The CDC, Anthrax, Illegal Immigration, And The Public Trust (Part 1 of 2)
by DR. ROBIN MCFEE
June 27, 2014
"The single greatest threat to man's continued existence on earth is the virus." Joshua Lederberg, Nobel Laureate
I always like to start off a talk or an article with a happy thought. And there are few happier notions than the concept that a virus - something a billionth our size - can kill us in the span of a few days.
But if the virus remains a persistent risk, one of the greatest threats to the health security of the United States, and our local communities, is the growing population of illegal immigrants who can carry into our cities and towns an array of viral and other infectious illnesses typically endemic to their home countries and relatively uncommon in our country. And if emerging diseases arrive in the US, how well prepared, or even how proactive are our preparedness agencies, including the CDC?
This article addresses three critical elements to our national health security - policies that increase the risk of disease, the most recent problems facing CDC, and bioweapons preparedness - areas which this administration continue to earn low marks for their collective performance.
Among all the irresponsible acts and failed policies of President Obama to protect the citizenry, the craziest include those related to immigration and border security or lack thereof. Everyone including the village idiot and his slow brother can recognize why the Democrats and Obama want open borders, and tons of poor immigrants from South America to flow into the United States - the Latinization of US demographics has been predicted to nearly guarantee all but total DNC control of Federal and Blue State governments well into the 21st century. Within thirty years if population trends continue, the United States could become a one party nation - leaving the Democrat party in near total control of all government policies, edicts and actions.
Sadly the DNC remains blithely unconcerned about the tremendous burden local communities face in terms of crime, overcrowding of schools, increasing numbers of welfare recipients, and burdening the community infrastructure (schools, hospitals, law enforcement) that, prior to amnesty and other policies designed to attract large groups of mostly unskilled people, would expand in a more predictable, natural way proportionate to people moving in based upon work, income, and affinity. The DNC answer - more taxes to pay for these programs.
Let's be clear - this isn't being anti immigrant (my grandparents came through Ellis Island); this is about Obama abandoning rational strategies that allow for controlled immigration of skilled, healthy and employable people, instead fostering the current craziness of uncontrolled floods of folks who are largely unskilled, potentially criminal, possibly sick, and likely requiring public assistance.
Why would the Democrats risk your safety and health under the guise of being generous and caring? Simple! Most Latinos vote Democrat, with few exceptions. Most union members and welfare recipients vote Democrat - the two enterprises where many illegal aliens end up in. Is it any wonder Obama and his government are using the power of the Treasury and Immigration to bring in new voters, while packaging it under the guise of "it's for the children" or quoting the script associated with the Statue Of Liberty, citing our nation is one of immigrants (one pesky difference - most of our ancestors came in healthy, sponsored, and skilled, not to mention LEGALLY). The DNC accuses those who advocate for tightening immigration as racist, or anti-poor or the GOP is anti-opportunity for the disadvantaged. To all but the most intoxicated on liberal Kool Aide, these arguments are disingenuous. Alas, they are effective. And while we could argue against lax immigration on the basis of politics, economics, or security, for this article let's look at it from the perspective of health.
From a health preparedness perspective, we can barely care for the legal poor in our nation - public health departments are the stepchild of contemporary healthcare - underfunded and unable to attract the best and brightest in clinical practice with few exceptions. Public health hospitals are all a thing of the past, forcing private hospitals to take on an ever increasing burden of nonpaying patients and overcrowding. This is not about class but about resource management. But President Obama is all about shifting - cost shifting, blame shifting, risk shifting, attention shifting. Clearly he is happy making someone else pay the price for his policies. And who might that be taking on the risk of Obama's failures? You and me!
Moreover, our poor do not typically present with rare diseases. Illegals on the other hand, not only bring in with them their culture, they bring in a microcosm of the many illnesses endemic in their home lands. And South America is a continent sized Petri dish of pathogens.
