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LB Cong. Steve Horn Chairs House Hearing on Preparations for Bio & Chem Attacks

  • CA Health Dir. Diana Bonta urges more federal funding to assist preparedness for biological and chemical terrorism at state and local levels
  • NY Congresswoman asks if panelists agree with Fed HHS Sec'y (on "60 Minutes") that U.S. is prepared for bio attack; none raise hands in agreement; some later call preparedness a matter of degree

    (October 5, 2001) -- LB Congressman Steve Horn, who chairs the House Subcommittee on Government Efficiency, Financial Management and Intergovernmental Relations, held a significant -- and at times disturbing -- hearing examining coordination efforts among federal, state and local agencies.

    Those testifying included:

  • Diana Bonta, R.N., Dr. P.H., Director of CA Dept. of Health Services (and former LB Health Dept. chief), who urged more federal funding to assist biological and chemical terrorism preparedness programs at the state and local levels;
  • Amy Smithson, Ph.D., Dir. of the Chemical and Biological Weapons Nonproliferation Project at the Stimson Center, the most plain spoken and arguably controversial of the panelists. Ms. Smithson said doctors and first responders should be vaccinated before the public and the public should use "common sense": "If you do see a crop duster overhead, get inside, shut the windows, shut the doors and you will have provided some ample protection for yourself. And if you're still nervous about it, go jump into a shower. I mean, ask fire folks, one of the most effective decontaminants is water";
  • Scott Lillibridge, M.D., Special Ass't to the Sec'y, Dept. of Health & Human Services, who indicated his agency is developing local response systems that include recognizing disease symptoms and the local capability to manage the remains of the deceased; and
  • Edward Norris, Police Commissioner, City of Baltimore urged that all levels of law enforcement must do a dramatically better job of collecting and sharing intelligence. "If we don't, the chances are much greater that terrorists can operate at will and cause even bigger disasters in our country."

  • A dramatic moment came when subcommittee member Cong. Carolyn Maloney (D, NY) asked a panel of witnesses (including Ms. Bonta) to raise their hands if they agreed with a statement by Health and Human Services Secretary Tommy Thompson on 60 Minutes that "we're prepared to take care of any contingency, any consequence that develops for any kind of bio terrorism attack."

    None of the panelists raised their hands, some hesitated and following an awkward pause, a few suggested the amount and type of preparedness was "a matter of degree."

    Ms. Bonta said, "[In California] we have the advantage of having years and years of preparing for earthquake preparedness and other natural disasters, but this is a unique situation in which we need more work on communication, on training, on laboratory preparedness and having surveillance in epidemiology."

    The hearing carried by C-SPAN 3 live on the internet.

    In his prepared opening statement, Congressman Horn called the Sept. 11 terror attacks "an unimaginable wake-up call to all Americans: We must be prepared for the unexpected." He noted that while "most experts believe that the likelihood of such an attack is relatively low, we must ensure that the nation has an emergency management structure that is prepared to handle even the most remote possibility of such an attack."

    Horn said that "despite billions of dollars in spending on Federal emergency programs, there are serious questions as to whether the nation's public health system is equipped to handle a massive chemical or biological attack." provides extended transcript excerpts below, which are unofficial, prepared by us, from oral and written testimony. Ellipses indicate text deletions; not all speakers are indicated; not all testimony is transcribed.

    Diana Bonta, R.N., Dr. P.H., Director, CA Dept. of Health Services

    : ...Many have asked, "Is the nation prepared for a biological or chemical attack?" If such a horrific event were to occur, the safety of every man, woman and child would depend on the public health system. This system must remain strong...

    Public health resources would be significantly challenged following a biological or chemical attack. In recent years public health systems in the nation's largest cities have become more involved in terrorism planning and preparedness using funds appropriated by legislation authored by Senators Nunn, Lugar and Domenici. Under this program, the nation's 120 largest cities -- including 18 in California -- have received funds for training, exercises and equipment to enhance their capability to respond to incidents involving weapons of mass destruction, including biological or chemical terrorism.

