Coordinated And Unified Responses To Unpredictable And Widespread Biothreats

SMi CBRN Address, 19.Sept.2006

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COORDINATED AND UNIFIED RESPONSES TO UNPREDICTABLE AND WIDESPREAD BIOTHREATS - PANDEMICS AND LESS

Dr Martin Joseph Dudziak, PhD

Chief Science Officer, TETRAD Technologies Group, Inc. (USA & CA)1 Intelligent and rapid dissemination of correct and qualifiable information is the essential ingredient, and to date the missing ingredient, in most national and regional response plans for CBRN threats, particularly those involving a biological component. While the focus is often directed currently toward avian flu threats, and in general toward massive trans-continental pandemics, the fact remains that there are a host of other fast-moving epidemic outbreaks possible including salmonella, e.coli, MRSA, CDIFF, VRE, TB, any of which can have devastating effects in localized communities where populations are congested and the response time inadequate. Casualty and debilitating illness risks are elevated further by the likelihood that in a pandemic situation, terrorists would also be likely to strike with unconventional CBRNE or cyber attacks in order to take advantage of an inherently disrupted social situation and thereby amplify the problems at hand. The opportunistic planning by terrorist factions to “piggy back” a new biological or even conventional set of multi-point attacks on a society otherwise under stress from a natural outbreak can no longer be underestimated. Such planning has been uncovered in the UK, in the USA, and it is one of the more novel avenues available to a terrorist network that is under pressure to improvise. Today we are increasingly at risk for both natural and intentional (e.g., terrorist) biothreats, and for a mixture of both types. However, it is not only a case of risk for the traditional outbreaks nor for those that an al Qaeda type of network may amplify. Due to the radical increasing instabilities and variances in climate due to rapidly increasing CO2 levels, and consequent global warming and sea level increases in general, there are more diseases spreading to regions of the globe where they were not present in the past. Vibrio vulnificus and ostreopsis ovata, both highly debilitating diseases normally found only in tropical waters, have been found in the Baltic and Mediterranean respectively. The former has resulted in death to at least one swimmer in Denmark, far removed from the tropics. Congo Crimea Hemorrhagic Fever and Malaria are both spreading out of their native zones. These in themselves may not be the basis for epidemics or pandemics but they pave the way and give clear indications of changing patterns in the movement and spread of diseases on the basis of climatic change, mostly of a global warming variety. The opportunity for variations in biothreats to large population centers due to the combination of rapid movement plus changing microorganism ecosystems, without any introduction of malicious intent by terrorists, is larger today than perhaps ever before in human history. The capacity for rapid dissemination of information to the populations at risk, once an outbreak is known and the containment process has begun, is also larger and faster today than ever before. However, some of the technology and systems that are part of this improved response-ability are also part of the problem, contributing to slowdowns and entanglements due to the formal processes and bureaucracies that have evolved, plus the dependency upon efficient but highly vulnerable infrastructures of communication, command, and energy. There is today a proliferation of available tools including sensors, information networks, emergency response protocols and plans, diagnostics and of course medical intervention in the form of immunization and therapeutic treatments. The challenge is in the coordination and

