Jewish World Review Oct. 14, 2003 / 18 Tishrei, 5764

John C. Bersia

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Consumer Reports

Reinstitute mandatory smallpox vaccinations as biodefense precaution? | Now that we have strengthened the homeland, should we feel safe and not fear a repeat of Sept. 11?

Various versions of that question popped up during a week's worth of discussions that I attended recently on international security issues, including terrorism. And the questions flowed despite the repeated urgings of speakers to take the long view in dealing with terrorists. After all, terrorism ranks among the world's oldest professions and likely will claim its nefarious place in society for millennia to come.

The United States' preparations to deal with that challenge have barely begun, from taking the fight to the miscreants to erecting barriers - such as biodefense - that limit terrorists' options inside the United States.

I believe that Americans have a firmer grasp on the extent of the terrorism scourge than they did two years ago. But I'm seeing distinct and disturbing evidence of a "drift," which typically occurs when people turn from one issue that has figured prominently in their lives to something new.

Similar behavior happened a decade ago, when the thrill of the Cold War's demise waned. Americans too eagerly moved on with their lives, especially in considering economic prospects, as if the world's problems and dangers had ended in the Soviet Union's death throes. Many essentially closed their eyes to critical international developments, ironically viewing the global realm as diminishing in importance even as the planet spun faster to the tune of globalization and interdependence.

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In part because of that early 1990s "drift," Americans found themselves mostly unprepared for the Sept. 11, 2001, terrorist attacks, which compounded the overall impact of the tragedy.

Well, the terrorists have not disappeared. Driven temporarily from Afghanistan, they have returned with a vengeance to plague the military forces of the United States and other countries. They have flocked in droves to Iraq, eager to snipe at the U.S.-led occupiers. They have fanned out to other countries, including the United States, armed not only with weapons and revolutionary zeal but fresh strategies and targets. And they have spoken through dozens of plots against the interests of the United States and its allies in numerous places. Some have succeeded, with bloody, destructive results; most have failed. That the terrorists have not struck within the 50 states should offer little comfort. They subscribe to the long view. Whether on the scale of 9-11 or not, another attack is inevitable.

While the terrorists ruminate and scheme, the United States should hasten to hone the edge of its fledgling homeland-security efforts. The mere establishment of an agency and the dispensing of massive amounts of money do not imply coherency and a clear sense of direction. Such results take time, training, cooperation, intelligence-sharing, planning and coordination at all levels - international, national, state and local.

Consider the biodefense issue. To reduce the threat, the United States and its allies must intensify their worldwide efforts to identify, understand, monitor and thwart groups that are trying to acquire anthrax, botulinum, brucellosis, cholera, plague, smallpox and other agents for use in weapons. The challenge requires brave men and women who are willing and able to think like terrorists and delve into the shadows. But it also calls upon Americans operating in the sunshine to focus more on bioweapons - not to frighten people, but as a pressing, public-health concern.

When natural smallpox threatened lives, Americans recognized the danger and accepted mandatory vaccinations. The official "eradication" of smallpox a few decades ago warranted an end to vaccinations. But the resurrection of the danger by terrorists who would not hesitate to spawn artificial smallpox outbreaks greatly changes the situation.

At the very least, the U.S. government should make smallpox vaccinations available to healthy Americans. Even better, Washington should reinstitute mandatory smallpox vaccinations.

When I have offered this opinion in the past, many readers have called the proposal heartless and dangerous. I understand the risks that smallpox vaccinations pose, although I hasten to add that health professionals dispute the "facts." I side with those health professionals who conclude that the benefits of routine smallpox vaccinations would outweigh the risks.

Two of them, Dr. William Bicknell, a former commissioner of public health in Massachusetts, and Kenneth Bloem, a former CEO of Stanford University Hospital and Georgetown University Medical Center, maintain, "As more and more people are vaccinated pre-attack, fewer are at risk post-attack. There are fewer to vaccinate, and the infection of others is more difficult."

Bicknell and Bloem don't stop with smallpox, though. They insist that Americans should be given the means to protect themselves against other terrorist threats. "A seven-day supply of Cipro per person, to be used only if an anthrax release takes place, will shorten by days the distribution of Cipro from government stockpiles. Add potassium iodide to reduce one effect of a dirty bomb, and at modest cost we will have maximized protection against three terrorist threats," they argue.

Such creative, proactive thinking must become the norm for Americans to build and sustain momentum in the long, difficult, deadly struggle with global terrorism.

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John C. Bersia, who won a Pulitzer Prize in editorial writing for the Orlando Sentinel in 2000, is also the special assistant to the president for global perspectives and a professor at the University of Central Florida. Comment by clicking here.


08/05/03: It's time to be realistic on new age of terrorism

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