    The program trains "first responders" -- the firefighters, police, emergency management teams, and medical personnel -- who will be on the front lines in case any of these attacks occur in a U.S. city...

    In 1999, the Centers for Disease Control and Prevention developed the chemical and biological terrorism response and preparedness program. California and several other states and large municipalities were awarded five-year funding to develop response and preparedness plans concentrating on five areas which I'll summarize:

  • Preparedness Planning and Readiness Assessment: [From written testimony: California is developing a terrorism response plan, assessing state and local public health capabilities, and conducting planning and training exercises with local, state and federal partners.]
  • Surveillance and Epidemiology Capacity: [From written testimony: California is finalizing surveillance and epidemiology plans for biological terrorism and for chemical terrorism, and providing training to local health departments.]
  • Laboratory Capacity-Biological Agents: [From written testimony: California has developed the capability of testing for all bioterrorism agents at the state laboratory facilities and is strengthening its local laboratory network.]
  • Laboratory Capacity-Chemical Agents: [From written testimony: California is developing analytical capability for chemical agents in blood and body fluids and is providing extra capacity to CDC's chemical agents laboratory.]
  • Health Alert Network/Training: [From written testimony: California is developing the rapid health electronic alert, communication, and training system that includes an automated notification system, and a secure web site and e-mail.]

    These grants were intended to "kick start" all of this preparedness at both the state and local health department levels and California received $2.5 million per year to develop the program. We [California] were the only applicant to be funded in all five areas in the country and Los Angeles County in addition received $900,000 to assist them.

    Since the start of this program certainly California has made great strides in preparation for biological and chemical terrorism and I can tell you that we've recently had training, for instance, in California. Just this week we had forums that involved hospitals, first responders, public health individuals, so that we would have additional training.

    I'll summarize then...First and foremost, we need additional resources to ensure that the federal, state and local public health infrastructure is strengthened. Bioterrorism knows no state boundaries. With additional resources, we would do the following:

  • We would improve existing surveillance systems, especially at the local level. [From written testimony: We must develop and expand rapid surveillance and detection systems using not only health care providers and laboratories, but also emergency responders, coroners, veterinarians and medical or pharmaceutical databases. Collecting this disease intelligence is just the first step. There is just as great a need to bring on professionals with epidemiological expertise to evaluate this information and interpret findings.]
  • We would further coordinate state and local planning and activities. [From written testimony: Effective communications systems and coordination of roles and responsibilities are essential. Training is needed for local public health workers, emergency medical crews and health care providers.]
  • We would provide ongoing technical training for state and local staff, and for the primary care provider community, in recognizing symptoms, treatment protocols, and prophylaxis involving bioterrorism agents.
  • We would conduct response readiness and risk assessments of the public health system through coordinated exercises.
  • We would expand the laboratory capability in chemical detection.
  • We would further develop prevention strategies. Risk assessments must be conducted in many areas such as food services, food production, nuclear and chemical industries and water supply systems. Currently, California is developing a guidance document for growers, food distributors, and food service industries regarding hazard assessment.
  • And lastly, to evaluate the legal and regulatory statutes to determine whether they provide sufficient authority for appropriate action during an emergency.

    .... I encourage the subcommittee to do everything it can to support federal funding and assist biological and chemical terrorism preparedness programs at the state and local levels...

    Amy E. Smithson, Ph.D., Director, Chemical and Biological Weapons Nonproliferation Project, Henry L. Stimson Center

    [Responding to reports that members of the public were buying gas masks] This is one of the aspects of the aftermath of Sept. 11 that has saddened me the most. Americans have rushed to do things that they think will serve their interest when in fact that may not be the case. If this gas mask is not fitted, and if you are not instructed in how to use it, and understand the changing of the cannisters, and how to make sure it fits when you're running, then you've bought yourself some false protection.

    If you do see a crop duster overhead, get inside, shut the windows, shut the doors and you will have provided some ample protection for yourself. And if you're still nervous about it, go jump into a shower. I mean, ask fire folks, one of the most effective decontaminants is water."

