Department of Homeland Security Bioterrorism Risk Assessment: A Call for Change (2008)

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Committee on Methodological Improvements to the Department of Homeland Security’s Biological Agent Risk Analysis Board on Mathematical Sciences and Their Applications Division on Engineering and Physical Sciences Board on Life Sciences Division on Earth and Life Studies 

THE NATIONAL ACADEMIES PRESS  500 Fifth Street, N.W.  Washington, DC 20001 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This study was supported by Contract No. HSHQDC-06-C-00046 between the National Academy of Sciences and the Department of Homeland Security. Any opinions, findings, conclusions, or recom- mendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the organizations or agencies that provided support for the project. International Standard Book Number-13: 978-0-309-12028-9 International Standard Book Number-10: 0-309-12028-4 Copies of this report are available from the National Academies Press, 500 Fifth Street, N.W., Lock- box 285, Washington, DC 20055; (800) 624-6242 or (202) 334-3313 (in the Washington metropolitan area); Internet, http://www.nap.edu. Copyright 2008 by the National Academy of Sciences. All rights reserved. Printed in the United States of America 

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is president of the N ­ ational Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the N ­ ational Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council. www.national-academies.org 



COMMITTEE ON METHODOLOGICAL IMPROVEMENTS TO THE DEPARTMENT OF HOMELAND SECURITY’S BIOLOGICAL AGENT RISK ANALYSIS GREGORY S. PARNELL, U.S. Military Academy, Chair DAVID BANKS, Duke University LUCIANA L. BORIO, University of Pittsburgh GERALD G. BROWN, Naval Postgraduate School L. ANTHONY COX, JR., Cox Associates JOHN GANNON, BAE Systems ERIC HARVILL, Pennsylvania State University HOWARD KUNREUTHER, University of Pennsylvania STEPHEN S. MORSE, Columbia University MARGUERITE PAPPAIOANOU, Association of American Veterinary Medical Colleges STEPHEN POLLOCK, University of Michigan NOZER D. SINGPURWALLA, George Washington University ALYSON WILSON, Los Alamos National Laboratory Staff NEAL GLASSMAN, Study Director, Board on Mathematical Sciences and Their Applications KERRY A. BRENNER, Senior Program Officer, Board on Life Sciences BARBARA WRIGHT, Administrative Assistant  

BOARD ON MATHEMATICAL SCIENCES AND THEIR APPLICATIONS C. DAVID LEVERMORE, University of Maryland, Chair MASSOUD AMIN, University of Minnesota TANYA STYBLO BEDER, SB Consulting Corporation MARSHA J. BERGER, New York University PHILIP A. BERNSTEIN, Microsoft Corporation PATRICIA FLATLEY BRENNAN, University of Wisconsin GUNNAR E. CARLSSON, Stanford University BRENDA L. DIETRICH, IBM Thomas J. Watson Research Center DEBRA ELKINS, Allstate Insurance JOHN F. GEWEKE, University of Iowa DARRYLL HENDRICKS, UBS AG JOHN E. HOPCROFT, Cornell University KAREN KAFADAR, Indiana University CHARLES M. LUCAS, AIG (retired) JILL PORTER MESIROV, Broad Institute ANDREW M. ODLYZKO, University of Minnesota JOHN RICE, University of California at Berkeley DONALD G. SAARI, University of California at Irvine J.B. SILVERS, Case Western Reserve University GEORGE SUGIHARA, Scripps Institution of Oceanography, University of California at San Diego LAI-SANG YOUNG, New York University Staff SCOTT WEIDMAN, Director NEAL GLASSMAN, Senior Staff Officer BARBARA WRIGHT, Administrative Assistant For more information on the Board on Mathematical Sciences and Their Applications, see its Web site at http://www7.nationalacademies.org/bms/, write to BMSA, National Research Council, 500 Fifth Street, N.W., Washington, DC 20001, call (202) 334-2421, or send e-mail to bms@nas.edu. vi 

