SMi CBRN Address, 19.Sept.2006integration of the teams and resources. A truly adaptable approach is one that can readily h...
SMi CBRN Address, 19.Sept.2006What makes CUBIT unique as a system architecture is that it is a set of medical and physical...
SMi CBRN Address, 19.Sept.2006                Sensor/monitor units                (devices, observers)                    ...
SMi CBRN Address, 19.Sept.2006CUBIT Components         Figure 2 – Rendition of One Possible Instantiation of CUBIT System ...
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Coordinated And Unified Responses To Unpredictable And Widespread Biothreats


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Coordinated And Unified Responses To Unpredictable And Widespread Biothreats

  1. 1. SMi CBRN Address, 19.Sept.2006 COORDINATED AND UNIFIED RESPONSES TO UNPREDICTABLE AND WIDESPREAD BIOTHREATS - PANDEMICS AND LESS Dr Martin Joseph Dudziak, PhD Chief Science Officer, TETRAD Technologies Group, Inc. (USA & CA)1Intelligent and rapid dissemination of correct and qualifiable information is the essentialingredient, and to date the missing ingredient, in most national and regional response plans forCBRN threats, particularly those involving a biological component. While the focus is oftendirected currently toward avian flu threats, and in general toward massive trans-continentalpandemics, the fact remains that there are a host of other fast-moving epidemic outbreakspossible including salmonella, e.coli, MRSA, CDIFF, VRE, TB, any of which can have devastatingeffects in localized communities where populations are congested and the response timeinadequate. Casualty and debilitating illness risks are elevated further by the likelihood that in apandemic situation, terrorists would also be likely to strike with unconventional CBRNE or cyberattacks in order to take advantage of an inherently disrupted social situation and thereby amplifythe problems at hand. The opportunistic planning by terrorist factions to “piggy back” a newbiological or even conventional set of multi-point attacks on a society otherwise under stress froma natural outbreak can no longer be underestimated. Such planning has been uncovered in theUK, in the USA, and it is one of the more novel avenues available to a terrorist network that isunder pressure to improvise.Today we are increasingly at risk for both natural and intentional (e.g., terrorist) biothreats, andfor a mixture of both types. However, it is not only a case of risk for the traditional outbreaks norfor those that an al Qaeda type of network may amplify. Due to the radical increasing instabilitiesand variances in climate due to rapidly increasing CO2 levels, and consequent global warmingand sea level increases in general, there are more diseases spreading to regions of the globewhere they were not present in the past. Vibrio vulnificus and ostreopsis ovata, both highlydebilitating diseases normally found only in tropical waters, have been found in the Baltic andMediterranean respectively. The former has resulted in death to at least one swimmer inDenmark, far removed from the tropics. Congo Crimea Hemorrhagic Fever and Malaria are bothspreading out of their native zones. These in themselves may not be the basis for epidemics orpandemics but they pave the way and give clear indications of changing patterns in themovement and spread of diseases on the basis of climatic change, mostly of a global warmingvariety.The opportunity for variations in biothreats to large population centers due to the combination ofrapid movement plus changing microorganism ecosystems, without any introduction of maliciousintent by terrorists, is larger today than perhaps ever before in human history. The capacity forrapid dissemination of information to the populations at risk, once an outbreak is known and thecontainment process has begun, is also larger and faster today than ever before. However, someof the technology and systems that are part of this improved response-ability are also part of theproblem, contributing to slowdowns and entanglements due to the formal processes andbureaucracies that have evolved, plus the dependency upon efficient but highly vulnerableinfrastructures of communication, command, and energy.There is today a proliferation of available tools including sensors, information networks,emergency response protocols and plans, diagnostics and of course medical intervention in theform of immunization and therapeutic treatments. The challenge is in the coordination and1 Contact Data: Martin J. Dudziak, TETRAD Technologies Group, Inc., 28 Chase Gayton Circle, Suite 736,Richmond, VA 23238 USA,, +1 (804) 740-0342, +1 (202) 415-7295 1
