Tevi Troy joins the Manhattan Institute’s Paul Howard to discuss a dreaded scenario: a bioterror attack in New York City.

Gotham’s status as a cultural and financial center makes it a more desirable target than any other city in the world. Of all the threats the city faces, a biological attack may be the most terrifying. 

Due to the city’s size, density, and transportation complexity, bioterror would present a significant challenge. Luckily, New York’s unmatched police and counterterror forces—along with federal agencies—remain ever vigilant to keep residents and visitors safe.

Tevi Troy is a presidential historian, former White House aide, and former deputy secretary of Health and Human Services. His latest book is Shall We Wake the President? Two Centuries of Disaster Management from the Oval Office.

Audio Transcript

Brian Anderson: New York City’s centrality as a cultural and financial capital has always made it a primary target for terrorists.  Thankfully, the city’s unmatched police and counterterrorism forces, along with federal agencies, have foiled more than 15 terrorist plots against New York since 9/11, and there has been no loss of life to terror since that tragic day.  For our next episode, Paul Howard, the director of health policy at the Manhattan Institute, interviews Tevi Troy to discuss the terrifying possibility of a bioterror attack on New York City and what the city has done to prepare for that possibility.  Tevi’s article, Is Gotham Ready for Bioterror?, appeared in City Journal’s Spring 2017 issue and it is available on our website.  The interview will begin after this.

Paul Howard: We are joined on 10 Blocks today by Tevi Troy.  Tevi is a presidential historian, CEO of the American Health Policy Institute, and former Deputy Secretary of Health and Human Services.  His latest book is Shall We Wake the President?  Two Centuries of Disaster Management from the Oval Office.  He holds a bachelor of science in industrial and labor relations from Cornell University and an M.A. and Ph.D. in American civilization from the University of Texas at Austin.  Tevi, thanks for joining us today.

Tevi Troy: Hey, thanks for having me.  More importantly than all that is I am a big fan of the 10 Blocks Podcast.

Paul Howard: As we all should be.  Tevi, you’ve got a terrific article in the current issue of City Journal, Is Gotham Ready for Bioterror?, and as a resident of the New York City metropolitan area, I have a real vested interest in knowing the answer to this question.  So, maybe we should just go up front and ask a couple of basic questions.  You know, for instance, why is it that New York remains, and I guess this is, you know, counterterrorism 101, why is it we remain within the crosshairs of international or, you know, U.S.-based terror groups?

Tevi Troy: Well, the number one reason is that New York is just the most likely target.  It is a symbol to the world.  Obviously, the World Trade Center was hit twice, as we know, and there is just a sense that if you are hitting New York you are really hitting not only America, but Western civilization.  And so I looked at a breakdown of 74 failed terrorist plots against the U.S. in the fifteen-year period from 9/11 to 2015, and I found that almost a quarter targeted New York, more than any other U.S. city.  So, New York does need to be worried and ready for this kind of thing, and the other thing is that New York is so big, so vast, with so many different languages and so many different areas that it is also very hard to defend, and that is another part of the equation.

Paul Howard: And could you talk about the evolution of the terrorist threat?  We have obviously unfortunately seen a lot in the headlines over the widening use of tools that terrorists use to attack, you know, quote unquote soft targets, civilian targets.  It has included, of course, bombs, knives, guns, most recently vehicles.  Why are you singling out bioterror at this time and what do you think is, you know, for lack of a better phrase, the learning curve for terrorist groups with this kind of technology, and on the face of it seems pretty complex?

Tevi Troy: I’ll tell you why.  Because we have learned that Al-Qaeda, ISIS, terror groups, can do all sorts of things to kill individuals, or even a handful of individuals, with all of those things you mentioned, cars, knives, guns, et cetera.  But, to do something really game-changing to really impact us and our civilization, which is what they loathe, you have to do something bigger, broader.  The 9/11 attack is an example.  And what they engage in is asymmetrical warfare, and a bio-agent that could spread a terrible disease that could kill thousands, if not hundreds of thousands of people, that is the kind of game-changer that, it seems to me, that they would be interested in.  And it’s not just my speculation.  There was a laptop that ISIS had that was recovered that speculated about how to weaponize bubonic plague, which obviously killed millions in Europe in the middle ages.  Almost one-third of the population of Europe went as a result of bubonic plague.

Paul Howard: And a couple of related questions, I guess one of which is, you know, is, in effect, technology working a little bit against us as, you know, I think you write in your article, you know, someone who has maybe a master’s or Ph.D. in molecular biology would have enough of a knowhow with basically off-the-shelf technology to potentially produce some potentially deadly pathogens in a home lab that would be very difficult to detect, and my second question, does it even have to rise to the level of, you know, a major bubonic plague, smallpox-like attack, or could it be something much smaller?  For instance, like the anthrax letter attack back in 2001.  Even that was, really, pretty disruptive.

Tevi Troy: Well, I wouldn’t call anthrax small.  Anthrax is one of the bio-agents that we worry about most.  In fact, I worry much more about anthrax than bubonic plague, which, I think, today, I’m not a scientist, but from what I’ve read, the bubonic plague could be handled with antibiotics.  Anthrax is a little more difficult and it’s a specialized antibiotic, so that’s one thing.  I also wouldn’t overstate that it is true that someone with a master’s or Ph.D. could potentially do this, but it doesn’t mean it is easy.  First of all, you need somebody who could get that level of degree, not raise any warning bells, and also to still be a rejectionist of Western civilization even while you are taking in the science and the technology of Western civilization.  I’m not saying it doesn’t happen, but, again, it’s a smaller subset.  And then, also, it’s not just creating the pathogen, but finding a way to spread it.  The anthrax mailings were terrible, killed five people, cost a lot of money, but, in the end, they only killed five people because it’s very hard to spread this stuff.  So, again, it is doable, but I’m not saying it is easy.