    In terms of stockpiling antibiotics...that's also false security, and it could backfire on Americans. If they start self-medicating themselves with the first case of the sniffles that they get this fall, the after effect could be that the medications won't work for them later when they really, truly need them...

    I hope that America's physicians will get better educated on what is happening in the country and stop writing prescriptions right now.

    Colloquy between Smithson and Cong. Maloney

    Cong Maloney: ...[T]here's [seemingly] a universal agreement that the smallpox virus is the single most dangerous raw material for a non nuclear terrorist attack...We know that it could kill, or in the past has killed, up to a third of those infected...Our own government has roughly 15 million doses of smallpox vaccine and has ordered 40 million more for delivery by the end of the year 2004.

    Many of my constituents in New York have called my office and asked for the smallpox vaccine. I have called the National Institute of Health, they have told me that it is not available...

    I'd like to ask some of our experts whether you think we should be developing more vaccine. Should our citizens have access to it? Even though we don't have enough for everyone shouldn't some of the people that are asking for it be able to have access to it?...

    Smithson: A few years ago, I spent several weeks in the former Soviet Union interviewing the former weaponeers who did this, who figured out how to turn diseases into weapons of war, and the Soviet Union did that with over 50 diseases...It's true, they did weaponize smallpox and they manufactured tons of it, and along with plague and anthrax, and they put it on top of ICBMs aimed at western population centers.

    And I think it would be foolhardy to assume that smallpox seed cultures only exist in one place in the former Soviet weapons complex, which consists of over fifty centers that were involved in the research, development, testing and production of these weapons.

    However when I talked with the weaponeers, there was one thing that they understood very clearly. Terrorists, they kept on telling me, are our common enemy, because Moscow has had its own encounter with terrorism...

    ...I did interview weaponeers and their colleagues who had gone to help Iraq, and Iran, and China, and North Korea. They had been invited to teach, but let's not make the assumption that that may be all that they did. Let's also not make the assumption that these governments would automatically share something like smallpox with a terrorist group, because if it's anything that a weaponeer understands, it's the consequences of unleashing something like that on a population, even if it's the population of your enemy, because that's something that goes around the world and would be very very difficult to contain.

    Let's also not the assumption that smallpox is for sale on the streets of Moscow or any other place. I mean, in today's environment, there's so many rumors that are floating around.

    ...If anybody should be getting smallpox vaccine in an emergency, it has to be the very people who are going to be there, we're expecting them to save our lives. The medical personnel, in hospitals, and the paramedics and other technicians as well as the firefighters and police.

    Cong. Maloney: Should we be vaccinating them now, in your opinion?

    Smithson: I think I'll leave that judgment call to others...I don't feel that there is imminent danger that smallpox is going to be released on this country. I think before we go doing a lot of knee jerk things, and this is an atmosphere that breeds knee jerk reaction, we need to carefully think through these matters...

    Show of hands on preparedness

    Cong. Maloney: ...How many people agree with [Health and Human Services] Secretary Thompson's statement, that he stated on 60 Minutes on Sunday, and I quote, "We're prepared to take care of any contingency, any consequence that develops for any kind of bio terrorism attack." Do you agree with this statement of being prepared? Raise your hand if you agree you're prepared? That we're prepared for all of this?...

    [No witnesses raise hands, some hesitate, awkward pause]

    Unidentified witness: I think it's all a matter of degrees, Congresswoman. I think we're prepared for many, many things and I think depending on the degree of it, we would quickly find that preparation outstripped by events...

    Diana Bonta: I think it is dependent upon degrees, because certainly we have experience in the United States where some local public health departments are still in buildings that were made for the polio epidemic. In 1988, when I was with the City of Long Beach, we were in just such a building. We had a rotary telephone and we had two computers that staff were even not fully trained in how to use. We've moved a lot way throughout the country and certainly in California, we have the advantage of having years and years of preparing for earthquake preparedness and other natural disasters, but this is a unique situation in which we need more work on communication, on training, on laboratory preparedness and having surveillance in epidemiology.

