Editing Bioterrorism (section)

=== Preparedness ===
Export controls on biological agents are not applied uniformly, providing terrorists a route for acquisition.<ref>{{Cite book|last1=Kuntz|first1=Carol|url=https://books.google.com/books?id=7bisH_7fo00C&q=A+Biological+Threat+Prevention+Strategy+:+Complicating+Adversary+Acquisition+and+Misuse+of+Biological+Agents&pg=PR3|title=A Biological Threat Prevention Strategy: Complicating Adversary Acquisition and Misuse of Biological Agents|last2=Salerno|first2=Reynolds|last3=Jacobs|first3=Eli|date=May 15, 2013|publisher=Center for Strategic & International Studies|isbn=978-1-4422-2474-2|language=en}}</ref> Laboratories are working on advanced detection systems to provide early warning, identify [[contamination|contaminated areas]] and populations at risk, and to facilitate prompt treatment.<ref>{{Cite book|last1=Nikolelis|first1=Dimitrios P.|url=https://books.google.com/books?id=k-m9CwAAQBAJ&q=terrorism|title=Biosensors for Security and Bioterrorism Applications|last2=Nikoleli|first2=Georgia-Paraskevi|date=March 12, 2016|publisher=Springer|isbn=978-3-319-28926-7|language=en}}</ref> Methods for predicting the use of biological agents in urban areas as well as assessing the area for the hazards associated with a biological attack are being established in major cities. In addition, [[forensic]] technologies are working on identifying biological agents, their geographical origins and/or their initial source. Efforts include decontamination technologies to restore facilities without causing additional environmental concerns.

Early detection and rapid response to bioterrorism depend on close cooperation between [[public health]] authorities and law enforcement; however, such cooperation is lacking. National detection assets and vaccine stockpiles are not useful if local and state officials do not have access to them.<ref>{{citation|last=Bernett|first=Brian C.|title=US Biodefense and Homeland Security: Toward Detection and Attribution|url=http://www.ccc.nps.navy.mil/research/theses/bernett06.pdf|access-date=May 24, 2009|date=December 2006|publisher=Naval Postgraduate School|location=Monterey, California, United States|page=21|url-status=dead|archive-url=https://web.archive.org/web/20080229164557/http://www.ccc.nps.navy.mil/research/theses/bernett06.pdf|archive-date=February 29, 2008}}</ref>

