Modest Gains Against Ever-Present Bioterrorism Threat

Officials say that the government is retooling efforts to encourage drug companies to invest in BioShield projects, and that the effort is paying off in new antitoxins for anthrax and botulism. Science is also being advanced by a dramatic expansion of federally funded university research, up from a handful of laboratories a decade ago to 400 today.

Still, the nation has seen few breakthroughs such as an anthrax vaccine that could safely inoculate Americans and end what many scientists consider a top-tier threat. Some analysts worry that the U.S. research effort is increasing the risk of abuse by a malevolent or unwitting insider, whether or not bioweapons expert Bruce E. Ivins turns out to among them.

The White House last fall refocused its years-long effort to meet the "big three" of bioterrorism preparedness needs: medical stockpiling, biosurveillance and mass casualty response.

On Oct. 18, the president signed a new homeland security directive to chart a fresh strategy for public health and medical preparedness, which included creating a panel at the U.S. Centers for Disease Control and Prevention to review biosurveillance efforts.

Early detection is critical because the impact of a bioweapons attack can spiral out of control in the hours or days it takes to discover it. Administration defenders have praised BioWatch, a five-year-old, $400 million effort to install sensors in more than 30 U.S. cities to detect the airborne release of biological warfare agents such as anthrax spores, plague bacteria and smallpox virus.

All 50 states now can receive urgent disease reports around-the-clock and conduct year-round surveillance for diseases such as influenza, according to the senior federal bioterrorism official. The number of state and local public health laboratories that can detect biological agents has increased from 83 to 110, and the number that can respond to chemical agents has climbed from zero to 47, said the official, speaking on the condition of anonymity because of the sensitivity of the FBI's anthrax investigation.

Critics say big gaps remain. BioWatch remains of limited use, because it takes 10 to 34 hours for samples taken by the machines to be analyzed. A new generation of sensors that can detect lethal agents within four to six hours was scheduled for pilot deployment in 2008 but now is not expected until 2010 or 2011.

Meanwhile, cities such as New York are pressing the federal government to spend tens of millions of dollars more on interim technology. Other analysts say it makes more sense to spend money to improve data collection and reporting by hospitals and clinics.

"There are a lot of fabulous new tools out there that could be turned to biosurveillance, but government hasn't figured out how to marshal them, who should control them or what to do," said Tara O'Toole, director of the Center for Biosecurity at the University of Pittsburgh Medical Center.

Washington also has sent more than $8 billion in grants to hospitals and public health agencies since 2002. The money reached more than 80 percent of 5,000 U.S. hospitals and funded 9,500 exercises in 2006 alone.

But the nation still lacks plans and an organized structure to respond to a massive disease outbreak with thousands of victims. "The system still isn't there," Osterholm said. Hospitals strain every day with overcrowded emergency rooms, while this summer's outbreak from salmonella infection underscores the challenges facing public health experts to trace outbreaks of even food-borne illness, he said.

It will do little good for the federal government to distribute stockpiled medications if health-care workers aren't there to dispense them, Osterholm said, or for the federal biosensor alarm system to ring if hospitals lack beds, nurses and tracking systems to manage patients.

"If we know the system is not going to work with everyone having a hospital bed, a nurse and all the modern medicines they need, then we better damned well prepare for that," he said.

At Congress's direction, DHS this year is developing a new National Biosurveillance Integration Center to coordinate federal efforts, but faces "big challenges" to being operational next month, Hooks said. Only six of 11 federal agencies have agreed to participate, and only one has completed a funding and staffing plan.

Henderson said such developments show that Washington is better prepared than it was in 2001 but is enmeshed in dangerous bureaucratic habits.

"There's a kind of complacency," he said. "You don't have the motivation now as they did right after 9/11 and the anthrax attack, and so, they can look at it now and say, 'Well, nothing has happened. We don't have to worry about it.' And they can sleep at night."