On June 11, President Bush signed legislation in a Rose Garden ceremony that provided over $4 billion for drugs, vaccines, training, and other initiatives to deal with a bio- terror attack. It committed $1.6 billion to states to help with emergency preparedness. “Biological weapons are poten- tially the most dangerous weapons in the world,” he said. “Last fall’s anthrax attacks were an incredible tragedy to a lot of people in America, and it sent a warning that we needed and heeded. We must be better prepared to prevent, identify, and respond.”
With overwhelming backing on Capitol Hill, Bush in- tended to use that consensus to create a Department of Homeland Security that incorporated all or parts of twenty- two federal agencies. The new department would be the lead agency in promoting research for new vaccines and anti- dotes, dealing with bioterrorism, and managing the National Pharmaceutical Stockpile. Bush aggressively promoted the reorganization plan, saying it would “align authority and responsibility.”
Afterward, the President and Tom Ridge attended the first meeting of sixteen business, academic, and government leaders drafted by the White House for a new antiterror ad-
If these had been patriotic murders, Amerithrax had achieved his goal with this legislation, though his final goal, probably one of personal aggrandizement, had yet to be achieved. Amerithrax was not running the war against an- thrax, but he certainly had started it.
On Thursday, June 20, a scientific panel advised the gov- ernment that twenty thousand health care workers in each state should be vaccinated against smallpox to protect them in the event of an outbreak. This would expand the use of the vaccine for the first time in nearly thirty years. Each state would designate at least one “smallpox response team” (physicians, epidemiologists, local policemen, lab techni- cians, nurses, and vaccinators) and choose one or more hos- pitals to be referral centers for possible cases. Vaccination would be voluntary. Smallpox vaccinia infected a person and set up an immune response that protected against small- pox. There were side effects and the risk of a smallpox virus attack was too meager to justify the complications that would arise from widespread vaccination. Health and Hu- man Services Secretary Tommy Thompson said he would “review the recommendation with experts... as the admin- istration works toward a policy on the smallpox vaccine.”
The next day, there was a Brentwood cookout at a D.C. park to raise money for Brentwood employees’ families. Their spirits were flagging. Depression was widespread. Members had received a chart listing the common signs of stress, “anxiety, survivor guilt/self-blame, grief and denial.” The EAP suggested mail handlers offer “realistic reassur- ance” to their children and provided these examples: “I have no symptoms and have not worked anywhere that has been exposed,” or “I am taking medicine as a preventative mea- sure because a few people in my facility did get sick. I have not been sick...I am going to continue to do everything I
strophic terrorism.”
The study went on to give a long list of shortcomings— lack of coordination in research on “dirty bomb” threats and “enormous vulnerabilities” in the ability of public health systems to defend against biological warfare. The report laid out challenges in developing vaccines for airborne patho- gens, creating better sensors and filters for dangerous chem- icals. Throughout, the NRC report lamented a lack of coordination among federal agencies and the absence of a “coherent overall strategy” to “harness the strengths of the
U.S. science and engineering communities, and direct them most appropriately toward critical goals, both short-term and long.”
The Pentagon announced a new anthrax vaccination pol- icy, which reversed a plan by the Clinton administration to immunize all 2.4 million men and women in the military. Factors contributing to the Pentagon’s decision were limited supplies, the cumbersome requirement of six shots spread over eighteen months (with a yearly booster), and the de- velopment of a new generation of vaccines.
The revised scheme limited inoculations to soldiers who would be deployed for more than fifteen days to areas that held a “higher risk” of biological attack—the Middle East and the Korean peninsula. The policy also committed to stockpiling 40 percent to half of the vaccine manufactured for the Pentagon for civilian use. Police officers, firefighters, rescue crews, and other “first responders” would receive shots only after exposure to anthrax. The Pentagon intended
resuming limited military vaccinations in June.
William Winkenwerder Jr., the assistant defense secre- tary for health affairs, explained, “We remain very commit- ted to the goal of protecting all forces from anthrax through a variety of approaches, including intelligence, surveillance, protective clothing, antibiotics and other countermeasures. We are committed long-term to the notion of a new vac- cine.” He said “roughly half” of the vaccine produced by BioPort, the nation’s only anthrax vaccine supplier, was des- tined for civilian use, either through the Department of Health and Human Services or the Office of Homeland De- fense.
BioPort had been purchased four years earlier for nearly
$25 million by a group of private investors, including ex- ecutives who had worked at the plant under Michigan own- ership. In 1997 the Michigan Biological Products Institute in Lansing had put the vaccine up for bids after wrangles with the FDA over quality control. After BioPort signed a contract with the DoD the following year, it quickly used up the old Lansing stock. In November 1999, the FDA ap- proved BioPort’s new vaccine and the price per dosage rose from $4.36 to $10.64. It was continuing to rise. BioPort president Bob Kramer said, “We’re not aware yet of any policy decisions that have been made regarding first re- sponders. We stand prepared today to increase our produc- tion based on policy requirements.” There was some question whether civilian emergency personnel should be vaccinated or simply use antibiotics.
