The Nightmare After the Wuhan Wakeup

Bioterrorism and open borders

By Andrew R. Arthur on March 31, 2020
  • A bioterrorism attack is the deliberate release of viruses, bacteria, or other germs to cause illness or death.
  • Numerous sources, including government agencies and universities, have raised the specter of bioterrorism attacks on the United States.
  • Such attacks could threaten the lives of numerous Americans, and cause significant economic damage, as recent events have shown.
  • One of al Qaeda's main strategies for undermining the United States was to bleed the country into bankruptcy. The significant economic disruption that would follow from the widespread outbreak of disease due to a bioterrorism attack could, if unchecked, lead to that result.
  • There are tens of designated foreign terrorist organizations operating in the world today, as well as government actors hostile to the interests of the United States.
  • Strong border enforcement, including at the ports of entry, is crucial to defending against foreign bioterrorism attacks.

You do not hear much about terrorism these days, with the attention of the public focused intensively on the Wuhan virus — following the president's near-daily press briefings (or in the case of many in the press, not), caring for school-aged children who are not in school, or worrying about their retirement accounts in a tumultuous stock market. The virus should be a wake-up, however, about a very real terrorist threat: bioterrorism, particularly transnational bioterrorism.

In my last post, I mentioned the case of a Pakistani-national physician, present in the United States on a temporary work visa, who was arrested a few days ago by the FBI on terrorism charges. According to prosecutors, he had pledged his allegiance to ISIS and "expressed [a] desire to conduct 'lone wolf' terrorist attacks in the United States." It is understandable if you are not familiar with the case — as noted, the focus right now is on the disease, the response to it, and its effect on the economy.

The Wuhan virus has revealed some glaring deficiencies in our public-health sector, however, to say the least. A lack of information (ironically enough), an insufficient number of hospital beds compared to other countries, even a lack of personal protection equipment like masks and gowns ("PPEs", for the few who have not heard the phrase on a daily basis for weeks). There is plenty of blame to go around, I guess, but I am nowhere near qualified to even broach the subject.

And it has revealed how illnesses can tank the entire economy and throw millions out of work.

You know who learns how to exploit these issues? Terrorists.

As a 2011 article in the Atlantic explained:

A key facet of [late al Qaeda leader Osama] bin Laden's anti-American warfare has always been economic. It's a lesson he drew from the Afghan-Soviet war, in which he first served as a financier of mujahidin efforts and then as a fighter. He watched the Soviet Union withdraw from Afghanistan in defeat and then dissolve altogether in 1991. Bin Laden asserted on multiple occasions that the mujahidin were responsible for destroying the Soviet empire. Whether or not he's right, he clearly believed that the high costs imposed by the Afghan-Soviet war prevented the Soviet Union from adapting to other challenges, such as grain shortages and a collapse in world oil prices.

After declaring war on America, bin Laden compared the U.S. to the Soviet Union on multiple occasions, arguing that al-Qaeda would undermine America in the same way the mujahidin undermined the Soviet economy. His strategy of economic warfare went through several iterations over time, as al-Qaeda responded to external events, seized upon opportunities provided to it, and incorporated lessons learned by the group over time.

My last job at the former INS was to respond to and address individual foreign terrorist threats, which meant understanding the motivations and goals of terrorists, and the strategies they used to achieve their ends. President George W. Bush was correct (if somewhat simplistic) when he stated that al Qaeda "hate[s] our freedoms: our freedom of religion, our freedom of speech, our freedom to vote and assemble and disagree with each other." That is the motivation. The goal was weakening if not destroying the United States, and the strategy to achieve that goal, as the excerpt from the Atlantic demonstrates, was economic devastation.

Part of that economic devastation was direct:

In a video he released in October 2004, [bin Laden] emphasized the cost effectiveness of the attacks. "Al-Qaeda spent $500,000 on the event," he said, "while America, in the incident and its aftermath, lost — according to the lowest estimate — more than $500 billion, meaning that every dollar of al-Qaeda defeated a million dollars."

That article explains, however:

A second identifiable phase in this economic warfare strategy, which al-Qaeda pursued even as it continued to attack economic targets directly, might be called its "bleed-until-bankruptcy" plan. Bin Laden first used this phrase in October 2004, in a video he released on the eve of the U.S. presidential election. He made clear that al-Qaeda sought to embroil the U.S. and its allies in draining wars in the Muslim world.

