2^nd National Symposium on Medical
and Public Health Response to Bioterrorism

A Public Health and National Security Threat

The Second National Symposium on Medical and Public Health Response to Bioterrorism was held November­ 28-29, 2000, in Washington, DC, as a collaborative effort among the Johns Hopkins Center for Civilian Biodefense Studies, the US Department of Health and Human Services, and the Infectious Diseases Society of America.

The symposium was intended to increase understanding of the threat of bioterrorism among national policy makers and medical and public health leaders. It also served as a platform for considering actions that the nation and its leaders might take to diminish the risk of bioterrorism and, should it occur, its potentially serious consequences.

Program Committee Members

• Michael S. Ascher, MD, FACP, Chief, Viral and Rickettsial Disease Laboratory, Division of Communicable Disease Control, California Department of Health Services
• John Bartlett, MD, Co-Director, Johns Hopkins Center for Civilian Biodefense Studies; Chief, Division of Infectious Diseases, Johns Hopkins School of Medicine; Past President, Infectious Diseases Society of America
• Scott Becker, Executive Director, Association of Public Health Laboratories
• Geraldine Bednash, PhD, RN, FAAN, Executive Director, American Association of Colleges of Nursing
• James D. Bentley, PhD, Senior Vice President, Strategic Policy Planning, American Hospital Association
• Ken Bloem, Senior Fellow, Johns Hopkins Center for Civilian Biodefense Studies; Former CEO Georgetown University Medical Center
• Christina Catlett, MD, Instructor, Department of Emergency Medicine, Johns Hopkins School of Medicine
• Edward Eitzen, MD, MPH., Commander, United States Army Medical Research Institute of Infectious Diseases
• Lily Engstrom, Senior Science Policy Analyst, Office of Assistant Secretary for Planning & Evaluation, US Department of Health and Human Services
• Richard A. Falkenrath, PhD, Assistant Professor of Public Policy, Co-Director, Executive Session on Domestic Preparedness, John F. Kennedy School of Government, Harvard University
• Annie Fine, MD, Assistant Medical Director, Communicable Disease Program, New York City Department of Health
• Margaret A. Hamburg, MD, Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services
• Sandy Harwood, Director of Meetings and Conventions, Infectious Diseases Society of America
• Jerome Hauer, MPH, Managing Director, Kroll Worldwide, Crisis and Consequence Management
• D.A. Henderson, MD, MPH, Director, Johns Hopkins Center for Civilian Biodefense Studies; Distinguished Service Professor, Johns Hopkins School of Public Health
• Thomas V. Inglesby, MD, Senior Fellow, Johns Hopkins Center for Civilian Biodefense Studies; Assistant Professor, Infectious Diseases, Johns Hopkins School of Medicine
• Robert Knouss, MD, Director, Office of Emergency Preparedness, US Department of Health and Human Services
• Donna Knutson, MS, Executive Director, Council of State and Territorial Epidemiologists
• John LaMontagne, PhD, Deputy Director, National Institute of Allergy and Infectious Disease, National Institutes of Health
• Andrea Lapp, Special Events Coordinator, Johns Hopkins Center for Civilian Biodefense Studies
• Marcelle Layton, MD, Director, Office of Communicable Diseases, New York City Department of Health
• Scott Lillibridge, MD, Director, Bioterrorism Preparedness and Response Program, U.S. Centers for Disease Control and Prevention
• Michael Osterholm, PhD, MPH, Chair and Founder, ican, Inc.
• Tara O'Toole, MD, MPH, Deputy Director, Johns Hopkins Center for Civilian Biodefense Studies
• Trish Perl, MD, MPH, Senior Fellow, Johns Hopkins Center for Civilian Biodefense Studies, Director, Infection Control and Hospital Epidemiology
• Phil Russell, MD, Senior Fellow, Johns Hopkins Center for Civilian Biodefense Studies, Professor, Johns Hopkins School of Public Health
• William F. Raub, PhD, Deputy Assistant Secretary for Science Policy, Office of Science Policy, U.S. Department of Health and Human Services
• Monica Schoch-Spana, PhD, Senior Fellow, Johns Hopkins Center for Civilian Biodefense Studies; Research Associate, Johns Hopkins School of Public Health
• Amy E. Smithson, PhD, Senior Associate, The Henry L. Stimson Center
• Joan Stanley, PhD, RN, CRNP, Director of Education Policy, American Association of Colleges of Nursing
• Stephen Teret, JD, MPH, Senior Fellow, Johns Hopkins Center for Civilian Biodefense Studies, Professor, Health Policy and Management, Johns Hopkins School of Public Health
• Kevin Tonat, DrPh, MPH, Acting Director, Division of Program Development, Office of Emergency Preparedness, US Department of Health & Human Services
• Joe Waeckerle, MD, FACEP, American College of Emergency Physicians
• Thad Zajdowicz, M.D., FACP, Command Surgeon, Joint Task Force, Civil Support US Joint Forces Command