Aspects of protection against bioterrorism in the United States include:
*Detection and resilience strategies in combating bioterrorism. This occurs primarily through the efforts of the [[DHS Office of Health Affairs|Office of Health Affairs]] (OHA), a part of the [[Department of Homeland Security]] (DHS), whose role is to prepare for an emergency situation that impacts the health of the American populace. Detection has two primary technological factors. First there is OHA's [[BioWatch]] program in which collection devices are disseminated to thirty high risk areas throughout the country to detect the presence of aerosolized biological agents before symptoms present in patients.<ref name="PrepX">United States. Cong. House. Committee on Homeland Security. Ensuring Effective Preparedness Responses and Recovery for Events Impacting Health Security Hearing before the Subcommittee on Emergency Preparedness, Response and Communications of the Committee on Homeland Security, House of Representatives, One Hundred Twelfth Congress, First Session, March 17, 2011. 112th Cong., 1st sess. HR 397. Washington: U.S. G.P.O., 2012. Print.</ref> This is significant primarily because it allows a more proactive response to a disease outbreak rather than the more passive treatment of the past.
*Implementation of the Generation-3 automated detection system. This advancement is significant simply because it enables action to be taken in four to six hours due to its automatic response system, whereas the previous system required aerosol detectors to be manually transported to laboratories.<ref name="PrepX"/> Resilience is a multifaceted issue as well, as addressed by OHA. One way in which this is ensured is through exercises that establish preparedness; programs like the Anthrax Response Exercise Series exist to ensure that, regardless of the incident, all emergency personnel will be aware of the role they must fill.<ref name="PrepX"/> Moreover, by providing information and education to public leaders, emergency medical services and all employees of the DHS, OHS suggests it can significantly decrease the impact of bioterrorism.<ref name="PrepX"/>
*Enhancing the technological capabilities of first responders is accomplished through numerous strategies. The first of these strategies was developed by the Science and Technology Directorate (S&T) of DHS to ensure that the danger of suspicious powders could be effectively assessed, (as many dangerous biological agents such as anthrax exist as a white powder). By testing the accuracy and specificity of commercially available systems used by first responders, the hope is that all biologically harmful powders can be rendered ineffective.<ref name="PrepY">United States. Cong. House. Committee on Homeland Security. First Responder Technologies: Ensuring a Prioritized Approach for Homeland Security Research and Development: Joint Hearing before the Subcommittee on Emergency Preparedness, Response and Communications and the Subcommittee on Cybersecurity, Infrastructure Protection, and Security Technologies of the Committee on Homeland Security, House of Representatives, One Hundred Twelfth Congress, Second Session, May 9, 2012. 112th Cong., 2nd sess. HR 397. N.p.: n.p., n.d. Print.</ref>
*Enhanced equipment for first responders. One recent advancement is the commercialization of a new form of Tyvex™ armor which protects first responders and patients from chemical and biological contaminants. There has also been a new generation of Self-Contained Breathing Apparatuses (SCBA) which has been recently made more robust against bioterrorism agents. All of these technologies combine to form what seems like a relatively strong deterrent to bioterrorism. However, New York City as an entity has numerous organizations and strategies that effectively serve to deter and respond to bioterrorism as it comes. From here the logical progression is into the realm of New York City's specific strategies to prevent bioterrorism.<ref name="PrepY"/>
*Excelsior Challenge. In the second week of September 2016, the state of New York held a large emergency response training exercise called the Excelsior Challenge, with over 100 emergency responders participating. According to [[WKTV]], "This is the fourth year of the Excelsior Challenge, a training exercise designed for police and first responders to become familiar with techniques and practices should a real incident occur."<ref>{{Cite web|url=http://www.wktv.com/news/A_new_challenge_for_police_and_EMS_personnel.html|title=WKTV.com {{!}} A new Challenge for police and EMS personnel|date=September 15, 2016|access-date=October 3, 2016|archive-url=https://web.archive.org/web/20161005104757/http://www.wktv.com/news/A_new_challenge_for_police_and_EMS_personnel.html|archive-date=October 5, 2016|url-status=dead}}</ref> The event was held over three days and hosted by the State Preparedness Training Center in [[Oriskany, New York|Oriskany]], New York. Participants included [[Bomb disposal|bomb squads]], canine handlers, tactical team officers and emergency medical services.<ref name=":1">{{Cite web|url=https://homelandprepnews.com/countermeasures/19747-first-responders-train-new-technology-n-y-s-largest-emergency-response-exercise/|title=First responders train with new technology at N.Y.'s largest emergency response exercise - Homeland Preparedness News|date=September 19, 2016|language=en-US|access-date=October 3, 2016}}</ref> In an interview with ''Homeland Preparedness News'', Bob Stallman, assistant director at the New York State Preparedness Training Center, said, "We're constantly seeing what's happening around the world and we tailor our training courses and events for those types of real-world events." For the first time, the 2016 training program implemented New York's new electronic system. The system, called NY Responds, electronically connects every county in New York to aid in disaster response and recovery. As a result, "counties have access to a new technology known as Mutualink, which improves [[interoperability]] by integrating telephone, radio, video, and file-sharing into one application to allow local emergency staff to share real-time information with the state and other counties."<ref name=":1" /> The State Preparedness Training Center in Oriskany was designed by the State Division of Homeland Security, and Emergency Services (DHSES) in 2006. It cost $42&nbsp;million to construct on over 1100 acres and is available for training 360 days a year.<ref>{{Cite web|url=http://www.newyorkupstate.com/news/2016/09/ny_police_train_for_terrorist_attacks_bombs_active_shooters_videos.html|title=Watch NY police train for terrorist attacks, bombs, active shooters (videos)|access-date=October 3, 2016|date=September 15, 2016}}</ref> Students from SUNY Albany's College of Emergency Preparedness, Homeland Security and Cybersecurity, were able to participate in this year's exercise and learn how "DHSES supports law enforcement specialty teams."<ref name=":1" />
* Project BioShield. The accrual of vaccines and treatments for potential biological threats, also known as medical countermeasures has been an important aspect in preparing for a potential bioterrorist attack; this took the form of a program beginning in 2004, referred to as [[Project Bioshield Act|Project BioShield]].<ref name="Hylton">[[Wil S. Hylton|Hylton, Wil S.]] "How Ready Are We for Bioterrorism?" The New York Times. The New York Times Company, October 26, 2011. Web.</ref> The significance of this program should not be overlooked as “there is currently enough smallpox vaccine to inoculate every United States citizen and a variety of therapeutic drugs to treat the infected.”<ref name="Hylton"/> The Department of Defense also has a variety of laboratories currently working to increase the quantity and efficacy of countermeasures that comprise the national stockpile.<ref name="PrepXYZ"/> Efforts have also been taken to ensure that these medical countermeasures can be disseminated effectively in the event of a bioterrorist attack. The National Association of Chain Drug Stores championed this cause by encouraging the participation of the private sector in improving the distribution of such countermeasures if required.<ref name="PrepXYZ">United States. Cong. House. Committee on Homeland Security. Taking Measure of Countermeasures. Hearing before the Subcommittee on Emergency Preparedness, Response and Communications of the Committee on Homeland Security, House of Representatives, One Hundred Twelfth Congress, First Session, April 13, 2011, and May 12, 2011. 112 Cong., 1st sess. HR 397. Washington: U.S. G.P.O., 2012. Print.</ref>