Now consider for a moment the risks of cohorting thousands of people from impoverished countries with poor sanitation, low vaccination rates, malnutrition, questionable hygiene practices, and high rates of communicable diseases including sexually transmitted diseases.
Obama et al by fiat are taking over military and other community resources in Arizona and Texas to warehouse illegals, especially the recent influx of unaccompanied minors, since our immigration enforcement agents are being burdened by hurdles in terms of sending these folks back. It is just a matter of time before the unaccompanied minors start an outbreak of influenza or other contagious illness. Already swine flu has been detected at a detention camp for minor illegal aliens (remember the outbreak in 2009?) otherwise known as H1N1 influenza, resulting in the need to implement a mass vaccination. And who is paying for this? And what about kids who have already been united with "relatives" (wink wink) likely illegal, across the country? Hope your flu vaccination is up to date!
Let's be clear - no one with a heart should feel anything but compassion for the impoverished who are trying to have a better life, especially the unaccompanied illegal minors, mere children who are sold, manipulated and most at risk. Having a porous border is not the answer. Solutions need to be sought after, starting with fixing their home countries.
We need to secure the borders - for public health reasons.
Now on to the CDC: mishandling anthrax and other challenges.
For many of you the anthrax threat of 2001 - otherwise known as the white powder events - remains a powerful memory and dark chapter in US history. The bioterrorist creed - kill some, scare millions, was alive and well.
Is it any wonder that biological weapons are more than the stuff of spy novels? Or that the notion of deadly pathogens causing global outbreaks continues to interest the public, which of course inspires the creation of films and television shows such as "Outbreak," "Contagion," or "The Last Ship." But the cold hard reality, beyond fiction, hype or politics - natural pathogens and biological weapons are capable of causing significant physical and psychological damage.
Consider the global outbreak of SARS, which in 2003 cost Canada over a billion dollars in lost business, as companies cancelled meetings in regions where the virus was causing illness, or avian flu outbreaks in the mid 2000's, where over 100,000,000 birds were killed, and numerous people in the Pacific Rim were sickened and died. Or the thousands that died during WWII at the hands of Japan's bioweapons program. Or the animals sickened during WWI when a fledgling bioweapons program emerged in Europe. Or Oregon in the 1980's when a cult successfully used rudimentary food-borne pathogens to sicken a town.
Which is why, at least in theory if not statute, the pathogens considered to be the most dangerous to people, livestock, agriculture and the environment are relegated to the highest level of biosafety labs. I say theoretically because over the years several of the facilities here and abroad that have been tasked with securing lethal bacteria, toxins and viruses have had significant lapses in security. In the early aftermath of the fall of the former Soviet Union (FSU), their bioweapons research facilities' security had a few "gaps" to say the least, (think ‘let's trade a vodka for a vial of smallpox?') resulting in some of the biological agents going unaccounted for. Lest we get tempted to feel superior to our Russian counterparts, US facilities continue to get less than exemplary marks for security or adhering to safety procedures.
Most recently the Centers for Disease Control (CDC) mishandled the deadly bacillus anthrax, resulting in over 80 people potentially at risk for infection. According to the CDC, two recurrent problems have occurred - failure to wear full protective gear because the workers believed the samples did not pose a risk, and failure to make the samples lack the capacity to cause disease. The technique used to neutralize the risk of anthrax didn't work completely. The CDC stated at one point the spores (bacillus anthracis) may have even been aerosolized and dispersed into the air. Nevertheless the CDC has offered antimicrobial meds to many of the lab workers. Anthrax carries a high case fatality rate untreated and, unfortunately even for those who are treated. Recall in 2001, shortly after 911, anthrax was spread through the mail, resulting in 5 deaths, over a dozen serious illnesses, and a nation afraid to go into their laundry room, fearing ‘white powder' and scared to death to open the mail. Terrorism 101 - scare the heck out of people. It worked.
