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Friday's lunchtime presentation

Richard Hutchinson, Ph.D. (BW Improved Response Leader, Soldier and Biological Chemical Command) gave a two-part presentation on threat variables and threat response, which was informative and thorough. Much of this information can be seen in the web-posted PowerPoint slides, white paper, and reprint, which he submitted.

A key idea that Dick championed was a Command & Control (C&C) simulator, which allows modeling of response components to see how all of these might work together. The simulation would also provide a tool to evaluate and improve these concepts. We are physically testing and modeling components of the BW response template, but a field test to really demonstrate such a comprehensive, system seems almost impossible. This simulation is needed to test our, and any other BW response system at the strategic level. Dr. Hutchinson mentioned there is beta testing of automating the BW response template at the city level through the RAMS (Response Assets Management System). This has been funded for 5 sites at present and takes two weeks to customize for each city. A much broader system would be needed to link the cities and other assets together.  Dick indicated his strong belief in the need for future research and development in this area.

Friday afternoon panels

The response teams from New Hampshire, New Mexico, and Maryland gave their insights for the afternoon's first panel discussion. New Hampshire is comfortable with the present Command and Control structure. They can active their command and control center within 15 minutes of being alerted to a disaster situation.

The two members of the Maryland National Guard Rapid Response Team, Bill Bograkos, D.O. (Lieutenant Colonel, Flight Surgeon) and Daniel Kaszeta (Disaster Preparedness Advisor, White House Military Office) stressed the following in their white paper and presentation: 1) build appropriate infrastructure to equip response. 2) the Crisis Management Planning cell is a multidiscipline team of people who must be ready to coordinate, communicate, and form an organized team (otherwise we will see (have seen) crisis, chaos, and confusion, 3) in comparing the 3 states presenting today, appreciate not only is the geography different but the threat analysis can be different, and, 4) The model to apply is the U.S. Interagency Domestic Terrorism Concept of Operations Plan, a copy of which they shared in reprint form. They are also confident in their area planning and preparation.

Paul Roth, M.D. (Dean, University of New Mexico, School of Medicine) led the team discussion for his state, reviewing some of the topics found in his white paper. They reviewed their collaboration with Los Alamos National Laboratories, Sandia National Laboratories, State Department of Health, and Lovelace Respiratory Research Institute to research new technologies, implement new population surveillance via real-time reporting of E.R. complaints which may be sentinel events, and to provide training of physicians and first responders. Paul stressed the very real danger of the current threat and pushed this concept of partnership between federal, state, and private entities to mount a meaningful response strategy.

There was a good discussion with Peter LaPorte (Executive Director, D.C. Emergency Management Agency) providing animated leadership. Peter¹s main point was that the response teams must share common training and communication skills.  In his experience, that public health people don¹t speak a common language with command and control personnel until they learn to understand one another.

The Response Technology Panel began with Mike Myjak (The Virtual Workshop, Inc.) reviewing how military technology and costs have made it cost-effective for the development of modeling and simulation (M&S) systems to improve training. The effectiveness of these systems was demonstrated convincingly in the Gulf War.  MEDical simulation NETwork (MEDNET) is a proposal to develop similar technology to apply to bioterrorism planning, training, and C&C implementation.  His paper provides many of the technological details, which Mike states are already in existence, ready to apply. The system could be useful for combat, natural disaster, and other training.

John Bowersox, M.D., Ph.D. (University of California, San Francisco) gave an overview of Telemedicine and how its present acceptance is limited to niches like prison or military medicine by social and market (reimbursement) forces rather than technological concerns.  In the future, informatics, the widespread use of computers and the Internet, and real improvement in patient care will lead to further acceptance.  John believes there will always need to be a human touch behind telemedicine and robotic surgery but he cited neurosugery as one area, this technology, is currently impacting.  Remote medical care, training, testing, and supervision are all feasible uses of this technology.

