion,” was not an accident. They wanted a reaction based on fear of a fictional global outbreak of a super-disease. Similar to their past report cards, this assessment was not a good news story.

“Today we face the very real possibility that outbreaks of disease — naturally occurring or man-made — can change the very nature of America,” the report concludes. Technology is also making it easier for terrorists to create deadly mischief, the report says.

A small team of individuals with graduate-level training and readily available equipment “could produce the type of bio-weapons created by nation-states in the 1960s,” the report warns.
—————
The center stressed that one key to improving the nation’s preparedness is leadership.

“We have recommended that there should be someone in the federal government who has (bioterrorism preparedness) as their sole responsibility,” Graham said. “That someone should be an individual who has the capability to direct and influence actions by the multiplicity of agencies that are involved and provide leadership to non-federal entities.”

The office of the vice president would be an appropriate spot for that job, Graham suggested.

Funny thing, former Vice President Dick Cheney and his advisor “Scooter” Libby were the original proponents for pushing a significant biodefense strategy for the United States, a strategy that has put about $6 billion per year into the Department of Health and Human Services, Department of Homeland Security, and Defense Department for the past ten years. The fact that this biodefense strategy has failed to protect the United States from a range of biological agents, due to lack of oversight, poorly chosen goals, and limited resources, doesn’t seem to faze Graham and Talent from suggesting putting that office in charge again.

The report card can be found at the former senators’ new digs, the “Bipartisan WMD Terrorism Research Center” or WMD Center for short – which ironically, doesn’t address WMDs, just biological terrorism. I don’t understand why they didn’t call it the “Bioterrorism Center” – it would have been more honest. But I suppose they miss all the attention given to them in their role leading the Congressional Commission on the Prevention of WMD Proliferation and Terrorism.

This report card gives the U.S. government 15 “Fs”, 15 “Ds”, and no “As” in its assessment of both small- and large-scale biological terrorist incidents.

The executive summary cautions the reader to view each grade on its own:

“it should not, however, be interpreted by calculating a grade-point average (GPA).”

You know, I used to tell my mother that when I brought home my report cards from junior high school, but she didn’t seem to view it that way.

It’s a strange assessment, one that seems to ignore the development of a National Biosurveillance Integration Center and the nation-wide Laboratory Response Network to give the nation a “D” for biosurveillance preparedness.

Not prepared enough, the report says, but “promising.”

Really? I thought a “C” would have been acceptable for “promising.” The way they assess the diagnostics and reporting process, you’d think that they were reporting about some third-world nation instead of the nation with the largest and most expensive health care system in the world.

Amazingly, the report says that it is “unclear” whether Project BioWatch, with its air samplers in 30+ cities, is worth the long term financial investment required to protect the nation.

Clearly it is not a sustainable program to expand to other cities, and the much vaunted “Gen III” detector has been in testing for some time. It’s not going to be cheap, just like DHS’s attempts to field next-generation radiological monitors in its “Global Nuclear Detection Architecture.” Are they trying to protect DHS’s S&T Directorate, which appears heading for significant budget cuts?

The report’s assessment on attribution capabilities is riddled with carefully parsed definitions to justify the failing grade that it provides the government. There are a few direct statements, but too many “probably” and “unknown” statements here for my taste.

Again, I am not sure why there is a National Bioforensics Center at Fort Detrick, one that includes participation from the FBI, DHHS, and DoD, but I imagine that it doesn’t deserve the charges that this report lays out.

The report’s assessors don’t seem to take into account the billions of dollars that DHHS is prepared to provide in the development of “private-public partnerships” for two new vaccine development centers. Yes, it will take a few years to build the centers and for the FDA to approve them, but still, not good enough to address a large-scale (multiple cities) outbreak. Yes, our past successes with pandemic disease outbreaks must have been flukes.

You can make up your own minds. From what I see, this is not an honest assessment of what the nation’s capability is to prepare for and respond to a bioterrorism incident. We are intended to overreact to this “lack” of preparedness because the report suggests bioterrorism is so easy. The report actually suggests that the success of Bruce Ivin in 2001, releasing his letters filled with anthrax, means that any general terrorist out there can do the same.

Yes, a man with more than 20 years experience working with anthrax on a regular basis in a well-prepared government lab; just the same as the man on the street. Really.

Fortunately, no one appears to be paying much attention to these Cassandras. They predicted in 2008 that there would be a bioterrorism incident prior to 2013. That’s only two years away. When this date comes and goes without such an incident, maybe we can shame them into retirement. We really don’t need these amateur-hour scare tactics. We have more important things to do with the billions of dollars poured into this money sink.

 

October 10, 2011

Anthrax Uncertainty

Filed under: Biosecurity,Terrorist Threats & Attacks,WMD — by Arnold Bogis on October 10, 2011

An interesting article in today’s New York Times casts additional uncertainty regarding the true perpetrator of the anthrax attacks:

A decade after wisps of anthrax sent through the mail killed 5 people, sickened 17 others and terrorized the nation, biologists and chemists still disagree on whether federal investigators got the right man and whether the F.B.I.’s long inquiry brushed aside important clues.

