Smallpox, Anthrax and Bioterrorism Agents

Welcome to Medicine and Health with Dr. Paul Anderson. This is a show about opening up the often mysterious world of how doctors think. The goal: to empower the listener to gain access to the best healthcare possible. Good day and welcome to. Medicine Health with Dr. Paul Anderson. That's me, I'm Dr. Paul. So, uh, today, at least if you're listening anywhere and you're live, uh, it's November 18th, 2021. So, um, if you're in the future, welcome from the future, but keep in mind this is November 18th, 2021 that we're talking about all this. And, uh, a lot of, uh, a lot of today, at least the base topic, is, is, uh, taken Partly from the headlines and a lot from history. So when I posted this, I think when we put it up on YouTube, the title is going to be Smallpox, Anthrax, and Bioterrorism Agents. Sounds like a real happy topic. But I want to talk about this because there have been a couple of blips in the news, some depending on what news you watch, bigger than others. And, uh, I got a lot of people asking me questions and also, you know, kind of wondering, well, how, how much of an issue is this? How possible is bioterrorism? Um, what can you do about it, et cetera? So I think that, um, and, and we'll get into all that, but I, I think the first thing to keep in mind is that, um, So bioterrorism, technically, in its narrowest definition, is the use of biologic agents. So, you know, things like viruses and bacteria and toxins from microbes and other things to— as a terrorist agent. So, you know, instead of bombs or shooting or other things. Uh, you poison the water, you poison people, you do something of that nature. And so if you expand it a little bit, and we'll talk about the CDC's definitions and some history there, uh, but beyond the biological agents, so these things that, you know, are alive or, or kind of alive like viruses, There are also toxins that are used, so we'll give a couple of examples of those that would be from the, you know, the inorganic part of the world, so things that aren't alive but can still harm you. So bioterror is a real thing. I think it's important to remember that biological warfare, biological use of agents against other humans is not a new idea. Um, you can go and look up all sorts of stories, uh, or probably YouTube videos, et cetera, about, um, old military tactics of, you know, launching, you know, an animal that had a particular disease over the wall of a city or, uh, putting, you know, diseased animal, dead animals in the water, uh, supply of a city, and on and on and on, giving out, you know, blankets that had smallpox and just all sorts of nasty things. So the idea of bioterrorism is literally terrifying if you think about it a lot. And we kind of think it, you know, has to be some high-tech thing that is a modern invention, but in reality, this has gone on for, you know, almost probably as long as humans have been, uh, fussing with each other. So What I want to do today is, although the history of bioterrorism is interesting, because of the news lately— and again, if you're here later, November 2021, you will probably have heard some of this or all of it— I want to talk about what's going on, you know, right now, because this, this is sort of the modern version of that. It is less likely, you know, someone's going to be launching dead animals over the wall at us and things like that. But there are other more modern ways to implement bioterror. So something to keep in mind with bioterror is it's, it's a well-known threat. So this is not like just, you know, a lot of people are just now, you know, hearing these news stories say about smallpox and other stuff. And they think, gee, you know, does anyone— has anyone thought about this? Bioterror is something that has been on the mind of the US government, Canadian government, et cetera, governments around the world, Russians certainly, for a long time. So none of these are new concepts. We tend not to discuss bioterror a lot because it is such an upsetting idea, and it is so disturbing to think that somebody could, you know, spread a toxin or an infectious agent or whatever, uh, that could potentially, you know, kill or harm a large number of people, and we wouldn't know it was coming. Well, that's true. That's what bioterror is. So, uh, the idea that, you know, it's not a common topic of, you know, table conversation is sort of reasonable. We tend not to focus on, you know, things that are that bad and that nasty. But, um, and, and we'll get into the background of this, but if you look at, um, you know, Dateline, uh, Pennsylvania here, and I'll— and when we put this up on YouTube, so these, these videos go on to my YouTube channel, um, and please like, share, and subscribe, by the way, because we need, we need viewers and we need hours of watching. There's a lot of good stuff on there. Take a look. But I'll put all the links up. And, uh, so NBC Philadelphia, uh, put out an update, uh, Deanna, uh, Durante and, uh, Brian McCrone, November 17th. Uh, they updated it twice on that day, so hot news as of yesterday. And, uh, the lead is smallpox files found at Merck lab in suburban Philadelphia. facility. So this certainly makes everyone in Philadelphia uneasy. And the rest of the lead says a batch of vials labeled smallpox, uh, was found in a freezer and immediately quarantined, the CDC told NBC. So, um, that doesn't sound very good. Now, if you don't remember smallpox, um, it's basically been eradicated from human transmission since, you know, the 1970s. Somewhere in here we'll talk about the last official case of transmission. And it's the kind of thing that if you're in the military, you're still immunized against it. Certain scientists are immunized against it because they may do research around that. And anybody who is being immunized before, you