Question

How can we respond when we see looming catastrophe, but bureaucracy disagrees or moves too slowly? How can we as a medical community be less dismissive of the renegade thinkers who are able to see the implications of a clinical problem early? What parallels did you find between what occurred during the early stages of the AIDS pandemic in the United States (based on the film!) and the early stages of the COVID-19 pandemic? Consider the influence of social media for the latter and how this relates to news stories (again, as you saw in the film) reported in the first few months of the AIDS pandemic. How can disinformation and rhetoric such as "fake news" result in harm in outcomes of controlling a pandemic? Finally, Bill Gates provided some insight regarding the work his organization has done as well as general observations of the COVID-19 pandemic. Consider his arguments, evidentiary value included, and offer a comparison between what Gates discusses as preventative measures to take for future pandemics and what you observed during the COVID-19 pandemic of the last few years.

          How can we respond when we see looming catastrophe, but bureaucracy disagrees or moves too slowly? 
How can we as a medical community be less dismissive of the renegade thinkers who are able to see the implications of a clinical problem early?
What parallels did you find between what occurred during the early stages of the AIDS pandemic in the United States (based on the film!) and the early stages of the COVID-19 pandemic? Consider the influence of social media for the latter and how this relates to news stories (again, as you saw in the film) reported in the first few months of the AIDS pandemic. How can disinformation and rhetoric such as "fake news" result in harm in outcomes of controlling a pandemic?
Finally, Bill Gates provided some insight regarding the work his organization has done as well as general observations of the COVID-19 pandemic. Consider his arguments, evidentiary value included, and offer a comparison between what Gates discusses as preventative measures to take for future pandemics and what you observed during the COVID-19 pandemic of the last few years.

Added by Andrea B.

PART 1 1. How could the epidemiology of abrin toxin be applied to determining the source of an outbreak, either natural or intentional? 2. What factors may help or hinder abrin toxin epidemiological analysis? 3. What factors make plague or ricin toxin possible or not possible for the reemergence of disease to happen? PART 2 1) Where did HIV come from? How about Ebola? Are these brand new diseases or have they been with us for a long time and we are only now just able to detect them? 2) Nonproliferation & Verification Part A What are the key factors that have motivated the development of biological weapons by states since its inception? What are the key factors that have led states to abandon biological weapon programs since the BWC came into effect? Explain why the verification protocol for the BWC collapsed in 2001. Explain why the U.S. opposed the protocol even to this day after several presidents and their administrations have come and gone? Use historical and contemporary examples to support your argument. Part B No new states have been added to public lists of countries with probable or knowledge of biological weapons programs in recent years. Since all of you have written that the BWC has "no teeth," to what do you attribute the restraint in biological weapons proliferation among states? Do you expect it to continue? Be sure to discuss the potential roles of strategy, science, arms control, and norms in such decisions. 3) Policy & Intelligence Part A What are the challenges faced by intelligence agencies, including but not limited to inspection regimes, in collecting and analyzing information about biological weapons programs conducted by states and by terrorist groups? Use historical and contemporary examples to support your analysis. Propose two recommendations for how the United States could improve its intelligence on biological warfare or bioterrorism programs. Part B. What are the three most important lessons learned relating to science, medicine, public health, law enforcement, and homeland security from the use of biological agents by the Rajneesh cult in The Dalles, a small town in Oregon in 1984? To what extent do you believe current biodefense strategies, programs, and policies reflect these lessons? 4) Terrorism Part A In 2008, the Commission on the Prevention of Mass Destruction Proliferation and Terrorism wrote that, "Given the high level of know-how needed to use disease as a weapon to cause mass casualties, the United States should be less concerned that terrorists will become biologists and far more concerned that biologists will become terrorists." Explain with all the passion you can muster why you agree or disagree with that assessment. Part B. Compare the potential for a large-scale terrorist attack on the Washington D.C. Metro Transit system using: (i) anthrax spores (ii) sarin gas and (iii) a conventional suicide attack. What are the pros and cons of choosing one specific agent over another from the perspective of a terrorist group? Discuss each agent, how it works within the attack scenario, and how first responders attempt to counter the attack. Part C What would a non-state actor require to (i) obtain and (ii) successfully use the weapons described above in Part B? Are there significant differences between chemical and biological agents that could affect the level of difficulty for successful acquisition and use? Be sure to analyze hurdles that must be overcome during each stage of the acquisition process, why a particular agent may be chosen, and why a particular approach may be chosen for dispersal. 5) The Future While not being political, during the current pandemic, a point was made in the media that the Trump Administration eliminated the White House Health and Security Office. Some individuals have claimed that this elimination resulted in the lack of preparedness of the US. But is that true? FACTS: The National Security Council staff is supposed to help the president coordinate the government response to international crises and homeland security issues, by identifying emerging problems and making sure Cabinet agencies and other departments are working cooperatively. After Barack Obama became president in January 2009, he eliminated the White House Health and Security Office, which worked on international health issues. However, after multiple issues arose with the 2014 Ebola epidemic, President Obama established a Directorate for Global Health Security and Biodefense at the NSC in 2016. This directorate had its own staff and was headed by an individual who no longer reported to the President but to the national security adviser. This structure survived during the early part of the Trump Administration, when the office was headed by Rear Adm. Timothy Ziemer. After John Bolton became the national security adviser, he decided the organizational chart was a mess and led to too many conflicts. He also thought the staff was too large, having swollen to 430 people, including staffers in the pipeline. Bolton reorganized the directorate and eliminated a number of deputy national security advisers so there was just one. And he folded the global health directorate into a new one that focused on counterproliferation and biodefense. Bolton thought there was obvious overlap between arms control and nonproliferation, weapons of mass destruction, terrorism, and global health and biodefense. Morrison, who headed the combined office beginning in July 2018, was named Deputy Assistant to the President and thus had more clout and access than the head of the previous Directorate under Obama. One can see the dueling narratives between the Obama and Trump administrations, neither entirely incorrect. The office â€” as set up by Obama â€” was folded into another office in the Trump Administration. Thus, one could technically claim the office was eliminated. But the staff slots did not disappear, and the key mission of the team remained a priority. So, one can also claim nothing changed. The positions that made up the old unit still are filled within the NSC and their funding was actually increased under Trump. Morrison answered directly to the President and could get things quickly to his attention Question: The real change between the Obama and Trump Administrations was a philosophical one. Under the Obama policy, epidemics and pandemics were treated as global health issues that could be addressed through international diplomacy, transparency, and international cooperation. By improving healthcare in third world countries, it was believed that outbreaks could be prevented. Under the Trump policy, it was felt that the epidemiology of a biological health emergency is virtually identical to a bioterrorism attack. As a result, during 2018, the NSC merged three directorates into one to create a seamless interaction between those preparing for biological threats, regardless of whether they are man-made or naturally occurring. You are now the advisor to the President, based on what you have learned in the BSBD program, which approach do you agree with (or maybe something different). Based on your concept, argue with all of your passion why this should be the US policy. How would you implement your approach, who would you use as advisors (expertise not names), how would you maintain the National Strategic Stockpile and prioritize what goes into it?

Dominador T.

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