Taming The Biological Beast

By Richard Preston
The New York Times, 21 April 1998

For decades, the conventional view among American scientists was that biological weapons
aren’t
much of a problem. Meanwhile, powerful bioweapons were developed and deployed by the Soviet
Union and probably by other countries, and the knowledge of how to make them has spread.
Smallpox virus can be made in glass jars the size of wine bottles and released into the air with a
humidifier. One F.B.I. scientist said to me: “We’re seeing a lot of hoaxes, and incompetent people
trying to make biological weapons. The incidents are happening at a rate of roughly one a month.
My feeling is that sooner or later someone is going to get it right.”

Having failed to identify the problem or come to grips with it intellectually or technically, the
scientific community and the Government now owe the public a makeup effort. It could start with
a few simple measures that would make us safer and less vulnerable.

As experts with whom I’ve been talking see it, the first step needs to be the involvement of
public
health doctors in emergency planning. Yet the Centers for Disease Control and Prevention
remains largely uninvolved, disconnected from the planning loop and inadequately financed for the
task. State and local public health surveillance needs to be strengthened. That would have an
immediate payoff, since it would help control new and emerging “natural” diseases that are now
taking lives in this country. And if a bioterror attack is recognized early, many lives can be saved.

Consider what might actually happen if a pound or two of dried anthrax were released into
the air
of New York City. Many thousands of people might be exposed, but only a small fraction of them
would get sick and die. It would happen over time — time enough to save many people if some
basic preparations have been made.

Anthrax incubates silently in the body for three days to several weeks after exposure. Then
the
first symptoms appear. Virtually no doctor in the United States has seen a case of anthrax or
knows how to diagnose it. The symptoms of anthrax resemble flu or a cold; then the victim dies of
what looks like pneumonia. Many days might pass before it would finally become apparent that
New York had been hit with anthrax. But where? And how much anthrax went into the air? The
F.B.I. would come under excruciating pressure to find the perpetrator, who would be long gone,
and the trail might have gone cold.

Everyone in the city would wonder if he had been exposed and whether another attack might
occur. There would be an overwhelming demand for antibiotics, which can cure anthrax provided
they are taken before symptoms appear. Antibiotics would disappear from the shelves instantly,
and the demand would create a national shortage.

There is a good vaccine for anthrax. It can work even if it’s given to a person who has already
been exposed. The Government would need to fly in many tons of antibiotics and vaccine. But
there’s no stockpile of antibiotics or anthrax vaccine. Such a stockpile could stop the dying
quickly and reduce fear. It might also discourage a terrorist from using anthrax.

A Web site should be set up that any public-health or primary-care doctor could look at,
offering
basic information and training modules in anthrax and smallpox. (Wannabe terrorists are already
using the Internet to spread information about bioweapons; they’re ahead of the public-health
doctors.) A medical training module would cost around $200,000 to set up: peanuts. Yet it could
make a big difference. Early detection of a bioterror event not only would save lives, it also would
enable law enforcement people to get on the trail of a terrorist faster.

Anthrax isn’t contagious and doesn’t spread. Smallpox spreads like chain lightning, and since
the
entire human species now lacks immunity to smallpox (the shot wears off), it is the planet’s most
dangerous potential biological weapon. If smallpox were released anywhere in this country,
experts believe that at least 20 million to 30 million people would need to be vaccinated quickly to
stop the surging outbreak. Right now, there are only about seven million usable doses of vaccine
on hand.

There is a new way to make smallpox vaccine that is fast and cheap. But it needs approval
from
the Food and Drug Administration, and manufacturing capability must be set up. Enough vaccine
to protect the entire American population could be stored in a building smaller than a garage, and
the vaccine would last for decades before it had to be replaced with fresh stocks. That would
pretty much remove smallpox from the arsenal of a terrorist. It would also take smallpox away
from Saddam Hussein far more effectively (and cheaply) than bombing his laboratories.

One other step is needed. The community of biologists in the United States has maintained a
kind
of hand-wringing silence on the ethics of creating bioweapons — a reluctance to talk about it with
the public, even a disbelief that it’s happening. Biological weapons are a disgrace to biology. The
time has come for top biologists to assert their leadership and speak out, to take responsibility on
behalf of their profession for the existence of these weapons and the means of protecting the
population against them, just as leading physicists did a generation ago when nuclear weapons
came along. Moral pressure costs nothing and can help; silence is unacceptable now.