Now, three scientists argue that distinctive chemicals found in the dried anthrax spores — including the unexpected presence of tin — point to a high degree of manufacturing skill, contrary to federal reassurances that the attack germs were unsophisticated. The scientists make their case in a coming issue of the Journal of Bioterrorism & Biodefense.

I do not have sufficient knowledge in biology or chemistry to provide an opinion on the veracity of these claims.  What I find interesting is that there is serious concern that the perpetrator(s) of biological attack may still be unknown after so many years.

The new paper raises the prospect — for the first time in a serious scientific forum — that the Army biodefense expert identified by the F.B.I. as the perpetrator, Bruce E. Ivins, had help in obtaining his germ weapons or conceivably was innocent of the crime.

Please read the article itself for details regarding conflicting explanations for substances (tin and silicon) found in the anthrax and the reasons they might point to a different conclusion than the one at which the F.B.I. arrived.  What I find interesting from a homeland security perspective is that the anthrax mailings likely rank in the top five of all domestic terrorist incidents and are the only ones still surrounded by so much uncertainty.  This is not a conspiratorial take on the event (a la Truthers) or a reflexive “blame Al Qaeda” response (which would not be so surprising given their perceived presence at almost every major event in the world these days), but serious scientific doubt concerning the evidence and conclusions.

Is this because of the particular facts regarding this case–a difficult to obtain but deadly substance utilized in a sub-optimal manner (if the desire was mass fatalities) with little indication of motivation or goal?

Or a harbinger of the general issues that will surround further terrorist or criminal utilization of biological materials that will be difficult to trace for goals that may or may not be publicly announced?

A one off or an event that revealed a potential framing of the risk of biological terrorism?

Update: I had no idea when I was writing this post that PBS’ Frontline was opening their new season with an investigation of the anthrax attacks.  I caught most of the episode and it includes a lot of interesting details.  You can review their collected wealth of additional information (and I believe eventually watch the entire episode) at: http://www.pbs.org/wgbh/pages/frontline/anthrax-files/

October 3, 2011

Prepositioning Antibiotics for Anthrax

Filed under: Biosecurity — by Arnold Bogis on October 3, 2011

A new Institute of Medicine report considers the issue of propositioning antibiotics to shorten the response time to an anthrax attack.

To be completely honest, I have yet to read the report.  However, it seems worthy of serious review by those concerned about biological events in general–regardless of origin.

I am almost always in favor of giving more discretion to those closest to the event in question.  Local and State responders, officials, and citizens will be better off if there is less centralized control of not only the relevant antibiotics needed for response to an anthrax attack, but also the authorities and capacity to deal with what might occur with the minimum of outside interference.

The difficulty is providing for funding for such rare events.  If not the federal government, can we truly depend or even hope that local officials will consider spending limited funds on infrequent threats?

September 13, 2011

Contagion of Fear

Filed under: Biosecurity — by Alan Wolfe on September 13, 2011


So we successfully made it through the tenth anniversary of 9/11  without “anything coming in over the water, chemical, biological, radiological.”

Better safe than sorry? Perhaps, but the degree of over-preparation cost time and resources that aren’t as plentiful as before. There are continued questions as to the adequacy of our nation’s preparedness to biological terrorism, fueled on ever more by the latest Hollywood thriller, “Contagion,” where a new deadly, contagious virus that infects a billion people and kills million before the end of the movie.

There’s been a lot of conjecture as to how “real” this movie plot was, whether a virus today could cause a global pandemic of that scale. From scanning the news articles on the net, it seems that many public health officials are quite willing to suggest that this is a realistic concept, in as much as there are viruses that can be highly infectious, that there are viruses that jump species, and that human contact and sneezing can be a source of transmission from person to person.

However, they don’t seem to confirm the idea that a virus that has all of the worst possible characteristics could break out tomorrow and infect a billion people within a few months. As one example, the movie’s virus (MEV-1) had a 20 percent mortality rate; the so-called “Spanish flu” had a 2.5 percent mortality rate.

But hey, it’s just Hollywood, right? You need to move the plot along, and what could cause more stress than an airborne virus that is highly infectious, has a high mortality rate, and doesn’t burn out like other viruses?

What’s perhaps more despicable are the people who might take advantage of the public’s fear of biological diseases,  like the authors of the “World at Risk” report:

“Hoping to capitalize on the movie, Talent and former Sen. Bob Graham, D-Fla., the chair of the WMD commission, plan to release a new report that reiterates the threat of biological attack and grades the nation on its preparations to withstand it. Previewing the report, the former senators said they worried especially about cuts in security spending, cuts felt already by states and localities that would be on the front lines of responding.

Talent has been warning former colleagues in Congress not to let down the nation’s guard. His message: The capacity to withstand attack is a form of deterrence because terrorists would choose only targets where they could inflict maximum damage.

Talent worries he’s not getting through. “On the Hill, they’re putting an enormous amount of energy into denying reality,” he said. “To a great extent, we’re just hoping it doesn’t happen.”

Graham, who headed the Intelligence Committee during an 18-year Senate career, said the WMD report was likely to reflect success in securing nuclear weapons and radioactive materials around the world.