Symposium Sponsors

• Johns Hopkins Center for Civilian Biodefense Studies
• US Department of Health and Human Services
• Infectious Diseases Society of America

Co-Sponsors

• American College of Preventive Medicine
• American Nurses Association
• American Society for Microbiology
• Association of Schools of Public Health
• Association for Professionals in Infection Control and Epidemiology
• Association of Public Health Laboratories
• Association of State and Territorial Health Officials
• Commissioned Officers Association of the US Public Health Service
• Council of State and Territorial Epidemiologists
• National Association of County and City Health Officials
• National Association of Local Boards of Health
• Partnership for Prevention
• Public Health Foundation
• Society of Hospital Epidemiologists of America
• The Henry L. Stimson Center

Agenda with Transcripts

Titles link to transcripts

Day 1: November 28, 2000

Symposium Introduction

• Welcome: D.A. Henderson, MD, MPH

Medicine and Public Health: Global Security Challenges

• Confronting a World of Infectious Diseases: Guenael Rodier, MD (transcript not available)

• Biological Weapons as a Strategic Threat: Paul Bracken, PhD

• Advances in Biotechnology: Promise and Peril: George Poste, PhD

Toward an Effective Governmental Response: Progress Thus Far

• CDC's Strategic Plan for Bioterrorism: Jeffrey Koplan, MD, MPH

• US Domestic Preparedness and the Complex Threat of Bioterrorism: Richard Falkenrath, PhD

Reducing the Bioweapons Threat: International Collaboration Efforts

• Moderator: Edward M. Eitzen, Jr., MD, MPH

• Olympics 2000: Preparing to Respond to Bioterrorism: Jerome Hauer, MPH

• International Cooperation to Prevent Biological Weapons Research and Development: Amy E. Smithson, PhD

Detecting Epidemics: Current Approaches, Future Possibilities

• Global Awareness of Disease Outbreaks: The Experience of Pro-Med: Martin Hugh-Jones, DVM, PhD

• Outbreak Surveillance and Management at the State and Local Level-Current Realities: Marcelle Layton, MD, MPH

Treating the Sick: Capacity of the U.S. Health Care System to Respond to an Epidemic

• Moderator: Ken Bloem

• Challenges for Hospitals: James D. Bentley, PhD

• Mobilizing Professional Communities: John G. Bartlett, MD

• Institutional Networks: Regional Response to Disasters: Jeffrey Rubin

• National Disaster Medical System: Robert F. Knouss, MD

• Department of Defense: Supporting the Health Care System: Major General Bruce Lawlor

Special Dinner Presentation

• International Leadership in the Control of Biological Weapons: Ambassador Richard Butler

Day 2: November 29, 2000

• Challenges Confronting Public Health Agencies: Margaret A. Hamburg, MD

Containing Epidemics of Disease: Making Difficult Decisions

• Lessons from TOPOFF: Thomas V. Inglesby, MD

• Understanding Public Response to Disasters: Thomas A. Glass, PhD

• How to Vaccinate 30,000 People in 3 Days:Realities of Outbreak Management: Michael T. Osterholm, PhD, MPH

• Legal Issues Surrounding Public Health Emergencies: David Fidler, JD

• Understanding Media's Response to Epidemics: Laurie Garrett

Epidemic Response Scenario: Decision Making in a Time of Plague

Panelists: [transcript] • Scenario

• Ken Bloem
• Steven Cantrill, MD
• David Fidler, JD
• Laurie Garrett
• Margaret A. Hamburg, MD
• Jerome Hauer, MPH
• Thomas V. Inglesby, MD
• The Honorable Jack Marsh
• Michael T. Osterholm, PhD, MPH
• Tara O'Toole, MD, MPH
• Jeffrey Smith

