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Bioterrorism Preparedness
What does national preparedness mean? It suggests the ability to respond to a wide array of threats and prevent unnecessary loss of life or injury. This requires translating national policy initiatives into local program implementation. It is a significant challenge to prepare for an unknown event, especially without a clear cut indicator of who and how many to protect, and from whom.
National activities to prevent or respond to a bioterrorism event have hinged largely on the development of biosurveillance programs and arms length detector technologies. As I’ve written for FSM back in 2008, when the National Biosurveillance Center was about to be officially opened, the GAO reported that they weren’t sure what the NBC could actually accomplish given the interagency rivalries, growing bureaucracy, problems with interoperability, and the ubiquitous ‘mission creep’ that evolves in such important undertakings. If these were the problems afflicting the NBC under a president, and administration that actually cared about homeland security, imagine how the various government agencies designed to protect the US are faring under an administration that seems consumed with shifting national resources to entitlement programs, decreasing the stature of the US from one of international superpower to that of merely an ordinary country, just another member of the United Nations.
As an aside, and general terrorism preparedness comment, having NY City downgrade its capabilities in their intelligence division so as not to offend the very people who are likely to attack our country – again – seems ridiculous. Our adversaries must laugh themselves to sleep.
According to studies by the GAO and US Department of Agriculture IG reports at increased risk for incidents at laboratories doing research of deadly pathogens as part of bioweapons research, in no small measure due to the feds failure to develop national standards for lab design, construction and operation.
The growing weakness in bio preparedness in the USA from the top down is staggering. From the ADD-like foreign policy and domestic preparedness edicts of President Obama, to the growing disinterest in bioterrorism among all but a handful of health care professionals and health care facilities are just some critical infrastructure issues that this current president is contributing to.
Emerging Pathogens & Public Health
We live in a global world where most people outside of North America are likely to die from an infectious disease – something the average US citizen doesn’t worry about, and hasn’t had to since the mid 20th century. TB, dengue, HIV, influenza, malaria, food-borne illnesses, and environmental (mosquitoes, worms, other insect vectors) threats pose daily risks to most people worldwide, especially the poor, which suggests immigrants from South America, parts of Africa, the Middle East, and Asia can import their illnesses as they immigrate or travel within our borders.
By May of 2014 the Middle East Respiratory Syndrome Coronavirus (MERS, or MERS CoV) arrived in the United States. For many of you, this is a new virus, and another threat emanating out of the Middle East, in case terrorism and energy insecurity weren’t enough! The World Health Organization (WHO) alerted the international community about MERS after identifying the new pathogen from two men who became ill in Jordan in 2012. Early in the MERS lifespan, cases were sporadic. A few cases were in clusters around health care workers and close contacts. Lately the numbers are growing seemingly exponentially. By March 27, 2014 WHO reported 206 confirmed cases. By end of April 2014 the WHO case count increased by more than 50 additional cases. The total as of last month there has been reported at 536 laboratory confirmed cases, and 145 deaths. While the apparent case fatality rate has appeared to decline, from ~50% in the early days of MERS to approximately 25% depending upon the country, that is still a high percentage of deaths per cases infected. While there is still no readily available vaccine against MERS, and the use of current antiviral medications remains in question, an early index of suspicion by well informed health care professionals can reduce the risk of spread, and initiate aggressive intervention, which can also provide life saving support at the earliest possible critical junction in care.