Living Terrors

John Schwartz and Michael Osterholm's new book Living Terrors paints a bleak picture of the preparedness of the United States -- and really the entire world -- for bioterrorism. Given the recent reports on the almost total lack of security in places like Russia's facility for holding the smallpox virus, their Cold War manufacturing of thousands of tons of the stuff, and the FBI sting operation of someone in Las Vegas trying to buy anthrax, the book's subject matter hits even closer to home.

Living Terrors author John Schwartz, Michael T. Osterholm pages 232 publisher Delacorte Press rating 8.5 reviewer Jeff "hemos" Bates ISBN 038533480x summary A reporter and a researcher pair up to tell us why bio-terrorism ought to scare us more than a raft of Dustin Hoffman films.

Unlike a nuclear assault, a biological attack can be even more insidious because of the time delay between deployment and effect. That delay means that even agents and diseases which may sound laughable could have a terrifying effect. Once a person has been infected with smallpox, for instance, he could interact with literally thousands of people before showing any symptoms, unknowingly furthering an epidemic. And with the eradication of it in the wild several decades ago, the vaccine hasn't been administered in years. Not suprisingly, there are very few doctors in the field who can actually diagnose a case of smallpox.

One of the book's interesting devices is the fictional story of someone who creates a smallpox 'bomb'and the effect it has. The story underlines how unready our government, our health care system, and we as citizens are for an attack of that nature. Explosive devices seem somehow OK and understood, while a biological attack, one that turns a person into a vector seems anathema to our understanding of war.

Living Terrors is far more then just fictional stories, however. Schwartz (reporter for the NY Times) and Osterholm (a bigwig in epidemology/public health) use a variety of data to highlight many of the holes and misunderstandings that both the public and the government share. One of the areas that I found most interesting is the shockingly slight degree of slack in our hospital system.

By slack, I don't mean how often the janitor steps outside to smoke a cigarette. It's the degree to which we have excess capacity to handle emergency events and situations outside of the norm. The last few decades of relentless financial pressure on the health care system has produced a system that can handle everyday events -- and little else. Even events like earthquakes in California, influenza outbreaks and other more "normal" disasters cannot be adequately handled by the hospital system. That's not to say that it is the hospital systems' fault: Funding for public health issues in general has dropped off in recent years, despite the continued rise of public health matters.

This situation, of course, becomes even more critical in the outbreak of a major event, like a bioterrorism attack, or a major disease outbreak. One of the necessary remedies to help control an event like this would be more public health funding, something which would have beneficial effects far beyond our ability to respond to bioterrorism.

One of the disturbing areas is the sheer availibilty of both the equipment to produce the viruses or bacteria necessary for an attack. As chemical manufacturers have stretched out to new markets, and as biotech has grown as a sector, the equipment to grow the vectors has become much more commonly available. And as we've all heard about former Soviet nuclear scientists showing up in rogue nations, the same is true for many of their former bio and chem scientists. The book cites several examples of scientists formerly associated with the Soviet bio and chemical weapons programs being seen in unsavory nations.

Living Terrors is well written, well researched, and does a great job of overviewing both our deplorable present situation and possible remedies. I heartedly recommend it to anyone interested in biology, or simply the world around us.

You can purchase this book at Fatbrain.

Comments

I happen to have Marshall McLuhan right here...

[jswatz]

I co-wrote Living Terrors, and want to thank Hemos for this stunningly positive review. It's great to see the work on the book rewarded!

lemme respond to a few of the comments:

* "you'd have to be crazy to deploy bioweapons."
That's true for state-sponsored terrorism, and for terrorists of the old IRA school, who felt a strong tie to their people and didn't want to lose support through gruesome acts. But with the rise of a new kind of terrorist like the "lone wolf" who seeks to destabilize socieities no matter the cost, the risk of somebody releasing an agent as virulent as smallpox has grown.

* "The also are generally used by BIG govt. to take away your freedom."
It's true that the prospect of bioterrorism has been used by some people to call for restrictions on academic freedom and civil liberties. If you read Living Terrors, however, you'll find that we focus instead on the kind of recommendations that preserve civil liberties while actually making a difference--chiefly, upgrading the public health system to be able to respond quickly to a bioterrorist attack. That kind of spending is needed anyway for responding to foodborne disease outbreaks and run-of-the-mill epidemics, so it's just sound public policy.

* "If Anthrax is so deadly, how come there weren't Bubonic type plagues of it when it was prevalent? It may be deadly, but it's not so easy to get. The odds of a person inhaling enough spores to get infected are pretty slim. "
Anthrax is deadly, but not contagious. Inhaling very few spores can begin the process of infection, but it stops there. An anthrax attack would be very different from a smallpox attack, clearly. Even so, the Office of Technology Assessment estimated that an airborne release of about 100 kg of anthrax spores over Washington, D.C. could kill between one and three million people. I guess you could say that they were scaremongering, too, but I wouldn't agree with you.
But terrorists don't need to kill EVERYBODY; they are happy to kill, say, thousands, and bring about a massive panic in the process. As Lord Kano wrote in this discussion, "even a moronic terrorist is going to be able to do a lot of damage to the general population with minimal effort." The chemical attack in the Tokyo subways was a very sloppy job: the Sarin was poorly made, and the deliver method (putting the chemical in plastic bags and breaking them open with umbrella tips) was laughably inefficient. But people died, thousands were affected, and a national panic ensued. You don't have to be especially good at this stuff to have an effect.
As for Ebola, you're partly right--it's not a very good bioterror agent. Though it's moderately contagious, it has proved difficult to cultivate and "weaponize" (at least that's what Soviet scientists found), and it can be pretty well controlled with Western sanitation methods.

* "To date no one has launched a bio warfare attack on the US, (At least that worked)."
It's true that no government has launched a bio warfare attack against the US, but biological terrorism has been attempted by groups not affiliated with the government. Members of the Rajneeshee cult infected a salad bar with salmonella in 1984, for example, attempting to affect the outcome of a local election.

--John

Medical information

[MarkusH]

If you are interested in the types of bacterium and virii used in Biowarfare and some of their symptoms, check out http://telemedicine.org/BioWar/biologic.htm.

Warning, the site is pretty graphic and is aimed at medical professionals. Examine it at your own risk.