Threat of Germ Warfare and Bioterrorism

Mr. FRIST. Mr. President, I rise to discuss an issue based on my observations over the past week, an issue clearly on the minds of many people, and that is the potential threat of germ warfare and bioterrorism. Over the weekend, there was a lot of discussion through the various media outlets about our broad vulnerability to terrorism in the United States of America, in part based on intelligence and in part based on the events of September 11. Over the last week, many people have rushed to obtain antibiotics and gas masks to prepare for the threat of bioterrorism or germ warfare-- the threat that is posed by germs, bacteria--if viruses fall into the wrong hands. Many people are concerned that given the powerful destructive ability of some of these viruses, they could used in a way that threatens not only all Americans, but all of civilization. A lot of people called me over the weekend, recognizing my interest in this topic and recognizing I had participated in passing a bill called the Public Health Threats and Emergency Act which was passed in the year 2000. People have asked if the threat of bioterrorism is real? The answer is yes, it is real. In fact, we have already seen the destructive use of bacteria by people in this country. In 1984, there was an outbreak in Oregon of salmonella poisoning from which over 700 people suffered some illness. This outbreak was caused by members of a religious cult placing living bacteria in the salad bars of 10 different sites across the State. The "bio" part of biogerm warfare or biochemical warfare is the living organism, and that is what was inserted in the salad bars that caused the illness of about 700 people. We know germ warfare has been used, so the threat is real.

But before people attempt to respond to this threat by rushing out and buying items, we need to put the threat of bioterrorism in perspective. The overall probability of a bioterrorist attack is low. I do not know exactly what that number is. In fact, we cannot put a specific number on it, but the overall probability of a terrorist attack using biology, bacteria, living organisms--is low. However, it is increasing. It is now our number one or number two threat, and, at least to me, it is clear that we are highly vulnerable in the event such an attack takes place. The consequences of such an attack, whether it is with anthrax, smallpox, tularemia, pneumonic plague, nerve agents or blister agents, is huge. Why? Because we are ill equipped. We are unprepared. However, in saying that, we have to be careful that we do not become alarmists. People will have nightmares, will not sleep at night, and the response should be the opposite. We need to recognize there are things we can do right now, first and foremost, to develop a comprehensive biodefense plan capable of preventing a bioterrorist attack. Obviously, prevention should be our primary goal from the outset. We want to keep biological weapons out of the hands of people who are intent on destruction. At the same time we can be prepared--if these germs and agents fall in the hands of a potential terrorist--by preparing an effective response plan. Third, is the response, an area called consequence management, crisis management after such an assault takes place. Yes, the threat is real, but very low--a tiny probability, but growing. Why do I say growing? Because on September 11 we witnessed a calamity the likes of which have never been seen before in the history of the world. It was unexpected and unfathomable--using planes as bombs. We know those events were carefully planned out over a period of years in a very sophisticated way that was obviously well financed. Therefore, I will say it is growing because we did not expect it, and because it has occurred several years after Khobar Towers and after the attack on the USS Cole. So there is an increasing threat of calamity and destruction. This threat is rising, secondly, because of scientific advances in areas such as aerosolization. People talk about anthrax and how you cannot really aerosolize it--that is, breaking it down into defined particles so it can be inhaled into the lungs--because 10 years ago we tried to do it and could not do it. However, over the last 10 years there have been huge advances in this technology. Today we use nebulizers in hospitals to aerosolize particles to get medication deep into the lungs. We did not have that technology 10 to 15 years ago, but the technology has been developed. Take perfume, for example. When one goes through a department store, one can smell the perfume around. The technology of aerosolization has progressed rapidly over the last 10 to 15 years. What we thought could not be done 10 or 15 years ago can be done today because of advances in technology. Another example is airplanes spraying chemicals. They say: Oh, those crop dusters cannot do it, but there are some dry chemical crop dusters that might be able to spray agents. I have mentioned these examples because science has changed and what we could not do years ago can be done today. In addition, the scientific expertise related to biochemical warfare is there. A lot of people don't realize that during the 1980s, well after a general pact in 1972 was agreed upon by really the world, the Soviet Union set out in a very determined and aggressive way to develop biochemical weapons. The number one goal of this project was the development of pathogens that could kill. This was not a little, secret project. This project involved as many as 7,000 scientists whose professional being, through the 1980s in the Soviet Union, was to develop these pathogens and effective mechanisms for their delivery. With the fall of the Soviet Union 13 years ago, those scientists all of a sudden became unemployed. With no employment available in the former Soviet Union, those scientists have gone elsewhere in the world. We do not know where they all are, but we do know that they spent their entire professional life studying how to develop the boichemical weapons that threaten us today. I say that because it is not beyond the realm of possibility that those scientists can be either hired or bought. All of this is in the public record, and, again, I want to be very careful because I do not want to be an alarmist. On the other hand, people need to realize that from the technology and the scientific standpoint, the expertise is out there. The third area, and the reason why I say the risk is rising compared to 10 years ago, is that the United States today has emerged as the sole superpower of the world. Without the cold war and the sort of balances and the trade-offs and the push and the pull, the United States has become the target of many people who resent us, who do not like us, who are jealous of us, and a lot of that fervor today will hit the surface, or was hitting the surface more than 10 or 15 years ago in the middle of the cold war. So, the threat is real: low probability but rising. Let me just close on an issue that has to be addressed, and that is this whole field of vulnerability. Why are we so vulnerable today? We have heard recently that the Federal Government has worked aggressively and compared to 4 years ago, there has been enormous improvement at the Federal level. We are investing money that was not being invested 4 years ago. We are organized. We have 12-hour push products that allow us to very quickly could get antibiotics and vaccine, although not enough vaccine. We have a delivery system that could be mobilized very quickly. All of this is good. We also know that at the Federal level we are not nearly as coordinated as we should be. Treasury, Defense, Energy, and Health and Human Services are all doing something, but according to the GAO report that came out last week, we need better organization and better coordination to eliminate the duplication and to eliminate the possible conflicting messages that are sent from the Federal level. So, we can coordinate better. I am delighted that Governor Ridge has taken on this overall responsibility because that is the first step toward better coordination. What really bothers me, when I say the vulnerability is high in spite of low probability, is that our public health infrastructure has been woefully and inadequately underfunded over the last really 15 years to two decades. If there were a bioterrorist attack using germ warfare, what would happen? Basically, you have to diagnosis, you have to have good medical surveillance, you have to be able to assimilate a response team, and you have to do in it a rapid fashion. That is done through our public health system. The difference between conventional weaponry and bioweaponry is that bioweaponry requires first responders that are not just the firemen and the policemen, which are so critical and whose courage was so well demonstrated 2\1/2\ weeks ago, but in addition the first responders have to be the physicians, nurses, and the people who are managing the public health systems today.