“I don’t think we’ve made that progress on the biological side,” he said. “Some of the most powerful pathogens are available in nature. There are others that can be manufactured in the lab, and there are thousands of people around the world who know how to weaponize them.”

This article also features Dr. Tara O’Toole, director of DHS’s Science and Technology Directorate, lamenting the deep cuts in research that the House of Representatives is proposing.

“It’s really difficult before somebody’s had their heart attack to get them to think about their cholesterol or go on a diet,” said O’Toole, a physician. “It’s really difficult before we see what a genuine bioattack would be like to continuously focus on biodefense.”

Of course, one could make the same argument about preparing for a Texas-sized asteroid from impacting the Earth, preventing terrorists from taking control of a Russian submarine and nuking the United States, or responding to a band of disgruntled American soldiers who have stolen nerve agent-filled rockets and are holding a US city ransom.

There are estimates that the US government has spent up to $60 billion on biodefense efforts, depending on how you count the federal funding. That sounds like a lot of money, but as homeland security analyst Randall Larsen notes, “The question is whether it has been spent properly.”

I don’t question how the funds were spent as much as the lack of strategic thinking and unrealistic expectations of what the biodefense efforts should accomplish. The federal government is unwilling to fully fund Project BioWatch to populate every major city with biological sensors and to fully fund Project BioShield to develop vaccines and other countermeasures for every dangerous biological disease and potential emerging disease. So why are we attempting half measures today? There are just too many other health concerns out there, such as the annual influenza season, while medical care costs continue to soar.

The good news behind the “Contagion” story could be the boost to the reputation (and hopefully, the budget) of the Centers for Disease Control and Prevention (CDC), whose professionals were the real heroes of the film. It wasn’t an Army colonel from Fort Detrick (“Outbreak”), it wasn’t a single brilliant researcher in an isolated lab (“Legend”), and it wasn’t a spiritual old woman in a Nebraska farm (“The Stand”). People don’t generally become infected by contagious diseases without direct and fairly prolonged face-to-face contact. And the Army isn’t going to quarantine cities and shoot people who are streaming out of the “hot zones” in panic.

Along that line of thought, Very Serious People shouldn’t be using Hollywood films to promote fear and to generate more funds for bioterrorism efforts without offering a strategic plan, metrics to determine how well the money is spent, and without consideration of all the other challenges our nation has to face.

As Winston Churchill noted, “Gentlemen, we have run out of money. Now we have to think.”

 

September 12, 2011

Contagion the new Top Gun?

Filed under: Biosecurity,General Homeland Security — by Arnold Bogis on September 12, 2011

The 1986 film “Top Gun” about the Navy’s elite fighter pilots proved to be a huge boon to Navy recruitment.  In fact, recruiters set up tables in the lobbies of movie theaters to sign up people while they were still reeling from the Tom Cruise-induced (helped in no small party by Kelly McGillis) adrenaline rush.  In  addition to reaping the benefits, the military was heavily involved in the production of the film itself.

This past weekend “Contagion” opened up at the box office.  It includes an array of Hollywood stars dealing with an outbreak of a deadly flu strain.  In the past, movies based on bio-hazards rarely were fact-based and almost never invoked a serious response from the public health community.  According to the CDC, this one is different:

"On September 9, Warner Brothers will be releasing the movie Contagion, a fictional drama that portrays CDC and other U.S. and international partners responding to an emerging infectious disease outbreak. We are reaching out to you in an effort to take advantage of this opportunity to provide accurate and potentially life-saving information to the public about how to prepare for a public health emergency.

When asked to respond to the inevitable question about the plot of the movie, “Could this really happen?” CDC is compelled to say,"Not only could it happen, CDC scientists are working 24/7 to find out if it’s happening right now.”

CDC scientists were involved in the film’s production and they are reaching out to promote flu preparedness and educate the public about the CDC’s vital missions.

Wouldn’t it be great if the public health profession received a boost(er) because of a popular film?  While recruiting for public health programs may not reach the Navy’s Top Gun-fueled peak, increased awareness of not only the CDC but also state and local efforts could help persuade decision makers not to balance budgets on the backs of these vital programs.

(h/t to Bill Cummings for the CDC quote, delivered through Eric Holdeman’s “Disaster Zone” blog.)

September 3, 2011

Visualizing history’s deadliest pandemics

Filed under: Biosecurity,Catastrophes — by Christopher Bellavita on September 3, 2011

This graphic comes from a site called Visual News (thanks WRC).  You can click on the picture for a larger, full screen, easier-to-read-the-details image.

If we were to look up into the branches of our ancient family tree, many of us would see limbs from our past that ended prematurely in the huge pandemics which have swept the world. In my tree for example, two relatives on oposite American coasts died of Spanish Flu in the same year. Created in a collaboration between GOOD and Column Five, this graphic details the ten deadliest pandemics both past and present, with a key explaining normal symptoms, estimated death tolls and the years they ravaged the world. If that sounds bleak, just make sure you notice how many of these global crisis’ have been cured in just the last century. What cures will the future hold?

