Short Programs

Pandemics and Bioterrorism: From Realistic Threats to Effective Policies [PI17.60s]

This course is currently only offered as a custom program. The below description should be taken as an example of content and can be tailored to meet company needs. If you have been thinking about a customized course for your group of 25 or more, please review additional information on the Custom Programs page.

Participants' Comments  |  Overview  |  Topics Covered  |  Learning Objectives  |  Who Should Attend  |  About the Program Faculty  |  Updates

Participants' Comments

"It was an invigorating experience and a particularly useful investment of my time. The quality of the information was what one would expect from MIT. The availability of the lecturers and the general social tenor of the course were gratifying. Great stuff. Thanks!" - Physician, U.S. Army

"The course was comprehensive, yet focused in areas with relevance and timeliness for modern day issues and concerns. Great learning and exchange opportunity with national colleagues." - Senior Public Health Specialist, The Tauri Group

"For anybody who works in the Security Industry, attending this course is essential in replacing a culture of fear surrounding this subject, with one of rationality and understanding." - Vice President, Concentric Solutions International, formerly UK Scotland Yard/ Special Branch

"Excellent - Great learning experience and an opportunity to share ideas with a diverse group." - Vice President for Health Sciences at West Virginia University

"Knowledgeable and experienced faculty - Very interactive - Multi-disciplinary approach - Students were very also knowledgeable and represented a wide variety of organizations." - Deputy Chief Scientist, Air Force Office of Scientific Research (AFOSR)

Recent participants in this course have come from the CIA; the Centers for Disease Control; IBM; Argonne National Lab; city, county and state Public Heath Departments from New York to Oklahoma; the US Army and Air Force; Police and Fire Departments from D.C., Illinois, Arizona and Texas; U.S. Senate staff, Scotland Yard Special Branch, Battelle Institute; the Defense Threat Reduction Agency, MITRE, and the National Security Agency.

Overview

The threat of bioterrorism poses new challenges for governmental agencies that now have the added responsibility to ensure biosecurity. For a bioterrorist attack is both a public heath emergency, and a criminal act whose perpetrators need to be apprehended. And the terrorists involved may or may not be part of an international network. Thus public health, law enforcement and national security agencies all face new priorities, including learning to collaborate with each other.

Implementing these new priorities will require substantial organizational learning and change. But agencies have deeply embedded professional norms and organizational culture, and they are resistant to change even in times of crisis. Each agency responds with its own routines, and its own distinctive view of “the threat,” which dilutes new initiatives and impedes effective collaboration.

The 2001 anthrax letter attacks provide many cases of unresolved organizational issues. The Federal Centers for Disease Control and Prevention (CDC) brought its own organizational style to investigating the outbreaks. It focused on the pathways of exposure, establishing an index case, and other public health procedures. The FBI though, faced with the same incident, saw a crime scene that needed to be secured, evidence that needed collection by its procedures, and perpetrators who needed to be identified. But the Bureau agents lacked the relevant scientific background. The military had studied anthrax for decades, but much of its information remains cloaked in secrecy and unavailable to other agencies. Thus, while the need for collaboration is great, the potential for differing organizational styles to produce conflict is high.

How then do we get existing agencies to actually change their priorities concerning bioweapons? How do we get them to understand and make use of alternative approaches brought by other agencies? How do we get them to provide accurate information to the public?

Topics Covered

Among the specific course topics that will be included are:

Swine flu 2009
How do we define a pandemic? Can we predict the behavior of the new virus? How do severity and spread interact? What would be the rationale for a worldwide immunization campaign? Who should it be targeted for, and where will the resources come from? Who will decide, and when? How will the responses differ from country to country?

Swine flu--lessons for mass immunization 1976
In 1976, the CDC mounted a national immunization campaign against a projected new influenza virus that was feared to be unusually virulent. However, the virus never arrived. Instead 25 people died from unexpected side effects from the vaccine itself. What can we learn from this program about decision making with fragmentary evidence; about probing medical assumptions; and about accurate public communication?

Learning from SARS / Avian Flu
The SARS epidemic and the threat of Avian Flu are striking reminders of how infectious diseases can spread in unexpected ways. What can we learn from these experiences about the problems of disease surveillance, accurate diagnosis, effective treatments, and the detection of novel viruses? How would the SARS outbreak have been different if it had been a deliberate release?

Impediments to Organizational Change: professional norms, organizational routines and culture
Is reorganization an effective response to these issues? Is the Department of Homeland Security part of the solution or part of the problem?

Case Study: the US postal anthrax outbreaks
The 2001 anthrax letters caught all the federal and state agencies off guard. What are the lessons for anthrax detection and treatment; for interagency cooperation; and especially for clear, consistent risk communication to the public?

Rethinking the Public Health Approach
A classical CDC investigation includes defining the scope of the epidemic; looking for environmental sources; and establishing treatment regimens. How should these activities change when both the virulence of the biological agent and its spread may have been intentional?

Case Study: the smallpox immunization program
How can we estimate the risks of an outbreak? How do we model the potential spread? What should be the risk threshold for policymakers evaluating immunizations? Who should bear the medical and financial burdens of the anticipated side effects? Does one public health program divert resources from other priorities?

Expanding the Law Enforcement Approach
The standard FBI and other law enforcement approaches stress careful examination of the crime scene and a search for the perpetrators of the crime. However law officers were not trained in the identification of biological agents, nor in the capabilities needed to make or spread bioagents. How do we expand law enforcement routines to respond to bioterrorism? How do we organize law enforcement and scientific capabilities to work in harness?

