[House Hearing, 107 Congress]
[From the U.S. Government Publishing Office]
THE SILENT WAR: ARE FEDERAL, STATE AND LOCAL GOVERNMENTS PREPARED FOR
BIOLOGICAL AND CHEMICAL ATTACKS?
=======================================================================
HEARING
before the
SUBCOMMITTEE ON GOVERNMENT EFFICIENCY,
FINANCIAL MANAGEMENT AND
INTERGOVERNMENTAL RELATIONS
of the
COMMITTEE ON
GOVERNMENT REFORM
HOUSE OF REPRESENTATIVES
ONE HUNDRED SEVENTH CONGRESS
FIRST SESSION
__________
OCTOBER 5, 2001
__________
Serial No. 107-95
__________
Printed for the use of the Committee on Government Reform
Available via the World Wide Web: http://www.gpo.gov/congress/house
http://www.house.gov/reform
U. S. GOVERNMENT PRINTING OFFICE
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___________________________________________________________________________
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COMMITTEE ON GOVERNMENT REFORM
DAN BURTON, Indiana, Chairman
BENJAMIN A. GILMAN, New York HENRY A. WAXMAN, California
CONSTANCE A. MORELLA, Maryland TOM LANTOS, California
CHRISTOPHER SHAYS, Connecticut MAJOR R. OWENS, New York
ILEANA ROS-LEHTINEN, Florida EDOLPHUS TOWNS, New York
JOHN M. McHUGH, New York PAUL E. KANJORSKI, Pennsylvania
STEPHEN HORN, California PATSY T. MINK, Hawaii
JOHN L. MICA, Florida CAROLYN B. MALONEY, New York
THOMAS M. DAVIS, Virginia ELEANOR HOLMES NORTON, Washington,
MARK E. SOUDER, Indiana DC
STEVEN C. LaTOURETTE, Ohio ELIJAH E. CUMMINGS, Maryland
BOB BARR, Georgia DENNIS J. KUCINICH, Ohio
DAN MILLER, Florida ROD R. BLAGOJEVICH, Illinois
DOUG OSE, California DANNY K. DAVIS, Illinois
RON LEWIS, Kentucky JOHN F. TIERNEY, Massachusetts
JO ANN DAVIS, Virginia JIM TURNER, Texas
TODD RUSSELL PLATTS, Pennsylvania THOMAS H. ALLEN, Maine
DAVE WELDON, Florida JANICE D. SCHAKOWSKY, Illinois
CHRIS CANNON, Utah WM. LACY CLAY, Missouri
ADAM H. PUTNAM, Florida DIANE E. WATSON, California
C.L. ``BUTCH'' OTTER, Idaho ------ ------
EDWARD L. SCHROCK, Virginia ------
JOHN J. DUNCAN, Jr., Tennessee BERNARD SANDERS, Vermont
------ ------ (Independent)
Kevin Binger, Staff Director
Daniel R. Moll, Deputy Staff Director
James C. Wilson, Chief Counsel
Robert A. Briggs, Chief Clerk
Phil Schiliro, Minority Staff Director
Subcommittee on Government Efficiency, Financial Management and
Intergovernmental Relations
STEPHEN HORN, California, Chairman
RON LEWIS, Kentucky JANICE D. SCHAKOWSKY, Illinois
DAN MILLER, Florida MAJOR R. OWENS, New York
DOUG OSE, California PAUL E. KANJORSKI, Pennsylvania
ADAM H. PUTNAM, Florida CAROLYN B. MALONEY, New York
Ex Officio
DAN BURTON, Indiana HENRY A. WAXMAN, California
J. Russell George, Staff Director and Chief Counsel
Matt Phillips, Professional Staff Member
Mark Johnson, Clerk
David McMillen, Minority Professional Staff Member
C O N T E N T S
----------
Page
Hearing held on October 5, 2001.................................. 1
Statement of:
Lillibridge, Scott R., M.D., Special Assistant to the
Secretary for National Security and Emergency Management,
Department of Health and Human Services; Bruce Baughman,
Director, Planning and Readiness Division, Federal
Emergency Management Agency; Craig Duehring, Principal
Deputy Assistant Secretary of Defense for Reserve Affairs,
Department of Defense; Woodbury Fogg, director, New
Hampshire Office of Emergency Management, co-chair,
Terrorism Committee, National Emergency Management
Association; Mark Smith, M.D., Washington Hospital Center,
representing the American Hospital Association; and Kyle B.
Olson, vice president and senior associate, Community
Research Associates........................................ 83
McHale, Sang-Mi, survivor of 1995 sarin gas attack in Tokyo;
Amy Smithson, Ph.D., director, chemical and biological
weapons nonproliferation project, the Stimson Center;
Martin O'Malley, mayor, city of Baltimore; Edward T.
Norris, commissioner, Baltimore City Police Department; Don
Lynch, emergency management director, Shawnee City and
Pottawatomie County, OK, and former emergency management
director, Oklahoma County, OK; Diana Bonta, Dr.P.H., R.N.,
director department of health services, State of
California; Janet Heinrich, Dr.P.H., R.N., Director, Health
Care and Public Health Issues, U.S. General Accounting
Office; and Lt. Gen. James Peake, M.D., Surgeon General,
U.S. Army.................................................. 8
Letters, statements, etc., submitted for the record by:
Baughman, Bruce, Director, Planning and Readiness Division,
Federal Emergency Management Agency, prepared statement of. 95
Bonta, Diana,Dr.P.H., R.N., director department of health
services, State of California, prepared statement of....... 59
Cummings, Hon. Elijah E., a Representative in Congress from
the State of Maryland, prepared statement of............... 169
Duehring, Craig, Principal Deputy Assistant Secretary of
Defense for Reserve Affairs, Department of Defense,
prepared statement of...................................... 105
Fogg, Woodbury, director, New Hampshire Office of Emergency
Management, co-chair, Terrorism Committee, National
Emergency Management Association, prepared statement of.... 122
Horn, Hon. Stephen, a Representative in Congress from the
State of California, prepared statement of................. 3
Lillibridge, Scott R., M.D., Special Assistant to the
Secretary for National Security and Emergency Management,
Department of Health and Human Services, prepared statement
of......................................................... 87
Lynch, Don, emergency management director, Shawnee City and
Pottawatomie County, OK, and former emergency management
director, Oklahoma County, OK, prepared statement of....... 44
Maloney, Hon. Carolyn B., a Representative in Congress from
the State of New York, prepared statement of............... 6
Norris, Edward T., commissioner, Baltimore City Police
Department, prepared statement of.......................... 37
O'Malley, Martin, mayor, city of Baltimore, prepared
statement of............................................... 28
Olson, Kyle B., vice president and senior associate,
Community Research Associates, prepared statement of....... 152
Smith, Mark, M.D., Washington Hospital Center, representing
the American Hospital Association, prepared statement of... 138
Smithson, Amy, Ph.D., director, chemical and biological
weapons nonproliferation project, the Stimson Center,
prepared statement of...................................... 12
THE SILENT WAR: ARE FEDERAL, STATE AND LOCAL GOVERNMENTS PREPARED FOR
BIOLOGICAL AND CHEMICAL ATTACKS?
----------
FRIDAY, OCTOBER 5, 2001
House of Representatives,
Subcommittee on Government Efficiency, Financial
Management and Intergovernmental Relations,
Committee on Government Reform,
Washington, DC.
The subcommittee met, pursuant to notice, at 10 a.m., in
room 2154, Rayburn House Office Building, Hon. Stephen Horn
(chairman of the subcommittee) presiding.
Present: Representatives Horn, Putnam, Schakowsky, Maloney,
and Cummings.
Also present: Representative Ehrlich.
Staff present: J. Russell George, staff director and chief
counsel; Matt Phillips, professional staff member; Mark
Johnson, clerk; Bonnie Heald, communications director; Jim
Holmes, intern; David McMillen, minority professional staff
member; and Jean Gosa, minority clerk.
Mr. Horn. A quorum being present, the hearing of the
Subcommittee on Government Efficiency, Financial Management and
Intergovernmental Relations will come to order.
On September 11, 2001, the world witnessed the most
devastating and horrific attacks ever committed on U.S. soil.
Despite the damage and enormous loss of life those attacks
caused, they failed to cripple the Nation. To the contrary,
this Nation has never been more united in its fundamental
belief in freedom and its willingness to protect that freedom.
The diabolical nature of these attacks was an unimaginable
wake-up call to all Americans: We must be prepared for the
unexpected. We must have the mechanisms in place to protect
this Nation and its people from further attempts to cause such
massive destruction.
Today, the subcommittee will examine the Nation's ability
to respond to the possibility of a biological or chemical
attack. Even though most experts believe that the likelihood of
such an attack is relatively low, we must ensure that the
Nation has an emergency management structure that is prepared
to handle even the most remote possibility of such an attack.
The aftermath of the September 11th attacks clearly
demonstrated the need for adequate communications systems and
rapid deployment of well-trained emergency personnel. Yet
despite billions of dollars in spending on Federal emergency
programs, there are serious questions as to whether the
Nation's public health system is equipped to handle a massive
chemical or biological attack.
A September 2000 report from the General Accounting
Office--and that is part of the legislative branch headed by
the Comptroller General of the United States--GAO found that
the 1999 outbreak of the West Nile Virus severely taxed the New
York public health system. This outbreak, which was ultimately
contained, affected hundreds of people. A biological attack
could affect thousands more.
Today, the subcommittee will examine how effectively
Federal, State and local agencies are working together to
prepare for such emergencies. We want the people of this Nation
to know that they can rely on these systems, should the need
arise.
I want to note that we had hoped to have Mayor Giuliani
with us today, but the city's ongoing needs, rightly, take a
higher priority. At the conclusion of today's hearing, we will
recess and reconvene at a later date to allow the Mayor an
opportunity to contribute his expertise to this hearing. In
addition, the subcommittee will be conducting similar hearings
throughout the country.
We are fortunate to have witnesses today whose valuable
experience and insight will help the subcommittee better
understand the needs of those on the front-lines--
representatives of the Nation's hospitals and its cities,
counties and States. We want to hear about their capabilities
and their challenges. And we want to know what the Federal
Government can do to help.
We welcome all of our witnesses and we look forward to your
testimony.
We'll start now with an opening statement from the ranking
individual, Mrs. Maloney, and Ms. Schakowsky and we want to
thank them for the help they've given us in gaining this
particular group of individuals.
And so I now yield up to 5 minutes to Mrs. Maloney, the
gentlewoman from New York.
[The prepared statement of Hon. Stephen Horn follows:]
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Mrs. Maloney. Thank you, Chairman Horn, and Ranking Member
Schakowsky for holding this hearing. I would also like to thank
our panel of witnesses.
Over the past few weeks I have been to Ground Zero many
times in New York. The amount of destruction and devastation I
have witnessed, more than any other assault on U.S. soil, is
indescribable and overwhelming. While we have maintained our
strength and resolve to rebuild and come back stronger than
ever, I shudder at the thoughts of what-ifs: What if those
planes had contained a chemical component or had the capability
of releasing a biological weapon? How would our response teams
have reacted? And could we have handled a two-pronged attack?
We now have to think of scenarios that would normally, in
the past, have been unthinkable, in order to prepare for any
type of attack that may come. The FBI disregarded a report of a
man who showed up at a flight school wanting to learn how to
steer a plane, but he didn't care about learning how to take-
off or land. Now we have to take every threat seriously. As we
quickly learned on September 11th, the world is different and
this war is different than any we have fought in the past.
The terrorists are becoming more sophisticated and their
network is widespread. They are using unconventional,
unpredictable means. If they are willing to give up their
lives, they can do enormous harm. And the enormous harm could
include chemical or biological attacks that threaten the lives
of millions of Americans.
I am concerned that despite all the carnage we've seen in
the financial capital of the world, we are not making
sufficient preparations for a worst-case scenario, that we are
more complacent than we are prepared.
I am told that anthrax and smallpox represent two of the
most likely forms of biological warfare. We have 7 to 10
million doses of smallpox vaccine and there are 280 million
Americans. One vial of anthrax has the potential to kill tens
of thousands of people in the New York City subway system. If
anyone can convince me by the end of this hearing that we have
the infrastructure in place to react to such an attack and
prevent mass carnage, I will be pleasantly surprised.
I look forward to learning about our local, State and
Federal Government's level of preparedness and ability to
coordinate and cooperate with each other. It is important to
identify the weaknesses in our infrastructure and then work to
address them so we can improve our reaction in a time of
crisis.
I am also interested in learning about the availability and
effectiveness of vaccines and antibiotics for certain
bioweapons. Are we partnering with our pharmaceutical companies
to prepare for an attack or are we going about business as
usual after September 11th? We must draw on all of our
resources, both public and private, to detect and respond to
all terrorism.
Again, I thank the chairman and the ranking member for
calling this hearing, and I thank all of our panelists for
being here. I hope that this will be the first of many hearings
that will focus on this tremendously important issue to our
country.
[The prepared statement of Hon. Carolyn B. Maloney
follows:]
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Mr. Horn. I thank the gentlewoman.
We will now swear in the witnesses. This is an
investigating committee, and we ask that you stand, raise your
right hands. And this includes also the staff behind you; just
take the oath, too, so we don't have to keep making changes.
The clerk will then get the names of the support.
[Witnesses sworn.]
Mr. Horn. I will note for the record that all the witnesses
and their support staff have taken the oath.
We start with a very interesting individual in particular.
Our first witness has a very unique perspective to share with
us, and that's Mrs. McHale, who was a victim of the chemical
attack that occurred in Tokyo in 1995; and we appreciate very
much her willingness to come before the committee and relate
her experience.
Mrs. McHale, it's a pleasure to have you.
Mrs. McHale. Thank you, Mr. Chairman, members of the
committee.
Mr. Horn. We're going to have to have the clerk maintain
getting the microphone there with everybody.
We have a terrible system in this place, and you would
think, with all the billions we give out to the executive
branch, we don't give much to ourselves.
So here we are. OK.
STATEMENTS OF SANG-MI McHALE, SURVIVOR OF 1995 SARIN GAS ATTACK
IN TOKYO; AMY SMITHSON, Ph.D., DIRECTOR, CHEMICAL AND
BIOLOGICAL WEAPONS NONPROLIFERATION PROJECT, THE STIMSON
CENTER; MARTIN O'MALLEY, MAYOR, CITY OF BALTIMORE; EDWARD T.
NORRIS, COMMISSIONER, BALTIMORE CITY POLICE DEPARTMENT; DON
LYNCH, EMERGENCY MANAGEMENT DIRECTOR, SHAWNEE CITY AND
POTTAWATOMIE COUNTY, OK, AND FORMER EMERGENCY MANAGEMENT
DIRECTOR, OKLAHOMA COUNTY, OK; DIANA BONTA, Dr.P.H., R.N.,
DIRECTOR DEPARTMENT OF HEALTH SERVICES, STATE OF CALIFORNIA;
JANET HEINRICH, Dr.P.H., R.N., DIRECTOR, HEALTH CARE AND PUBLIC
HEALTH ISSUES, U.S. GENERAL ACCOUNTING OFFICE; AND LT. GEN.
JAMES PEAKE, M.D., SURGEON GENERAL, U.S. ARMY
Mrs. McHale. My name is Sang-mi McHale. I am here to
testify about my experience of being poisoned in the Tokyo
subway in 1995, but first of all, I would like to express my
deepest sympathy toward the victims and their families of the
recent terrorist attacks. I would also like to express my
greatest respect and support for the rescue workers and both
State and municipal government officials who have been working
tirelessly since the tragedy.
On the morning of March 20, 1995, I was on my way to Saint
Luke's International Hospital in Tokyo for a prenatal checkup.
I was 36 weeks pregnant. I had been living in Japan with two
young children, since 1992, and with my husband who had been
assigned to the U.S. Embassy in Tokyo as a staff assistant to
Ambassador Walter Mondale. I arrived at the subway station
around 8 a.m. The train arrived shortly after I reached the
platform.
As I boarded, I saw on the floor by the door a rectangular
package wrapped in a newspaper, a sticky looking transparent
substance was oozing from it. I walked by the package and sat
diagonally across from it. It was about 6 feet away. I don't
remember a particular smell, but I somehow felt the air being
thick.
Within a minute or two after the train started moving, I
noticed that I was having difficulty breathing, and I started
to cough. I remembered reading a little article earlier that
week in the newspaper about a chemical substance in a train
which made some passengers sick. I worried that exposure to my
chemical might be harmful to my baby and decided to move to the
next car. Even from the next car I could still see through the
window both the substance and the other passengers. The
passengers who remained in the last car were all covering their
mouths, coughing hard and had reddened faces. They all appeared
sick.
At the next station, as soon as the door opened, all the
people from the last car rushed to get off except for an old
man who was sitting directly across from the chemical
substance. He was still in the seat and appeared unconscious.
He had turned purple and soon went into convulsions. A
passenger from the end car returned into the car and dragged
him out. I later learned that this old man was one of the first
victims to lose his life that morning.
At that moment, there was an announcement in the train that
there had been a bomb incident on a different line and that all
subways were halting service. We all gasped and hurried off the
train. Luckily, the stairs to the street level were nearby. I
found a public phone and called my husband. Placing a call was
hard because my vision started getting blurry. Distinguishing
the taxies from the regular cars was difficult as well. Many
people were gathered at the intersection, some sitting on the
curb and some people were helping the others.
Soon I started hearing sirens, and I remember seeing an
ambulance nearby. I was lucky enough to get a taxi about 50
minutes later and went to the hospital. Again, I was lucky that
I already had an appointment with a doctor, because I could see
my doctor fairly quickly. He was alarmed at my condition and
told me to stay in the hospital. I was soon given a room in a
maternity ward and was placed on an IV. My symptoms included a
fever, a headache, and blurry vision.
The Japanese authorities identified the chemical substance
as Sarin rather quickly, I think, for by that afternoon I was
given an antidote to Sarin, atropine. Apparently, the hospital
had enough doses for all the patients who needed it.
I was released from the hospital 2 days later and quickly
recovered except for miosis, darkened vision, which lasted
about 2 months. After the incident, the hospital provided great
care and conducted Sarin victim surveys, periodically
monitoring the emotional distress among the patients, and
offered counseling for those in need.
Several things helped me that day: First, the knowledge
that a similar incident involving chemical substance occurred
in a train before; second, my health consciousness just because
I was pregnant, which made me move to that next car; third, my
general belief that Japan is actually much less safe than its
reputation, which made me pay attention to my surroundings.
Last, I'm happy to report to you that I delivered a healthy
baby boy 3 weeks later, after the incident, at the same
hospital, and he is now a happy first grader.
I hope this has been helpful. Thank you very much.
Mr. Horn. It has been. We're very glad for your family, and
we thank you very much. And if you can stay with us, we'd
appreciate it.
Let us now go to Dr. Amy Smithson, the Director of Chemical
and Biological Weapons Nonproliferation Project from the
Stimson Center. So, Dr. Smithson.
Dr. Smithson. Good morning, Mr. Chairman, and thank you for
the invitation to appear here today.
What you have just heard is the account of a woman who was
exposed to the nerve agent, Sarin. Nerve agents were
essentially discovered in the mid-1930's. In laymen's terms,
what happens when you're exposed to very small amounts of this
stuff is, your system short-circuits and death can occur very
rapidly, within minutes. Other examples of nerve agents, aside
from Sarin, would include VX and Tabun.
There are two other basic categories of chemical warfare
agents, including blister agents where exposure can occur on
the skin or through the lungs and the result is as the category
would describe, heavy, heavy blistering and other side effects
that can be much more serious. Examples of blister agents,
which were used quite frequently during World War I, included
mustard gas.
A third category of chemical weapons is called a blood
agent, and examples of that agent include hydrogen cyanide.