know, 19— the mid-1970s, people like myself and people older than myself had immunizations to smallpox, probably. The upside of that is, well, you did. The downside of it is most of that immunity is gone now. That was a long time ago that the last immunizations were done. So before we get into the rest of the story, what makes smallpox a perfect bioterror agent? It's the fact that we haven't had a human-to-human transmission, a natural case of smallpox, since the '70s. It's technically then eradicated. Okay, that's great, but that also means nobody has either native natural or immunization immunity to smallpox. That's not so great. So if you have a novel infectious agent that nobody in the world has immunity to, and it's a rather nasty agent, that's a really good bioterror agent. Smallpox was supposed to be— all the residual smallpox was supposed to be destroyed everywhere in the world. Except for two places. One is at the CDC, and the other is I believe they call it the Health Federation or something in Russia. So when the world decided, which basically meant Russia and the U.S., decided that everyone's going to destroy their their smallpox remnants that they had because it's gone, the only people keeping it, just like in the arms race, was the U.S. and Russia. Hmm. So here, the big— other than the bioterror angle here, the big news here is, is that this is not the CDC where they found these vials and they have to test them and figure out what's in them, uh, but where they found these vials that said smallpox on them. Nobody is supposed to have those outside of those— the CDC and the Russians. So finding them at a suburban Philadelphia Merck facility by accident is remarkable. Okay. Um, so that's one level of problem. Next level of problem is this is a bioterror agent no one is supposed to have outside of those 2 government agencies. And, uh, the, the, the deal is supposed to be, well, okay, if, if you're good with your smallpox, I'll be good with my smallpox, and nobody will use it against anybody. But the fact that, that there could be smallpox somewhere that is not with the Russian Federation or the CDC is— it's sort of like having a nuclear weapon that's not with the people you thought it was. That means that somebody could divert it and it could be used for bioterror. So that's really the meat of that particular story. Now, there's a lot of potential bioterror agents. Right. Okay. It's just that smallpox, A, is a very good one because nobody has current immunity to it, uh, and, and B, we haven't seen it, you know, in, in real time since the '70s, and C, it's not that hard to spread as a bioterror agent. That's the other thing. If, if you have a, um, a bug or a toxin, and in order to spread it you have to run around and inject people, that's probably a bad bioterror agent. Okay, uh, there are intelligence services around the world that use that, uh, and they will inject accidentally, you know, supposedly, uh, people they don't like, uh, with a bioterror agent that will either make them real sick or kill them. Uh, but that's a one-to-one thing. Okay, and you can That's, that's a show for another day, but that currently goes on. Okay, what we're talking about with bioterror, that's more personal, you know, personal terror, spy on spy, that sort of stuff. Or usually it's a government, uh, a higher government official that doesn't like a lower government official. That's, that's the current stories you read about. Not in the US that we know about. This is other countries. Um, but This whole thing with smallpox. So then it's like, well, okay, we're going to talk about other bugs and how they can be bad, but smallpox is airborne, generally an airborne transmission. And so there are ways to deliver an airborne virus in this case, or an airborne toxin, that aren't that hard to poison and infect large groups of people. Later, I will tell you a story about another agent and how the US was on pretty high alert for a while for all that. Let me just read from this NBC update because I think they did a really nice job. It's NBC. Smallpox is caused by a virus that was eradicated from human transmission in the late 1970s after centuries of epidemics across the globe. It is so deadly that only 2 laboratories in the world are allowed to have doses of the virus: the CDC main lab in Atlanta and a facility in Russia. The CDC said— now this is talking about these ones, these vials that they found at the Merck facility. CDC is quoted as saying, because Merck is probably wisely not talking about this, um, the frozen vials were incidentally discovered, quote unquote, by a lab worker. Imagine being that lab worker. The discovery occurred at the Merck Upper Gwyddyn facility in North Wales, about 30 miles northwest of Philadelphia, according to a source. It's not clear exactly when the vials were discovered. So we think this is pretty recent, but nobody has direct intel on that. Kind of doesn't matter at this point. They've been discovered. Merck is in the process of figuring out why it was there. Okay, so this is patently not cool. Like, this is— nobody outside of the CDC's main branch in Atlanta is supposed to have this stuff. So saying, gee, we stumbled upon potentially some smallpox samples in a freezer. Yeah. And we have no idea why it's there. Okay, now, other side of the coin. While it's reasonable that, you know, this could have been an incidental discovery, um, there are samples of all manner of things kept in laboratories for a very long time, especially in freezers. Okay, so for example, Uh, one of the ways that some tracing was done with HIV infection was actually looking at frozen blood samples that went back, you know, into, uh, the '70s, '60s, '50s, '40s, a long, long way back. And these were being held in labs frozen, uh, you know, because maybe someday we would discover something and we