They had gathered from around the country, 100,000 people marching along the San Francisco waterfront to protest what they believed to be an impending Israeli-American air attack on Iran's nuclear facilities. As protesters held aloft signs declaring NO MORE IRAQS! a few aging Hollywood stars lectured to the crowd, reminding everyone that they had failed to stop a war in 2003—-and could not fail again. The San Francisco rally was the first of three scheduled for that weekend; the next day the scene would be repeated in Chicago and New York.
The protesters wanted to make sure they were heard, and vendors were ready with just the thing: air horns, which sent a blast from a canister of compressed air. All afternoon, the air horns blared—so loudly that people turned away. They did not see the mist as each canister was emptied.
These air horns, it turned out, were blasting out more than noise. Several of the canisters had been deliberately contaminated with Yersinia pestis, bacteria that, once inhaled, causes the pneumonic plague, which is fatal if untreated.
The attackers had time on their side. Although the symptoms of the plague can show up quickly, it initially resembles a cold or flu—headaches, coughing a fever. And while San Francisco was one of the first cities equipped with detectors under the federal government's BioWatch program, the warning that an attack had occurred would not come for hours. Biodetectors don't go off like smoke detectors; a technician has to come around daily to remove a filter, and it takes hours to get the sample analyzed. That left plenty of time for repeat attacks in Chicago and New York, where more air horns were being handed out. 1
It was Tuesday, a day after people began to fall ill and arrive at hospital emergency rooms, before the Centers for Disease Control began to figure out what had happened. Then the system kicked into action: Fortunately, the needed antibiotics—primarily streptomycin, gentamicin, or one of a number of tetracy-clines—had been stockpiled in strategic warehouses across the country. Radio and television messages warned those with symptoms to go to the nearest hospital and cautioned everyone else on how to reduce their chances of exposure.
Still, the combination of hundreds of truly infected victims and millions who were concerned that they might have contracted a disease that sounded like the terror from the Middle Ages led to panic. Hospitals around the country were soon overwhelmed. Government officials offered reassurances that almost all of the patients who received the antibiotics relatively soon after exposure would be fine. They should have known that the statistics didn't matter. Millions feared they or their children would not get the antibiotics in time. Few went to work for fear of exposure to the disease. Schools were closed. People stayed out of supermarkets and malls. Even with the government doing just about everything right—telling people how to protect themselves, distributing medicine, isolating the sickest—the economy came to a screeching halt.
SEVEN YEARS AFTER 9/11, the United States is in far better shape today to respond to a biological attack than it ever has been before. After the anthrax attacks in 2001, the government initiated a program called BioWatch that collects air samples to detect biological agents in the air above major cities across the United States. Life-saving drugs are strategically stockpiled around the country, even if there is still debate about the most effective way to distribute them. Yet despite these advances, we remain almost as vulnerable as before, largely because almost everything about a biological attack is different from other types of terrorism.
Though politicians tend to talk about nuclear and biological attacks in the same breath, they have almost nothing in common. We invest in nuclear detection to protect ourselves from a detonation; after it happens, it's way too late. Biological attacks are almost undetectable in real time. There's no boom, no mushroom cloud to tell you that an aerosol can has just dispersed anthrax or pneumonic plague. The dirty little secret of those BioWatch detectors is that they are designed to tell you what happened a few hours ago, not what's happening now.
To catch a bioterrorist, the authorities would have to get pretty lucky. Conventional explosives leave a residue on the clothing of a bomb-maker or a bomb-carrier. That, of course, is what airport security officials are looking for when they swab a briefcase or a piece of hand luggage and put it in a sniffing machine at security checkpoints. But if your briefcase contained a package of dry anthrax material, enough to kill thousands, the machines would detect nothing. The helpful guard from the Transportation Security Administration would hand you back your computer bag, apologize for delaying you, and wish you a safe flight.