Earlier, in an opening statement, I heard mention of one of
the biological agents that is discussed quite frequently these
days, anthrax.
There are two basic kinds of biological agents, and let's
keep in mind that these are things that have to be alive when
they reach the human lung in a very, very small particle size,
1 to 10 microns, in order to infect us and make us ill. And one
of the rumors that keeps making the rounds these days is that
crop dusters are well suited for the purposes of distribution
of biological agents. Having spent quite some time with people
who fly these aircraft, they assure me that this is not as
easily done as is often portrayed today.
Crop dusters disperse materials in a micron size of 100
microns and above. And that is a far cry from the very small
particle size that would be needed to infect us. So let's get
things straight about crop dusters, please.
In terms of biological agents, they come in two basic
categories: contagious and noncontagious. Anthrax would be the
example that we have heard most often. There is a case down in
Florida. But last year, when there was a case in North Dakota,
the only people who took notice were those in health and public
health communities. In our heightened state, I think there are
a lot of persons who are afraid that this is a sign of
something worse to come. I simply do not believe that to be the
case.
Smallpox and plagues are examples of contagious biological
warfare agents. And these do present a problem if indeed they
were ever to be released, a very serious problem.
I'd like to return to the case of the cult that did this
woman harm to illustrate how difficult it is to achieve a
capability to disseminate these agents in a way that would
cause mass casualties. Aum Shinrikyo was my nightmare case.
This was a cult determined to acquire these capabilities and
use these weapons.
They spent over $30 million on their chemical warfare
program. They had a state-of-the-art chemical production
facility. They had over 100 scientists and technicians in this
program. And they could not figure out how to make the
significant quantities of chemical agent that would really
cause mass casualties of the type that we're seeing in New York
City a couple of week ago. That's one thing we should keep in
mind.
The biological warfare program was also quite significant.
And they tried for several years to acquire this capability.
But the thing we need to understand is that they flopped
totally and utterly. Not only could they not acquire the lethal
seed cultures, they were unable to disperse what they thought
they had in a manner that would cause us to fall ill.
So let's look to what terrorists can do and the hurdles
that face them in trying to acquire these types of
capabilities, and not get carried away with hyperbole and with
speculation.
In terms of what worries me, what worries me is, this
country is peppered with over 850,000 facilities that work with
hazardous and extremely hazardous chemicals. These facilities,
if someone were to sabotage them, would have a very, very
dangerous outcome. And there's information that has now been
made publicly available about these facilities. And if there is
one thing that I ask from you today it is that you take steps
to make sure that information is contained.
The remarks that I will conclude with here are based on a
study that I did surveying 33 cities across this country in
their readiness to contend with a chemical or a biological
disaster.
One thing you need to keep in mind when you think about
what the Federal Government can do to help this country get
prepared for this type of an event is that all emergencies are
local, and that the lives that are saved will be lives saved by
local rescuers. If you need to understand that point, remember
what happened on September 11th at the Pentagon and at the
World Trade Center. It wasn't some Federal rescue team that
swooped in; it was the local firefighters, police, EMS and
physicians. And if you are to get this country ready, I would
encourage to you get the domestic preparedness program back on
track.
The initial intent of this program was to get the locals
ready. But last year, out of $8.7 billion spent in this
program, only $311 million went to readiness in our communities
across this country.
So with that, I see my time is up. I would be delighted to
elaborate on the lessons that I learned in my survey from many
people who I consider to be much more authoritative than
myself.
Mr. Horn. We will have questions from our colleagues on
both sides, so stick with us.
[The prepared statement of Dr. Smithson follows:]
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Mr. Horn. Now I'd like to give a welcome by Mr. Ehrlich,
the very able person representing the city and State of
Maryland; and he is going to introduce the mayor of Baltimore
and the commissioner of the Baltimore City Police.
And that's bipartisan, because Mr. Ehrlich is a Republican.
Yes, they've had only one Republican mayor; as I remember, it
has been all Democratic.
So we're glad to have you here, and the same for the Chief.
So, Mr. Ehrlich.
Mr. Ehrlich. Mr. Chairman, thank you. I appreciate this
opportunity.
Ranking Member Schakowsky and Mr. Chairman, members of the
committee, on July 18th, we thought at the time we had a major
incident, and certainly for Baltimore, MD, it was major. That
day, a 60-car CSX freight train, traveling to New Jersey,
derailed under Howard Street in Baltimore, MD. Subsequent fires
sent smoke billowing out of both ends of the tunnel, a cloud
over Camden Yards. Fire caused water main breaks in the tunnel,
literally flooding streets above.
The entire city was shut down. The U.S. Coast Guard shut
down the Inner Harbor. Thirty thousand fans were removed from
Camden Yards. Intense heat and fire were a problem, preventing
our firefighters from initially getting to the flames. Our
city's police and fire departments worked together with the
mayor's office around the clock for the next few days, and the
fire was subdued. It was a total team effort and a dire
situation--a wonderful example of what cooperation can do.
In the aftermath of September 11th, our city, under the
mayor's leadership, has done some things that could not have
been thought of 3 weeks ago. We've hired a former New York City
Police Department official to come up with a terrorism plan,
which the mayor, I'm sure, will talk about. We've beefed up
security at the city government buildings and around Penn
Station. We brought in branches to protect Baltimore's own
World Trade Center. Emergency medical personnel are now
connected to major emergency rooms online with what Mayor
O'Malley calls our, ``first-time, real-time reporting time,''
that will help our health department track any unusual spikes
in cold and flu symptoms that might warn of an attack.
I really appreciate these two gentlemen, friends of mine,
great public servants, taking the time to come to speak to our
committee, to our Congress, to our Nation today. Both are
proactive, both are forward-thinking, both are aggressive, both
are thoughtful, both understand the dimension of the problem
that they particularly face today.
They need--they have to have cooperation from the Federal
Government, all agencies of the Federal Government.
I had the opportunity to talk to Commissioner Norris and
the mayor prior to this hearing. If the message in the past has
been, ``You protect your turf, we'll protect ours,'' those days
are long gone. Let the message go out from September 11th
forward that sort of mind-set is no more and cannot be the case
in this new world we live in.
So, Mr. Chairman, I want to welcome my two friends and true
leaders in a time of great national emergency, Mayor Martin
O'Malley and Police Commissioner Ed Norris.
Mayor, thank you.
Mr. Horn. Welcome Mayor O'Malley. We look forward to your
testimony.
Mr. O'Malley. Thank you, Mr. Chairman.
And thank you, Congressman Ehrlich, for your introduction
and for being part of this committee's hearing today. I want to
thank you for the opportunity to join you today, as we all try
to struggle with this new unconventional war, which, I would
submit to you, is one that is being fought on two fronts.
One of those fronts is far away from American soil. We have
our soldiers on the ground, we have the best technology, the
best and most rapid communication systems to forward
intelligence to them, so they can accomplish their mission.
The other front is the one that all of us sadly witnessed
in New York City and also in Washington. It is a front where we
have already sustained many, many casualties, not only civilian
casualties, but also casualties among our first responder local
fire and police officers. And while much of the discussion and
grief has been about the 6,000 lives lost, we should not lose
sight of the fact that thanks to preparedness, thanks to the
efficiency and bravery of those first responders, there were
about 40,000 lives that were saved. And that is really the key
to all of us who are in big cities.
You know, Baltimore is not unlike many other large cities
in America in terms what we need to be doing right now, as
quickly as possible, to protect as many lives as possible in
our cities in the event that there are other attacks on our
population centers. We're not the largest city, but we're not
the smallest either; and we take our responsibility very, very
seriously since we consider ourselves truly to be on the front
of one of the two fronts in this war.
Baltimore, however, is in a unique position because of our
proximity and history to come up to speed very quickly. And
we've done that--and special thanks to Marc Morial and the
Conference of Mayors for the work that they're doing to help
all of us share best practices with one another.
Any of you who know American history and, particularly, the
War of 1812 know that Baltimore does not wait for advice from
Washington when it comes to matters of self-defense. Indeed, if
we had, we would all be singing, ``God Save the Queen,'' still.
So we have moved forward ourselves, and we're very lucky to
have been able to have some great resources around us.
Some of you may know that Baltimore was selected as a lead
city in the chemical warfare improved response program, due to
our proximity to Washington and also our proximity to the U.S.
Army Soldier and Biological/Chemical Command in Aberdeen, MD.
Also Baltimore is home to the only center for civilian
biodefense studies at Johns Hopkins University, and you'll
shortly hear from our Police Commissioner, Ed Norris, formerly
of the New York City Police Department, where they have done
extensive work on civil preparedness in the wake of the first
World Trade Center bombing.
And finally, I guess as Congressman Ehrlich mentioned, we
had an emergency just back in July that was a chemical
emergency. It shut our city down for about 5 days. And
Baltimore had a chance to test our readiness in a chemical
incident when a CSX train, loaded with toxic chemicals,
derailed and burst into flames, burning in a long tunnel that
ran directly beneath our city. The fire was in the southern end
of that tunnel, and it happened in the middle of a doubleheader
at Camden Yards, which is located right at that exit of the
tunnel.
Now, during that train fire, as is the case in virtually
any crisis, local government was the first on the scene. In
fact, the folks from the NTSB located down here in Washington,
a mere half-hour drive away, did not show up until the next
morning.
Local government is the first on the scene, and one thing
that is immediately apparent is that you have to set up a
unified command structure; and this command structure, in this
case, was under our fire chief. It was effective. We
coordinated fire, police, health, State Department of the
Environment, as well as the Coast Guard and our State
Department of Transportation; and it all went very well. Key to
this was also that the Governor ordered the State agencies to
defer to the local unified command structures.
Based on our experience, we learned a few things, and
important things, that everybody should be asking. Who are your
critical personnel? Where is the command center? What is the
unified command? Do you have redundant communications? Are you
talking to the public so that the public maintains an
appropriate level of alert? What do your mutual assistance
agreements set into motion?
At the same time, as well as our emergency folks handled
that particular incident, when we watched with horror, with all
Americans, what happened in New York and Washington, we
realized we needed to do more. We need to do more. And we've
set about doing several things on three different fronts, if
you will, and every city in America needs to be doing this.
Those fronts are the three that break down, just in a
thumbnail, into: security, emergency preparedness, and
intelligence. I'm going to defer to Commissioner Norris to talk
to you about the most worrisome one of all of those to me,
which is criminal intelligence.
On security, we've been able to recruit from New York City
Chief Lou Anemone, and we have been taking a series of steps to
improve our preparedness, looking at public buildings, looking
at the public infrastructure, looking at the private
infrastructure.
It is absolutely alarming the degree to which our rail
system is open to everyone. I'm talking--we are not unlike many
other big cities. When you think of the amount of chemicals and
armaments that move along our rail system that is clearly
someplace where we could use some Federal help in pushing
greater security measures. But we're looking at all of those
sorts of things, as I said, the public buildings as well as the
private infrastructure, bolstering police and security presence
at water supplies.
On the emergency preparedness, we are continuing to
coordinate with the Center for Civil Biodefense. We've worked
with all of our hospitals so that the ones who had bioterrorism
plans have now shared them with their colleagues. And on the
intelligence front we have created a biosurveillance system in
a matter of just 2 short weeks where we make sure that, in real
time, we're looking at the symptoms being displayed in our
emergency rooms, in our clinics, that our paramedics are
seeing, we're watching the number of dead animals that our
animal control people pick up and we're looking at absentee
rates.
It's simple. It hasn't cost millions and millions of
dollars. The hospitals were willing to do it with local
leadership. So we actually do have a pretty good intelligence
network set up to identify it early.
My time is running out. I'm going to wrap up and defer to
Commissioner Norris to go to the more worrisome side of this.
But in conclusion, I just want to again emphasize, as the
doctor did before me, that I think we have models that work
like the Chemical Warfare Improvement Response Program. Those
models involve direct local funding.
You have to get the help to the first responders; and the
first responders are not the States, they are the cities--
direct local funding to the cities. I could talk to you at
greater length about our equipment wants and desires, our
vaccination wants and desires and things of that nature. And
all of them are concerns, and none of us are where we want to
be, where we hope to be.
But the biggest concern of all of these is the lack of
criminal intelligence, the lack of a connection between the
3,000 local law enforcement officers under my command in the
city of Baltimore and the 200 or so FBI agents who cover the
entire metropolitan area. I would ask you to do whatever you
can on that front.
Because, again, this is a war on two fronts: one where we
don't skimp, where we have the best technology, the best
communication, the best intelligence rushing to the front line;
and another one which is our local front, where none of those
things are rushing to the front lines of major cities' fire and
police departments.
Thank you.
[The prepared statement of Mr. O'Malley follows:]
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Mr. Horn. Well, thank you, Mayor. I think you have given
outstanding thinking and results, and that would be good advice
for every mayor in the country. Hopefully--at your various
national conferences, I would hope that you and some of the
other mayors get that through to your fellow mayors.
As to the FBI, we will certainly be making some
recommendations on that one to the attorney general, because I
know exactly what you're talking about.
Commissioner, it's a great pleasure to have you with us.
And we're delighted to have you. Now, you are in charge of the
city police department. And I take it there is a separate fire
department.
Mr. Norris. Yes, sir.
Mr. Horn. Because I would certainly like--what you know
about the fire department and what they did would be very
helpful in the record.
Mr. Norris. Mr. Chairman, Mr. Ehrlich, members of the
subcommittee, thank you for giving me the chance to talk with
you today.
The subcommittee has heard Mayor O'Malley describe the many
steps being taken to carry out his responsibility for the
overall safety and security of Baltimore. As police
commissioner, I am the individual responsible to the mayor for
preventing criminal actions that could lead to loss of life and
property. I would like to focus on just one area he has
mentioned, the area of collaboration and contact between the
Federal authorities and local law enforcement.
There has been much discussion about the disconnect on
Federal agencies that share responsibility for homeland
security. What has not been discussed is the disconnect between
Federal and local law enforcement.
My main point to you today is that I believe all levels of
law enforcement must do a dramatically better job of collecting
and sharing intelligence. If we don't, the chances are much
greater that terrorists can operate at will and cause even
bigger disasters in our country.
Neither we nor any other local law enforcement agency we
know of has been asked to contribute manpower in any broadly
coordinated way. For example, there are thousands of leads
related not only to the September events, but to the continuing
threats the attorney general has repeatedly warned us about.
Local law enforcement has the manpower to followup on a very-
high-volume of leads. The Federal agencies do not.
For example, the FBI has a total of 11,533 agents. There
are nearly 650,000 police officers in this country. We want to
help, and I think the Nation needs us to help. To prevent other
terrorist incidents, pressure needs to be brought to bear on
anyone who may be planning any attacks.
Local law enforcement, not Federal agencies, are in daily
contact with literally millions of people every day. The NYPD,
the department where I spent most of my career, and the last
year as a deputy commissioner in charge of operations, has over
10 million documented interactions with citizens. Those include
arrests, citations, field interviews, stop-and-frisk. They
don't include the millions of other discussions officers
routinely have with citizens.
We deal on a daily basis with network of registered
informants. We can debrief prisoners about suspicious
activities that may be terrorist in nature at the same time we
debrief them about traditional crimes. But we have to know what
the FBI knows about threats, tips and even just rumors. We have
to know more about what there is to look for in our own
communities, so we can protect our own people and be more
effective gatherers of intelligence for the FBI.
While the FBI has done nothing to prevent us from doing
this work on our own, they have given us nothing but a watch
list to go on. In the week after the attack, the watch list had
names, few dates of birth, no addresses, no place of
employment, no physical descriptions and no photographs. By
Friday of the same week, we got a revised list which contained
more information, but still no pictures.
I do not understand this. When someone commits a murder,
rape, robbery, you plaster his picture all over police stations
and, whenever possible, in the media to help locate the
individual before he commits a crime. Now we're looking for
murderers of thousands who may become the murderers of
millions. Why aren't we all working together to find the people
the FBI is looking for?
In short, I think the rules of engagement for law
enforcement have changed forever inside this country. It may
have once made sense for Federal agencies to withhold from
local police their information about developing cases. Today,
we all need each other if we as a nation are going to
successfully counter threats that can come from virtually
anywhere, at any time, in any form, including those that could
destroy whole cities.
To prevent recurrences of terrorism which could drive this
Nation to panic and economic collapse, I believe we must do the
following. Federal agencies must share all locally relevant
information with the nearly 650,000 State and local police
officers who could be helping them today, but who for the most
part are not. Police chiefs should receive regular briefings on
even highly classified information to help those chiefs better
direct their own internal intelligence and counterterrorist
efforts.
The Communications Assistance for Law Enforcement Act
[CALEA], which was passed in 1994, but has never been fully
implemented, must be enforced. CALEA requires telephone
companies to ensure their systems and networks can accommodate
Federal, State and local wiretaps in the face of changing
telephone technology. Right now, we can't intercept certain
digital telephone technologies, and that is keeping all of us
dangerously in the dark.
In short, we must do all in our collective power not only
to locate the collaborators of last month's hijackers, but also
to deter all terrorists from operating against our still-
vulnerable transportation systems infrastructure and people. I
think the threat is so great that we should have every police
officer in the America in this fight.
Like hundreds of firefighters in New York, my fellow
officers at the NYPD showed their willingness to give their
lives to save others. My officers in Baltimore are ready to do
the same. I think we must be allowed to help. I believe the
life of the Nation may depend upon it.
Mr. Horn. Thank you very much, Commissioner.
[The prepared statement of Mr. Norris follows:]
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Mr. Horn. We're going to go through the next three and then
one more, and then we'll go into Q&A.
Mr. Lynch is the Emergency Management Director, Shawnee
City and Pottawatomie County, OK, former Emergency Management
Director, Oklahoma County, OK.
So, Mr. Lynch, we're delighted to have you here. You went
through the experience of the Federal building that was wiped
out there.
Mr. Lynch. Thank you, Mr. Chairman, and to Ranking Member
Schakowsky, to the other honorable members of this committee,
it is a great pleasure for me to come before you today to
discuss the preparedness efforts for chemical and biological
terrorist attacks in our country.
First, let me say that all Oklahomans, but especially my
fellow emergency managers and allied emergency services
personnel extend our deepest compassion and prayers to the
emergency workers, victims, family members and citizens of
those communities affected by the attacks on September 11,
2001. Every emergency worker in Oklahoma was ready to come to
the aid of those communities impacted to repay in some way the
support that you gave us in the Murrah Building incident.
While we wanted to respond physically, we knew that our
presence would create an unnecessary logistical burden on the
community. Therefore, we have sent our support financially,
spiritually and emotionally to our brothers and sisters in New
York, Pennsylvania and Virginia. We shall continue to do so as
long as there is a need. We will always remember the heroism
displayed in those communities.
I think it's important to point out, as my colleagues on
the panel have done, that a lot of work has been done in the
last 6 years to prepare our communities. Among those activities
are, State and local emergency operations plans have been
modified to include terrorism preparedness activities and
mirror the Federal response plan.
No. 2, State and local emergency exercises have been
changed to incorporate response forces working in and around
terrorist activities.
No. 3, national, regional, State and local training
programs have been created which integrate personnel from all
levels of government into private sector and voluntary agencies
active in disasters.
And No. 4, communities have received limited Federal and
State support for equipment to use in response to these
terrorist events.
The Nunn-Lugar-Domenici Act was a good starting point.
However, somewhere along the way, the good intentions got
slightly skewed under the Federal bureaucracy. Both Oklahoma
City and Tulsa, OK, were on the list of the 120 cities to
receive this training. In my capacity at the time, I
participated in activities for both communities.
The actual training itself was outstanding. It was
relevant, it was useful. However, getting there was
inefficient. There were a lot of meetings that were held prior
to the actual training itself. In fact, when it came down to
doing the training and providing the equipment caches, what was
promised was not delivered. I think probably that's because the
money went toward meetings instead of toward actual training
programs.
