Worries over domestic terrorism rarely extend to biological weapons; if the authors are correct, that may be a fatal mistake.
Osterholm (former Epidemiologist in Chief for the state of Minnesota) and Washington Post reporter Schwartz present three fictional scenarios illustrating the raw potential of bioterrorism. The first, in which a lone terrorist spreads anthrax spores over a football stadium from a crop-dusting plane is frightening enough. But the real nightmare is the third, showing the probable effects of the release of smallpox in a Chicago shopping mall near Christmas season. This highly contagious disease, against which only a minority of the population now has any real immunity, would wreak havoc in a modern city—especially now that insurance plans have made hospitals pare back their facilities to the absolute minimum. The system is no better prepared for plague, tularemia, or botulism—the diseases most widely being developed as bioweapons. Osterholm points out the lack of training (one simulation showed that few medical personnel would even recognize the symptoms of anthrax), of vaccines, and of antidotes (the supplies currently in stock would barely suffice for emergency workers). Nor has the government recognized the distinctions between the kind of threat posed by bombs or chemicals and the more difficult problems (e.g., enforcing quarantines) inherent in an outbreak of infectious disease. Government officials cite Iraq’s failure to deploy biological weapons in the Gulf War as proof that the threat is still remote. That may be true for military weapons designed for battlefield delivery, says Osterholm, but the expertise necessary for a terrorist strike is within the reach of many graduate students. He concludes with a seven-point plan for change, addressing the key loopholes in our defenses.
A sobering exposé; required reading for anyone concerned with the state of our medical preparedness.