September 11, 2001 : Attack on America
Statement of Michael V. Drake Before the Committee on Judiciary, Subcommittee on Technology, Terrorism and Government Information; November 6, 2001

Congress of the United States
U.S. Senate
Subcommittee on Technology, Terrorism, and Government Information
of the Senate Judiciary Committee
Hearing on Germs and Toxins as Domestic Terrorist Threats
November 6, 2001
Testimony of Michael V. Drake, MD
Vice President for Health Affairs
University of California, Office of the President
Steven P. Shearing Professor, Department of Ophthalmology
University of California, San Francisco School of Medicine

Madame Chair, Distinguished Members of the Subcommittee:

I am Michael V. Drake, Vice President for Health Affairs at the University of California and a member of the faculty at the University of California, San Francisco School of Medicine.

The University of California's mission includes a strong emphasis on basic research in the public interest. The University manages 10 campuses and three national laboratories, including 15 health sciences schools such as medicine, public health, and veterinary medicine.

Speaking of the national laboratories, UC is proud of the contributions for over 50 years by our faculty and staff to our nation's national security through the Los Alamos, Lawrence Livermore and Lawrence Berkeley national laboratories. Scientists at Lawrence Livermore, for example, have developed an advanced hand held analyzer that can identify pathogens based on DNA. Some cities have already deployed this device. At Los Alamos, researchers have developed technologies that can identify the unique origins of biological organisms based on DNA. This technique can help authorities establish a library of genetic profiles of different strands of organisms, including anthrax.

A Coordinated, Statewide Response

In response to the discovery of anthrax in Florida in early October, California Governor Gray Davis contacted the University of California and other institutions around the state to learn more about this biological agent and our state's ability to respond to such an attack. He followed this contact with an Executive Order establishing – under the auspices of the State Strategic Committee on Terriorism – a series of subcommittees, including the Subcomittee on the Protection of the Public Health. Along with Dr. Diana Bonta, Director of the California Department of Health Services, I co-chaired this committee. The committee met on October 19 and submitted its confidential report to the Governor on October 25. Per the executive order, the committee includes "representatives from the University of California, medical and health care associations, public health organizations and state agencies and departments."

While the findings and recommendations to the Governor remain confidential due to the sensitive nature of the information, I am pleased to share with this committee today a general summary of our findings and recommendations on several important issues related to bioterrorism.

Our subcommittee found that there is an acknowledged need to improve the communication between and training of personnel in the continuum of public health services, from the initial response teams to the treating physicians and nurses. This involves improving information services directed at both public health professionals and the general public; improving coordination among local, state and federal agencies; and doing all of this in ways that will strengthen the public health system, even in the hopeful event that no further terrorist attacks occur.

As part of the 1999 Bioterrorism Initiative of the Department of Health and Human Services, the Centers for Disease Control and Prevention took the lead in an effort to improve the nation's ability to respond to an attack. A multi-faceted program is currently underway. The Rapid Response and Advanced Technology laboratory and the newly established National Pharmaceutical Stockpile Program are products of this effort. The Health Alert Network, National Electronic Data Surveillance System and the Epidemic Information Exchange will facilitate communication among health professionals, particularly between clinical providers and public health officials and epidemiologists. Obviously the events of the past several weeks teach us that we must accelerate our efforts to make these programs fully operational and expand their reach.

In all cases it is crucial to make certain that our crisis management infrastructure and protocols enhance our ability to manage the ubiquitous chronic problems that affect the public's health on a daily basis. There's a common aphorism used on the wards of our teaching hospitals that states : "When you hear hoof beats it's more likely a herd of horses than a stampede of zebras." Stated differently, common diseases occur in uncommon ways more often than uncommon diseases occur. In preparing for attacks of bio-terrorism we are guarding against the uncommon. But we must not lose sight of the myriad problems we were dealing with on September 10th. We were very engaged, rightfully so, in issues of great importance to the health of the public on a daily basis. Those problems did not disappear on September 11th, although they have been obscured to some degree by the enormity of the events of that day, and the unfortunate biologic events of the past month. Ideal solutions must address both of these concerns. Our public health system is understaffed and under funded; many Americans are vulnerable to disease and injury in ways that we could avoid. We should seek solutions that not only enhance our national security, but that also improve the public safety.

In demographically diverse states like California it is important to provide public information in a culturally competent manner and in multiple languages. Recent health care financing decisions, which have led to the increased marginalization of vulnerable communities, have had the additional effect of compromising the State's ability to deal with serious public health challenges regardless of the origin (i.e. terrorism or a naturally occurring epidemic).