All the quality training in the world, Mr. Chairman, as you
have heard from everybody here, all the plans that are prepared
are not valuable if you don't have the tools you've trained on
to respond with, and if you don't have the capability to
sustain and augment that training.
Both Oklahoma City and Tulsa were kind enough to include
their neighboring Federal, State and local jurisdictions in the
training programs. This not only helped spread the training to
additional communities, but it helped foster teamwork and
continuity of operations across jurisdictional boundaries.
Additionally, the FBI, the Federal Emergency Management
Agency, the U.S. Public Health Service have all sponsored
outstanding training programs that have helped communities
achieve a higher-level of preparedness. Most of these programs
have been open to participants from all disciplines.
However, we need more equipment. I cannot emphasize this
enough. While Nunn-Lugar-Domenici provided some minimal
equipment and prior hazardous materials training encouraged
larger communities to equip firefighters to respond to
potential chemical emergencies, many communities across this
country, and particularly in the heartland, simply do not have
all of the equipment that would be needed in a chemical or
biological attack.
I have proposed the following recommendations: No. 1,
funding for assistance to the firefighters program of the
Federal Emergency Management Agency should be at least doubled
for fiscal year 2002, and increased reauthorization for Federal
fiscal years 2003 through 2007 of at least $1 billion per year
should be passed.
No. 2, more pharmaceuticals are needed to be stockpiled.
The current stockpile maintained by the Department of Health
and Human Services is dangerously insufficient to handle more
than two simultaneous events. Local communities need to be able
to readily access these equipment caches within their
jurisdiction. We can't wait for 8 hours or more for a supply to
be flown in.
And the capability has to be developed at the local level.
While there is great technical expertise at the Federal level,
waits of up to 6 hours for a technical support team will not
make it in those critical first few hours. So we have to
develop this capability across our country.
In summary, Mr. Chairman, I believe that our communities
should not be characterized in terms of gloom and doom. We have
done a lot to help; the Federal and State governments have done
a lot to develop emergency management systems. Likewise, the
situation should not be characterized as shipshape.
While the foundation has been laid, now is the time to
buildupon that foundation. The recommendations I have mentioned
in this testimony and in my written prepared remarks I believe
will guide us on a proper path to enhancing our preparedness
and serving our citizens.
We recognize that true emergency management requires a
partnership between the Federal, State and local governments,
business and industry, individuals and families, and voluntary
organizations active in disaster. While we at the local level
are ready to do all that we can to support the war against
terrorism, we stand firmly behind the President and the
Congress and we eagerly anticipate your assistance in this war.
I thank you for your willingness to investigate this matter
and to help us with the task ahead. I thank you for the
opportunity to address this committee.
Mr. Horn. Well, thank you very much, Mr. Lynch. We'll look
forward to you in the question period.
[The prepared statement of Mr. Lynch follows:]
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Mr. Horn. We now have the Honorable Diana Bonta, the
director of the department of health services for the State of
California. Before that she was director of the city of Long
Beach's excellent health services, which is very rare for most
cities in America.
So, Dr. Bonta.
Dr. Bonta. Good morning, Mr. Chairman and members. Thank
you very much for the opportunity to be here this morning.
In addition to serving as director of the California
Department of Health Services, I am the immediate past chair of
the executive board of the American Public Health Association
as well.
And thank you very much, Congressman Horn, for your ongoing
support of local public health programs.
Since the tragic events of September 11th, national
security has been become our national concern. In California,
Governor Gray Davis has led the creation of the California
Antiterrorism Center, which will enable all law enforcement
agencies to share information on terrorist threats and
activities.
Additionally, the Governor's Office of Emergency Services
coordinates and responds to all types of hazards, including a
biological or chemical terrorism event. OES facilitates and
coordinates statewide efforts in planning and response by
bringing together Federal, State, local, nonprofit
organizations and key infrastructure officials through various
forums, such as the State Strategic Committee on Terrorism and
the Threat Assessment Committee of which the Department of
Health Services is a member.
Also note, Governor Gray Davis has mobilized the California
National Guard now to increase security at key airports.
In the aftermath of the terrorist attacks, there has been
heightened awareness of potential biological and chemical
threats to our communities; and many have asked, ``Is the
Nation prepared for a biological or chemical attack?'' If such
a horrific event were to occur, the safety certainly of every
man, woman and child would depend on the public health system.
This system must remain strong.
Traditional public health activities have focused on
preventing the spread of communicable diseases and ensuring the
safety of the air that we breathe, the water that we drink and
the food that we eat. More recently, public health efforts have
expanded to include disease prevention activities to promote
healthier lives. It's a big job and it has been done very well.
Now, in addition to all of our other responsibilities, the
public health system is faced with the intentional spread of
disease. Public health resources would be significantly
challenged following a biological or chemical attack.
In recent years, public health systems in the Nation's
largest cities have become more involved in terrorism planning
and preparedness use funds appropriated by Congress. Under this
program, the Nation's 120 largest cities, including 18 in
California, have received funds for training, exercises and
equipment to enhance their capability to respond to incidents
involving weapons of mass destruction, including biological or
chemical terrorism. The program trains first responders, the
firefighters, police, emergency management teams and medical
personnel who will be on the front lines in case of any of
these attacks occur in a U.S. city.
In addition, this effort has been enhanced over the past
several years by funding from the Department of Health and
Human Services, allowing for the development of the
metropolitan medical response system in a dozen California
cities. These funds have provided an essential first step in
developing a coordinated response to bioterrorism that involves
enforcement, law enforcement, public health and the medical
communities.
In 1999, the Centers for Disease Control and Prevention
[CDC], developed the chemical and biological terrorism response
and preparedness program. California and several other States
and large municipalities were awarded 5-year funding to develop
responses and preparedness plans concentrating on five areas,
which I'll summarize as preparedness and planning and readiness
assessment; surveillance and epidemiology capacity; laboratory
capacity, both for biological agents as well as chemical; and
our health alert network/training system. These grants were
intended to ``kick start'' all of this preparedness at both the
State and local health department levels, and California
received $2.5 million per year to develop the program. We were
the only applicant to be funded in all 5 years in the country.
And Los Angeles County, in addition, received $900,000 to
assist them.
Since the start of this program, certainly California has
made great strides in preparation for both biological and
chemical terrorism. I can tell you that we've recently had
training, for instance, in California. Just this week we had
forums that involved hospitals, first responders, public health
individuals, so that we would have additional training.
I'll summarize, then, that we need to continue to
strengthen our systems throughout the State, and first and
foremost, we need additional resources to ensure that the
Federal, State and local public health infrastructure is
strengthened.
Bioterrorism knows no State boundaries. With additional
resources, we would do the following.
We would improve existing surveillance systems at the local
level, especially at the local level.
We would further coordinate State and local planning
activities.
We would provide ongoing technical training for State and
local staff and for the primary care provider community in
recognizing symptoms, treatment protocols and prophylactics
involving bioterrorism agents.
We would conduct response-readiness and risk-assessment of
the public health system through coordinated exercises.
We would expand the laboratory capability in chemical
detection.
We would further develop prevention strategies. Risk-
assessments must be conducted in many areas, such as food
services, food production, nuclear and chemical industries, and
water supply systems. Currently California is developing a
guidance document for growers, food distributors and food
service industry regarding a hazard assessment.
And last we would evaluate the legal and regulatory
statutes to determine whether they provide sufficient authority
for appropriate action during an emergency.
Mr. Chairman, members of the subcommittee, I appreciate
your dedication to protecting the American public from these
terrible threats and the opportunity that you've given me
today. I encourage the subcommittee to do everything possible
to support Federal funding and assist us in these programs at
the State and local level.
Thank you.
Mr. Horn. Thank you.
[The prepared statement of Dr. Bonta follows:]
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Mr. Horn. Now we have Janet Heinrich, who is the director
of Health Care and Public Health Issues, U.S. General
Accounting Office. Again, the General Accounting Office is the
programmatic reviewer for the legislative branch. We're
delighted to have Dr. Heinrich here.
Please proceed.
Dr. Heinrich. Mr. Chairman and members of the subcommittee,
I appreciate the opportunity to be here today to discuss our
ongoing work on public health preparedness for domestic
bioterrorist attack.
Last week we did release a report on Federal research and
preparedness activities related to the public health and
medical consequences of a bioterrorist attack on a civilian
population. I'd like to begin by giving a brief overview of the
findings in our most recent report, and then address weaknesses
in the public health infrastructure that we believe warrant
special attention.
We identified more than 20 Federal departments and agencies
as having a role in preparing for or responding to the public
health and medical consequences after a bioterrorist attack.
These agencies are participating in a variety of activities
from improving the detection of biological agents and
developing new vaccines to managing the national stockpile of
pharmaceuticals.
Coordination of these activities across departments and
agencies is fragmented. Our staff are struggling over there
with a chart that we have prepared that gives examples of
efforts to coordinate these activities at the Federal level as
they existed before the creation of the Office of Homeland
Security.
I won't walk you through the whole chart. Certainly, if you
have questions, we'll try to answer them, but as you can see, a
multitude of agencies have overlapping responsibilities in
various aspects of bioterrorism preparedness. Bringing order to
this picture will be a challenge.
Federal spending on domestic preparedness for terrorist
attacks involving all types of weapons of mass destruction has
risen even 310 percent since fiscal year 1998 to approximately
$1.7 billion in fiscal year 2001. Funding information and
research preparedness on a bioterrorist attack as reported to
us by these Federal agencies generally shows increases from
year to year, but from a generally low level in 1998.
For example, within HHS, CDC's bioterrorism preparedness
and response program first received funding in fiscal year
1999. It's funding has increased from approximately $121
million to about $194 million in fiscal year 2001.
While many of these activities are designed to provide
support for local responders, inadequacies in the public health
infrastructure at the State and local levels may reduce
effectiveness of the overall response effort.
Our work has pointed to weaknesses in three key areas:
Training of health care providers; communication among the
responsible parties; and capacity of hospitals and
laboratories.
Because physicians and nurses and emergency rooms and
private offices will most likely be the first health care
providers to see patients following a bioterrorist attack, they
need training to ensure their ability to make astute
observations of unusual symptoms and patterns and report them
appropriately.
Most physicians and nurses have never seen cases of
diseases such as smallpox or plague, and some by biological
agents initially produce symptoms such as the ones I have
today, of colds, influenza, other common illnesses that are
very much like these other virulent diseases.
In addition, physicians and other providers are currently
underreporting identified cases of diseases to the Infectious
Disease Surveillance Systems.
Because the pathogen used in a biological attack could take
days or weeks to identify, good channels of communication among
the parties involved is absolutely essential to ensure as rapid
a response as is possible.
Once the disease outbreak has been recognized, local health
departments will need to collect information, collaborate
closely with personnel across a variety of agencies, and bring
in needed expertise and resources.
Past experiences with infectious diseases and the response
have revealed a lack of sufficient and secure channels for
sharing information. Our report last year on the initial West
Nile virus outbreak in New York City found that as the public
investigation grew, lines of communication were often unclear
and efforts to keep everyone informed were cumbersome.
We have also heard people speak to the need for laboratory
capacity and hospital capacity. We have seen the patient load
of regular influenza season--patients overtax regular care
facilities and emergency rooms in metropolitan areas are
routinely filled and unable to accept patients in need of
urgent care.
In conclusion, although numerous bioterrorism-related
research and preparedness activities are underway in Federal
agencies, we remain concerned about weaknesses in the public
health and medical preparedness at the State and local levels.
And, Mr. Chairman, members of the committee, I would be
happy to answer any questions.
Mr. Horn. Thank you very much. I am going to have one
individual who has a problem, and it is General Peake, who is
the Surgeon General of the Army. And his presence in the
answering and questioning is very important for going through
the panel that we have just heard.
And so if the clerk can get a chair for the general over
here at the table. We will--OK, general, if you wanted to give
us your presentation. And then we will start with our
colleagues here on the questions.
LTG. Peake. Well, Mr. Chairman, Congresswoman Schakowsky,
distinguished members. On behalf of Dr. Clinton, I thank you
for the invitation to represent military medicine here today.
The military health system really has a long history of
supporting our Nation in time of domestic emergencies. That
ability comes as a byproduct of our readiness to support our
military in the defense of our country and in the protection of
vital interests.
That mission requires active, guard and reserve medical
soldiers trained to standard, prepared to work under austere
and demanding environments, with an understanding of the
spectrum of threats that can be faced on the battlefields of
the world, endemic diseases, trauma, chemical or biological or
nuclear threats.
They train to work as teams in a task-organized manner with
leaders who not only have technical skills, but organizational
and planning skills that come through a progressive development
process. They represent all of the skills of an integrated
health care delivery system. They have equipment that can be
moved as part of a self-sustaining task force and still provide
high-quality and reliable medical care in austere and harsh
conditions.
They have the back-up of world class laboratory support,
access to unique capabilities such as aeromedical isolation
teams, bioprotection for containment facilities, and world-
class medical centers that are integrated through an air
evacuation system that we practice.
The written testimony that has been submitted by Mr.
Duehring describes in some detail the supporting role that we
in the military have to FEMA and the Federal response plan, and
more particularly, to the public health service under Emergency
Support Function 8.
We can smoothly integrate into the incident command
structure that is quite universally accepted in this country.
We can task organize to bring individuals with special
expertise, or teams with special capabilities, preventative
medicine, mental health, facilities engineers or major units
such as a hospital or a medical task force such as we had at
Hurricane Andrew, with medical helicopter evacuation, primary
care, hospitalization, a logistics battalion, a major military
medical command headquarters commanded by a general officer.
That joint task force, civil support, is now a standing
organization that can serve as an integrator of military assets
assigned to include such medical units.
The most important thing that we bring, though, is where I
started. That is the dedicated, trained and motivated soldiers
like the National Guard soldier in New York who walked several
miles from her office to her home, changed into her uniform and
then went to where she knew her unit was supposed to go in
emergencies. She did not have to be called. She was trained,
and she just went. Charlie Company 342nd Forward Support
Battalion New York Guard was part of the immediate set-up for
emergency response because she lived there; she was part of
that community.
The 101 Cav, New York Guard, was the first medical unit
deployed at the disaster site on the 11th. They provided care
to fellow Guardsmen for things like respiratory distress and
eye injuries, keeping the rescue effort going.
And within 11 hours of the incident, one of our new, new
New York Guard civil support teams, under the control of the
Governor, had not only moved from Albany, NY, to New York City,
but had gathered and tested environmental samples from Ground
Zero, coordinated with local, Federal, and State officials, and
were able to deem the site clear of nuclear, chemical, and
biological contaminants. That sure made a positive impact on
those that were working in that ongoing rescue effort.
At the Pentagon, active units were augmented by reserve
units working with the incident commander on the scene.
Sergeant Delgado of the 311th Quartermaster Company from Puerto
Rico was at the Pentagon leading his squad by September 16th,
absolutely professional in the tough duty of recovering
remains.
I am proud of the trained and ready soldiers of all of our
components, their professionalism, honed through training for
support of our wartime fighting mission provides an asset to
augment the local response, the State response, the Federal
response, to chemical or biological attack here at home.
I must tell you that your support of a robust military
medical system is so important to keeping this capability. It
is our direct care system that provides the training platforms
where these soldiers of all components get their initial set of
skills. And it is in that direct care system that skills are
honed and maintained for the active force. And it is in those
research laboratories like these you have already heard
mentioned, USAMRIID, our Institute for Infectious Disease, that
world-class scientists can examine militarily relevant medical
threats which unfortunately now are civil relevant medical
threats. And be available on a moment's notice to support this
Nation.
So I thank you for the chance to be here today and for your
support of military medicine. Thank you, sir.
Mr. Horn. Thank you, General.
I would like to know, for the record, in terms of the
military hospitals, have we got compacts in any way where there
would be, say, the FEMA for the State Governor and then the
FEMA--a smaller one--is often there in a county such as Los
Angeles with 10 million people? And Los Angeles County as well
as to have also Los Angeles City, and something like this
happens. And there is veterans hospitals, obviously.
In the case of Washington, you have a very fine hospital
here in the terms of Washington. But we also have a world-class
hospital known as Walter Reed Medical Center.
And then you also have the Navy's Bethesda. Is there
anything we have worked out with the cities, with the counties,
with the States that are adjacent, so forth and would the
military people take in the individual civilians that are
either ill or gassed or whatever?
How are you going to work that out and have you worked that
out?
LTG. Peake. Sir, it works through, as was mentioned,
through the incident command center. So with the Pentagon as an
example, we had our injured taken to many hospitals throughout
the Washington, DC, area. Some went to Walter Reed, some went
to Washington Hospital Center, to Arlington, to Inova and so
forth. They were dispersed by the incident command center and
the emergency support.
Almost every place that we have an installation there is an
integration with the local community in terms of how that
community would plan for dealing with an emergency or a
disaster? I would agree that it varies across the country about
how good that planning is, and there is room for improvement in
that.
But we are always integrated. As you know, under the
Stafford Act, the local installation commander can offer
immediate response while we are waiting for the rest of the
system to kick in.
Mr. Horn. Yeah, as I recall in California in 1906, the
military were there to help on that situation where you had an
earthquake and then fires, and then the gas pipes were broken
and all of that, and the military were there to help on that.
And the civilians, on this recent mess at the Pentagon
where this terrorist knocked out part of a wing, a lot of fire
companies I am sure went to help you.
LTG. Peake. They did, sir. And they were in charge of that
operation and we subordinated ourselves within--I happened to
be on the cell phone with one of my officers en route to the
Pentagon when he saw the plane go in. I was able to contact
Walter Reed. We had surgical teams en route by the time the
smoke was really starting to billow.
But when we got there, the civilian response folks were
there, tremendously professional and we locked ourselves under
them to be a part of the team effort.
Mr. Horn. One of the problems is to get a proper laboratory
to know what is this toxic that is out there. Do we have that
pretty well in terms of your hospital system?
LTG. Peake. Sir, there are a couple of answers to that.
One, this civil support team that I referenced in my remarks
has that kind of capability. And it is a relatively new
capability, and it worked pretty well in this instance.
They are mobile, and they bring that equipment down. At the
Pentagon we brought from the Center for Health Promotion
Preventive Medicine immediately we launched some folks down to
start sampling the air, soil and water in that--in the Pentagon
environment so that we could know what was in the smoke, and
reassure the 22,000 people that work there.
Regarding the laboratory business, we have committed
ourselves to integrate with the CDC's network of laboratories
around the country. We are upgrading the laboratories in our
medical centers, in the six medical centers that the Army has
to link in and be able to do the diagnostics on things like
anthrax and brucellosis and so forth, and do that networked
with the CDC.
Mr. Horn. Well, thank you. If you can stay with us for a
while. I want to yield to the ranking member, Ms. Schakowsky,
the gentlelady from Illinois.
Ms. Schakowsky. Thank you, Mr. Chairman. I would appreciate
the opportunity to make a short statement, and then to ask a
couple of questions.
I really appreciate your holding this hearing today after
the terrible events of September 11th. And the panel that has
been put together, and I am sure the next one as well, is
really excellent.
Over the last couple of years, a national security
subcommittee on which I sit has participated in a number of
hearings on this subject. But none has been more useful or more
meaningful than the one that we have heard today with the
witnesses that we have had the honor of hearing so far.
We have heard time and time again from experts in GAO and
HHS and elsewhere that we need a comprehensive threat and risk-
assessment for chemical and biological attacks.
Through this hearing today, we are developing a much
clearer understanding of the strengths and weaknesses of our
defenses. It is my desire that we reach an understanding that
both reassures the public that they are safe and provides us
clear guidance of the appropriate Federal role in responding to
the chemical and biological threats that may exist.
Earlier this week, the Secretary of Health and Human
Services assured the public that our country was, in fact,
prepared for any threat to our Nation's health. But, I am not
sure that I share his confidence.
