individual because of arrangements and relationships already established would be able to transfer that individual after that -- >> yes, ma'am, absolutely. and that works that works very well. and that is really what i'm saying. we should not create something different. they still have the same requirements for reporting the trama statistics and everything. and some of the more esoteric type responses. >> i'm a big fan of the post office department. the last time i remember them implementing anything it was medicare. i don't remember them having refrigerators refrigerators. wouldn't we be better off using the pharmacy network in the united states for the distribution of vaccines or anything else? it seems to me we have a system it is private sector, but it is

pretty well organized. i think if i want today get things out fast, bringing in the palettes palettes, if i remember, the federal contract governments with fed ex and ups, i would distranscript them to an existing network of pharmacies and i assume that was looked at as well. there is more pharmacies than post offices these days. i would think that we would use an existing system with a controlled mik nism rather than rebuilding one for a redistribution system. >> i agree i think we want to use any and all capabilities for counter measures. there may be particular scenarios where that may be more attractive, for example, a pandemic, where you want -- perhaps you want to distribute antiviral medications.

that is not a attack scenario. and you would leverage your pharmacies to distribute those medications. if we're talking about a bio attack, when you look at distribution points, it's maintaining security. and it is slightly different. in terms of distributing counter measures, if you need to distribute to five million people in a 24 hour periods, you try to go to a million, it takes about 12 days. one million seconds is 12 days. that's how big five million is. you could have multiple channels to distribute to but it underscores the challenge you face in a very short period of time. to very rapidly distribute counter measures to a population where you don't know what is happening next. this is not a naturally

occurring disease. i flew into washington on 9/11 about 10:00 in the morning and what struck me was the uncertainty of what would happen next. and during that initial 12 hour period, it was very uncertain. i would put myself in the setting of a bio attack. you're in the midst of that attack very early on and not knowing what is coming next and i would think security would be a critical issue. so the challenge is being able to balance those distribution points and maintaining safety and security for the public. >> thank you thank you for your remarks, gentleman. great to see you again. chief, i would like to direct this to you. i noted your comments about the

amount of intelligence briefing you receive from the federal government. you and others from the first responder community. concerned about getting generally classified information. it is critical information. it looks like it is more like chemical threat, pair it one way, a bio threat another way. so that is critical if that happens. i know with the local police they have more regularized intelligence briefing process and partly because of the infrastructure that is going out and doing the investigating on the front end. from the perspective of someone on the nonpolice community, are you getting the intelligence

briefing you think you need about what our adversaries are looking at so you can sort of position yourself and be poised and respond to what is the threat of the day rather than what you got the year before? >> i think it is both, sir. i think a lot tof depends on the area that you're in the nonlaw enforcement first responder community may be more or less involved in that. if you have a fusion center that gathers and disseminates intelligence information. my deputy chief is briefed regularly. i think there are gaps in other

places where you don't have a good relationship, there may not have been a relationship established between the law enforcement agencies that don't get as regular and in-depth of briefings as they should. overall we seem some improvement. i this it is incumbent on us to keep pushing in that regard to make sure we get the information that we need and sometimes that's what it takes. so it boils down to a communication and trust issue. in some cases in terms of the federal government, those federal agencies that collect and disseminate evidence, there is security issues that come into play. we know there is a threat out there, the potential of that

threat and the credibility of that threat, i see improvement but still work to be done. >> maybe it is uneven around the country based on relationships, based on the tradition that you have in a particular center. looks like you're well positioned as chairman of the national associations. you know where the weaknesses and strengths are, and you can let us know. that will be part of our view on that. >> we just need you and the chiefs and others to keep pushing and developing that need to share culture and relying

simply on relationships is a good start but not the finish line that we want to see develop. advisory board, multiple questions, go ahead. >> first i would like to endorse the secretary's comment about using private sector for distribution. i think it is a very good idea. they have received some resistance, and i think it is something we should look at. for dr. mecher, you're one of the few that was on the homeland security council, can you talk about whether that led to the diminishment of capabilities, and with homeland security and the national staff and how you

see the homeland security function in the white house fitting in the four d's that you discussed. >> when it was the homeland security county till i served with the bio director of senior defense. so i had the opportunity to see a senior director in place who had dealings with bio defense. there was an identified individual with primary responsibility to lead the bio defense effort. following the transition and the reorganization of homeland security council into the national security staff, that off was subsumed into a director of resiliency. that position was removed and all of those portfolios associated with those individuals under bio defense really moved under resiliency.

