THE MAGAZINE

The State of Bioterrorism Surveillance

By Lilly Chapa

Actionable Results

If a lab testing shows a BAR, a BioWatch Advisory Committee meets to analyze the situation to decide whether the city should go to a full-scale response or if the BAR is due to naturally occurring bacteria in the environment that simply resembles the reading of a pathogen. The committee members include CDC and FBI officials, state and county health department directors, and DHS’s chief medical officer.

While the committee deliberates, the local resources of the public-health community are put on alert to look for symptoms of the suspected pathogen; law enforcement officials are sent out to investigate; and additional samples are taken from buildings in the area. The city has to handle the cost of these efforts.

There have been 149 BARs to date, and while none have been due to an actual bioattack, localities have been forced each time to take those costly precautions in the time between a BAR reading and a determination that no real risk exists. While the DHS does not consider this a false alarm, because technically there was a correct reading of a substance that later proved of no concern, others consider these false alarms, leading to criticism of how the system works.

Arthur Kellermann, a RAND analyst who served on the Institute of Medicine (IOM) committee that issued a report on BioWatch for Congress in 2009, says that during hearings for the IOM report, local public health officials said their cities’ public health funds were “devastated” whenever a BAR occurred.

These BAR readings can also cause trouble at large-scale events. In 2005, for example, several Washington, D.C. BioWatch detectors registered positive results during an anti-war protest on the National Mall. Public health officials had to make a tough decision in what the IOM refers to as a “high-regret action” situation. In this case, the choice was whether to evacuate the thousands at the Mall or take the chance that serious illness or worse could occur. After further investigation, officials decided not to evacuate the area, and fortunately, no one got sick.

Such alarms have also occurred during events such as the 2004 and 2008 Superbowls, the 2008 Democratic National Convention, and the 2006 National League Baseball playoffs. However, the DHS has said they are working to lower the incidence of unnecessary BARs, and there have been no alarms so far in 2013.
 

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