As some of our witnesses have explained, our public health
system, good as it is, could have difficulty responding to a
significant biological or chemical attack, not to mention even
a major flu-like outbreak.
The capacity of our public and private hospitals is
strained each year during flu season. A disaster with 10,000
injuries that requires hospitalization could be very difficult
for that system to handle. We must question whether our system
could handle such a situation.
The front lines in most disasters as we have heard so
eloquently today, and I thank Dr. Smithson and Mayor O'Malley
and all of the other witnesses for pointing this out so
poignantly, is local government and local health care providers
as well as State.
We see this again and again as towns and cities are struck
by hurricanes, tornados and even disasters like we saw last
month. The first there to tend to those in need are the local
firemen, police officers, emergency medical personnel.
Any response we develop now as you have said as our
witnesses must keep that fact in mind. Training and
communications are key to disaster response and should be a
major part of our planning and investment. We heard you.
The majority of that investment should be made at the State
or local level with an appropriate level of coordination and
assistance from the Federal Government.
Past experience has also shown that the public health
system is the second line of response. Once the disaster scene
is surveyed, the injured are moved to hospitals, it is often
the case that the hospital capacity is reduced by the same
disaster.
We have taken our public health system for granted for some
time now. It has suffered as a result. Community cooperation is
the third line of response. Once the level of damage is
assessed, those hardest hit will have to call upon their
neighbors for assistance. As we saw after the events of
September 11th, every one wants to help.
We need to develop a network of community organizations,
much like that under development by the Office of Emergency
Preparedness at HHS. The goal is to provide every community
with the preparation and resources to respond to a disaster.
Those are just some of the many critical issues that we will
need to assess, and many others you outlined for us today as we
move to improve the emergency response infrastructure in this
country so we are able to address the current shortfalls and
the possibility of future threats to our health and security.
I would really appreciate being able to ask a few
questions, Mr. Chairman. I want to make sure, Dr. Smithson, I
heard you clearly. Were you saying in terms of crop dusters,
because there was some evidence that one of the terrorists at
least was looking into the use of crop dusters that the
particles that would be distributed really are too big to cause
any kind of health risk?
Dr. Smithson. Yes. You have got me exactly right. This is a
very closed community. There are small businesses. One of the
things that isn't being discussed today is really the fact that
Atta didn't even get a peek inside the cockpit. These are
people that are required to have a 1-year apprenticeship just
to learn how to fly these things and operate the sprayers
behind them. And the sprayers would be suitable for chemical
agent dispersal, I won't joke with you about that.
But for biological agent dispersal, you would have to go in
there and change everything around. You can't even dial them
down to the particle size required, very, very small particle
size required for effective biological agent dispersal.
Ms. Schakowsky. But it can be useful for some sort of
chemical?
Dr. Smithson. That is what crop dusters do. But again, if
you just fly low a regular light aircraft, and the assumption
is that somebody is going to jump into one of these things and
get it successfully off the ground, it would be the difference
between driving a little Miata sports car and driving a couple
of 18-wheelers hitched together fully loaded. Things handle
differently.
And there is no assurance that they will crash, but they
are not going to be able to operate these things automatically
and cause the havoc that seems to believe the assumption
working in press circles today.
Ms. Schakowsky. No, but if they were able to get the
training and were to load it with some sort of deadly chemical,
and then fly it over some of--a densely populated area, it
could, in fact, be a problem; is that not true?
Dr. Smithson. I would agree with you in that, but again the
assumption is that it would be effective. In cities, there is
micrometeorology that is going to come into play.
These crop duster pilots are trained to go way down and lay
something right on the Earth and be effective in what they do.
We are making several leaps of logic right now, and everything
appears to be very frightening. I would encourage you, just as
I have done, to spend time with people who have actually made
these weapons so that you understand how technically difficult
it is, with people who actually fly crop dusters so that you
have an appreciation about this.
One of the things that is happening in this country is our
citizens are getting their wits scared out of them by what they
are hearing over the airwaves, often from people that don't
seem to know their technical stuff.
Ms. Schakowsky. You did mention hazardous chemical
facilities? Have you looked at all into nuclear power plants as
a potential danger for a terrorist attack?
Dr. Smithson. No, ma'am. My jurisdiction is chemical and
biological. However, in the survey of 33 cities that I took,
talking with individuals just like this; the locals are very
aware, in fact, I defy you to find a HAZMAT captain who does
not know off the top of his or her head how many of these
facilities are in their communities. In most of the locations
where I went, they had already a great appreciation of what
these facilities were in terms of a danger to their citizens.
Listen, the chemical industry takes the security of these
sites very seriously. But so do the local responders around
them. And in many cases, they have already begun working with
these facilities and other locations like sporting arenas and
major buildings, landmarks, to enhance the security of those
sites.
So there are things that are happening across this country
in spots that will definitely protect Americans. What needs to
be done here in the mindset that needs to be adjusted inside
the Beltway, is that the preparation needs to be nationwide.
And that you need to institutionalize the training, not
just train here and there. The Federal Government's role is mid
to long-term recovery assistance, not rescue. Because right now
you cannot fit any more rescuers on top of the rubble pile in
New York City.
If you threw every Federal asset at it, it just wouldn't
work.
Ms. Schakowsky. Then finally, speaking of Federal assets.
All of you have spoken about the need for Federal assistance at
the State and local level. If we were with--with our finite
resources to put--to make a Federal investment, what would you
think is the most important thing? Let me just kind of--if we
can quickly go down the panel--the most important investment
that we could make to guarantee the safety of our citizens
against chemical and biological threats.
Mr. Horn. We are going to be three amendments to these
questions.
Dr. Smithson. Institutionalization of the training in the
Nation's fire academies, police academies, medical and nursing
schools as well as in public health training. That is the only
way you are going to raise the standard of readiness and
preparedness across this country.
Mr. O'Malley. I mentioned before, yes, about Federal
dollars. It is going to take Federal dollars. I really still do
believe that for all of the other things we are talking about,
that the disconnect in criminal intelligence is the biggest
threat right now and the most dangerous one.
But I would piggyback on that just to add that protective
equipment and the additional vaccinations and stockpiles
around.
Mr. Norris. I agree with everything. Preventative
equipment, stockpiles of vaccinations, but I can't stress
enough that all of these things are carried out by human
beings. What is missing right now is human intelligence. While
these things are very, very important to mitigate once a
disaster strikes, I think we need to just as seriously take the
intervention before they strike and be tracking down the people
that are trying to deliver whatever may come in this country.
And that is really lacking.
I think most of the discussion I have heard at the top
levels regarding equipment, the biochem. threats, nuclear
threats and the like, the choice of terrorists around the world
is still bullets and bombs. The World Trade Center was done
with a very low-tech operation and we seem to be losing sight
of that.
We are missing human intelligence and we need much more
coordination with our Federal counterparts to arrest the people
out there right now who have been in this country for over a
decade preparing to do this.
Mr. Horn. Let me add to that, and that is, some people are
out getting gas masks and all of the rest of it. It has
happened in Israel sometimes. But also there have been deaths
when the individual didn't pull the cord for oxygen. What is
your advice on that.
Mr. Norris. Very important. Just as the mayor was saying,
one of the most important things is to be prepared when an
attack occurs because a lot--Dr. Smithson said it best. People
are being terrified. If air raid sirens go off in cities around
America and people start to leave their homes when in fact
maybe they should stay in place and things like that, people
are buying gas masks, gas masks, well, we have them, police
departments and fire departments. They have to be tested to
OSHA specifications for seal.
You could put on a gas mask and still get killed if you run
out the door, because they don't fit properly. And people are
misleading themselves giving them some sense of comfort. But
representing my city as the police chief, I still say we need
to intervene in these acts before they occur.
You concentrate as much of our efforts that way as you are
to the rescue efforts afterwards.
Mr. O'Malley. I can tell you that all 36 of the gas masks
on stock in stores in the Baltimore area have sold out
immediately, and none of them would do much good anyway when it
comes to a biological attack.
Dr. Smithson. This is one of the aspects of the aftermath
of September 11th that has saddened me the most. Americans have
rushed to do things that they think will serve their interests,
when in fact that may not be the case. If this gas mask that
you purchased is not fitted, and if you are not instructed in
how to use it and understand the changing of the canisters and
how to make sure that it fits when you are running, then you
have bought yourself some false protection.
Let us use common sense. If you do see a crop duster
overhead, get inside, shut the windows, shut the doors and you
will have provided ample protection for yourself. If you are
still nervous about it, go jump into a shower. Ask fire folks.
One of the most effective decontaminants is water.
In terms of stockpiling antibiotics, I am sure that Scott
Lillibridge will touch on this in just few minutes. That is
also false security. It could backfire on Americans.
If they start self-medicating themselves with the first
dose--in the case of the sniffles that they get, the after
affects could be that the medications won't work for them later
when they really, truly need them.
So, I know Scott will get to this, too. I hope that
America's physicians will get better educated on what is
happening in the country and stop writing prescriptions right
now.
Mr. Horn. Would any others like to respond?
Ms. Schakowsky. Any others want to respond? I also wanted
to thank Mrs. McHale for that very dramatic testimony and
sharing that information and to say how happy I am. I was
waiting to hear about your child being born healthy.
Dr. Bonta. Mr. Chairman, I would like to address a question
if I can. It is really difficult to pinpoint down the one
single actual thing that if we had to eliminate it to just one,
because all of the suggestions that have been here are good and
we all have ideas that we think are important.
But if I had to narrow it down, I would say making sure
that we get the right equipment for response into the hands of
the local first responders. It is imperative that we have that.
We have to have good communications equipment. We have to have
good detection of surveillance equipment. We have to have good
personal protective equipment for those folks too if we expect
them to be able to do their job.
Mr. Horn. Let me ask one question before I turn to Mr.
Cummings. That is that in the case of Baltimore, what was the
toxin? And did you know how much--when did you first know which
toxin it was, and had those individuals had violated the rules
of the Department of Transportation to note on the storage
there with the toxins so that the firemen going in would know,
particularly under tunnels and so forth?
Tell us a little bit about what was the toxin and were they
terrorists or were they just incidental accidents?
Mr. O'Malley. Well, on your last point we have yet to have
a cause determined by the NTSB. So we don't know what the cause
of it was at this point.
Recently we did arrest a person of Middle Eastern descent
coming out of the tunnel with camera equipment and a knapsack
and a hood. And whether that person was a probe or a kid that
didn't get enough love from his dad early in life or what that
was, we don't know.
But when this incident actually broke out and a fire was
happening inside this tunnel, keep in mind this tunnel, it was
built in the 1890's. It bankrupted the B&O Railroad. It was
their last and greatest public works project. It is almost like
a mile and a quarter-long brick oven with two entrances. We
found a third one only because of memory.
So we knew right away from the manifest what was on the
train. You can't be 100 percent sure that the people recording
it on the manifest didn't make a mistake. So you really don't
know what you are dealing with until you get inside and the
order of things.
And the other curious thing was that although we knew what
was on the train, without being able to get up inside the
tunnel, we couldn't tell you where the fire was on the train.
In retrospect, we were fortunate in that the people
assembling the train had indeed put buffers between some of the
chemical cars so that there was not a chain reaction. I mean,
there was, of course, a chain reaction in that the chemical
fire was adjacent to a car containing trash and garbage and
packed paper, so there was a reaction, but not the sort of
combustible reaction there would have been had all of the
chemicals been tied together.
I forget, the one that actually exploded was. And that was
the one that had caused the fire. It ruptured an adjacent car
that had hydrochloric acid in it. That basically ran out,
diluted or was burned. The other car whose polysyllabic
chemical name escapes me at this time, ``methylethylbadstuff''
we will say for the sake of this hearing, was fortunately at
the other end of the car. And our great fear--it was some sort
of a chlorine agent. Our fear was that would rupture, that
would somehow be in gaseous form and become a deadly gas.
And that was fortunately at the other end. There has been
an uncoupling of the cars, so the cars that had jumped off the
rail where the fire happened, you know, kind of came to a rest
quickly. The other half of the car continued to roll a little
bit on the back of the engine and so there was a separation of
space.
But, keep in mind, when all of these suckers were pulled
out of that tunnel late at night in front of our fire
department and a very nervous mayor at about 2 a.m., they were
all charred and looked like a bunch of hot-dogs being pulled
out of a fire.
So I am sorry, I can't tell you exactly what the bad one
was. But it was some sort of chlorine agent.
Mr. Horn. What is the situation of that particular tunnel
or whatever?
Mr. O'Malley. Not unlike other tunnels, including one--you
know, not unlike other tunnels in cities up and down the East
Coast or rail yards or the tracks that go through them, those
tracks are very much open. They are open to pedestrians. I
mean, fortunately, thanks to Commissioner Norris and our
assessment of vulnerabilities, the reason we apprehended the
individual coming out of that tunnel was because we were
keeping an eye on that tunnel and had additional security, had
spoken to CSX.
But there is very little security around any of these rail
yards. While it is true, as the doctor said, that the chemical
companies take the security of their chemicals very seriously,
they take it so seriously that most of the dangerous tankers
are left out open on the yard instead of coming inside their
plant, inside the chained gates. So this is a serious
vulnerability for a lot of cities, Baltimore, Philadelphia and
many other--industrial cities along the corridor.
We have identified it. Obviously, it is going to cost a bit
of money to do the proper fencing, to do security cameras. The
gentleman from the train company, as I asked him about great,
simply security measures like that, said we have 23,000 miles
of track in the United States, to which I answered, I am sure
you do. And which percentage of that track runs through
America's 20 largest population centers?
Mr. Horn. We thank you very much.
And now I want to yield 3 minutes to the gentleman from
Maryland, Mr. Cummings.
Mr. Cummings. Thank you very much, Mr. Chairman, for your
courtesy. And I certainly am very pleased to welcome the mayor
of Baltimore, Mayor O'Malley, and certainly our police
commissioner.
Mr. Chairman, Mayor O'Malley has done an outstanding job. I
think his testimony today indicates that Baltimore is as
prepared as we can be, and we can always use some help. And I
think the mayor would agree with me on that. We can use
resources, as we debate in the Congress about how we are doing,
with these pocketbooks open and dealing with these emergency
circumstances, I think it is very important that we keep in
mind, that as Mayor O'Malley has said, we are indeed on the
frontline of this.
Mr. Chairman, one of the things that I find so interesting,
coming from our police commissioner, Commissioner Norris, who,
too, is doing an outstanding job in our city, and the crime
rate has gone down dramatically, it is shocking to the
conscience that the cooperation that he talked, a lack of
cooperation between our Federal agencies and our local police.
And, you know, when we think about all that we have heard,
and all of the concerns that we have heard in the news media
about how the FBI, DEA and all of the other Federal agencies,
CIA, trying to track down the criminal element, the terrorists
involved in this matter, and to not be working closely with our
local police is very--I mean it should concern every single
American who may be listening to this.
And so one of the things that we will do, Mr. Chairman, and
the committee, subcommittee of this committee which I rank on,
Criminal Justice, is I have asked Chairman Souder, and I hope
that you will help me with this, to convene a subcommittee
hearing or with the chairman of our overall committee,
Congressman Burton, to ask the FBI to ask the other agencies,
Federal Government law enforcement-type agencies, why don't
people like Commissioner Norris have the kind of cooperation
that he wants to have?
And so I think that while we have got great police and we
saw it in New York, and we see it all over the country, people
work every day, they knew their territories, just like
Commissioner Norris said, they knew the people, they know every
square inch of their cities, it seems logical to me that we
would try to have that maximum cooperation.
Finally let me say this. I think that when, as I have
listened today, I hope that we understand--it sounds like when
I listen to the mayor, what he is basically saying is, look,
you know, let us not put a blinder up to our eyes and then
listening to Dr. Smithson, let us not put a blinder up to our
eyes and act like one thing is going on, when actually it is
another.
And let's be practical and deal with these things. And I
think that is what--I hope that we in the Congress will listen
to them very carefully, because what they bring to us are the
practical--first of all, the information that is accurate, and
then the practical solutions to the problem so that we will not
be fooled.
Americans, I think, after September 11th, they thought that
they had a level of security, which we quickly found out that
we didn't. So the kinds of things that are coming forth today,
Mr. Chairman, again, I thank you. It is the kind of information
that we need to address the problems that we are confronting.
Again, I thank you for your courtesy.
Mr. Horn. I thank the gentleman. And as I said earlier
today, Mrs. Maloney, the gentlewoman from New York has helped
us on this, as many other things. And so I now yield 3 minutes.
We are going to just have to keep going, because we want the
second-tier to come and we would love you to have your role
after you hear some of the second-tier.
So, Mrs. Maloney.
Mrs. Maloney. First of all, I want to thank all of the
panelists, particular to welcome my friend, Mayor O'Malley,
with whom I have had an opportunity to work on other important
issues before this Congress.
I agree very much with the theme that many of you have put
forward that all emergencies are local and the number of lives
that will be saved is very much due to a local response. In New
York it was New York's bravest and finest that were the first
at the scene.
And on Monday, when I was at Ground Zero, it was still fire
that was in charge of the scene. Yesterday, a member of what we
call in New York the ``Bucket Brigade,'' was in my office. This
is the group of volunteers that supported the fire in removing
debris by hand in buckets trying to look for lives.
And they told me that even when there was a notice to
evacuate, because they were afraid a building was going to
fall, that the firefighters and officers refused to leave the
site. They kept looking, trying to save people and responding.
To me they are the greatest heros in our country.
Later today we will be authorizing the intelligence
committee. And I will certainly be bringing to the floor in my
statements the items that you brought on better coordination.
We definitely need to invest and strengthen our intelligence.
I would like to ask about smallpox. Many people who are
experts in this have told me that there is a universal
agreement that the smallpox virus is the single most dangerous
raw material for a non-nuclear terror attack. One expert said
it is almost like a smallpox and then everything else.
We eradicated it in 1978. It is supposed to exist, the
virus, in two places, the CDC in Atlanta and in Russia. But I
am told by some experts that they believe that many of these
smaller countries have the smallpox virus. We know that it
could kill, or in the past has killed up to a third of those
infected. And the World Health Organization is trying to speed
up responses.
Our own government has roughly 15 million doses of smallpox
vaccine; has ordered 40 million more for delivery by the end of
the year 2004. Many of my constituents in New York have called
my office and asked for the smallpox vaccine.
I have called the National Institute of Health. They have
told me that it is not available. Many experts believe that it
is a threat. Russia apparently developed weapons that could put
the virus on the tip of it and send it to our country.
And we have not really had a great control of some of their
weapons after the cold war. I would like to ask some of our
experts whether you think we should be developing more vaccine?
Should our citizens have access to it? Even though we don't
have enough for everyone, shouldn't some of the people that are
asking for it be able to have access to it?
As a child, I was vaccinated, but I am told that anyone who
was vaccinated many years ago is no longer covered or immune to
a smallpox virus. I would like anyone on the panel who would
like to comment on what we should be doing. Should we be
developing more vaccine? Should we be distributing it? What
should we be doing?
Dr. Smithson. A few years ago, I spent several weeks in the
former Soviet Union interviewing the weaponeers who did this,
who figured out how to turn diseases into weapons of war. And
the Soviet Union did that with over 50 diseases, including
Marburg. It is true. They did weaponize smallpox. They
manufactured tons of it, along with plague and anthrax.
And they put it on top of ICBM's aimed at Western
populations centers. I think it would be foolhardy to assume
that smallpox seed cultures only exist in one place in the
former Soviet weapons complex, which consists of over 50
centers that were involved in the research, development testing
and production of these weapons.
However, when I talked with the weaponeers there was one
thing that they understood very clearly. Terrorists, they kept
on telling me, are our common enemies, because Moscow has had
its own encounter with terrorism.