BOARD ON LIFE SCIENCES KEITH YAMAMOTO, University of California at San Francisco, Chair ANN M. ARVIN, Stanford University School of Medicine RUTH BERKELMAN, Emory University DEBORAH BLUM, University of Wisconsin VICKI L. CHANDLER, University of Arizona JEFFERY L. DANGL, University of North Carolina PAUL R. EHRLICH, Stanford University MARK D. FITZSIMMONS, John D. and Catherine T. MacArthur Foundation JO HANDELSMAN, University of Wisconsin KENNETH H. KELLER, Johns Hopkins University School of Advanced International Studies JONATHAN D. MORENO, University of Pennsylvania RANDALL MURCH, Virginia Polytechnic Institute and State University MURIEL E. POSTON, Skidmore College JAMES REICHMAN, University of California at Santa Barbara BRUCE W. STILLMAN, Cold Spring Harbor Laboratory MARC T. TESSIER-LAVIGNE, Genentech, Inc. JAMES TIEDJE, Michigan State University CYNTHIA WOLBERGER, Johns Hopkins University School of Medicine TERRY L. YATES, University of New Mexico Staff FRANCES E. SHARPLES, Director KERRY A. BRENNER, Senior Program Officer ANN H. REID, Senior Program Officer MARILEE K. SHELTON-DAVENPORT, Senior Program Officer EVONNE P.Y. TANG, Senior Program Officer ROBERT T. YUAN, Senior Program Officer ADAM P. FAGEN, Program Officer ANNA FARRAR, Financial Associate MERCURY FOX, Program Assistant REBECCA L. WALTER, Program Assistant vii 



Acknowledgments This report has been reviewed in draft form by individuals this report rests entirely with the authoring committee and chosen for their diverse perspectives and technical expertise, the institution. in accordance with procedures approved by the National The committee also acknowledges the valuable contribu- Research Council’s Report Review Committee. The purpose tion of the following individuals, who provided input at the of this independent review is to provide candid and criti- meetings on which the interim and final report are based: cal comments that will assist the institution in making its published report as sound as possible and to ensure that the Norman Coleman, National Institutes of Health, report meets institutional standards for objectivity, evidence, George Famini, Department of Homeland Security, and responsiveness to the study charge. The review com- Cyril Gay, Department of Agriculture, ments and draft manuscript remain confidential to protect the Peter Highnam, Department of Health and Human integrity of the deliberative process. We wish to thank the Services, following individuals for their review of this report: Marc Lipsitch, Harvard University, Thomas McGrann, Lawrence Livermore National Vicki M. Bier, University of Wisconsin, Madison, Laboratory, Baruch Fischhoff, Carnegie Mellon University, Darrell Morgenson, Institute for Defense Analyses, Edward H. Kaplan, Yale School of Management, Mark Mullen, Department of Homeland Security, Terrance Leighton, Children’s Hospital Oakland ­Research Tapan Nayak, George Washington University, Institute, Tara O’Toole, University of Pittsburgh, Edward L. Melnick, New York University, James Petro, White House Homeland Security Council, Tara O’Toole, Center for Biosecurity of the University of Gregory Pompelli, Department of Agriculture, Pittsburgh Medical Center, Adam Rose, Pennsylvania State University, Harvey Ruben, University of Pennsylvania, Raymond Schuder, Lawrence Livermore National Ponisseril Somasundaran, Columbia University, Laboratory, William Studeman, Reston, Virginia, and Mark Teachman, Department of Agriculture, Henry Willis, RAND Corporation. Detlof von Winterfeldt, University of Southern ­California, and Although the reviewers listed above have provided many The Staff of the Battelle Memorial Institute, Columbus, constructive comments and suggestions, they were not asked Ohio. to endorse the conclusions or recommendations, nor did they The committee also thanks Alan R. Washburn, U.S. Naval see the final draft of the report before its release. The review Postgraduate School, for his thoughtful review of and report of this report was overseen by B. John Garrick, independent on the Department of Homeland Security’s 2006 Bioterror- consultant. Appointed by the National Research Council, ism Risk Assessment, and Marc Lipsitch, Harvard University, he was responsible for making certain that an independent for allowing his remarks to the committee to be paraphrased examination of this report was carried out in accordance with in this report. institutional procedures and that all review comments were carefully considered. Responsibility for the final content of   After the report in prepublication form was returned from a required security review conducted by the sponsor, the committee made a few revi- sions in the text to modify statements that might be misinterpreted. ix 



Contents SUMMARY 1 1 INTRODUCTION 6 This Is the Challenge, 6 The Threat Is Growing, 6 The Government Has Taken Action, 7 The National Research Council Established This Committee, 7 Completion of the Interim Report, 8 Overview of the Final Report and of Its Recommended Methodological Improvements, 8 Structure of the BTRA of 2006 Examined, 8 Hypothetical Anthrax-Attack Scenario Employed, 9 Lexicon of Risk Terminology Developed, 9 Technical and Process Improvements Recommended, 9 References, 10 2  THE CRITICAL CONTRIBUTION OF RISK ANALYSIS TO RISK MANAGEMENT AND 11 REDUCTION OF BIOTERRORISM RISK Risk Analysis Is the Discipline That the Department of Homeland Security Should Use, 11 Problem Formulation, 11 Risk Assessment, 12 Risk Perception, 13 Risk Communication, 14 Risk Management, 15 Terrorist Threats Differ from Natural Hazards and from Other Humanly Made Hazards, 16 References, 18 3  DESCRIPTION AND ANALYSIS OF THE DEPARTMENT OF HOMELAND SECURITY’S 20 BIOLOGICAL THREAT RISK ASSESSMENT OF 2006 Details of the Model Used to Produce the Department of Homeland Security’s BTRA of 2006, 22 The BTRA of 2006 Uses a Probabilistic Risk Assessment Event Tree, 22 The BTRA of 2006 Does Not Use Event Trees for Consequence Analysis, 27 The Event Tree Can Be Improved, 27 The Approach to Determining the Probabilities of Terrorist Decisions Is Incomplete, 27 The Mathematics Used by the BTRA in Modeling Multiple Attacks Has Errors, 28 The 2006 BTRA’s Assessment of Outcome Probabilities Is Unnecessarily Complex, 28 BTRA Results Should Not Be Normalized by an Unspecified Constant, 30 The BTRA Event Tree Can Be Simplified, 30 xi 