Universities and Academic Medical Centers

In addition to the public health response, the University of California, like other universities in the state and across the nation, has volunteered assistance and expertise in many ways. While some of the work has taken place in specific response to recent events, much of it highlights or accelerates activities that were already underway. For example, University faculty working in the field of bio-filtration are investigating ways of removing highly toxic materials from the air, as well as novel detection techniques and methods for degrading toxic pollutants. Researchers in the Environmental Energy Technology Division at Lawrence Berkeley National Laboratory are developing building management strategies to reduce occupant exposures to an unexpected release of a toxic aerosol or gas.

Although much of our country's attention and concern over the past month has appropriately focused on bio-terrorism, we remain vigilant to the possibilities of other types of threats as well. Within the field of cybersecurity, researchers are exploring new developments in computer security, encryption, online secrecy and monitoring of Internet communications. The Center for Digital Security at UC Davis, with funding from the United States Air Force, uses physical and mathematical modeling to investigate threats to communications networks that might develop in the next five to ten years and countermeasures that will allow people to defend these networks. Two of our newly funded California Institutes for Science and Innovation are also conducting research into ways to defend critical infrastructures such as the telecommunications system, power grid, air traffic control system and financial markets against physical cyber attacks.

UC also continues to work internally with university officials to assess the levels of campus and laboratory security, both in terms of employee safety, which has properly been the overriding focus of regulations over past years, and in terms of protecting valuable laboratory equipment, and materials. Laboratory safety and laboratory security are related, but not identical. Developing procedures for protecting the public from exposure risk to hazardous substances is an ongoing enterprise, and applicable campus and government regulations have been re-examined by campus officials. These steps take place on top of already stringent laboratory security response procedures. For instance, in regard to anthrax, which is often collected from the field and freeze-dried for use by diagnosticians, isolates are kept in a separate, locked area in a locked keycard access room. Any sharing of these samples must be cleared first with the CDC.

Our research scientists are critical to this endeavor in another way. At a recent meeting hosted by the Association of Academic Health Centers, Tara O'Toole from the center for Civilian Biodefense Studies at Johns Hopkins observed that biology is on the precipice of losing its innocence in the 21st century, the way that physics lost its innocence in the 20th. Unlike weapons of mass destruction arising from the realm of physics, biological weapons do not necessarily require a state supported program. They can be developed by a few individuals, with fairly modest resources. We will be increasingly dependant on the scientific community to work with law enforcement and other branches of government to develop effective measures for insuring the public safety. It is important that the federal government continue to work with the scientific community on this issue, and that we avoid regulations or policies that curtail the ability of our scientists to advance their craft in beneficial ways. My colleagues at the University of California, and I am certain I speak for faculty at other academic institutions as well, would welcome the opportunity to work with you on developing policies that increase laboratory security without crippling laboratory research.

Another area in which the University's faculty and academic medical centers can have an immediate impact is by providing timely information to our students, residents and other trainees, as well as the practicing community and general public. Academic medical centers – enterprises that include a hospital, medical school, and at least one other health sciences school, such as a school of nursing or pharmacy – serve as a unique locus for education, training and multi-disciplinary research. With their academic and volunteer faculty, they also provide an important link to medical practitioners in the community. Although the vast majority of physicians will not see a case resulting from a chemical or biological attack, our hospitals and community providers will see an influx of frightened patients with flu symptoms this winter. We must arm practitioners with the ability to tell the difference, and to address the mental health issues that arise in a population living in a heightened state of anxiety.

Collectively, the country's academic medical centers are also organizing several new activities that will pool their resources and strengths. The Association of Academic Health Centers is addressing this issue. As part of this effort it held a day long planning meeting here in Washington yesterday in advance of a national meeting devoted to the topic of the appropriate bio-terrorism response for academic medical centers across the country. And joined by some of your esteemed colleagues, the Association of American Medical Colleges last week announced an initiative to help educate and prepare the nation's physician workforce to respond appropriately to terrorist attacks. One component of this project will focus on integrating bio-terrorism education into the medical school curriculum.

Research universities, medical schools, and academic medical centers take seriously their public service responsibility to respond in any appropriate manner to major threats to our health and security. This is particularly clear to us at the University of California because of our successful half-century of management of the national laboratories in Berkeley, Livermore, and Los Alamos. The marriage between academic scientific inquiry and national security has been sound and mutually beneficial. We, along with our sister institutions here and around the world, stand ready to address prevention and respond to terrorist attacks and natural disasters. We are actively pursuing these issues at the present time, and look forward to working with you as we refine and improve programs that address the reality of terrorism in the future.

Senator, on behalf of the University of California, we applaud your leadership in the wake of the recent threats to our homeland security and we look forward to working with you and your colleagues as you continue to work on the many difficult issues facing our nation.

Thank you for your time and attention. I would be pleased to answer any questions you may have.

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