•   Public health officials are in the position of making high-regret decisions in the face of uncertainty—the information provided must be accurate and reliable.

•   Public health stakeholders—as the end users—want to be engaged at all stages (design, development, and testing).

•   Desired features and considerations for a detection system include

o   faster detection time;

o   remote access;

o   instrument-specific performance data;

o   information on agent identity, viability (alive or dead), and susceptibility to medical countermeasures;

o   spatial resolution (information about release location and amount); and

o   archived sample data for later testing.

INFORMATION NEEDED FOR DECISION MAKING

In her overview of BioWatch as it relates to public health, Sandra Smole stressed that BioWatch is viewed in the public health community as a surveillance tool that is used in conjunction with other tools, such as syndromic surveillance, for detecting the presence of an infectious agent or toxin of public health significance. In that respect, information from BioWatch contributes to and is interpreted within the context of the larger surveillance picture. As was mentioned in an earlier presentation, no two BioWatch jurisdictional operations within the 30-plus locations where BioWatch is permanently deployed are exactly alike.

As a laboratorian, Smole said, she sees the definition of a BAR as having two components (see Figure 3-1). In the laboratory setting, a BAR is the production of a reliable, reportable laboratory result, backed by a laboratory-quality system. In the operational setting, a BAR is a determination that a result is actionable within the context of other key pieces of information. She said that autonomous detection technology has the potential to improve the depth of information provided by the BAR by, for example, improving pathogen identification and strain discrimination capabilities. It also has the potential to provide a quantitative BAR result that offers useful information for those considering the response to multiple collector “hits” and developing an appropriate response, particularly with respect to indoor and transportation venues.



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