want to look at genetic profile, see how far back, let's say, HIV go in the human population. Uh, and, uh, and other infectious diseases are done that way. So there's all sorts of stuff stored in laboratories, but when it comes to something like this, where the governments of the whole world, but in the US, uh, have said, we're going to destroy all the smallpox, um, samples, except for a few. Um, that's a pretty big deal. Like— there's supposed to be a chain of custody of these things, and you're supposed to destroy them. And so the fact that these guys had it is curious. Uh, CDC investigation is underway, of course. Um, and, you know, they go on to say, uh, the frozen vials were just labeled quote-unquote smallpox. Okay. Um, and this worker was cleaning out a freezer. Again, hate to be that worker, but these were sealed vials. Um, this person had personal protective equipment on, including glove, mask, you know, all the things you, you don't— generally anyway, you don't clean out a lab freezer without a lot of PPE on. Uh, so they believe, you know, the worker is pretty well protected, uh, and probably not, uh, you know, exposed. And they also say that, you know, it's not like a lab leak where there was probably exposure, but the fact that they found it is a pretty big deal. Okay. Um, and so because that's literally a news story from yesterday, uh, that's, that's as much as we know. I'd imagine you'll be seeing news updates today and in the days to come that might elaborate more on that. But this is, um, now a CDC investigation, and there, you know, there may be other government agencies investigating too, uh, because there's Government agencies get involved in this. What is also interesting, though, and again, you know, kind of ripped from the headlines, this is reported if you if you for instance just you know put this in your search browser. Everybody did a story on this, so I'm going to quote one from the Independent in UK. But everybody did the same story, and this is. About 9 days earlier, November 9th, Tuesday. So about 7, 8, 9 days earlier. Um, and it says— here's the lead on this one— Bill Gates warns of smallpox terror attacks as he seeks research funds. Now, a lot of questions that I got yesterday and today were Isn't it weird that a week prior to discovering this mystery smallpox batch that should have never been there, or should have been removed a long time ago, that a week prior, you know, we have one of the most influential people around public health saying we need, you know, we need some research funding around smallpox terror attacks? Curious. Now, like a lot of things, one thing may have nothing to do with the other, but it's made a lot of people really worried, you know. And I think that the thing, as I said at the top of the show, when you get to terror attacks, I mean, it's something that, like, this is just the thing you don't want to talk about. You want to think about it, right? Having, you know, this thing, you know, where Bill Gates brings up we need to do more you know, bioterror research, uh, big deal, you know, big mover in the world. And then all of a sudden we discover some, you know, seemingly sort of random out-of-place smallpox. Uh, certainly it's at, you know, it's at Merck, uh, you know, so it wasn't like at a 7-Eleven or something, but still, uh, here it is. And then it makes people think, well, how many other, you know, how many other labs might have not got rid of all their smallpox. And then, could anybody— could terrorists have had it? You know, because the chance of like Merck, uh, turning into a terrorist organization is probably low, but, uh, the chance of a terrorist, you know, getting a hold of something like that, probably high. So, and I'm not going to belabor the Bill Gates thing other than, you know, it was a week prior to discovering this stuff One thing may have nothing to do with the other, but it's gotten a lot of people talking, made a lot of people really, really concerned about smallpox terror attacks. Now, I wanna frame this as smallpox is a perfect bioterror agent. And back in the days when I used to teach medical students about microbiology and immunology and bugs, we would always tell them that, you know, that it's not available, the CDC and the Russians are the only people that have it. But as a concept around bioterror, it's a perfect agent. You got no immunity, it's a bad infection, and it's not hard to spread. It's not as easy as other things, but it's not that hard to spread. Okay, you don't have to run around injecting people with it, you can aerosolize it. So, and in modern times where we have the ability to synthesize things in labs at high quantity, It, it's not that far of a stretch that someone could do that. Okay. But if that wasn't sort of bad enough, um, and, and I don't know whether this, the Bill Gates thing, uh, you know, if, if he just picked smallpox out of the air because it's the usual, um, you know, bioterror scenario that people talk about in, you know, courses and stuff like I used to do, or whether there was something else behind smallpox kind of moving up the ladder as something that we need to worry about. you remember there's a whole bunch of other agents in the world that also qualify as either very good or marginally good bioterrorism agents. So that should make us all feel a little less, uh, you know, a little less easy when we think about bioterror. So, um, to be specific, nobody has naturally acquired smallpox in the whole world since 1977. So I said mid-'70s, it was 1977. But it's been known since then, since the 2 countries decided they were just going to keep a few samples and destroy everything else around the world, that if this ever got out, it could be a big deal. And I think that the other side of this, and you probably see people, you know, talking heads and things talk about