Biological Weapons and National Security
Why did governments develop biological weapons? How did their militaries forsee the benefits and costs of battlefield use? Why were the programs so secretive? Why did the major powers never make use of biological weapons? Why the Iraqis did develop them? What is the potential for transfers of expertise and materials to terrorist groups?

Barriers to Bioweapons: the Case of Filoviruses
Filoviruses (marburg- and ebolaviruses) are feared and lethal viruses on an individual level, but they are not very communicable and have never killed more than a few hundred people per outbreak. How realistic is it that aggressors could modify these viruses by genetic engineering to become more effective bioweapons? Are the resources and expertise needed for this within the likely reach of terrorist groups? Or is it all just threat inflation?

The New Focus on Vaccine Development
Many of today's vaccines were first developed and tested in the military. Is this a good model for future efforts? How does the military perception of appropriate vaccine use differ from civilian policymakers? The new national vaccine initiative foresees a major federal role in the development and purchase of the next generation of vaccines. Who should manage this ambitious effort? What should be the roles of public health agencies ad the private sector?

Learning Objectives

• Describe impediments to organizational change: professional norms, organizational routines and culture.
• Appreciate the following case studies: the 2001 U.S. postal anthrax outbreaks; the smallpox immunization program; the 1976 swine flu outbreak.
• Analyze the public health approach: a classical CDC investigation including defining the scope of the epidemic, looking for environmental sources, and establishing treatment regimens.
• Investigate expanding the law enforcement approach.
• Assess biological weapons and national security.
• Interpret the new focus on vaccine development.
• Examine learning from the SARS/avian flu.

Who Should Attend

Professionals in public health, law enforcement, and national security, and academics who have responsibilities for containing pandemics or bioterrorism.

About the Program Faculty

All of the faculty have been extensively involved with research and policymaking on public health and national security issues.

Jeanne Guillemin is Senior Advisor at the Security Studies Program at MIT, and Professor of Sociology at Boston College. She is the author of Anthrax: The Investigation of a Deadly Outbreak, which examined the Soviet release; and Biological Weapons : From the Invention of State-Sponsored Programs to Contemporary Bioterrorism (2005). Her current research, supported by the MacArthur Foundation, is on the anthrax postal attacks of September-October 2001. For more information: http://web.mit.edu/ssp/people/guillemin/fellow_guillemin.html

Kendall Hoyt is an Assistant Professor of Medicine at Dartmouth Medical School, where she studies international biosecurity strategy and biodefense research policy.  Dr. Hoyt is a research associate at the New England Center for Emergency Preparedness. Previously she was a Fellow at the International Security Program  at Harvard University. She has also worked at the White House Office of Science and Technology Policy and McKinsey and Company. For more information:
http://www.dartmouth.edu/~engs13/syllabus/hoyt.kendall.html

Gregory Koblentz is an Assistant Professor in the Department of Public and International Affairs and Deputy Director of the Biodefense Graduate Program at George Mason University. Dr. Koblentz is also a Research Fellow with the Security Studies Program at MIT, and a member of the Scientist Working Group on Chemical and Biological Weapons at the Center for Arms Control and Non-Proliferation in Washington. He previously worked at Georgetown and the Kennedy School at Harvard. He is the author of Living Weapons: Biological Warfare and International Security (Ithaca: Cornell University Press, forthcoming) and co-author of Tracking Nuclear Proliferation (Washington: Carnegie Endowment for International Peace, 1998). He has also published articles in International Security, Nonproliferation Review, Arms Control Today, and Jane's Intelligence Review.
For more information, see http://pia.gmu.edu/faculty_staff/bio.php?fname=Gregory&lname=Koblentz&type=full

Jens Kuhn is the Lead Virologist (contractor) at NIAID's new maximum-containment institute, the Integrated Research Facility Frederick. He specializes in highly virulent viral pathogens and recently published "Filoviruses - A Compendium of 40 Years of Epidemiological, Clinical, and Laboratory Studies" (Vienna: Springer, 2008). He has worked at AIDL, CDC, and USAMRIID, and was the first Western scientist to work in the former Soviet biological warfare facility "Vector" in Siberia, Russia, within an international disarmament program.

Anthony Robbins is in the Department of Family Medicine and Community Health at Tufts Medical School. Previously he was state health director in Vermont, and in Colorado; and Director of the National Institute of Occupational Safety and Health. He is also past President of the American Public Health Association. One of his main public health interests is vaccine research and development, and immunization policy. For more information: http://www.tufts.edu/med/gpph/Faculty/Robbins.htm

Richard Swensen was most recently the Undersecretary for Homeland Security within the Executive Office of Public Safety for the State of Massachusetts, where he coordinated efforts to prevent and respond to terrorism. Swensen previously served with the FBI for 29 years, including as the Special Agent in Charge of the FBI offices in Boston and New Orleans.

Sanford L. Weiner is a Research Associate at the Center for International Studies at MIT. He has written about organizational change and innovation in both military and public health agencies, including the CDC's response to emerging diseases. He is now studying priorities for risk assessment and implementation among agencies responsible for biosecurity, including policies for pandemic flu. For more information: http://web.mit.edu/ssp/people/weiner/affil_weiner.html

Updates

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