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bioweapon is well within many people™s capabilities. In terms of dif¬culty,
making a bioweapon is more comparable to making a dirty bomb that
disperses radioactive material without detonating a nuclear reaction. But
a bioweapon can kill many more people than can a dirty bomb.
Preparing and effectively weaponizing pathogens might require
sophisticated equipment and scienti¬c expertise but far less than what
would be required to produce even a rudimentary nuclear weapon.
Pathogens are naturally available, and re¬ned seed stocks of potentially
weaponizeable agents are found widely in laboratories around the world.
Getting weapons-grade nuclear material is, by contrast, extraordinarily
dif¬cult and far more expensive. Handling nuclear material requires radi-
ation protective gear that is harder to get and use properly than the biolog-
ical protective gear one would use to prevent self-infection. Furthermore,
the equipment necessary to produce nuclear weapons is far more tightly
regulated than what biological weapons would require.2 And the risks of a
covert laboratory being detected are slim.
The “footprint” of making and transporting a nuclear weapon is, by
orders of magnitude, larger and more detectable than comparable activ-
ities related to bioweapons. If a nuclear weapon has to be moved from
its place of preparation to its place of use, the chances of detecting a
heavy metal item that emits radioactivity and is surrounded by precision
17
WHY WORRY?

explosives is incomparable to the chances of detecting a tiny vial full
of an innocuous-looking gas or liquid. A single individual can transport
bioweapons across borders by land, sea, or air and through airports and
customs checks. A common perfume bottle can deliver plenty of agent that
can, of course, multiply on its own to meet the bio-offender™s requirements.


Contagious Panic!!!
The truly unique characteristic of some bioweapons “ the characteristic
that distinguishes them from nuclear weapons or indeed from all other
types of weapons “ is contagion. No other type of weapon can replicate
itself and spread. Any other type of attack, regardless of its horror, is con-
¬neable in time and space; the harm is in¬‚icted at the point of attack. It is
awful for the victims, but if you aren™t there, its effects are emotional “ grief,
empathy, rage; it does not harm you physically. But a contagious bioattack
somewhere puts everyone at risk everywhere.
The Spanish Flu outbreak of 1918 killed more than forty million peo-
ple in a world with one-third of today™s population and without modern
transportation networks. With today™s modes of circulation, an effective
biological attack could be far more strategic than nature in spreading a
highly contagious disease that could run amok and expose vulnerabilities
around the planet. No other attack offers similar capabilities to spread
itself.
A bio-offender could infect himself with a disease, cross through cus-
toms or border control before symptoms are obvious, and then spread
it to unsuspecting victims who would themselves become extended
bioweapons carrying the disease indiscriminately. There are challenges
in timing one™s entry to precede the onset of symptoms and yet be in a
crowded area before one succumbs to the overwhelming agony of a hor-
rible disease. Taking a stroll through Grand Central Station or Heathrow
Airport while contagious with ebola would require true dedication. Yet,
a well-executed “invasion” of purposely infected carriers could be effec-
tive. It bears mentioning here that fanatical terrorist organizations seem
to have an endless supply of suicide attackers.
All this leads to the ¬nal distinguishing characteristic: mass panic.
All weapons are frightening, but the insidiousness and omnipresence of
disease raises incomparable fears. Use of contagion means hiding our
children. It is about planes ¬‚ying empty or perhaps not ¬‚ying at all. It
is about people refusing to interact with each other for fear of unseen
and horrible af¬‚iction. It is about canceling public entertainment and
18 BIOVIOLENCE: PREVENTING BIOLOGICAL TERROR AND CRIME

tourism “ even going to a movie would be too dangerous. It is about seis-
mic disruption of investment markets, perhaps for months. A biological
attack makes everyone in a society potentially vulnerable to our most fun-
damental terror: the fear of disease.
Ultimately, if your ambition is to rattle the pillars of modern civilization
and perhaps cause it to collapse, there are only two options: nuclear or
biological weapons. Use of either would set in motion political, economic,
and health consequences so incomparably severe as to call into question
the ability of existing governments to maintain their citizens™ security.
Bioweapons are far more available, cheaper, easier to use, undetectable,
and could have more widespread and long-lasting effects. If you want to
stop modern civilization in its tracks, bioviolence is the way to go.


