Inkwell: Authors and Artists
Linda Castellani (castle) Thu 25 Jan 01 13:58
John Schwartz is a reporter at the New York Times who writes about techhnology and society. Before coming to the Times, he worked at the Washington Post as a science and technology writer, having come to the Post from Newsweek magazine. He has written about the Internet, the Ebola virus, food safety, the Food and Drug Administration, the dinosaurian origins of birds, the tobacco wars, the Canadian band Moxy Fruvous and more. He worked with former Minnesota state epidemiologist Michael T. Osterholm on "Living Terrors," a book that braided many of the strands of his prior reporting in public health, science, technology and law. He lives in New Jersey (the Garden State!) with his wife of 16 years and three children. He is licensed to practice law, but hopes that it will never come to that. Living Terrors is a book about the horrible prospect of biological terrorism. The authors argue that the technologies necessary to mount an attack are now within the reach of people with a graduate student education. At the same time, they show that despite highly-publicized and expensive steps that the United States has taken to defend itself against weapons of mass destruction such as nuclear, chemical and biological weapons, America's leaders have left its citizens unprepared for biological attack. Osterholm and Schwartz outline a handful of recommendations that would enhance the nation's ability to cope with any public health emergency, from an anthrax attack to a influenza pandemic. John will be interviewed by Eric Mankin, who was fascinated by biology before puberty, because of repeated readings of the All About Books: his favorites wwere "All About Dinosaurs" and " All About Whales." Subsequently he read Paul De Kruif's "Microbe Hunters," which fixed the people who conquered disease in his firmament as among the primary beneficiaries of mankind. Among the OTHER books that have guided his thinking on the influence of disease on history are "Plagues and Peoples" by William H. McNeill and "Guns, Germs, and Steel" by Jared Diamond. Mankin has written about science for eight years for the University of Southern California, including a year for writing about achievments of the Keck School of Medicine AT USC. He currently works for the public information office of USC's Information Sciences Institute. Please join me in welcoming John and Eric to inkwell.vue!
Eric Mankin (carapace) Fri 26 Jan 01 10:26
John, can you begin by describing how you hooked up with your co-author, epidemiologist Michael Osterholm -- was this an arranged marriage by DeLacorte Press, or elective affinity?
John Schwartz (jswatz) Fri 26 Jan 01 12:40
In classic singin' media business style, his agent called my agent. I had interviewed Mike a number of times about such issues as food safety--a big concern of his as Minnesota's chief epidemiologist, and a big issue for me as a reporter covering the Food and Drug Administration. I liked his straightforward style, and his willingness to make wake-up calls when he thought they were necessary on issues as diverse as food safety, antibiotic resistance and biological terrorism. He always seemed to speak from the perspective of a concerned public health professional who saw things at the juncture of disease and society. But I had no idea that he was hoping to write a book about bioterrorism. And although I had hooked up with an agent, Rafe Sagalyn, about two years before, and although we had discussed a number of book projects, nothing had seemed right to us. But when Mike's agent got in touch with Rafe about finding a science writer who could work with Mike, everything clicked. Here was a guy I knew, though not very well, and a topic that I cared about. It drew on my background as a reporter on science and technology issues, and also my experience covering Washington and the regulatory scene; there was even a component that would call on my training as an attorney. (I knew it would come in handy some day!) Mike and I got together and discussed the issues, and it became clear that we agreed about a few things. The current situation is a mess. Efforts to improve things are not going to do enough to meet the challenges of biological terrorism. People need to hear about this and to get the message in an accessible way. So we shook on it, the agents drew up contracts, and we wrote the proposal together. From start to finish, it has been a great partnership.
Eric Mankin (carapace) Fri 26 Jan 01 13:07
Let's start with what was for me the single most astonishing fact in the book: you note that in the century that just ended, one half billion people died from smallpox, compared with 320 million people dead from wars (including two world wars) and all other epidemics. Where did this number come from? And what did you think when you first heard it>
Eric Mankin (carapace) Fri 26 Jan 01 17:11
Here's what I thought when I read it: I'm not immune. I grew up after people stopped being vaccinated for smallpox. Because smallpox had been eradicated. What the book made me think was that maybe it was time to, just on the safe side, go to my clinic and ask for a scratch.
Eric Mankin (carapace) Fri 26 Jan 01 20:33
Moving right along: Defense Secretary Rumsfeld has today announced that he is going to unilaterally suspend the ABM treaty (since he says it was with the now no longer extant Soviet Union, not with the successor Russian Federation) and proceed to build an ABM system at a cost that will spiral well into the hundreds of billions. <jswatz>'s new book illustrates that to a first approximation no effective defenses exist against an attack that could be launched at a cost in the tens of thousands of dallars, causing thousands to (with the right agent) millions of casualties and virtual paralysis of states, regions or even the whole nation. How much sense does this make?
