Sunday, April 26, 2015

Psychological Warfare In Reverse: "I Feel So Cared For!"

How can something be "known to have no diagnostic value" as a tool, on the one hand, while also being the method by which 33 people were diagnosed with "exposure" to anthrax?

You can't tell me that almost 11,000 nose swabs were sent out to a laboratory for culturing in a blind, numbered study, and they happened to pick out the two tabloid mailroom workers in Florida, and the group from Daschle and Feingold's offices (And three in New York? Erin O'Connor was "diagnosed" by the head man at the CDC an hour before the fact, if not her name, went flashing around the zipper at Rockefeller Center. The woman at the New York Post had a lesion on her middle finger, which she defiantly saluted to Saddam-Osama in a full, front-page photo in the newspaper. This was their value.

Ernesto Blanco was originally reported to have been found with a single--that means one--spore in his nose, at a time when only a "trace" of anthrax was found on Robert Steven's computer. There are many other references in the record to testing finding one spore, which is a medically and legally defensible position. Call it monosporic reality. Can anyone prove it's not there?

In October, 2001:
When the Amerithrax event occurred, the extent of contamination was difficult to ascertain, especially before the source and route of the bacterium was known. Samples were taken to discover the extent of exposure, including dry and wet swab samples and nasal swabs.

At least 10,775 nasal swabs were taken; 33 came back positive: 2 in Florida, 3 in New York, and 28 on Capitol Hill. Among those exposed were at least 9 people who directly handled contaminated letters as well as people who were in immediate or adjacent proximity to where letters were handled or opened.30,31 Environmental samples were also collected by the CDC, EPA, and USPS and included the sampling of 286 postal facilities.32 Nationwide, approximately 120,000 samples were taken, placing great strain on many laboratories’ ability to process the samples.32

In 2005:
In addition to the large number of samples taken on Capitol Hill, the comparatively quick turnaround, 24/7 cleanup schedule, media quotes, and public addresses assuring the public that they were safe, as well as the act of taking nasal swabs from anyone in the region who requested one, all demonstrate that more effort went toward remediating the Capitol Hill buildings."4,"12 Nasal swabs are a particularly good indication that extra care was taken on Capitol Hill, primarily because they were already known to have no diagnostic value and their function in the Capitol Hill cleanup was largely to "...convey[ed] the message that the hazard that building occupants might face was being taken seriously."12(p68) Comments made by a Capitol Police spokesman illustrate the prevailing sentiment: "It cost what it cost. The bottom line is we have to ensure the public safety."22


2012, Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science, Volume 10, Number 1, 2012, Mary Ann Liebert, Inc. DOI: 10.1089/bsp.2010.0053, Total Decontamination Cost of the Anthrax Letter Attacks, Ketra Schmitt and Nicholas A. Zacchia,


30. Pennsylvania Department of Health. Health Alert #17. October 25, 2001.

31. U.S. Centers for Disease Control and Prevention. Update: investigation of anthrax associated with intentional exposure and interim public health guidelines, October 2001. MMWR Morb Mortal Wkly Rep. 2001 Oct 19;50(41):889-893.

12. Committee on Standards and Policies for Decontaminating Public Facilities Affected by Exposure to Harmful Biological Agents: How Clean is Safe? National Research Council. Reopening Public Facilities After a Biological Attack: A Decision-Making Framework. Washington, DC: National Academies Press; 2005

22. Kenen J. Hart Senate Building reopens, anthrax-free. Reuters January 22, 2002.

Reuters, January 22, 2002.

Hart Senate Building Reopens, Anthrax-Free

By Joanne Kenen
WASHINGTON (Reuters) - The Hart Senate Office Building reopened on Tuesday after a technically challenging three-month anthrax cleanup that cost at least $14 million after a potent anthrax-laced letter was sent to Senate Majority Leader Tom Daschle.
"I feel completely safe,'' said Daschle, who entered the building at midday after the cleanup involving fumigation with a powerful gas, high-tech vacuums, foam and liquid cleansers.
"I think we have done everything possible to remediate this building.''
The letter opened in his office Oct. 15 contained highly potent powdered anthrax. It was part of a spate of anthrax-tainted letters sent to government officials and media outlets in Washington, Florida and New York. Five people died and about a dozen others were treated for inhalation anthrax or the less serious skin version.
Coming just after the Sept. 11 attacks on America, U.S. officials had feared a foreign bioterror attack, but investigators now believe it was probably a domestic source. No suspect or motive has been publicly identified.
Authorities said they are confident that the nine-story Hart building, which is part of the U.S. Capitol complex, is safe after the cleanup and the examination of more than 5,000 environmental samples.
"It's good to be back,'' said Daschle, a South Dakota Democrat. "It's good to be confident that we can return to normalcy.''
Authorities said the final cost could be well beyond the $14 million the Environmental Protection Agency (EPA) has estimated, once additional costs from the Defense Department, the Capitol Police and Congress itself are tallied.
"It cost what it cost,'' said Capitol Police spokesman Lt. Dan Nichols. "The bottom line is we have to ensure the public safety.''
The building was still quiet Tuesday, as people drifted back from makeshift offices a day before Congress reconvenes for its 2002 session. Many staffers used luggage carts to bring back files and materials that had accumulated since October.
Carrying boxes back in Sen. Craig Thomas, a Wyoming Republican, put the inconvenience in perspective. "If you consider what might have happened, it wasn't so bad,'' he said.
"They gave me a laptop and I've been working at home -- and I liked it,'' said Reed Garfield, a staffer at the Joint Economic Committee. "The only real problem I had was that I had left Library of Congress books in Hart, and the library kept canceling my account because they were overdue.''
Daschle was one of two senators who received anthrax letters. A letter to Vermont Democrat Patrick Leahy, chairman of the Judiciary Committee, was discovered before doing any harm and was sent to a military research lab in hopes that it could help trace the source of the anthrax.
All mail to Congress is now irradiated and screened for bioterror threats or explosives, Nichols said.
Although the contamination was concentrated in Daschle's suite, traces of anthrax were found elsewhere in Hart so the entire building was sealed off.
Less extensive anthrax contamination was found in several other House and Senate office buildings, but those "hot spots'' were easier to decontaminate.
Thousands of people who had been in Hart were given antibiotics for at least a few days, and those who had been in or near Daschle's office were then placed on a 60-day drug regimen. Some were later offered an anthrax vaccine and another 30 days of antibiotics.
No one became ill in Congress but several postal workers got sick and two died before experts realized the anthrax had been so finely milled it had seeped through the envelope.
Daschle's suite, the epicenter of the contamination, was stripped down to bare walls and floors and his staff will work in a temporary Hart office while it is refurbished. As majority leader, Daschle also has offices in the Capitol building.
Supervised by the EPA, government cleanup experts and private contractors used chlorine dioxide gas to fumigate Daschle's office and related heating and ventilation systems. They have also used liquid and foam decontaminants.

Nonfumigated Buildings

Table 2 shows all nonfumigated buildings: 21 USPS buildings, 6 Capitol Hill buildings, 5 corporate office buildings, and 3 government mail facilities. Existing data on nonfumigated buildings includes $15 million for the Morgan PDC and a total cost of $2.1 million for 6 Capitol Hill buildings. Since the entire facilities were not decontaminated, considering data on a per square foot basis does not make sense. For these buildings, per square foot costs are $7.14 and $3.10, respectively. The high variance between these can be explained by several factors; most significant is the lack of knowledge about the actual area decontaminated.

Capitol Hill Buildings

Collectively the cost of remediating the buildings on Capitol Hill was about $27 million.4 These buildings are discussed separately from all others for a number of reasons. First, detailed contractual information is available for these buildings. More important, the cleanup cost for Capitol Hill buildings is likely significantly higher than it was for other comparable sites. The National Academies Board on Life Sciences conjectured that ‘‘[t]he high-profile users of the buildings undoubtedly created pressure to reopen the buildings quickly, yet a conservative definition of ‘clean’
was adopted by EPA. More important, there was a lack of a standard protocol to drive remediation, which in some cases led to repeated decontamination.’’12(p66) Office buildings on Capitol Hill were reopened in a matter of 3 months, whereas some large USPS PDCs stayed closed for years. The standard for anthrax removal was initially considered to be ‘‘no detectable, viable anthrax
spores.’’4(p8) As this is not possible to demonstrate, the EPA set the standard as ‘‘zero B. anthracis growth on any samples taken’’ and ‘‘[t]o ensure credibility, EPA took a large number of samples,’’ more than 9,000.12(p67) By comparison, USPS took about 10,000 samples in total for its 23
contaminated buildings as well as the 286 other buildings it sampled.21 This difference demonstrates an exacting standard of cleanup exercised on Capitol Hill.

In addition to the large number of samples taken on Capitol Hill, the comparatively quick turnaround, 24/7 cleanup schedule, media quotes, and public addresses assuring the public that they were safe, as well as the act of taking nasal swabs from anyone in the region who requested one, all demonstrate that more effort went toward remediating the Capitol Hill buildings.4,12 Nasal swabs are a particularly good indication that extra care was taken on Capitol Hill, primarily because they were already known to have no diagnostic value and their function in the Capitol Hill cleanup was largely to ‘‘.convey[ed] the message that the hazard that building occupants might face was being taken seriously.’’12(p68) Comments made by a Capitol Police spokesman illustrate the prevailing sentiment: ‘‘It cost what it cost. The bottom line is we have to ensure the public safety.’’22

The only Capitol Hill facility fumigated was the Hart Senate Office Building, costing at least $14.3 million, approximately half of the $27 million Capitol Hill cleanup.4,22 Therefore, each of the remaining 6 Capitol Hill sites cost about $2.1 million to decontaminate. At the Capitol Hill sites, technical contracts accounted for over 26% of total costs for nonfumigated buildings, while "technical contracts typically account for about 10 percent of total contract costs at a cleanup site."4(p15)

Corporate Office Buildings

Corporate buildings affected by the Amerithrax attack included the offices of NBC Nightly News, CBS News, ABC News, the New York Post, and American Media, Inc., as well as an office building on Kuser Road, exposed through cross-contamination.18 Of these buildings, the American Media, Inc., building, which housed the National Enquirer newspaper office, was the most contaminated. The owners of the building decided simply to move and sold the building for $40,000 to Sabre Technical Services, a company that was involved in remediation at USPS facilities.23 According to a Sabre spokesperson, the building cost "significantly less than 5 million dollars" to decontaminate and they were able to sell it in 2007 for $9.3 million.12,24 Details about the remediation done at this building were not released, and it is important to remember that Sabre Technical Services was the only stakeholder in this operation, likely expediting the decontamination effort. However, from this we can say that it is at least feasible to decontaminate a building like this for under $5 million. This value results in a fumigation cost of $7.70 per cubic foot. This is lower than the $9 to $10 per cubic foot for the Trenton and Brentwood PDCs and validates the idea that remediation (at least in theory) became easier and cheaper over time.