this. The other part of this that's a real, uh, clunker here is the fact that this was discovered somewhere, even though it's a laboratory that's a registered laboratory and it's— it used to supposed to be there, but they were supposed to get rid of it. The fact that anything was discovered, um, should, you know, it strikes fear into people's heart because then it's like, well, you've got the potential for maybe it's in other places. Maybe the wrong people could get ahold of it. Right now, the CDC has all of this stuff and they're investigating it. So hopefully they're doing the right thing with it. But this is the same thing that we used to think about and talk about, you know, when the, uh, when, uh, USSR was breaking up and there were all these nuclear weapons, you know, possibly in the hands of people, you know, who shouldn't have them. or selling them to people who shouldn't have them. That can be a problem. Well, what if the same scenario happened with bioterror agents? Okay. So that kind of gets us up to date on the news of yesterday and a week ago, between Merck finding, surprise, surprise, we got something called smallpox in our freezer. And then Bill Gates a week prior saying, hey, we need to pay attention to smallpox. pox as a bioterrorism agent. Again, I didn't look into the Bill Gates thing other than read part of the news release, but it seemed to me that's what was being said. It's a little odd that those 2 things happened at the same time almost. What does the CDC tell us? Again, when we put this up on YouTube, I'll put all links to all this stuff so you can find it if you want interesting and very disturbing reading. So the first thing is the CDC has a stratification of bioterror agents. Okay, now remember, bioterror specifically is going to be microbial, and that could be the microbe itself or its toxin or some other thing. But basically they have a category A, B, and C for bioterror agents. Then they have toxins that could be put in the water supply or something of that nature. So on the Category A, these are considered high-priority agents by the CDC that are very potentially easy, if you've got ahold of them, to manufacture, to spread, and also they're very deadly. So for example, we have things like anthrax. Now we'll get into anthrax. There have been anthrax scares and anthrax sent to people and all that. botulism, and certainly if you recall or you've heard, so botulism is a botulinum toxin, same stuff they make for Botox. So botulism is— botulinum toxin is not sequestered. Okay. Anthrax is not sequestered, and it's naturally occurring in the world, and you can find it and do stuff with it, and that's partly why it's such a big deal. What about the plague? Yeah, so there's actually a discrete Yersinia. Yersinia pestis is the, is the bacteria that caused the plague. That would be a really bad one to have out there. Smallpox, and then some, you know, things like tularemia and viral hemorrhagic fever like Ebola, and then some other oddballs. The second priority is the B, the Class B bioterror agents are a little harder to disseminate. So part of it is pathogenicity, how bad is it for you? The other is, how easy is it for me to give it to a large group of people? So Category B are a little bit harder to get around to large groups of people. But this is things, and I won't go through all of them, but Certain types of toxins that can cause like tissue necrosis, things that can be spread in the food, like some of the more nasty E. coli agents and salmonella and things of that nature. A whole bunch of other things that are often spread by birds and other animals, so they're easy to get. Staph toxin, again, easy to get. The viral encephalitis agents— so you hear about these— is the alpha and flaviviruses. So things like the equine encephalitis of different types. And then things that can be put into the water, you know, like the agents of cholera or Cryptosporidium or other things, you know, things that sometimes show up in the water, people get sick. What if I— you know, not me, but what if someone put that in our water supply? A lot of people get sick. And then of course, for those who watched Breaking Bad, the TV show, you'll remember ricin toxin, ricin from castor beans. And again, castor beans are not that hard to find. They're not sequestered either. So if you see this, the Class A and Class B things, most of these things are not sequestered. So if you have somebody— now I will tell you that if you're, uh, somebody who has the technical knowledge to produce, um, microbial, you know, contaminants or toxins, etc., usually the government knows who you are and keeps track of where you are. Um, and, uh, I have a lot of friends in, in that world, not in the government side but in the academic side, and And depending on what type of lab they work in, everything has to be registered so that, you know, if suddenly a bunch of anthrax shows up and they're wondering where the spores were made, you know, they start looking at the, you know, the obvious suspects. So there's a couple of things, and then of course there's a Category C. Category C is essentially You know, a little harder to get out there, but includes some kind of nasty viruses that again would be pretty easy to get if you knew where they were and what the vectors were. But there was a couple of things that have happened in the past that you may remember or may not. Um, and, um, there was a— this is a number of years ago, okay? Um, there used to be an annual meeting that, that I would go to, and it was, um, it was kind of by invitation only. Uh, it tended to be researchers or physicians, and it was all about infectious disease. And it became closed to the degree that if— unless you were kind of on the list, you, you know, you really couldn't go. Um, it was all this very interesting information. And then all