By Dawn Levy

Responding to a terrorist attack employing biological or chemical agents requires knowledge spanning many disciplines. Three Stanford researchers were among nearly 135 leading scientists and technical experts from industry, academia and government invited to participate in the Gordon Research Conference on Chemical and Biological Terrorism Jan. 30-Feb. 4 in Buellton, Calif. The conference brought together public and private sectors to discuss what has worked, where problems are now and may appear in the future, and what needs more attention in responding to and preventing terrorism. The goal was to move toward a better "systems approach" to defense.

The Stanford participants were Margaret E. Kosal, a science fellow at the Center for International Security and Cooperation (CISAC) with a doctorate in chemistry; Steven M. Block, a professor of applied physics and of biological sciences and senior fellow, by courtesy, at the Stanford Institute for International Studies; and Mark A. Musen, a professor of medicine (medical informatics) and, by courtesy, of computer science.

The conference included discussions of public health surveillance and response, food supply vulnerabilities and agricultural security, forensics of biological and chemical evidence, and the changing nature of the threat environment.

Both biological and chemical terrorist attacks have the potential to cause a large number of causalities and overwhelm medical capabilities, or "surge capacity." The nation's terrorism defense plans focus on mass-effect bioterrorism--events with the potential to infect tens of thousands and kill more than a thousand. But those plans may not effectively counter small-scale biological or chemical attacks, much less nuclear or radiological attacks, Kosal asserted.

Musen spoke about the computational problems of automating surveillance for possible bioterrorism using "prediagnostic" indicators that become available even before health-care workers can identify a specific epidemic.

"There is enormous enthusiasm--and enormous spending--for combining databases of over-the-counter drug sales, absenteeism records, 911 calls and admitting diagnoses to emergency rooms and clinics," he said. "There has been virtually no empirical evaluation of any of these efforts, despite all the excitement."

Musen discussed difficulties computers have making sense of high-volume, low-signal data streams, including basic problems with the way that the data typically are represented, difficulties of integrating disparate data sources and uncertainty in how to present the results of computational analyses to public-health officials in an optimal way.

"Although there is enormous political pressure to be 'doing something' to monitor for bioterrorism, it's also important to take a step back and to engage in the research needed to determine what we really should be doing," Musen said.

Chemical threats are underestimated

The focus on bioterror threats may miss a more frequent occurrence--chemical attacks. In a presentation titled "The Shifting Face of Chemical Terrorism: Assessing an Emerging Threat," Kosal examined the growing trend of non-state actors to use improvised chemical devices (ICDs) that may include choking and blistering agents.

"The path from the 'street chemistry' of improvised explosive devices [IEDs] to ICDs incorporating commercial chemicals is very short, whereas the path from IEDs to transgenic biological agents effectively weaponized is a substantial leap for states and even more so for terrorists," Kosal said. "While U.S. policy is focused on defending against a mass-effect bioterrorism attack, we may be missing a lower-tech threat of much higher probability."

Half of the U.S. fatalities in Iraq have been due to IEDs, typically roadside bombs, Kosal said. "This strongly suggests there is a substantial tacit knowledge base and readily available materials for constructing these types of weapons--one guy has not been making them all in a Mosul garage." While incorporating chemicals into roadside bombs would not dramatically increase military casualties, incorporating them in devices employed in enclosed spaces could, Kosal said.

An analysis of terrorism between 1910 and 2003 from open-source information shows the lion's share of 265 terrorist attacks--76 percent--were chemical. Only 17 percent were biological, 0 percent nuclear (involving fissile material, such as that powering an atomic bomb) and 7 percent radiological (involving radioactive elements that cannot be used for fission or that contain less than a critical mass of fissionable material, such as those employed in "dirty bombs").

It used to be that the major threat of chemical weapons came from state-based programs. Chlorine and mustard gases were used extensively in World War I, for example. The United States and the former Soviet Union amassed stockpiles exceeding 40,000 tons, which are still being destroyed. International efforts to control the exchange of certain chemicals, such as precursors for nerve and blister agents, have been effective. Kosal cited the refusal in the 1980s during the Iran-Iraq war of the world community to sell Iraq the key precursor to mustard gas.

Nowadays, terrorists both foreign and domestic may disperse traditional chemical warfare agents using improvised methods. In 1995, for example, the Aum Shinrikyo group crudely dispersed a nerve agent in a Tokyo subway--killing 12 and panicking thousands--using umbrellas to puncture 11 garbage bags, each filled with a common solvent and about a pound of sarin. Today's chemical weapons may just as likely come from common commercial sources, such as agrochemicals. Radical Islamists have even attempted to weaponize a research chemical, osmium tetroxide, used to prepare biological specimens for electron microscopy.