I was tempted to title the article "CDC and the Anthrax Follies" except that most of us who have been in the biopreparedness arena hold the CDC in high esteem, which makes their ongoing pattern of security, sample-handling, and environmental problems especially worrisome, and disappointing. The CDC is considered one of the "go to" and critical infrastructure organizations to protect the public in terms of emerging biological threats - terrorism weapons, natural epidemics or novel pathogens like HIV in the 1990's or swine flu in the 21st century. Their good works notwithstanding, the CDC is betraying the public trust by not remedying their ongoing lapses in security, the mishandling of materials, and the ongoing structural/environmental problems, that have been documented by various governmental and non-governmental investigations.
As someone who headed a bioterrorism preparedness center during the 2001 anthrax events, this naturally occurring pathogen that can be altered to create a biological weapon, is not something to become cavalier about. So while poisons like cyanide, toxins like ricin, viruses like ebola or bacteria such as anthrax are the stuff of spy novels and SciFy movies - spawning the Andromeda Strain and other cinematic interpretations of biologically based doomsday weapons, the fact is, these pathogens are in the here and now, and capable of causing a major problem. There are indeed pathogens out there for which no cure exists, and quite frankly most of us wish were never invented, created or discovered. As listed in my books, there are dozens of pathogens suitable as bioweapons; the use of toxins, poisons, and diseases dating back to before Christ.
As of 2014, there are hundreds of labs in the US and internationally, that are doing legitimate biodefense research, and many players - state and non-state sponsored groups that are interested in creating, or stealing biological weapons, not the least of which are Russia, China and Syria. The threat is real, widespread, and growing. Syria not only has a robust chemical weapons program, but a biological weapons threat, more rudimentary but never the less real. Russia by far has the most advanced offensive bioweapons capabilities, but China and other less than savory nations have spent much effort developing asymmetric, and WMD capabilities.
In addition, Mother Nature can pack a whallop just with her non weapon emerging pathogens - ones that are newly discovered as we encroach upon previously undeveloped regions, or because of the inherent capability of microbes to interact with similar ones and become more lethal as something we've never seen before. Such is the case with the early avian flu strains of 1997 through 2014, or SARS coronavirus.
Whether research is for good or evil purposes, handling tiny microbes requires multiple layers of security and safety protocols, beginning with the buildings, labs, ventilation and containment systems, and site selection, to the training and personal protective equipment for the people inside those facilities, and procedures to protect people nearby.
Unfortunately from a preparedness perspective, the CDC has had a variety of safety breaches and security lapses between 2007 and 2014 - not inspiring confidence at a time when very little in the Obama Administration that deals with homeland security inspires confidence - from the shambles of border security, to the redacting in security policy documents anything suggesting Islamic radicals as terrorists, to, well you get the idea.
Almost ten years ago, vials of the 1957 influenza virus were mistakenly sent to various labs across the globe, most of which were in the US. The CDC response was to have the labs certify they destroyed the vials - they would accept a faxed document as sufficient ‘proof.' Hmm, call me crazy, but the CDC might have wanted to employ a bit more aggressive stance in ensuring the causative agent to a widespread outbreak might have been better contained, and more compelling evidence the vials were indeed handled appropriately.
Over the years malfunctioning airflow and ventilation systems have, if you will excuse the pun, plagued the CDC. It is a no brainer - the ventilation system, negative pressure rooms, air quality - these are the bedrock and foundation for safe handling of deadly pathogens from an infrastructure and facilities perspective. ABC News and others reported the CDC reportedly used duct tape to seal a lab that was housing Coxiella burnetii - the causative agent for Q fever - a pathogen that is considered useful as a bioweapon. A top flight facility, using duct tape - seriously?