 

The Deadliest Disease Outbreaks Visualized

July 28, 2011

New Study on Aum Shinriko’s Bio and Chem Programs

Filed under: Biosecurity,Chemical Security,Risk Assessment,Terrorist Threats & Attacks,WMD — by Arnold Bogis on July 28, 2011

Ten years of Al Qaeda-focused concern about terrorism may have faded the memory of a group that in the 1990s had significant programs aimed at developing biological and chemical weapons and successfully used Sarin nerve gas in an attack on the Tokyo subway, killing 13 and injuring thousands. Reminding us of those efforts and seeking to cull insights from their work, The Center for a New American Security (CNAS) has released a report, “Aum Shinrikyo: Insights Into How Terrorists Develop Biological and Chemical Weapons.” According to their website, this report

“culminates a multi-year project led by Richard Danzig, former Secretary of the Navy and Chairman of the CNAS Board of Directors; with Marc Sageman, Advisor to the Deputy Chief of Staff of the Army on the Insider Threat; Terrance Leighton, Senior Staff Scientist at Children’s Hospital Oakland Research Institute and Chief Scientist at Science Applications International Corporation; Lloyd Hough, Senior Research Scientist at Battelle in International Technology Assessments; Zachary Hosford, Research Associate at CNAS; and two Japanese colleagues investigating these issues.  Through personal interviews and correspondence with former members of Aum Shinrikyo’s leadership, the report provides never-before documented information on the terrorist group and its operations.”

It is an interesting document that provides a great deal of detail about the cult’s evolution, members, and technical background on their efforts to produce and deploy biological and chemical weapons.  From this narrative the authors have pulled out ten points that they feel can be useful in understanding future terrorist groups who may attempt to go down a similar path.  Here are the points, though I would strongly recommend reading the report itself for explanation and in-depth analysis of each observation:

1. Aum’s biological program was a failure, while its chemical program was even more capable than would have been evident from its successful release of sarin in the Tokyo subway system in 1995.

2. Effectively disseminating biological and chemical agents was challenging for Aum.

3. Accidents recurred in Aum’s chemical and biological programs but did not deter pursuit of these weapons.

4. When Aum’s top members transitioned to using violence, they readily brought other leaders down this path and effectively persuaded, isolated or killed dissidents.

5. Though police pursuit of Aum was remarkably lax, even intermittent or anticipated enforcement actions highly disrupted the cult’s efforts to develop chemical and biological weapons.

6. The key work on Aum’s biological and chemical programs was conducted largely by the leadership group.

7. Aum’s hierarchical structure facilitated initiating and resourcing biological and chemical programs.

8. Even a retrospective assessment of biological and chemical weapons programs like this one is difficult and burdened with gaps and uncertainties.

9. Aum displayed impressive persistence and produced successes despite its commitment to many bizarre ideas, its misallocation of resources and its numerous operational failures.

10. Significant failures preceded or accompanied Aum successes.

Guns and bombs will continue to be the most likely weapon utilized by terrorists, and as Anders Breivik demonstrated, they can be horrendously destructive.  Yet it has been more than 15 years since Aum used Sarin in the Tokyo subway and technological trends are not moving in a direction that will make it more difficult for future groups to attempt something similar.  A balanced counter-terrorism approach is necessary to prevent the most likely types of attacks while not closing our eyes to the possible, if more remote, threats.

Or as the authors put it:

“Groups such as Aum expose us to risks uncomfortably analogous to playing Russian roulette. Many chambers in the gun prove to be harmless, but some chambers are loaded. The blank chambers belie the destructive power that the gun can produce when held to the head of a society.”

 

July 26, 2011

Implementing the 9/11 Commission’s Recommendations: Bio, Rad, and Nuke Threats

Filed under: Biosecurity,Radiological & Nuclear Threats,WMD — by Alan Wolfe on July 26, 2011

As reported in this blog, the Department of Homeland Security (DHS) has released its 2011 progress report against the 9/11 Commission’s recommendations (released in July 2004). Of particular interest was the section on page 31 titled “Strengthening Efforts to Detect and Report Biological, Radiological and Nuclear Threats.” This section directly addressed the Commission’s recommendation to “strengthen counterproliferation efforts” related to weapons of mass destruction (WMD), notably nuclear weapons.

(The military term “counterproliferation” is misused in the commission’s report.  The proposed recommendations actually address nonproliferation and antiterrorism activities as measures to prevent a terrorist WMD incident. But I digress.)

DHS identifies its progress in countering radiological and nuclear threats by citing the deployment of thousands of radiological monitors at border crossings and to state and federal agents to “scan cars, trucks, and other items and conveyances for the presence of radiological and nuclear materials,” in addition to training on these devices. It cites the “Securing the Cities” initiative that has actually secured only one city – New York City – by the similar deployment of nearly 6000 pieces of radiological detection equipment and large scale exercises.

However, the progress report did not elaborate on DHS plans to spend more than $300 million on Advanced Spectroscopic Portal monitors, a plan that the Government Accountability Office says has not been assessed by an independent review panel. Such a review was suggested after DHS was accused of underestimating the cost of the monitors, overstating their benefits, and providing misleading information to Congress.