The offices of NBC Nightly News, CBS News, ABC News, and the New York Post were all contaminated; however, little public information is available on the extent of contamination or the cost of cleanup. Inquiries into the subject received no response. None of these sites showed evidence of aerosolized anthrax, nor were there any cases of inhalation anthrax associated with these sites. However, contamination seems not to have been localized. At NBC there were 3 areas contaminated
by anthrax spores. They included the set of NBC Nightly News, a security room, and the mail room.12 Ensuring the safety of employees and earning their confidence seemed important at least to NBC, whose ‘‘management went overboard’’ with the standards they set themselves.12(p65) The office building on Kuser Road was the site of one case of cutaneous anthrax. After extensive environmental sampling, the only area to produce a positive result was a mail bin that had likely contained a cross-contaminated letter. At this site remediation was restricted to cleaning the area around where the positive sample was taken.18

USPS Buildings

The greatest amount of remediation was done at USPS sites. Contaminated letters passed through a number of post offices and PDCs, which use high-speed mail sorting machines. Anthrax spores were often spread when letters passed through these machines. USPS had to do major remediation at 5 main sites as well as 18 other buildings.

Major decontamination efforts took place at 3 PDCs: Trenton, Brentwood, and Morgan. The 2 largest sites were the Trenton and Brentwood PDCs located in New Jersey and Washington, DC, respectively. At both sites there was evidence of widespread aerosolizing of anthrax spores,25
and mail workers at both facilities developed inhalation anthrax.25 The decision was made to do complete fumigations of both buildings with chlorine dioxide. The complete remediation, including fumigation, took over 2 years and, for both buildings, cost $200 million.2,26 In addition to fumigation and decontamination costs, remediation at these sites included miscellaneous costs. For
example, $4.5 million was spent busing postal employees from their usual Brentwood or Trenton workplaces to other locations while cleanup was happening.27 Additionally, after the fumigation, USPS spent $10.8 million renovating the Trenton PDC to refurbish the facility.28 We assume
these expenses are included in the overall remediation costs of these sites.

The other large PDC to be significantly contaminated was the Morgan PDC in New York City, which occupies 2.1 million square feet.27 The cleanup at this facility involved closing only a section of the facility for about 2 weeks while decontamination was going on 24 hours a day at a cost of about $15 million.29

There were 20 other USPS facililities that produced positive environmental samples.13 Contamination at these sites was generally low and usually thought to have occurred through direct physical contact of cross-contaminated letters. Many sites produced just 1 or 2 positive samples, and
in some cases remediation involved cleaning the area of the room around the positive sample. In some cases, potentially contaminated items were disposed of.13 According to the Vice President of Engineering for USPS, ‘‘.15 location  had very small amounts of contamination. Cleanup procedures
were very limited; closing was generally a 24 to 48 hour time period. Again, no employees at these locations ever became infected.’’10(p114) Given the extremely low level of decontamination necessary in these buildings, we construct a lower bound estimate on cost by assuming that no
additional cost was incurred decontaminating these buildings (eg, current staff and resources were used to decontaminate).

However, we present the data here to illustrate. For these buildings, per square foot costs are $5.70, $7.14, and $3.10, respectively. The high variance between these estimates can be explained by several factors; most significant is the lack of knowledge about the actual area decontaminated.
In addition, the Department of Justice Mail Facility was partially fumigated and thus would be expected to have higher costs.

Cost of Sampling

When the Amerithrax event occurred, the extent of contamination was difficult to ascertain, especially before the source and route of the bacterium was known. Samples were taken to discover the extent of exposure, including dry and wet swab samples and nasal swabs.

At least 10,775 nasal swabs were taken; 33 came back positive: 2 in Florida, 3 in New York, and 28 on Capitol Hill. Among those exposed were at least 9 people who directly handled contaminated letters as well as people who were in immediate or adjacent proximity to where letters were handled or opened.30,31 Environmental samples were also collected by the CDC, EPA, and USPS and included the sampling of 286 postal facilities.32 Nationwide, approximately 120,000 samples were taken, placing great strain on many laboratories’ ability to process the samples.32

Environmental samples included both dry and wet wipes or swabs, HEPA vacuum samples, air quality samples, and other samples that included control samples used to ensure the efficacy of fumigation. At the DOJ Mail Facility, dry samples cost approximately $40 each, while wet samples were $85 each.5 We assume that HEPA vacuum and air quality samples as well as ‘‘other’’ type samples also cost $85 each. Sampling performed at 23 USPS sites shows that about 28% of samples were of the dry type.32 Generalizing this distribution and multiplying by the respective costs yields a value of about $8.7 million.

For the purposes of our model, we consider these to be unique costs and add them to the overall decontamination costs.

Cost Estimates for Unknown Buildings

No cost estimate could be obtained for 29 contaminated buildings. First, we consider the case of GSA 410. The other 4 completely fumigated buildings showed relatively consistent costs on a per unit volume basis. GSA 410 has similar dimensions to and was remediated in the same manner as Department of State Annex 32. Therefore, we assume identical decontamination costs ($9 million) for the 2 buildings.

Very little data was available for nonfumigated buildings. In order to better inform policy decisions, we created an....

April 11, 2003, New York Times, Anthrax Cleanup to Close Mail Center a Year More, by Iver Peterson,

HAMILTON, N.J., April 10— It has been 18 months since the big mail-sorting plant here was contaminated by anthrax spores and closed. But it will be at least a year more before it is safe for its scattered workers to go back inside.

The Postal Service announced today that the final step in cleaning out the anthrax that once had Trenton-area residents wearing rubber gloves to open their letters and bills would not begin until this fall. And it said that final cleanup -- a fumigation with chlorine gas -- and installation of new equipment would probably not be finished until next April.

At separate briefings for local officials, the news media and local residents, the Postal Service's top engineer said that machinery to produce the chlorine gas had not yet been disassembled from the sorting plant outside Washington, where anthrax decontamination was recently completed.

The centers there and in this Trenton suburb were contaminated in the letter-borne anthrax attacks in September 2001 in which five people, including two postal workers, died. The crimes are unsolved.

The news of further delay disappointed the Hamilton center's 500 workers, who now have to commute farther, to a temporary center north of here, just off the New Jersey Turnpike in Monroe Township. But Thomas G. Day, vice president for engineering for the Postal Service, said he would rather be safe than sorry.

''I wish we could have had this done by now, but we have not,'' Mr. Day said at a news conference in Princeton. ''Our unofficial motto has been, 'Do it right, not fast,' and it's still going to take time to get this done the right way.''

Bill Lewis, president of the Trenton-area local of the postal workers' union, expressed disappointment but not surprise. ''It's really depressing that we're not going back for so long,'' he said. ''You've got to understand that these people have been out of that facility for 18 months now.''

The temporary center, a former warehouse, not only is farther from the workers' homes, Mr. Lewis said, but also lacks proper heating and ventilation and has too few toilets.

The change in sorting centers has not affected mail service in central New Jersey, but the inconvenienced postal workers have long been a strong voice in local politics, and elected officials in both parties, including Glen D. Gilmore, the mayor of Hamilton, have taken up their campaign for a swift return to their old work site.

''I'm disappointed that it has taken so long, but I realize at the same time that they are dealing with something here that no one has had to deal with before,'' Mayor Gilmore, a Democrat, said today.

While the fumigating gas, chlorine dioxide, has long been used in water and sewer treatment plants, its use for killing anthrax spores has not been approved before, Mr. Day said, so special permits had to be obtained for the Washington sites. They are the Hart Senate Office Building, where anthrax-laden letters were mailed to Senators Tom Daschle of South Dakota and Patrick J. Leahy of Vermont in 2001, and the 14.2-million-cubic-foot Curseen-Morris mail distribution system in suburban Washington. Both have now been cleaned using the gas.

Although Mr. Lewis complained that Trenton was put last in line for a cleanup, Mr. Day said the experimental gassing of anthrax spores was tried first in Washington because the Hart building was relatively small and easier to use for a first try. After that, it made sense to keep the machinery in Washington for the big suburban center.

In each case, the Postal Service and its contractors had to design and build machinery, resembling a small chemical plant, that turned the building into a gas chamber for the living anthrax spores.

The Washington cleanup cost about $105 million, and the Hamilton work is expected to cost an additional $65 million.

Photo: During the 2001 outbreak, a temporary post office was set up in the parking lot. (Keith Meyers/The New York Times)

October 21, 2003, The Philadelphia Inquirer, Postal center cleanup to begin; The Hamilton Twp. building infected by anthrax in 2001 will be cleaned with chlorine dioxide gas. Officials assure safety, y Troy Graham, Inquiring Staff Writer,

TRENTON — Engineers will begin fumigating the anthrax-infected mail-processing center in Mercer County this weekend, clearing the way to reopen the long-shuttered building next fall.

State and federal environmental agencies gave final approval yesterday to begin the cleanup, and engineers plan to start the decontamination Friday afternoon.

The 282,000-square-foot Trenton Processing and Distribution Center in Hamilton Township is the last of three buildings infected in the 2001 anthrax attacks to be cleaned. The center, which had nearly 700 employees sorting mail for 51 post offices, has been closed for two years.

Crews will set the temperature inside the building at 75 degrees and raise the humidity to 75 percent. Then they will begin pumping in chlorine dioxide gas.

The gas must remain in the building, at the same temperature and humidity levels, for 12 hours to kill the anthrax spores. The gas is then sucked out of the building through filters that turn the gas into a saltwater solution.

Postal officials said there would be no effect on the surrounding community, other than a slight smell of chlorine in the air. All roads around the building, including Route 130, will remain open.

"It would not be unusual, depending on where you're standing and wind direction, to get some whiff of some level of chlorine," said Tom Day, engineering vice president for the postal service.

If there is a significant gas leak, surrounding residents are warned to remain indoors. They are not required to evacuate. Chlorine dioxide dissipates safely in the air, Day said.

Officials plan to begin the work around 4 p.m. Friday, after schools release their students for the weekend. They plan to finish before Sunday morning, when Hamilton Township will host a road race.