Not to give the devil his due, but in retrospect, it was an inventive, and somewhat effective, strategy — not even counting the devastating human toll in fallen troops and displaced persons.

Now assume, for just a moment, that what remains of al Qaeda and its fellow terrorist organizations (by my count, there are 69 foreign terrorist organizations (FTOs) designated by the Department of State under section 219 of the Immigration and Nationality Act (INA), including various iterations of ISIS, al-Shabaab, and Boko Haram) or governments that are openly hostile to the United States (Iran's powerful Islamic Revolutionary Guard Corps (IRGC) is a designated FTO), wanted to achieve those same goals in 2020. How would they do it?

Weaponizing commercial airliners would be a dodgy proposition, given the number of protections that the U.S. government has put into place to prevent another September 11th. Bollards and security measures have reduced the likelihood that truck bombs, which have been successful in the past (and again, and again, and again), would produce the same level of carnage today (although they are still a concern).

Even concerted conventional weapons assaults (like the November 15, 2015, Paris attacks), which kill tens to hundreds of people, elicit little more than temporary societal disruptions and the isolated security crackdowns.

If you wanted to cause a human and economic calamity like September 11, 2001, (or worse) in 2020, the answer is right on the front page of every newspaper in America today: You would spread a disease, like the Wuhan virus, as far and wide as you could. That is the definition of bioterrorism.

You don't have to take my word for it. Here is how the U.S. National Library of Medicine at NIH puts it:

A bioterrorism attack is the deliberate release of viruses, bacteria, or other germs to cause illness or death. These germs are often found in nature. But they can sometimes be made more harmful by increasing their ability to cause disease, spread, or resist medical treatment.

Biological agents spread through the air, water, or in food. Some can also spread from person to person. They can be very hard to detect. They don't cause illness for several hours or days. Scientists worry that anthrax, botulism, Ebola and other hemorrhagic fever viruses, plague, or smallpox could be used as biological agents.

Understand — I am not saying that the Wuhan virus is a bioterrorism attack. There is no reason to believe that it is, and every reason to believe that it is not. But the spread of that virus, the response to it, and its effects are a blueprint for any would-be modern-day Osama bin Laden who hates our way of life and wants to therefore attack the country and drain our economy dry.

Anthrax? The CDC states that: "Bacillus anthracis, the bacteria that causes anthrax, is one of the most likely agents to be used in a biological attack." Why? It explains:

Anthrax spores are easily found in nature, can be produced in a lab, and can last for a long time in the environment.

Anthrax makes a good weapon because it can be released quietly and without anyone knowing. The microscopic spores could be put into powders, sprays, food, and water. Because they are so small, you may not be able to see, smell, or taste them.

Anthrax has been used as a weapon before.

I personally worked through the 2001 attacks, at its epicenter. For those who have forgotten, CDC notes: "In 2001, powdered anthrax spores were deliberately put into letters that were mailed through the U.S. postal system. Twenty-two people, including 12 mail handlers, got anthrax, and five of these 22 people died."

It continues:

An anthrax attack could take many forms. For example, it could be placed in letters and mailed, as was done in 2001, or it could be put into food or water. Anthrax also could be released into the air from a truck, building, or plane. This type of attack would mean the anthrax spores could easily be blown around by the wind or carried on people's clothes, shoes, and other objects. It only takes a small amount of anthrax to infect a large number of people.

If anthrax spores were released into the air, people could breathe them in and get sick with anthrax. Inhalation anthrax is the most serious form and can kill quickly if not treated immediately. If the attack were not detected by one of the monitoring systems in place in the United States, it might go unnoticed until doctors begin to see unusual patterns of illness among sick people showing up at emergency rooms. [Emphasis added.]

Ebola? Read a 1992 article from the New Yorker, "Crisis in the Hot Zone", which discussed a very real, albeit accidental, Ebola scare in Reston, Va., a DC suburb. I read it 27 years ago, and can still remember the effect it had on me (sample excerpt: "In the pre-agonal stage of [Ebola] (the endgame), the patient leaks blood containing huge quantities of virus from the nose, mouth, anus, and eyes, and from rips in the skin."). Or read the non-fiction bestseller based on it, The Hot Zone. Or watch the Dustin Hoffman film inspired by it, Outbreak.