David Gans (tnf) Fri 26 Jan 01 21:01
None, unless you're in the business of selling overpriced weapons systems.
Eric Mankin (carapace) Sat 27 Jan 01 08:49
The book contains a lot of detail about the activities of the Japanese terror group that carried out a nervce gas attack on the Tokyo subway, material that isn't widely known, but that illustrates how biological weapons -- bacteria, viruses, and the toxins they produce -- are within a very modest budget and degree of technical expertise - John, can you describe what Aum was able to do?
John Schwartz (jswatz) Sat 27 Jan 01 22:02
Well, Eric, you've given me a lot to respond to! Let's start with smallpox. Like you, I was stunned when Mike, in our preliminary discussions, laid out the astonishing figure of a half billion dead from smallpox. The estimate, if my memory serves, came from the World Health Organization, which launched the effort that finally eradicated smallpox, and was brought up separately by D.A. Henderson, who led the W.H.O. effort. The number is even more frightening when you consider the fact that smallpox, while eradicated in the wild, is still out there in test tubes and could possibly be brought back to be unleashed on a global community that has lost just about all of its resistance to this terrible disease. Eric, you weren't vaccinated against smallpox, but I was. I thought it was one of the advantages of being an old fart. But as I researched the issue, I realized that most scientists who have studied the issue believe that the resistance wears off after about 20 years. So I'm probably not any better off than you are at this point. And if you want to go get that scratch, well, good luck. The smallpox vaccine stockpile is tightly guarded and too small to handle an outbreak that spreads to several cities; in fact, an outbreak in one city would spark calls for vaccine in so many places and for so many people that the current stockpile couldn't handle the demand. It will be years before more can be produced. And now on to the question of guns versus bugs: Yes, the ABM news marks a new era in expensive government programs. And the number of people who could launch such an attack is so very small; meanwhile, the tools that could be used to launch a bioterror or biological warfare attack are within the abilities of graduate students. While such an attack hasn't happened yet--terrorists tend to stick with simpler tools, such as explosives--both Mike and I feel that it's really only a matter of time before a biological terrorist mounts an attack. The ABM news shows that when America perceives a threat, it responds by funding the tools of the military and law enforcement. That's been the pattern of the nation's response to weapons of mass destruction as well... enormous amounts of money go to preparedness for attacks using nukes or chemical agents, where some horrible event will occur and an immediate response to control the populace will be necessary. But a biological attack is very, very different: it could come silently, with the initial attack drawing no attention at all. The first sign would be sick people coming to doctors' offices and hospitals. In other words, the police response is not very useful when the attackers are too small to be seen. Mike and I make the case in Living Terrors that the proper way to respond to biological terroris m is to upgrade the nation's public health system to detect and respond to disease outbreaks. Spend the money there, and it helps everyone. Spend the money on an ABM system and... well, I don't think I need to finish the sentence. Finally, Eric, you bring up the Aum Shinrikyo group, which carried out an attack with sarin gas in the Tokyo subways. The group was able to develop the chemical attack under the radar, so to speak--they were able to synthesize deadly nerve gas without being caught. They didn't do a very good job--the chemical process wasn't of the quality that a top-flight weapons lab would come up with, and the delivery method (sealing the sarin in plastic bags, dropping them in the subway and poking the bags open with umbrella tips) was amateurish. But people died and thousands were sickened, and a tremendous panic resulted. In other words, mission accomplished. Aum Shinrikyo was trying to develop biological agents as well, but the efforts didn't come to fruition, luckily. There are people who say that biological terrorism attacks are highly unlikely, and the point to the failures of Aum Shinrikyo to come up with a biological attack as proof. The group, after all, was well funded and had no small amount of scientific expertise among its members. But Mike and I point out in the book that they were continuing to work on biological projects and might well have come up with a successful attack over time. The chemical attack itself was a rush job because the leaders of the group feared that police might be about to move in; the result might have been far more horrible if they had had the time to develop a more efficient delivery system.
Undo Influence (mnemonic) Sun 28 Jan 01 03:49
John, it seems to me that a good next step would be for Congress to hold hearings about America's preparedness for a public-health crisis of the sort you describe in your book. Has there been any interest from any reps or senators? And, if not, when are you and Mike going to publish your op-ed calling for such hearings?
John Schwartz (jswatz) Sun 28 Jan 01 21:03
Hearings are a good idea, Eric--especially hearings that would break out the threat of biological terrorism and the best responses to it. Most hearings so far that have touched in the subject have lumped biological terrorism in with other terrorism using weapons of mass destruction--and, as we point out in the book, that treatment does a real disservice to the special horrors that biological terrorism would visit upon us. What's more, the hearings on weapons of mass destruction that have been held involved Clinton administration officials. With a new president in Washington and new heads of the Department of Health and Human Services and Justice Department, we need to know what the new administration plans to do. On the other hand, you're giving Mike and me a little too much credit for cunning--or even planning--to ask when our op-ed might appear. We haven't written one, or even discussed it. Darned good idea, though.
