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Four Ways to Reduce the Time and Cost of Anthrax Cleanup

Crystal Franco

This article is part of Crossroads in Biosecurity: Steps to Strengthen U.S. Preparedness, published by the Center for Biosecurity September 8, 2011 to mark the 10th anniversery of the 2001 anthrax attacks. Full document | Printable PDF

          
Given that cleanup of the 2001 anthrax attacks required 2 years of effort and cost hundreds of millions of dollars to remediate only a few buildings, it is hard to imagine what it might take to remediate a city contaminated in a large-scale anthrax attack. Federal, state, and local preparedness experts have estimated that a wide-area release of anthrax would render a city, such as Seattle, WA, contaminated, uninhabitable, and unusable for an extended period of time—up to 5 years by some estimates, given the limitations of current plans and technologies.1

An anthrax attack, then, would be not just a public health and medical catastrophe, but an economic catastrophe as well. Five years might as well be an eternity for the businesses and residents of a contaminated city, which means that residents and business owners would likely cut their losses and relocate well before acceptable levels of contamination could be achieved.

How might we change this equation and avoid long-term devastation? If the nation is firmly committed to decreasing the impact of an anthrax attack like the one articulated in the National Planning Scenarios (#2, Biological Attack—Aerosol Anthrax), then we must identify the knowledge gaps and political stumbling blocks that are keeping us from being truly prepared. With continued sound planning and additional research, the time and resources needed to clean up after an attack could be dramatically reduced.

Most immediately, the USG can achieve progress in this area by taking the 4 steps outlined below.

Determine How Clean Is Sufficient

It is time to confront this difficult question, the answer to which has important public health, financial, and political ramifications. In 2001, government buildings and media offices contaminated by anthrax spores were remediated to the highest possible standard—to the point at which no (zero) viable anthrax spores could be detected. The process was thorough but costly and would be impossible to replicate following a wide-area attack within a reasonable period and for a manageable cost in human and financial resources.2

Central to answering this question is understanding and being able to characterize with reasonable certainty the public health risk posed by contamination. Bacillus anthracis is a hardy bacterium that can live for many years in its spore form. Unlike most other bacteria and viruses, which attenuate naturally with time, anthrax can survive and be resuspended in the air (reaerosolized) long after an initial aerosolized release of the spores.

Because there are few historical examples of aerosolized releases, there is limited insight into the infectious nature and aerosol dynamics of anthrax spores. To date, scientific study has not been able to elucidate the true public health risks associated with anthrax reaerosolization. We don’t know, for example, very much about the infectivity of reaerosolized B. anthracis—whether it is capable of causing disease in humans—or about reaerosolization dynamics, which can differ depending on surface (ie, concrete, carpet, vegetation, etc) and climate. Health risk is especially uncertain when it comes to outdoor environments.

Without additional research, it will be impossible to characterize the public health risks and the levels of remediation necessary to keep people safe without causing terrible economic impact. While some research has been done, there has been no definitive study that answers fundamental questions: Under what conditions do anthrax spores pose a reaerosolization risk? Under what conditions do we actually need to decontaminate? Are there some environments (outdoor, in particular) where normal environmental degradation will sufficiently diminish the risk without other intervention? Is the 2001 standard of zero viable spores necessary? Is there a less rigid standard that would be reasonable and acceptable? In other words, we need to know how clean is sufficient and under what conditions.

Given our risk-averse society and the precedent set by the 2001 anthrax remediation process, policy discussions regarding how clean is safe are stuck on the zero viable spores standard.3 Should an anthrax attack occur, decisions about remediation would depend on the best political judgment and the scientific expertise available at the time. But it would be a mistake to fail to confront these issues now by funding the science and preparing ahead to the degree possible. This is not something we should have to tackle for the first time during an emergency. Policymakers ought to define, in advance of an attack, a scientifically sound approach to determining appropriate clearance levels for decontamination. This can be accomplished with a focused research and policy analysis agenda and forthright examination and debate of the issues at hand.

