The Anthrax Letters: The Attacks That Shocked America (46 page)

By the end of 2008, economic and political conditions in the United States were adding to the pressure. With the nation’s financial system facing a crisis, the government provided more than $700 billion dollars to banks, corporations, and other institutions to forestall a ruinous collapse. The soaring national debt meant that other expenditures, including the defense budget, would be more carefully scrutinized. Moreover, during the presidential campaign, John McCain and his fellow Republicans far more often than Barack Obama and the Democrats highlighted terrorism and security as issues of concern. The Democratic chairman of the House Financial Services Committee, Barney Frank, called for a 25 percent reduction in defense spending. The election of Obama and Democratic majorities in both houses of Congress increased the likelihood of cuts in funding for biodefense.

While on the subject of Ivins, I asked Perlin what he thought about the scientific evidence that linked the spores in Ivins’s RMR-1029 flask with those used in the attacks. I had asked the same of Ebright, and on this matter there was total convergence. Both believed that the science established the connection. “Unequivocally,” said Ebright; “I have no doubt,” echoed Perlin. Further, neither was convinced that the evidence produced thus far by the FBI would necessarily have convicted Ivins. “If they found the spores in his house or car, I’d have more confidence,” Perlin said. “The spores emanated from his laboratory. That’s good circumstantial evidence, but not sufficient for me to indict the guy. And I wonder how good a case they would have had in court.”

Similar skepticism had already been professed by others, including members of Congress. Recognizing that an assessment of scientific issues would still leave many other questions unaddressed, toward the end of 2008, Congressman Rush Holt introduced legislation to create a congressional commission. Modeled after the 9/11 Commission, the proposed body would investigate the anthrax attacks and the government’s response. Holt’s bill would require that a final report be issued eighteen months after the commission begins its operations. Whether Congress would act on Holt’s bill was unclear. Senator Charles Grassley and others were considering whether extensive congressional hearings might be a preferred alternative. Either way, their efforts again signaled that prospects for an early closing of the case were slim.

Whatever the disposition of the case against Ivins, the threat of an assault with anthrax or another bioagent persists. If no other good came from the attacks in 2001, the experience offers numerous lessons. Some were evident soon after the event and were referred to in the original edition of this book. Others became manifest with the passage of years. The following list recapitulates the principal lessons of the anthrax attacks:

First, identification of a particular bioagent as the cause of illness can be challenging.
As the disease outbreak in 2001 showed, physicians often initially failed to consider anthrax in their diagnoses. Moreover, local laboratory tests were sometimes erroneous or ambiguous, while more reliable tests were often not available.

Second, characterizing an outbreak as intentional and understanding the consequences can present challenges.
Although the dissemination of the mailed anthrax spores was widespread, this fact was not initially apparent. An experiment in early 2001 (conducted in a confined chamber with simulated anthrax powder) had demonstrated that spores in letters could readily disperse after an envelope was slit open. But this study did not foretell the extensive leakage that could occur even from unopened letters. Nor did it signal the large-scale contamination of buildings and cross-contamination of other mail that could result.

Third, the anthrax bacteria in the letters may have been simple spore preparations that required no special microbiological skills to produce.
According to a 2006 report by a lead FBI microbiologist, the mailed spores were not produced with additives or sophisticated engineering, which contradicts a supposition by some observers. This finding means the number of potential perpetrators could be very large.

Fourth, identifying the source of an attack agent and the perpetrator can be elusive.
Not until seven years after the attacks did the FBI identify the alleged perpetrator. However, he killed himself before being formally charged with the crime and, if guilty, his motivation may never be understood.

Fifth, the initial responder to a biological event may be a healthcare worker rather than a police, fire, or military official.
The first professional to see the anthrax victims during the 2001 attacks was, in most instances, a physician. Therefore, the level of training and awareness of doctors and other health workers may be critical to recognition of a bioattack.

Sixth, some anthrax victims resided or worked in remote communities and some in urban areas.
This fact is a reminder that preparation for bioterrorism is as necessary in rural and suburban areas as in large metropolitan centers.

Seventh, launching a bioattack can be simple: as simple as dropping a letter in a mailbox
—which is how the anthrax assault began. Although acquiring and processing this bioagent could pose challenges, releasing it as an instrument of terror can be easy.