The professionals in the business all understand that we probably won't be able to stop an attack from happening; the real question is how good we can be at mitigating the effects. But astoundingly, years after Dick Cheney took an emergency trip to the Centers for Disease Control to try to lock down America's biological vulnerability—probably his most constructive act in a largely destructive term in office—no politicians or Homeland Security officials want to explain the real dangers, or the plan, to the American people. The scenarios simply sound too scary, the government too helpless. Merely having the conversation would prompt speculation that government officials have evidence of an imminent attack, even if they didn't. But it's a conversation we cannot afford to ignore. If there is a nuclear attack, there's not much that ordinary citizens can do to protect themselves from the radiation; the choices are to lock yourself in your duct-taped basement or flee. If there is a biological attack, individuals can do plenty to protect themselves, especially if they are prepared and informed. But the Bush administration did not want to discuss the subject. They didn't even want to fund it: The one major program the administration created, which sought to train Americans on what to do during an attack and created a Medical Reserve Corps of professionals who could administer antibiotics, saw its funding halved during Bush's second term.1*
Richard Danzig, who served as secretary of the Navy under President Clinton, captured the problem elegantly in a report he wrote in May 2008. After seven years of work, he concluded, the effort to defend Americans against bacteria, viruses, and toxins “is an agglomeration of tactics presented as a strategy.”2
During the Clinton administration, Danzig had developed a fascination with the challenges of preparing for bioterrorism, and he negotiated an uneasy accord with the Bush administration that allowed him to keep pushing both government and academic institutions into action. By early 2007 Danzig had signed on as one of Barack Obama's top foreign-policy advisers, telling him he was convinced that the Illinois senator, then the longest of long shots, was the right man for the job. He also told Obama that he would almost certainly lose the Democratic nomination. “So much for my political predictions,” the white-haired Danzig told me as the campaign wound down. “Maybe I should stick to biodefense.”
Danzig had worked for a president whose interest in bioterrorism was piqued by reading a novel: Clinton reportedly asked the FBI to tell him whether a biological attack of the kind Richard Preston wrote about in The Cobra Event could actually happen.3 But Clinton left his successor with a flurry of reports and few action plans, and until the 2001 anthrax attacks, the problem got little attention. When Bush's National Security Council was first forming, recalls Kenneth W. Bernard, a member of Clinton's national security staff who would later serve as Bush's special assistant for biodefense on the Homeland Security Council, “There was a general sense that health wasn't a real security issue.”
It soon became one. In October 2001, an envelope arrived at the office of Tom Daschle, then the Senate majority leader, with a return address for the nonexistent “4th Grade, Greensdale School.” Another letter was mailed to Senator Patrick Leahy of Vermont, with just a gram of anthrax—which amounts to about one trillion spores. That would be enough to kill, in theory, 100,000 people if it had been spread outdoors under perfect conditions. One study later concluded that if a kilogram or two were released in a city like New York, and sucked into the air handlers of skyscrapers, the result could make the buildings uninhabitable for more than four decades. (Later, the number was revised to three hundred years. The fact is, no one knows for sure.)4
As it was, about thirty workers on Capitol Hill and several more postal workers tested positive for anthrax exposure. That was enough to shut down the House of Representatives and the Senate office buildings; across the street, the Supreme Court was evacuated. And that was from just a few grams of powder, contained in a few envelopes.
Soon Cheney and his staff were seized with the threat of a possible biological attack. Intelligence reports indicated that North Korea, Iraq, and Russia had undeclared samples of smallpox virus. (So did France, the intelligence indicated. “The one country that Cheney trusted less than Iraq,” one White House aide joked darkly.) Cheney pushed for a mass inoculation of the entire country, despite warnings that the inoculations themselves would kill about three hundred people. He concluded that was better than having thousands, or tens of thousands, die in an attack—if one ever happened.5
“This was the moment when I first saw the president split away from Cheney,” one White House official who was in the room told me. “He just wasn't ready to see three hundred people die for a low-probability event, even if Cheney was.”
Bush went for something more modest: a flurry of new presidential directives, of the kind already issued regarding counterprolif-eration programs and counterterrorism operations. The initiative was called “Biodefense in the 21st Century.”6
Bush and Cheney deserve significant credit for kicking the federal bureaucracy into action. Lawrence M. Wein, a professor of management science at Stanford's Graduate School of Business who constructed the mathematical models about how long it would take to decontaminate New York, credits the administration with stockpiling enough vaccine for everyone in the country in the event of a smallpox attack.