Ensure Sufficient Laboratory Resources

Remediation after an anthrax attack will begin and end in the laboratory. Therefore, labs must have the resources and capabilities to process the thousands of environmental samples needed to characterize the amount and extent of contamination and to verify success in decontamination.

A number of federal agencies have a limited number of laboratories with environmental testing capabilities. They would be quickly overwhelmed in a large-scale attack. To build greater capacity, the Environmental Protection Agency (EPA) has established the Environmental Response Laboratory Network—the only network dedicated solely to testing environmental samples.4 The USG should support EPA efforts to further develop and strengthen this network in order to ensure rapid processing of samples after a biological attack.

Involve the Private Sector

Private sector businesses and building owners and managers will be severely affected by an anthrax attack on a U.S. city. Representatives from the private sector have made clear that long-term abandonment of a city due to anthrax contamination would be devastating. Most businesses would not be able to sustain a shutdown of months, let alone years, waiting for remediation to be completed.

And they should not have to. Remediation of a bioterrorism attack is often thought of as a function of the USG, but the job will be too large to be handled by the public sector alone. There are not enough government personnel or resources to manage remediation on a city-sized scale. The private sector’s help will be essential. Private sector representatives, including property owners and managers, will need to be educated about the threat, involved in the planning process, and provided with the necessary resources and authorities to carry out decontamination and remediation of their own assets.

Current planning for anthrax remediation is largely a government-centric function, despite the fact that most of the country’s assets reside in the private sector. If there is any potential for bringing the time and cost of remediation within the realm of the manageable, it will be achieved through engagement of the private sector as a partner in both preparedness and response.

Plan for Vaccination

The need for anthrax remediation could be greatly lessened through strategic use of anthrax vaccine. If inhabitants of an anthrax-contaminated city could be vaccinated post-attack, it would offer protection from residual anthrax spores. While vaccination would not supplant the need for a remediation response, it would decrease economic damages and reduce the public health risk. Moreover, vaccination would allow remediation to be completed without the pressures of an unvaccinated population.

To date, an anthrax vaccine strategy has not been well incorporated into remediation plans. The U.S. has stockpiled anthrax vaccine, but we do not have a concrete plan for its use after an attack. Policymakers at the state and federal levels should consider the use of vaccine as part of the broader strategy for anthrax remediation.

Achievable Goals Within Reach

Ten years later, we certainly know more about anthrax remediation than we did in 2001, but we still have critical knowledge gaps that are limiting our preparedness. Now, we need to cross the finish line by actively seeking the answers to those questions and using that scientific knowledge to inform sensible policy and planning. The collective result of implementing the 4 measures detailed above would be a substantial reduction in the time and resources needed to remediate a city after a wide-scale anthrax attack. But that result depends on all 4: we need the science to develop attainable, safe, and sufficient standards; we need laboratory capacity to ascertain the effects of an attack and cleanup; we need the involvement of private sector partners to make remediation feasible; and we need vaccination plans to protect the public and buy the time needed to decontaminate to a safe level. All of these goals are achievable and within our reach.

References

  1. Regional Recovery Framework for a Biological Attack in the Seattle Urban Area. September 2010. Prepared for the Interagency Biological RestorationDemonstration Program. http://nwrtc.pnnl.gov/PDFs/RegionalRecoveryBioAttack201009.pdf. Accessed July 26, 2011.

  2. Crockett K. IBRD: a collaborative approach to biological incident recovery. Biosecur Bioterror 2011;9(3).

  3. Interim Consequence Management Guidance for a Wide-Area Biological Attack. Lawrence Livermore National Laboratory. LLNL-TR-484706. May 24, 2011.

  4. Environmental Protection Agency website. Environmental Response Laboratory Network. http://www.epa.gov/oemerln1/biological.html#add. Accessed July 26, 2011.