  2. 2. SMi CBRN Address, 19.Sept.2006integration of the teams and resources. A truly adaptable approach is one that can readily handlebreakdowns in communications and logistics and also rapid changes in medical and socialsituations for a population that may be undergoing both evacuations and quarantines in closegeographic proximity.The Katrina experience taught many lessons about critical infrastructure dependency and theconsequences of both inadequate preparedness in many cases and over-reliance upon themodern infrastructures. The disaster within the city of New Orleans has been highly publicized;the situations in many smaller adjoining cities and towns is less well known and actually can bemore illustrative of how the problems evolved and how solutions can improve.In Slidell, LA there was virtually total flooding and isolation of the population that remained –thousands of individuals – from a city of approx. 32,000 covering several tens of square miles andwith more than 400 miles of streets and roads. No lives were lost due in great part to theimprovisations of the local police, fire and other public safety teams and to the fact and blessingthat no significant outbreak of any contagious disease occurred following the hurricane andflooding. An occurrence of a similar natural disaster at the time of an influenza outbreak, or witha significant spread of sewage or infestation into an isolated and dependent population couldeasily have dire consequences, especially if the affected population was isolated from medicaltreatment and caregivers.In order to address these types of situations, where the Biothreat is pervasive, possibly multi-pathogen in type, and where customary infrastructures of transportation, electricity, lighting, andcommunication are damaged, a new approach for identification, analysis and response isnecessary. A method is needed that does not depend upon chains of communication andcommand that may simply not exist or be accessible anymore.CUBIT – Coordinated Unified Biothreat Intervention and Treatment – is one such solution,employing a model that has been developed as a viable and truly adaptive solution to threatswhose geographic, demographic and health risk parameters cannot be clearly predicted ormodeled in advance. CUBIT provides for the rapid configuration of the sensing model to beused for a given area and situation at hand. It provides as well for the rapid configuration of theanalytics and diagnostic elements including staffing and transportation for sensors, diagnosticunits, and treatments. CUBIT provides for the ad hoc, fault-tolerant replanning of responseoperations including evacuation and patient treatment.The architecture of CUBIT is based upon a history of studying how responses have been made todate in several real, simulated, and false-positive threat situations ranging from 9-11 and theUSPS anthrax incidents, the London and Madrid bombings, the Moscow metro bombings, andVirginia’s mistaken alerts about anthrax in the Pentagon and the Capitol nerve gas threat. Thereare now realistic and pragmatic indicators and tools worth sharing about how to be betterprepared for the Unpredictable.CUBIT provides an architecture for systems that will mitigate epidemic-scale diseasetransmissions emerging from the introduction of new or unexpected pathogens into a population.A system designed and built according to CUBIT principles incorporates sensors and datacollectors, human observers and monitors, an informational framework of autonomouscooperating software agents, bioprotectant and/or decontamination procedures, compact andrapid-turnaround diagnostic tests, population control protocols, and clinical treatment plans. ACUBIT system is designed to be employed as a preventive and responsive component that canbe embedded within larger public health, emergency management and homeland securityoperations for specifically addressing the emergence of particular biothreats that, regardless oftype (bacteria, viral) or origin (natural, accidental, terrorist), pose an unpredictable set of long-term threats to one or more populations (human or animal). 2
  3. 3. SMi CBRN Address, 19.Sept.2006What makes CUBIT unique as a system architecture is that it is a set of medical and physicalprocesses, instruments and protocols – incorporating a diversity of physical devices, chemicalcompounds, and information processing applications, that are organized as scalable, modularcomponents capable of dynamic and adaptable interaction – and it capitalizes upon the use ofsystem designs drawn from classical computing and information technology. CUBIT is anapplication of “plug and play,” “platform independence,” and “object oriented” design principlesinto the domain of environmental biosurveillance and pathogen detection and the domain ofemergency incident management and medical response. An alternative way of describing CUBITis that it is a system architecture for coordinating and unifying the identification, forecasting, andnecessary intervention including diagnostics, antimicrobial protection and decontamination, andmedical treatment including vaccination, quarantine and mitigation of vectors, for situations inwhich there is a risk of high-consequence infection and transmission.As an example, consider a system that is intended for providing biothreat intervention directed attransmission through airports and other pubs of public transportation. The necessary logicalcomponents include monitoring and sensing to detect incidents of pathogen presence andtransmission vectors, plus communication with other systems that are sources of information onevents outside the logical space of airports, commercial aircraft, public transportation and thegeneral community. In addition there are logical components for analysis and prediction includingsimulators of airborne, waterborne or host-carried bioagents. Next there are necessarycomponents providing for several types of responsive action – population and vehicle controlincluding quarantine and culling operations, diagnostic testing, inoculation, antibiotic and otherpharmacological treatment, and follow-up observations. Collectively these components will beunder constant restructure