if you recall very early in the administration we were hit with h h1n h1n h1n h1n1. so when it began, it was early and several months into the new administration. we did not have a seen your director. what was organized was a response of leadership in the office of resiliency to lead the effort for h1n1 a major bio effort. what i saw was the difference between having a leadership that was identifiable for defense, and not having a single individual a that you could identify as bio defense. i think there is some

advantages, i saw them in the past administration of that individual and leading the effort which bob certainly did. >> i would say -- i was talking about the advantages of having someone identifiable, a senior individual, to lead the effort in bio defense i think it could certainly be lead from the national security staff. oklahomaland efforts were identified in the national security staff. what was missing was an identified senior official for defense. >> i would like to ask about the effective respond from the communities. we have relatively few proxies.

do you think we did better or worse than anticipated. is there anything that surprised you that we could think about in terms of preparing for biological threats? >> who wants to go first? >> this speaks to the coordination problem. >> so i'll speak to -- i'll give an anecdote from the corporate sector. we're a multinational. we have people in western africa at the time who are performing things for infrastructure support. we worked with government partners, we initiated a quick communication campaign. we looked at how we would move someone if we had someone that was ill. it is a private concern it was between the private sector and a

individual coming back for care. i think it was reasonable to say across the board that what we saw was mixed result and that is fair. i think that what if i was going to say anything that i would look at in terms of changing, because i think that was your -- the root of your question, the root of a system and referral of a individual to the proper facility that can take care of them very rapidly. i think we're in better condition to do that now. we made some mistakes and have done some things well. what i would like to see is rather than do this every single time disease specific is i would like to start to do this with the idea of infectious disease or bio defense. the nature of the different

agents. i think that is the safest and smartest way to do this. that may not be in place right now, and i think that is something that we can start to attend. that is my thought. >> two comments, one was on communication on being able to convey the risk and the reaction to a highly infectious disease communicated itself. we saw a spike in fear. what i saw was being able to conceptualize what that risk truly is in terms of trying to quantify that risk. and a lens that they like to talk about the outrage factors, the public views that risk within. so i think the risk communication is always a challenge in any kind of an event. to get to the issue that i think matt was mentioning, i think we

focused on where to create these individuals and what was needed was the assessment capability. does everybody need the ability to treat a patient or the capability to recognize it recognize simple things they can do to protect themselves and other staff and patients and get that person to a specific center to take care of these patients. that i saw was that there was a attention between developing this capable versus focusing the capability in a small number of centers and expanding the capability like the infectious disease. you have that capability everyone where but you have them a concentrated capability to manage the high consequence

infectious diseases. so i think between assessment and where we would provide that treatment and a setting to protect our staff. the other thing i think we came to realize is that they're most infectious when they're critically ill. we staff with very intensive in terms of personnel. in terms of controlling a disease outbreak, we're almost doing the opposite thing. we're exposing potentially large numbers of people to a highly lethal and infectious disease when those patients are probably the most infectious and have the highest viral lobes. i think what it brought was thinking about icu;u] medicine and icu care. it has lots of people and when

you think about ebola you're almost going in the opposite direction. you have drying to limit the staff having contact with the patient. >> that is why isolating the space is important. >> jerry parker next. >> just a question for carter and perhaps matt, and it is similar, but your testimony really highlighted the need we talked about how novel the bio threat is and low probability and high consequences and it demands novel approaches. and it requires people thinking outside of their box and outside of their comfort zone, and it requires cultural change. and the postal model home stockpiles, and the private