In October 2001, the Hamilton center processed anthrax-contaminated letters mailed from Trenton to the New York Post, NBC News anchor Tom Brokaw, and U.S. Sens. Tom Daschle (D., S.D.) and Patrick J. Leahy (D., Vt.). Three Hamilton employees and a West Trenton letter carrier were infected with anthrax. All four survived.

No one has been arrested in the anthrax attacks.

The letters also contaminated the Brentwood postal center in Washington, causing the death of two employees, and the Hart Senate Office Building. Both of those buildings were cleaned with chlorine dioxide, which is commonly used to treat water and sewage, to bleach wood pulp, and to sterilize medical equipment.

The price for cleaning both postal facilities will top $200 million, Day said.

During the Washington cleanup there were six minor leaks of gas, but none raised any health concerns, officials said.

Engineers tested the process earlier this month in Mercer County, pumping in a small amount of gas and finding no leaks, Day said.

Sensors at the processing center will monitor for leaks, and federal environmental officials will drive around the area in a modified bus taking samples of the air.

After the decontamination is completed, officials will take samples from inside the building, culture them, and check for anthrax spore growth.

"Our standard for success . . . is to gather samples and achieve a no-growth objective," Day said.

An independent commission of environmental officials and academics will review the findings to determine if the building is safe, Day said. That process will take about two months.

After that, it will take six to eight months to refurbish the building. Because the cleaning process is corrosive, equipment, ceiling tiles, carpet and some walls will need to be replaced, Day said.

The facility's 700 employees were shuttled around to different sites before settling in a warehouse the postal service has been leasing in Monroe Township, Middlesex County. Most of the employees have said they are eager to return to their old site.

Contact staff writer Troy Graham at 856-779-3893 or


October 21, 2001, USA Today, FBI baffled by anthrax letters' link to town, by Traci Watson,

Updated 10:37 PM ET

EWING, N.J. — Federal investigators on Sunday continued to comb a mail route in this town outside Trenton for leads to who might have sent a rash of envelopes bearing lethal anthrax spores. Anthrax-tainted letters addressed to NBC anchor Tom Brokaw, the New York Post, and Senate Majority Leader Tom Daschle, all went through a mail-processing center in nearby Hamilton. And the Brokaw letter appears to have been mailed from somewhere on the route of a Ewing postal carrier who has come down with cutaneous, or skin, anthrax.

Investigators have few solid leads about the culprit. More than 100 FBI agents here have interviewed hundreds of people, but no search warrants have been issued. And postal inspectors will only say they have seized one or more drop boxes, the large, free-standing receptacles for outgoing mail.

Privately, FBI agents admit to being baffled as to the connection between Ewing — described by more than one resident as a place where nothing ever happens — and the taunting, tainted letters.

The handwriting on all three envelopes is similar. The strain of anthrax sent to Brokaw matched the strain sent to Daschle and to a supermarket tabloid, the Star, in Florida. The strain sent to the Post is not yet known.

What is known is that the letters to the Post, NBC and Daschle all passed through a large mail center in Hamilton, a town some 20 miles northeast of Ewing that processes mail from nearly 50 post offices in the surrounding area.

Two workers at the plant have contracted anthrax. One is an unidentified 35-year-old man from Levittown, Pa., who has a confirmed case of cutaneous anthrax. Officials said he handles packages; co-workers said he handles letters, magazines and large envelopes.

Another worker at the facility, Rich Morgano of Hamilton, also has cutaneous anthrax, according to his girlfriend, Dianne Abbott. Morgano maintains mail-processing machinery at the facility.

The processing facility remained closed Sunday as investigators conducted tests for anthrax spores. New Jersey health officials said Sunday that 13 of 23 samples taken from the facility showed evidence of anthrax. The plant could be closed for up to 4 weeks.

The FBI referred inquiries about the case to the New Jersey health department, which said that federal investigators are reporting a "suspect case" of anthrax in an employee of the Hamilton center.

Among the mail processed by the postal center in Hamilton is that from the West Trenton post office, which is in Ewing. A West Trenton letter carrier identified by The (Newark, N.J.) Star-Ledger as Teresa Heller came down with cutaneous anthrax but is recovering, health officials say. It's her route that FBI agents and postal inspectors have zeroed in on.

Postal employees are increasingly concerned about their safety now that they know they are the method of delivery for the nation's anthrax scare.

A postal worker in Washington, D.C., was in serious condition with the more deadly type of infection, inhalation anthrax, on Sunday. His diagnosis prompted the testing of about 2,000 postal workers in the nation's capital. Inhalation anthrax occurs when the bacteria moves deep into a person's lungs.

"As the postal machinery and sometimes the workers compress it, the anthrax then can come out," Sen. John Kerry, D-Mass., said Sunday on CBS' Face the Nation. "Most of the envelopes were sealed all around, and the theory is that it came out in a burst of air, and that's how it's inhaled."

Heller, the postal carrier in Ewing, delivers mail to more than 500 houses, apartments and businesses and picks up outgoing mail from home and business mail boxes, co-workers say. But she doesn't collect mail from drop boxes.

Complicating the trail, postal officials say, Heller did not work Sept. 18, the day the letters to Brokaw and the Post were postmarked. The letter to Daschle was postmarked Oct. 8 or 9. Co-workers say carriers have little contact with mail other than what they deliver or pick up from private mailboxes.

"I'll pick up one of these buckets, maybe half a bucket" of mail, said West Trenton letter carrier Sean McSherry of Levittown, Pa., pointing to a plastic crate stamped "United States Postal Service."

"That bucket of mail goes into another bin that goes onto a truck and goes away," McSherry said. He said it's a mystery to him how Heller could have become infected.

It's even more of a mystery to the residents of Ewing, a tranquil, middle-class suburb of 37,000, known for neatly kept front yards and Italian restaurants. It's a place where many people spend their lives and where the closest thing to a town center is an intersection that has two gas stations and a convenience store.

"This is really a first, in having Ewing Township the focal point of international concern," Mayor Al Bridges says. "You can't slip into Ewing. If a group of terrorists bought a house in Ewing, people would notice."

Especially if those terrorists were Middle Eastern, because Ewing is nearly 80% white, mostly Italian-American. African-Americans and Latinos live here, but there are "no tensions," says Bridges, who is African-American.

Fernwood, the neighborhood that includes much of Heller's route, is like the rest of Ewing: tranquil, stable and mostly white. Full of small houses decorated for Halloween, it seems an unlikely breeding ground for terrorism.

"There's never anything going on here," says Ala Trzewik, a high school student who lives along Heller's route. Pressed to recall any kind of unusual incident, she ponders and says, "Some of my neighbors screamed or something."

"It's not anybody from this neighborhood," Fernwood resident Carl Ayre says.

Ayre grew up here and is now raising his own family here, like many others who live here. Besides, he says, "There are enough old biddies on the block that stay abreast of everything."

Thursday, April 09, 2015

Friday October 12 7:49 PM ET

October 12, 2001, AP, Anthrax Case Reported at NBC News, by Larry McShane, Associated Press Writer, Screen Capture,

NEW YORK (AP) - An assistant to NBC anchorman Tom Brokaw contracted the skin form of anthrax after opening a "threatening" letter to her boss that contained a suspicious powder, authorities and the network said Friday.

Officials quickly said there was no known link to either the Sept. 11 terrorist attacks or the far more serious inhaled form of anthrax that killed a supermarket tabloid editor in Florida last week. The 38-year-old NBC employee was being treated with antibiotics and is expected to recover.

The letter was postmarked Sept. 20 and opened Sept. 25, authorities said.

A federal criminal investigation was launched to find the source of the anthrax, and health officials scrambled to retest the powder to see if contained the germ. Initial tests had been negative, but authorities said the sample was so small they were reluctant to interpret the results.

The letter to NBC and a letter containing an unknown powder received Friday by The New York Times both were postmarked from St. Petersburg, Fla., said Barry Mawn, head of the FBI office in New York. The Times' letter was postmarked Oct. 5.

There was some similarity in the handwriting on both letters, Mawn said, declining to discuss the contents. Both were anonymous letters with no return address.

The case sent a chill through a city still reeling from the World Trade Center disaster. Emergency rooms reported a higher number of patients asking for anthrax tests or requesting antibiotics. News organizations across the country shored up mailroom security. And the postmaster general advised everyone to watch for suspicious letters and packages.

There have been anthrax scares from Connecticut to Nevada over the past week but no known cases except in Florida and New York.

President Bush said the government was doing all it could to protect the public.

"The American people need to go about their lives. We cannot let terrorists lock our country down," Bush said, addressing the anthrax case at a White House event celebrating Hispanic heritage. "They will not take this country down."

The anthrax case - the nation's fourth in a week - was reported early Friday by the federal Centers for Disease Control and Prevention after tests were completed on a skin sample from the victim. Further tests on the envelope and its contents were under way.

"The most likely explanation is it was linked to this particular letter," said Dr. Steven Ostroff of the CDC. "It makes sense."

The CDC said it was possible the NBC employee was contaminated by something other than the envelope. NBC News reported that the envelope also contained a "threatening" letter.

NBC employees were evacuated from part of the 70-story GE Building in Rockefeller Center, which is home to Brokaw's "Nightly News," "Saturday Night Live" and "Late Night with Conan O'Brien."

"Living in New York and working in this building for this company, you're already on edge," said Brian Rolapp, 29, a business development manager for NBC. "I think everyone is a little startled that it's this close to home."

The NBC employee who tested positive was a Brokaw assistant, NBC officials said on condition of anonymity. One official said that Brokaw, who has appeared on NBC's evening newscasts for the last 18 years, was being tested for anthrax.

The "Nightly News" was broadcast Friday from the ground-floor "Today" show studios, instead of its usual third-floor home.

At the end of the broadcast, Brokaw thanked viewers for their concern and then spoke of his colleague.

"She has been - as she always is - a rock. She's been an inspiration to us all," he said. "But this is so unfair and so outrageous and so maddening, it's beyond my ability to express it in socially acceptable terms. So we'll just reserve our thoughts and our prayers for our friend and her family."

A few blocks away, two floors of The New York Times building were cleared after Judith Miller, a reporter who co-wrote a recent best seller on bioterrorism, opened a letter containing a powdery substance a spokeswoman said smelled like talcum powder.

Executive Editor Howell Raines said initial tests indicated that the powder did not pose any immediate problem. Air tests for radioactive and chemical substances were negative.

The Associated Press, located across the street from NBC, temporarily closed its mailroom. Other media organizations modified mail security procedures.