As for the troubled “Securing the Cities” initiative, perhaps the less said, the better. This 2006 initiative was originally intended as a pilot project to evaluate how law enforcement agencies might use radiological detection equipment within a major metropolitan city to detect, track, and interdict the movement of radiological or nuclear material.

New York City has required (demanded?) constant federal funding to continue this project because of the expense of sustaining this equipment and particular concept of operations, leading to a proposal that the federal government should permanently fund the New York City project and examine possibilities of replicating it in other cities. Of course, other cities will never see a similar project because of its high costs and the need to fund other, more conventional emergency response requests.

On the biological threat side, DHS has not yet expanded its Project BioWatch effort from the initial 30+ sites that were established over five years ago. More than 270 cities have populations over 100,000 people, which means there are a lot of major cities without any biological samplers.

DHS seems to be putting all of its chips on the development of a “Gen 3” detector that will significantly reduce operational costs by doing some level of automatic detection and analysis and reporting to officials. The current system only samples the air, requiring manual collection and analysis. However, the traditional wisdom has been that confirmatory identification in a laboratory is still required prior to alerting the state (and nation) as to a possible biological terrorist incident, because the severe consequences of announcing a “false positive” as real is something the federal government wants to avoid.

The cost and operation of an expanded detector array, addressing the majority of the nation’s major cities, will still be considerable, considering that DHS spends about $84 million a year to maintain the current system at 30 cities. I doubt that DHS will ever deploy and sustain a true nation-wide Project BioWatch effort.

This fixation on deploying biological and radiological monitors disturbs me for reasons other than cost and coverage. First, there is an obvious and deliberate lack of metrics in any discussion of the DHS projects described here. It’s easy to announce progress when there’s no ultimate objective in sight – you can avoid addressing those nasty details such as effectiveness of coverage and what limited range of hazards one is in fact addressing.

Second, when one actually reads the 9/11 Commission’s recommendations on addressing the proliferation of WMD (pp. 380-81), it becomes clear that the commission never called for such a detection array or even envisioned such a system. The commission focused on nonproliferation and law enforcement activities. That is because it recognized that “a complex terrorist operation aimed at launching a catastrophic attack cannot be mounted by just anyone in any place” (p. 365). It would require a large staff, opportunity and time to recruit operatives, a logistics network, access to special material, reliable communications, and ability to test the workability of the plan. In short, the larger the desired incident, the more visible the terrorist organization becomes.

The administration’s recently released “National Strategy for Counterterrorism” calls the danger of nuclear terrorism “the greatest threat to global security.” The nonproliferation community has jumped onto the alleged expansion of Pakistan’s nuclear arsenal and potential vulnerability to al Qaeda attacks as evidence for the need for more nuclear nonproliferation and threat reduction programs, despite assurances by Admiral Mike Mullen and other security experts that Pakistan’s nuclear arsenal is in fact secure.

That doesn’t assure others that there could still be the potential leakage of nuclear weapons or material in the future. However, if the real concern is sourced at Pakistan’s nuclear program, then the strategy needs to be improving relations between India and Pakistan and continuing nonproliferation efforts, not in developing a “Global Nuclear Detection Architecture” that mirrors the Maginot Line in its effectiveness.

DHS developed its operational concepts for countering biological, radiological and nuclear threats based on the Defense Department’s operational concepts for nuclear and biological warfare between states. It is the wrong approach for countering transnational terrorists seeking to use WMD against the United States. What remains unexplained is the failure of the homeland security enterprise to assess or acknowledge the inadequacies of the current approach to meet the 9/11 Commission’s recommendations on countering the possibility of a terrorist WMD incident.

 

July 5, 2011

Legislative Action Isn’t Automatically Good Policy

Filed under: Biosecurity — by Christopher Bellavita on July 5, 2011

Today’s post introduces a first-time contributor to Homeland Security Watch:  Alan Wolfe.  Mr. Wolfe retired recently as a national security policy advisor.

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So we’re coming up on an election year, which means it’s time for congressional representatives to show how intrepid they’ve been in securing the homeland from terrorist attacks. And what could be better than enacting legislation that promises to protect Americans from weapons of mass destruction?

From The Hill’s website, we read:

Reps. Bill Pascrell (D-N.J.) and Pete King (R-N.Y.) will introduce the Weapons of Mass Destruction Prevention and Preparedness Act of 2011 on [July 24th]. The congressmen first introduced the legislation in 2010, but the bill was never considered by the entire House.

The bill would establish a new “special assistant” to the president for biodefense who would create a federal biodefense plan and a yearly budget. The bill also contains legislation that would allow state and local first responders access to surplus vaccine.

In particular, the House Committee on Homeland Security promises to deliver a bipartisan bill that will call for:

  • the appointment of a special assistant to the President for biodefense to coordinate federal biodefense policy
  • the development of a national biodefense plan and a coordinated budget that assess capability gaps and spending inefficiencies
  • a national biosurveillance strategy
  • provisions for our first responders, including voluntary vaccinations and response guidance for chemical, biological, radiological, and nuclear incidents
  • authorization of the Securing the Cities program to allow for interdiction of a radiological device in high-risk cities

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Interestingly, the title of the bill is the “WMD Prevention and Preparedness Act of 2011,” (you can download it here) and the first thing I would notice is that it does not prevent or prepare one’s city or state for “WMD” at all. It’s strictly aimed at biological terrorism incidents, attempting to address the faults that the Graham/Talent WMD Commission’s “World at Risk” report identified.