    Excerpts of Smithson written testimony

    [From Smithson written testimony] ...In all candor -- and these rescuers rarely mince words -- front-line responders are dismayed at the disarray of the federal government's preparedness programs. Any time the subject of federal leadership of terrorism preparedness programs was broached, the local officials gave eerily similar replies, which can be paraphrased as:

    "They've been at this for five years and they still can't figure out who is in charge." I was told time and time again that "all the federal agencies constantly preach at us about everybody working together at the local level, but it doesn't take a rocket scientist to see they are fighting with each other tooth and nail over the money and missions."

    ...Federally, the main challenge is not that more assets need to be built but that federal involvement needs to be coordinated and streamlined. Dozens of federal entities have been fiercely competing for the missions and money associated with unconventional terrorism response, an unfortunate circumstance that has resulted in redundant capabilities, wasteful spending, and, at the local level, confusion as to which agency would spearhead the federal component of a response.

    ...Given that monies to combat terrorism have been buckshot across over 40 federal agencies, the pace and size of the expansion of federal programming led inevitably to efforts that not only waste taxpayer dollars but imperil the overall effectiveness of the federal government's programming to prepare for and respond to terrorism. Duplication of effort certainly exists in the plethora of research and development programs that were launched to find new detectors and other response equipment. Had Washington policy makers consulted experienced first responders before throwing money at the problem, they might have realized that these individuals do not need all of the equipment that is being developed in their name...

    ...The time-tested and common sense alternative to the proliferation of training courses is the one that also underpins the all-hazards, echelons-of-response system that both states and cities know and advocate: institutionalization. If preparedness is truly to take hold nationwide on the front lines and be sustained in perpetuity, then it belongs in the local and state training academies, as well as in the nursing and medical schools...

    The prerequisite for institutionalization is standards, and all of the response disciplines-fire, police, EMS, hospital care providers-expressed an abundance of frustration over the absence of standards and protocols to guide them. Standards command the attention of rescue and healthcare personnel because they are the backbone of accountability. Other standards are established at the state level, flowing from the responsibility of governors to ensure public safety...

    Those who know first-hand the tremendous demands of responding to a disaster have a saying: "All emergencies are local." In a chemical or a conventional terrorist attack, the life-savers are not some federal response team that swoops in from across the country, but the local firefighters, police, paramedics, nurses, and physicians.

    ...Since the Domestic Preparedness Program began, talk inside the beltway has centered not on improving local response capabilities, but on how to enhance federal roles and capabilities. Accordingly, the federal government and its host of contractors have swallowed most of the domestic preparedness monies. In the year 2000, only $311 million out of the $8.7 billion spent on defense against terrorism went to enhancing the capacities of local emergency personnel to deal with unconventional attacks. If lives are to be saved in the aftermath of disasters, this ratio clearly has to be reversed...

    ...On behalf of the local public health and safety officials who have shared their experience and common sense views with me, I urge Congress to waste no time in passing legislation that brings the burgeoning federal terrorism preparedness programs and bureaucracies into line and points them in a more constructive, cost-effective direction. The key to domestic preparedness lies not in bigger terrorism budgets and more federal bureaucracy, but in smarter spending that enhances readiness at the local level. Even if terrorists never strike again in this country, such investments would be well worthwhile because they would improve the ability of hometown rescuers to respond to everyday emergencies.

    Scott Lillibridge, MD, Special Ass't to Health and Human Services Secretary Tommy Thompson

    ..Currently, states lack an optimum public health infrastructure at both the state and the local level. We will need to discuss and make planning on the long term as part of our overall preparedness effort.

    ...The HHS Office of Emergency Preparedness is also working on a number of fronts to assist local hospitals and medical practitioners to deal with the effects of biological, chemical, and other terrorist acts. Since Fiscal Year 1995, for example, OEP has been developing local Metropolitan Medical Response Systems (MMRS). Through contractual relationships with local communities, MMRS uses existing emergency response systems - emergency management, medical and mental health providers, public health departments, law enforcement, and public health departments - to provide an integrated, unified response to a mass casualty event. As of September 30, 2001, the OEP has contracted with 97 municipalities to develop MMRS systems. The FY 2002 budget includes funding for an additional 25 MMRS systems.