The skin and inhaled forms of anthrax are caused by the same bacterium. The only difference is whether the microscopic spores enter the skin through a cut or are inhaled into the lungs. It takes more than 8,000 spores to cause the inhalation form of anthrax. Neither form can be spread directly from person to person.

When caught through the skin, anthrax is a much less serious disease. The first symptoms are reddish-black sores on the skin. If the disease is caught at that point and treated with antibiotics, it is easily cured. Even without treatment, cutaneous anthrax is fatal in only one case out of 20.

Dr. Scott Lillibridge, the bioterrorism chief for the U.S. Health and Human Services Department, said the NBC employee is believed to have handled the envelope on Sept. 25. Three days later, she noticed a dark-colored lesion, Lillibridge said, and on Oct. 1 began taking the antibiotic Cipro for another infection.

When the lesion started developing characteristics of anthrax, "a very alert and astute clinician" ordered skin tests, CDC Deputy Director David Fleming said. The results came back Friday.

NBC said it had immediately contacted the FBI, the CDC and the New York Department of Health after the envelope arrived.

Although the complaint was received the day the letter was opened, the FBI didn't respond until a day later, Mawn said. Tests were delayed by two or three days because FBI agents were unable to speak with Brokaw's assistant, he said.

Mayor Rudolph Giuliani said all network employees exposed to the powder will be tested for anthrax and treated with Cipro.

"People should not overreact to this," Giuliani said. "Much of this is being done to allay people's fears."

Giuliani said there appeared to be no connection between the two New York letters and an FBI warning issued Thursday about additional terrorist action at home or abroad.

Last Friday, a photo editor for The Sun supermarket tabloid in Boca Raton, Fla., died of the more serious inhaled form of anthrax. The American Media building where Bob Stevens, 63, worked was sealed off after anthrax was found on his keyboard.

Traces of anthrax were later found in the mailroom. Two other employees turned out to have anthrax in their nasal passages, but neither has developed the disease. Both are taking antibiotics, and one has returned to work.

In Florida, FBI agent Hector Pesquera said test results of 965 people who were in the building recently found no new infections. Pesquera said investigators are still trying to determine how the anthrax got into the building.

Saturday, April 04, 2015

Frederick Post-News,

August 2, 2008, Frederick Post-News, Anthrax case turns, Archived,

August 3, 2008, Frederick Post-News, FBI seizes library computers, Archived,
August 3, 2008, Frederick Post-News, Woman' ties to anthrax case unclear, Archived,

August 4, 2008, Frederick Post-News, Ivins colleague rejects therapists description, Archived,
August 4, 2008, Frederick Post-News, FBI to meet with families in anthrax case, Archived,
August 4, 2008, Frederick Post-News, Duley describes harassment, threats, Archived,

August 5, 2008, Frederick Post-News, 'This is different:' Son of scientist who died in 1953 compares cases then and now, Archived,
August 5, 2008, Frederick Post-News, 'I'm scared to death' of Ivins, Duley testifies, Archived,
August 5, 2008, Frederick Post-News, FBI wants to meet with anthrax survivors, Archived,

August 6, 2008, Frederick Post-News, Friends portray Ivins as funny, caring, Archived,
August 6, 2008, Frederick Post-News, Judge unseals Ivins documents, Archived,
August 6, 2008, Frederick Post-News, Anthrax victims' families, survivors arrive in Washington, Archived,
August 6, 2008, Frederick Post-News, Families to meet with FBI today, Archived,
August 6, 2008, Frederick Post-News, Ivins memorial today at Fort Detrick, Archived,

August 7, 2008, Frederick Post-News, Public library computers latest focus of Ivins investigation, Archived,
August 7, 2008, Frederick Post-News, Ivins comments on News-Post stories, Archived,
August 7, 2008, Frederick Post-News, Excerpts from e-mails Bruce Ivins sent to a friend, Archived,
August 7, 2008, Frederick Post-News, Documents reveal series of federal search warrants, Archived,
August 7, 2008, Frederick Post-News, Ivins alone responsible for attacks, feds claim, Archived,

August 8, 2008, Frederick Post-News, Army creates team to review security at Detrick, Archived,
August 8, 2008, Frederick Post-News, FBI obtains search warrants for local library computers,, Archived,

August 9, 2008, Frederick Post-News, Army to review USAMRIID security,, Archived,
August 9, 2008, Frederick Post-News, Crowds expected for Ivins service, Archived,
August 9, 2008, Frederick Post-News, When do threats supersede the rules of confidentiality?, Archived,

August 10, 2008, Frederick Post-News, Friends, colleagues gather to remember Bruce Ivins, Archived,
August 10, 2008, Frederick Post-News, Lawyers skeptical FBI could have convicted Ivins, Archived,

August 11, 2008, Frederick Post-News, City Notes Detrick an unavoidable risk, Archived,

August 13, 2008, Frederick Post-News, Talk Back: Do you believe Bruce Ivins was responsible for the anthrax attacks?, Archived,

August 16, 2008, Frederick Post-News, Senate could grill FBI on anthrax investigation in September, Archived,
August 16, 2008, Frederick Post-News, Senate could grill FBI on anthrax investigation in September by Justin M. Palk, Archived, 32 words, On that day, the Senate Judiciary Committee is scheduled to hold an oversight hearing on the FBI, and Director Robert Mueller III is scheduled to attend.

August 19, 2008, Frederick Post-News, Scientists: FBI destroyed Ivins' matching anthrax sample, Archived,
August 19, 2008, Frederick Post-News, Scientists: FBI destroyed Ivins' matching anthrax sample, by Justin M. Palk, Archived,
756 words, FBI scientists released that information Monday in a briefing at FBI headquarters, where researchers who assisted in the investigation discussed the scientific process they used to track the anthrax used in the 2001 mailings back to Fort Detrick and Ivins.

August 20, 2008, Frederick Post-News, Scientists still looking for FBI to release anthrax data,, Archived,

August 25, 2008, Frederick Post-News, Evidence is slow in coming, Archived,
August 25, 2008, Frederick Post-News, Biodefense campus tenants preparing security plans, Archived,

DOJ: Amerithrax Court Docs,

September 7, 2008, Frederick Post-News, Early anthrax suspect doubts guilt of Ivins by Nicholas C. Stern, Archived,
904 words, Ivins, a Fort Detrick anthrax specialist, had become the sole focus of a seven-year FBI investigation into the 2001 anthrax attacks that killed five and injured 17. The FBI has since released evidence it claims proves Ivins' guilt, but has admitted much of it is circumstantial.

September 11, 2008, Science behind the anthrax case, by Nicholas C. Stern, Archived, 614 words Claire Fraser-Liggett, who was speaking Wednesday at a University of Maryland Law School forum on the attacks, also said the work she performed while helping the FBI was based on sound scientific techniques.

September 13, 2008, Frederick Post-News, Congress to take up anthrax investigation, Archived,

September 16, 2008, Frederick Post-News, Independent scientists to review evidence against Ivins, Archived,
September 16, 2008, Frederick Post-News, Ivins' last will and testament reveals his wishes, Archived,

September 17, 2008, Frederick Post-News, Ivins puts cash on cremation, Archived,
September 17, 2008, Frederick Post-News, Independent scientists to review evidence against Ivins, Archived,

September 18, 2008, Frederick Post-News, Sen. Leahy doesn't believe Ivins acted alone, Archived,

September 24, 2008, Frederick Post-News, Ivins lost lab access in March after anthrax spill, Archived,
September 24, 2008, Frederick Post-News, Ivins bragged he knew anthrax killer, Archived,

September 25, 2008, Frederick Post-News, Ivins e-mailed self, claimed knowledge of anthrax killer, Archived,

September 29, 2008, Frederick Post-News, Report shows no illnesses from USAMRIID exposures, Archived,

October 14, 2008, Frederick Post-News, State police surveillance included Frederick residents, Archived,

October 29, 2008, Frederick Post-News, Detrick releases Ivins' personnel file, Archived,

November 13, 2008, Frederick Post-News, Judge orders Hatfill search warrant to be made public, Archived,
November 13, 2008, Frederick Post-News, Military Intelligence Papers suing for access to more files, Archived,

November 18, 2008, Frederick Post-News, A look back at the Bruce Ivins saga, Archived,

November 26, 2008, Frederick Post-News, Court unseals Hatfill anthrax documents, Archived,

December 19, 2008, Frederick Post-News, Security at military biolabs to get tighter, Archived,

January 5, 2009, Frederick Post-News, Ivins admitted suicide attempt, reports show, Archived,

Bruce Ivins, a Fort Detrick scientist and leading anthrax researcher, was named the sole suspect in the 2001 anthrax mailings that killed five people and 17 others.

The U.S. Department of Justice and FBI publicly presented their case against Ivins on Aug. 6.

The evidence, although lacking in physical proof, could have found Ivins guilty of the mailings beyond a reasonable doubt, said Jeff Taylor, U.S. Attorney for the District of Columbia.

Complete coverage of the Bruce Ivins saga is below, listed with most recent stories first. On the right, below the file photo of Ivins, are links to related content, letters to the editor and multimedia.