xii CONTENTS Additional Observations Regarding the Department of Homeland Security’s BTRA of 2006, 30 Reporting Results, 30 Tailored Risk Assessments, 31 Analysis of Sensitivity and Risk, 31 Critical Knowledge Gaps and Biodefense Vulnerabilities, 31 Planned Improvement for the BTRA of 2008, 31 References, 33 4 DEPARTMENT OF HOMELAND SECURITY DECISION REQUIREMENTS FOR RISK MANAGEMENT 34 Risk Management Requires Timely, Accurate Information, 34 The Biological Threat Risk Assessment Should Support Risk Management, 35 Transparency of Risk Assessment Is Necessary for Successful Risk Management, 36 Risk Assessment Transparency Improves Confidence, 36 There Are Several Other Ways to Build Confidence, 37 The Department of Homeland Security’s BTRA of 2006 Was Not Transparent, 37 The BTRA Should Become a Decision Support System, 38 Use Scenarios, 39 Sensitivity Analysis Is Important for Validation, 39 Create a Context for Use, 40 References, 41 5 RISK ASSESSMENT FOR UNKNOWN AND ENGINEERED BIOTHREAT AGENTS 42 Biological Threat Risk Assessments Need to Include Unknown and Engineered Agents, 42 Including Unknown and Engineered Agents Is Challenging But Possible, 44 References, 45 6 IMPROVING BIOTERRORISM CONSEQUENCE ASSESSMENT 47 Existing Knowledge Does Not Support the Detail in Department of Homeland Security Consequence Models, 47 Other Consequences Need to Be Modeled, 49 References, 50 7  IMPROVING THE DEPARTMENT OF HOMELAND SECURITY’S BIOLOGICAL THREAT RISK 51 ASSESSMENT AND ADDING RISK MANAGEMENT The Use of Probabilistic Event Trees Alone Is Insufficient to Model Terrorism Threats, 51 Several Methods Are Available for Improved Modeling of Intelligent Adversaries, 52 Red Teaming Can Be Used to Understand Intelligent Adversaries, 52 Decision Trees Can Model Bioterrorist Threats, 52 Attacker-Defender Optimization Can Unify Risk Management, Risk Assessment, and Resource Allocation, 53 Game Theory Models Can Help with Risk Management, 56 Risk Management Strategies, 57 The Existing BTRA Framework Should Not Be Used for the Risk Analysis of Biological, Chemical, or Radioactive Threats, 58 Intelligent-Adversary Risk Analysis Techniques Can Be Used on Radioactive and Chemical Threats as Well as on Biological Threats, 58 References, 58 APPENDIXES A Lexicon 63 B Mathematical Characterization of the Biological Threat Risk Assessment Event Tree and Risk Assessment, 78 Gerald G. Brown C Computational Example Illustrating the Replacement of a Joint Distribution of Arc Probabilities with Marginal 80 Expected Values of Individual Arc Probabilities, Alyson Wilson and Stephen Pollock 

CONTENTS xiii D Bioterrorism Risk Analysis with Decision Trees, Gregory S. Parnell 85 E Optimizing Department of Homeland Security Defense Investments: Applying Defender-Attacker (-Defender) 90 Optimization to Terror Risk Assessment and Mitigation, Gerald G. Brown, W. Matthew Carlyle, and R. Kevin Wood F Combining Game Theory and Risk Analysis in Counterterrorism: A Smallpox Example, David L. Banks and 103 Steven Anderson G On the Quantification of Uncertainty and Enhancing Probabilistic Risk Analysis, Nozer D. Singpurwalla 111 H Game Theory and Interdependencies, Geoffrey Heal and Howard Kunreuther 116 I Review of BTRA Modeling, Alan R. Washburn 122 J Reprinted Interim Report 126 K Meeting Agendas 149 L Biographies of Committee Members 153 M Acronyms 157