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IP: CDC on Bio Threat
From: David Farber <dave () farber net>
Date: Sun, 14 Oct 2001 07:52:48 -0400
Date: Sun, 14 Oct 2001 00:57:44 -0400 To: dave () farber net From: Charles Fine <charley () MIT EDU> Subject: CDC on Bio Threat-----Original Message-----From: owner-y1975-l () aya yale edu [<mailto:owner-y1975-l () aya yale edu>mailto:owner-y1975-l () aya yale edu]OnBehalf Of Tauxerob () aol com Sent: Friday, October 12, 2001 10:13 PM To: y1975-l () aya yale edu Subject: Re: Bio Threat Hola. It has been a tough and painful week. I will respond with my own musings on this. I am not directly engaged in the investigations, though have loaned some of my people to the anthrax teams. Had you asked me what I thought of the likelihood of a bioterror attack 5 weeks ago, I would have given you a carefully thought out rationale for why I personally thought it was unlikely, and if attempted unlikely to succeed. I would have touched on 1) how dangerous it is to the person attempting it, 2) how difficult it is to get something to really spread around enough to make a lot of people ill at once, 3) how other methods of terror are easier, and kill lots more people (like truck bombs, or maybe blowing! up bridges) and 4) the only real attempts I know of, including the 1984 incident at The Dalles, Oregon, which I helped investigate, were the work of tightly organized religious kooks, not state sponsored terror - the latter seem to go for the bombs. I would have also underlined my personal distress at the latent xenophobia that surfaces within 5 minutes of any discussion of bioterrorism, usually around some satanized Middle Eastern figure, and how what I most feared was our homegrown wackos, like Tim McVeigh or Eric Rudolph (the Olympic bomber), still on the loose in the North Carolina Mountains, possibly being harbored by the locals. On Oct 4, I wrote to myself about the WTC "It becomes increasingly clear that this was a small, dedicated and elusive group that planned it for years - a brilliant coup that shocked all of us. If they can do this, then other previously unimaginable horrors are back on the table". And now! - what are we to think? I speak only for myself, not my agency. The chances that the anthrax events in Florida have a natural or non-intentional explanation? As our director put it the other day, "nil to none". There have been two previous cases of anthrax of any sort in the US in the previous decade - - one in 1992 in Texas, and one in 1999 in North Dakota - both in persons working with or burying animals with anthrax. This is the only obvious exposure that is "natural " in this country, and anthrax is pretty rare in animals. Goat hair products imported from deep in the developing world are a second possibility (one case got it once from a Haitian drum with a goat skin head) - - but again no other such cases have occurred in many years. The only other theoretical source is old wool felt insulation that might still be around in older buildings (pre 1960's) wrapped around some hot air or water pipes pipes. This is a theoretical concern! - no one has yet gotten anthrax during a building teardown or renovation (See B Roueche's "the Incurable Wound", in a collection of short stories from the New Yorker of the same title for the whole story here.) But American Media Inc, is a newer building. No goat skins either. Finding the spores in the mailsorters and the mailroom in the Florida building speaks volumes about how it could have come in. But the target was wierd! Why the Sun/National Inquirer? Could it be just a convenient test run of the system on a locally available target? Did the name "American Media Inc" get someone's goat? Did articles in those rags irritate someone? And now today a case of cutaneous anthrax in the NBC news department, and a history of a strange powder filled letter from Florida. Even without the letter story, there is no natural explanation I can think of for this New York case. This was almost certainly intentional, and it seems logical t! o connect it with Florida. The bit about the powder being tested and coming up negative is curious, but there are some recently ginned up tests out there that have never been properly evaluated - tests that DOD and DOE research created outside the routine for clinical test evaluation. Not hard for me to believe the test was not sensitive. Or maybe it was the wrong envelope after all. As soon as these events were defined as a crime, i.e. better explained by intentional rather than national contamination, the FBI assumed control. The CDC teams and the FBI are working closely together, but the FBI is controlling the release of information, and they do not share much. I am not going to know the juicy investigative details about envelopes, postmarks, etc. any sooner than anyone else. However, my personal epidemiological hypotheses are something like this:1) someone has loaded envelopes with an anthrax preparation they got fromsomewhere. This is a risky thing to do, but we know that death is notfeared by at least one group of terrorists. 2) once the infectious agent was in the envelopes, then the range and targetting was defined by the perp's Rolodex, and by how many stamps they bought. 