In March, the Institute of Medicine had released a report endorsing the vaccine’s safety, apparently answering com- plaints first raised when veterans complained of illness after receiving shots during the Persian Gulf War. Since the pro- gram’s inception in 1997, several hundred servicemen and servicewomen have refused to take the shots, and about one hundred have been court-martialed for this refusal. Winken- werder said the new policy “is mandatory” for those who qualify.
In all, the vaccine had already been given to a half- million servicemen. In the months to come highly trained pilots and crews in the National Guard and Air Force Re-
“Anthrax is a serious threat that our soldiers might face on the battlefield. At the same time, this vaccine has been controversial, and it has caused serious reactions in some individuals,” Rep. Dan Burton, chairman of the House Gov- ernment Reform Committee, would report. No research was available on the possible effects of the vaccine on older people, children, and pregnant women.
By July 2000, there had been cases of adverse reactions to the vaccine—joint pain, nausea, swelling, muscle spasms, and spinal pain. Only a month after the first anthrax letter, the BioPort contract had been in jeopardy. Then the FDA granted its long-delayed approval and the cost of one dose of vaccine climbed from $10.64 to $90.
Dr. Meryl Nass said, “The existing vaccine may or may not be effective. The one human study ever done on any anthrax vaccine was about 70 percent effective at preventing anthrax infections. The current vaccine’s effectiveness, though 95 percent effective in monkeys, has not been tested in humans.” Doxycycline and ciprofloxacin prevent anthrax in 80 to 90 percent of a small number of monkeys, but they may respond better than humans.
The Army understood the shortcomings of the anthrax vaccine, acknowledging the existing formulation was “highly reactogenic” and “may not be protective against all strains of the anthrax bacillus.” A handful of patients had suffered serious reactions after taking the shots, including brain damage and death. Winkenwerder said while vacci- nations could begin almost immediately, individuals and even quick-reaction forces like the Marine and airborne di- visions would not start the six-shot course of inoculations until they were forty-five days from deployment.
Tensions between the U.S. and Iraq were heating up. The Amerithrax case put everyone in mind of their presumed stocks of chemical and biological weapons. However, during the Gulf War Iraqi warheads had detonated on impact and were poorly designed for disseminating biowarfare agents. The U.S. did not know Iraq possessed new warhead designs. It did know Iraq could use warplanes or helicopters to spray germ agents. The best way to neutralize the danger was by occupying Scud launching areas and seizing control of the skies.
The FBI had expended a lot of brain power and shoe leather trying to nab Amerithrax. They had conducted nearly six thousand interviews and served about seventeen hundred grand jury subpoenas in what FBI officials called “one of the largest operations in the Bureau’s history.”
Residents of Middle Eastern descent were questioned, and in some cases their homes raided by agents. Labs and pharmaceutical research facilities with the probable ability to create anthrax were looked over. Since autumn 2001, fifty
U.S. bioweapons experts had been targeted for intense scru- tiny and their homes and offices searched. They had been ordered to take polygraph tests and a few had been under open or covert surveillance.
“The pool of suspects contains hundreds more, including researchers of biopesticides, biopharmaceuticals, and veter- inary products,” said one federal investigator. “Remember, it doesn’t have to be a top scientist. It could just be a good bench technician.”
Anthrax Search
ON
Tuesday, June 25, 2002, the FBI conducted a high- profile search. Such searches were common in the Ameri- thrax probe. Agents had searched apartments before, but never with so much media attention. For months, Dr. Steven
J. Hatfill, a former Army researcher, had been extensively discussed by scientists, journalists, and other professionals speculating about possible domestic suspects in the anthrax investigation.
Since late January and early February, biowarfare experts in and out of government had spoken quietly (and some not so quietly) of Dr. Hatfill as fitting their profile of the anthrax attacker. Hatfill’s bigger-than-life personality, and remarks he had made about the dangers of biological attacks against the U.S., made him suspicious. The previous fall Hatfill found himself on a long list of those questioned by federal authorities.
Private experts, chief among them Barbara Hatch Rosen- berg, a bioweapons authority, decided Amerithrax was a federal insider. She and others believed that Amerithrax was someone who meant to warn the nation of the dangers of biological terrorism. Publicly she named no one, and though the FBI had no clear suspects at the time, Hatfill’s name circulated in the scientific community on a shorter and shorter list.