sector is -- needs to be incorporated in this in novel approaches but it is really speaking to leadership. it comes back to leadership, and it is also maybe not in addition to the white house leadership, but you know having the secretary and deputy secretaries also engaged on this is very very important as well. and that leadership, you already told us that you believe having a bob catholic, and that leadership in the white house is important. but what other lessons learned since you were in the eye of the hurricane, so to speak in the white house, in addition to just having that position whether attributes need to be attached to that position to be most effective. >> there is a consensus here we like to have we can't do that. we know at various spots we can

be truly coordinated. absent of that we're looking for alternatives. >> one of the things that the leadership provides is -- i had the good fortune, the opportunity to watch a transition in administrations and see what happens as administrations change. i was able able to see h1n1 and i got to see firsthand what it feels like when a disaster unfolds. and you watch it stutter and unfold. while it was unfolding, we would have conversations some of us in bio defense and say it is 24 hours after something that could have been a bio event do you think we could have done it in 24 hours? and then we look at the

information that we had at the moment of the event, and you watch how the information changed and you saw how most of the time the initial information was not correct, and you're dealing with this evolving situation, uncertainty and ambiguity and you still need to act. and i think the borns of leadership is in that type of environment where the information will never be complete. it will be inexact. you will be looking through a fog. you will need to be able to give advice, or someone will be need to be able to give advice to leadership in terms of options of actions, and that needs to be as informed as it can be. i think having someone that has been been in bio defense for a long time, offering that kind of

a kind of advice is important. >> is there anything they need for budgetary -- >> it is hard to get things done without the ability to control dollars. i think having influence in some way of being able to move resources, if you can identify an issue but you can't swing resources to assist, it will probably not get done. >> can you say anything about what you observed at the department level that might be helpful? >> so i want to touch on anthrax. there was two attacks at the time when we talk about the postal hhs. there was patient care

individuals that care about the disease. that is difficult in the hospital base. there is another concept that is classically for medicine the idea that there may have been an exposure and you want to prevent the manifestations. what i saw at the department level with this is i think when we talk about health care coalitions. you're talking about everybody that supporting the health care system so it is a faith based initiative, and folks that do logistic requirements and all of that enterprise. that is a big animal i think you want to bring as many of those support capabilities to the table as possible. i want to point out that that was not something that was federally driven, it was identified by a local jurisdiction that this was part

of, not in lieu of using pharmacies, more points of dispensing, or any other initiatives, it was in adjunct to them. and the thought was that perhaps there would be a population because of mobility issues traffic arteries, or something, they might want this delivery to instead of a pull out and go location, and the jurisdiction were successful and they thought they had a good working model and aagreed. i mentioned culture change and this is what we're talking about. when i talked about the idea of bringing in a training requirement, or some sort of credentialing element necessary with these boards to provide

that nugget, if you will. we're talking about a 21st century health construct in the community. it's not a bad idea. as with all things, the particulars will be the success or the undoing. so from a state and local department standpoint, i think what you have to do is allow enough latitude for a local to make tactical decisions that will -- and you can probably support me on this. i think states then become sort of the funneling capability, it's easier for the funds initiatives, and i think at the forecast level it's important to allow that latitude for the ex-cushion of those duties so they're effective. because this is a very diverse country in terms of resources.

>> how constraining is the practice routing of a state. what you're suggesting works as long as there are not a narrow scope of practice rules for what health professionals can do. >> so i would distinguish what we're talking about with scope of practice, so for informations or individuals with ontonomy of practice, there is generally a great deal of latitude. they're determined in the civil courts and criminal behavior evaluation by their board. states set those limits and what i mentioned the study done at the university of maryland, they were very, very different depending on where you were. so when i talk about practice,