1 Contact Data: Martin J. Dudziak, TETRAD Technologies Group, Inc., 28 Chase Gayton Circle, Suite 736,

Richmond, VA 23238 USA, [email protected], +1 (804) 740-0342, +1 (202) 415-7295


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integration of the teams and resources. A truly adaptable approach is one that can readily handle breakdowns in communications and logistics and also rapid changes in medical and social situations for a population that may be undergoing both evacuations and quarantines in close geographic proximity. The Katrina experience taught many lessons about critical infrastructure dependency and the consequences of both inadequate preparedness in many cases and over-reliance upon the modern infrastructures. The disaster within the city of New Orleans has been highly publicized; the situations in many smaller adjoining cities and towns is less well known and actually can be more illustrative of how the problems evolved and how solutions can improve. In Slidell, LA there was virtually total flooding and isolation of the population that remained – thousands of individuals – from a city of approx. 32,000 covering several tens of square miles and with more than 400 miles of streets and roads. No lives were lost due in great part to the improvisations of the local police, fire and other public safety teams and to the fact and blessing that no significant outbreak of any contagious disease occurred following the hurricane and flooding. An occurrence of a similar natural disaster at the time of an influenza outbreak, or with a significant spread of sewage or infestation into an isolated and dependent population could easily have dire consequences, especially if the affected population was isolated from medical treatment and caregivers. In order to address these types of situations, where the Biothreat is pervasive, possibly multi-pathogen in type, and where customary infrastructures of transportation, electricity, lighting, and communication are damaged, a new approach for identification, analysis and response is necessary. A method is needed that does not depend upon chains of communication and command that may simply not exist or be accessible anymore. CUBIT – Coordinated Unified Biothreat Intervention and Treatment – is one such solution, employing a model that has been developed as a viable and truly adaptive solution to threats whose geographic, demographic and health risk parameters cannot be clearly predicted or modeled in advance. CUBIT provides for the rapid configuration of the sensing model to be used for a given area and situation at hand. It provides as well for the rapid configuration of the analytics and diagnostic elements including staffing and transportation for sensors, diagnostic units, and treatments. CUBIT provides for the ad hoc, fault-tolerant replanning of response operations including evacuation and patient treatment. The architecture of CUBIT is based upon a history of studying how responses have been made to date in several real, simulated, and false-positive threat situations ranging from 9-11 and the USPS anthrax incidents, the London and Madrid bombings, the Moscow metro bombings, and Virginia’s mistaken alerts about anthrax in the Pentagon and the Capitol nerve gas threat. There are now realistic and pragmatic indicators and tools worth sharing about how to be better prepared for the Unpredictable. CUBIT provides an architecture for systems that will mitigate epidemic-scale disease transmissions emerging from the introduction of new or unexpected pathogens into a population. A system designed and built according to CUBIT principles incorporates sensors and data collectors, human observers and monitors, an informational framework of autonomous cooperating software agents, bioprotectant and/or decontamination procedures, compact and rapid-turnaround diagnostic tests, population control protocols, and clinical treatment plans. A CUBIT system is designed to be employed as a preventive and responsive component that can be embedded within larger public health, emergency management and homeland security operations for specifically addressing the emergence of particular biothreats that, regardless of type (bacteria, viral) or origin (natural, accidental, terrorist), pose an unpredictable set of long-term threats to one or more populations (human or animal).