“While it would cause a lot of panic, we would not see anywhere near 100,000 people dying,” Wein said. “We would see hundreds or a couple of thousand at most. I think that's one we've taken off the table as a catastrophic scenario.” Unfortunately, there are many others still on the table.
WHEN RICHARD DANZIG explains the biological threats that the government needs to be prepared to face, he breaks them down into four categories, each requiring a different response, each a different strategy. “We've got many of the tools, we've made some progress,” he told me one day on his back deck in Washington, “but this is all about preparation, and I don't think you can say that at this point we're anywhere near prepared. We've got huge disconnects in the system—mostly between the federal government and localities that will be doing the treatment. We haven't figured out how to engage people in thinking about this without panicking them.” And, he added, “if you are going to have a strategy, you need to think about how this fits into a broader concept of terrorist threats.”
The first entry in Danzig's catalog of four threats is viruses, of which smallpox is the best known. Viruses can be enormously contagious, and getting people vaccinated fast enough would be the main challenge.
Danzig's second category is poisonous toxins, such as botulin, a neurotoxin that can be found in badly preserved meats or vegetables and that could be deliberately introduced into the food supply. Unlike smallpox and other viruses, toxins are not contagious, but the trick is finding the poisoned food in time—which could cause huge disruptions and food shortages.
His third category is an indirect agent such as foot-and-mouth disease, a highly contagious virus that can affect cattle, sheep, goats, pigs—but almost never humans. People could eat meat from an infected animal with no worries. But the disease itself can devastate herds and wipe out food supplies. It's highly transmissible; it can be carried on clothes, shoes, even a handkerchief if it got close enough to a cow or pig with the disease. So anyone who has been on a farm in an affected area would have to be disinfected and put under travel restrictions to prevent wider spread of the disease.2*
Each of these problems requires a different response: efficient vaccination for smallpox; food screening and destruction for botulin and other toxins; quarantines and herd slaughters for foot-and-mouth disease. Each taxes an overburdened medical system in different ways. But it is the fourth category for which we remain significantly underprepared—largely because by the time we recognize an attack is under way, several others may have already taken place.
That fourth category is anthrax, the bacterium that consumes Homeland Security planners. A gram inside each of several envelopes killed five people in the 2001 attacks—two postal workers in Washington, a New York hospital worker, a Florida photo editor, and an elderly woman in Connecticut. Seven years later, what worries Danzig is the primitive state of our detection capability, which slows the response time and creates a huge opportunity for repeated attacks before anyone realizes we've been struck.
“Reload,” Danzig said to me, letting the word hang in the air a moment. “By the time you realize an attack is happening, whoever did it has time to reload.”
It's not easy to refine the production process to make anthrax in a form that can be turned into an aerosol weapon. It would cost tens of thousands of dollars and require a good deal of expertise. But once the facility is created, you don't need a big, easy-to-find factory to make a few hundred grams of anthrax. Nuclear terrorists may have one bomb; a bioterrorist could have plenty of anthrax to hit multiple cities sequentially. That's the crux of the reload problem. “It's a campaign of terrorism you have to worry about,” Danzig explained. “Suppose a determined terrorist sprays an aerosolized form of anthrax in one city and then moves on to Minneapolis or Chicago or Dallas. Just think about what that does: You have a crisis in one part of the country, and then in another and another, and you don't know how to stop it or how to spread your resources to treat it.” It took the better part of two months, he notes, to find a couple of snipers who terrorized Washington in the fall of 2003, and they were operating in only one metropolitan area.
Reload is also a problem because of the primitive state of the detection technology. There are now thirty-one cities that have BioWatch detectors installed; for obvious security reasons, the federal government does not name all of them. They sniff the atmosphere, but their filters still have to be physically collected and sent off to labs. It's a labor-intensive, time-consuming process. As a practical matter, it only tells you what happened yesterday or the day before, and the detectors cannot pinpoint the source of the attack. That isn't much solace if you are an air traveler squeezed into the middle seat of a crowded plane with nothing to eat but a measly bag of airline peanuts, sitting next to a carrier of the pneumonic plague, fresh from an antiwar demonstration.