January 6, 2009, Frederick Post-News, Details of Ivins' death released in police report [audio], Archived,

January 23, 2009, Frederick Post-News, Army releases some Ivins e-mails, Archived,

February 13, 2009, Frederick Post-News, Start making sense, Archived,

April 22, 2009, Frederick Post-News, Fort Detrick disease samples may be missing, Archived,

May 8, 2009, Frederick News-Post, FBI, National Academy of Science agree to scope of anthrax science review, Archived,

May 14, 2009, Frederick News-Post, End of story?, Archived,

May 24, 2009, Frederick News-Post, The lynching of Bruce Ivins, Archived,
May 24, 2009, Frederick News-Post, Overdrive, Archived,

July 2, 2009, Frederick News-Post, Committee formed to review FBI anthrax investigation, Archived,

July 26, 2009, Frederick News-Post, Anthrax case: Studies scrutinize lab security, shy away from federal investigation, Archived,
July 26, 2009, Frederick News-Post, Anthrax case: Amerithrax debate lives online, Archived,

July 27, 2009, Frederick News-Post, Anthrax case: Seeking an ending, Archived,

July 31, 2009, Frederick News-Post, Group begins scientific review of FBI's anthrax investigation, Archived,
July 31, 2009, Frederick News-Post, Local filmmaker works on anthrax documentary, Archived,
July 31, 2009, Frederick News-Post, Dubious study, Archived,

August 1, 2009, Frederick News-Post, Experts urge panel to deepen forensic understanding, Archived,

September 23, 2009, Frederick News-Post, Panel continues study of anthrax mailings, Archived,
September 23, 2009, Frederick News-Post, Panel, residents question Army's assessment of Fort Detrick health risk, Archived,
September 23, 2009, Frederick News-Post, Cardin calls for legislation on lab security, Archived,

September 29, 2009, Frederick News-Post, Expert: Anthrax spore coatings not unique, Archived,

February 20, 2010, Frederick News-Post, Agents saw Ivins taken to hospital, Archived,
February 20, 2010, Frederick News-Post, Bartlett seeks review of FBI's anthrax case, Archived,
February 20, 2010, Frederick News-Post, FBI report fails to end questions about Ivins' guilt, Archived,
February 20, 2010, Frederick News-Post, FBI buries Ivins, Archived,
February 20, 2010, Frederick News-Post, A look back at the Bruce Ivins saga, Archived,
February 20, 2010, Frederick News-Post, Government closes 'Amerithrax' case, Archived,

March 4, 2010, Frederick News-Post, Police: Ivins not linked to other unsolved cases, Archived,
March 4, 2010, Frederick News-Post, Holt seeks investigation into FBI's case against Ivins, Archived,

March 20, 2010, Frederick News-Post, Administration rejects call to further probe Amerithrax, Archived,

April 23, 2010, Frederick News-Post, Co-worker: Ivins didn't do it, Archived,
It is absolutely impossible that Bruce Ivins (left), accused of mailing anthrax and killing five people in 2001, could have created and cleaned up anthrax spores in the timeline and manner the FBI alleges, Ivins' former co-worker said Thursday. The National Academy of Sciences brought in former USAMRIID microbacteriologist Henry Heine to explain spore preparation to the panel.

September 17, 2010, Frederick News-Post, GAO to review FBI's Ivins investigation, Archived,

November 30, 2010, Frederick News-Post, Amerithrax experts debate FBI findings, insist Ivins was innocent, Archived,

December 5, 2010, Frederick News-Post, Ivins case lives on despite FBI judgment, Archived,
December 5, 2010, Frederick News-Post, Ivins' lawyer, colleague share details FBI left out, Archived,

December 10, 2010, Frederick News-Post, Amerithrax review delayed after FBI releases more documents, Archived,

February 16, 2011, Frederick News-Post, Report casts doubt on FBI's investigation of anthrax attacks, Archived,

February 20, 2011, Frederick News-Post, One year after FBI closes Ivins case, doubts still linger, Archived,

March 23, 2011, Frederick News-Post, Expert panel faults Army in anthrax case, Archived,

June 4, 2011, Frederick News-Post, Lessons from Amerithrax, [92-page .pdf Revised] Archived,

July 19, 2011, The Frederick News-Post, Justice Department stands by belief in Ivins' guilt, Archived,

July 20, 2011, The Frederick News-Post, Department of Justice upholds stance on Ivins, Archived,

September 3, 2011, The Frederick News-Post, Senator asks Justice Department for explanation of anthrax investigation of Bruce Ivins, Archived,

October 10, 2011, The Frederick News-Post, Scientists question anthrax attack findings, Archived,

October 11, 2011, Frederick News-Post, Scientists question anthrax attack findings, Archived,
October 11, 2011, Frederick News-Post, Was science up to identifying anthrax killer?, Archived,

October 25, 2011, Frederick News-Post, With security spotty, many had access to anthrax at Fort Detrick, Archived,

November 29, 2011, Frederick News-Post, U.S. to pay $2.5M in anthrax death, Archived,

July 16, 2013, Frederick News-Post, Risky Business, by Alison Walker, Archived,
July 16, 2013, Frederick News-Post, Transcript of the FBI's briefing for the scientific media, including Science and Nature, Archived,
July 16, 2013, Frederick News-Post, Transcript of the FBI's briefing for the general media, Archived,
July 16, 2013, Frederick News-Post, Search warrant, C. Burr Artz Public Library CPU station 54,
July 16, 2013, Frederick News-Post, Search warrant, C. Burr Artz Public Library CPU station 41,
July 16, 2013, Frederick News-Post, DOJ: Amerithrax Court Docs,
July 16, 2013, Frederick News-Post, A look back at the Bruce Ivins saga,
July 16, 2013, Frederick News-Post, FILE - Press conference: Ivins alone responsible for attacks, fed claims, Archived,
July 16, 2013, Frederick News-Post, FILE footage from Ivins' memorial service, Archived,
July 16, 2013, Frederick News-Post, FILE - Military Road abuzz with activity, Archived,

July 28, 2013, Frederick News-Post, Bruce Ivins' Frederick News-Post letters to the editor, Below is a list of letters he wrote to The Frederick News-Post dating back to April 12, 1997, Archived,
July 28, 2013 Frederick News-Post, Questions on anthrax suspect linger, by Courtney Mabeus, Bruce Edward Ivins is still receiving patents for his scientific work nearly five years after his death. Archived,

July 29, 2013, Frederick Post-News, Scientists who worked with Ivins still question government's methods, by Courtney Mabeus, News-Post Staff, Archived,
Scientists who worked with Bruce Ivins said it would have been impossible for him to produce the amount of spores necessary to carry out deadly anthrax attacks given the time frame and equipment available to him at the U.S. Army Medical Research Institute of Infectious Diseases.

July 16, 2013, The Frederick News-Post, Beyond the Breach - The April 2002 breach in containment at the U.S. Army Medical Research Institute of Infectious Diseases at Fort Detrick, Archived,
A series on the April 2002 breach in containment at the U.S. Army Medical Research Institute of Infectious Diseases at Fort Detrick.

Wednesday, April 01, 2015

Oct. 30, 2011, NYT Sunday Magazine, Warning: There's Not Nearly Enough Of This Vaccine To Go Around, by Wil S. Hylton,

October 26, 2011, New York Times Sunday Magazine, Archived Title: How Ready Are We for Bioterrorism?, by Wil S. Hylton,

October 30, 2011, New York Times Sunday Magazine, page MM26, Original Print Title: Warning: There's Not Nearly Enough Of This Vaccine To Go Around, by Wil S. Hylton,

A few days after 9/11, a retired Air Force colonel named Randall Larsen entered the northwest gate of the White House, crossed a courtyard to the Eisenhower Executive Office Building, stepped through the front door and stopped dead in his tracks.

In place of the usual security checkpoint, there was an elaborate upgrade that included not only metal detectors but also machines to sniff out radiation and explosives, elaborate pat-downs and a mandatory search of all personal belongings. It was the search that worried Larsen most.

After passing through a body scan, he stood quietly while a guard thumbed through the contents of his briefcase. It was mostly books and papers, but after a few seconds, the agent pulled out a respirator mask and shot Larsen a quizzical look. “That’s just for demonstration,” Larsen said quickly. “You saw Mayor Giuliani wear one at ground zero, right?” The agent turned the mask over a few times, then stuffed it back in the briefcase. Seconds later, Larsen was through.

BE PREPARED Are we ready for a biological attack? Probably not.Credit Richard Burbridge for The New York Times

Inside the building, he followed a long corridor to a room where Vice President Dick Cheney and members of the national-security staff soon joined him. Also in the room were Tara O’Toole, who is now the Obama administration’s top official for biodefense research at the Department of Homeland Security, and Thomas Inglesby, who runs the Center for Biosecurity. Three months earlier, Larsen, O'Toole and Inglesby collaborated on a national-security exercise to simulate the effects of a smallpox attack. Now, with the twin towers in ashes, they had come to brief the vice president on their findings.

As O'Toole began the presentation, Larsen studied Cheney’s expression. The vice president showed no reaction as O'Toole listed the officials who participated in the simulation, the complications they encountered as they tried to develop an emergency response and the arguments that broke out as they watched the disease spread beyond control. She concluded by telling the vice president that the country was unprepared for a biological attack.

Cheney nodded. “O.K.,” he said. “But what are we looking for? What does a biological weapon look like?”

At this, Larsen reached into his briefcase and pulled out a small test tube. "Mr. Vice President,” he said, "it looks like this.” Inside the tube was a weaponized powder of Bacillus globigii, almost genetically identical to anthrax. "And by the way," Larsen said, "I just smuggled this into your office."

At one of the most secure buildings in the world, in a moment of unprecedented alarm, the White House guards had searched Larsen's briefcase — and never even saw the powder. "They were looking for the wrong things," Larsen says now. "They still are."

The specter of a biological attack is difficult for almost anyone to imagine. It makes of the most mundane object, death: a doorknob, a handshake, a breath can become poison. Like a nuclear bomb, the biological weapon threatens such a spectacle of horror — skin boiling with smallpox pustules, eyes blackened with anthrax lesions, the rotting bodies of bubonic plagues — that it can seem the province of fantasy or nightmare or, worse, political manipulation. Yet biological weapons are as old as war itself. The ancient Hittites marched victims of plague into the cities of their enemies; Herodotus described archers’ firing arrows tipped with manure. By the 20th century, nearly every major nation developed, produced and in some cases used a panoply of biological weapons, including anthrax, plague, typhoid and glanders.

A decade after the 9/11 attacks, it is easy to forget the anthrax letters that sprang up just a few weeks later and to dismiss the fear that swept the country as a relic of a fragile moment that already belongs to history. But in the wake of those events, many national-security experts began to reconsider the risk of a biological attack — and reached some unsettling conclusions. Since the collapse of the Soviet Union, most scientists had assumed that the difficulty of building a bioweapon was far beyond the ability of a terror cell, but looking again in the early 21st century, many experts came to believe that advances in laboratory technology brought the science within reach. “What took me three weeks in a sophisticated laboratory in a top-tier medical school 20 years ago, with millions of dollars in equipment, can essentially be done by a relatively unsophisticated technician,” Brett Giroir, a former director at the Defense Advanced Research Projects Agency (Darpa), told me recently. “A person at a graduate-school level has all the tools and technologies to implement a sophisticated program to create a bioweapon.”

Even some nuclear experts began to wonder if the risk of a biological attack had eclipsed the nuclear threat. Graham Allison, the founding dean of Harvard’s John F. Kennedy School of Government and a leading expert on nuclear proliferation, told me: “Nuclear terrorism is a preventable catastrophe, and the reason it’s preventable is because the material to make a nuclear bomb can’t be made by terrorists. But in the bio case — oh, my God! Can I prevent terrorists from getting into their hands anthrax or other pathogens? No! Even our best efforts can’t do that. I think the amazing thing is that one hasn’t seen more bioterrorism, given the relative ease of making a bioweapon and the relative difficulty of defending.”