The Wuhan virus can be deadly (as Harvard Medical School puts it, "According to the most recent estimates, about 1% of infected persons will succumb to the disease."). But according to the World Health Organization (WHO) the average death rate from Ebola virus disease is 50 percent, with fatality rates up to 90 percent in certain outbreaks. WHO notes that "human to human transmission ... occurs when blood or other bodily fluids or secretions (stool, urine, saliva, semen) of infected people enters a healthy person's body through broken skin or mucous membranes."

Ebola is so deadly it would be difficult to weaponize, but not impossible. Scientific American reported in 2014 that it could be done in three ways: "by taking large quantities of it and inserting them into a small 'bomblet' that, once detonated, would spray the virus perhaps 30 feet — potentially infecting people" (which Dr. Anthony Fauci stated "would be like a hundred people simultaneously touching an Ebola-infected person"), "recruit[ing] individuals for Ebola suicide missions" (the simplest way, but "the plot would need to overcome substantial technical challenges including the extreme weakness that arises from Ebola"), or "genetically modifying the virus to enable it to spread more readily, perhaps through the air" (which "would be a major research undertaking").

The magazine concluded that:

With [a then-] Ebola outbreak that ha[d] already killed more than 2,800 in west Africa and laid siege to the health care systems of Guinea, Liberia and Sierra Leone, it is clear that already Ebola is terrorizing thousands. Nevertheless, the possibility of rogue organizations sowing this terror on a similar scale seems largely out of reach.

A "similar scale" hardly seems necessary — all that is needed is the fear of an outbreak of the disease in the United States.

There have been so many suicide bombers in the recent past that RAND has an entire page dedicated to the phenomenon, so it may not be difficult for a terrorist organization to find a wiling victim. Plus, given the public reaction to Ebola in 2014 (the first diagnosis of the disease in this country caused a 1-percent stock market drop), again, even the threat of a spread could have devastating effects on American life and the economy.

Botulism? Way back in February 2001, Dr. Thomas Inglesby of the Johns Hopkins Working Group on Civilian Biodefense stated: "Botulinum toxin [the source of botulism] is a serious threat as a weapon, because it is extremely lethal and easy to produce. Only a very low quantity of toxin is needed to cause a life-threatening or fatal illness."

Botulism isn't contagious, but the Johns Hopkins Working Group has concluded that "intentional contamination of the food supply or aerosol dissemination of the toxin is the greatest terrorism concern." You can stop taking Tylenol for a while, but you can't stop eating for long. And the working group noted: "Botulism is so rare that it is often misdiagnosed."

Thus, by the time we realized that the attack was underway, it could be over, but, as the 1982 Tylenol poisonings showed, the economic effects would linger: "Before the 1982 crisis, Tylenol controlled more than 35 percent of the over-the-counter pain reliever market; only a few weeks after the murders, that number plummeted to less than 8 percent."

Smallpox? It is a virus that "is spread by coughing, sneezing or talking. Contact with an infected person must be fairly close (within about 6 feet) in order for spread to occur." Sound familiar?

It has a 30 percent mortality rate, but I likely won't catch it — like most people my age and older, I have a scar on my shoulder from when I was vaccinated as an infant. But "vaccination of the general population was stopped in the U.S. in 1971." Worse: "Administration to healthcare workers was discontinued in 1976 and administration to international travelers was discontinued in 1982."

WHO notes that "smallpox has been considered a potential weapon in a bioterrorism attack," however: "If a bioterrorist attack were to occur, vaccine recommendations would likely be considered for the public as well." In a world where toilet paper is impossible to find, how difficult would it be to inoculate every American younger than 48? Bloomberg reported in 2018 that there were then more than 173 million Americans in their 40s or younger.

The CDC notes that: "No bioterrorist attack using smallpox has happened in modern times." American colonists allegedly attempted to use the tactic during a siege by Delaware, Shawnee, and Mingo warriors at Fort Pitt in present-day Pittsburgh in 1763, however, so there is precedent.