David Zelter, Ph.D. (Fraunhofer Center for Research), reviewed how computer visualization technology can contribute to detection through the use of sensors and monitoring. Situation awareness requires systems to monitor data and give alerts, filtering events from background, constantly data-mining to discover emerging threat patterns, and to utilize artificial intelligence (AI) stratagems to test the hypothesis, "Is an attack underway?" Decision-centered visualization is an interactive information architecture ergonomically assisting human thinking and analysis.

The panel on threat protection for biological and cyber threats had Dennis Kleinman, MD of the FDA further talk about the growing power for scientists to select virulent organisms through natural selection and then modify with variable genetic code that can be changed easily to defeat vaccine development. Dr. Jian Zhao presented his white paper on "mobile code," which will be covered in our white paper section. Mobile code refers to code that is transferred to a computer chip/system, via wire or wireless transmission, as instructions or data to change the behavior of the instrument or robot.  There are security concerns that terrorists could exploit to shut down our power and communication networks, by attaching this instruction code.

The panel on nanotechnology, robotics and genetic engineering featured scientific presentations by three Dartmouth College professors. Ursula Gibson described nanotechnology as engineering at the molecular level using physics, chemistry, and biochemistry to make a machine which can function at a molecular level. Daniela Rus reviewed her work with robots which can assemble and operate in different modes while using identical robotic parts, like a Lego set. Chris Lowery, MD, reviewed the remarkable progress of genetic engineering in attempts to treat human disease, emphasizing that this technology could be used for offensive or defensive weapon development.

Friday night address with panel discussion, public invited

Dr. George Baer, Chairman, Strategy and Policy Department, US Naval War College, welcomed the public and spoke on, "Is the American public safe from bioterrorism?"  Dr. Baer states that there is no certain answer this question.  Public awareness must not become public panic. Because there is a possibility of some attack, some social disaster, there is an absolute need to prepare.  Dr. Baer asks what are the social costs of public safety? Consider the New Hampshire state motto, "Live free or die." Will society trade freedom for security?  How does one balance the two? 

Does a potential terrorist have social rights?  Should a terrorist be treated by standard criminal process and procedures, or, should a terrorist be subject to vigorous counterterrorist measures which may abrogate that terrorists rights?  If urgent intelligence were needed, would torture be used as an effective means of reflecting the community's moral authority to protect itself from more terrorism?  The key to all counterterrorism is timely and accurate intelligence. This may require intrusive information collection by more powerful governmental agencies.  This may impose significant restrictions or even violations of what we think it means to "live free," that is to our civil liberties and perhaps even our constitutional rights.  This could affect our rule of law, our right to privacy, even the fabric of our "open society."  Dr. Baer asks us, if Bioterrorism is such a threat to national security that we will decide to sacrifice some freedom in the face of this threat?  Or would we choose to sacrifice the liberty and safeguards which we guarantee the innocent until they are proven guilty?  Would we allow torture and other violations of due process constitutional guarantees, which could protect an innocent terrorist, rather than sacrificing freedom for all?

Dr. Baer stated that is from discussions and debates such as this one, that society established political values and maintain cohesion.  This process can be aided by wise political leadership, by good information gathering, and our democratic election process.  We will have to decide how much is a society willing to live "less free" to prevent death.  Dr. Baer concluded by stating that the answers to these questions depend ultimately on public awareness, on results of a "live free or die" debate, and value judgments discussed above.  With this answer, politicians, police authorities, government agencies, and our military can plan intelligence gathering, preemptive action, and response planning.

Dr. Ken Alibek provided a broad and comprehensive review of bioweapons. He discussed his personal experience in the Russian bioweapons program. Key to his discussion was the nature of individual agents that have been developed and can be developed in the near future. He discussed the agents and how the specific weapons are classified. He also discussed have violated its our modify from their natural state to their new state to optimize delivery as a weapon. He also discussed examples of a series of known agents and how they can be weaponized further. Dr. Alibek discussed how these agents can be delivered to their targets, and how they would be spread throughout the targeted population.

Note:  We welcome additional information on these talks, panel comments, and audience participation.

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