In contrast with nuclear or mass-effect biological weapons, chemical weapons may not require sophisticated knowledge to produce. In 2003 at a rented storage space in Tyler, Texas, government agents seized half a million rounds of ammunition, more than 60 pipe bombs, remote-controlled bombs disguised as briefcases, pamphlets on how to make chemical weapons and improvised hydrogen cyanide dispersal devices hypothetically capable of killing thousands in a minute. The stockpiler, William J. Krar, described as a white supremacist and anti-government extremist, was sentenced to 11 years in federal prison. His specific objectives remain unknown to authorities.

Kosal said terrorists do not appear to be concocting new chemicals; they're co-opting existing ones. "Chemical terrorism is likely to be a crime of opportunity and familiarity with chemicals and chemistry," Kosal said. "Perhaps the basic knowledge and materials--commercial dual-use chemicals in this instance--are too globally widespread to justify efforts to control the capability of terrorists to co-opt them for malfeasant uses. . . . The best threat-reduction policy may be to reduce the motivation.

"Much of the academic and policy dialogue segregates the folks discussing motivation from the folks discussing capacity and vulnerability. The former tend to be historians and social scientists and the latter, biologists, chemists and physicists. It may prove that decreasing terrorist motivation is unfeasible in the near term, but here is an example where those with the technical knowledge and those with the social science knowledge need to be working cooperatively, the type of interaction that the CISAC Science Fellows program fosters," Kosal said.

Ten thousand fingers on the bioterror "button"

Block's talk focused on the growing threat of bioterror. While chemicals have killed more people to date than have biological weapons, future biological attacks using infectious, untreatable pathogens have the potential to kill more people than chemicals. Block wryly called such biological attacks "the gift that keeps on giving."

Block said post-9/11 restrictions aimed at keeping pathogens out of the wrong hands have backfired. One is the Department of Health and Human Services' "Select Agent Rule," which establishes requirements regarding possession and use in the United States, receipt from outside the United States and transfer within the United States of a particular list of agents and toxins.

"We're shooting ourselves in the foot," Block said. "We've made it so hard to work on these pathogens that even our so-called 'A-Team' can't do research with them." World-renowned plague researcher Stanley Falkow of Stanford and famed anthrax expert John Collier of Harvard have stopped working on live pathogens because of restrictive effects of recent legislation, according to Block. They now confine their research to a handful of cloned genes. "It's almost impossible to hire grad students or postdocs to work on Select Agents. Such research has been driven underground or into our national labs, which historically have not had the biological expertise found in the top academic labs and biotech companies."

Much of our response to bioterror threats is based on how we've historically responded to nuclear terror threats, Block said. "With nuclear weapons, only two things can be made to go 'boom'--plutonium and highly enriched uranium," he said. That made it comparatively easy to track and control materials, and to get a handle on the problem. "We tried to keep nuclear secrets secret. Not everyone knows how to make an atomic bomb."

In contrast, the genie has long been out of the bottle when it comes to biological agents. Virtually all research is reported in the open literature. "Even if we were to stop publishing everything now, there'd be enough public information to keep bioterrorists busy for at least another 50 years," he said.

"Back in the nuclear age, only a few countries were nuclear powers, and only a few people were authorized to have their 'fingers on the button,'" Block said. "Like them or not, they were responsible people. Contrast that with a world where genetically engineered weapons can be produced by, say, 10,000 people. Someone is guaranteed to press that button. We can't stop [bioterror acts] at the source any more than we can stop a computer virus at the source."

Rather than futilely attempting to thwart biological threats at their sources, which are ubiquitous, Block advocated shoring up the public health system so it can respond nimbly once threat turns to reality. A new generation of antitoxin, antiviral and antibacterial agents may mitigate ill effects, and improved vaccines may prevent damage altogether. "We need to work the problem from the other direction," he said. "To confine our attention to Select Agents alone is essentially putting on blinders. The future threats we may face may bear little relation to the organisms on the current list."

While the improving U.S. economy remains the engine of growth for the world economy, an underlying trend involving "huge imbalances and risks" should be cause for serious alarm, Paul Volcker warned Feb. 11 during a speech on campus. Americans have virtually no savings, the former chairman of the Federal Reserve said, and the nation is consuming more than it is producing. Furthermore, Social Security and Medicare are threatened by the retirement of millions of baby boomers and skyrocketing health care costs. More broadly, he continued, the world economy is lopsided.

"Altogether, the circumstances seem as dangerous and intractable as I can remember," Volcker said during a keynote address at the second annual summit of the Stanford Institute for Economic Policy Research. "But no one is willing to understand [this] and do anything about it."

