Gilmore Commission - Minutes

Panel to Assess the Capabilities for Domestic Response
to Terrorist Acts Involving Weapons of Mass Destruction

RAND, Arlington VA
Tuesday, July 18, 2000

Present:
James Clapper, Vice Chairman 
Paul Maniscalco 
William Reno 
William Jenaway 
Kathleen O'Brien 
Richard Falkenrath 
Joseph Samuels 
George Foresman 
Hurbert Williams 
Jack Marsh 
J. Paul Bremer 
Raymond Downey 
William Garrison 
Patrick Ralston 
Dallas Jones 
Kenneth Shine 
Patricia Quinlisk 
Ellen Embrey, OSD Representative 
Michael Wermuth, RAND project director

Members absent:
The Honorable James Gilmore, Chairman 
James Greenleaf 
Ellen Gordon

Visitors:
Nick Teta & Tara Sweeney - Bechtel Nevada 
James Stanton - University of Maryland 
N. Andrew Donofrio - Corsec Security 
Ed Anderson - Department of the Navy 
Craig Howard - Department of the Navy 
Gary Wertz - Department of the Navy 
Steven Hart - Department of the Navy 
Daniel J. Kaniewski - The Congressional Fire Servies 
Steven Caldwell and Deborah Colantonia - GAO 
Nick Palarino - House Subcommittee on National Security 
David Beaupre - Tridata

I. The meeting started at 0830 EDT.

Vice-chair Clapper: We have a quorum and the Governor is unable to be here today. Let's get started.

II. Technology, Equipment, and Standards Update (Continued).

Wermuth: I want to introduce Brian David and Don Buley from the DoD Joint Program Office for Biological Defense (JPO-BD). They will be giving us a presentation of Environmental sampling, concentrating on detection of biological agents.

The presentation stressed the difference between biological and chemical hazards. The presenters illustrated and explained the processes used to detect the presence of biological agents in different environments. They stressed that no single technology was providing a 'sure cure' to the problem of the bio-threat. They stressed that they were looking for and participating in an evolutionary and incremental approach to using complementary technologies, creating a system of systems. A brief explanation of the type and function of their detection equipment was given. The military it was explained is looking for early warning rather than just standoff. A hand-held assay kit was passed around for the panelists to see. It was stressed that using their new equipment, there have been no false positives indicators (less than one half of one percent).

Vice-chair Clapper asked during the presentation that presenters be more clear when using military jargon, and Dr. Richard Falkenrath questioned the figures that were being used.

Some of the questions, statements and reactions to the presentation:

Wermuth: Is this the device that they used for the NATO fifty-year anniversary? How long did it take to set it up?

Brian David: Yes, one day to set up and then a brief explanation of how it can switch from random to smart selection. The biggest problem is getting the power.

Wermuth: So they work pretty well in urban environments.

Falkenrath: Is the equipment tested with live agents?

Brian David: Yes. We test the assays on almost a daily basis. There is a perception that there is a high false positive rate with these but it our experience that there is not if they are used correctly. It is really for fixed site detection. That's where it does its best work.

Downey: Is this only available to the military?

Brian David: Yes, it can't be sold to state and local agencies because it is classified. It can be sold to any federal agency. We don't get the dollars back from the other agencies.

Maniscalco: So, it's budget relief, not the classification.

Vice-chair Clapper: So the vendor is restricted not to sell except to the government?

Brian David: Well, we own all the antibodies, so as long as there was budget relief, we could.

Wermuth: Paul, the law may be changing and we may need to talk a bit more about that later.

Clapper: So yesterday when we heard from Lisa, but it's not available to local agencies?

Bremer: Why is the government producing these at all?

Brian David: They are the only ones that can because they are classified.

Shine: Can we get a list of the agents that we have kits for?

Brian David: Yes, it is classified but we can try to do that.

Shine: What is your current approach to use of vaccines and the FDA process?

Brian David: The joint vaccine acquisition program is designed to take it all the way through the FDA process.

Mike Wermuth introduced Andy Mitchell from the Office of State and Local Domestic Preparedness Support, DoJ.

Mr. Mitchell gave an update on equipment and training support for state and local governments; he represents the principle grant-making program for first responders. They work with 3200 counties and 1800 municipal authorities, and they have a congressional mandate to make equipment grants to the nations 157 largest jurisdictions. The awards were completed in the spring of 2000 and based on three years. During the fiscal-year 1999 they restricted the money to basic defensive equipment.

This presentation precipitated a discussion related to the presentation by Lisa Gordon-Hagerty from Monday. It was this presenter's opinion that the local agencies were better prepared to select the equipment they needed than the fed was.

Williams: Lisa's point was that there should be certain categories. Do you mean that she was telling the locals what to buy or to have certain minimal standards?

Andy Mitchell: We provide a list of allowable equipment and give the basic equipment types allowed. If we had some way of determining what they needed then we could do that, but we don't.

Williams: Part of the problem has been the disconnect leaving us with no strategic plan. How do we get beyond everyone doing their own thing?

Bremer: The more I talk to people out in the field, the more I think that Lisa is wrong.

Wermuth: We still don't have that consumers digest if you will …… on specific pieces of equipment that are approved.

Williams: My experience is that local government follows state law . . . but much of the equipment tested doesn't meet standards.

Wermuth: I had heard some horror stories; that's why I am raising some questions.