EVALUATING RISKS

How likely is it that rogue States, terrorists, or criminal organizations will
get and perhaps use bioweapons to commit a catastrophic attack? Any
de¬nitive answer here must be suspect; in truth, no one can say with
any con¬dence. Most experts concur that a small attack (for example,
murder of a spouse) is virtually inevitable, but it is not a simple matter
to leap to an attack that far exceeds what can be done with a knife or
gun. Another unanswerable issue has to do with the risks posed by lone
attackers or small groups of persons who are tragically disaffected. The
Unabomber, Ted Kaczynski, was a sophisticated mathematician capable of
making ingenious letter bombs in his covert cabin in the woods “ a similar
loner with bioscience sophistication could produce far more lethal devices.
Perpetrators of the Columbine and Virginia Tech massacres did not share
an ideological commitment with Al Qaeda or anyone else; assessing the
risk that similarly alienated teenagers will turn to disease instead of guns
would be mere speculation.
Consider the recent warnings from Interpol Secretary General Ronald
K. Noble:

We know from recent events that terrorists remain committed to perpe-
trating large-scale violence.
We also know that as biotechnology industries continue to expand
throughout the world, new pathogens and pathogen-making technologies
are rapidly proliferating, increasing the risk that terrorists could get their
hands on deadly pathogens or their means of production. This is the so-
called dual-use dilemma, and it is not going away anytime soon.
19
WHY WORRY?

It is also becoming ever more possible for terrorists themselves to pro-
duce the weapons, as the volume and sophistication of the necessary infor-
mation becomes increasingly accessible through publications, the Inter-
net, and other sources. . . . And there is much evidence that terrorists have
a strong interest in the use of biological weapons and are planning to use
them.
Yet, in the face of all of this, some people still question whether the
danger is real. They question whether it is truly necessary to prepare for
it. I have no doubt that the threat is real. Moreover, given the magnitude
of the harm that would be caused by a bioterrorism attack “ hundreds,
thousands, and even millions of deaths are possible “ it is clear to me that
this alone mandates that we take this threat seriously. Even if thousands or
millions did not die, the panic and the subsequent harm that would follow
such an attack would represent yet another set of reasons why we should
care about this potential harm and do all in our power to ¬ght against it.

Unfortunately, the progression of bioscience is raising risks. This
progression is both vertical and horizontal. Vertically, escalating bio-
logical research offers the potential to uncover elemental principles of
pathogenicity that could enable cultivation of a disease of such devasta-
tion that civilization itself could be fundamentally maimed with attendant
risks of economic collapse and political upheaval. Horizontally, the bio-
science sectors (academic research, pharmaceutical, and governmental)
are proliferating rapidly across the planet, with a concomitant multiplying
of the diversity of persons trained and engaged in that sector.
In short, there is opportunity and there is motive, and anyone con-
cerned with crime and violence will attest to the danger of passivity in
such circumstances.
2 Methods of Bioviolence




There are countless ways to commit bioviolence. Bioweapons are not a
single, undifferentiated set of devices all used to common effect. Choices
can be made from a lengthy menu of pathogens and a longer menu of
dissemination methods to create many combinations; each faces differ-
ent obstacles and has different consequences. Decades ago, there were
only a few ways to commit a biocatastrophe, but bioscience progress is
recon¬guring and rapidly expanding options.
How hard is it to commit bioviolence and how much specialized knowl-
edge is needed? Much depends on the perpetrator™s objective, the available
pathogens and equipment, his organization™s technical skill and sophisti-
cation, the risks of detection, and how those risks could be avoided. His
choices in turn affect our tactics to defeat him. The essence of bioviolence
prevention strategies is to make the hurdles of committing bioviolence
more arduous; the bio-offender™s challenge is to surmount or outwit
those hurdles. This perpetual threat-response dynamic is one reason why
bioviolence poses unique threats.
It is widely reported that bioviolence is easy, but even well-funded
State programs have stumbled trying to make effective bioweapons. If it is
that easy, why has there not yet been a successful catastrophic attack?
Perhaps because it is actually more complicated. Many pathogens are
ubiquitous and easily propagated; critical challenges tend to be about
how to disseminate them either by physically spreading them amidst the
target or by contagion. Yet, modern genomics is opening gateways for
novel pathogens, and innovative engineering makes them easier to dis-
seminate. There are premier scientists who certainly know how to make
awesome bioweapons with minimal resources and pedestrian equip-
ment, but it is unclear whether anyone so skillful wants to in¬‚ict a mass
catastrophe.

