A large-scale biological attack, or campaign of attacks, against one or more US cities could lead to catastrophe, both in terms of lives lost and in economic and societal disruption. However, it is within the power of the US government to mitigate the consequences of a biological crisis through effective leadership, policy, research, and emergency response.
The anthrax attacks in 2001 galvanized government action to advance national programs in biodefense research, drug and vaccine development, medical countermeasure (MCM) stockpiling, hospital preparedness, and a range of other biosecurity and biodefense initiatives. As a result, the United States currently has a much higher level of biopreparedness than it did prior to 2001. Yet, despite the progress made since 2001, a large-scale biological attack (or the immediate threat of such an attack) against one or more American cities would require additional and extraordinary national action in short order.
This report examines a scenario in which the United States is suddenly faced with a newly emerged intentional biological threat (biothreat) that could produce catastrophic public health consequences and threaten our economy, government, and social structure. This scenario was presented to 71 biodefense, medical, public health, life science, and homeland security thought leaders who were then asked what near-term and long-term policies and programs they would recommend in response to such an emerging crisis.
Based on our analysis of expert responses, this report condenses the best ideas into an organized set of proposals for leadership in the areas of:
- Governance and Strategy
- Public Health Response
- Medical Countermeasures
- Healthcare System Response
- Decontamination and Remediation
- Environmental Detection
In other words, this report is intended to provide a Jump Start for an effective response in a time of national crisis. If the recommendations in this report are fully implemented, the effects of a biological attack on this country could be significantly reduced.