of a sudden, one year, they, uh, start talking about, um, there had been— and you may remember this— there had been a, uh, an anthrax, uh, out— outbreak. And then, uh, and then subsequently people were like mailing some anthrax spores around and things of that. nature. And one of the problems with anthrax that makes it such a great bioterror agent is— and this is what they were trying to tell, you know, the clinicians in the group— was, you know, we don't see a lot of anthrax, at least in North America. And there's 3 different kinds of anthrax, which is what you learn. But if you get the respiratory kind, which is the kind of the bioterror agent would spread by the powder, the spores, Uh, it, it opens up, it creates— the Bacillus anthracis comes out of, uh, out of its, uh, quiet state, its spore state, and then you get, you know, respiratory anthrax, which is a really, really quick way to die. The biggest problem with that was by the time you figured out— let's say you did the imaging of the lungs and the chest and finally found the kind of classic presentation of anthrax, which again, people in— at least in our part of the world, you don't see. Uh, by the time you could see it on the imaging, most of the people would die before you could treat them enough. So then the, uh, plan came: if there's even a chance that anthrax, Bacillus anthracis spores, uh, have been spread around and you have somebody exposed, you should treat them presumptively before they get that bad, and you can stop them from dying. And that indeed can happen. Okay, so this became very disturbing, and you probably remember the stories about, you know, boxes of powder showing up and all that stuff. Um, so that was one thing, uh, and then, um, I think it was the following year, or there was a year And there was a huge kerfuffle because there was a lot of big athletic events going on in the US. There was a lot of foreign folks coming in. And there was a real concern. And again, this is all at this meeting, and the leaders of the meeting were talking about, well, this is what the CDC is telling us, this is what, you know, is being planned and all that. Um, and they were saying, well, you know, the problem is that if you had something like either, you know, smallpox or you had anthrax, you could literally just fly over large groups of people, let it out, and because it's airborne, you could potentially infect a lot of them. And so, and I— this is long enough ago, I don't really remember the the trajectory of, of what year what happened. But I believe what happened was the following year they sort of told the rest of the story, which was the U.S. government had a contingency plan in case there was an outbreak of something like smallpox, uh, at this large athletic thing that was going on, um, or, or anthrax. But mostly they were prepared for smallpox. And what they were saying was, is that, you know, smallpox kills a lot of people. Obviously, you go back and you look at the number of people that died in the past, etc. But their theory, which I think does work out, was if we had the ability in the old days to hospitalize people like we could now and care for them and not let the smallpox collateral damage of the infection you know, uh, decompensate them and kill them, um, more people would live. So what do we do if we get, you know, someone flies over a stadium and sprays everyone or whatever, right? Well, what the government actually had set up— and again, I'm— I don't work for the government. This is information given to me by people who, uh, worked with the government on these problems, but they were not part of the government either, at least as far as I know. What the government had set up was there was a— I'll just say there was a large government agency in the city where this athletic event was going on, and their headquarters used to be a hospital. And so the government agencies— military usually helps out with these things— bring semi-trucks full of hospital equipment, and they usually have it at the ready. Um, and they were— they had a plan in place where if this bioterror thing happened at this athletic thing— and I'm being vague about what and who and where, uh, because I mean, you probably go look it up, but that's not mine to tell you. Um, if this actually happened, this government agency was ready to evacuate, and they were gonna, through the help of the military, bring in and set this hospital back up with all this modern equipment and be able to triage people and treat them. And it was a rather large facility. The other thing that they had were, um, medicines, I'll just say, that were available to help with a couple of different types of bioterror agents that could be taken from— let's say it was the CDC. Let's, let's say— I don't remember, but a government agency that deals with infectious diseases, and they had, uh, jets on standby that could fly the medicine to this city very quickly. Now thankfully that never happened, but in, in hearing this— and I believe that's the order it went in, that there was sort of, I think there was the anthrax stuff, and then there was this potential smallpox thing, and, and it was just a potential— and then to hear After the event, because they didn't tell us before the event that they had this big master plan, here after the event, the amount of master plan that went into what happens if this goes on, um, is— it does a couple of things. One is it tells you that this is not something that is taken casually at the level of, of the government, which is good. It also tells you that there's— there are a lot of moving parts. to the infectious disease and public health response system. Now we think of this— again, this is November 18th, 2021— we think of this in regard to COVID, and we think, geez, you know, they did this maybe good, this was bad, or whatever. Um, this type