Also, before that even happened, Aum Shinrikyo, the cult in
Japan, had knocked on the National Health Institute doors for
both chemical and biological weapons knowledge. I don't want to
feed you a line here. I did interview weaponeers who knew
colleagues who had gone to help Iraq and Iran and China and
North Korea.
They had been invited to teach. But let us not make the
assumption that is not all that they did. Let us also not make
the assumption that these governments would automatically share
something like smallpox with a terrorist group, because if it
is anything that a weaponeer understands, it is the
consequences of unleashing something like that on a population,
even if it is the population of your enemy. Because that is
something that goes around the world and would be very, very
difficult to contain.
Let us also not make the assumption that smallpox is for
sale on the streets of Moscow or any other place. In today's
environment, there are so many rumors that are floating around.
If I were to give you a remark on the other aspect of your
question, it would be that if anybody should be getting
smallpox vaccines in an emergency; it has to be the very people
who are going to be there. We are expecting them to save our
lives.
The medical personnel, both in hospitals and the paramedics
and other technicians as well as the firefighters and police.
Mrs. Maloney. Should we be vaccinating them now, in your
opinion?
Dr. Smithson. I think I will leave that judgment call to
others. It is not for me to advocate that. I don't feel that
there is imminent danger that smallpox is going to be released
on this country. I think before we go doing a lot of knee-jerk
things, this is an atmosphere that breeds knee-jerk reaction,
we need to carefully think through these matters.
And, by the way, I agree with what Governor--excuse me, I
just promoted you, Mayor O'Malley said----
Mr. O'Malley. Thank you. I accept your nomination.
Dr. Smithson [continuing]. With what Mayor O'Malley said.
It is not just the frontline personnel, it is also their
families, because they have to be assured that their family is
going to be OK if something bad happens.
Mr. O'Malley. I think the long-term issue of prophylaxing
your emergency responders, though, it is just that--it is
slightly longer-term issue, but it is a very important issue.
We assume that when the calls go out, everybody goes and they
do their duty. And we have seen the courage. And many and most
probably will. But ask people to--in these sorts of things, to
leave their families behind is a tough thing to ask human
beings to do in these times of emergency.
But I would think that given the level of vaccinations that
we currently have, that go doing them all over the country in a
knee-jerk way would not be a wise use of the limited vaccines
we have on smallpox.
Dr. Smithson. Right. The thing is, we need to assure these
people now what the priorities are going to be, that they would
be the first to receive these medications, simply because they
will have to save us.
Mrs. Maloney. Can I ask one brief show of hands on one
brief question, Mr. Chairman.
Mr. Horn. Yes.
Mrs. Maloney. I would like a show of hands, because we have
to get on to other people, as the chairman said, of how many
people agree with Secretary Thompson's statement that he stated
on 60 Minutes on Sunday? ``We are prepared to take care of any
contingency, any consequence that develops for any kind of
bioterrorism attack.''
Do you agree with this statement of being prepared? Raise
your hand if you agree you are prepared for all of this.
Raise your hand if you think we are not prepared.
Mr. Horn. Well, wait a minute.
Mr. O'Malley. I think it is all a matter of degrees. I
don't think that we are prepared for many, many things. And I
think, depending on the degree of it, we would quickly find
that preparation outstripped by about----
Mr. Horn. I remember where the previous administration had
warehouses all over the place on the flu and nobody ever used
them. And that is why we need doctors to know, and chemists to
know if any of this is--otherwise, I don't believe in sort of
scaring the living daylights out of people. Because--I would
like Ms. Bonta to respond.
Dr. Bonta. I think it is dependent upon degrees. Because
certainly we have experience in the United States where some
local public health departments are still in buildings that
were made for the polio epidemic.
In 1988 when I was with the city of Long Beach, we were in
just such a building. We had a rotary telephone and we had two
computers that staff were even not fully trained in how to use.
We have moved a long way throughout the country, and certainly
in California we have the advantage of having years and years
of preparing for earthquake preparedness and other natural
disasters. But this is a unique situation in which we need more
work on communication, on training, on laboratory preparedness
and having disease surveillance and epidemiology.
LTG. Peake. I would just say, ma'am, you know, I am a doc.
And so you are the one doc in the ER, and three or four people
come in, that is a mass casualty. It is a matter of degree. And
the issue is having the systems back-up that can pull the
things together where you need it, when you need it, to be able
to make that response.
And I think that has sort of been a consistent theme as I
have heard here.
Mr. Horn. Thank you. And we thank you. And our last
questioning goes to Mr. Kanjorski, the gentleman from
Pennsylvania, 3 minutes.
Mr. Kanjorski. Thank you very much, Mr. Chairman.
I want to make a few observations to the panel, because I
have been sort of monitoring the channels over the last several
weeks on television. It seems that if anybody has written a
book lately, in the extreme has been a guest. And they make all
of those proposals. And then I have been talking to
constituents that have a legitimate reason to try and make an
analysis and a judgment of how they should carry on their daily
lives.
And what I am most interested in is the lack of our system
for having a central clearinghouse operation to adequately
inform people as to what the risks and various categories are,
some--what the symptomologies are and what disadvantages of
taking proactive action.
One member of the health community made a great point the
other day. Vaccines, for instance, have a percentage of
detrimental effects on society. If you were to inoculate the
entire country, even though it may be one half percent a
negative effect, you are talking about a million and a half
people that may suffer irreparable injury as a result of just
taking the shot itself.
A lot of people aren't aware of that. They think that it is
a sure cure. The other things that they aren't aware of is the
difficulty of delivering the longevity of life of some of those
biotechnology methodologies that would be used in germ warfare
and also in gas warfare; what the chances are of getting the
proper nozzles on a crop duster.
I guess what I am most interested in, and the observation I
would make over the last 3 weeks, is that we in government and
in leadership have a tendency to underestimate the intelligence
and rationale of the American people. They don't want, even the
Secretary of HHS, to come out and make a pronouncement. They
want to know the basis on which his pronouncement was made so
they can analyze in their own mind what their chances of having
an exposure would be.
In order to bring the level of that type of understanding
up, are you aware of anything that we are doing to create a
national institute of reliability, if you will, for this
information, whether it be on the Internet, should we do it in
the national broadcast--what is the educational factor here?
Because we just have entirely too many people that are in a
State of anxiety that shouldn't be there, are giving up their
normal course of life and business and having a major impact on
our economy and other things.
I just came from a session, Mr. Chairman, where we talk
about security. And after we got to $25 or $30 billion in
expenses of changing railroad lines and doing all kinds of
things, which are probably intelligent things to do, I realized
that we could on our way to spending ourselves into bankruptcy
in trying to take care of every contingency that could happen
knowing fully well, the open country that we are, we can't
accomplish that.
So do you have any ideas? I'll just ask the panel: What
could we do to provide a level of intelligence and information
that would meet the needs of the average American who wants to
be informed as to what to do and do away with the rumor mills
that are out there that are paralyzing us?
Mr. O'Malley. Your point is--I think it is an excellent
point. One of things we have tried to do through the conference
of mayors is inform each other and try to encourage well
informed local officials to talk about these things.
We had a teleconference with about 200 cities that chimed
in, and our guests--and the first one was last week. And it was
done with--on bioterrorism, going through the likely agents. I
mentioned the Hopkins Center for Civil Biodefense Studies. It
is www.hopkins-biodefense.org, I think.
And we are going to be doing one next week on chemical
readiness. So it would probably be a good idea to have some
sort of 800 number or something in cities that people could
call. But fortunately, I think the Internet, I think you are
right. I think a lot of Americans are educating themselves.
But we need to do a better job. And I don't think it does
any of us any good to not discuss it. I know there are some
local elected officials who feel like, ``Oh, my goodness, if I
go on camera or talk about this, I might make it worse.''
Indeed if they are uninformed they may make the hysteria
worse. So I think it is incumbent on us locally to get the word
out and do it through our local affiliates.
Mr. Horn. That is very well answered.
I would like to now play musical chairs where the group in
the back, our panel two, and if some of you could stay around,
we would like that.
Let us start here with Scott Lillibridge, special assistant
to Secretary Thompson. Second one is Bruce Baughman, FEMA.
Craig Duehring from the Department of Defense. Mr. Fogg, New
Hampshire Office of Emergency Management. Mark Smith,
Washington Hospital Center, and Kyle Olson, vice president and
senior associate.
We will start with Mr. Scott Lillibridge, M.D., special
assistant to the Secretary for National Security and Emergency
Management Department of Health and Human Services which is
headed by one of the best cabinet members I have ever known,
that is Mr. Thompson. He is on top of it. And I am delighted to
have one of his special assistants here.
So, Mr. Lillibridge, proceed to give us a summary of your
excellent--all of you had wonderful papers, and that
automatically goes in the record. But we would just like to see
an overview from you at this point.
STATEMENTS OF SCOTT R. LILLIBRIDGE, M.D., SPECIAL ASSISTANT TO
THE SECRETARY FOR NATIONAL SECURITY AND EMERGENCY MANAGEMENT,
DEPARTMENT OF HEALTH AND HUMAN SERVICES; BRUCE BAUGHMAN,
DIRECTOR, PLANNING AND READINESS DIVISION, FEDERAL EMERGENCY
MANAGEMENT AGENCY; CRAIG DUEHRING, PRINCIPAL DEPUTY ASSISTANT
SECRETARY OF DEFENSE FOR RESERVE AFFAIRS, DEPARTMENT OF
DEFENSE; WOODBURY FOGG, DIRECTOR, NEW HAMPSHIRE OFFICE OF
EMERGENCY MANAGEMENT, CO-CHAIR, TERRORISM COMMITTEE, NATIONAL
EMERGENCY MANAGEMENT ASSOCIATION; MARK SMITH, M.D., WASHINGTON
HOSPITAL CENTER, REPRESENTING THE AMERICAN HOSPITAL
ASSOCIATION; AND KYLE B. OLSON, VICE PRESIDENT AND SENIOR
ASSOCIATE, COMMUNITY RESEARCH ASSOCIATES
Dr. Lillibridge. Thank you, Mr. Chairman and members of the
subcommittee. I am Scott Lillibridge, special assistant for the
Secretary of Health and Human Services, Tommy Thompson, for
National Security Issues and Emergency Management.
I appreciate the opportunity to appear before you today to
discuss the issues and the role in State and local government
preparedness to respond to acts of terrorism, including
biological terrorism and chemical terrorism. I would like to
take heart in the comments that I have heard today from plain-
speaking Amy Smithson about preparedness, the comments from Dr.
Bonta about State and local preparedness in the public health
sector, and of course, Baltimore for taking matters into their
own hands, once again. Thank you.
At any rate, I would like to acknowledge that our State and
local public health programs comprise the foundation of an
effective national strategy for preparedness and emergency
response. Preparedness must incorporate not only the immediate
responses to threats such as biological terrorism, it must also
encompass the broader components of public health
infrastructure which provide the foundation for immediate and
effective emergency responses.
These components include, one, a well-trained, well-
staffed, fully prepared public health work force. Two, a
laboratory capacity to produce timely and accurate results for
diagnostics and public health investigations.
Three, we need epidemiology or disease detective work
including surveillance for infectious diseases which provide
the ability to detect health threats urgently.
Four, we need secure accessible information systems that
can help us analyze essential information, communicate it
rapidly, and analyze trends and interpret data.
And last, of course, we need an effective communication
system. I believe several members today spoke to the issue of
important public health information and relating that
accurately to the public.
Currently States lack an optimum public health
infrastructure at both the State and the local level. We will
need to discuss and make planning on the long-term as part of
our overall preparedness effort.
I would like to begin talking about HHS activities and
preparedness and response, and start with the Centers for
Disease Control activities.
The HHS CDC has used funds provided--has provided funds for
the past several years from Congress to begin the process of
improving expertise, facilities and procedures of State and
local health departments to respond to biological and chemical
terrorism and other acts of terrorism.
For example, over the past 3 years the agency has awarded
more than $130 million in cooperative agreements to 50 States,
one territory and four major metropolitan health departments,
and has created a bioterrorism preparedness response program
and other components that anchor as part of that overall
program, including stockpiles, chemical preparedness, health
information, and a health alert network.
We must continue our work with our State and local public
health systems to make sure that they are more prepared. This
requires interaction of State departments of health with State
emergency managers to fully integrate the States' capacity to
effectively distribute life-saving medications to victims,
whether it be a biological or a chemical attack.
The HHS Office of Emergency Preparedness is also working on
a number of projects to assist local hospitals and medical
practitioners to deal with the effects of biological, chemical
and other terrorist acts.
Since fiscal year 1995, for example, the Office of
Emergency Preparedness has been developing local metropolitan
medical response systems [MMRS]. Through contractual
relationships with local communities, MMRS uses existing
emergency response systems, emergency management, medical and
mental health providers, public health departments, law
enforcement and public health departments, to provide an
integrated unified response to a mass casualty event.
As of September 30, 2001 the OEP, Office of Emergency
Preparedness has contracted with 97 municipalities to develop
MMRS systems.
The fiscal year 2002 budget includes funding for an
additional 25 MMRS systems. MMRS contracts require the
development of local capacity, capabilities for mass
immunization, prophylaxis in the first 24 hours following an
identified disease outbreak, and the capability to distribute
material deployed to the local site from the National
Pharmaceutical Stockpile.
Local medical staff are trained to recognize disease
symptoms so that they can initiate treatment, and the local
capability to manage the remains of the deceased are also
included in this effort. We have important lessons learned from
the recent September 11th activities.
First of all, I would like to talk about the response and
just highlight a few things that I think are quite exciting.
Second, we were able to respond to two sites with medical
emergency teams in a matter of hours and provide assistance
onsite and some cases minutes to hours. And involved on-the-
ground assistance in both Virginia, near the Pentagon, and in
New York City.
Our stockpile became operational for the first time in
terms of deployment, and with a timeline of 12 hours or less we
actually got it there in 7 hours. That was one of the few
things able to fly and move during that time of crisis with
complex coordination with the Federal Aviation Administration
and the national security community of the United States.
We had teams in place. Shortly surveillance was enhanced,
particularly in New York City. Our disease detectives from the
Centers for Disease Control were onsite amplifying
surveillance, and working with State and local communities,
building on the infrastructure, largely since West Nile, to
enhance local public health capacity.
A number of important activities have been undertaken by
the Secretary of Health and Human Services since September
11th. And they include meeting with pharmaceutical agents,
accelerating vaccine production, and taking aggressive steps to
accelerate the development of--long-term development of our
national pharmaceutical stockpile.
On the long-term overview, as an indication of the Nation's
preparedness for bioterrorism, I would like to review a little
bit about the lessons learned from the Top Off 2000 exercise in
May 2000.
This national drill provided scenarios related to weapons
of mass destruction, to a mass destruction attack against our
population. It involved the cooperation at the State and local
level, FEMA, Department of Justice, HHS, Department of Defense,
and many other vital community sectors that would play a role
in an actual response.
While much progress has been made to date, the number of
important lessons that have been, from that event have begun to
shape our overall views of preparedness. And they are as
follows.
It is clear from the health perspective, and there are many
ways to look at this, but from the health perspective,
improving the public health infrastructure, both at the statute
and local level remain a critical focus of our terrorism
preparedness and response efforts. Such preparedness is
indispensable for reducing the Nation's vulnerability to
terrorism from infectious agents and from other potential
emergencies through the development of these broad public
health capacities, again, State and local capacities.
Second, it would also be extremely important to link
emergency management services and health decisionmaking at the
most local levels for the purpose of rapidly addressing the
needs of larger population, particularly a population affected
by bioterrorism or other chemical terrorism events.
I would like to conclude and say a few things on behalf of
our department, that the Department of Health and Human
Services is committed to ensuring the health and medical care
of our citizens, and we have made substantial progress to date
in enhancing the Nation's capability to respond to a
bioterrorism event.
But there is more we can do to strengthen our readiness. I
was glad to see through a show of hands that people were
neither convinced that we were ready nor not ready. I think
that is an important indication that the issue of preparedness
is a long-term endeavor and will require us to broaden the
depth and the breadth of our preparedness activities along all
fronts in this war against terrorism.
Priorities include strengthening our local and State public
health surveillance capacity, continuing to enhance our
national pharmaceutical stockpile, and helping our local
hospitals and medical professionals better prepare to respond
to a biological or a chemical attack.
Mr. Chairman, that concludes my prepared remarks, and I
would be pleased to answer any questions that you or members of
the subcommittee may have. Thank you very much.
Mr. Horn. Thank you very much.
[The prepared statement of Dr. Lillibridge follows:]
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Mr. Horn. And our second presenter is Bruce Baughman,
Director of Planning and Readiness Division of the Federal
Emergency Management Agency [FEMA].
Mr. Baughman. Good morning, Mr. Chairman, members of the
subcommittee. I'm Bruce Baughman. I'm Director of Planning and
Readiness for the Federal Emergency Management Agency. It's my
pleasure to represent Director Allbaugh at these important
hearings on biological and chemical terrorism.
The mission of FEMA is to reduce the loss of life and
property and assist in protecting the Nation's critical
infrastructure from all types of hazards. When disaster
strikes, we provide a coordination and management framework to
responding Federal agencies and a source of funding for State
and local governments.
The Federal Response Plan is the heart of that management
framework. It reflects the labor of an interagency group that
meets in Washington and in all 10 of our FEMA regions to
develop an interagency capability to respond as a team. This
team is staffed by 26 departments and agencies and the American
Red Cross, and is organized into interagency functions based
upon the authorities and expertise of the member organizations
and the needs of our counterparts in State and local
government.
Our plan is designed to augment, not supplant, the response
systems of State and local government. Since 1992, the response
plan has been a proven framework for managing major disasters
and emergencies regardless of cause. It works. It worked in
Oklahoma City. It worked at the World Trade Center. We're
basically coordinating the responding teams of 14 agencies
responding to that event.
However, biological and chemical attacks present a unique
challenge. Of the two, I am more concerned about biological
terrorism. A chemical attack is very similar to a large-scale
HAZMAT incident. Through the National Response Center, the
National Contingency Plan, the Environmental Protection Agency
and the Coast Guard, managed systems that can act, local, State
and Federal responders, and the chemical industry, these
systems are used routinely in HAZMAT incidents. EPA and the
Coast Guard are also the primary agencies for hazardous
material function under our plan.
The model we will use, it is our intent to use this model
in the event of a chemical attack. However, to make this model
robust and functional, we need to provide additional training
for first responders at the State and local level and
equipment.
In an undetected biological attack, first responders would
be doctors, hospital staff, animal control workers, instead of
police, fire and emergency medical personnel. Connections
between nontraditional first responders and the larger Federal
response is not routine. The Department of Health and Human
Services is the critical link between the health and medical
community and the larger Federal response. FEMA works closely
with the Public Health Service as the primary agency for health
and medical under the Federal Response Plan. We rely on them to
bring the right expertise to the table when we meet to discuss
potential biological events and how they will spread and the
sources and techniques that will be needed to control them.
We are making progress. As Scott mentioned, Exercise TOPOFF
in May 2000 involved a chemical attack on the East Coast
followed by a biological attack in the Midwest. We have
incorporated these lessons learned in the exercise into our
response procedures. This process is active and ongoing. It
takes time and resources to identify, develop and incorporate
changes into the system.
In January 2001, the FBI and FEMA jointly published the
U.S. Government's Interagency Domestic Terrorism Concept of
Operation, or CONPLAN. The Departments of Health and Human
Services, Defense, Energy and the Environmental Protection
Agency were part of that plan. Together, the CONPLAN and the
Federal Response Plan provide the framework for managing the
response to the causes and consequences of terrorism.
On May 8th, the President asked that the Vice President
oversee the development of a coordinated national effort
regarding domestic preparedness. The President also asked that
the Director of FEMA create an Office of National Preparedness
to coordinate Federal programs dealing with preparedness for
and response to terrorists' use of weapons of mass destruction.