and revision due to the need for accommodating highly dynamic andunpredictable changes in geography, climate and weather conditions, population behavior(especially where wildlife are concerned), traffic flow, responder availability, resource suppliesincluding those for both diagnosis and medication, and adaptive pathogen biology. It is thereforemandatory that all of the components have some flexibility in terms of how they will interact andcommunicate among one another. A flexibility tensegrity structure will be more suitable than arigid skeleton, in bioresponse system design just as it is naturally within biology.Prior to the introduction of the CUBIT architecture, there has been a consistent and chronicproblem of mission within biothreat intervention, situation awareness and response. This hasbeen the absence of a coordinative and unifying network of dynamic and intelligentcommunications, precisely the type of logic that has been the focus of development andexperimentation within other sectors of defense, intelligence and crisis management, especiallywithin combatant military forces. Composable Heterogeneous Agents for Intelligent Notification(CHAIN) and Collaborative Analyst/System Effectiveness (CASE) are two projects, the formercompleted and now being extended into multiple applications including maritime domainawareness for CBRNE threat intervention, that exemplify what can serve well the biosecurity andepidemiology communities. Another, the Intelligent Services Layer (ISL) is a computationalintegration framework for sensors, analytical applications and actuator devices to dynamicallyregister their presence in a network, discover available resources, identify data and formats forexchange, and manage publish/subscribe functions among an open-ended network of agents.These technologies have grown out of a common matrix of research and development sponsoredby a number of defense and intelligence programs [1]. Collectively they provide in turn thebuilding blocks for a CUBIT architecture and implementations into the biomedical sphere.Figure 1 illustrates the major components of a CUBIT system. There are five major categories ofcomponents which interface with one another through a critical “operating system” layer ofdynamic registration, discovery and exchange logical agents responsible for handling all of thecommunications. These are: sensing and detection, analysis and forecast, diagnostics,protection and decontamination, and treatment. This comprises the “anatomy” of a CUBITinstantiated system. 3
  4. 4. SMi CBRN Address, 19.Sept.2006 Sensor/monitor units (devices, observers) Examples: ArcWebServices, OGC GIS and Examples: SWIPE, PROFILE luminescence, GPS colloidal gold arrays services Pattern discovery and Sensor/monitor agent inference services services (software) EM & Pharma database portal resources Grid Framework for agent registration, discovery and Examples: BioWatch, RODS exchange (CHAIN / ISL) Intel and open- source Notifications, alerts, news triggers, new agents services Diagnostic testing Routing services (PCR chips) and Examples: InCheck-based planning diagnostic systems (chip, operation cycler, reader) resources Examples: CMDRS, Verona, Antimicrobial protection LUCY, EMPIRES and decontamination Example: BIOSAFE for surfaces and fabrics Vaccination and antibiotic treatments for humans and animals Figure 1 – Basic CUBIT system architecture 4
  5. 5. SMi CBRN Address, 19.Sept.2006CUBIT Components Figure 2 – Rendition of One Possible Instantiation of CUBIT System Components Two particular features of CUBIT make the architecture and its implementations versatile and rapidly adaptable for different applications. One is the CUBIT Designer, a software toolset that is employed to design configurations including the selection and integration of sensors, diagnostic units, emergency response components and therapeutics (e.g., vaccine) distribution. This is as much a design tool for the system-level selection and configuration of electronic and biomedical devices as it is a logistics planning and management tool. The second special feature of CUBIT is in the user community. CUBIT is designed for use by a very widespread and open community, not exclusively by one dedicated group of professionals. This is a very important concept that belongs in any comprehensive plan to be able to accommodate the unforeseeable effects of a widespread pandemic or a combination of biothreats with other emergencies and disasters on a large scale. It is important for the system and the technology to be usable by non-specialists to some extent because there may very easily arise situations where there are simply not enough medical and health department technicians to go around. Police, fire, and other responders can and should be able to handle some of the physical aspects of deploying and monitoring sensors and other units. Diagnostic units for individual patient testing need to be of a type that can be effectively and accurately used by persons who have some basic training and good common sense but who are not specialized lab technicians. It is essential in such conditions and environments as a pandemic or any serious outbreak that the people who are available to assist, to work, to manage, can also perform multi-tasking and carry out some jobs that have not been within their original scope of training. It is this kind of adaptability that is part of the path to survivability. 5