IP: CDC on Bio Threat

[David Farber <dave () farber net>]

> 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]On
> > Behalf 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 not
> > feared
> > 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 edu
> Cambridge, 
> Massachusetts  02139 
> <http://www.clockspeed.com>http://www.clockspeed.com
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