On a CNN news broadcast in 2011, the CNN chief medical correspondent, Dr. Sanjay Gupta, weighed in on the American government's recent approach to bioterrorist threats. He explains how, even though the United States would be better fending off bioterrorist attacks now than they would be a decade ago, the amount of money available to fight bioterrorism over the last three years has begun to decrease. Looking at a detailed report that examined the funding decrease for bioterrorism in fifty-one American cities, Dr. Gupta stated that the cities "wouldn't be able to distribute vaccines as well" and "wouldn't be able to track viruses." He also said that film portrayals of global pandemics, such as ''[[Contagion (2011 film)|Contagion]]'', were actually quite possible and may occur in the United States under the right conditions.<ref>John King, USA. CNNW. San Francisco. December 20, 2011. Television.</ref>

A news broadcast by [[MSNBC]] in 2010 also stressed the low levels of bioterrorism preparedness in the United States.  The broadcast stated that a bipartisan report gave the Obama administration a failing grade for its efforts to respond to a bioterrorist attack. The news broadcast invited the former New York City police commissioner, Howard Safir, to explain how the government would fare in combating such an attack. He said how "biological and chemical weapons are probable and relatively easy to disperse." Furthermore, Safir thought that efficiency in bioterrorism preparedness is not necessarily a question of money, but is instead dependent on putting resources in the right places. The broadcast suggested that the nation was not ready for something more serious.<ref>MSNBC News Live. MSNBC. New York City. January 26, 2010. Television</ref>

In a September 2016 interview conducted by Homeland Preparedness News, Daniel Gerstein, a senior policy researcher for the RAND Corporation, stresses the importance in preparing for potential bioterrorist attacks on the nation. He implored the U.S. government to take the proper and necessary actions to implement a strategic plan of action to save as many lives as possible and to safeguard against potential chaos and confusion. He believes that because there have been no significant instances of bioterrorism since the anthrax attacks in 2001, the government has allowed itself to become complacent making the country that much more vulnerable to unsuspecting attacks, thereby further endangering the lives of U.S. citizens.<ref name=":0">{{Cite web|url=https://homelandprepnews.com/biological-threats/19645-rands-gerstein-u-s-needs-biodefense-strategy-protect-terror-threats/|title=RAND's Gerstein: U.S. needs biodefense strategy to protect against terror threats|last=Rozens|first=Tracy|date=September 2, 2016|website=Homeland Preparedness News|language=en-US|access-date=September 19, 2016}}</ref>

