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An Overview of BioWatch Strategic Priorities
In the workshop’s first session, Mike Walter, BioWatch program manager in the Office of Health Affairs (OHA) at the Department of Homeland Security (DHS), provided a broad overview of the ongoing efforts at DHS to enhance BioWatch technology and practices as a federally managed, locally operated system to detect the intentional release of select aerosolized biological agents. Walter started his presentation by noting that for the first time in the program’s history, the needs and strategic vision for the BioWatch program have been captured in a strategic plan that will be used to guide the direction of the program going forward. This living document will be reviewed and updated regularly as the threats and challenges the nation faces in the area of bioterrorism and weapons of mass destruction change. “The BioWatch program and our planning has to be nimble enough to adapt as those threats adapt,” said Walter.
The strategic plan was developed with input from the program’s federal, state, and local partners. It clarifies the vision for BioWatch to be a recognized leader in aerosolized biodetection that enhances and integrates preparedness and response actions. Walter said he knows of no program that is doing both surveillance and working at the state and local levels on preparedness and response. The strategic plan describes the program’s mission as one of operating a nation-wide aerosol detection system providing early warning across all levels of government to support public health and emergency management communities to prepare for and respond to a biological incident. To fulfill this mission, one key function of BioWatch will be its role as a coordinator. “Unless we have figured out what we are going to do, how we are going to do it, and who is going to do what so that we do
not have agencies tripping over each other and getting in the way of each other as we do this response, we are going to incur higher casualties than we need to,” said Walter. He added that BioWatch not only has a national security mission, but it also serves as a tool for state and local public health.
Walter explained that as his office went through the process of developing the strategic plan, four strategic priorities were identified:
- Collaborate with stakeholders on communicating the program’s value and core capabilities in as transparent a manner as possible.
- Upgrade the program’s technology for faster, more relevant, and actionable results at a lower overall cost.
- Build a robust operational information-sharing mechanism, beyond the current website and conference calls, that provides situational awareness and relevant data for making decisions.
- Expand the program’s impact via increased geographic coverage, new partnerships, and new technology.
With regard to this last priority, Walter said the program is under increasing pressure at the state and local levels to expand its operations in the more than 30 metropolitan areas in which it is currently installed and to add other jurisdictions that have expressed an interest in becoming partners. In addition, the program is getting pulled at the state and local levels into indoor locations. BioWatch, he noted, was initially deployed as an outdoor system and its technology is appropriate for that use. To serve as an indoor detection system, BioWatch’s technological capabilities will need to be upgraded and expanded.
One challenge the program faces is that no two local jurisdictions operate the same way. “One of the things that has become apparent to me in 7 years is, if you have visited one of our jurisdictions, you visited one of our jurisdictions,” said Walter. “Long Beach [California] does things similar to but different from San Antonio, and nobody does things the same way Atlanta does things.” As the program moves forward, Walter said it needs to address the needs for standardization while accounting for the different ways that different jurisdictions organize the local program.
An obvious strength of the program, said Walter, is how collaborative it is, and he considers the formation of the BioWatch Advisory Committees as an important achievement. “Collaboration at all levels of government to enable a rapid response to a threat is the key to biodefense,” said Walter. These committees, with substantial input from state and local authorities, are playing an important role in drafting the strategic execution plan that allows his office to prioritize its efforts given that it does not have the resources to do everything simultaneously.
BIOWATCH ACTIONABLE RESULTS
Walter explained that a BioWatch Actionable Result (BAR) is declared by a jurisdictional BioWatch laboratory director when the laboratory analysis and verification process detect genetic material of a threat agent on a BioWatch filter, and when the laboratory director finds the result actionable. A BAR does not necessarily mean a terrorist attack has occurred. So far, of the more than 2 million samples tested between 2003 and 2016, there have been only 160 BARs triggered by a “true-positive result.” To date, said Walter, no BAR has been determined, upon further examination, to be tied to an intentional release. The number of false positives, in which the test indicates an agent is present when it is not, has been zero.
When a BAR is declared, state and local decision makers are informed in a timely and efficient manner, triggering a technical laboratory conference call and a BioWatch national conference call. Risk assessment is conducted through a collaborative discussion among federal, state, and local decision makers. Successful risk assessment can serve as the basis for key decision makers to direct response actions under two scenarios—environmental detection and intentional release. If the BAR is determined to have been caused by the presence of a naturally occurring organism in an environment where it can be expected to occur, such as Bacillus anthracis (anthrax), no action is taken and the system returns to the steady state. Local and state agencies may decide to conduct enhanced surveillance including follow-up of reported diseases and syndromic surveillance after notifying hospitals and veterinarians.
If the BAR is determined to have been caused by an intentional release that poses a public health threat, additional sampling is conducted along with a transition to a response framework that includes an emergency declaration and a request for federal assistance. Emergency operations centers are activated and staffed, and critical medical countermeasures are distributed. A risk communication conference call is arranged, and enhanced surveillance is initiated, as is a joint public health and law enforcement investigation of agent-related disease. The public is alerted when appropriate, and BioWatch program officials brief elected political leadership at all levels of government.