    MMRS contracts require the development of local capabilities for mass immunization/prophylaxis in the first 24 hours following an identified disease outbreak; and the capability to distribute materiel deployed to the local site from the National Pharmaceutical Stockpile. Local medical staff are trained to recognize disease symptoms so that they can initiate treatment; and the local capability to manage the remains of the deceased are also included in this effort.

    ...The issue of preparedness is a long term endeavor and will require us to broaden the depth and the breadth of our preparedness activities along all fronts in this war against terrorism. Priorities include strengthening our local and state public health surveillance capacity, continuing to enhance the National Pharmaceutical Stockpile, and helping our local hospitals and medical professionals better prepare for responding to a biological or chemical terrorist attack.

    Edward T. Norris, Police Commissioner, City of Baltimore

    [From written testimony]...As you know, Mr. Chairman, there has been much discussion about the disconnect among federal agencies that share responsibility for homeland security. What has not been discussed is the disconnect between federal and local law enforcement.

    My main point to you today is that I believe all levels of law enforcement must do a dramatically better job of collecting and sharing intelligence. If we don't, the chances are much greater that terrorists can operate at will and cause even bigger disasters in our country.

    Neither we, nor any other local law enforcement agency we know of, has been asked to contribute manpower in any broadly coordinated way. For example, there must be thousands of leads related not only to the September events but to the continuing threats the Attorney General has repeatedly warned us about. Local law enforcement has the manpower to follow up a very high volume of leads. The federal agencies may not. For example, according to the Bureau of Justice Statistics, the FBI has a total of 11,533 agents. There are nearly 650,000 local law enforcement officers in this country. We want to help, and I think the nation needs us to help.

    To prevent other terrorist incidents, pressure needs to be brought to bear on anyone who may be planning any attacks. Local law enforcement - not the federal agencies - is in daily contact with literally millions of people every day. The NYPD -- the department where I spent most of my career, in the last years as Deputy Commissioner in charge of Operations -- has over 10 million documented interactions with citizens. Those interactions include arrests, citations, field interviews, stop and frisks. They do not include the millions of other discussions officers routinely have with citizens.

    We deal on a daily basis with a network of registered confidential informants. We can debrief prisoners about suspicious activities that may be terrorist in nature at the same time we debrief them about traditional crimes. But we have to know what the FBI knows about threats, tips, or even just rumors. We have to know more about what there is to look for in our own communities so we can better protect our own people and be more effective gatherers of intelligence for the FBI.

    While the FBI has done nothing to prevent us from doing this work on our own, they have not given us anything but a watch list to go on.

    ...Why aren't we all working together to find the people the FBI is looking for? In short, I think the rules of engagement for law enforcement have changed forever inside this country. It may once have made sense for the federal agencies to withhold from local police their information about developing cases. Today, we all need each other if we as a nation are going to successfully counter threats that can come from virtually anywhere, at any time, in any form, including forms that could destroy whole cities.

    To prevent recurrences of terrorism, which could drive this nation into panic and economic collapse, I believe we must do the following:

  • 1. Federal agencies must share all locally relevant information with the nearly 650,000 state and local police officers who could be helping them today but who, for the most part, aren't.
  • 2. Police chiefs should receive regular briefings on even highly classified information to help those chiefs better direct their own internal intelligence and counter-terrorist efforts.
  • 3. The Communications Assistance for Law Enforcement Act (CALEA), which was passed in 1994 but has never been fully implemented, must be enforced. CALEA requires telephone companies to ensure that their systems and networks can accommodate federal, state, and local wiretaps in the face of changing telephone technology...

    In short, we must do all in our collective power not only to locate the collaborators of last month's hijackers, but also to deter all other terrorists from operating against our still vulnerable transportation systems, infrastructure and people.

    I think the threat is so great we should use every police officer in America in this fight...I believe the life of the nation may depend on it.

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