Gerstein formerly served in the Science and Technology Directorate of the Department of Homeland Security from 2011 to 2014. He claims there has not been a serious plan of action since 2004 during George W. Bush's presidency, in which he issued a Homeland Security directive delegating responsibilities among various federal agencies. He also stated that the blatant mishandling of the Ebola virus outbreak in 2014 attested to the government's lack of preparation. This past May, legislation that would create a national defense strategy was introduced in the Senate, coinciding with the timing of ISIS-affiliated terrorist groups get closer to weaponizing biological agents. In May 2016, Kenyan officials apprehended two members of an Islamic extremist group in motion to set off a biological bomb containing anthrax. Mohammed Abdi Ali, the believed leader of the group, who was a medical intern, was arrested along with his wife, a medical student. The two were caught just before carrying out their plan.<ref>{{Cite web|last=McCormick|first=Ty|title=Foiled Kenya Anthrax Plot Hints At Islamic State's Scramble For Africa|url=https://foreignpolicy.com/2016/05/04/foiled-kenya-anthrax-plot-hints-at-islamic-states-scramble-for-africa/|access-date=October 19, 2020|website=Foreign Policy|date=May 4, 2016 |language=en-US}}</ref> The Blue Ribbon Study Panel on Biodefense, which comprises a group of experts on national security and government officials, in which Gerstein had previously testified to, submitted its National Blueprint for Biodefense to Congress in October 2015 listing their recommendations for devising an effective plan.<ref name=":0" />

Bill Gates said in a February 18, 2017 ''Business Insider'' op-ed (published near the time of his Munich Security Conference speech) that it is possible for an airborne pathogen to kill at least 30&nbsp;million people over the course of a year.<ref>{{Cite web|last=Foundation|first=Bill Gates, Bill & Melinda Gates|title=BILL GATES: A new kind of terrorism could wipe out 30 million people in less than a year — and we are not prepared|url=https://www.businessinsider.com/bill-gates-op-ed-bio-terrorism-epidemic-world-threat-2017-2|access-date=October 19, 2020|website=Business Insider}}</ref> In a ''New York Times'' report, the [[Gates Foundation]] predicted that a modern outbreak similar to the [[1918 flu pandemic|Spanish Influenza pandemic]] (which killed between 50&nbsp;million and 100&nbsp;million people) could end up killing more than 360&nbsp;million people worldwide, even considering widespread availability of vaccines and other healthcare tools. The report cited increased [[globalization]], rapid international air travel, and [[urbanization]] as increased reasons for concern.<ref name=":3">{{Cite web|url=https://www.hstoday.us/subject-matter-areas/border-security/exclusive-pandemic-crossroads/|title=Exclusive: Pandemic Crossroads|date=July 9, 2017|website=www.hstoday.us|language=en|access-date=April 8, 2025}}</ref> In a March 9, 2017, interview with CNBC, former U.S. Senator [[Joe Lieberman]], who was co-chair of the bipartisan [[Blue Ribbon Study Panel on Biodefense]], said a worldwide pandemic could end the lives of more people than a nuclear war. Lieberman also expressed worry that a terrorist group like ISIS could develop a synthetic influenza strain and introduce it to the world to kill civilians.<ref name=":3" /> In July 2017, Robert C. Hutchinson, former agent at the [[United States Department of Homeland Security|Department of Homeland Security]], called for a "whole-of-government" response to the next global health threat, which he described as including strict security procedures at our borders and proper execution of government preparedness plans.<ref name=":3" />