If this worries you, get a job in the Pentagon. Not because it's the place that plans out counterterrorism attacks, but because it is the only large building in the country right now protected by an experimental new technology that can warn, in real time, of an approaching cloud of anthrax.7 Once the kinks are worked out (there are still too many false alarms, including from diesel exhaust) these devices will be able to map a cloud as it envelops a city and point authorities to the cloud's source. LIDAR—think radar for toxic clouds—gives the authorities a decent chance of capturing the terrorists before they can move on to the next attack. It also would enable a warning to be sent out immediately to other cities—potentially creating the 9/11 effect, where passengers on the flight headed for Washington, realizing what had happened to the other planes, were able to overpower the hijackers.
Danzig compares where we are now to where the British were in the 1930s, facing the Luftwaffe. “They didn't think they could stop long-range German bombers,” he wrote. “But they built an air defense system—and they had it mostly in place for the Battle of Britain.”8
WHEN I WAS a correspondent in Japan in the early 1990s, the cult group Aum Shinrikyo was experimenting with anthrax. But the police in the area had no idea about what was going on, even when faced with unexplained events, including the deaths of a number of farm animals near the Aum compound. It turned out that while the Aum desperately wanted to use anthrax to attack Tokyo, they made some big mistakes, employing a vaccine form that was essentially harmless as a weapon.
They got away with the experiments for so long because the local authorities were clueless. (So were the foreign correspondents.) Japanese police will come by your house to measure that your parking space is bigger than your car (you cannot buy a car in Tokyo unless you can prove you have a place to park it, a law that would spark rioting in many American cities), but when confronted with bioweapons, they did not know what questions to ask. Ultimately, Aum turned to an easier terror weapon to handle: sarin gas, a chemical weapon, which they used to conduct a deadly attack in the Tokyo subways. Though it didn't seem so at the time, the Aum attacks could have been much worse. The gas did not go very far in the subway tunnels. Anthrax would have made those tunnels uninhabitable for years.
But the next time we, or the Japanese, may not be so lucky. The fact that the anthrax attack in Washington in 2001 proved so deadly, even though it was never released on a large scale, demonstrated the power of the weapon. Authorities were able to close off mailrooms on Capitol Hill and in newsrooms around the country. But you can't shut down the atmosphere.
The reality is that we can't prevent a biological attack, but we can prepare to deal with it—and to mitigate its effects. And so far, the preparation of the general public has been miserable. There has been little effort to get communities to talk about how to distribute vaccines or antibiotics quickly. One of the best ideas, promoted by Lawrence Wein and others, involves using the United States Postal Service to deliver antibiotics directly to Americans’ doorsteps.9 Under the plan, postal carriers—the same people who were the target of the 2001 attacks—would travel the same paths they traverse each day to distribute the drugs. Trials in Seattle, Boston, and Philadelphia have shown, according to Wein, that antibiotics could be distributed to a large chunk of the population in fewer than eight hours.
“Here you have a federal asset that specializes in doing something like this every day,” Wein said in his office at Stanford. “It would be one less headache for the local health community to think about.”
Contagious pathogens such as the plague or smallpox would be a more complex problem: Some people cannot be safely vaccinated, including pregnant women, small children, and people with immune deficiencies. In the days after 9/11, cities and states were encouraged to work with doctors and specific hospitals to develop their own plans for handling the vast lines of people who would suddenly seek vaccination. But that is clearly not enough: As Wein observes, “It's clear that very few of these cities are capable of doing this.”
The next president can get them ready. Like stopping a stock-market panic, stopping a biological threat begins with creating confidence in the system—confidence that the disaster can be dealt with effectively. That is why the Bush administration's approach—leave the preparation to professionals, and say little to the public-has been so damaging. But in the Bush administration's view of the world, fighting the war on terror was supposed to be a job for the Special Forces and the CIA, not ordinary citizens. That attitude also explains how Bush blew the chance to get Americans to conserve oil. And it explains why most Americans know little more about what they should do in the aftermath of a biological attack than they knew at the end of 2001.