Somewhat optimistically, CDC asserts:

Most likely, if smallpox is released into the United States as a bioterrorist attack, public health authorities will find out once the first person sick with the disease goes to a hospital for treatment of an unknown illness. Doctors will examine the person and use tools developed by CDC to figure out if the person's signs and symptoms are similar to those of smallpox. If doctors suspect the person has smallpox, they will care for the person and isolate them in the hospital so that others do not come in contact with the smallpox virus. The medical staff at the hospital will contact local public health authorities to let them know they have a patient who might have smallpox.

Local public health authorities would then alert public health officials at the state and federal level, such as CDC, to help diagnose the disease. If experts confirm the illness is smallpox, then CDC, along with state and local public health authorities, will put into place their plans to respond to a bioterrorist attack with smallpox.

Well, "asserted". That webpage was last reviewed on December 19, 2016. CDC may want to think about updating it. Respectfully, it sounds like an ideal description of what is happening now, or how your grandchildren will be taught about the 2020 Wuhan virus outbreak in 2059.

I've not even mentioned the bubonic plague yet. Medical News Today states:

Once a human is infected [with Yersinia pestis], the resulting disease can either develop into bubonic plague, which is difficult to transmit among humans and fairly easy to treat with antibiotics, or — if the infection spreads to the lungs — it becomes pneumonic plague, which develops rapidly and does not respond well to antibiotics.

A paper written on the plague and its potential for use in biological terrorism says:

Given the presence and availability of plague around the world, the capacity for mass production and aerosol dissemination, the high fatality rate of pneumonic plague, and the potential for rapid secondary spread, the potential use of plague as a biological weapon is of great concern.

And the U.S. National Library of Medicine reports that:

During World War II, the Japanese army, Unit 731, is reported to have experimented on plague and to have dropped plague-infected fleas over populated areas in China and Manchuria. ... In the years following World War II, several countries, including the USA and the former Soviet Union, among many others, performed research on plague as a potential biological weapon. The former Soviet Union focused on the possibility of releasing plague in aerosolized form, thereby eliminating the dependence on the flea vector.

...

While the USA did not succeed in making quantities of plague bacilli sufficient to use as an effective weapon, Soviet scientists were able to produce large quantities of plague organisms suitable for placing into weapons. [Hardly comforting] ... There is little published information indicating actions of autonomous groups or individuals seeking to develop plague as a biological weapon. However, in Ohio in 1995, a microbiologist with doubtful motives was arrested after deceitfully acquiring Y. pestis by mail.

These are just a few. CDC lists, by my count, 45 different bioterrorism agents/diseases.

Lest you think any of the foregoing is purely theoretical, think again. Prior to its March 1995 Sarin gas attack on the Tokyo subway (which killed 13 and injured thousands), the Japanese cult Aum Shinrikyo (itself a designated FTO) launched 16 other chemical and biological warfare attacks. Seven of those attempted attacks were carried out with biological agents, three of them with botulinum toxin (one near two U.S. naval bases) and four with anthrax, although fortunately, the strains involved were apparently nonvirulent. It is also believed that members of the group traveled to then-Zaire in October 1992 to collect samples of Ebola.

In other words, bioterrorism is a threat — a real one — and as recent events have shown, one single outbreak of disease can bring the American economy to a halt, and the American people to their knees. This is not alarmism — it is experience that has been earned the hardest way: through trial and error. It would be foolhardy to think that foreign terrorist organizations could see America's response to the Wuhan virus and not recognize an opportunity.

Plainly there are home-grown terrorist threats that confront the American people, and we must be vigilant against those as well. Until recently, however, we had an overwhelmed force of Border Patrol agents on the Southwest border, as well as a corps of U.S. Customs and Border Protection (CBP) officers at the ports of entry whose resources were strained in assisting with the disaster that was unfolding at the border. Only administrative action slowed the flood of migrants, and enabled CBP to gain some semblance of control over the border.

CBP's mission statement explains why the agency exists: "To safeguard America's borders thereby protecting the public from dangerous people and materials while enhancing the Nation's global economic competitiveness by enabling legitimate trade and travel." It is "charged with keeping terrorists and their weapons out of the U.S." In the second decade of the 21st Century, those weapons include "[b]iological agents spread through the air, water, or in food".

Simply put: Borders matter, now more than ever.