DISCUSSION
In response to a question from Lisa Gordon-Hagerty about how BioWatch interacts with the intelligence community with respect to possible threats to the nation and how that information is then relayed to state and local agencies, Walter explained that BioWatch receives intelligence related to potential bioterrorism threats from the Counterterrorism Center
and from threat and response data generated from the DHS Science and Technology Directorate (S&T) biothreat risk assessment. He noted that BioWatch works with all of its state and local partners to ensure they have the proper security clearances, particularly as people rotate in and out of those state and local agencies. He also noted that the BioWatch national meeting that was being planned will include a threat briefing. “The problem we’re dealing with is that this is an extremely difficult threat to identify, and the real threat we face is uncertainty,” said Walter. “We do not know what anybody is doing because it is so easy to do this in secret.” He added that as biotechnology advances, the ability to engage in what is known as synthetic biology is becoming a major issue, and that if the intelligence community could point with certainty to who is creating what potential bioterrorism agents, he would go back to working on remediation because BioWatch would not be needed.
Elaborating on Walter’s last point, Jonathan Greene, deputy assistant secretary and director, Health Threats Resilience Division, OHA, DHS, said that developing a credible defense against a potential bioterrorism attack takes time and investment that cannot be built based on the latest intelligence report, though there is new and evolving information about this threat. The challenge in working with the intelligence community, he said, is to take either raw or developed intelligence community products, drill down, and get to a message to share with state and local officials. “First responders do not need to know who in a cave is talking about what and what intercepted phone conversation is on what frequency. What they need to know is if somebody is planning to do something and when, where, and with what agent, and give them the time and space to take preparatory actions for an effective response,” said Greene.
John Vitko, Jr., said the desire to expand BioWatch to detect an indoor release is understandable and was first raised with BioWatch Gen-2. The issues then were not primarily technological, but focused more on process and local issues, such as potential local actions, a locality’s legal responsibility, and how a locality would restore functionality in a reasonable time if there is a preliminary positive but not an actionable BAR. “These are issues that the localities worked on for quite a while,” said Vitko. Walter agreed that indoor monitoring and detection are more complicated than in an outdoor setting, and to illustrate the point he recounted what happened when the Gen-3 technology was going to be tested in an underground rapid-transit station in Chicago. At a workshop designed to kick off this operational test, an official from the city noted that if the device were to send out an alert, she would need to send someone wearing personal protective equipment to retrieve the filter, which would in itself cause a panic and result in the station being closed. “That was the high point of the conversation and it spiraled down from there,” Walter said.
What the BioWatch program has done is develop a guidance document for indoor applications that identifies a number of issues that need to be considered before deploying BioWatch indoors. BioWatch is also working with S&T to develop a response plan in the event of a BAR that occurs indoors, including remediation and decontamination. Part of a remediation and decontamination effort, he noted, would have to include public education because it would be impossible to eradicate every spore of anthrax in a city if a mass release ever occurred.
Referring to Walter’s comment that there are different modes of operation in different localities, Stephen Morse, professor of clinical epidemiology, Mailman School of Public Health, Columbia University, asked if there is a general set of operating principles and if localities have compared processes to identify best practices. Walter replied that one of the driving forces for holding a national meeting is to bring everyone together so they can discuss their procedures and determine best practices. He noted that collection times, protocols, and laboratory processes are standardized across the system. The differences, he explained, have more to do with who is in charge of the program and who is responsible for collecting samples—in some cities it is the fire department’s hazardous materials group, in others it is the police department or the civil support team—and the subsequent reporting, communication, and response processes.
Morse then asked Walter about whether the mere existence of BioWatch is meant to deter or discourage adversaries from trying to release a biological agent in the United States. Walter replied that the message needs to be sent that BioWatch works, that it is deployed, that local jurisdictions have response and remediation plans in place, and that as a result, the potential benefits of launching such an attack would not be worth the risk given how difficult it would be to do so. His major concern is what would happen in the event of a false positive from an indoor monitor that resulted in closing down a subway system or an airport terminal, for example. Greene commented that the deterrent effect of BioWatch is not discussed publicly in the way that aviation security is, which perhaps warrants further discussion.
Al Romanosky, medical director and state emergency preparedness coordinator, Office of Preparedness and Response, Maryland Department of Health and Mental Hygiene, suggested that BioWatch could develop a partnership with the Centers for Disease Control and Prevention (CDC) through its Public Health Emergency Preparedness Cooperative Agreement and the Hospital Preparedness Program administered by the Office of the Assistant Secretary for Preparedness and Response (ASPR) in the Department of Health and Human Services (HHS). The goal would be to add medical and environmental surveillance information to that generated by BioWatch. Walter replied that medical and environmental surveillance are important pieces of the overall effort to detect possible bioterrorism events.
Romanosky then asked about efforts to improve coordination with respect to intelligence reports and getting those to local public health departments. Walter said the information fusion centers are a good place to transmit information from the intelligence community. Kathryn Brinsfield added that DHS OHA has been working on the communication and coordination pieces both within DHS and with the fusion centers,1 state and local law enforcement groups, and public health. Romanosky acknowledged that the exchange of information is much greater today than when BioWatch began.
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1 Fusion centers operate as state and major urban area focal points for the receipt, analysis, gathering, and sharing of threat-related information among federal; state, local, tribal, territorial (SLTT); and private-sector partners. For more information, see https://www.dhs.gov/ state-and-major-urban-area-fusion-centers (accessed November 1, 2016).