there was practitioners that function in much the same way, but have a supervisor agreement or arrangement. that is changing to some degree in the united states. it is hard to answer that question in totality. you then get into vocation and technical trainings. that requires symptom driving supervision. so the answer is how do you do that? that's why i'm going back to the boards. if that is a piece of the requires cme's for the license to renew or to have it as part of the curriculum, that might be the best way to do it. >> if you look at what is

happening in health care there is less and less practitioners. there is less acas or acos or their employers. >> that's quite true. that said even if they're employed, they can't do what they do unless they have their licensure. so i'm saying rather than making it part of a social organization, or a guild or something of that nature, i think that the licensing board that allows themselves to have that boimt and process is probably the most effective way to do it although there are many. >> you have been very helpful and provocative. we're going to move on to the second panel. as they come forward we thank you for your participation and your contribution today. thank you.

we're going to try to keep this thing going. we'll break for ten minutes for lunch, but we will proceed with our second panel and the public health response and we would like to proceed with you first. we have a segues from the last panel. >> thank you mr. secretary, i will be continuing some of the themes and i hope to provide a transition to public health response. so since leaving government i

have taught on a variety of topics. i think it is of a key important to our nation especially when we have another bio event like ebola. and that topic is revil -- resilient resilient. >> she describes a major medical center without e lick tristy, clean water, ventilation, and limited communications supplies, and transportation. patients deprived of live saving technology lingered and died in the heat. a nightmarish scenario in deed.

of the 16 krit catcritical sectors. those hospital patients are argumently the most vulnerable segment of our society. and the sector is one of increasing complexity and relies on a combination of support from other sectors especially the power grid and a reliance on moment to moment connectivity. i will refer to that as i.t. so resiliency, the working definition, is the ability to take a blow and come back. resilient hospitals are able to prepare for and adapt to changing conditions and with stand and rekofrcover from

disruptions. patients receive care to include long-term care and increasingly at home. it is not just the physical infrastructure that must withstand the blow and come back. an aviator friend told me once that truly superior pilots plan ahead to avoid their situations where they might have to use their superior skills. hospitals have used their superior skills but we would prefer less heroics and more standard carrying out of the plan. hospitals have unique vulnerabilities. patients are sensitive to changing in environment temperature, noise. the very young, old, and very

sick have different requirements. some patients have to be isolated from others, ventilation systems, changing rooms, et cetera. some rely on ventilators with a limited battery supply. when the battery goes off back up generators are tasked to perform beyond their limits and news devices begin to run down as well. some medical devices to include some life sustaining medical devices, can be hacked remotely, turned off or settings changed. when the power goes completely off, hospitals become dark and dangerous places. most back up generators are designed for now more than 48 to 72 hours for continuous

operations. another unique issue of hospitals is the evacuation of critically ill patients connected to life support. when health care facilities across an entire region are afblgted we have to be able to continue to provide care in place. one example was you recollect gustav is when hospitals were able to discharge but held back because of the difficulty of evacuations. until basically we reached the limit for aero medical evacuation. it can be a help and a hindrance. modern medicine as we know it ceases to exist.

valuable patient records and other data may exist somewhere out there on a server, inability to access or retrieve data stops our business as usual. the ability to record and store on a secure hand held device is essential. the data can be downloaded later or sent to a device when connectivity is restored. tracking patients and family members is particularly important. papers and clipboards may have to go back to being used. less effective legacy system is also an indicator of resiliency. it is an integration of information from the hospital to ems, to public health responders

that needs to be shared across the board and that is really a key to success here. a point made earlier supply chain complicates disaster health care recovery. there is less waste and less wasted shelf space. the days of large stocks are gone. vendors may maintain supplies from domestic and overseas. and i.t. systems connect them all. as systems become increasingly complex, they're also increasingly fragile.

for no fail missions intensive care units, we need redundancy and additional capability. it could include more trained staff, equipment, staff supplies in house. functions within the hospital are then prioritized as mission critical. or nonmission critical like we do in the military, and functions of lower priority may need to be turned off in an orderly manner as in the afraid "failing gracefully which, is already practiced. this adds to business costs, staff, overhead liability and is an additional risk to the hospital. i just attended a meeting where a survey was given out money ceo, cfo and cros.