How a biological attack might unfold depends on a number of variables, including which biological agent is used, the extent of its weaponization, the amount released and the method of delivery. Some agents, like the smallpox virus, are highly contagious and could spread widely from a small release. Others, like the plague and tularemia bacteria, are not typically contagious but are relatively easy to make into wet slurry and disperse. Some of the most vivid descriptions of how such an attack might look come from the national-security exercises used to develop biodefense policy. The exercise briefed to Dick Cheney in 2001, for example, was known as Dark Winter and was coordinated by the Center for Strategic and International Studies and the Johns Hopkins Center for Civilian Biodefense Studies. It took place over two days at Andrews Air Force Base, with former Senator Sam Nunn playing the role of president, David Gergen acting as national-security adviser, the former C.I.A. director James Woolsey leading intelligence and the retired four-star general John Tilelli serving as chairman of the Joint Chiefs of Staff. As the smallpox virus began to appear, first in Oklahoma and then in pockets across the nation, the participants quickly discovered that the country had no standing response plan and only enough vaccine to protect 5 percent of the public. Within weeks, as many as a million people in the United States were estimated dead.

Not all experts are convinced that simulations like Dark Winter offer a realistic view. Milton Leitenberg, a prominent arms-control expert, has argued that the exercise relied on faulty premises to increase the death toll and “assure a disastrous outcome.” In particular, Leitenberg objects to the rate of secondary transmission assumed in the Dark Winter exercise. This is the figure to describe how many additional people each patient would infect, and it is highly contextual, depending on biological traits, like the genetic vulnerability of the target population; social habits, like the number of personal interactions by each victim; and meteorological conditions, like the weather and the time of year. Because the exercise was set in winter, which is favorable to smallpox, and because Americans are not routinely vaccinated, planners assumed a transmission rate of 10 new infections by each victim. Leitenberg says that number should be three. Other estimates vary. The Centers for Disease Control and Prevention uses a range of five to seven; the last comparable cases of smallpox to appear in Europe averaged between 9 and 17; and the authors of a 1999 article in Science magazine used the same figure as Dark Winter. But if Leitenberg is right, the death toll from the exercise would be much lower — most likely in the tens of thousands.

Whatever the transmission rate of smallpox, the more salient question for biodefense may be whether an attack will happen at all. On this, the expertise of microbiologists is limited, but there is surprisingly broad agreement among the officials in charge of national security over the past 10 years. Since 2001, senior members of both the Obama and Bush administrations, who have reviewed classified intelligence, have consistently placed biodefense at or near the top of the national-security agenda. In 2004, a report from the National Intelligence Council warned, “Our greatest concern is that terrorists might acquire biological agents.” Michael Chertoff, the secretary of Homeland Security between 2005 and 2009, told me, “In terms of catastrophic attacks, bio was at the top of the list.” In 2008, the director of national intelligence, Adm. Mike McConnell, described a biological attack as “my personal greatest worry.” In 2009, McConnell’s successor in the Obama administration, Dennis Blair, warned the Senate Select Committee on Intelligence that “the terrorist use of biological agents represents a growing threat.” In November 2009, the National Security Council estimated that a biological attack could place “hundreds of thousands of people” at risk of death and cost more than $1 trillion. Heidi Avery, a top biodefense official in the White House, told me recently that biological terrorism poses “the ultimate asymmetric threat; it should be considered in the same class as the nuclear threat." And a report by the Congressional Commission on the Prevention of Weapons of Mass Destruction Proliferation and Terrorism, formed in 2007, concluded: "To date, the U.S. government has invested most of its nonproliferation efforts and diplomatic capital in preventing nuclear terrorism. The commission believes that it should make the more likely threat — bioterrorism — a higher priority."

To heighten the nation’s biodefenses, the federal government has invested more than $60 billion since 2001, developing and distributing air sensors, educating doctors about the symptoms of bioterror pathogens and distributing medical supplies for biodefense to hospitals around the country. At the root of these efforts is a list of specific biological agents, known as “material threats,” that have been identified by the Department of Homeland Security as the most urgent pathogens to defend against. These include smallpox, anthrax, ebola, plague and a handful of lesser-known organisms.

Since 2004, the Department of Health and Human Services has overseen a program called Project BioShield to develop and stockpile vaccines and treatments, known collectively as “medical countermeasures,” to defend against the pathogens. After seven years, the achievements of BioShield are measurable. According to Robin Robinson, who directs the countermeasure program at Health and Human Services, there is currently enough smallpox vaccine in the stockpile to inoculate every United States citizen; enough anthrax vaccine to respond to a “three-city attack”; and a variety of therapeutic drugs to treat the infected. Yet many other goals of the program are incomplete and, in some cases, not even begun. After spending hundreds of millions of dollars, for example, to develop a new vaccine for anthrax that would replace the controversial formula developed 50 years ago by the Army — which is known to have serious side effects and has never been approved for children — there is still no new vaccine. There also are no new broad-spectrum antibacterial drugs in the stockpile and no new antivirals. “We don’t even have candidate products” for antivirals, Robinson told me.

Last year, two separate review boards evaluated the state of the country's biodefense program, and each report came back scathing. The National Biodefense Science Board, a nonpartisan task force created in 2006 to oversee countermeasure development, delivered a 103-page report to the secretary of Health and Human Services, Kathleen Sebelius, describing “lack of urgency,” “lack of coherence,” “lack of prioritization” and “lack of synchronization.” The title of the report was “Where Are the Countermeasures?” And the commission created by Congress in 2007 to evaluate all defenses for chemical, biological, radiological and nuclear threats delivered its final report, offering letter grades in several categories. For attention to the safe storage of toxins, the government received an A. For openness and transparency, a B-minus. For biodefense, the grade was an F.

“The lack of U.S. capability to rapidly recognize, respond and recover from a biological attack is the most significant failure identified in this report card,” the commission wrote. “Especially troubling is the lack of priority given to the development of medical countermeasures — the vaccines and medicines that would be required to mitigate the consequences of an attack.”
Continue reading the main story

Even within the biodefense community, there is a widespread sense that the countermeasure program is failing. Early this year, Sebelius described the effort as “full of leaks, choke points and dead ends,” and in more than 100 interviews with senior officials from each of the federal agencies related to countermeasure development — including past and current program heads at the White House, the Pentagon, the National Institutes of Health and the Departments of Homeland Security and Health and Human Services — I heard an endless series of grim diagnoses on the health of the nation’s biodefenses. As one senior official in the Obama administration put it: “We need a new model. This is never going to work.”

Since the 1990s, the United States’ approach to biodefense has been redesigned at least three times. Each time, the new approach was presented as a remedy; each time, the remedy failed to cure.

The story that circulates among officials is that the first modern president to focus on biodefense was Bill Clinton in 1998: after staying up all night reading “The Cobra Event,”by Richard Preston, a thriller about a terrorist strike with modified smallpox, Clinton called a high-level meeting of scientists, ordered the F.B.I. to review the plot and began pushing copies of the book on other politicians. By 1999, the White House and Congress had created a new division of theC.D.C., known as the National Pharmaceutical Stockpile, to store medicines for crises. But in the absence of an actual crisis, financing for the stockpile was fairly minimal. By summer 2001, it held only 15 million doses of smallpox vaccine and little else.

After the anthrax letters in October 2001, everything changed: by 2002, spending on biodefense rose to more than $4 billion, from $633 million, with an emphasis on expanding the stockpile. One of the program’s first priorities was to increase the supply of smallpox vaccine. Smallpox is regarded by biodefense experts as the most threatening biological weapon, because it can spread as easily as the flu and kills about one in three victims. To expand the stockpile, the Bush administration called in a legendary epidemiologist. In the 1960s and ’70s, D. A. Henderson led the World Health Organization’s program to eradicate smallpox in nature, chasing outbreaks through villages in Brazil, the mountains of Yugoslavia and the jungles of India before finally containing the last known cases in the Horn of Africa in 1977. Today, smallpox is the only human infectious disease ever eradicated by science.

Returning to public service in 2001, Henderson called in another legend of microbiology, Maj. Gen. Philip K. Russell, a former commander of the Army’s medical research program and a figure so revered that one commanding general was known to keep a bumper sticker on his wall that read, “What would General Russell do?” Between 2001 and 2004, Henderson and Russell, along with leaders at the National Institutes of Health and civilian research laboratories across the country, raced to develop new production techniques and expand the smallpox-vaccine supply. Today, the stockpile holds more than 300 million treatment courses.

Officials at Health and Human Services were also determined to produce and store a large supply of anthrax vaccine, but they were unsatisfied with the existing formula. Some veterans blamed the vaccine for gulf war syndrome, citing research at Tulane University, and after vaccination was made mandatory in 1998, hundreds of service members actually refused the shots. Some resigned from service in order to avoid it; a few were court-martialed for insubordination. In 2002, the most comprehensive study of the vaccine, by the Institute of Medicine at the National Academy of Sciences, concluded that while the vaccine was “reasonably safe,” a new vaccine was “urgently needed.”

Developing a new vaccine is vastly more complicated than increasing the supply of one that exists. In the pharmaceutical industry, the cost to develop a new drug or vaccine averages about $1 billion. To encourage companies into development, the Bush administration in 2003 announced the creation of a special fund within Project BioShield, filled with $5.6 billion for the purchase of countermeasures like a new anthrax vaccine, yet by the middle of 2004, not a single large pharmaceutical company had begun development. “The belief was: Fund it and they will come,” Senator Richard Burr, who is prominent in biodefense, told me. “Well, they didn’t come.” Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases (N.I.A.I.D.) at the National Institutes of Health, told me $5.6 billion was simply not enough money. “The Mercks and the GlaxoSmithKlines and others looked at it and said, ‘Forget it,’ ” he said.

Officials at Health and Human Services turned to smaller drug companies, instead. In November 2004, they offered the first major contract under BioShield to a young company called VaxGen, based in California. If VaxGen could develop and deliver a new anthrax vaccine, the government promised to purchase 75 million doses for $877 million.

From the outset, the choice of VaxGen proved controversial. The company had never produced a drug before, it had been delisted from Nasdaq a few months earlier for failure to file timely financial statements and it was embroiled in an ethical dispute in Thailand over human testing of another drug. But VaxGen did have certain advantages, not least that it had been working on a new anthrax vaccine for two years already, financed by $100 million from Fauci’s N.I.A.I.D.

