S. HRG. 108–797 TERROR ATTACKS: ARE WE PREPARED? HEARING BEFORE THE COMMITTEE ON HEALTH, EDUCATION, LABOR, AND PENSIONS UNITED STATES SENATE ONE HUNDRED EIGHTH CONGRESS SECOND SESSION ON EXAMINING PREPARATIONS FOR POSSIBLE FUTURE TERRORIST AT- TACKS, FOCUSING ON A CONCEPT OF OPERATIONS PLAN, TAILORED TO EACH NATIONAL SPECIAL SECURITY EVENT, WHICH ESTABLISHES A FRAMEWORK FOR MANAGING FEDERAL PUBLIC HEALTH AND MED- ICAL ASSETS AND COORDINATING WITH STATE AND LOCAL GOVERN- MENTS IN AN EMERGENCY JULY 22, 2004 Printed for the use of the Committee on Health, Education, Labor and Pensions ( U.S. GOVERNMENT PRINTING OFFICE 95–103 PDF WASHINGTON : 2005 For sale by the Superintendent of Documents, U.S. Government Printing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512–1800; DC area (202) 512–1800 Fax: (202) 512–2250 Mail: Stop SSOP, Washington, DC 20402–0001 VerDate 11-MAY-2000 15:37 Apr 12, 2005 Jkt 000000 PO 00000 Frm 00001 Fmt 5011 Sfmt 5011 S:\DOCS\95103.TXT SLABOR3 PsN: SLABOR3 COMMITTEE ON HEALTH, EDUCATION, LABOR AND PENSIONS JUDD GREGG, New Hampshire, Chairman BILL FRIST, Tennessee EDWARD M. KENNEDY, Massachusetts MICHAEL B. ENZI, Wyoming CHRISTOPHER J. DODD, Connecticut LAMAR ALEXANDER, Tennessee TOM HARKIN, Iowa CHRISTOPHER S. BOND, Missouri BARBARA A. MIKULSKI, Maryland MIKE DEWINE, Ohio JAMES M. JEFFORDS (I), Vermont PAT ROBERTS, Kansas JEFF BINGAMAN, New Mexico JEFF SESSIONS, Alabama PATTY MURRAY, Washington JOHN ENSIGN, Nevada JACK REED, Rhode Island LINDSEY GRAHAM, South Carolina JOHN EDWARDS, North Carolina JOHN WARNER, Virginia HILLARY RODHAM CLINTON, New York SHARON SODERSTROM, Staff Director J. MICHAEL MYERS, Minority Staff Director and Chief Counsel (II) VerDate 11-MAY-2000 15:37 Apr 12, 2005 Jkt 000000 PO 00000 Frm 00002 Fmt 5904 Sfmt 5904 S:\DOCS\95103.TXT SLABOR3 PsN: SLABOR3 CONTENTS STATEMENTS THURSDAY, JULY 22, 2004 Page Gregg, Hon. Judd, a U.S. Senator from the State of New Hampshire, opening statement .............................................................................................................. 1 Kennedy, Hon. Edward M., a U.S. Senator from the State of Massachusetts, opening statement ................................................................................................ 2 Thompson, Hon. Tommy, Secretary, Department of Health and Human Serv- ices; accompanied by Julie Geberding, M.D., Director, Centers for Disease Control and Prevention and Anthony S. Fauci, M.D., Director, National Institute of Allergy and Infectious Diseases ...................................................... 4 Prepared statement .......................................................................................... 7 Alexander, Hon. Lamar, a U.S. Senator from the State of Tennessee, opening statement .............................................................................................................. 18 Dodd, Hon. Christopher J., a U.S. Senator from the State of Connecticut, opening statement ................................................................................................ 21 Tolbert, Eric, Director, Response Division, Federal Emergency Management Agency (FEMA), Department of Homeland Security ........................................ 25 Prepared statement .......................................................................................... 27 Mitchell, Andy, Deputy Director, Office for State and Local Government Co- ordination and Preparedness, Department of Homeland Security .................. 29 Prepared statement .......................................................................................... 31 Sellitto, Mike, Deputy Fire Chief, Washington, DC. ............................................ 38 Prepared statement .......................................................................................... 40 Thibault, George E., M.D., Vice President, Clinical Affairs, Partners Healthcare ............................................................................................................ 98 Prepared statement .......................................................................................... 100 Waltman, Susan, Senior Vice President and General Counsel, Greater New York Hospital Association ................................................................................... 102 Prepared statement .......................................................................................... 105 Martinez, Ricardo, M.D., Super Bowl Senior Medical Advisor, National Foot- ball League, Chairman and Chief Executive Officer, Medical Sports Group .. 116 Prepared statement .......................................................................................... 