number one were costs associated with regulation. number two, interestingly was cyberthreats. number three was infectious diseases. alternate technologies can be yutful in a disaster if they're baked in. ppd has a resilient design and critical infrastructure and more secure accompanying cyber technology. now as an example an architectural firm in boston is designing hospitals from the ground up that have more natural ventilation in lighting, more sparing in the use of water, and have a reduced requirement for waste water treatment. some of these hospitals include a thermal tower that pulls air through the facility. they have large fans in common areas in case this doesn't work.

the day today requirements are more of hospitals on ground level and they can be used more easily without the change of elevators. so why is this technology not used more commonly? they're being designed for third world applications. situations in africa and elsewhere. certainly these countries that experience disaster and loss of life more frequently than we do here benefit from this technology. maybe certain adaptations of this technology is needed here to make our hospitals more resilient. they're appropriate and resource saving all of the time and do not have to be turned on in a disaster. cyber secure micro grids. another use of technology useful all of the time is a back up electrical generation system incorporating generators,

renewables batteries, and the ability to push power back into the grid. they're less susceptible to hack attacks and electromagnetic pulse. i have seen them provide power for a large military base to putting energy back into the grid and storing energy and batteries. also for portions of the system to go offline for a period of time so they can be maintains and refuelled. you remember that was a problem in super storm sandy. they have such a joint capability demonstration, that could be adapted for use in a medical campus, and i can

discussion that further with you if you're interested. a favorite slide that i like to use is one showing the various critical infrastructure sectors stacked on top of each other with lines of interconnectedness. the power grid relies on transportation, transportation is connected to water the water sector needs electricity and it connects all of them. health care may not effect the other sectors, but it's fair to say that all of the other sectors affect health care. they must have an electrical outlet like jengenerators.

>> i ask that you submit your testimony to the panel, i just want to speak also in stay or as have some preefs attackvious speakers of coalitions. grant funding from the government will never be enough. a colleague told me you could never grant your way to preparedness, but specific funding toward a specific as a rule -- vulnerability can help. i think with that i will close, sir. >> thank you, good morning. i was asked to respond to the public health role and realtime

epidemiology and other tools. so we will highlight a few of the roles that we face. it requires skill staff, and relationships with key partners across all levels of government nonprofits, the private sector, and community leaders and advocates as well. public health officials are responsible for characterizing the threat utilizing bio surveillance an tools and investigative proceeders. it helps to facilitate situational awareness across other pub lib safety partners. public melt officials must

coordinate with the health care system providing treatment recommendations for laboratory testing and other diagnostic procedures and personal protective equipment for proper protection as well as continuous communication with partners to maintain the surveillance activities and bidirectional flow. on the operations side, counter measures must be distributed or dispensed to affected populations to protect against the threat particularly any potentially exposed that were not -- that means they must be in place preevent that account for not only the medication distribution, but all of the logistic

logistical components that operate in the background. i emphasize operationally sound because it is not efficient to just have a plan, but staff needs to be continuously trained on those plans, and full scale exercising is necessary to evaluate the viability of those plans. in other words there needs to be proof that the plan can do what it says it can do. and i'm happy to say that in any jurisdiction, our public health responders are fully integrated and we don't have the turf wars and resource pulling that can occur when it is time to respond. the need for quick, efficient communication messages to the public continuous information shares, and engagement of those

most vulnerable includes those with access and functional needs and may not be able to get to medication distribution points. the elderly, and the chronically ill residing at home and those socially isolated and may be distrusting of information sources. there is a need for relationships and partnerships. it is not the time to be distributing business cards. we under estimate the power and strength of relationships with key partners who have resources and tools that can be brought to bare to support the public health mission in response to a buy logical event. mcand health care coalitions, community leaders and advocates. i often tell the personal story of an elderly man with whom i

