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Introduction¹

The Department of Homeland Security’s (DHS’s) BioWatch program aims to provide an early indication of an aerosolized biological weapon attack. The first generation of BioWatch air samplers were deployed in 2003. The current version of this technology, referred to as Generation 2 (Gen-2), uses daily manual collection and testing of air filters from each monitor to detect the presence of biological pathogens. Until April 2014, DHS pursued a next-generation autonomous detection technology that aimed to shorten the time from sample collection to detection to less than 6 hours, reduce the cost of analysis, and increase the number of detectable biological pathogens. Because of concerns about the cost and effectiveness of the proposed Generation 3 system (Gen-3), DHS canceled its acquisition plans for the next-generation surveillance system.

In response to the cancellation announcement, Congress asked the Government Accountability Office (GAO) to conduct a review of the program and the proposed system enhancements that would have been incorporated in BioWatch Gen-3. This review, issued in October 2015 (GAO, 2015), made three recommendations (see Box 1-1) with which DHS concurred. However, Mike Walter, BioWatch program manager, Office of Health

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¹ The planning committee’s role was limited to planning the workshop, and the Proceedings of a Workshop was prepared by the rapporteur as a factual account of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants and have not been endorsed or verified by the National Academies of Sciences, Engineering, and Medicine. They should not be construed as reflecting any group consensus.

Affairs, DHS, said that DHS did not agree with all of GAO’s characterizations of the BioWatch program efforts described in this report.

In response to this report, DHS requested that the National Academies of Sciences, Engineering, and Medicine conduct a workshop to further explore the findings of the 2015 GAO report and discuss the impact these findings may have with regard to the future development of the technical capabilities of the BioWatch program. The National Academies’ Health and Medicine Division, under the auspices of the Standing Committee on Health Threats and Workforce Resilience, established an ad hoc committee to organize a 2-day public workshop. As part of this discussion of GAO’s findings, the workshop was to explore current BioWatch program technologies and approach the question of how technological evolution

now and in the future might impact the next generation of the program. In addition, the workshop was to discuss existing and possible collaborations between BioWatch, public health laboratories, and other stakeholders that could contribute to the enhancement of biosurveillance capabilities at the federal, state, and local levels. Editorial and other minor corrections have been incorporated since the prepublication of this proceedings. The workshop Statement of Task, including the workshop objectives, is described in Box 1-2.

In her opening remarks to the workshop, Kathryn Brinsfield, assistant secretary for health affairs in the DHS Office of Health Affairs (OHA), said she appreciated that so many people from state and local governments were present. “As we look at the ways people perceive the program, we need to make sure that we are getting the full story because there are misconceptions about how hard the program has worked with state and local agencies and how they feel about the program, such as whether it is helpful or not helpful,” said Brinsfield. “I want to make sure that what works and what does not work, what you need and what you do not need, [are] captured in the next 2 days.”

ORGANIZATION OF THE PROCEEDINGS

The workshop (see Appendix A for the agenda) was organized by an independent planning committee in accordance with the procedures of the National Academies. The planning committee’s members were Lisa Gordon-Hagerty (chair), president and chief executive officer, LEG Inc.; Suzet McKinney, executive director, Illinois Medical District Commission; Terry Mullins, chief, Bureau of Emergency Medical Services and Trauma System, Arizona Department of Health Services; Colin Stimmler, director, Biodetection Preparedness and Response Unit, Office of Emergency Preparedness and Response, New York City Department of Health and Mental Hygiene; and John Vitko, Jr., former director, biological and chemical countermeasures, DHS Science and Technology Directorate (S&T), and currently rector, St. Luke Serbian Orthodox Church. This publication provides a factual account of the workshop’s presentations and discussions as authored by an independent rapporteur. In accordance with the policies of the National Academies, the workshop did not attempt to establish any conclusions or recommendations about needs and future directions, focusing instead on issues identified by the speakers and workshop participants. In addition, the organizing committee’s role was limited to planning the workshop. Opinions expressed within these proceedings are not those of the National Academies, the Standing Committee, or its agents, but rather of the presenters themselves.

Chapter 2 provides an overview of the BioWatch program’s strategic priorities. Chapter 3 discusses the recommendations and findings in the GAO report, the DHS response to the GAO’s recommendations and assessment of the gaps in BioWatch capabilities, and reviews the available capabilities for biosurveillance and reporting that might be suitable for BioWatch. Chapter 4 describes the collaborative activities within BioWatch and across multiple levels of government. Chapter 5 explores opportunities for additional collaboration and coordination between BioWatch and relevant federal, state, and local public health partners to support effective and efficient capability development. Chapter 6 recaps the key messages presented at the workshop.

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