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21
METHODS OF BIOVIOLENCE

For policy makers trying to prevent bioviolence, these back-and-forth
assertions are frustrating. Where should limited resources be most effec-
tively allocated? What risks are more serious and therefore deserve more
attention? What risks are far-fetched and therefore might be deferred
in view of more immediate threats? Answering these questions requires
understanding how a catastrophic bioattack might proceed and what tech-
nical hurdles must be overcome.
This chapter discusses only catastrophic attacks having extensive and
severe casualties or causing immense costs or long-term panic. There are
virtually limitless ways to use bioagents for murder or vandalism; little
purpose would be served in cataloguing the many ways to do what guns
and explosives can already do more simply. This discussion is limited to
what makes bioviolence unique “ its potential to in¬‚ict truly vast harm “
and focuses on how that high-end catastrophe can be accomplished.


INTERWOVEN CHOICES

Choices about which pathogen to use, how to obtain and prepare it for
dissemination, and what device to use against which targets are all inter-
woven. Obstacles in one aspect affect choices in other aspects. No single
pathogen is perfect for all objectives. Some are harmful to humans; some
attack livestock or crops. A few are contagious. Some are easy to get but
need to be highly re¬ned to be used as weapons; some are dif¬cult to get
but, if obtained, can be readily put to malevolent use. For some there are
vaccines; some are susceptible to environmental stress; some have a long
incubation period; some cause diseases that are dif¬cult to distinguish
from a natural outbreak.
This chapter highlights some of the more realistic and often-discussed
methods of bioviolence but does not try to present an encyclopedic
description of diseases. Attention focuses on 1) smallpox, 2) in¬‚uenza and
hemorrhagic fevers, 3) anthrax, 4) toxin contamination of food, 5) attacks
against agriculture, and 6) various agents historically used as bioweapons.
Following discussion of these types of bioviolence, attention turns to
emerging scienti¬c advances and how they might contribute to biovio-
lence.
Table 2-1. brie¬‚y describes the more notable bioviolence agents.

Readers might notice this discussion™s vagueness. Specifications that
might be misused are intentionally omitted. Experts who focus on biovio-
lence have an ongoing debate about what information and ideas should be
Table 2-1. PRI NCI PAL B IOVIOLENCE AG ENTS




22
Pathogen Lethality Incubation; Symptoms Contagiousness Special Attack Attributes

Anthrax Bacillus 0.5“60 days; Organs swell Cutaneous lesions are Natural agent needs to be re¬ned; very
Inhalational = near 100% if
Anthracis and fail, bleeding of brain slightly contagious; not stable; easy to store for long periods;
untreated; gastroenteric =
(spore-bacteria) 25“65% if untreated; and nervous system contagious via respiratory extremely lethal; can be disseminated by
sputum air with proper equipment
cutaneous = 2% if
untreated

Botulinum Toxin from 6% if treated; nearly 100% if 2“72 hours; respiratory Not contagious Extremely poisonous; easy to cultivate
Clostridium botulinum untreated paralysis and collapse and transport

Brucellosis Brucella 1“3% 7“21 days; Long-term fever Not readily contagious Can be transmitted through dairy
(Bacterium) products; used as an incapacitating agent

Cholera Vibrio 1% if treated (depending on 0.5“5 days; Diarrhea Low: primarily via Could be used to contaminate food and
cholerae (Bacterium) the type of strain; 50“90% if leading to dehydration contaminated water water supplies in developing countries
untreated

Ebola Filoviridae family 50“90% 2“21 days; Fever leading to Moderate: through direct No approved vaccine; high mortality rate;
(Virus) bleeding from bodily human-to-human contact; victim is infectious after recovery; exists
ori¬ces recovered patients may naturally in primates
still be infectious

Glanders Burkholderia 50% if treated 1“14 days; Fever, organ Low: via direct Common in the developing world;
mallei (Bacterium) and circulatory system human-to-human contact; historical use in World War I; high
dysfunction possible animal-to-human mortality rate in humans; highly infectious
via aerosol

In¬‚uenza 1“4 days; Fever, aches Always, but rates vary Readily available; hard to eradicate; fast
Normal = .008% 1918 =
Orthomyxoviridae incubation; slow vaccine production;
1% H5N1 = 50% greatly. 1918 = High;
family (Virus) highly contagious
Avian ¬‚u = Low

Marburg Filoviridae 25“100% 3“9 days; Vomiting, rash, Moderate: spread only No cure or vaccine; extremely infectious;
family (Virus) bleeding, organ failure through close spreads and multiplies in the host quickly
hypovolemic shock human-to-human contact
Mad Cow Bovine 100% plus euthanasia of 2“8 years Through feed made with Huge economic effects; long incubation
spongiform animals in contact infected tissue period leads to mass euthanasia of
encephalopathy infected herds

Plague Yersinia pestis High: Infected vector; Rapidly fatal if untreated; possible
Septicemic = 30“75% if pneumonic = 3 hours“4

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