Most physicians have never been trained to recognize smallpox or to recognize the pneumonic plague that affects the lungs or to recognize tularemia or the various types of food poisoning. They have not been trained. When you see 100 cases of flu, you do not even think about pneumonic anthrax. So we need better training. We have underfunded the public health infrastructure. Communities of fewer than 25,000 people are being served by public health units of which fewer than two-thirds have fax machines or an Internet connection. The ability to communicate between public health units once something is suspected or identified between the public health entities is absolutely critical. This communication infrastructure, at least from my standpoint, as a physician, as someone who has dealt in treating the immuno-compromised host through the field of transplantation for 20 years before coming to the Senate, is totally inadequate today. There are four other things that we can do. The bill that we passed in this body last year, the Public Health Threats and Emergency Act, is a good first step. It addressed this prevention, it addressed this preparedness, and it addressed this third category of consequence management. Unless we support our public health infrastructure, we cannot minimize the vulnerability that is out there today by training those first responders, by making sure that coordination at the local level among various entities is intact. This coordination is not there today because we have underinvested. Finally we must make sure that there is coordination at the State level and then at the Federal level and then across the Federal level, and that there is appropriate coordination without duplication. I will simply close by saying that now is not the time for individuals to go out and hoard antibiotics or to buy gas masks. Now is the time for us to come together and develop a comprehensive biodefense plan that looks first at prevention to make sure we have the adequate intelligence, the appropriate research in terms of viruses, in terms of vaccines, and in terms of methods of early detection; second to look at preparedness, to make sure we are stockpiling the appropriate antibiotics, that we have a sufficient number of vaccines, which we simply do not have today but we are working very hard to get; and third that our consequence management and crisis management could handle what is called the surge product, the rush of people to emergency rooms, in a straightforward way. I am very optimistic. We are working very hard over the course of this week on how much money should be put into this effort. We had a good first step last year in the Public Health Threats and Emergency Act. I am very confident that the American public will be very well served by this body and by the administration as we look at this critical area of biodefense. I yield the floor. The PRESIDING OFFICER. The Senator from North Dakota. Mr. DORGAN. Mr. President, we are in morning business, is that correct? The PRESIDING OFFICER. We are in morning business.