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From the buzzards perspective...

Random articles that are created as I travel, experience new things, meet new people and discover new insights.

  • Writer's pictureEddy Weiss

Are we training for the real threat?

For some reason, Bill Gates has gained a reputation for predicting certain climate changes and while I do not like him nor all he stands for, I am always intrigued by minds like mine that think in terms of “climates”.

Gates warned of the impending pandemic back in 2015 and was relatively accurate in his predictions as to how it would be dealt with.

Lately, Bill Gates has been speaking about another climate change and warning leaders around the globe about the threat of bioterrorism and how it is being relatively ignored at the moment..

I do not get to speak on bioterrorism as much as I would like, in fact, it has been 6 years since I was allowed to address the issue on a stage, so I am taking the opportunity here to do a little education and join Mr. Gates in a little forecasting.

Bioterrorism refers to “the intentional release of biological agents or toxins for the purpose of harming or killing humans, animals or plants with the intent to intimidate or coerce a government or civilian population to further political or social objectives".

In light of rogue balloons floating around overhead, it gives one pause to think about the implications. Why go to the trouble of a bombing or blowing up buildings? Why spend months and months planning an attack that could be thwarted by the slightest slip-up?

How simple it would have been to have dropped a glass vial or two in the stands at the State Farm Stadium in Glendale Arizona last Sunday? The cheap seat tickets ran $4,886.

imagine a sugar packet. That much Anthrax (Bacillus anthracis), about one gram, will contain one trillion spores that if effectively distributed would kill thousands of people. The 9-11 attacks only killed 2,996.

So how difficult is it to get those "sugar packets"? Anthrax spores are easily found in nature and can be produced in a relatively basic lab and can also last a long time in the open environment.

So let us return to last Saturday. perhaps the decision was to buy two tickets to the Super Bowl so two of us could go. We have grown our Anthrax and now we have it in powder form. With over 70,000 in attendance, not including staff and security, this bioterrorism looks like a pretty efficient way to make a point.

Compared to the $500,000 September 11 attacks, this scenario looks to be more like $20,000.

Recently, British journalist Amol Rajan asked Bill Gates what was in his view the big future threat facing humanity that we were not thinking about enough.

Gates replied, "bioterror, which is really awful".

Bioterror and pandemics are sort of the same, says Gates, because they expose mankind to dangerous and even deadly diseases, but “bioterror is a little harder to defend against, because whoever’s trying to do it is [doing it] consciously and understands your defense system, so they can be trying to design around them”.

So who would create and carry out a bio-terrorism plot in the United States?

The sad answer is…anybody that wants to.

This may come as a shock to most of you, but despite some pretty drastic failures, ISIL (ISIS), or Da’esh, continues to pose a threat to international peace and security and they have an axe to grind. Recent analysis of the situation shows a growth in not only numbers but activity amongst ISIL ranks.

A report released just last week stated that there are many concerns on the part of global security leadership regarding increased risk of attacks in non-conflict areas by unaffiliated lone wolves or small cells inspired by the ISIL messaging.

Da’esh has gotten much better at the use of the internet and social media to perpetuate hate and inspiration that results in radicalization but more worrisome should be their newfound expertise in unmanned aerial systems (drones).

I would be amiss if I did not take another inch of the page to bring up that domestic terror threats are rising faster than anything coming from ISIS. While most Americans still see groups like ISIS as the biggest threat to the country, the truth is that American extremists are responsible for three times more attacks on U.S. soil. This situation is further complicated by the fact that a majority of these attacks are actually aimed at responders which could prove beyond catastrophic with bioterrorism.

Let’s go back to our scenario but move the location and time to Memorial Stadium in Lincoln, Nebraska.

It is a cool fall Saturday and both the Huskers and the Hawkeyes have taken the field for their rivalry game. Believe it or not, this game will pack the stands with 90,000 fans. 20,000 more than the Super Bowl. And security doesn’t even compare. The cost of a simple drone? Two cheap EXO’s will run about $600.

Getting the picture?

If a cop walks into your living room, looks on the mantelpiece, and sees an ashtray with a few joints in it, he can arrest you. If that same cop walks into your living room, looks on the mantelpiece, and sees a Petri dish growing anthrax spores, he can’t arrest you. That’s because possession of anthrax is not a crime unless it can be proved that it’s “for use as a weapon”. Oh, sure, there are a few more legal restrictions. If you want to get your anthrax culture from a U.S. lab, you have to obtain permission from the Centers for Disease Control and the Agriculture Department. This is basically impossible if you cannot demonstrate that you are a serious researcher or scientist. The relevant law was passed in 1996 in response to an incident in which a member of the white-supremacist group Aryan Nations purchased three vials of plague bacteria by mail. BY MAIL.

Bioterrorism and other high consequence biological events can result in mass casualties, epidemic illness, healthcare worker illness, environmental contamination, legal issues, and cause unease within the medical community and the community at large. Bioterrorism is perhaps the most catastrophic of terror attack when you factor in the fear, emotion, comprehensive inclusion of people and the overload of the medical response and treatment systems.

Biological incidents call for collaboration between multiple disciplines including healthcare, public health, emergency management, and law enforcement and require specific planning and response interventions, but how often have we addressed this type of terrorism? In my 30+ years at this game I have NEVER seen an exercise in a rural area for such an attack and have rarely seen larger cities do anything more than tabletop exercises!

As I read a CDC white paper on emerging diseases and the potential for bioterroism, I was shocked to learn that the CDC recognized the biggest challenge (and threat) from bioterrorism was the delay in reporting. In most cases studied, it took 26 days from attack to discovery. It was confirmed in this study that because sick people go to different clinics, go to different emergency rooms, go to and call different Doctors, that the delay in discovering that you have an outbreak on your hands takes more than three weeks! It was recommended that bioterrorism preparedness education should be emphasized to frontline workers as well as healthcare frontline workers so that the recognition occurs faster and thus the discovery of signs of an outbreak or attack can be responded to properly and in a timely manner.

So, I will go back to my previous statement regarding training and exercises; why are frontline workers not focus-training on this threat?

The most important step in the event of a bioterrorist attack is the identification of the event itself yet I doubt that I could find more than a handful of frontline responders that could tell me what this might look like s they pick up patients during flu season. This can be achieved by generating awareness, having high degree of suspicion and having a good surveillance system to assist quick detection.

In a previous blog this week I wrote about our current norovirus outbreak. How would you decipher the difference and be able to report an attack?

Without specific training and effective exercises, we could find most frontline workers lost in that 26 day period known as the “notification phase” before ever getting to the “response phase” where lives can be saved. By then, in most cases, it would be too late.

A bioterrorism attack is the deliberate release of viruses, bacteria, or other germs to cause illness or death. These germs are often found in nature. But they can sometimes be made more harmful by increasing their ability to cause disease, spread, or resist medical treatment. Because of this, they are perfect for a subtle attack that can take hours or days to manifest.

Biological agents spread through the air, water, or in food. Some can also spread from person to person. They don't cause illness for several hours or days. Current worries? Anthrax is at the top of the list followed by botulism, Ebola and other hemorrhagic fever viruses, plague and even smallpox.

Formulating and putting into practice SOPs/drills at all levels of health care will go a long way in minimizing mortality and morbidity in case of a bioterrorist attack.

If we do not start to look, train and exercise better, and if Mr. Gates is correct again, we could be in a lot of trouble. Maybe it is time we start to include this threat in our regular training or at least start having serious conversations about it whether we administrate an urban school or just drive an ambulance in a small town.


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