of response has a little more history. So COVID was novel and all of that, and COVID has showed us, you know, what a novel agent like Okay, smallpox would be novel now to anybody who's alive, right? COVID tells us what, what, you know, uh, what smallpox could do if it really spread around and was, you know, really used in an area. Now, it's, it's not gonna, you know, transmit probably like that, but if I was a terrorist and I wanted to get you and your area or destabilize something, it would be a great way to do it. Okay, so the government does have a lot of contingency plans. Now, are they good or bad? I don't know. I don't make them up, and I've only known about a couple of them. But when they have— what I have known about how they were working on this, they were, you know, they were pretty aggressive and pretty well thought out. The problem is, what if it's not an international sporting thing that's going on where you kind of know hey, we gotta, you know, we gotta watch out for trouble here. Um, what if it's, you know, something random? Or, you know, which, if you're a terrorist, would be the way to go. Um, then you have to think, well, let's hope that there's contingency plans so that if a lot of people get sick with something like anthrax or, uh, you know, or one of these other things like smallpox, um, some things happen so that not everybody, you know, dies or gets very sick and dies. Um, so, you know, you take that information as you will, take it or leave it. Um, but that's the kind of thing that goes on, you know, in, in the behind-the-scenes world. Um, so, you know, and so in, you know, my better angels tell me, well, maybe, you know what, Bill Gates, a week prior to the smallpox being found, he's talking about smallpox in the research for bioterror, you know, my better angels say, well, this is— this has been a problem, you know, those of us in my world known about for a long, long time. And maybe, you know, maybe it's just stating the obvious that, hey, we maybe need to step it up because it's just a matter of time before we get another thing of anthrax spores being sent around or smallpox being distributed or something like that. And maybe we ought to look into it. So let's, let's hope that, that's what was going on there. Now, what else could be a— oh, oh, the good news isn't over yet, people. Gee, you know, you're thinking, all right, we'll take a break from talking about COVID for a week and talk about something happy. So let's talk about bioterror. So here we go. Uh, what are other bioterror things? Well, there's a lot of poisons and toxic things that are not— they're, they're, they're not, um, classic bioterror because they're not biologics. Okay, it's not a bacteria or, you know, something like that. And those then would go— and of course I'll put the links in if you want to look these babies up too, but, uh, CDC's got a lot of info on them. And these would be things like arsenic and other, other poisons. Now, one of the things about things like, you know, especially your, um, inorganic poisons, you know, like, like arsenics and— Poison people, things, the toxins, the food toxins like salmonella and some of the other, some of the other toxins that go on. But when it comes to something like, say, you know, the bad form, there's a lot of forms of arsenic, as I said. some are very, very deadly. They could be used and put into a food or a drinking supply, and you could poison a lot of people all at once. And you think, well, has that— has that happened? Okay, well, obviously it has happened. There are people who have done this to individuals, but there are also people— and the one event I'm going to tell you about was not a bioterror I mean, it was, it was an act of terrorism against a group of people, but the person was, I believe, deranged in some way, and they weren't what you'd classically consider a terrorist. They weren't going against a country or something. But there was a time in some testimony with the Food and Drug Administration that I was involved in. And one of the things that I was testifying about, that I was trying to, uh, and others were trying to work on the FDA to keep available in the public domain for pharmacies to get easily, is an antidote to certain metal poisonings. Arsenic is one that's real high on the list. Okay, for this particular antidote. And so in the preparation for testimony to talk about this, um, this was a number of years ago at the Food and Drug Administration, there was a toxicologist, um, from Colorado, I believe, and myself, and I spoke on behalf of keeping this antidote. Uh, the FDA was of a mind to not allow it except in extreme circumstances and all of this business, um, for reasons that we don't have time to go into here. But it was sort of a dumb thing. But anyway, uh, so toxicologist spoke and basically, you know, and I am not a toxicologist. I, I do use environmental medicine agents. I do detoxify people with certain, uh, anti-toxin agents, but the toxicologists, top of the food chain in the poisoning business, they basically said, look, there's no other drug that works the way this drug does. This is a drug that was developed in Russia, and it was used a lot in Europe. And then we were importing it from Europe for use here in America. So it was sort of looked at by the FDA as this sort of, you know, stepchild of toxicology, but in reality it was probably the best antitoxin for things like arsenic especially. And one of the things that was brought up was, has it ever been used and did it, did it clearly show that it could save people's lives? And so in my testimony, I brought up this domestic terror case where somebody got mad at, I think it was a church group, And they took a reasonable amount of arsenic, the bad kind. And so when I say bad kind of arsenic, there's different forms of arsenic, but some will kill