Also, novel approaches in biotechnology, such as synthetic biology, could be used in the future to design new types of biological warfare agents.<ref>{{cite book |doi=10.1007/978-90-481-2678-1_7 |title=Synthetic Biology |year=2009 |last1=Kelle |first1=Alexander |chapter=Security Issues Related to Synthetic Biology: Between Threat Perceptions and Governance Options |pages=101–119 |isbn=978-90-481-2677-4 }}</ref><ref>{{Cite web|title = JCVI: Research / Projects / Synthetic Genomics {{!}} Options for Governance / Overview|url = http://www.jcvi.org/cms/research/projects/syngen-options/overview/|website = www.jcvi.org|access-date = January 24, 2016|archive-url = https://web.archive.org/web/20160130071934/http://www.jcvi.org/cms/research/projects/syngen-options/overview/|archive-date = January 30, 2016|url-status = dead}}</ref><ref>M.Buller, The potential use of genetic engineering to enhance orthopox viruses as bioweapons. Presentation at the International Conference ‘Smallpox Biosecurity. Preventing the Unthinkable’ (October 21–22, 2003) Geneva, Switzerland</ref> Special attention has to be laid on future experiments (of concern) that:<ref>Kelle A. 2007. Synthetic Biology & Biosecurity Awareness In Europe. Bradford Science and Technology Report No.9</ref>
# Would demonstrate how to render a vaccine ineffective;
# Would confer resistance to therapeutically useful antibiotics or antiviral agents;
# Would enhance the virulence of a pathogen or render a nonpathogen virulent;
# Would increase transmissibility of a pathogen;
# Would alter the host range of a pathogen;
# Would enable the evasion of diagnostic/detection tools;
# Would enable the weaponization of a biological agent or toxin
Most of the biosecurity concerns in synthetic biology, however, are focused on the role of DNA synthesis and the risk of producing genetic material of lethal viruses (e.g. 1918 Spanish flu, polio) in the lab.<ref>{{cite journal |last1=Tumpey |first1=T. M. |last2=Basler |first2=CF |last3=Aguilar |first3=PV |last4=Zeng |first4=H |last5=Solórzano |first5=A |last6=Swayne |first6=DE |last7=Cox |first7=NJ |last8=Katz |first8=JM |last9=Taubenberger |first9=JK |last10=Palese |first10=P |last11=García-Sastre |first11=A |title=Characterization of the Reconstructed 1918 Spanish Influenza Pandemic Virus |journal=Science |date=October 7, 2005 |volume=310 |issue=5745 |pages=77–80 |doi=10.1126/science.1119392 |pmid=16210530 |bibcode=2005Sci...310...77T |s2cid=14773861 }}</ref><ref>{{cite journal | last1 = Cello | first1 = J. | last2 = Paul | first2 = A. V. | last3 = Wimmer | first3 = E. | year = 2002 | title = Chemical synthesis of poliovirus cDNA: generation of infectious virus in the absence of natural template | journal = Science | volume = 297 | issue = 5583| pages = 1016–1018 | doi=10.1126/science.1072266 | pmid=12114528| bibcode = 2002Sci...297.1016C | s2cid = 5810309 | doi-access = free }}</ref><ref>{{Cite journal|title = Synthetic viruses: a new opportunity to understand and prevent viral disease|journal = Nature Biotechnology|date = December 1, 2009 |pmc = 2819212|pmid = 20010599|pages = 1163–72|volume = 27|issue = 12|doi = 10.1038/nbt.1593|author1-link=Eckard Wimmer|first1 = Eckard|last1 = Wimmer|first2 = Steffen|last2 = Mueller|first3 = Terrence M|last3 = Tumpey|first4 = Jeffery K|last4 = Taubenberger}}</ref> The CRISPR/Cas system has emerged as a promising technique for gene editing. It was hailed by The Washington Post as "the most important innovation in the synthetic biology space in nearly 30 years."<ref name="WangerMRoleOfClinicalInformationSystems" /> While other methods take months or years to edit gene sequences, CRISPR speeds that time up to weeks.<ref name="WangerMRoleOfClinicalInformationSystems" /> However, due to its ease of use and accessibility, it has raised a number of ethical concerns, especially surrounding its use in the biohacking space.<ref>{{Cite news|title = The Crispr Quandary|url = https://www.nytimes.com/2015/11/15/magazine/the-crispr-quandary.html|newspaper = The New York Times|date = November 9, 2015|access-date = January 24, 2016 |first = Jennifer|last = Kahn}}</ref><ref>{{cite journal |last1=Ledford |first1=Heidi |title=CRISPR, the disruptor |journal=Nature |date=June 1, 2015 |volume=522 |issue=7554 |pages=20–24 |doi=10.1038/522020a |pmid=26040877 |bibcode=2015Natur.522...20L |s2cid=4456595 |doi-access=free }}</ref><ref>{{Cite news|title = Everything you need to know about why CRISPR is such a hot technology|url = https://www.washingtonpost.com/news/innovations/wp/2015/11/04/everything-you-need-to-know-about-why-crispr-is-such-a-hot-technology/|newspaper = The Washington Post|date = November 4, 2015|access-date = January 24, 2016 |first = Dominic|last = Basulto}}</ref>