A little truth in labeling is always a good thing, but it’s not apparent here.

This isn’t a good bill for several reasons: first of all by its intent to appoint a special assistant to the President to coordinate biodefense policy. We’ve seen “special assistants” come and go, and we do have a “special assistant” for WMD proliferation and terrorism, although he’s much more interested in Iran’s and North Korea’s nuclear programs than biodefense for the military or homeland security.

But more importantly is the colossal mistake of trying to segregate “biodefense,” whatever that means to people, as a distinct issue separate from counterproliferation, combating terrorism, public health, or homeland defense/civil support. You can’t just target a biological disease distinct from its source, man-made or natural. A “biodefense” expert who doesn’t know the context of the threat is going to be useless, an impediment to the national security experts trying to address real threats.

The idea that such a “biodefense czar” (if I may use that term) could develop a strategy and control a budget across existing executive agencies is beyond ridiculous. It’s never been done, and if put into practice, congressional committees would have a field day with the special assistant. We have a proliferation of committees already involved in oversight of the armed forces and homeland security – this biodefense assistant will be more busy in Congress than he would be in actually trying to get his arms around the issues.

In developing a new “national biosurveillance strategy,” the House committee would first kill the Department of Homeland Security’s (DHS) National Biosurveillance Integration Center (NBIC).  Now it’s clear that NBIC has some significant challenges, but it’s idiotic to tear down an existing center – which is at least in the right government agency – so that you can create another one from scratch, another agency that will have to re-learn all the mistakes that NBIC caused and all the disfunctions of the “whole of government” ideal that we hear about but have not seen in action.

What a bad idea.

The last two bullets are easily shot down. While it is a shame to see millions of doses of biological vaccines be thrown out every year, it ought to be clear from recent history that the state and local first responders really don’t want to receive annual anthrax and smallpox vaccine shots every year (not to mention the research on plague vaccine, ricin vaccine, tularemia vaccine, etc). It’s not something they need, and they don’t want the side effects that come with vaccine shots. And the only reason that the failed, overly expensive “Securing the Cities” initiative is mentioned is because Rep. Peter King (R-NY) really wants to show off the prize federal steer that he’s delivered annually to New York City.

Poor form.

A wise person once observed that “the causes of policy failure are, at root, political.” If politicians were really concerned about the threat of biological terrorism, they’d demand a review of the Project BioWatch, where only thirty-plus cities have active biological agent samplers. And that’s for a very good reason, it would be cost-prohibitive for DHS to suggest expanding the program to the more than 270 cities with over 100,000 inhabitants.

They might demand a more rational approach to Project BioShield than to pour billions of dollars into a pharmaceutical industry that’s really not interested in producing biological vaccines. They might demand a deeper explanation into the perception that a terrorist WMD attack will “more likely than not” occur somewhere in the world by the end of 2013.

But no, that would involve real work.

So instead, we have to put up with people like former Senators Graham and Talent, telling us that “terrorists have ready access to pathogens, the capability to weaponize them, and the means to effectively dispense a biological weapon. There is no question on intent.”

This is ten years after the Amerithrax attacks that were caused by a US government expert in anthrax who had decades of training and ready access to materials and equipment. This is after year after year, seeing thousands of cases where terrorists are effectively using automatic rifles, improvised explosives, and handguns to achieve their goals. We see Dr. Bob Kadlec testifying before the committee, pining for his old job as the former White House homeland security special assistant on biodefense. We see the CBRNE industry rubbing their hands together, delighted that Congress is going to throw them some business after all the hype has failed on WMD terrorism, even as our military service members continue to be attacked by conventional weapons.

We really deserve better.

 

February 3, 2011

Nuclear Wikileaks: Al Qaeda seeks dirty bombs (and other bad stuff)

Filed under: Biosecurity,Radiological & Nuclear Threats — by Arnold Bogis on February 3, 2011

The latest Wikileaks-related news concerns Al Qaeda’s pursuit of radioactive material for use in a dirty bomb. Despite the sometimes alarmist headlines, the cables made available to the newspaper The Telegraph do not point to an imminent dirty bomb attack.  Instead they underline existing risks, not just dirty bombs but also nuclear and biological terrorism.

The focus on dirty bombs is understandable, as the majority of the reporting focuses on smuggled radioactive material.

Alerts about the smuggling of nuclear material, sent to Washington from foreign US embassies, document how criminal and terrorist gangs were trafficking large amounts of highly radioactive material across Europe, Africa and the Middle East.

At a Nato meeting in January 2009 , security chiefs briefed member states that al-Qaeda was plotting a programme of “dirty radioactive IEDs”, makeshift nuclear roadside bombs that could be used against British troops in Afghanistan.

More troublesome, and not stressed in any of the headlines, are the nuclear terrorism-related nuggets:

An Indian national security adviser told American security personnel in June 2008 that terrorists had made a “manifest attempt to get fissile material” and “have the technical competence to manufacture an explosive device beyond a mere dirty bomb”.