Eighth, a small amount of bioagent can cause havoc.
The total volume of powder in all the anthrax letters was limited (an estimated 7-14 grams). This small amount of powder became broadly dispersed, prompted widespread anxiety, and caused at least twenty-two casualties, including five deaths.

Ninth, ridding contaminated facilities of anthrax spores can be difficult and expensive.
Many initial attempts at decontamination were unsuccessful and needed several repetitions. The Brentwood postal center in the Washington DC area was not declared free of spores until the end of 2003, and the Hamilton facility in New Jersey not until early 2005.

Tenth, doubts about the efficacy of delayed antibiotic therapy for inhalation anthrax proved overly pessimistic.
Before the 2001 experience, it was commonly believed that following the onset of symptoms, mortality was “essentially 100 percent despite appropriate treatment,” according to a textbook on military medicine. In fact, all eleven inhalation cases in 2001 were symptomatic before receiving antibiotic therapy, and six of them survived. Also worth noting is a conclusion by the Centers for Disease Control and Prevention (CDC) that administering antibiotics to more than 30,000 people who were at risk from exposure likely prevented “substantial illness and death.”

Eleventh, the mode of recovery from inhalation anthrax is not fully understood.
Seven years after they became ill, some of the six inhalation survivors still had symptoms compatible with the disease (muscle ache, shortness of breath, neurological manifestations, malaise). Whether the cause of those lingering symptoms was physical or psychological remains unclear. The National Institute of Allergy and Infectious Diseases has been studying the long-term effects of anthrax disease—both inhalation and cutaneous—since 2002.

Twelfth, launching a bioattack can be inexpensive.
The pool of possible perpetrators, accordingly, could be large, which would further complicate the quest for the culprit. In the 2001 event, samples of
Bacillus anthracis
were evidently grown from an existing stock at virtually no cost. The equipment necessary to process the attack bacteria—an incubator, centrifuge, freeze dryer, spray dryer, protective clothing and apparatus, various chemicals, and possibly an electron microscope—probably cost less than $50,000, and perhaps as little as $5,000.

Thirteenth, the consequences of a bioattack can be expensive.
Expenses related to the 2001 event included costs for laboratory tests, drugs and other medical treatment, salaries of engaged personnel (FBI, CDC, state and local authorities), decontamination of infected locations, reduced postal revenue, and lawsuits by victims and families. The total likely exceeded $6 billion, as I documented in the
McGraw-Hill Homeland Security Handbook
, 2006.

Fourteenth, procedures employed in a criminal probe may conflict with those in an epidemiological investigation.
According to the CDC, public-health investigators may have been denied access to information during the anthrax outbreak because it was protected for use in a criminal investigation.

Fifteenth, expect the unexpected.
The widespread leakage of spores from sealed letters was unexpected, probably even by the perpetrator, who had taped the seams of the envelopes evidently to prevent such leakage.

While these lessons could help prepare for future bioattacks, they say little about who was behind the 2001 anthrax mailings. For more on that, we await further word from the FBI and the findings of the various investigative panels. But unless some blockbuster surprises are produced, the FBI will close the anthrax case and Bruce Ivins will be marked officially as the sole perpetrator. Would a jury have found him guilty beyond a reasonable doubt? We will never know. Still, the existing evidence argues persuasively that Ivins was behind the assaults. The attack bacteria almost certainly came from his flask, he worked unusually long hours alone on the nights before the mailings, and others with access to his laboratory were vetted and ruled out as suspects.

Even when the case is closed, however, questions will persist. Months after several survivors and relatives expressed satisfaction that the FBI had solved the case, a few revealed lingering uncertainties. Leroy Richmond and Ramesh Patel told me they believed that Ivins was probably guilty, though not beyond a reasonable doubt.

For Richmond, Patel, and others, one particular comment by an FBI agent will likely have resonance. In an allusion to the assassination of President John F. Kennedy, the agent supposed there would always be an anthrax spore on a grassy knoll. But for many survivors, as for much of the country, enough evidence has been produced to provide sufficient relief when the government declares, as it seems bound to, that the anthrax case is officially closed.

The following items represent only a fraction of the vast literature on bioterrorism. Organized by predominant themes in each chapter, they augment the discussion of the anthrax letters and provide a base of information about bioterrorism in general.