Eric Mankin (carapace) Sun 28 Jan 01 21:28
One thing struck me about the possible preparations for a biological agent attack. Unlike almost any other kind of military preparedness action you can think of, they aren't otherwise totally useless. They involve preposition of material and people that would be lifesaving in all kinds of non-biological war situations. It basically means just a drastic upgrade in the emergency health delivery infrastructure, plus careful advance planning for epidemics. This is something a sane person would want, just as a matter of principle, even if you didn't have to worry about a nut with a mason jar full of anthrax spores. It would be comforting to have just in case, for example, a passenger comes out of a jet from a duck market in South Asia where a new strain of flu had just jumped species, or from Central Africa, where a patron of a bushmeat market had just picked up something novel from his monkey brain omelette. the comparison with (sorry to be repetitions about this) missile defense leaps out. The cost is a minute fraction, and the usefulness extends across a wide range of civilian applications. Is this a no-brainer, or am I?
John Schwartz (jswatz) Mon 29 Jan 01 07:57
I come down on the side of "no brainer," but of course I'm pushing the book! In fact, when you look at it, raising the quality of the public health infrastructure would improve the nation's health in every way. That's why Mike and I didn't recommend, say, that everybody make space suits or dig fallout shelters, or that the government vaccinate every American against smallpox. We tried to focus on recommendations that would provide a benefit whether or not an attack ever came. The ability to spot a foodborne outbreak or disease epidemic early helps us all by putting the proper treatment in place; suffering is alleviated and lives are saved. These aren't $500 toilet seats. These are valuable additions to the public health system that will save lives no matter how they are used. And we're up against a resource crunch that means most hospitals are overwhelmed by simple flu epidemics.
Eric Mankin (carapace) Mon 29 Jan 01 10:28
What reaction if any has there been so far to the book?
John Schwartz (jswatz) Mon 29 Jan 01 11:26
The response has amazed me; Mike has been interviewed on 60 Minutes and Good Morning America, and the book has been discussed in articles in The Washington Post, USA Today and elsewhere. People familiar with public health issues have praised it highly--a good sampling of those opinions can be found on the Amazon.com page devoted to the book. So the message is getting out there. Here's one of the comments from the Amazon: A Frustrated Public Health Professional November 25, 2000 Reviewer: A reader from Washington DC I'm part of the problem! I'm one of those individuals that Mike Osterholm talks about in this very important book. Unfortunately he is right on target. The federal response, of which I'm supposed to be a part of, remains disorganized and lacking leadership... , if you really care about our future and the potential of what bioterrorism can and will do to our country, you should take to heart what Dr. Osterholm has said. I know my coworkers who have read the book all wish our bosses and their bosses would read it and take it to heart. I'm afraid that is not going to happen on this watch and I'm not optmistic it will happen on the next one, regardless of who is President. If we are to get our act together, it will have to come from the people...who in turn get their local, state and federal elected officials to REALLY understand the issues and respond accordingly. Dr Osterholm's book should be the their Bible. It's the best we've got.
John Schwartz (jswatz) Mon 29 Jan 01 11:30
And no, I didn't write that comment.
Paulina Borsook (loris) Mon 29 Jan 01 23:40
john, i dont recall where i read it sometime this year (mother jones?) but some magazine article i read somewhere seem to debunk the notion of bioterrorism...alas, i havent read yr book yet, and anything that wants to upgrade public health is fine by me...but can you address this? are you familiar with the article i vaguely remember?