was quite familiar living in the lower ninth ward as hurricane katrina who refused to evacuate his home and he didn't trust the messages being delivered through the main stream media. but if those messages were delivered by the pastor of his church, he perhaps would have trusted those messages and his outcome would have been different than it actually was. again i stress that relationships are key. we won't always know how we may need to leverage those relationships until the situation is upon us. in terms of challenges there are many. particularly with regards to epidemiology and surveillance in the effort to characterize the threat. what we know is that they will

learn in any number of ways. one would be through the bio watch system. another could be the bds hmm that is present in my postal facilities across the country, or most likely through an astute physician on duty when a symptommatic patient presents in the e.r. my point is there is no single detection mechanism consistent across all jurisdictions or standard competency level. there is great news for bio surveillance that has multiple approaches or mechanisms for bio surveillance to improve coordination across jurisdictions and increase competency for quick detection of a lie logical release. we have many tools in the tool box, but we need to figure out

how to best regulate those tools. and briefly in conclusion some of those outstanding conclusions continue to be remediation. in other words, how clean is clean after a biological event. who is the authority to determine that a facility can reopen for business? what is the balance between public health and law enforcement investigations. how can we ensure that we coordinate with one another without interfering with the very different investigations we're respectively trying to carry out. lastly how do we ensure that as a public safety community we're resilient from high regret decisions that might be made in the face of a biological attack. >> thank you very much. >> thank you for this opportunity to share some reflections.

and while i apologize in advance, i'm going to speak about the politics of response a little more than some of the ep deem logical challenges that we face or some of the successes that we experienced. >> that is adherent to the challenges we face, so you're on topic. you don't have to apologize for that, you're on topic. >> i don't have any funding to defend or a portfolio to protect, so consequently i'm going to speak in my personal capacity as a risk analyst and consultant that has worked on this side for about 20 years. so while we're here to talk about the public health response to a high consequence -- i realize that we're sort of shafting it today, and this is an incident of any origin against humans and ag with a focus on livestock. i think the point that i really want to focus on is the

assumptions surrounding the act of responding and not all of my comments will remain within the per view of health and some things may include hub lick health and clinical professionals in this room pip was going those was ebola in west africa in the united states, since it's been discussed so much, i think i'm going to not talk about that instead i'm going to talk about polio in pakistan, nigeria and afghanistan and the western united states. obviously. we could talk about mers in the middle east, dengue hemorragic feev and others the assumptions we are looking at, who should respond, what should the response be. where does the response begin and when. and how should response be

handled. should it be using health care officials. i wanted to add a few assumptions of my own. leadership is too fragmented and lacking. that's one of the issues that's come up repeatedly. also in my personal opinion, responding to a kennettinetic biological attack is somewhat less challenging than a kennettinetic accident. i would say that the majority of u.s. policies prioritize a duty to treat or care over a duty to contain the threat and concept ulee we envision triage in terms of individual health. a standard of care as opposed to populational th and sufficient care. also decontamination is seen as inferior to therapeutic counter measures. also, there's still a lot of

reluctance from what i can tell for nontraditional partners in the response arena and in the response generally. that would include the private sector which we just heard a bit about in the military. these folks have a lot of cool toys and at their convenience whether it's geo spatial data, uavs things that we don't normally associate with people in clinical and public health environments. we're also reluctant to communicate more with the public about mass fatality management, for both humans and livestock. we were really loathed to address burial practices and actually talk about cultural differences. and the need to actually potentially put aside some of those differences rather than appeal to each and every individual's preference. slow onset disasters like ebola in west africa, polio in

pakistan are generally responded to like rapid on set disasters. and by that i mean, that you often get duplicated and desperate resources and coordination mechanisms that are thrown together in an ad hoc manner. and health care professionals should focus on the health aspects of the disaster. so i wanted to talk a little bit about polio and pakistan and afghanistan in nigeria. while currently the u.s. doesn't have a problem with polio when there's an infectious disease of high consequence, it has the possibility of becoming a problem back in the united states. so in the polio virus which in the aftermath of world war ii, the thing that americans feared the most. today remains endemic in three