Freight trains were found to be carrying weapons-grade nuclear material across the Kazakhstan-Russia border, highly enriched uranium was transported across Uganda by bus

Tomihiro Taniguchi, the deputy director-general of the IAEA, has privately warned America that the world faces the threat of a “nuclear 9/11″ if stores of uranium and plutonium were not secured against terrorists.

Senior British defence officials have raised “deep concerns” that a rogue scientist in the Pakistani nuclear programme “could gradually smuggle enough material out to make a weapon,” according to a document detailing official talks in London in February 2009.

If that is not enough bad news for you, biological weapons are also mentioned in the leaked diplomatic cables:

The briefings also state that al-Qaida documents found in Afghanistan in 2007 revealed that “greater advances” had been made in bioterrorism than was previously realized.

A lot of bad news.  But not new news.  The alarm about these threats has been raised repeatedly over the years.  Just a few thoughts:

Dirty Bombs

If a dirty bomb is detonated inside the U.S., the radioactive material will most likely have originated within the U.S. and not have been smuggled from Eastern Europe or Central Asia.  There should be a greater focus on improving the security of the potentially most dangerous dirty bomb materials used within our borders and on developing technologies and techniques for cleaning up after an attack.

Nuclear terrorism

It is heartening to see foreign officials raising the alarm about nuclear terrorism.  There exists a perception that it is a particular “American” neurosis instead of a shared risk. Expanding understanding of the risks should hopefully make it easier to take the (relatively) simple steps towards securing weapons-usable fissile material (which exists in much smaller amounts compared to radioactive sources that could be utilized in a dirty bomb).

Bioterrorism

Recent focus as been on efforts to produce anti-virals and vaccines quickly to emerging natural pathogens or even engineered bioterrorist weapons.  While important, I fear that there is not enough focus on the ability to distribute these drugs or the eroding ability of public health services around the nation to detect a natural or man-made outbreak.  The Trust for Americ’a Health most recent “Ready or Not” report points out that the “economic recession has led to cuts in public health staffing and eroded the basic capabilities of state and local health departments, which are needed to successfully respond to crises.”

So even if we wake up tomorrow to discover that the biomedical fairy has gifted us the ability to quickly produce the needed drugs, how sure are we that authorities could get them to the people in need in a timely manner?  Or even realize that they are needed in the first place?

December 19, 2010

H1N1 messaging muddle? Or leading indicator?

Filed under: Biosecurity,Preparedness and Response — by Philip J. Palin on December 19, 2010

For the last two or three weeks I have noticed much more attention to flu stories — and especially H1N1 – in the British media than I have seen in the United States.  But when I have checked the health  informatics I have seen no statistically significant difference. 

The divergence in attention has, however, finally gotten to the point where I will at least aggregate some of the recent reports for the benefit of the — mostly stateside — HLSWatch reader.

If swine flu pandemic is over, why the panic?  (The Telegraph)

Warning over number of previously healthy swine flu patients suffering lung problems (The Mirror)

Doctors warn of flu crisis (The Guardian)

Seventeen people die from flu this winter (The Press Association)

Swine flu now dominant virus as cases rocket (The Mercury)

Region is facing major flu crisis (Norther Echo)

Sussex facing flu epidemic as patients refuse vaccines (The Argus)

There is some indication that — unlike in the US — the percentage of the British population receiving flu vaccinations has dropped from last year.   How much of this is a “health vector” and how much this is a “perception vector” would require more attention than I have given the issue.

Basic information on the status of influenza is available from:

World Health Organization Flu Net (information is a bit dated)

UK Health Protection Agency Weekly National Influenza Report (December 16)

US Centers for Disease Control and Prevention Weekly FluView (December 17)

November 19, 2010

Vulnerability to various viruses and other poisonous ooze

Filed under: Aviation Security,Biosecurity,Cybersecurity,Radicalization — by Philip J. Palin on November 19, 2010

The re-introduction of cholera to Haiti — the US and Dominican Republic — is a huge step backward in a century long effort to corner, contain, and eliminate the highly infective and deadly disease.  The precise cause of the outbreak is not yet known, but experts have said the simple absence of hand soap has considerably accelerated the spread of the bacteria that causes the disease.

This week for the first time in seven years a human case of Avian Influenza was confirmed in Hong Kong.  But already this year there have been 22 confirmed cases and nine deaths in Egypt and seven cases and two deaths in Vietnam.  Most epidemiologists continue to consider the world past-due for a serious pandemic. The Avian H5N1 virus is thought to be the most likely source.

Last year’s Swine Flu or H1N1 pandemic should have been – and in some ways was — a fantastic real-world exercise for pandemic preparedness.  We were lucky the particular virus was fairly low-grade.  Our weaknesses were exposed, but the consequences were modest.  But from what I can see, the less-than-dire consequences of H1N1 may have suppressed personal and institutional preparedness for H5N1 or other potential strains of pandemic influenza.