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What makes CUBIT unique as a system architecture is that it is a set of medical and physical processes, instruments and protocols – incorporating a diversity of physical devices, chemical compounds, and information processing applications, that are organized as scalable, modular components capable of dynamic and adaptable interaction – and it capitalizes upon the use of system designs drawn from classical computing and information technology. CUBIT is an application of “plug and play,” “platform independence,” and “object oriented” design principles into the domain of environmental biosurveillance and pathogen detection and the domain of emergency incident management and medical response. An alternative way of describing CUBIT is that it is a system architecture for coordinating and unifying the identification, forecasting, and necessary intervention including diagnostics, antimicrobial protection and decontamination, and medical treatment including vaccination, quarantine and mitigation of vectors, for situations in which there is a risk of high-consequence infection and transmission. As an example, consider a system that is intended for providing biothreat intervention directed at transmission through airports and other pubs of public transportation. The necessary logical components include monitoring and sensing to detect incidents of pathogen presence and transmission vectors, plus communication with other systems that are sources of information on events outside the logical space of airports, commercial aircraft, public transportation and the general community. In addition there are logical components for analysis and prediction including simulators of airborne, waterborne or host-carried bioagents. Next there are necessary components providing for several types of responsive action – population and vehicle control including quarantine and culling operations, diagnostic testing, inoculation, antibiotic and other pharmacological treatment, and follow-up observations. Collectively these components will be under constant restructure and revision due to the need for accommodating highly dynamic and unpredictable changes in geography, climate and weather conditions, population behavior (especially where wildlife are concerned), traffic flow, responder availability, resource supplies including those for both diagnosis and medication, and adaptive pathogen biology. It is therefore mandatory that all of the components have some flexibility in terms of how they will interact and communicate among one another. A flexibility tensegrity structure will be more suitable than a rigid skeleton, in bioresponse system design just as it is naturally within biology. Prior to the introduction of the CUBIT architecture, there has been a consistent and chronic problem of mission within biothreat intervention, situation awareness and response. This has been the absence of a coordinative and unifying network of dynamic and intelligent communications, precisely the type of logic that has been the focus of development and experimentation within other sectors of defense, intelligence and crisis management, especially within combatant military forces. Composable Heterogeneous Agents for Intelligent Notification (CHAIN) and Collaborative Analyst/System Effectiveness (CASE) are two projects, the former completed and now being extended into multiple applications including maritime domain awareness for CBRNE threat intervention, that exemplify what can serve well the biosecurity and epidemiology communities. Another, the Intelligent Services Layer (ISL) is a computational integration framework for sensors, analytical applications and actuator devices to dynamically register their presence in a network, discover available resources, identify data and formats for exchange, and manage publish/subscribe functions among an open-ended network of agents. These technologies have grown out of a common matrix of research and development sponsored by a number of defense and intelligence programs [1]. Collectively they provide in turn the building blocks for a CUBIT architecture and implementations into the biomedical sphere. Figure 1 illustrates the major components of a CUBIT system. There are five major categories of components which interface with one another through a critical “operating system” layer of dynamic registration, discovery and exchange logical agents responsible for handling all of the communications. These are: sensing and detection, analysis and forecast, diagnostics, protection and decontamination, and treatment. This comprises the “anatomy” of a CUBIT instantiated system.


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Figure 1 – Basic CUBIT system architecture

Grid Framework for agent registration, discovery and exchange (CHAIN / ISL)

Sensor/monitor units (devices, observers)

Examples: SWIPE, PROFILE luminescence, colloidal gold arrays

Sensor/monitor agent services (software)

Pattern discovery and inference services

GIS and GPS services

EM & Pharma database portal resources

Examples: ArcWebServices, OGC

Examples: BioWatch, RODS

Intel and open-source news services

Routing and planning operation resources

Examples: CMDRS, Verona, LUCY, EMPIRES

Diagnostic testing services (PCR chips)

Examples: InCheck-based diagnostic systems (chip, cycler, reader)

Notifications, alerts, triggers, new agents

Antimicrobial protection and decontamination

Example: BIOSAFE for surfaces and fabrics

Vaccination and antibiotic treatments for humans and animals


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Figure 2 – Rendition of One Possible Instantiation of CUBIT System Components Two particular features of CUBIT make the architecture and its implementations versatile and rapidly adaptable for different applications. One is the CUBIT Designer, a software toolset that is employed to design configurations including the selection and integration of sensors, diagnostic units, emergency response components and therapeutics (e.g., vaccine) distribution. This is as much a design tool for the system-level selection and configuration of electronic and biomedical devices as it is a logistics planning and management tool. The second special feature of CUBIT is in the user community. CUBIT is designed for use by a very widespread and open community, not exclusively by one dedicated group of professionals. This is a very important concept that belongs in any comprehensive plan to be able to accommodate the unforeseeable effects of a widespread pandemic or a combination of biothreats with other emergencies and disasters on a large scale. It is important for the system and the technology to be usable by non-specialists to some extent because there may very easily arise situations where there are simply not enough medical and health department technicians to go around. Police, fire, and other responders can and should be able to handle some of the physical aspects of deploying and monitoring sensors and other units. Diagnostic units for individual patient testing need to be of a type that can be effectively and accurately used by persons who have some basic training and good common sense but who are not specialized lab technicians. It is essential in such conditions and environments as a pandemic or any serious outbreak that the people who are available to assist, to work, to manage, can also perform multi-tasking and carry out some jobs that have not been within their original scope of training. It is this kind of adaptability that is part of the path to survivability.

CUBIT Components

Coordinated And Unified Responses To Unpredictable And Widespread Biothreats

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