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The other lurking threat to America’s public health

The other lurking threat to America’s public health


Former federal officials are warning that the U.S. isn’t ready for the possibility of biological warfare, just as it failed to prepare for pandemics, and that it’s time to invest more in countermeasures.

Why it matters: Though there’s no immediate threat, concern that Russia may use biological or chemical weapons against Ukraine underscores the need to prepare for worst-case scenarios.

  • “We need to be prepared to be able to respond to the next crisis, whatever that might be. It may be another emerging infectious disease, it may be an intentional biochemical event … we can’t predict that,” said Robert Kadlec, who was the HHS assistant secretary for preparedness and response during the Trump administration.
  • “When [Putin] rattles the saber over bio, nuclear and chemical weapons, we better sit up and take note and be ready,” said Greg Walden, a former chairman of the House committee with jurisdiction over public health and preparedness.

The big picture: The U.S. has historically invested in a stockpile of treatments, vaccines and equipment to use in the event of an emergency.

  • This is the same stockpile that held masks and ventilators that we have used during the coronavirus pandemic. But it also stores therapeutics and other countermeasures that can be used against smallpox, anthrax, radiation and nuclear burns, among other threats.
  • What is kept in the stockpile and at what levels is determined by the government based on threat levels. However, investment hasn’t kept up, by the government’s own standards.
  • “We are far short of looking at these challenges in the same way we look at many of the traditional national security issues we face,” said Tom Daschle, the former Senate majority leader. “I think it’s the future of the real threats we face in national security.”
  • “We are absolutely not close to meeting requirements. Ever,” said another former HHS official who worked in the Trump administration. “We’ve routinely not been as prepared as our own government says we should be.”

Where it stands: HHS is required by law to create multiyear budgets for medical countermeasures that incorporate the funding demands of various agencies involved in developing and stockpiling the countermeasures.

  • But Congress hasn’t funded the initiatives at the recommended level, although it did just add more funding for the stockpile in the sweeping spending bill it just passed.

What they’re saying: The pandemic itself should serve as a wakeup call, Kadlec said.

  • “We’re not learning the lessons we should that are relevant and immediately applied to something like a chembio event, particularly [initiated by] a nation-state, like Russia, who we know has a biological weapons program and has advanced chemical weapons,” Kadlec said.

Be smart: The advantage to preparing for biologic or chemical weapons versus COVID is that we know what’s already out there — even though novel pathogens could be made — and have developed tools to use against these threats.

  • “In the case of smallpox and some of the others, we have the treatments and the antidotes that we need,” Walden said. “The question is, do we have enough of it, is it current, and can we deploy it effectively in time to prevent a catastrophe?”
  • “Literally, are we set up to do drive-through distribution of whatever the medicine is in a major city? We saw how hard that was to pull off,” Walden added. “Having lived through [the pandemic] now, I have trouble believing we’re set up to pull this off.”

What we’re watching: There’s a lot of overlap between preparing for another pandemic and preparing for biologic or chemical warfare, experts say, and both are worth heavy investment.

  • Kadlec now works for Sen. Richard Burr and has helped craft a bipartisan pandemic preparedness bill, but says even that wouldn’t make all of the necessary changes.
  • “We didn’t even go far enough for the pandemic with lessons learned,” Kadlec said. “The question is, what is it going to take for us to understand that we live in a world that these things can happen tomorrow?”


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