A New Model Proposed for U.S. Bioterrorism Response

On 17 January 2017, the InterAgency Board released its “Proposed Model for Bioterrorism Response: Initial Operations and Characterization” position paper (BT Position Paper). This 28-page document puts forward a method to make use of the many federally developed standards and strategies produced over the past 16 years – at a cost of millions of taxpayer dollars – that have yet to produce a national capability.  The paper begins by pointing out that, since 2001, the United States has invested $17,000,000,000.00 in civilian biodefense and continues to have major capability gaps.

Established under authority of the U.S. Attorney General, following the 1995 Oklahoma City Bombing, the InterAgency Board (IAB) is a voluntary, collaborative panel of emergency preparedness and response practitioners whose members are from a wide array of professional disciplines. The IAB includes members from all levels of government and operational, technical, and support organizations. It provides a structured forum for the exchange of ideas among local, state, and federal response communities to improve national preparedness and promote interoperability. Based on direct field experience, IAB members advocate for and assist with developing and implementing performance criteria, standards, test protocols, and technical, operating, and training requirements for all-hazards incident response equipment with a special emphasis on chemical, biological, radiological, nuclear, and explosive (CBRNE) issues. The IAB also provides subject matter expertise to inform the development of emergency preparedness and response policy, doctrine, and practice.

The BT Position Paper came about as the effort of an IAB Special Project Group on Bioterrorism National Strategy.  The need for this effort was recognized when the U.S. Department of Homeland Security, Office of Science and Technology (DHS S&T) sought responder input on the continued funding of a standards development project.  Responders replied that the continued funding of standards that have no impact upon capability was a waste of tax dollars.  In response DHS S&T supported the execution of a special project to find a path forward, and give the nation a Bioterrorism response capability.

The Special Project working group included representation from both within and outside of the IAB.  Panelists included representatives from fire departments, local and federal law enforcement, DHS, the military, local, state and federal public health, public health laboratories, standards organizations, national laboratories, and other federal entities.  A series of meetings and conference call were held over a two-year period.

The three core elements of the model would;

1. Centralize the responsibility for coordinating bioterrorism capabilities under a single federal authority, supported by other federal agencies.  
2. Allow the federal government to contract with existing (hazmat) response teams to meet qualifications as validated bio-threat response teams within their own jurisdictions, requiring that they are trained, equipped, tested, and that these teams operate under approved procedures.  This approach is like other existing programs, such as the Laboratory Response Network, Secure the Cities Initiative, and the Metropolitan Medical Strike Teams.
3. Increase federally supported staffing within the Laboratory Response Network labs and the National Guard Civil Support Teams to allow their involvement as trainers and liaisons within their jurisdictions for those contracted response teams.

Using these core elements, the model seeks to develop a pathway for response teams to meet the capabilities and criteria described in what has come to be called the Stakeholder Panel on Agent Detection Assays (SPADA) Onion.  SPADA was a working group managed by the Association for Analytic Communities (AOAC), a standards organization with its origins in food safety, working under contract with DHS.  The objective of SPADA was to write a standard for a “Public Health Actionable Assay.”  When such a term was rejected by public health, it sought to write a standard for a “Public Safety Actionable Assay,” but no accepted standard for field instruments resulted.

However, a critical benefit came out of the SPADA deliberations in the “Onion.”  The onion was framed by Dr. Matthew Davenport of DHS S&T and chair of SPADA to describe the interrelationship requirements that include, but extend well beyond the instrument, or assay. The layers of the onion are:

1. CONOPS- The agency’s processes and procedures to manage bio-threat responses.
2. Training – Consistent training in all aspects of bio-threat response, conducted by expert trainers.
3. Proficiency Testing – Demonstrated competencies in the methods of sample collection and field screening, including use of devices.
4. Sampling and handling- Use of approved sampling methods and devices, including aseptic technique, packaging and documentation
5. Assays – The device or devices used to identify bio-threat agents, as well as those used to screen for hazardous chemicals, radiation and explosives.

To become reality, the model will require adoption by the U.S. Government, legislation to enable it and a budget to support it.  Efforts have begun to garner support from the stakeholders and to bring this proposal to the attention of the new administration.

The full position paper can be found at https://www.interagencyboard.org/publications/documents.  For further information, contact the InterAgency Board Program Office, 1550 Crystal Drive, Suite 601, Arlington, VA. 22202, telephone 703-413-7251, or info@interagencyboard.us.