need for transparency and a need for local public health offices to manage the data from a networked system.

Donald Prosnitz, an independent consultant, asked the panelists if they would take BioWatch into their jurisdictions today, given what they know now and the experiences they have had with BioWatch. Plante said that he would because, for all its limitations, BioWatch is still better than syndromic surveillance in terms of shortening the time for detection and saving lives. Stimmler said yes as well but added that he would want to have more input in terms of the agents being tested for and the logic behind those choices. Pan agreed, but said she would insist on more local involvement at the beginning of the rollout process. She added that resource constraints today would make BioWatch seem like an unfunded mandate, a sentiment that McKinney seconded. Persse agreed that BioWatch was valuable and said that he would have it in his jurisdiction again because, in addition to the information it supplies, it has also created a network among state, local, and federal officials that is valuable, a comment that Smole seconded. Shah was the most reluctant, saying that at the time BioWatch was originally deployed, there was no good understanding of what a BAR meant. However, assuming that state and local officials have more input and information as future programs are deployed, he said he is looking forward to the autonomous detection system. He noted that people need to view it in the context of all the tools available in the surveillance toolkit and also recognize that resources are limited.

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