3) they were probably mailed after Sept 11, suggesting that these are not the very same people who were actually on the planes 4) they actually need not cause a lot of cases to scare a lot of people, if the right target is selected. Attacking media guarantees lots of coverage (as opposed to attacking some other group that might hush it up). the coverage is all that is needed to scare us all. 5) could be tightly organized religious (state-sponsored?) kooks In other words I have to qualify everything I would have said 5 weeks ago. Here is a devilishly clever, super low tech delivery system that you can basically do on your kitchen table if someone supplies you with! the anthrax preparation (a more high tech product, admittedly), a good tight mask, rubber gloves, and a bunch of chlorox and sodium hydroxide to clean up with. And some 34 cent stamps. It rides home on a core function of society, the open mail, and therefore makes everyone feel at risk . So What To Do? I do not think that gas masks or cipro prescriptions are rational general responses. Vaccination is not a realistic option (it takes 6 shots, protection incomplete, have to boost every year, and there are sides effects). I would not want the vaccine myself, even if I were participating in the investigation, unless I was going to work directly with the organism in the lab. I think I run a far greater risk of getting killed driving to the airport than getting on a plane, or opening my mail. I am tempted to get a rubber stamp that says "Return to sender - Do not mail me any more suspicious letters" and use it on all my junk mail! ! Remember - there are farmers in North Dakota, Texas and elsewhere that live with this stuff in their backyards, and they rarely die of it. For the moment, for almost all of us, we sit tight while the investigation proceeds. Hard, but I guess this is one of the reasons we have a government. If I were in major news media, I'ld be very careful in the mailroom. I bet within a few days we will get a good description of the size and shape and postmarks of the letters to avoid. Actually, in past centuries, the mail coming from parts of the world with smallpox, or plague or cholera was routinely disinfected before it was delivered. Do we begin to contemplate that for society as a whole now ? IMHO, only if for some reason we cannot catch them,and this mess continues. What do we have going for us? First of all, all the things I said up front are still true - If letters are the MO, the powder-in-an-envelope is not likely to make enough ! of an aerosol to get more than the person who opens the envelope and pulls out the contents. 300 plus work at American Media, and only one got it bad enough to die. That is bad, very bad, of course, but not the same thing as 80% of them getting it. Second, if the targetting system is the rolodex, and there are a number of these letters out there now, A) we are alerted, and can deal with suspicious letters immediately, and backtrack from them,and B) each new event increases the probability that the bastards will be caught. Third, the resources that are being poured into this are incredible. Your tax dollar hard at work (and there will need to be a few more of them, please, or we will have to close down later this year). CDC is mobilizing to a degree I have never seen before - 2 big labs cranking 24 x 7 on the flood of specimens, and at least 30 investigators in the field now and the number likely to rise. (For comparison, ! we usually do our outbreak investigations with 2 investigators - I handled the huge South American cholera epidemic of 1991 with at most 5 of our folks in the field at a time). Youall should know that as a consequene of the Bush 41 era budget cuts we has basically closed down anthrax and a buch of other rare disease labs early inthe 1990s, and hae been puwshingto reagain expertise ever since. Concentrate your resources on the common diseases, ran the mantra. But if we lose expertise in the rare ones,who will maintain it, we all cried? It was a near thing, and you can all be glad that the mid 1990s brought in new funds. The FBI is totally engaged as well Fourth, a faint cheer for molecular subtyping, or "fingerprinting" (faint, because it is actually tough to do for anthrax, and the results are not in yet). We are all eager to see if the bugs in Fla resemble the sequences detected in NYC, or elsewhere in the future. We have so! me grand new tools to try to show this. But I doubt that finger printing will let us define the region of origin for the strain - vet labs have been swapping strains back and forth for a long time, and if this came from a lab stock strain (which would be a lot less work than getting it fresh out of a dead animal) the Iowas "Ames" strain could be available in a lab in Bagdad or Florida. What is next? Do we have a group that read the graduate level textbook? Chapters one - four was bombs and explosives, and Chapter five is biologics and bioterror. Chapter six could be nasty chemicals, and there are other chapters after that. Do we have a chapter or two more to go in this round? Eternal optimist though I am, I fear we do. No cheers tonight, Rob Tauxe-------------------------------------------------------------------- Charles H. Fine, Chrysler LFM Professor of Management Massachusetts Institute of Technology Tel: 1-617-253-3632 Sloan School of Management Fax: 1-617-258-7579 50 Memorial Drive, E53-393 email: charley () mit eduCambridge, Massachusetts 02139 <http://www.clockspeed.com>http://www.clockspeed.com</blockquote></x-html>
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