Volcker spoke at the end of a daylong conference that attracted about 450 corporate leaders, entrepreneurs, policymakers and academics. The event included discussions on the stability of the global economy, the U.S. economic outlook and the role of the Internet in helping to level the competitive playing field worldwide. The conference also featured sessions on outsourcing, Medicaid and Medicare, technology policy and the Sarbanes-Oxley Act, which was implemented in 2002 to restore investor confidence in corporate America following a series of bankruptcies and far-reaching accounting scandals.

During a morning session, William J. Perry, a former secretary of defense and a senior fellow at the Stanford Institute for International Studies, gave a chillingly stark assessment of the crisis of terrorism that was reinforced by George Shultz, a former secretary of state.

"I fear that we're headed toward an unprecedented catastrophe where a nuclear bomb is detonated in an American city," Perry said. "The bomb will not come in a missile at the hands of a hostile nation. It will come in a truck or a freighter at the hands of a terror group."

Perry, who holds the Michael and Barbara Berberian Professorship, said the "awesome military capability" of the United States has had unintended consequences in that it has increased the incentive for a hostile power, unable to compete in conventional warfare, to acquire weapons of mass destruction and launch terror attacks against America. U.S. military superiority is not particularly effective against such tactics, he said. "There exist terror groups, of which al Qaeda is the most prominent, that have the mission, the intent to kill Americans," Perry said. "They have the capability to do so; they have the resources to do so." A truly nightmare scenario would involve a terror group using nuclear weapons acquired clandestinely, he said: "After 9/11 that threat seems all too real."

Such a catastrophe is preventable, but the United States is not taking the necessary measures to avert it, Perry warned. Important steps should include a major expansion of the Nunn-Lugar Cooperative Threat Reduction Program with the support the G-8 group of industrialized nations. The program was created in 1991 to reduce the threat posed by the legacy of the Soviet nuclear arsenal and succeeded in dismantling and destroying weapons in Kazakhstan, Ukraine and Belarus. Furthermore, Perry said, a clear strategy of "coercive diplomacy" should be used against North Korea and Iran, followed by a major diplomatic initiative to convince other nuclear powers that the threats posed by terrorists are real and not just directed at Americans. "While America must show real leadership in dealing with this problem, [it] cannot deal with it alone," he said.

Shultz, the Thomas W. and Susan B. Ford Distinguished Fellow at the Hoover Institution, said the United States faces a huge problem in combating Islamic radicals intent on using terror to achieve their goals. "Eventually, what they want is to change the way the world works by creating a unified Islamic theocratic state," he said. "It's a worldwide agenda."

Shultz argued that the United States must help supporters of mainstream Islam understand the fundamental nature of the problem so they will take action against the radicals themselves.

"That's why Iraq is of such overwhelming importance," he said. "Here we have a country in the heart of the Middle East where there is a chance. If Iraq can emerge as a sensibly governed country--that's a gigantic event in the Middle East and in this war on terror. Our enemies recognize that just as well as we do, and that's why we're having so many problems."

Other measures that Shultz said should receive greater support include efforts to set up independent media in countries such as Iraq, as well as a revival and expansion of the U.S. diplomatic service, which he said was allowed to atrophy after the end of the Cold War. "We have developed an awesome military capability," he said. "We need a diplomatic capability that is as every bit as good." Shultz also stressed the need to reduce U.S. dependence on foreign oil. "We are out of our cotton-picking minds not to be doing much, much more to figure out how to use much, much less oil," he said to applause from the audience.

In the afternoon, Thomas Friedman, a columnist at the New York Times, also called for greater efforts to develop alternative energy supplies. This should be the "moon shot of our generation," he said.

Friedman discussed how the convergence of personal computers, cheap telecommunication and workflow software has changed the way the world works. In his upcoming book, The World Is Flat: A Brief History of the 21st Century, Friedman explained that the world has shrunk to the point where individuals, not countries or companies, are increasingly able to think and act globally. "And it's not just a bunch of white Westerners," he said. "It's going to be driven by individuals of every color of the rainbow."

Friedman told the audience that these technological advances quietly unfolded just as the 9/11 terror attacks, the Enron collapse and the dot-com bust grabbed America's attention. "People thought globalization was over but actually it turbo-charged globalization; it drove it overseas," he said. "9/11 completely distracted our administration, and then there was Enron. We have hit a fundamentally transformative moment and no one is talking."

In this new scenario, people anywhere in the world will be able to "innovate and not emigrate" if they have the required skills, Friedman said. This means that engineers in India and China will be able to compete on a level playing field with people in this country. "When the world goes flat, everything changes," he said.

To address this challenge, Friedman said the United States must radically improve science, mathematics and engineering education and encourage young people to enter these fields. "We're not doing that," he said. "In the next two years, five years, it won't matter. In 15 years, which is the time it takes to build an engineer, it will matter. We will not be able to sustain our standard of living."