Mike Wermuth asked that the Chair consider a motion to approve the minutes of the previous meeting; the movement was made, seconded and approved. Vice-chair Clapper stressed the importance of finishing the 'marching orders' for RAND.

III. Health and Medical Issues.

Mike Wermuth introduced Henry J. Siegelson MD. Dr. Siegelson made a presentation about the preparedness of hospitals to deal with a catastrophic terrorist attack. The Doctor felt that most hospitals has sufficient capability to deal with bio events, and that many were already on their way to being prepared for catastrophic chemical terrorist attacks based on their effectiveness in dealing with HAZMAT situations, but that they need help developing the necessary policies. He felt that lead hospitals in each city should be chosen for planning and response.

Vice-chair Clapper:  Does the fed need to set up a minimum standard?

Siegelson: Hospitals are listening; just let them know, send them a letter.

Foresman: You paint a pretty bright picture, but I am afraid I don't share that view with you. What is the organizational structure that we need to engage the hospital?

Siegelson: Hospital CEO's are afraid of a bottomless (expense) pit. Let them know that it isn't a bottomless pit.

Shine: This is a field that is most notable by extremes on both sides - bio arguments are grossly over stated - so is Henry's view of bio preparedness - some hospitals aren't ready, normal and significant events are different things.

CEO’s are worried about ear infections not events they think will never happen. Let me make a few points:

1. National interest in new and emerging infections – can you nest terror with the overall programs for these new and emerging infections?
2. Bio –- Emphasis needs to be in recognition; and the investment in public health infrastructure is critical.
3. Health care is local – you can bring in experts from all over. We need regular assessments of the health care capacity, of all the health care facilities. That assessment would include the role of:
4. 1. Ambulance delivery systems
   2. Poison centers

Lead hospital concept is difficult with the open market. There must be better communication about potential outbreaks.

Education: There are also standards of practice, which are NOT widely known. We need to look at the education of internists and pediatricians. We need to involve the local medical society.

JCHO makes a site visit every 7 years.

Standards should be state standards.

The FDA: I am very concerned with the debate on vaccines. I am troubled because of the testing in humans, how do we indemnify the pharmaceutical houses that may be engaged. There is a substantial risk that is not being considered.

Finally, for most bio, we do have something that we can do for many biological agents, but we don't have that for smallpox. Smallpox is scary. It could be introduced, and there we don't do well.

I would like to know more about the Denver TOPOFF. The real issue is when they all show up - often you have more people than you need.

Quinlisk - Also felt that Dr. Siegelson had overstated the reality of the situation and she agreed with Ken Shine's views above. She stated the basic issues were:

a. Getting surveillance information - how do we get the information?

b. Getting information out to the people. That issue is critical; it stops panic. You must have a consistent message.

Shine: Truth in advertising (especially from politicians) is important; and that is not happening.

Quinlisk: Like the expert from the university giving out improper information: people trust it and then it turns out to be wrong. We can't sell a bio-terrorism plan by itself- we have to sell it on dual use for what they are actually seeing day by day. We have hospitals that panic with one case of meningitis. Even at CDC they are confused by the bio/chem differences.

Falkenrath: I completely agree with Ken (Shine) and it is something we can recommend to the nation's executive and congress. We should fight against drawing walls around money.

Quinlisk: On the subject of spokespeople, in Israel they have found that there needs to be a credible individual identified before the event - that will cut down the confusion.

Falkenrath: It's nice to be able to censure the press. The bigger problem in bio is what do you say?

Quinlisk: I'm not talking about censuring the press.

Shine: In California, there was a woman, a regular on all these issues; she really had a substantial effect.

Quinlisk: It's better to have your talking head, than nothing that's being said at all. You need someone saying what you know and don't know, and what you are doing.

Siegelson: I don't want you thinking I'm too optimistic. I think our chemical weapons response ability is dismal. I wanted to give you some hope.

At this point, Vice-chair Clapper made a break in the discussion and carried out some administrative duties related to the setting of times for the up coming meetings. Although the November meeting was scheduled for Nov. 28, it was suggested that this was too late if they wanted the December report to be on time.

IV. Falkenrath Presentation.

Dr. Richard Falkenrath made a presentation on his view of what was needed for the upcoming report. He stated that his presentation was very preliminary and a 'first pass'. See handout in the notebooks for copies of the slides presented.

There was a discussion following this presentation critical of the use of the proposed scoring system. It was felt (suggested by Ken Shine and agreed to by most of the panelists) that to use a scoring system would eventually make the score the focal point for those reading it. A suggestion was made and supported to include the readiness model as an appendix, with a statement that the panel had created the model as one potential way to establish readiness indicators.

There was a strong statement by many that perhaps this report should deal with the issues in a macro sense and then flesh them out in the third report. The issue of cyber terrorism also was highlighted during this discussion, especially the extent to which it would be considered in the next report. It was agreed that cyber terrorism would be covered in the upcoming report, but not in the same level of detail as other topics. There will be more concentration on cyber in the third report.

V. Public Comments.

Peter Laporte is the director of the District of Columbia Emergency Management Agency. He gave a two-minute presentation pointing out the difference between chemical and bio events. He feels that the work on detection should be paramount and that there needs to be a surveillance network. He highlighted the fact of the multi-jurisdictional problems, interagency cooperation as well as the need to redefine the definition of the first responder.

The meeting was adjourned at 1500 EDT. 

Minutes approved by Advisory Panel at its meeting on Friday, September 29, 2000