John Schwartz (jswatz) Tue 30 Jan 01 07:39
It was pretty discouraging to see the Mother Jones article, which made exactly the same misjudgements as the policymakers. The article is the cover story of the October 2000 issue; the title is "The Phantom Menace: Could terrorists attack the United States with weapons of mass destruction? Highly unlikely, say defense experts. So why is the Clinton administration spending billions to foil a most improbable threat?" Here's the URL: http://www.motherjones.com/mother_jones/SO00/phantom.html The main flaw in the article, as I hinted above, is that it lumps biological terrorism in with other weapons of mass destruction such as nukes and chemical weapons, and then treats the whole movement as an excuse to boost defense and law enforcement budgets. Part of the argument is valid--heck, in our book, WE criticize programs that seem to be the merest excuses to boost those budgets while doing precious little to improve the ability of the nation's health care system to respond to attacks. When the story DOES talk about biological terrorism, it falls back on discussions of the relatively botched Aum Shinrikyo attack (try to explain what a lousy attack it was to the people whose family members died or were sickened in the attack) and quotes Milton Leitenberg of the University of Maryland, who explains that turning bugs into weapons is very hard. Well, it is very hard. But it's not impossible. That's why we quote people like William Patrick, who actually made bioweapons for a living before the U.S. signed treaties prohibiting such weapons in the 1970s; he said "O dpm "I don't think our domestic terrorists have the capability to make a weapon yet..." but the emphasis was on the yet, and he has spent a good deal of time and effort to show that a perfectly simple delivery system for spreading biological weapons can be smuggled through weapons checkpoints and airport scanners. One of the most frightening interviews I conducted for the book was with David Pui, director of the particle technology laboratory at the University of Minnesota's mechanical engineering department. He easily debunked the notion that creating delivery systems for bad bugs is impossible for any but the most sophisticated scientists. ""Actually, there are some bypes of medical nebulizer that people can buy in a drugstore," he said. "For just a few dollars, you can put this biological material in a supension form and spray it--it's really quite effective." He said that any of his graduate students could put together a handheld device to disperse dry spores or biological agents in suspension. I've gotten pretty long-winded on this point, but it's crucial: yes, there are experts who believe that the threat is overstated. Mike and I don't agree with them, and wouldn't have written the book if we felt that those arguments were correct. As a reporter, I have always sought to get the TONE right, along with the facts: That means not sounding an alarm when none is called for. It also means sounding an alarm when people are sleeping through an emergency.
John Schwartz (jswatz) Tue 30 Jan 01 07:41
"O dpm" was not part of the quote from William Patrick, of course. Please pardon my pre-coffee typo lifestyle.
Paulina Borsook (loris) Tue 30 Jan 01 11:46
thanx. just wondered about that mojo piece...
RUSirius (rusirius) Tue 30 Jan 01 12:04
I undertand that Clinton was obsessed with this, and was very inluenced by the fiction works of Robert Preston. Did you go into that, and did that have much to do with the Anti-terrorism bill of 1996?
Eric Mankin (carapace) Tue 30 Jan 01 13:23
I don't think Clinton could have been too obsessed with it, or he would have pressed to spend more money. Another truly disquieting fact -- I don't remember it in John's book -- was the comparison between the budget for "Outbreak," the Dustin Hoffman helicopter chass turkey about infectious disease; and the budget of the office in the Centers for Disease Control which Hoffman worked for in the film. The studio spent much more on the film than the U.S. spends in a year on the real-life agency.
John Schwartz (jswatz) Tue 30 Jan 01 14:18
It doesn't qualify as an obsession, but Clinton was very concerned about the prospect of a chemical or biological terrorism attack, and did read The Cobra Event, Richard Preston's harrowing novel about bioterrorism. In January 1999, in an interview with Judith Miller of the New York Times, he said that such an attack is "highly likely" within the next few years. "I want to raise public awareness of this," he said, "without throwing people into an unnecessary panic." The prospect of a biological attack, he said, is the one that "keeps me awake at night." The interview kicked off an effort to pass a $2.8 billion anti-terrorism budget. (Most of the money, of course, was slated for military and law enforcement programs.) But Clinton was clearly not just reacting to a novel; in the interview, he said that he really started to worry about the issue after the 1993 World Trade Center bombing, and his concerns grew after the blasts in Oklahoma City and at American facilities in the Middle East and Africa, as well as the Aum Shinrikyo attack. (Oops--let me correct something here. Clinton's budget that year included $10 billion to defend against terrorism, with $2.8 billion for existing and a few new programs to counter biological, chemical and cyber attacks.) Ultimately, little of the money got through the budgetary process for new programs. And as Mike and I point out in Living Terrors, much of the money that is earmarked doesn't really do much to meet the threat.
Cynthia Dyer-Bennet (cdb) Thu 1 Feb 01 13:07
John, this is all pretty depressing stuff, from the perspective of the average citizen (me). What can *we* do to call attention to this problem? Is there anything we can do to protect ourselves as individuals from the possibility of this kind of attack?
Eric Mankin (carapace) Thu 1 Feb 01 13:29
And if there's one single thing that's the highest priority, what would it be?
Neil Glazer (neil-glazer) Thu 1 Feb 01 14:17
John, not to be completely doom and gloom, but isn't it relatively useless to worry about bioterrorism? I mean, after all, a well-orchestrated bioterrorist strike can -- as the less successful ones have shown -- wreak havoc and death on huge swaths of densely populated cities and, as you point out, it is getting easier and easier for people to generate the necessary stuff. Other than being fully prepared to execute a rapid response to the aftermath, is there really anything that can be done to prepare for such an eventuality? Not to say that our intelligence gathering organizations ought not to be keeping a lookout for such threats, but we do have a thing called civil liberties here that pretty much circumscribes the government's ability to act as a complete risk reducer.
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