you. Okay. Um, they took, uh, the, the most deadly form and they put it in coffee at some meeting that people were at at this church. And there were 16 people, I believe, who all drank the coffee and all got acute arsenic poisoning, which is a horrendous, bad, bad problem. Uh, a lot of, uh, usually nausea and vomiting and pain and just, you go downhill really quickly. And so all of a sudden people start presenting to these local hospitals. It had to be in a rural area. So they're going to these little hospitals and, and they're, so then they're called poison control and they're trying to figure out what's wrong with these people. They didn't know it was arsenic until they tested everything. And then it was like, what in the world? You know, when's the last time we had arsenic poisoning and what do we do for it? So there was an old— and this is part of the whole FDA case we were making— was there's an older drug that is an FDA-approved drug, and they start giving that, one of these antidotes. Well, it didn't work very well. So it's a cumbersome drug to give. It doesn't really work that well, and especially if you're dying of arsenic poisoning. Yeah. So someone through the, the toxicology community and poison control got a hold of someone who knew about arsenic poisoning antidotes, and they said you can get this other drug from a pharmacy in California, and they had it made up and, and I think overnighted. And out of the 16 people, I believe 16 people who all got poisoned, The 15 who got the drug in question all lived, and the one that got the old drug that the FDA was trying to say was better was the one who died because it didn't work very well. And some were given both. Well, so the upshot of that was that the FDA decided we should probably now make this an approved antidote drug to use in the US, which was wise. They don't always do that. So that was good, but the downside of it was, um, it took something like, you know, an act of domestic terror, even though it's not, like I said, a classical terrorist that you think of. There's someone terrorizing a group of people that I, I don't, I don't know why they were upset or whatever. You, you don't need to know, I guess. Um, but they just tried to kill everybody, and, and arsenic is one of those things that you can kill people And there's a bunch of other ones. So again, we get up on YouTube, down in the description box I will put, um, the link to, you know, the, the, the non-biologic chemical terror agents if you want to look those up at, at the CDC. Now the problem with them is chemical agents are easier to get. You often don't need to be a PhD Um, you know, microbiologist or something like that, uh, as you might need to be to get some anthrax grown or some smallpox grown or something like that. If you want to go and poison a bunch of people by putting, you know, arsenic or some other chemicals into the water supply, all you need to do is find a source of those chemicals. Now, are, are many of these chemicals hard to find? Yes, but they're not impossible to find. C. They're also a lot easier to get a hold of than, say, smallpox or even anthrax or some of these other things that I mentioned. So chemical poisoning is another issue. This is why, for those of you that remember back to 9/11, one of the early things that was done in the response after, um, after the towers fell was usually National Guard units were sent out to Uh, have 24-hour guards on the water supplies for cities and municipalities. So the water supplies became a really high, uh, protection target, and they still are. And, and that's largely because either through a biologic poison or toxin or through a chemical poison or toxin, you could distribute it to a lot of people, um, through their water supply. You can do it through food too. The water supply is a little bit more ubiquitous in its use throughout people. So, um, so then that, uh, gives you, uh, chemical bioterror. So beyond, uh, smallpox and all of these other things. So, um, I think, you know, because we're, we're headed in the last few minutes here of the show, and I don't want to end on a sour note because we've been talking about bioterror and people dying and all of that. Um, so how is it that the CDC specifically, uh, would respond to, say, a smallpox emergency? And I'll put links in for, for all this CDC stuff. You'll get links if you're really curious. I would recommend you go read, read these things because they're in the public domain. So If you had an emergency, if it was something like, um, a water supply contamination with a poison or a toxin, so say arsenic or, or one of these biologic poisons, the CDC would get involved, but also the military would probably get involved, and then there would be a sequestration, uh, and, and notification to people not to use you know, whatever the supply was. Now, this happens for other reasons, for non-terrorist contaminations too. You'll hear every now and then about Cryptosporidium or something like that getting into a supply, or something being in food, and don't eat that, don't, don't use that water, whatever. Um, but if it's something like a biologic, like smallpox or whatever, the CDC would immediately go into action with their other partners, which usually would be first federal and then state groups that would have access to wherever the vector is. So if it's airborne, if it's waterborne, if it's whatever, they would have access to at least control and monitoring of those things. And they have an emergency operations center that Does that. They would next tell the public. You really need people to know as soon as possible if there's a possibility. And the levels that you notify people of are, first is avoidance if possible. So if it's in the water, where's it come from? Don't, don't, obviously don't drink it, don't use it. If it's potentially been spread