Paul Howard: No, absolutely.  But I think it is a little bit of a warning sign that even a partially successful, and I know, you know, people were killed during the anthrax attack, that the uncertainty of an event like that, and the inability, ultimately, of us to catch the person or persons who did that, you know, could create an awful lot of chaos in a relatively short period of time.

Tevi Troy: Yeah, that’s a really good point because I list a couple of bioterror-type events that have happened in our history, and in general we either have not found the person, have not definitively identified the person, only found the person after they confessed, so the record of law enforcement in a, preventing, and b, even identifying the perpetrator after it happened is not great.  I mentioned the Tylenol poisonings of the 1980s, which are technically not bioterror, but they are the same concept, and we still haven’t identified who did those terrible poisonings in Chicago in the 80s.

Paul Howard: So, the next part of your analysis, I think, moves into what I might call resilience or recovery, and here I think you have some pretty encouraging things to say about how well New York authorities are prepared for these kind of attacks, in part because they feel like they have had to go their own way and do more without the assistance of the federal government.  Could you talk a little bit about how New York has approached, you know, kind of building a defense in response in depth to the potential of a bioterror attack?

Tevi Troy: Yeah, I think that initial point that you made is really an excellent one, in that New York has felt it has had to go its own way.  I remember reading this book about securing the city that talked about how New York feels that the FBI and the CIA don’t share information with it in real time and that they had to develop their own intelligence capabilities and then, later, subsequently also their own bio-preparedness capabilities.  So, that’s not good that they didn’t feel like they could count on the feds.  The good thing, though, is that as a result of feeling that they couldn’t rely on the feds, they did develop their own capabilities, they are, probably, the readiest city in America when it comes to dealing with bio-preparedness, and with resilience, and detection.  So, New York is kind of on the ball in the context of recognizing that it is very hard to be on the ball and that it’s very hard to secure such a large, diverse, complex city.

Paul Howard: And how has the city worked with, for instance, federal authorities to ensure – I know that there is a national stockpile of counter-bioterrorism tools, vaccines, drugs, and other things that are stockpiled at a number of different sites, classified sites, around the U.S.  We don’t know where they are, but you write about how some of those materials have actually been moved into New York because we are recognizing, in the event of a serious incident, trying to disperse those at the point of need is going to be extremely challenging.

Tevi Troy: Yeah.  It is important to recognize that the defense strategy that we have against a bio-attack is predicated on this concept of the SNS, the Strategic National Stockpile, and we do have these locations around the country.  The locations are classified, the actual sites themselves are classified.  I have been to them, had to sign a nondisclosure waiver, but these are very good at getting materials to a certain area within 24 hours, because that’s the time you need to be able to respond to the bioterror attack.  However, the question is, once you are in that area, let’s say they deliver it to Times Square, Kennedy Airport, or wherever, some place in New York, how do you distribute it to a complex and vast population in a short period of time?  So, I think the federal government is in good shape at getting to a general location and, maybe, that helps in a smaller city like Omaha, Nebraska.  But, in New York City, it is a separate equation to figure out how to get it to all eight-and-a-half million people in real time.

Paul Howard: Are there other tools that we are using or should be using?  Of course, creating surveillance networks through New York-area hospitals, I know Google did an experiment a few years ago where they tried to track flu outbreaks based on search terms – are there other tools that we could bring to bear using some 21st-century network, social media, other opportunities to try and give us an early warning signal of any kind of attack like this?

Tevi Troy: Yeah.  I think that point you made about Google is not necessarily a Google solution, but there are ways to detect these problems emerging before the typical response networks notice them.  So, for example, in the 2009 swine flu, there was a company that had this technology that measured doctor and hospital visits, and measured mentions of certain symptoms, and they detected the swine flu emergence about two to three weeks before the government agencies detected them.  So, yes, we do have new technologies that we need to deploy to help make this happen.

Paul Howard: And New York has actually ran some mock attacks to try and test their preparedness level.  How would you grade the city at this point?

Tevi Troy: I think New York has tried a number.  They have also had some experiences of distributing countermeasures for, for example, the swine flu in ’09, and I think that they have been, overall, pretty good.  But, as you say in this field, you train on the practice field so you can make mistakes there.  You don’t want to make mistakes when the real game happens, because it is so important and so vital that you respond appropriately.  So, I am encouraged by the amount of effort New York has put into this and the early measures in terms of their experiments at tabletop exercises, but if, God forbid, such a thing were to happen, the proof would be in the pudding.

Paul Howard: Just one final question for you, Tevi, if you were going to give some advice to Mayor de Blasio, Governor Cuomo, other state officials right now, what would you ask them to think about focusing on, or, for that matter, coordination with the federal government?  Where are there places where you think we could still raise the level of our preparedness for events like this?

Tevi Troy: I think it’s a couple things.  In integrating new technologies, making sure that you have communication down, support for law enforcement, which I know has been an issue in the de Blasio administration, and, as much as you are testing, I think, more testing, more tabletop exercises are better.  So, I think there are a number of things to make it even stronger and I am worried about the fact that New York has overall felt that they don’t have great communication with the federal government, so I think all those areas could be bolstered.  But, the signs are very encouraging in what is really a very difficult thing to handle, if it should happen.

Paul Howard: Well, let’s hope we never have to deal with that eventuality.  Tevi, thanks for joining us.  Once again, Tevi Troy’s article, Is Gotham Ready for Bioterror?.  Thanks very much for joining us on 10 Blocks.

Tevi Troy: Thank you.

Photo: Bart Sadowski/iStock

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