In July, the Director formally established the office at the
FEMA headquarters and had staff elements in each of the 10 FEMA
regions.
On September 21st, in the wake of the horrific terrorist
attack at the World Trade Center and the Pentagon, the
President announced the establishment of the Office of Homeland
Security and the Office of the--in the White House to be headed
by Governor Ridge of Pennsylvania. The office will lead,
oversee and coordinate the national strategy to safeguard the
country against terrorism and to respond to the attacks that
may occur. It is our understanding that the office will
coordinate a broad range of policies and activities related to
the prevention, deterrence and preparedness and response. The
office includes the--a Homeland Security Council comprised of
key Federal departments and agencies, including the Director of
FEMA.
We expect to provide significant support to this office in
our new role as the lead Federal agency for consequence
management.
Mr. Chairman, you convened this hearing to ask about our
preparedness to work with State and local government agencies
in the event of a biological and chemical attack. Terrorism
presents tremendous challenges. We rely heavily on the
Department of Health and Human Services to coordinate the
efforts of the health and medical community to address
biological hazards. We also rely on the Environmental
Protection Agency and the Coast Guard to coordinate the efforts
of the hazardous material community to address chemical
hazards. They need your support to increase the national
inventory of response resources and capability. FEMA needs your
support to ensure that the system that the Nation uses 65 times
a year to respond to major disasters has the tools and the
capacity to adapt to a biological and chemical attack on any
other weapon--or any other weapon of choice.
Thank you, Mr. Chairman. I would be happy to answer any
questions at this time.
Mr. Horn. Well, I thank you.
[The prepared statement of Mr. Baughman follows:]
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Mr. Horn. We have a little problem here as usual. We're
sent here to vote, and we're now down to the 10-minute bit. And
that is the 10-minute warning. And so we're going to go into
recess until 12:35, 12:40, and right below us in the basement
is the splendid, fine, wonderful restaurant known as the
Rayburn cafeteria. So we'll be glad to see you back here, and
we'll get to work at 12:35.
[Recess.]
Mr. Horn. The agriculture bill now passed in the House of
Representatives, and we are out of recess, and at 12:35 we will
start now with Craig Duehring, the Principal Deputy Assistant
Secretary of Defense for Reserve Affairs of the Department of
Defense. Mr. Duehring, we're glad to have you here.
Mr. Duehring. Good afternoon, Mr. Chairman. Thank you for
the invitation to testify before you today on the Department of
Defense's continuing efforts to ensure a strong national
defense against domestic terrorists using weapons of mass
destruction, or simply WMD. America's National Guard and
Reserves are critical to our Nation's capability to support an
enhanced and integrated Federal, State and local response to
incidents involving weapons of mass destruction.
We're going to use the term ``consequence management''
quite often. At DOD we define WMD consequence management as
emergency assistance to protect public health and safety,
restore essential government services and provide emergency
relief to those affected by the consequences of an incident
involving WMD agents, whether they are released deliberately,
naturally or accidentally. DOD normally provides such
assistance only in response to requests from the appropriate
lead Federal agency to support specific State and local
authorities in mitigating the consequences of a domestic,
nuclear, chemical, biological, radiological or high-yield
explosive incident.
My testimony today will provide a brief description of
DOD's role in Federal response preparations, as well as an
overview of the initiatives we have undertaken to better
prepare us to provide the support requested. Presidential
decision directives established 3 years ago directed the U.S.
Government to enhance its plans and policies to protect against
unconventional threats to the homeland and Americans overseas.
Since then there has been a concerted effort to identify and
streamline Federal agency coordination mechanisms to address
the growing possibility of asymmetrical assaults on U.S.
vulnerabilities at home and abroad.
These efforts focus primarily on establishing policies and
programs to enhance the Nation's preparations to thwart and, if
that fails, respond to terrorists' use of weapons of mass
destruction or cyber-warfare. Federal agency consequence
management responsibilities and the need for extensive
interagency coordination and response to a significant
terrorist incident here or at home have been delineated in the
documents that were presented 3 years ago, but which today
still serve as the basis for all current Federal disaster
response plans.
Today Federal response to a WMD incident in the United
States will likely involve many agencies of the U.S.
Government, each bringing specialized talents and expertise
honed in the execution of larger programs designed for purposes
other than terrorist attacks. No one agency possesses all the
talents, but a few such as the FBI, FEMA and HHS know they have
lead responsibilities to coordinate our Federal response to
national emergencies.
The Federal Response Plan articulates that distribution of
the responsibilities and authorities for cooperation and
coordination for disaster response. In the event of an
incident, we recognize that those closest to the problem are
going to be the first to respond, but the presumption is that
in the event of a catastrophic incident, those State and local
capabilities may be quickly overwhelmed. If a civilian
authority requests Federal support, the lead Federal agency,
FBI, or FEMA, for example, is likely to request support from
many other Federal agencies including the Department of
Defense.
We have undertaken a number of steps within the department
to address how we will support the Nation in responding to
incidents involving weapons of mass destruction. First, we have
sought to define more clearly what the department's role should
and should not be. We do not call consequence management
homeland defense, but refer to it rather as civil support. This
reflects the fundamental principle that DOD is not in the lead,
but is there to support the lead Federal agency in the event of
a domestic disaster contingency.
Four principles guide DOD's response in the event of a
domestic WMD contingency. First, there will be an unequivocal
chain of accountability and authority for all military support
to civil authorities. Second, DOD's role is to provide support
to the lead Federal agency. Third, though our capabilities are
primarily war-fighting capabilities, the expertise that we have
gained as a result of the threats that we have faced overseas
can be leveraged in the domestic arena as well. DOD also brings
communications, logistics, transportation and medical assets,
among others, that can be used for civil support. And fourth,
our response will necessarily be grounded in the National Guard
and Reserves as our forward-deployed forces for domestic
operations.
The National Guard and Reserves will play a prominent
support role for State and local authorities in consequence
management. DOD has assigned full-time National Guard WMD civil
support teams in 27 States to provide as part of a State
emergency response capability the first wave of support to
overwhelmed local incident commanders in dealing with incidents
involving weapons of mass destruction. We will soon announce
the stationing of five new teams authorized by Congress last
year in five additional States, bringing the total to 32 civil
support teams.
These teams are comprised of 22 highly skilled, full-time,
well-trained and equipped Army and Air National Guard
personnel. These teams provide specialized expertise and
technical assistance to the local incident commander in, first,
facilitating on-scene communications and command and control
among the different responding agencies; second, exchanging
technical data and information with military laboratory experts
on weaponized chemical and biological agents; and finally,
helping to shape or revise the local incident commanders'
response strategy based on the specific chemical, biological or
radiological agents found at the scene.
The WMD civil support teams are unique because of their
Federal-State relationship. They are federally resourced,
federally trained, and expected to operate under Federal
doctrine, but they will perform their mission primarily under
the command and control of the Governors of the States in which
they are located. Operationally they fall under the command and
control of the adjutants general of those States. As a result,
they will be available to respond to an incident as part of a
State response, well before Federal response assets would be
called upon to provide assistance.
During fiscal year 2002, DOD will also continue to train
and sustain 100 chemical decontamination and 9 reconnaissance
platoon-sized elements in the Army Reserve. Medical patient
decontamination teams in the National Guard and Air Force
Reserve will receive additional training in domestic response,
casualty decontamination. They will be provided with both
military and commercial off-the-shelf equipment and will
receive enhanced training in civilian HAZMAT procedures.
I have more information dealing with the domestic
preparedness program and also with WMD advisory panel.
Mr. Horn. Why don't we put it in the hearing, without
objection, so it can be distributed.
Mr. Duehring. Yes, sir. And I'll be happy to answer any
questions that you have.
[The prepared statement of Mr. Duehring follows:]
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Mr. Horn. Well, I have one right now. I noticed in the
paper this morning that Deputy Secretary of Defense Wolfowitz
is the--mentioned the Posse Comitatus situation, and I wonder,
was the Reserve involved in that particular situation?
Mr. Duehring. I'm not aware of what that particular
situation is. I am aware of the Posse Comitatus, and when the
National Guard operated in a State setting, in a call-up by the
Governor, of course, then their rules are different than if
they were Federalized. So I'd have to give you kind of a
general answer. I can't be specific because I don't really know
what it was they were referring to.
Mr. Horn. Well, I can understand that, but I think it said
he had a 71-page memo on the subject.
I happen to agree with him. I read that 30 years ago. So it
isn't new to me, but I would like to have anything you have to
put at this point in the record.
Mr. Duehring. Yes, sir.
Mr. Horn. Thank you.
We'll go to Mr. Fogg, who is the director of the New
Hampshire Office of Emergency Management and co-chair of the
Terrorism Committee, National Emergency Management Association.
Mr. Fogg.
Mr. Fogg. Mr. Chairman and members of the subcommittee,
thank you for the opportunity to appear. I am here today
representing the National Emergency Management Association,
NEMA, whose members are the Directors of Emergency Management
for the States and territories. We're the ones responsible to
our Governors for disaster mitigation, preparedness, response
and recovery. This includes responsibility for terrorism,
consequence management and preparedness in each of our States.
We each serve as the central coordination point for our State's
response activities and interface with Federal agencies.
I serve as the current co-chair of NEMA's Terrorism
Committee along with Peter LaPorte, the director from the
District of Columbia Emergency Management Agency. NEMA's
Terrorism Committee has been actively engaged for a number of
years on this topic.
I also serve as chairman of the Northeast States Emergency
Consortium [NESEC], comprised of the Emergency Management
Directors for the six New England States, plus New York, plus
New Jersey.
And I'd like to begin by thanking you all for recognizing
the importance of preparing for acts of terrorism. We need and
appreciate your support for what we must accomplish.
We've taken an all-hazards approach to disaster
preparedness, and I want to emphasize that, all-hazards
approach, and, therefore, we're able to integrate into our
domestic preparedness efforts those proven systems we already
use for dealing with natural and technological disasters. We
also recognize clearly the value of prevention and mitigation
in minimizing the consequences of disaster, and we incorporate
those considerations in all our planning.
NEMA has developed a list of recommended enhancements to be
incorporated into a nationwide strategy for attaining better
preparedness for catastrophic events. The full text of these
recommendations is included in the attached NEMA white paper
for your reference.
I'd like to highlight the highest priority items in my
testimony today, and before I do that, I'd just like to make
the point that the lessons learned from the September 11th
attacks are not brand new ideas. Many are concepts we've been
working on for years and just have not yet had the resources to
fully implement.
Now is the time for Federal, State and local governments to
take action. It is not the time to prepare reports or criticize
past actions or issue sweeping new directives. You have our
detailed written testimony, which is fairly comprehensive, but
the committee asked us to focus on how the Federal Government
can best work with State and local governments to deal with
chemical and biological terrorist attacks, so I'll limit my
comments to that issue.
There are four main points. No. 1, our Nation requires an
overall national, not Federal, national domestic preparedness
strategy that is developed collaboratively with full
involvement by local, State, Federal and private partners, and
it is built upon existing all-hazards plans and systems. This
national preparedness strategy must be a pillar of our national
and homeland security strategy; that is, the preparedness
component and the law enforcement component together comprise
our all security strategy. We should base that strategy on
tried and proven all-hazards systems, particularly the Federal
Response Plan, the Incident Command System and our Emergency
Management Assistance Compact [EMAC], that 41 of our States and
territories have adopted, with others in process.
We need the Federal Government to be a catalyst, an
enabler, not a controller, and we also need to use the system.
Don't bypass the States in their role in coordinating statewide
and regional plans. Oftentimes we hear about going directly to
the municipalities, and that is great. It gets money where it
needs to go, but it leaves the States out of their coordinating
role, and we need to be very careful with that.
Two, our Nation's preparedness for catastrophic events
would be well served by strengthening our regional
capabilities. Strong consideration should be given to
developing that strategy by strengthening our regional
capabilities to provide a rapid, flexible response capable of
dealing with multiple mass casualty events occurring in
different places at the same time. If we put all our resources
in one place, we could get in trouble real quick.
Our Federal agencies can help by delegating decisionmaking
authority to their regional offices. Some do that quite well
now. Director Allbaugh at FEMA is pushing that concept, and
that has worked well in the past.
Mr. Horn. Let me ask at that point, is that the Federal
Government regional areas? There are about 10 they've blocked
out over the last 30 years, and you want to operate within that
area?
Mr. Fogg. That's correct, sir, that's correct. Delegate the
authority to make decisions and make plans to that level. And
what that does is develop those relationships, that trust and
credibility that is so important in crisis situations, and
understanding each other's resources, constraints, methods of--
modus operandi, if you will, and it eliminates the who's in
charge in the turf, and we found that out. That was one of the
major lessons learned from our TOPOFF Exercise. And we hosted
one of the venues in New Hampshire. Those agencies who had
developed those relationships and used them succeeded. The
others did not.
We would encourage broader use of existing regional
relationships, and I will just cite NESEC as an example, at
Northeast States Emergency Consortium. The details are in the
written testimony, but it's been done at very little
incremental cost. We expanded on existing structure, and it's a
good use of Federal support.
The other thing we should do is develop our international
relationships. I think we've overlooked that in the Federal
emergency management field.
Three, medical surge capacity is the main key to dealing
with mass casualty events, regardless of cause. The most
noticeable hole in our system is our limited ability to access
and deliver surge capacity rapidly to the site of a mass
casualty event. We have some impressive national capabilities,
but we need more local and regional capacity close to home to
deal with true mass casualties until a cavalry can get there.
We need one of those disaster and medical assistance teams
widely dispersed. There are some parts of our country that now
are not covered very well by that system. We need to fill those
gaps, and we need faster access to military reserve medical
units with their own deployable equipment. And I really want to
wave the flag on that one.
We need to assist the health care industry in restoring a
surge capacity to our hospitals. The pressures of managed care
have virtually eliminated that surge capacity, and we need to
work together to restore some of it.
Four, the other real key to preparedness is timely sharing
and dissemination of critical intelligence information to those
who really need to know. Commissioner Norris said it very well
this morning. But don't leave the State police and the county
sheriffs out. All levels have got to be involved in sharing of
pertinent intelligence. Again, for the same reason, the State
folks need to be able to sort that out on a statewide level and
work with their local counterparts and Federal counterparts to
direct resources where they need to go.
And the other main issue about the intelligence issue is--
and it is about--it lets the health care system and the other
first responders have a heightened awareness about the
potential symptoms. It gives them a heads-up, gives them a
little warning, and it lets them avoid being second victims and
to contain the spread and effect of the agent.
And last, on sharing the intelligence, use the
compartmented need-to-know system that the military uses. It
works quite well. But we need to have greater reciprocity of
security clearances between Federal agencies. Right now if
you've got a FEMA clearance, you can't see DOD stuff. If you've
got a DOD one, you can't see Health and Human Services stuff.
We need to clean that up so we can share intelligence
effectively.
Let me summarize. No. 1, we need a clear national domestic
preparedness strategy built collaboratively at all levels,
local, State, Federal and private. Two, we need to consider
strongly strengthening our regional capacities. Three, we need
to increase our mass casualty surge capability, especially
regionally and locally. And four, we need to improve
intelligence-sharing across the board.
I want to end by emphasizing----
Mr. Horn. That has been the suggestion, and I think we're
going to have to go to your two other colleagues to----
Mr. Fogg. OK. I just have one more sentence here. I want to
end by emphasizing that we should buildupon the proven systems
that we have in place and not reinvent the wheel. Add a spoke
or two, maybe even combine some, and definitely make the wheel
turn faster, but please, let's not come up with a new wheel.
And remember, this is not just about terrorism. It is about
all-hazards preparedness. Thank you.
Mr. Horn. Well, thank you. That was very lucid.
[The prepared statement of Mr. Fogg follows:]
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Mr. Horn. Dr. Smith, Mark Smith is from the Washington
Hospital Center, very distinguished institution in Washington,
representing the American Hospital Association. Dr. Smith.
Dr. Smith. Thank you, Mr. Chairman. I'm Mark Smith, the
chair of emergency medicine at Washington Hospital Center in
Washington, DC, and I'm here today on behalf of the American
Hospital Association's nearly 5,000 hospitals, health systems,
networks and other health care provider members. We appreciate
the opportunity to present our views on hospital readiness for
a potential terrorist attack utilizing chemical, biological or
radiologic weapons, as well as explosives, incendiaries and
other more traditional means of destruction.
The special responsibilities of hospitals in a terrorist
attack is to treat, manage and mitigate the acute medical
consequences that occur, and as this great Nation enters into a
war on terrorism, the American people and government officials
need to have confidence in our hospitals and our systems of
health care, and I have no doubt that American hospitals will
rise to the occasion just as they did on September 11th,
hospitals in New York and New Jersey, Virginia and Washington,
DC, who relied on their training, their experience and their
prior disaster planning. They performed outstandingly. The
hospital system worked.
Here at Washington Hospital Center, the regional burn
center for Suburban Maryland the District of Columbia and
Virginia, we treated 15 survivors from the Pentagon. Many of
the victims were severely burned. On September 11th, we were
all part of a seamless single system of rescue, fire, police,
EMS, hospital, and it was not only those hospitals that
directly cared for the victims. Our region's vast network of
hospitals responded. At Washington Hospital Center that
morning, we received offers of aid and assistance from Malcolm
Grove Medical Center, University of Maryland Medical Center,
Johns Hopkins, and MedStar Health's Baltimore hospitals, offers
of personnel, ventilators, medical supplies and hospital beds,
whatever was needed.
America's hospitals were ready for the foreseeable, but now
we must plan for what once seemed extraordinary. To date the
AHA has created a disaster readiness site on its Web page,
engaged in frequent communication about biological and chemical
preparedness with hospitals across America and sent out two
advisories on hospital readiness. Preparedness work that had
occurred quietly behind the scenes during the past several
years is coming out at the public view, such as the District of
Columbia Hospital Association's Mutual Aid Plan led by Dr. Joe
Barbera, or the ER-1 Readiness Project at the Washington
Hospital Center to develop the design specifications for an
all-risks emergency department, one that has national
capability built into it to manage the medical consequences of
these terrorism disasters and epidemics.
To meet the new challenges that we now face, our
recommendations include the following: First, integration of
hospitals with police, fire, EMS and public health needs to
occur to a much greater level than exists today. Although not
traditionally thought of as such, hospitals are, in fact, one
of the core elements of a community's public safety
infrastructure. Hospital is the final destination of every
public service agency when injury, illness or acute exposure
occurs.
Two, hospitals need to increase inventories of drugs,
antibiotics to combat the effects of chemical and biological
weapons such as anthrax, nerve gas.
Hospitals need to increase reserves of ventilators,
monitors, stretchers, all the basic equipment and supplies
needed to treat victims of a mass disaster event.
Hospitals need much more robust systems for communicating
in real-time with other hospitals and with public service
agencies in order to better coordinate care for victims.
Information provides light, and we are often in the dark.
Hospitals need improved systems of surveillance detection
and reporting in order to identify potential biologic outbreaks
as early as possible.
Hospitals need backup water supplies or auxiliary power
sources and adequate fuel storage. We need our hospitals to be
secure and safe under all conditions.
Hospitals need to be able to utilize nurses and health care
personnel who are not licensed locally, but who are licensed in
other parts of the country.
Hospitals need enhanced stability that currently exists to
decontaminate contaminated patients and then to expeditiously
care for them.
In order to implement those recommendations, we need
people, health care workers, and right now American hospitals
are facing a severe work force shortage. Hospitals nationwide
have 126,000--this shortage cuts right to the heart of
communities across America and to our ability to be ready for
any need. Legislation has been introduced to address the work
force shortage, and we urge its passage.