in your town or at your ballgame or whatever. your, your potential. And so first is how to avoid it and how to protect. And then the next thing is sort of 2 phases, which is telling the healthcare providers what to look for and then telling people what to look for if they start to get sick during this time where there was potential exposure. Okay. The other thing that the CDC has is called the LRN, the Laboratory Response Network. Which is sort of 2 ways as well. One would be tell the laboratories that are going to get samples from people, either if they, if they don't test for these things, how to test for it, or if they do test for them, to be ready and then to notify the CDC of positives, etc. And then they have response teams that can be You know, CDC and other government— it's not just the CDC, there's other government agencies that get involved, including the military. And depending on how large of a problem it is, it might be like that thing I was telling you about, about the potential exposure at that big sporting event all those years ago, where it would involve all federal agencies, including the military, to roll out a person-to-person response, etc. And then if there is, uh, a, a, uh, antidote or a vaccination, uh, or some other thing, there's something called the SNS, a Strategic National Stockpile, and that does exist. And so part of— remember I said there were jets at the ready to bring antidote to this one particular issue? Um, the Strategic National Stockpile is there for this particular purpose. There are— and I've never been there. I don't run it. I only know from what the government people tell me about what it can do. But also I've had it— I've had crossover with the National Stockpile and stockpiling chemicals and drugs that I was working with and trying to get for research. And I know that they can take all of it if they have to, which they have done. And so there's a lot of things that are available through the Strategic National Stockpile. And so again, if you think, well, why didn't they do this with COVID It's because they didn't have anything for COVID. This was just, you know, COVID was sort of another problem. And then you go along and let's say you're a healthcare provider, doctor like myself, and you're in this area. It's, it's all hands on deck, and you basically, you may be starting to see people who come in and you need to figure out if they have symptoms of anthrax or arsenic or smallpox or something like that. Well, the CDC has very quick algorithms that you can read through that say, here's low, medium, and high risk behavior, signs and symptoms. Here's the labs to do, and here's what you need to do for treatment or where you need to send them for treatment or whatever. Okay. So, and I know maybe that's disturbing that we have that much uh, pre-preparedness, but, uh, I wanted to end on that as, uh, as the silver lining that we do know something about what to do with these problems. And, uh, the fact that, you know, uh, Bill Gates is talking about we need more research for smallpox bioterrorism, and then a week later we find some smallpox where it shouldn't be— maybe unrelated, maybe, who knows, uh, but it's got everybody buzzing, it's got everybody on their mind, and everyone's saying that that should have never happened. Well, of course not. I mean, it'd be like finding a nuclear bomb where you shouldn't, you know, where you weren't expecting to find one, right? So here's the bottom line. There's a lot of this that is beyond our control. And you have to know that if, if it does become an issue, there is a lot of machinery in it, certainly in North America and Europe and Russia, et cetera. to deal with this through the means that I was telling you about. There are many of these things that there are medical treatments for, or antidotes, or whatever, and a lot of it is mobilizing the medical community to know what to look for, but also to know how to treat it. Okay, because a lot of these bioterror agents, the perfect ones, are ones that the medical community will not have treated in their lifetime. Smallpox, for example. Or in many cases, anthrax or something like that, or arsenic. So that's the next thing is there has to be a mobilization. There has to be two-way communication. And the thing that I would leave you with, because we've got like a minute left here, is yes, this is very disturbing. We're already disturbed because we've had a worldwide COVID pandemic and it's all sorts of business going on with that. People are on their last nerve, you know, and then all of a sudden the news is talking about a new potentially deadly bioterrorism agent. So, you know, keep in mind that to the degree it's possible, A, not much you can do about other than be aware. B, it's kind of hard to not think about it now that everyone's bringing it up. But C, there are mechanisms and controls in place where if something were to happen, It's not like, you know, 100 or 200 or 500 years ago where smallpox is just going to spread through everybody. There are ways to hem it in, there are ways to treat it, and there are ways to keep people alive with them, you know, to a lesser degree, but even with anthrax or other stuff, and certainly with arsenic and other poisonings. All right. Well, I'm Dr. Paul Anderson. It's Medicine and Health with Dr. Paul Anderson. We always put these over— we do Facebook Lives and we put it over on YouTube. So if you're on YouTube, please Please like, share, and subscribe. Take a look at all my other videos there. And you can go to dranow.com. That's where all my media is, my newsletters, uh, the hub to all of, uh, like the radio show and everything else. But we're out of time for this week. Next week we'll probably pick a happier topic, uh, other than bioterror, and, uh, we'll be back. So thank you, and I'll see you in a week. You've been