To add another layer of confidence to the deal, officials at H.H.S. structured the VaxGen contract with unusually stringent terms. During the proposal process, VaxGen executives submitted a 1,000-point outline to show the approach they hoped to take. H.H.S. officials now made the outline binding: according to the former chief executive of VaxGen, Lance Gordon, officials notified the company two weeks before the deal became public that if VaxGen could not stick to the plan, the company risked breach of contract. In retrospect, Gordon told me, VaxGen never should have taken the terms. “It’s impossible,” he said. “In the history of mankind, nobody has been able to predict 1,000 tasks for hundreds of people over a five-year period. Life doesn’t work that way.”
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Vaccines especially don’t work that way. Their development is notoriously complex and requires frequent adjustment as complications arise in the lab. Predictably, within months of signing the contract, VaxGen slipped off schedule and was technically in breach. At the same time, officials at H.H.S. were discovering that the VaxGen contract did not add to the countermeasure program’s appeal: by 2006, the third year of the contract, not one other major project was in development under BioShield.

It was time for a third overhaul. In the summer of 2006, Burr instructed his legislative staff to figure out what was wrong in the countermeasure program. He came to believe that the problem was institutional. If the early research at the N.I.H. was producing valuable leads for new drugs, and the money in Project BioShield offered an incentive at the end of development, then what was missing was an agency in between to help guide companies across what Burr’s staff called the Valley of Death. “What we saw,” Burr says now, “was that we had to become more than a procurer. We had to become a partner.” That July, Burr introduced a bill to establish a new agency at H.H.S., known as the Biomedical Advanced Research and Development Authority(Barda), with an annual budget of $1 billion, to finance the development of countermeasures and steer companies through the gantlet of clinical trials and F.D.A. approval. That December, the bill passed both houses of Congress unanimously — but even as executives at VaxGen watched to see how the new agency might help them, H.H.S. announced that the VaxGen contract would be canceled.

Five years later, the cancellation of that contract is still a matter of fierce debate in biodefense circles. Many experts say that the decision had less to do with science than politics. Scott Lilly, a senior fellow at the Center for American Progress, recently studied the role that lobbying may have played in VaxGen’s demise. Between 2004 and 2006, Lilly writes in a new study, the company that produced the old anthrax vaccine, which is now called Emergent BioSolutions, employed an army of lobbyists to undermine the VaxGen contract. “Each time VaxGen’s test results were less than had been hoped for,” the report says, “Emergent pounded VaxGen with a highly orchestrated campaign to overstate the problems and discourage government support of the effort.”

Executives at Emergent acknowledge the campaign against VaxGen but say it was not directed at the company so much as the structure of the BioShield contract. “Our issue was not with respect to VaxGen,” the president of Emergent, Daniel Abdun-Nabi, told me. “It was with respect to the approach of moving to a single supplier with an unproven technology. We thought it was premature. We thought it added risk to the country.” According to Abdun-Nabi, the company’s message to legislators was: “You shouldn’t put all your eggs in one basket. There’s a role for multiple suppliers.” The fact that this lobbying contributed to the implosion of VaxGen and another five years in which Emergent was the only supplier of anthrax vaccine, which has earned the company $1.5 billion, also troubles Abdun-Nabi, he said. “It puts us in a very difficult position to be the sole supplier. I mean, the whole nation is reliant on Emergent. And in one sense, we’re very honored to be in that position, but it’s a tremendous responsibility.”
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General Russell, who led the early countermeasure program, told me: “It was Emergent lobbying that killed VaxGen. Period. Emergent bought the Congress. Congress killed VaxGen.” Several current officials share Russell’s view. When I asked one senior biodefense official about the lack of a new anthrax vaccine, the official nearly exploded: “Why don’t we have a second-generation anthrax vaccine? The reason is Emergent lobbying!” Even the director of Barda, Robin Robinson, acknowledged that politics played a role in the decision. “Should we have kept it? I think there’s a long debate,” he said. “They had brought in some really top-flight people in there, and Lance Gordon was really good at judging talent. Unfortunately, there was a lot of political pressure.”

Soon after the VaxGen contract failed, the company folded into another, and Emergent bought the rights to develop the new anthrax vaccine it had spent three years lobbying against. Abdun-Nabi told me his company was still trying to develop that vaccine, but critics question whether Emergent, which signed another contract this month to deliver $1.25 billion more of the old vaccine to the stockpile, is pursuing the replacement vaccine as enthusiastically as possible. “They bought the technology and buried it,” Russell says. “We are five or six years behind where we should be. We should be working on a third-generation vaccine.”

If the pursuit of a new anthrax vaccine has been halting, the pursuit of many other vaccines has halted altogether. In fact, other than the vaccines for anthrax and smallpox, there are no vaccines in the stockpile for any other agents on the material-threat list, nor are any of those vaccines in the advanced development program, nor will any of them enter the program any time soon.

Robin Robinson, the director of Barda, is a big, easy fellow, with a trim goatee and a light Southern drawl. The first I met him, two years ago, we sat at a long table with his new boss, Nicole Lurie, who had just been appointed by the Obama administration as the assistant secretary for countermeasure development. Lurie had an air of unpretentious surety and a sudden, piercing laugh, and she and Robinson wasted no time trying to hide the failings of their program. Although Barda was established in 2006 with an annual budget of $1 billion, it never actually received the money. In 2006, the agency received $54 million; in 2007, $104 million; in 2008, $102 million; and by the time I sat down with Robinson and Lurie in 2009, Barda had received in four years about half of what it was intended to receive in one. Lurie reminded me of the high cost required to develop drugs. “What does it take in the pharmaceutical industry?” she asked. “A billion dollars per product! The advanced development part of that might be about $350 million, so that’s the part that we should be funded for.”

"For each product!” Robinson said.

"For each product," Lurie agreed. "So, we're nowhere near it. We're nowhere near the level that we need to be, to be able to protect the American public."

In the two years since that conversation, financing for Barda has gone up, but with many of the goals still incomplete and criticism pouring in — two weeks ago, the Bipartisan W.M.D. Terrorism Research Center in Washington gave the agency a D for performance — the affinity between Robinson and Lurie is less apparent. Lurie, for example, has removed from Barda all contracting officers, instructing them to report to her instead of Robinson. This many seem minor, but companies working with Barda suggest that it has led to ballooning bureaucracy at an agency that was specifically created to attract business. “Now you really have two bosses,” Eric Richman, the C.E.O. of PharmAthene, which is one of four companies still working on a new anthrax vaccine, told me. “We actually spend as much time managing our contracts as we do developing our drugs. It’s a real burden.” Other C.E.O.’s echoed Richman’s concern, and friends of Robinson’s suggest that the move has compromised his ability to lead the program effectively. “This becomes very frustrating for him,” an H.H.S. official told me. “What does he tell the companies — ‘Now I have to go ask for permission’?”

But the gap between Robinson and Lurie also seems to extend to basic matters of policy and fact. Nowhere is the division in countermeasure development more apparent than on the question of vaccine development. Because a vaccine is only effective against a single pathogen, and because development is so expensive, Barda has focused much of its energy on therapeutic drugs — which may not offer protection to the healthy but can treat a broad range of diseases.

When I visited Barda recently to speak with Robinson and Lurie again, I heard two very different explanations for the move away from vaccines. Lurie described the decision as an unfortunate but necessary concession to the budget. “You’d like to have vaccines further along in the pipeline for all the threats we have, and you’d like to have a way to manufacture them quickly,” she told me. “But I don’t think there’s anywhere near enough money in the system.” Yet Robinson insisted that the move would have happened even if financing was not an issue. “There are only two biothreats — smallpox and anthrax — that we feel vaccination is the appropriate way to go,” he said. When I asked if that meant he would not even want a vaccine for other agents, like tularemia, he said: “I don’t think there’s a case to be made for that. What we're doing is therapeutics."

The debate over vaccine development is by no means limited to Robinson and Lurie. Ten years after the anthrax attacks, and with more than $16 billion committed to countermeasure development, there is still broad disagreement among officials over whether the stockpile should include other vaccines. When I asked Tara O’Toole, who leads the Science and Technology Directorate at the Department of Homeland Security (where the list of biological material threats is created and the countermeasure process begins) whether she believed the stockpile should include vaccines for other agents, she snapped: “Vaccines are essential. If there’s a bio attack, people are going to want their children vaccinated. It’s the only defense against reload.”

By “reload,” O’Toole was referring to a concept first developed by Richard Danzig, who is a former secretary of the Navy under Bill Clinton and one of the leading intellectuals in biodefense. Danzig currently serves as chairman of the board at the Center for a New American Security, sits on the Defense Policy Board at the Pentagon and is a member of the President’s Intelligence Advisory Board. The reload concept, he told me recently, describes a fundamental difference between biological weapons and all other weapon types. “When we talk about terrorists’ acquiring a nuclear weapon, we’re talking about just that — they’re acquiring a weapon,” Danzig said. “With biological weapons, we’re talking about acquiring the ability toproduce weapons. So if you acquire the ability to produce 100 grams of anthrax, you can keep doing that. You really have to think about biology as potentially the subject of acampaign, where somebody keeps attacking, rather than a one-shot incident.” When I asked Danzig how the reload concept influences the debate over vaccines, he said: “You can reassure people that there will be antibiotics available for them, and you can keep producing ever greater numbers of antibiotics. But you can see that if you had the ability to vaccinate people and protect them, it would provide a larger degree of protection. So to the extent that these things come to pass, I think there will be more pressure to develop vaccines.”

Brett Giroir, who directed the Defense Sciences Office at Darpa and is now vice chancellor for strategic initiatives at Texas A&M University, shared Danzig and O’Toole’s belief that other vaccines should be developed. “Vaccines are critical components of a biodefense posture, and anybody who thinks they’re not isn’t thinking seriously about how we approach this,” Giroir told me. “If we got sprayed with tularemia in College Station and a biodefense sensor went off, that would be an ideal opportunity for vaccine.”

Tularemia is an especially difficult case. Found naturally in animals around the world, it can be transmitted during butchering and spread by ticks. Although it is highly infectious, it is seldom lethal. But during the 1950s and ’60s, Army researchers became interested in weaponizing tularemia.

It has been more than 40 years since the American bioweapons program shut down, and many of the details remain classified. Last fall, the final director of the program, William Patrick, died of cancer at 84, but in the final months of Patrick’s life, Robert Kadlec, the former biodefense chief in the second Bush White House, and Joel McCleary, a former aide to Jimmy Carter, spent hundreds of hours interviewing him on the history and accomplishments of the program. Over the past year, McCleary has delivered a presentation on the bioweapons program to members of Congress, the White House national-security staff and senior officials at the Departments of Defense, Homeland Security and Health and Human Services. One night this summer, I stopped by McCleary’s house to see the presentation myself.

