9/11, Anthrax, and Life in Public Health: Part 1

The following is a guest post by Scott J. Becker, MS, Executive
Director, APHL. It is also available on the APHL blog

Everyone has a story of when their life changed forever. It could be
before kids or after kids – or a traumatic life event like the death
of a spouse, or a happy event like graduating from university. For an
entire generation it was 9/11 and the anthrax events that soon
consumed those of us in public health.

Like many of you, I remember exactly where I was when the towers fell.
I was on my way to deliver a keynote address to the Mississippi
Public Health Association and the topic was Branding Public Health.
Upon landing in Atlanta, I called my hosts to let them know when I was
due to land in Jackson, and heard that there was some “trouble” but
that we should be in touch when I landed. I then started to pick up
snippets of conversation around me, words that sent a chill down my
spine. “Bombing… New York… Washington…” were just a few. I jumped
back on the phone to call my wife to ask her to please go pick up our
5 month old daughter, Sophie, at daycare. You see, that very day was
Sophie’s first full day in daycare, and the daycare center was a few
blocks from the White House. I caught my wife back at home in
Bethesda, who immediately turned on the TV, and then headed back
downtown. I wandered the terminal for a minute or two, trying to wrap
my head around what I was hearing and then called a colleague at CDC,
realizing that I would be stuck in Atlanta. He offered me his office
and I headed up after encountering the longest taxi line I’ve ever
seen (I was quick; I got out in 20 minutes. Folks that waited longer
were there most of the day).

Once I got to CDC it was apparent what had transpired. And then CDC
was evacuated, as it was deemed a possible target by the unknown
enemies. We had now moved into our new life, but were too numb to
understand it. Soon thereafter I checked into a hotel, and joined
many others glued to a TV. We were a new “family” of sorts, all of us
stuck together in this unfolding national tragedy. I was finally able
to get a call back to my wife and was relieved to learn that she had
gotten Sophie out of DC, even before the Pentagon was attacked.
Sitting there, I learned that my flight that morning left Dulles the
same time as the one used by the terrorists that flew into the

Hearing that sent me into action; I needed to get home. Through
divine intervention and many phone calls, I secured a one-way car
rental the next day. Virginia’s lab director Jim Pearson, APHL staff
Jeff Jacobs (now with ASCP) and I drove straight home. No planes in
the sky; no cars on the road; patriotic signs on many overpasses from
Georgia to Maryland. After 12 hours of travel we came over a small
hill on 395 in Arlington and looked down on the smoldering black hole
in the Pentagon complete with the American flag… and the quiet almost
desolate city of Washington just beyond.

What I couldn’t quite grasp was exactly how our world was now
completely different. There were Humvees on every corner, security
officers with guns and policemen… just about everywhere. Our city,
like New York, was transformed overnight. So were our professional
lives, particularly for those of us working in public health.

At APHL, we’d been focused on lab preparedness for terrorism since
1999, when we constructed the Laboratory Response Network (LRN) with
CDC and the FBI. But on this day, September 12, 2001, the once obscure
threat was palpable; it was real. We worked with CDC to ensure that
all the state labs had the tests, materials and equipment they needed
in case a threat was made to human health in some sort of attack. We
made sure that all of the contact lists were accurate and that we knew
with whom to consult if needed. The LRN went onto a high state of
alert – we were on the lookout for any suspicious samples or
specimens. Our members were told to report anything out of the
ordinary, no matter how small it seemed. Everyone was on edge, and
for good reason. News reports were issued daily (for weeks) and used
terms like “biological or chemical warfare,” “possible use of
bioweapons,” “biowarfare,” or “smallpox.” And then the question was
being asked first privately and then publicly: “Are we prepared?”
That question is still with us and always will be – the real question
is for what and for how long?

Vice President Cheney was particularly concerned as President Bush had
asked him upon his inauguration to take charge of overseeing
intelligence matters and to conduct a study of the nation’s
vulnerability to biological weapons and terrorism in general. One
vulnerability identified was access to dangerous pathogens such as
anthrax, plague and pandemic strains of influenza viruses. And public
health labs had access.

On October 2nd, all the possibilities of bioterrorism became a
reality. It was on that day that an infectious disease physician
recognized a possible case of inhalational anthrax in a man who was
hospitalized in Palm Beach, FL. The local health official immediately
began an investigation which included having the patient’s clinical
specimen sent to a lab for diagnosis. The clinical lab couldn’t rule
out anthrax, so according to protocol, they contacted Dr. Phil Lee,
the Biological Defense Coordinator for the Bureau of Laboratories at
the Florida Department of Health Lab in Jacksonville. Once he received
the specimen (On Wednesday October 3rd at noon) he began the analysis
immediately. The series of tests took less than 24 hours, and early
on Thursday October 4th he confirmed what is now known as the index
case of anthrax. All eyes were on Florida as the index case worked
and lived there, and CDC was sending investigators to his work place,
AMI Media, to figure out how this could have happened.

Since the Florida anthrax case followed the 9/11 attacks so closely,
it was unclear what we were dealing with, but we were at the ready.


2 thoughts on “9/11, Anthrax, and Life in Public Health: Part 1

  1. Thanks for sharing Scott! IMO the performance of Secretary Tommy Thompson in the Anthrax attack event was abysmal. He largely blamed the understaffed and underfunded CDC staff that had been in that condition for years. Not sure what he thought CDC was supposed to as far as prevention. Apparently earlier that summer in a large International conference in Australia, the Canadians had reported and briefed that weaponized Anthrax could be mailed and therefore that capability needed to be addressed. Weaponization of Anthrax largely entails utilization of dispersal agents. Anthrax of course is a naturally occurring substance.A decade later still many uncertainties about the Anthrax attacks and the FBI analysis confirmed in part and rejected in part by the NAS!I am still uncertain other than possible vaccine production what has been done even as 100,000 biological “agents” packages are mailed daily in the USPS to prevent another attack or even to respond to it. Some indication that EPA spent almost $400M to decontaminate the Hart Senate Office Building after the attack there.

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