Even back in 2012 it was noted that the CDC's building 18 which houses some pretty snarky pathogens, well it looks like there was a poorly engineered airflow system, and that the daily samples were not always checked in a timely manner. The CDC invested hundreds of millions of dollars to do research on deadly pathogens. First rule of working with these agents....you don't even allow the lab to open up and bring people in, unless key protocols, safety procedures, and critical infrastructure are in place, and well practiced. Given the postlude update that the ventilation system may have been sub-optimally working in more recent times, and that the CDC will now go back and check the daily air samples - would you trust their assertion that all is well? There is a reason for layered safety protocols. Of course the CDC was allowed to investigate and control the report on their findings.
The CDC reported 639 potential release incidents between 2004 and 2012 with 11 lab acquired infections confirmed. More than 10,000 people have approved access at places working with "select agents" biospeak for biological weapons pathogens and deadly agents capable of disrupting food supplies as well as harming people.
In 2013 the Dept of HHS IG repeatedly cited the CDC for safety and security problems in its labs in Atlanta and Fort Collins - failure to secure potential bioterror agents, not properly training employees who work with these pathogens. Yet CDC remained responsible for inspecting itself. This is like deputizing the five year old who just pilfered the chocolate chip cookies to then investigate who robbed the cookie jar! Ludicrous.
Federal security and science leaders in the Executive office of the President do not seem to share the sense of urgency the GAO has. In their February 2013 report the GAO states "There is still no one agency or group that knows the nation's need for all US high containment laboratories." There continue to be no national standards for lab design, construction and operation, making it more difficult to assess and guarantee safety the report stated.
Two years ago ABC did a nice job reporting on the CDC -It appears the CDC recognized they would fail objective reviews of their safety procedures. Instead of covering their tails, they should be concerned about the residents in the Atlanta area, the scientists who daily risk their lives, and the citizens of the USA who entrust at least some of their health security to this organization, which like so many under the Obama regime are increasingly concerned about hiding errors, instead of fixing them. With such ongoing mishaps, years of examples of ventilation system malfunctioning, does CDC still have the right to police itself?
When our top civilian preparedness agency can't keep its house in order - and allowed to investigate their own house, this calls into question the CDC's ability to uphold basic security and begs the question - why are we continually allowing the CDC to police itself?
Congressional reports have also repeatedly found flaws in the security of high security labs nationwide, including government installations.
Interestingly a friend was flown out to an oil platform, exhorted the virtues of their culture of safety. This oil platform has entrusted the operations to a safety officer. When my friend was visiting the platform as an attaché from the CEO of the corporation, the safety engineer came into a high level meeting, and announced she was concerned about slightly elevated readings on a particular well - still within safety limits, but she was concerned, so she shut it down to investigate. She didn't ask, she announced - "close it down." The head of the rig later said that just cost the company around 2 million dollars - a day! And she has the authority to do it for safety. Yet by comparison the CDC uses duct tape and masks its safety flaws. This is not the behavior of a first class US agency. For an agency arguably entrusted with the public welfare, there are some tasks you don't screw up on or get lax with.
For an agency that is tasked with and accustomed to handling deadly pathogens, against the backdrop of the anthrax events of 2001, and widespread recognition in the bioterrorism preparedness community that there are many country and non state sponsored interested parties with wide ranging capabilities - from nascent to well developed bioweapons - the CDC must be above reproach, and make some tangible, sustainable and institution-wide changes.
(Please return for Part 2)
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Dr. Robin McFee, MPH, FACPM, FAACT, is a physician, and clinical toxicologist. As medical director of Threat Science - and nationally recognized expert in WMD preparedness, she consults with government agencies, corporations and the media. Dr. McFee is the former director of the Center for Bioterrorism Preparedness (CB PREP) and bioweapons - WMD adviser to the Domestic Security Task Force, the former chair of the Global Terrorism Council of ASIS International, and a member of the US Counterterrorism Advisory Team. She has coauthored two books: Toxico-Terrorism by McGraw Hill and The Handbook of Nuclear, Chemical and Biological Agents, published by Informa/CRC Press