If America's less-than-rapid response to the H1N1 pandemic is an indicator of how the U.S. public health system would react in the event of a bioweapon attack, we are in deep, deep yogurt, folks.
It's taken more than six months to ramp up production of a vaccine for a contagious disease that health officials worldwide knew was coming.
Wouldn't it have made sense to vaccinate children against H1N1 before school started this fall?
"Sure, it would have," said retired Air Force Col. Randall Larsen, executive director of the Commission on the Prevention of Weapons of Mass Destruction Proliferation and Terrorism and author of "Our Own Worst Enemy." "But there's a problem. There's (just) one facility in the United States making H1N1 vaccine, and it's using the same technology we used 50 years ago."
Inoculating eggs — produced at the 35 U.S. chicken farms operated with the sole purpose of vaccine production — with a virus that then creates hundreds of thousands of copies of itself is Cold War technology.
The efficiency of the virus replication determines how much and how fast vaccine can be produced.
In the case of the H1N1 vaccine, reproduction was "sluggish," admitted Health and Human Services Secretary Kathleen Sebelius in an Oct. 28 news conference.
The nation's lack of progress in moving to cell-based vaccine technology — which would cut production time from about 23 weeks to between 12 and 14 weeks and produce more vaccine — should be a concern to every American who has given so much as a nanosecond of thought about the country's ability to recover from a bioweapons attack. Because preventing such an incident is nearly impossible.
"It is hard to have a preventive policy for bioterrorism because of the vast variety of agents available," said retired Maj. Gen. John Parker, the former commanding general of the U.S. Army Medical Research and Material Command at Fort Detrick in Maryland.
A December 2008 report issued by the Commission on the Prevention of Weapons of Mass Destruction Proliferation and Terrorism concluded that terrorists will be more likely to use a biological weapon than a nuclear one in a future attack on the United States.
As disquieting as it is to hear, the materials to construct a bioweapon aren't difficult to obtain, even in a post-Sept. 11 world. The level of technological expertise needed to manufacture a bioweapon isn't high, said the "World at Risk" report.
And the materials needed to make such a weapon aren't all closely monitored. Many of the pathogens are readily available — in nature, in sick people and in laboratories.
The key to mitigating the long-term terrorism value of a bioweapon is rapid response, recognition and recovery — and recovery includes having therapeutics available as soon as possible for those exposed and vaccines to prevent the spread.
"The point of terrorism is not just to claim victims but to terrorize everyone around them," said Cliff May, president of the Foundation for Defense of Democracies.
The impact of a dirty bomb or a biological weapon going off somewhere in the United States wouldn't be confined to the number of people killed or exposed to the pathogen or radiological agent, he said.
"The psychological and economic effects would be far greater than the initial public health threat," May said.
As Larsen concludes in his book, terrorists will again attack the United States. The appropriate reaction, he wrote, "should be shock, but not surprise.
"Americans will always be shocked when ruthless, immoral cowards intentionally kill innocents, but we can no longer justify being surprised."