Our Nation's nurses, doctors and health care workers
answered the call on September 11th and stand ready to do so
again, whenever and wherever it comes. But let me leave you
with my final--the summation thought, which is that America's
hospitals need to be considered and treated for what they, in
fact, really are, an integral part of our public safety
infrastructure.
Thank you.
[The prepared statement of Dr. Smith follows:]
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Mr. Horn. Can you give us that nurse estimate? Is it
128,000?
Dr. Smith. 126,000.
Mr. Horn. 126,000. Thank you very much.
And now we go to--maybe Mrs. Maloney would like to
introduce him--Kyle Olson, vice president, senior associate,
Community Research Associates.
Mrs. Maloney. His resume is quite long, quite
distinguished. He's been at the head of this issue for many
decades. Many of you may have already met him, as I did,
originally from his many statements on television, 60 Minutes,
Dateline, Frontline. He's been on the front- line on this
issue, and I'm pleased that he's been a constituent of mine,
and I am very delighted that he was able to join us, and I
thank you, Mr. Chairman, for allowing him to be part of the
panel. I always find his insights incredibly important on this
important issue. Thank you for coming.
Mr. Olson. Thank you, ma'am.
Mr. Horn. Mr. Olson, you're vice president and senior
associate to the Community Research Associates. Is that sort of
a consulting firm to hospitals?
Mr. Olson. Well, by way of disclosure, I will acknowledge
that I have been, am now, and hopefully after my remarks today
will continue to be a scum-sucking government contractor. My
firm has worked with the Department of Justice, Department of
Defense, State and local governments for a number of years,
particularly in the area of WMD training, preparedness and
other support. I will also acknowledge that my remarks today
have not been reviewed, probably a mistake on my part, by any
of those entities.
Again, I want to thank you for the opportunity to speak
today and offer my thoughts on the biological and chemical
terrorism problem to this committee. In the aftermath of the
tragic events of September 11th, the specter of terrorists' use
of weapons of mass destruction has gone from being a remote
possibility that is probably worth planning for to one more
aspect of what has become a national nightmare. Many have
looked at the threat posed by chemical and in particular
biological weapons for the very first time in the last few
weeks, while others, including many of today's witnesses, have
been working on this problem for a long time.
Today you, me, all of us are being asked by the American
public for an answer that will put, frankly, this grim genie
back into the bottle and let us get back to our lives.
Unfortunately, there is no silver bullet that is going to slay
this monster, nor ensure that it is going to stay in the grave
once it's put there. Even as we focus on Osama bin Laden and
his organization, we have to confront the truth. He is not the
first nor will he be the last man to covet weapons of mass
destruction. After we run him to ground, we will still have to
deal with the potential that these weapons, created in the
middle of the last century, will wreak havoc on the new. To
that end, it is important that the answers be simple, that they
be complete.
It has been suggested that the efforts made to ready cities
of this Nation to respond to WMD terrorism have been lacking.
They've been characterized as a mile wide and an inch deep.
This much is true. We could have done more. We can always do
more. Navy exercises could have been more demanding. Maybe the
training could have been more complete. Yet it is also true
that the Nunn-Lugar-Domenici training and exercise program
introduced thousands of first responders to a threat that they
had never even thought about. New problems demanded new
responses and new ideas from police, fire and emergency
managers, and they worked those problems in the context of that
program. As a result, there is no doubt we are far better
prepared today than we were 5 years ago, particularly for
potential chemical use.
On the other hand, the argument has been made all too
convincingly that our health establishment is still ill-
equipped to deal with bioterrorism. I don't argue that point.
Over the course of the last 4 or 5 years, the element of
emergency services that has been most consistently a no-show at
these integrated training and exercises has been the medical
community. For whatever reason, time constraints, budgetary
limitations, skepticism, in many cities the doctors have not
been in the tent, and now we are seeing evidence that this is
changing. Yesterday's news out of Florida suggests that this
foxhole conversion comes none too soon. Serious work remains to
be done.
For example, while it is true that we have Federal
stockpiles of drugs, we do not have plans that have been tested
for distribution of those drugs in the event of a major
biological event. We have plans on paper that have not been
field-tested by and large.
But before we join those who fully discount our
preparations, consider this. When the World Trade Center fell,
New York City activated an emergency response system that had
for years deliberately tested itself against the darkest WMD
scenarios, chemical, biological, even radiological. New York's
leaders understood perhaps better than the rest of us that the
world's first city was terrorism's potential primary target,
and so they prepared themselves. They took advantage of Federal
training, exercises, equipment, funding and other help. They
pushed, they grabbed, they shook the money tree. They played
Federal agencies against each other. They enjoyed using those
duplicative programs that everybody complains about, and at the
end of the day, after a lot of work and a lot of soul-
searching, the city's emergency management system was
structured to deal with an event that could leave 5,000 or more
New Yorkers dead.
New York's planners invented ways to work around the loss
of power, communications, transportation. They even confronted
the possibility of losing scores of men and women from the
city's now legendary fire and police departments. Because they
did all these things and thought their way through all these
horrible ideas, New York City was better prepared than any city
on Earth when those towers fell. Observers have noted that the
city didn't quit. It wept. We all wept. But New York got up and
fought, and I believe beyond the spirit of the city's people
that the training helped. No, september 11th was not sarin, and
it wasn't smallpox, but it was mass destruction. The responders
in New York had been encouraged to think about the unthinkable,
and when it became real, those same responders' actions saved
more than 20,000 lives.
A similar story played out here in Arlington, VA, where the
capital-area responders after years of preparation managed an
efficient, professional response in the attack on the Pentagon.
As we discuss where the Nation must go in the days ahead,
as Congress and the administration consider how to invest our
hope and our treasure, I hope we can appreciate that the
efforts of the past 5 years have not been wasted. They haven't
been perfect. What government program ever has been? But they
have not been wasted.
Much of the criticism directed against the current
hodgepodge of Federal agencies arrayed against terrorism is, I
would argue, a little bit out of date. There truly has been a
shake-out over the last couple of years with a broader
understanding of the way things are supposed to work. It is a
little bit wider appreciated now. It's not a streamlined
system, but its functions have become more sophisticated and
better targeted over the last several years. We still have
overlaps, there are still food fights at budget time, but
responder agencies at the State and local level have in many
cases a pretty good idea of where to go to get help.
A major restructuring in the middle of everything else that
is going on right now holds out the potential for confusion
rather than clarity. I don't know that the best course for this
government is to pursue a single homeland defense
counterterrorism agency that tries to do everything well and
ends up doing many things poorly. I actually tend to believe
that competition among competing ideas is a pretty good idea.
I've seen the wiring diagrams. I know there's urgency to
rearrange the deck chairs, but I also know that the small
successes of the first few days of the last few weeks in this
bizarre, necessary twilight world we are embarking upon stemmed
from earnest to frequently clumsy efforts to make a difference.
As you consider the path forward, as we all wrestle with the
unimaginable, let's remember the instructions given to
physicians when they enter into practice: First, do no harm.
Thank you.
Mr. Horn. Thank you.
[The prepared statement of Mr. Olson follows:]
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Mr. Horn. Let's start the questioning. I'm going to take 5
minutes, and I'd like to know from Mr. Lillibridge and Mr.
Duehring, Mr. Fogg and Mr. Olson in particular in educating
people through professional conferences that go on all over
America, are we giving training from the Federal side and
having people at these conferences so they can bring people up
to the level that they ought to be if they're going to really
be useful? I just wondered how we're using the grant money.
Dr. Lillibridge. Thank you, Mr. Chairman. I would also ask
after a few minutes that I be dismissed, I have some other
pressing engagements, but I'd like to answer that question as
best we can.
We could always do more, but let me tell you what's in
progress and what's been done along that avenue.
First, we've worked with both the Department of Defense to
do satellite broadcasts to reach as many as 18,000 health
providers at a time. These have been highly successful and have
dealt with both chemical and biologic weapons response on the
health and medical sector.
The second thing is that we've also partnered with the
major guilds, professional organizations, and there are a huge
number of preparedness efforts in terms of training at these
annual and regional meetings, and those are ongoing.
Recently we've also looked forward to the partnership at
HHS with FEMA on linking emergency management and training at
the State, local level in terms of integrating our capacities
in those areas.
Mr. Horn. Well, we'll just go down the line. Mr. Baughman,
any thoughts on this as to grants and how we get that--people
across the country, be it hospital administrators, doctors,
also in our medical schools and our public health schools, and
I suspect the--I would hope the public health schools in
America would certainly have a course on terrorism and all the
rest?
Mr. Baughman. I think one of the things we do need to do is
to work closer with our public health partners at the State and
local level. At the Federal level--and we can talk about the
State level--we work at that level, but what is lacking right
now is guidance, guidance to put out to State and health
providers, local health providers on what they ought to be
doing.
An example is right now. What--the word that we ought to be
putting out to the American public on what should we be doing
as far as protection and guidance. As a matter of fact, we had
a dialog with HHS the day before yesterday on this, but I think
what State and local health providers are hungry for is a lot
more guidance on what they ought to be doing to make their
health care network more robust in light of a WMD-type
scenario.
Mr. Horn. Mr. Duehring.
Mr. Duehring. Well, sir, the training that the Department
of Defense does is oriented pretty much toward practical hands-
on application for our own people, and that is continuing. That
is ongoing. We have, of course, wartime commitments that
parallel the threat that you have here in the United States,
and I addressed that very briefly in my opening comments.
Now, in addition to that, under the 1997 defense
authorization bill, called the Nunn-Lugar-Domenici Act, we were
tasked initially to go out and conduct training with
communities, and there has been references today about the
training that had gone on in New York. That was part of that
program. We actually trained leaders of these various cities
and 105 communities. But the provisions of that bill have now
expired. So, to my knowledge, the only other agency that is
involved now would be the Department of Justice, and they may
have a little more to add, if they are here.
Mr. Horn. Mr. Fogg.
Mr. Fogg. From a State level, I would say that the National
Governors Association, FEMA, through the Emergency Management
Institute, all of our other Federal partners have been
providing good training, and we've been delivering it. The
problem--and we've been getting a lot of guidance in terms of
planning, you know, how to do planning, and of course we have a
pretty good--we know how to do that ourselves, but the problem
is we need to link and coordinate those various offerings from
all the different agencies and coordinate them so we get the
best bite at a local responder's limited time. Most of them are
volunteers. There's plenty of training out there, but focusing
it, coordinating it so they get the best use of their time so
we can attract them is an important thing.
And last, I would say the place we really need to
concentrate some effort is on exercising. We can have great
plans, we can have great training, but if we don't exercise
them, you know, to get people used to working with each other
and understanding what is going on, we're missing the boat, and
we're not spending enough money and enough time exercising.
Mr. Horn. I'm going to recess that question. I see Mr.
Lillibridge does have a chance to get away and do certain
things, but could you tell me on what's apparently yesterday's
news about an anthrax case in Florida? Was there one? Do we
know? Is CDC looking at it or what?
Dr. Lillibridge. Thank you, Mr. Chairman. Let me update on
that and give you an indication of how the public health system
works, where we are in that case, and what we know today.
As you know, yesterday the press reported there was an
apparent anthrax case in a single individual who was thought to
be noncommunicable and thought to be sporadic in nature. That
means one of those cases that occur from time to time.
We have a robust State and local health department, and
many accolades to the department--the Florida Department of
Health in their early response. Remember, they're into a 3-year
preparedness effort with their lab and their surveillance
activity, and as we hone our surveillance activity, we're going
to be more aware of these outlier kinds of cases.
What we know is that the case was entered into the hospital
on October 2nd, and within 24 hours the State had done some
preliminary investigation, was able to confirm laboratory
testing on this, and confined this to a single case at the
local facility in--near Miami. The prognosis of that person is
unclear at this time; however, the test was reconfirmed at CDC
in a partnership with our--according to our plans, with our
State and local partners.
CDC, disease detectives and laboratorians are working with
the State health department to see if there is any additional
cases or any additional facts that would help determine where
this case came from.
As of this morning--and I talked with the people on the
ground just before coming to this hearing and asked if there
was any indication that there was a widespread outbreak or any
other information that might relate to this hearing, because we
might be asked, and the answer was no. But I will assure you
disease detectives are on the ground from both the Florida
State Health Department and the Centers for Disease Control,
and we'll keep you updated as information is developed.
Mr. Horn. At this point, there's no second case.
Dr. Lillibridge. At this point we are advised by the FBI
that this does not seem to be a biological agent attack. We are
not finding secondary cases. This person was--became ill nearly
a week ago, and by that time we certainly should see additional
cases if this was going to be a widespread problem.
Again, we'll keep you updated and keep the public updated
as information is known.
Mr. Horn. When was the last anthrax case in this country?
Dr. Lillibridge. Well, we have information from 1955 to
1978. We have a total of 11 cases that were documented. Now,
remember, as you enhance surveillance, we don't find all these
cases until you begin looking, but at any rate we have
information on 11 cases, and the last 1 in 19--clearly 1978,
and recently this case in Florida. Most of these are
occupational or related to something you're doing with animals,
hides and that sort of thing, but, again, those occurred in the
absence of a bioterrorism attack.
Mr. Horn. Thank you.
Dr. Lillibridge. Thank you, Mr. Chairman.
Mr. Horn. You're quite welcome.
Let's pick up here now with Dr. Smith on----
Dr. Smith. Training and education.
Mr. Horn [continuing]. How we educate and train people.
Dr. Smith. I think what is important to understand is that
training and education, medical training, medical education,
it's not a one-time affair. It occurs in multiple venues,
national meetings, grant rounds. In fact, 2 days ago the
Washington Hospital Center department of medicine put on a
grant rounds on biological agents. It was standing room only,
and I suspect a similar thing is happening in hospitals across
the country.
What we need are resources, knowledge, material, and I must
say, the CDC has done a terrific job on its Web site. The
material that is there is outstanding and has been a resource
for many of us, as well as the material that the military has
put out with its little handbooks on bio and chemical agents.
So I think what we're going to see is that there's going to be
an explosion of courses and talks on this subject.
Mr. Horn. Is anybody on public television doing a, say, 1-
hour on it or something like that?
Dr. Smith. I don't know, but I suspect they probably are.
Mr. Horn. You ought to head in their direction.
Dr. Smith. Thank you.
Mr. Horn. Mr. Olson, anything else on this?
Mr. Olson. Mr. Chairman, just a couple of thoughts. First
of all, there is a robust or a fairly robust training program
that did indeed migrate from the Department of Defense to the
Department of Justice, and, again, by way of disclosure, my
firm has a small part of that, but that doesn't mean it's not
any good.
And the program is designed to reach out to carry the
training to the people when they're in the States, local
jurisdictions in recognition to the point that's been made
abundantly clear throughout the day, that the first responders
are the first line of defense, and that is absolutely true.
But I also just want to point out my very real appreciation
of the fact that the medical community in Washington, DC, led
by George Washington University Medical Center and the
Washington Medical Center, those are actually a couple of
institutions that are right out there in the lead. They have
taken the point on this thing. I think they point a very
important direction for the medical community in this country.
However, I do go back to my initial point, which is that I
do not believe that is representative, unfortunately, at this
point, of where the Nation's medical communities--they're just
a little bit behind the power curve at this point.
Mr. Horn. Thank you.
I now yield to the ranking member, Ms. Schakowsky, the
gentlewoman from Illinois.
Ms. Schakowsky. Thank you, Mr. Chairman.
I'm sorry that Dr. Lillibridge left. And I was pleased with
his comments that there was still much more to do, because
while I think it's important for us not to unnecessarily alarm
people and to overreact, at the same time I think it is not a
good idea. I know that the Secretary of HHS has been assuring
the public that our country is perfectly prepared and sounded
as if in all instances for any threat to our Nation's health,
and I think we have to take a very clear and thoughtful look at
this approach to it, and I appreciate all of your comments.
Two of you--and I don't remember--mentioned Nunn-Lugar and
the funding that it provides for the domestic work to defend
against weapons of mass destruction and provide training, not
to mention securing the Russian stockpile of nuclear weapons.
My understanding is that in this budget, in the defense
authorization bill, that there is a $40 million cut in Nunn-
Lugar. Even at the same time as we have about an $8 billion
increase in national missile defense, there's been a cut.
Clearly, this bill was crafted before this threat.
How important is this program and is this funding stream to
the work that you're doing? Anyone can answer.
Mr. Olson.
Mr. Olson. Congresswoman--and I don't want to speak too far
on this because I wasn't involved in the agency perspective in
these things--but the cut in Nunn-Lugar, the program was
essentially designed to reach out to the 120 or so largest
cities. That program is actually pretty well completing that
cycle of work. It was a cycle of training followed by a series
of chemical and biological exercises.
With the goal of completing the 120 cities, that training
program and that exercise program, again, was transitioned from
the Department of Defense to the Department of Justice. And has
been rolled into other training initiatives which are being
managed by that agency. Now those programs are still, frankly,
under development to some extent at this point. Nunn-Lugar is
continuing, I believe through the next year or so. All of the
cities that were promised training will receive that training,
and then, if you will, the next generation of training and
exercises will follow. Exactly what shape that is, I think is
still under development, though. But there is a commitment
within DOJ to continue training and exercise work.
Ms. Schakowsky. So there is no loss of actual
implementation due to the reduced funding? Just seems to me, if
we're looking at where we most usefully put our resources, that
kind of effort does need to continue. I want to be assured,
then, that it is.
Mr. Olson. My understanding and--again, as a scum-sucking
contractor, my hopes are that this level of effort will
continue. I would probably direct you to get a better sense of
the detailed planning from the Department of Justice's Office
for Domestic Preparedness, which has the mandate for continuing
that training and exercise program.
Ms. Schakowsky. I wanted to quickly ask about our public
health infrastructure; and while I applaud the response that
there was, it seems to me that had there been--and we all wish
there were, actually--more injured than there were dead,
whether or not our system could respond.
But what I'm concerned about, New York I think was, as you
said, Mr. Olson, probably more prepared than anyone else. Had
it been elsewhere, it seems that there are many public health
offices that are without even some of the basics. The doctor
from the State of California was saying that her local office,
before this job, was like that, unequipped with fax machines
and computers and not updated.
How big a problem is that around the country, that we don't
have this kind of infrastructure? And do we have the
communications systems nationally that can transmit information
about an anthrax case, or this or that, that would be needed to
coordinate a response?
Anybody respond to that?
Mr. Olson. I will just offer one thought, ma'am.
Penicillin and streptomycin pretty much killed the public
health service. Once we shifted to an antibiotic-based approach
to medicine, we tended to walk away from any of the things that
we had done back in the era of polio, tuberculosis, smallpox.
At that time we had a very robust system, because our only
options were to identify outbreaks early and then rely upon
techniques like quarantine to control them.
Once we found we could defeat these diseases, we
essentially--I won't say we dismantled, but we tended to
ignore. The phrase ``benign neglect'' comes to mind. I think it
became a less pressing investment in terms of public
infrastructure.
We are now, I think, recognizing that we have to
reconstitute that. I'm not suggesting that we're going to go
back to having armies of public health nurses. There are new
technologies, new ways of doing things; and I know the medical
community is addressing those surveillance technologies. The
Internet is a powerful tool. But the public health system is
not what we would like to think it is.
Ms. Schakowsky. And, Dr. Smith, how do we increase the
numbers to the extent that we need to in terms of nursing
shortages, etc?
Dr. Smith. It's part of the legislation that has been
introduced, support for nursing schools, scholarships, all the
different ways you encourage people to go into a profession
that is the backbone of our health care system. And like most
things, it's going to require a multiplicity of efforts.
Mr. Horn. Go ahead. We have all the peace and quiet now.
They're all adjourned.
Dr. Smith. I think that we have to look at the reasons why
there has been such--there is now a shortage. It really is
going to become one of the great health care crises in this
country. If you look at the age spectrum of nurses right now,
the ones who are working are slanted toward the older age
group. We do not have the younger nurses coming in that we are
going to need to sustain all of us when we get to an age where
we're going to need them even more.