Finding McCleary’s home in Georgetown was a bit like passing through the looking glass. I started down a cheery row of town houses, but as I approached the right number, I realized there was no house — just a gravel path that trailed away from the street with vines and shrubs surrounding it. I followed the path and came to a gate and, finding no bell or button, fiddled with an iron latch to enter a lush green courtyard shaded by a walnut tree. It was as if I made a wrong turn in Georgetown and wandered into the English countryside. In the center of the yard sat a small cottage, as wide as it was tall. I rang the buzzer a few times and rapped a brass knocker on the door, and after a few minutes, McCleary burst outside in a pair of bright red slippers. He is a large man, brimming with energy, and we stood in his yard admiring the flowers for a moment, then retreated inside to review the last known record of the American quest for a microbial army.

It was immediately apparent that the Army’s research on tularemia went far beyond what is commonly known. In hundreds of experiments, scientists weaponized the bacteria to extraordinary potency and then proceeded to mix the slurry with another agent, known as S.E.B., which multiplied the effects logarithmically, shattering the human immune system just as the tularemia plunged in. In several large outdoor tests, scientists drifted clouds of tularemia over cages of live monkeys to evaluate the infectivity. At high doses, the weaponized bacteria were determined to have an incubation period of just a few hours. If left untreated, the combination of tularemia and S.E.B. was projected to cause death within the same period. Patrick called these “killing winds.” In one video, he calmly warned, “Between 50 and 60 pounds of freeze-dried tularemia produced in our production facility would eliminate about 60 percent of the population of London, England.”

When I asked Robinson, who knew Patrick and has seen McCleary’s presentation, whether the extreme weaponization of tularemia suggests the limits of a therapeutic response and a role for vaccination, Robinson became circumspect. “I’ve got to be careful on this one,” he said, “because there is classified information.” Then he went on to explain that Barda is considering the possibility of such an attack but still hopes to respond by treating the sick, rather than by vaccinating the healthy. “What we’re doing,” he reiterated, “is therapeutics.”

To date, the United States has never developed an original vaccine for tularemia. Instead, for the past 50 years, scientists who study tularemia must be vaccinated with a weakened version of the bacterium, which was first obtained through mysterious means from the Soviet Union during the early days of the cold war and then modified. But today, supplies of the live vaccine are running thin. In fact, they are virtually gone. Although some lab workers still receive it, the official literature of the C.D.C. lists the tularemia vaccine as “not currently available,” and Karl Klose, who runs a tularemia lab at the University of Texas, San Antonio, told me that federal research into tularemia has dwindled over the past few years. “They’re basically just abandoning the effort,” he said. “It’s like the A.D.D. has kicked in."

There is one vaccine candidate for tularemia currently in development. Although it is not a novel product and represents a different formulation of the old Soviet vaccine, it is currently in clinical trials at several locations around the country. Typically, the point at which a product becomes eligible for all the support and financing of the advanced development program at Barda is when the product enters Phase II testing. The new tularemia product entered Phase II this fall, but without interest from Barda, it has remained under the auspices of the early development program at N.I.A.I.D. If this seems organizationally confusing, it makes sense in at least one way. Since 2002, the financing for N.I.A.I.D. has outpaced that for advanced development by as much as 15 to 1. Partly, this is a result of N.I.A.I.D.’s being an older, established institution; partly it is a consequence of the institute’s powerful director, Fauci, who has led the agency since 1984 and is sometimes called the J. Edgar Hoover of biology. On the heels of the anthrax attacks in 2001, Fauci vigorously promoted N.I.A.I.D. as the best agency to lead countermeasure development and since 2003 has received about $1.6 billion each year for biodefense research. Some of that money goes into projects like the tularemia study, which would not be financed otherwise. Much more has gone into other kinds of projects entirely. A close look at Fauci’s budget last year shows that the director has steered about 70 percent of his biodefense funds toward research into natural disease, including AIDS, SARS and malaria — choosing to define “biodefense” however he likes.

The offices of N.I.A.I.D. lie within the sprawling N.I.H. campus in Bethesda, Md., just below the rim of the Washington Beltway. Among the stately grounds of the N.I.H., the N.I.A.I.D. building is mostly remarkable for how unremarkable it is: the exterior is smudged with mildew and laced with steel electrical conduit, and the corridors are dim and yellowing with age. One day recently, as I stood with Fauci in his seventh-floor office, he paused to admire the dishevelment around him. “Look at this!” he cried, running a hand over the dented surface of his desk. “I inherited this from my predecessor!” He pointed to an old sofa in the corner. “If there’s ever a Congressional investigation, I don’t want them to say I spent it all on myself!”

Fauci is a small, muscular man with an outsize manner. He is from New York in the most obvious ways. After three decades leading one of the most prestigious research programs on earth, he retains a booming Brooklyn patois that sounds, even when he is discussing matters of virulence and pathogenesis, as if he is shouting a pizza order to the back. As we sat together in his library, he explained that although he has overseen most federal spending on countermeasure development since 2002, he does not fully embrace the mission. The list of material threats, he said, reflects an outmoded way of thinking. "It's less of a priority to say, ‘O.K., now here's our menu for the Strategic National Stockpile,'" Fauci said. "We call that the military model." He added, "Do we have this little thing in the stockpile or not? I don’t judge the safety of the country on that basis. To me, the idea of a naturally occurring threat is infinitely greater.”

Many agents on the list, Fauci said, were a product of the cold war, when the U.S. military kept a list of “Category A” pathogens being developed by the Soviet bioweapons program. “So when the decision was made to make an investment into developing countermeasures,” he told me, “that was essentially their matrix from the beginning: these are what we know the Soviets had. We know they have stockpiles. This is what we’re going to protect against.” He mentioned the bacterium glanders, which was reportedly used by Germany in World War I and by Japan in World War II but seemed to Fauci a comparatively minor threat today. “I think the unknown threat of a mutant microbe is infinitely greater than someone coming and dropping a glanders on us!” he said. “I mean, seriously! Get real about that!”

When I mentioned Fauci’s comments to O’Toole, who oversees the biological-threat list at the Department of Homeland Security, she said he was “completely wrong” to suggest that the list is rooted in cold-war thinking. “We use current intelligence as an integral part of every material-threat determination,” O’Toole said. “I’m surprised anyone in N.I.H. would think otherwise, particularly since the details of the material-threat determination process are briefed at the White House. It does raise a troubling question about how seriously N.I.H. is engaged in the biodefense mission.”

Whether or not Fauci is right about the origins of the material-threat list, his observation that a natural outbreak is more likely than a biological attack is difficult to dispute. Each year, seasonal flu leads to about 200,000 hospitalizations and several thousand deaths in the United States. Although a biological attack could be much larger, there is no certainty that such an attack will ever happen. How to balance the unlikely but catastrophic potential of bioterror with the steady advance of natural disease is one of the most puzzling challenges for biodefense policy going forward.

To some extent, this is also a question of framework. Fundamentally, the countermeasure program is a public-health project, yet with its reliance on classified intelligence and secret-threat assessments, it is more closely aligned in many respects with the methodology of other national-security projects. Where biodefense fits into government bureaucracy will have a profound impact on its financing. In public health, the $12 billion necessary to develop new vaccines for a dozen material-threat agents can seem a towering, even absurd, figure. Within the realm of national security, the same amount represents less than a quarter of the cost of the military’s experiment with the V-22 Osprey heli-plane, or about what the U.S. will spend in Afghanistan between now and Christmas.

“We spent trillions of dollars in the cold war preparing for a potential nuclear exchange that never occurred,” says Kenneth Bernard, who was the senior biodefense official in the Clinton White House from 1998 to 2001 and then again in the Bush White House from 2002 to 2005. “We’re not spending that kind of money to prevent a bio attack because the people who work on biology are not trained to think like that. They are much more interested in dealing with the three particular strains of influenza that are in the dish this year than they are in thinking about a plague attack in 2018.”

Even if the leadership and financing for biodefense were to shift toward a national-security framework, the task would still require complex coordination among agencies with expertise in disparate spheres. This challenge is not made easier by the personal hostility that has emerged among many current program heads — some of whom have close ties to the competing companies they oversee. In the course of several months of reporting, I heard senior officials from each of the major countermeasure agencies question the motives and professional credentials of the others, sometimes in a manner involving spittle. At times it seemed that the most virulent pathogen in biodefense was mutual hostility, and everybody had it.

Senior officials in the Obama administration say that the president is committed to improving coordination on biodefense and is entering a fourth major overhaul of the countermeasure enterprise. Last year, officials from the countermeasure agencies met weekly with the White House staff to discuss the merits and drawbacks of the current approach. Officials who attended those meetings say the administration hopes to develop a more “nimble, flexible” program, in which a single drug can treat multiple diseases and a single manufacturing plant can produce multiple drugs. If that plan, after 10 years and hundreds of millions of dollars trying to create a new anthrax vaccine that is still not ready, sounds optimistic, it is. Whether it is also realistic, only time will tell. Critics are quick to note that, three years after taking office, the administration is still holding meetings and announcing bold new plans.

A number of former and current officials also point out that no one in the Obama White House is focused exclusively on biodefense. In both the Clinton and Bush administrations, there was a biodefense director whose primary job was to coordinate the agencies. Today, there are four senior White House officials with partial responsibility for biodefense, but each of them is also responsible for a raft of other issues, like natural disasters, terrorism and large-scale accidents like the Deepwater Horizon oil spill. Whatever you think U.S. biodefense policy should be, it is difficult to imagine that it would not benefit from clear, central leadership. Kenneth Bernard, the biodefense czar in both the Clinton and Bush administrations, told me, “The only way that you can get all of those people in the room is to call them into the White House, and to have a coordinating group under a single person.” Robert Kadlec, who was the senior official for biodefense in the second Bush term, said, “Unless someone makes this a priority, it's a priority for no one."

Randall Larsen, who first smuggled a tube of weaponized powder into the meeting with Dick Cheney 10 years ago — and went on to become the executive director of the Congressional Commission on Weapons of Mass Destruction — said: “Today, there are more than two dozen Senate-confirmed individuals with some responsibility for biodefense. Not one person has it for a full-time job, and no one is in charge.”

Wil S. Hylton is a contributing writer for the magazine.

Editor: Joel Lovell

A version of this article appears in print on October 30, 2011, on page MM26 of the Sunday Magazine with the headline: Warning: There's Not Nearly Enough Of This Vaccine To Go Around