very terrorist riffe countries. afghanistan, pakistan and nigeria. many of these al qaeda taliban and bookka haram are anti-vaccine. in 2014, there were outbreaks in somalia with al shabaab, cameroon syria south sudan and madagascar. the likelihood for cross border infection particularly in con contiguous nations, consequently into regions with growing allegiances and affiliations with organizations poses a risk to irradication strides made over the last 40 years. if polio is not effectively managed, the resurgence of polio could paralyze more than 200,000 children worldwide every year within a decade.

while there's no such thing as a microbial manifesto terrorists that are rejecting polio vaccination on behalf of their children are functionally turning their children into -- it could be labelled as passive bioterrorism. terrorists are intentionally disrupting vaccines, as well as sacrificing children to the disease. anointing them as martyrs should they succumb to illness or death. this insidious form of bioterrorism doesn't mimic the effects of an endemic disease. or successfully weaponize and disburse polio. rather denying prevention measures, the disease is permitted to run its course.

violent and obstructionist acts that have been taking place, we've seen in 2014 there were nearly 90 related killings of health care workers that went out to vaccinate children. >> 80 of those were in pakistan, with about 10 in nigeria. in short, the effects of preventing access due to violent extremism and thus denying children a potentially life saving intervention are no different than actively exposing children to polio as a weapon. on that, a point that i would like to make as a recommendation, until there's recognition by the security apparatus in pakistan, whether it's law enforcement or military, polio's threat to its national security whereby security forces are actively engaged in threat reduction efforts, polio will continue its resurgence, that also raises a national security concern for the united states and the rest

of the world. >> from there i want to go on to talk about brusilosis. i'm not a veterinarian, but i've looked a lot at the economic impacts of these diseases. last friday i was sitting in a round robin when we began speaking to the table of people next to us brian and marcia who own and operate a family run cattle ranch were visiting washington, d.c., from montana to meet with their congressman about the problems they're facing. while brucilosis is an exotic disease, one can infect animals and spread to humans there concern is about domesticated livestock and wildlife in and around their farm. as it happens, it was a weaponized agent the u.s. had as part of its stockpile as well as the u.s. perceived some other countries had as well. in the words of these ranchers they said the disease has been

previously controlled and eradicated in cattle and humans a reservoir remains in wild bison. in yellowstone park and has spread to wild elk herds of montana. they begun spreading the disease into cattle in the state. the consequence of this is that there's been revenue lost as well as operational disruption of the ranches. and one of the things i found interesting i didn't know was that the cattle were also being sent to montana in drought ridden states like kwal cal and texas. the fear was those states would not do that and montana would lose revenue for that as well as not being able to sell the cattle back and/or any of the beef byproducts. so one of their concerns was they wanted to ensure that political issues were managed to eradicate the disease while the bison population continues to grow and spread to wild elk heard to wander into idaho and

wyoming about they've had concerns with aphids and the montana department of livestock, we're seeing on a smaller scale disperate leadership. who is necessary and who gets the right resources to allocate toward which effort. and what they really wanted and i'm not here as a plug to them. but they were really quite ilus electrative in term ss of foot and mouth disease we saw sars, and the billions and billions of dollars that came out of that and my work in the private sector and doing a lot of pandemic planning of food safety and supply chain security. this can't be understated. this is billions of dollars some of it is state funded some of it is all private

partnerships, there's a lot of money at stake here, which means there's a lot of livelihoods affected. so the exports are waning as we said of diseased remains, unmitigated and potentially the effects that can reach our national livestock industry, which i think in and of itself presents a threat. the issues about whom we -- who responds, when do we respond, do we respond before something becomes a disaster? because with ebola, had we responded in a rural environment it would not have become a disaster disaster. just having an outbreak or epidemic does not make it a disaster, it's a disaster when everything and all the people and resources are overload eded and the management falls to pieces. i just wanted to thank