For nearly two decades, the federal government has committed to biopreparedness and made significant progress toward enabling our country to withstand and respond to biological attacks and pandemics. Funding for some of these programs has declined over time, but the new federal budget released last week by the Trump administration is uniquely drastic. It would undo the bipartisan progress to build our biodefenses by crippling, and in some cases eliminating, programs that are vital to our national health security.
Threats to national and international biosecurity are far from speculative. In October 2001, anthrax spores were sent through the mail in an unprecedented act of bioterrorism against the U.S. This experience served as a wake-up call regarding our nation’s vulnerability to biological threats.
Today, ISIS and other terrorist organizations are showing continued interest in using biological weapons. In 2014 an ISIS laptop was recovered containing a 19-page document on how to develop biological weapons, and late last year Kenyan authorities disrupted an anthrax plot by a medical student and associates affiliated with ISIS. Earlier this year, South Korea raised concerns that North Korea possesses biological weapons and could use drones to carry out attacks.
One important domestic biological threat is the potential for wide-area anthrax attacks, much larger than occurred in 2001. In such an attack, emergency rooms would be flooded with patients of all ages experiencing severe respiratory distress, extreme anxiety about their potential exposure, or both.
Politicians, individuals on social media and media would be trying to assess the damage, attribute blame and understand what was being done to respond. All would be trying to save lives, understand what happened and figure out what to do next. Political concerns, economic prosperity and societal stability would hang in the balance. Such an event would be terrible, but if the proposed budget cuts are enacted, the impact would be far more dire.
In the first moments after the attack is identified, we’d want to know the identity of the pathogen used in the attack, whether it could spread from person to person and what drugs and vaccines would work to treat and protect people. But with a 13 percent cut to CDC’s preparedness and response capability, and complete elimination of DHS’s National Biodefense Analysis and Countermeasures Center, the delay before these and other facts are known would increase, costing many lives.
First responders, hospital staff and public health professionals would be pressed into round-the-clock service. Hundreds of millions of dollars in cuts to FEMA grants, including the State Homeland Security Grant Program and Urban Area Security Initiative, would degrade local emergency responders’ ability to mitigate the crisis on the ground by limiting their ability to train, plan and purchase needed equipment. An 11 percent reduction in funding (on top of a cumulative 50 percent reduction in prior years) to the Hospital Preparedness Program would limit hospitals’ ability to plan and prepare jointly and to collectively meet the surge in demand for care generated by the attack. People would die unnecessarily while waiting for care.
In addition, public health officials would need to distribute life-saving drugs and vaccines to the men, women and children who may have only hours before the onset of life-threatening complications. But more than $100 million in cuts to the Public Health Emergency Preparedness Cooperative Agreement would limit local responders’ ability to set up points of dispensing for needed medications.
The government and the public would demand the rapid identification of the perpetrator(s). Scientists at the National Bioforensics Analysis Center and in the Bioforensics R&D Program at DHS would have played an essential role in determining the origin of the bioagent and attributing the attack. Unfortunately, these programs would be eliminated in the new budget. Without this unique capability, not duplicated anywhere in or out of government, the odds that the perpetrator(s) would go free would be significantly increased.
Evacuations would likely be necessary in the aftermath of a widespread attack on a U.S. urban center. But with a 36 percent cut to EPA’s Homeland Security Preparedness, Response, and Recovery programs, there may be no one to lead the decontamination efforts or to determine how clean is safe. The operation of the city’s business, education and government sectors would be suspended indefinitely. Entire communities could be abandoned.
We urge Congress to reject the severe cuts proposed by the Trump administration and to support the continuation of these and other critical national biopreparedness and response assets, which protect the health and safety of all Americans.
Tara Kirk Sell, Ph.D., Crystal Watson, DrPH, and Matthew Watson are faculty at the Johns Hopkins Center for Health Security at the Johns Hopkins Bloomberg School of Public Health. The Center has been the recipient of grants and contracts from a number of the federal organizations mentioned in this piece, including DHS, CDC, ASPR, and FEMA.
The views expressed by this author are their own and are not the views of The Hill.