117 ADDITIONAL MATERIAL Articles, publications, letters, etc.: Questions to Secretary Tommy Thompson from: ........................................... Senator Gregg ............................................................................................ 124 Senator Kennedy ....................................................................................... 125 Senator Murray ......................................................................................... 125 Senator Clinton ......................................................................................... 126 Question of Senator Clinton for Andy Mitchell ..................................................... 127 (III) VerDate 11-MAY-2000 15:37 Apr 12, 2005 Jkt 000000 PO 00000 Frm 00003 Fmt 5904 Sfmt 5904 S:\DOCS\95103.TXT SLABOR3 PsN: SLABOR3 VerDate 11-MAY-2000 15:37 Apr 12, 2005 Jkt 000000 PO 00000 Frm 00004 Fmt 5904 Sfmt 5904 S:\DOCS\95103.TXT SLABOR3 PsN: SLABOR3 TERROR ATTACKS: ARE WE PREPARED? THURSDAY, JULY 22, 2004 U.S. SENATE, COMMITTEE ON HEALTH, EDUCATION, LABOR, AND PENSIONS Washington, DC. The committee met, pursuant to notice, at 10:00 a.m. in Room 430, Dirksen Senate Office Building, Hon. Judd Gregg (chairman of the committee) presiding. Present: Senators Gregg, Kennedy, Dodd, and Alexander. OPENING STATEMENT OF SENATOR GREGG The CHAIRMAN. If we can get everybody’s attention, Secretary Thompson is on his way. He is in a car on his way. I thought in order to expedite the hearing since we have got some very interest- ing witnesses we want to hear from, and unfortunately we have a variety of votes coming up which may totally disorient the events here—here is Secretary Thompson. Great. Nice to have you, Mr. Secretary, and it is nice you are joined by Dr. Gerberding and Dr. Fauci, obviously. The purpose of this hearing is to review the status of our prepa- ration and our capacity to deal with a significant biological event. One would presume it would be terrorist driven. There has obvi- ously been a tremendous amount of attention to this issue by this committee, but more importantly by the government generally. Since 9–11, we have put over $14 billion in the issue of defending this country against a biological attack, and we would like to re- view where we stand with the members of those government agen- cies which have the priority responsibility in this area. The issue, I believe, breaks down into a number of functions. The first is our ability to detect prior to an event biological agents com- ing into the country and potentially being dispersed and where we stand in our capacity for such detection. The second goes to the issue of our capacity to deal with a biological event, specifically what our status is relative to the production and development of antibodies and vaccines, a major issue, our stockpile capability and what we have in the pipeline to deal with things like anthrax, bot- ulism, smallpox, plague, and the top six areas that we have identi- fied. The third area that this breaks down into is our capacity to con- tain an event and to handle the surge of need in the area of health care which would occur from an event. If it is, for example, a small- pox outbreak, the capacity to contain the actual outbreak, if it is an anthrax attack, the capacity to deal with the issue of health care and caring for people who have come in contact with the (1) VerDate 11-MAY-2000 15:37 Apr 12, 2005 Jkt 000000 PO 00000 Frm 00005 Fmt 6633 Sfmt 6633 S:\DOCS\95103.TXT SLABOR3 PsN: SLABOR3 2 agent, and specifically whether or not we have gone through and participated in enough preparation in those areas which would be most likely subject to such attack; and, finally, the coordination issue, which is a constant issue of concern between the State and Federal agencies which are responsible. I think the 9–11 report which has just come out, which I have only had a chance to review, as I suspect most people have, in a superficial way, but one of the very apparent conclusions of that is that preparation is absolutely key in our capacity to deal with these types of events, and our job, I think, as a Congress is to re- view where we stand in that preparation process. That is what this hearing is about, and we look forward to hearing from our wit- nesses. We have got an exceptional group of folks here to talk to us, and I will yield to Senator Kennedy for his thoughts. OPENING STATEMENT OF SENATOR KENNEDY Senator KENNEDY. Well, thank you very much, Mr. Chairman, and thank you for having this hearing. I think it is enormously im- portant and it is timely as well. If we look at just yesterday when we were at the White House and the President signed the Bio- Shield legislation which will bring together both the private sector and the public sector in order to try and develop the kinds of vac- cines and treatments to protect against