Setting Strategic Priorities: Health Professionals in a Belligerent World

• Envisioning World-Wide Disarmament: Admiral Stansfield Turner

• Intentional Epidemics as a Human Rights Issue: Scott Lillibridge, MD

• The Problem of Biological Weapons: Next Steps for the Nation: Tara O'Toole, MD, MPH

• National Leadership in Confronting Bioterrorism: John J. Hamre, PhD

Closing Address

• National Leadership in Confronting Bioterrorism: Senator Edward M. Kennedy

Speakers

• John G. Bartlett, MD, Chief, Infectious Diseases, Johns Hopkins Hospital and School of Medicine; Co-Director, Johns Hopkins Center for Civilian Biodefense Studies

• James D. Bentley, PhD, Senior Vice President, Strategic Policy Planning, American Hospital Association

• Ken Bloem, Senior Fellow, Johns Hopkins Center for Civilian Biodefense Studies; Former CEO, Georgetown University Medical Center

• Paul Bracken, PhD, Professor, Political Science and Management, Yale University

• Ambassador Richard Butler, Former Executive Chairman, United Nations Special Commission; President, Economic and Social Council of the United Nations; Diplomat-in-Residence, Council of Foreign Relations

• Colonel Edward M. Eitzen, Jr., MD, MPH, Commander, US Army Medical Research Institute of Infectious Diseases

• Richard A. Falkenrath, PhD, Assistant Professor and Co-Director, Executive Session on Domestic Preparedness, John F. Kennedy School of Government, Harvard University

• David Fidler, JD, Associate Professor, Indiana University School of Law

• Laurie Garrett, Reporter, Newsday; Author, The Coming Plague and Betrayal of Trust: The Collapse of Global Public Health

• Thomas A. Glass, PhD, Assistant Professor, School of Hygiene and Public Health, Johns Hopkins University

• Margaret A. Hamburg, MD, Assistant Secretary for Planning and Evaluation, Department of Health and Human Services

• John J. Hamre, PhD, CEO, Center for Strategic and International Studies

• Jerome Hauer, MPH, Managing Director, Kroll Worldwide, Crisis and Consequence Management

• D.A. Henderson, MD, MPH, Director, Johns Hopkins Center for Civilian Biodefense Studies

• Martin Hugh-Jones, DVM, PhD, Professor, Louisiana State University School of Veterinary Medicine

• Thomas V. Inglesby, MD, Senior Fellow, Johns Hopkins Center for Civilian Biodefense Studies; Senior Fellow, Infectious Diseases, Johns Hopkins School of Medicine

• The Honorable Edward M. Kennedy, United States Senator (D-MA)

• Robert F. Knouss, MD, Director, Office of Emergency Preparedness, Department of Health and Human Services

• Jeffrey Koplan, MD, MPH, Director, U.S. Centers for Disease Control and Prevention

• Major General Bruce Lawlor, Commander, Joint Task Force, Civil Support

• Marcelle Layton, MD, MPH, Director, Office of Communicable Diseases, New York City Department of Health

• Scott Lillibridge, MD, Director, Bioterrorism and Response Program, U.S. Centers for Disease Control and Prevention

• Michael T. Osterholm, PhD, MPH, Chair and Founder, ican, Inc.

• Tara O'Toole, MD, MPH, Deputy Director, Johns Hopkins Center for Civilian Biodefense Studies; Former Assistant Secretary of Energy for Environment, Safety and Health

• George Poste, PhD, CEO, Health Technology Networks; Chair, Defense Science Board; Former Chief Scientist, SmithKline Beecham

• Guenael Rodier, MD, Director, World Health Organization Department of Communicable Disease Surveillance and Response (CSR)

• Jeffrey Rubin, Chief of Disaster Medical Services, California EMS Authority

• Amy E. Smithson, PhD, Senior Associate, The Henry L. Stimson Center

• Admiral Stansfield Turner, US Navy, Retired, Former Director of Central Intelligence