Wednesday a series of cyber specialists told the Senate Homeland Security and Governmental Affairs Committee that the Stuxnet Wormhas viral capabilities. “What makes Stuxnet unique is that it uses a variety of previously seen individual cyber attack techniques, tactics, and procedures, automates them, and hides its presence so that the operator and the system have no reason to suspect that any malicious activity is occurring,” according to Sean P. McGurk, acting director of the DHS National Cybersecurity and Communications Integration Center.

But while Stuxnet is visciously sophisticated once it infects a system, prevention measures are classic.  According to PC Magazine these include, ”Deploy an anti-malware solution; watch out for vendor security notifications and alerts, and apply patches; ensure that users are updated via security education and awareness programs; and be aware of their assets.”  Attention and discipline are the most important preventive measures.

A Russian biologist, Dmitry Ivanovsky, discovered viruses in the late 19th century.  The word virus has a Latin origin that usually referred to a poisonous ooze.  

Virus is closely related to the Latin virulentus.  The English “virulent” also means poisonous, but today is probably more often used for anything that is extremely infective and rapidly spreading. Especially in this context, it has made sense to use the biological term for malicious computer code and now for anything digital that is rapidly consumed.

The John Tyner — “don’t touch my junk” — video and narrative has certainly gone viral.  I am disgusted by it.  The combination of a puerile wanna-be passenger and a couple of aggressively bureaucratic TSA agents has certainly produced a poisonous ooze of invective going every which way. 

Like soap in Haiti and disciplined attention with our computers, a reasonable dose of recognizing the humanity of one another might have avoided the entire drama. 

In regard to transportation security, there are meaningful issues of privacy and security that deserve serious consideration. In their Tuesday post Chris Bellavita and Dee Walker outlined several.  Most persuasive to me is that TSA is too often  preoccupied with going through the motions.  They need our help, as informed and active citizens, to focus on delivering real security value.

But John Tyner is no Rosa Parks.  Neither are the two slightly obnoxious TSA agents a latter day Sheriff Clark and Governor Wallace. John Tyner missing his plane is no Bloody Sunday.

What I perceive in most — not all — reactions to the John Tyner incident is an epidemic of self-righteous rage.  I saw similar symptoms yesterday on the streets of Baltimore.  I can’t always flip the channel quickly enough to miss it on television.  I hear it on radio talk shows and in the halls of Congress.  I don’t know the epidemic’s source, but the destruction caused is easy enough to see.

I can understand the rage of some Haitians – ten months after the earthquake, two weeks after being flooded out of their tents and shanties, and now told the water on which they depend is deadly — in some moments I share their rage. 

But how do we diagnose — or treat — the rage of  the well-fed and warmly housed?  There seems to be some virus attacking our sense of relationship with one another, of being Americans together, of our shared humanity.

In 1992 the rap metal band Rage Against the Machine wrote what seems to have become the angry anthem of those from the left, right, and plenty in the middle:

I’ve got no patience now
So sick of complacence now
I’ve got no patience now
So sick of complacence now
Sick of sick of sick of sick of you
Time has come to pay…
Know your enemy!

It is an epidemic: virulent, poisonous, and just as deadly as any other infection.

November 18, 2010

Cholera in Florida and DR

Filed under: Biosecurity,Catastrophes,Preparedness and Response — by Philip J. Palin on November 18, 2010

According to the Miami Herald:

A Southwest Florida woman who visited family in the disease-stricken Artibonite Valley of Haiti and a Haitian construction worker who lives in the eastern Dominican Republic but recently spent two weeks in Port-au-Prince became the first people to import deadly cholera.

The spread is worrying public health specialists in several countries who fear the illness could spread internationally.

The acute intestinal infection first surfaced in Haiti four weeks ago and has killed 1,110 people and hospitalized 18,382 since.

The Collier County woman does not work in a job that puts her in close contact with the public, so the chance that she might pass on the disease is small, Florida health officials said. Several more cases are under investigation in other counties, said Dr. Thomas Torok, a cholera expert in the Florida Department of Health’s Bureau of Epidemiology.

Read more: http://www.miamiherald.com/2010/11/18/1931309/cholera-fear-spread-beyond-the.html#ixzz15cpynwQD

Yesterday, November 17, the Pan American Health Organization released its most recent Situation Report.  Violence in Haiti – related to suspicions cholera was introduced by UN peacekeeping troops — is complicating efforts to contain the disease. According to PAHO:

Civil unrest since November 15 has slowed several activities of the response to the outbreak. In the northern city of Cap Haitian prevention and treatment supplies are were not delivered in last three days. WHO/PAHO cholera training was postponed, as well as an Oxfam initiative to chlorinate water for 300,000 people. A nearby World Food Programme (WFP) warehouse was looted and burned. In Hinche, six MINUSTAH personnel and a number of bystanders were injured, according to the MINUSTAH.

The full Situation Report and other updates are available via a new PAHO blog focusing on health conditions and operations in Haiti: http://new.paho.org/blogs/haiti/index.php?lang=en

As we have previously discussed at HLSWatch, catastrophes – especially in contrast to disasters – are almost always the result of a cascade of events over time.  It is the cumulative affect of the cascade, especially on human expectations, that permanently interrupts the status quo ante and results in a “new normal.”

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