Ms. Schakowsky. Thank you.
Mr. Horn. Mrs. Maloney, the gentlewoman from New York.
Mrs. Maloney. I want to thank all of the panelists,
particularly Mr. Baughman, and publicly acknowledge for my
constituency, New York City, and express our appreciation for
the ongoing leadership, assistance, help that FEMA is giving to
New York City. Director Allbaugh has spent a great deal of time
there. We appreciate, really, all of your professional
expertise and assistance and help.
I appreciate the comments of all of the panelists. I
particularly want to thank you for the comments about how well
New York responded to the crisis that we had. The command
central for emergencies was completely destroyed in the attack
on the World Trade Center. It was in one of the buildings that
later collapsed. And within 3 days, the city totally rebuilt an
alternative command center down at Pier 92, which I think
speaks well for the resourcefulness and strength and
determination of the American people.
I'd like to ask any of the panelists to comment on this
question. It's my understanding that if there was an anthrax
outbreak in one of our cities and it turned out to be
widespread, that the Federal Government would immediately get
involved and would tap the emergency medical warehouses at one
of the eight sites--at one of the eight sites around the
country. How quickly could these supplies be distributed and
how coordinated are the various governments to ensure quick
delivery as well, since we know that different people would
possibly be getting sick at different times?
And if anyone would like to respond to that question, I
would----
Mr. Baughman. There are now 10 caches, there were 8. We've
just beefed that up to 10.
Mrs. Maloney. There are 10.
Mr. Baughman. The caches can be to the city, or cities, in
a matter of hours. The problem we found in Top Off, that I
think still exists is, the ability of the local government to
do the distribution and inoculation, the local health care
system. That was a problem if you saw the GAO report in Top
Off. So that is what I think is the long pole in the tent right
now.
Mrs. Maloney. Would anyone else like to comment on how we
address this problem?
Mr. Baughman. By the way, in addition to that, we work with
HHS. We are surging the national stockpile as far as
pharmaceuticals in addition to that.
Mr. Horn. I might add on Mrs. Maloney's question, if there
is anyone from the first panel and if they'd like to comment on
any of the testimony here of the second panel, please come
forward and just read your name into it, so the reporter of
debates will be able to know who said it--if you're still
around.
So go ahead.
Mrs. Maloney. Anyone else care to comment?
Dr. Smith. The distribution is a real issue. Most
jurisdictions are only now thinking about how to do it. And
they have very little experience in doing something similar.
And if you look--one of the tenets of response in a disaster is
the doctrine of daily routine. You try to do in a disaster
extensions of what you do in your day-to-day job because that's
how you're going to perform the best. If we're trying to do
something that is totally new and totally different, it's going
to be much more difficult to effect, and----
Mrs. Maloney. Earlier, Dr. Smithson responded to my request
about buying antibiotics and possibly a gas mask by saying that
it was totally unnecessary. And I have to ask if it gives
people a sense of security and buys them peace of mind, what's
wrong with having antibiotics in your medicine cabinet that
some doctors say could be helpful in case of a chemical or
biological attack?
And I ask anyone to respond.
Mr. Olson. Mrs. Maloney, Congresswoman, this is when it
actually hits close to home. I've been working in this area for
about 15 or 16 years. And I can sit back and look at this thing
very rationally and very calmly and say, well, OK, the best
strategy is to rely on the public health system, to count on
the surveillance system to be heightened to a higher level, you
know, to recognize that there are those, now, 10 caches of
pharmaceuticals. Yet when I go home at night, my wife is asking
me, what can I do to protect my daughters? What can I do--I
need to do something.
And given that, I guess I'll take exception with my good
friend, Dr. Smithson, from the earlier panel. I don't
necessarily see anything wrong, if it makes you feel better, go
out and buy a gas mask, why not--$50, $100, if it makes you
feel better that you've got that on the shelf? Odds are you're
never going to pull that thing down, but you're never going to
hurt yourself with it either.
If you go to your doctor and get a prescription for
antibiotics, if he knows you and gives you a meaningful
prescription and gives you some good advice on what and when,
why not? There are very few things that an individual can do.
This is a mission for government and collective response.
But I tend to fall on the side of those people who are
saying, you know, look at the Israelis. They have been living
on the edge for 50 years and they do these things. We've been
on the edge for 3 weeks. If it buys us a little peace of mind
in these very uncertain times, I'm not sure I'm going to stand
up and tell somebody don't do it.
Mrs. Maloney. What I find somewhat troubling from the
presentations we've heard today is, everyone says, ``Don't
worry, be calm,'' and yet the testimony is saying that we have
these caches, but we don't have in place a way to distribute
it, or antibiotics or vaccines, in a quick way; and we don't
really have the surveillance or the intelligence.
We don't have the coordination between the FBI and the
local response people. And you're telling us basically that we
don't have the health care workers that are trained, and
they're not vaccinated yet for certain things that some people
are saying may happen? And yet you're telling us not to be
concerned.
So the question that I get asked the most when I go home is
the question that Mr. Olson's children are asking him and his
wife is asking him, ``What can we do for civil defense?'' When
I go home to my community meetings, people know we're at risk.
It's common sense.
Who would ever have dreamed that anyone would fly and turn
our airplanes into a weapon of mass destruction against our own
Department of Defense and our own financial center? Absolutely
unbelievable. They even had one man who was saying, ``Just
train me to fly a plane; I don't want to know how to land, I
don't want to know how to take off.'' That was reported, and no
one knew what to do with it because no one could ever imagine
that this could happen.
So I think that we have to imagine or think that something
horrible may happen. And my question is, what can we do for
civil defense back in our own homes?
Mr. Olson mentioned Israel. Israel has trained for many
years for civil defense, having had many terrorist attacks in
their own country. Are there programs or models that they have
that we could implement here in our own country? And what can
we tell our constituents when they say, what can we do back in
our own city or our own farm or wherever they are to protect
ourselves in the event of one of these terrible attacks?
Mr. Baughman. I think there's a couple of things. First
off, one of the things that we're working on right now is to
set up a joint information center with all of the agencies that
have expertise in this particular area to talk about what we
need to be telling the American public and when we ought to be
telling the American public. A lot of it is just information.
But how do we get the information down to folks like Woody and
the fire chief to get that information out? Right now, we don't
have real good dissemination systems.
For example, while in the law enforcement arena you do have
a means of passing law enforcement sensitive data, there is no
means that we have readily available to pass it down to the
firefighter on the street that needs that information.
So how do we get that out? That is one of the things that
has been pointed out that has caused problems in past
disasters. We, right now, have got some things in the works to
look at some short-term fixes for that. But that is a long-term
pole in the tent that I think we need to come up with a
solution to.
Mrs. Maloney. But before you even get to the firefighter or
fire officer in a real disaster, many people will not have the
opportunity to talk to anyone except their immediate family.
And my question is, what do we say to these people who are
saying, what do we do for our own defense, that we can do
ourselves to protect ourselves, because we don't have enough
police or firemen out there in the event that--if something
happened quickly?
Mr. Baughman. There is a list of protective action guides
that many hospitals have, many health care systems have, that
we could quickly put together to deal with a situation like
this. In some cases, we have already done that.
Mrs. Maloney. We should be getting that out now to the
public.
Mr. Baughman. That is correct. We should.
Dr. Smith. I think it's a very real question. And the
answer has got to be based on facts, and the answer may turn
out to be something we're going to do, things we never did
before.
The truth is the--a number of the bioagents have an
incubation period. And during that incubation period where you
are asymptomatic, if you were to take a simple antibiotic you
can prevent yourself from getting the disease. It's a
reasonable question to ask when you're in a high-risk area,
whether you should have a supply of doxycycline, which is the
drug, around.
There are always problems with taking antibiotics--with
side effects, with outdated drugs. That's why the answer is not
simple. But it definitely has to be considered. Quite frankly,
many of my health care colleagues have personal stocks of
doxycycline and ciprofloxacin. If you abide by the Golden Rule
that you should do unto others as you do unto yourself, we
should be considering this.
Mr. Olson. I've been watching the news over the last couple
of weeks. I would much rather see people out there buying some
antibiotics than buying guns. It's going to make a much bigger
impact.
Ms. Schakowsky. Thank you. I thank the gentlelady for
yielding.
I think that individuals do want information. We do it for
planning escape routes from our own home in case of fire,
evacuation plans from buildings and those kinds of things. But
I think, and I would recommend--and I don't know if it's up to
FEMA or to HHS. I think people are also looking for collective
ways of what to do, and there may be a nongovernmental
organizational infrastructure that people could be plugged into
in an effective way, that we might want to make suggestions to
people, ways that we can help our local fire departments or
ways that we can get involved in--we have it for fighting crime
neighborhood watch groups, communications systems.
I'm not really sure. But I think some thought is useful.
Because people are lining up to give blood; people want to do
something. I think there may be constructive ways that ordinary
people in their communities can play a really constructive
role, who would welcome those suggestions and would even
implement them themselves at a local level if they were good
ideas.
Mrs. Maloney. Reclaiming my time, I have just one last,
brief question. I'd like every panelist to answer it.
And it's, what is the No. 1 thing you think we should focus
on in preparing for chemical and biological attacks? What's the
No. 1 thing we should focus on? Just go down the line and give
us your thoughts.
Mr. Olson. Medical community. We need to train doctors to
recognize these things; we need to teach them what to do when
they recognize them. And we need to ensure that the systems
that exist in the very best hospitals for surveillance and
communication are present across the board.
Dr. Smith. Creation of a much more robust information and
communication infrastructure that will permit integration
across agencies, among hospitals, people.
Mr. Fogg. Sharing of intelligence, that's the best way to
prevent it, minimize it, in the first place.
Complete implementation of the health alert network, that's
a great idea. We've got well--gotten well down the road, but we
need to get the rest of the way. We need buy-in from everybody.
That's something the public should be informed about and
supportive of.
And last, medical surge capacity at the local and regional
level.
Mr. Duehring. From a defense angle, if you want just one
issue, training. Training is a very perishable commodity,
because you can train one person today and that person may be
gone tomorrow. With such a large program like this, we have to
always make sure we are organized and funded to be able to
train our people and continuously train them so that whenever
the next crisis occurs, wherever it occurs, that we're there to
help them.
Mr. Baughman. I'm going to voice my organizational bias. I
think we've got to have a strong emergency management system
from local government to State government, up. Our system and
Woody's system at the State level integrates all the State
agencies.
Responding to a situation like that is not a single agency.
In New York City, we responded with 14 Federal agencies to that
one incident. So you've got to have HHS, you've got to have
EPA, Coast Guard, DOD, and the other agencies integrated in
that process.
Down at the State and local level, you need to have fire,
hazmat and public works integrated in that response. Right now,
we are putting very little money into emergency management at
the State and local level.
Mr. Horn. I'm glad you mentioned that, because the
Comptroller General of the United States has a very good crew
in the GAO, General Accounting Office; and we're looking just
at those to see if those places--by State and region. And we'll
be doing that over the next 2 months to--there are the pieces
there, but again, the communications sometimes are lacking.
Let me ask my last question, I'm sure, and that's--Mr.
Duehring is the Principal Deputy Assistant Secretary of Defense
for Reserve Affairs. And I note here in Dr. Smithson's
testimony on the New York City terrorist attacks, she said that
the New York State National Guard's civil support team did not
reach the site until 12 hours after the collapse of the Twin
Towers. What caused the delay?
Mr. Duehring. There were a couple of things that happened.
No. 1, they were notified and alerted immediately. Within 90
minutes they had moved to a staging area and were ready to go.
Of course, as a lot of people know with the things that
happened after 90 minutes, the communications were destroyed
and the people who were tasked to actually call out the team
were killed. So there was a bit of confusion.
And they were summoned eventually. They responded. They did
their work, I believe, in a 17-block area searching for
possible contaminants of some type. They determined the area
was free and clear.
They withdrew and actually were recalled two other times to
assist in communications, because the teams have some unique
equipment installed in their vans which allows them to actually
marry together various communications systems that the fire
department or the EMT's or whoever happens to be there might
have; and when they can't talk to each other, they can through
this unit.
So they were very valuable. It was a unique situation
driven by the events of the time.
Mr. Horn. Have any of you had a role for the AmeriCorps? A
lot of us pushed that 10 years ago, and it came out of a group
of university presidents, that we thought this was a good idea.
Have any of you used it? And should they be used?
Mr. Fogg. Yes, we have. We've used AmeriCorps folks rather
extensively in the State of New Hampshire--not specifically for
biological/chemical preparedness, but all-hazards
preparedness--by having them work with some engineers, do
review for critical facilities in the State and assess their
vulnerability and measures we can take to improve their
survivability, not only to man-made issues, but to natural
disasters, hurricanes, earthquakes, snowstorms, ice storms,
that sort of thing as well.
They have been extremely valuable in that process.
Mr. Baughman. Likewise, we use AmeriCorps too on natural
disasters. We haven't worked out a role for them in this type
of environment.
Mrs. Maloney. Will the gentlemen yield for one quick
question on September 11th? I want to respond to your comments
on communications.
On September 11th I drove home and went to what was then
command center at One Police Plaza. The No. 1 thing they said
they needed was communications, all communications were down.
They really couldn't talk to each other.
And one of the things I did was call Chairman Young and his
staff because he was involved with defense; and I know he
shipped a load of satellite phones down, which is what they
were asking for.
So my question to you, learning from the World Trade Center
disaster and your comments earlier that the response time--the
early days are when you save people, each day that goes by, the
opportunity to recover someone diminishes. One of the things
the rescue workers have told me is that what really strapped
them for days was the inability to communicate, that you
literally had to walk to a person to communicate with them.
There was very little communication.
And I just ask--maybe not for this panel, but maybe to get
back to the chairman--your ideas of what we could do to improve
communications. Did the satellite phones work? Were they--is
that what we should have ready at FEMA to deliver quickly?
You know, I just didn't know how to get them, so I called
Chairman Young; I thought, if anybody has got them, defense has
got them.
In other words, how do you respond to that one problem that
you were mentioning? And really I heard at Ground Zero the
night of September 11th one of the biggest challenges was the
inability to communicate. And it went on for days, weeks, that
the communication system wasn't working.
Mr. Baughman. The problem was, cell phones were useless, as
they normally are in any major disaster, because the usage
goes--on the cells goes up to saturate. The public switch
network was affected, so it was sporadic at best. Satellite
communications and high-frequency radio were the only means of
communications at the time.
We do, and if a request comes to us, we can tap into any 1
of the 26 agencies. DOD is one of those national communications
systems, and their national communications center has about 27
agencies that have telecommunications assets that can be
brought to bear. Satellite communications or sat phones,
getting that to the area, shouldn't have been a problem. If the
request is put in the right channels, we can get in there.
Mr. Horn. On that point, the Army, as you know, over the
last few years, has started moving communications and generally
computing different things that a soldier does. And it does
that with one person on the battlefield. And it seems to me,
some of the domestic agencies might want to look at the
communications side of that, because I have heard a lot of
complaints about the 999's, and either we ought to have more
operators or more satellites or something.
I remember at my university in Long Beach we had an
exercise there and nobody could talk to each other--and in all
of L.A. County. Now, that's 10 million people there, and no
other part of the United States has 10 million within that
particular jurisdiction. And they were told, well, all the
licenses are on the East Coast.
And I don't know how much that has been changed, because
nobody's brought it to me if they have. But we need some
linkage there in terms of getting that.
I don't know if FEMA is familiar with that. If not, let's
all go to the FCC.
Mr. Baughman. Yes, sir. As a matter of fact, one of the
things we're doing is, we are in the process of doing some
catastrophic planning. Terrorism is one of the scenarios. We
are putting a lot of time and effort into that in the upcoming
year, primarily in five scenario areas. The L.A. Basin is one
of those to take a look at, each 1 of our 12 functional areas,
and what we need to do to enhance telecommunications, health
and medical, in that particular area following a catastrophic
event.
Dr. Smith. Would you permit me 90 seconds to respond to one
of the points of my colleague to the left about the lack of
involvement of the medical community in this planning, because
I think it's an important issue?
I think it's important to realize where there has been--why
it has occurred. In my view, it is not because of the
disinterest of physicians to participate. In many cases, the
medical community is simply not asked. We have been excluded by
the public safety agencies because we're not considered a
public safety agency. It's all police, fire and EMS.
The second point is that hospitals have lots of things on
their plate. Their primary mission is taking care of individual
patients. That's their job. And that's actually what they get
paid for. No insurance payer pays for emergency preparedness.
We're sort of at the margins.
In fact, Ms. Schakowsky asked about, why the nursing
problem? Part of the problem is money. Because we don't have
money to pay maybe the salaries that we need to pay to attract
people. So that we have to figure out a way to support
hospitals, which are really the only private sector in this
quadrant of police, fire and EMS. The other three are all in
the public sector.
Mr. Horn. Yes. Mr. Olson.
Mr. Olson. We're going to step outside and drop the gloves
in a second. But whereas that may, in fact, be the case in some
locals, there have certainly been other opportunities where the
public health sector, the private health community, was
specifically invited and again opted not to participate. There
are no simple answers.
I'm not even suggesting that there is a lack of desire to
do something. I acknowledge every one of the structural
problems that was identified by Dr. Smith just now. I think
that, nonetheless, the bottom line for all of us now--and I
heard it down the way here--it's not to go back and beat each
other up over what we didn't do in the past, it's to identify
what we need to do together in the future.
Mr. Horn. Yes. Mr. Fogg.
Mr. Fogg. I would have to say that our experience has been
extremely positive. Once--and I guess we did it from the
emergency management profession. But in New Hampshire, we asked
and actually our three States Maine, Massachusetts and New
Hampshire, together, as a result of the Top Off exercise,
reached out to the medical community. And I've been very
pleased with the response we've received.
We recognize that there are gaps there. We recognize the
economic concerns. And we're trying to work together in spite
of those constraints to improve the medical surge capability.
I've been very impressed at the response and the progress
we've made already. But can we do it without additional help?
No. We need help.
Mr. Olson. I would indicate that I think Top Off is an
example of one case where it definitely worked with the medical
community in not only the Northeast, but also in Colorado and
Denver and others did come together and did play well. But that
was a very high-profile, very long-term effort that took a lot
of effort to make that happen.
Again, that's in the past. Let's move forward.
Mr. Horn. Whatever happened to Vermont? You didn't seem to
mention Vermont.
Mr. Fogg. I'm glad you asked, because right now the best
cooperation we're getting, once we started that after Top Off,
has been our upper valley in New Hampshire that actually
reaches up into Vermont in the watershed along the Connecticut
River. The cross-coordination between the Vermont medical
community and the New Hampshire one, spearheaded primarily by
Dartmouth Medical Center in Hanover, right on the border, has
been astounding. We have reached out to public health services
on a national level.
I feel really good about what we're doing there. We just
need time and a little more resources to get where we want to
go.
Mr. Horn. Well, thank you. Any other thoughts before we
gavel this down?
Well, if not, I'm going to thank the staff that put this
hearing together, and the hearings about to come all over the
country. J. Russell George, staff director and chief counsel;
Matt Phillips, on my left, is the professional staff member
that put all the pieces together for this hearing; Mark
Johnson, our clerk; Bonnie Heald, communications director; and
Jim Holmes, our intern. And the minority staff: David McMillen,
professional staff; Jean Gosa, minority clerk, and two
faithful, hard-working court reporters, namely Julie Thomas and
Mark Stuart. And we thank you all. It's a tough one.
So we are now going to recess the committee until we go to
New York.
[Whereupon, at 1:58 p.m., the subcommittee was adjourned.]
[The prepared statement of Hon. Elijah E. Cummings and
additional information submitted for the hearing record
follow:]
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