Is a Pandemic a Risk to Homeland Security?
By Nadav Morag, Ph.D.
CTU’s Global Security Series offers background on current national and homeland security topics. In this new series, Dr. Morag, will focus on an often unaddressed area of homeland security: public health. Today he begins by taking a deeper look at pandemics, the threats that they pose and how they are discovered and tracked.
Most people associate homeland security with counterterrorism intelligence-gathering, investigations, tactical teams breaking down doors to capture suspects, and other, more immediate threats. Those who travel frequently often associate the field with aviation security when they encounter Transportation Security Administration (TSA) personnel at an airport checkpoint. Others associate homeland security with areas such as border security and disaster relief. Few people, however, realize that public health, in particular elements that focus on discovering, mapping and addressing major disease outbreaks, is a critical part of the homeland security enterprise. In many ways, pandemics represent a far greater threat in terms of lives lost and economic damage than any terrorist - unless that terrorist has access to a weapon of mass destruction. While public health, in most people’s minds, may not be as “sexy” as counterterrorism, it is of grave importance to homeland security.
Pandemic vs. Epidemic
A pandemic can be defined as a disease that attacks a large population across great geographic distances – in other words, a disease outbreak of national, or global, proportions. Pandemics are larger than epidemics in terms of the area and number of people affected. Epidemics are typically seasonal and affect a much smaller area. Seasonal outbreaks of the flu virus, or influenza, are examples of epidemics. Pandemics are also usually caused by novel sub-types of viruses or bacteria for which human beings have little or no natural resistance and as a result, they typically result in more deaths, social disruption and economic loss than epidemics. Generally speaking, influenza viruses represent the most common agent for pandemics.
6 Phases of a Pandemic Outbreak
According to the Geneva-based World Health Organization (WHO), a part of the United Nations, an influenza pandemic can go through six phases:
- Phase 1 is the natural state in which influenza viruses circulate continuously among animals, especially birds, but do not affect humans.
- Phase 2 involves animal influenza circulating among domesticated or wild animals that have caused specific cases of infection among humans.
- Phase 3 represents the mutation of the animal influenza virus in humans so that it can be transmitted to other humans under certain circumstances (usually very close contact between individuals) so that small clusters of infection have occurred.
- Phase 4 involves community-wide outbreaks as the virus continues to mutate and becomes more easily transmitted between people (such as transmission through the air).
- Phase 5 represents human-to-human transmission of the virus in at least two countries in a given WHO region (the WHO divides the world into six geographic regions) and suggests that a global pandemic is imminent.
- Phase 6 is the pandemic phase, characterized by community-level influenza outbreaks in at least one other country in another WHO region and often means that the pandemic has spread to multiple locations around the world.
Epidemiologists are public health researchers who study the causes, effects and spreading of communicable diseases, as well as their potential treatments. They are the public health equivalent of the FBI agent gathering intelligence and building cases against suspected terrorist cells. These researchers engage in “syndromic surveillance,” also known as “clinical surveillance” - the collection and analysis of data about diseases (and in particular infectious diseases). Syndromic surveillance through the analysis of medical data can help epidemiologists identify new disease outbreaks, isolate the infectious agent and determine the “disease vector” – the person, animal or microorganism that spreads the disease. They look at data on hospital admissions and reports from physicians to public health officials on patients exhibiting mysterious symptoms or symptoms caused by a known infectious agent in order to discern patterns.
Pandemics often start with a “whimper” rather than a “bang” with a few people (sometimes in disparate geographic locations, though usually with a person or animal acting as a disease vector) exhibiting symptoms that are sometimes misdiagnosed, and then they gradually, or quickly, spread - depending on the behavior of the bacteria or viruses in question. Just as a counterterrorism investigation can begin with information provided to the FBI from a local law enforcement agency that received a report from a patrolman who noticed suspicious behavior, epidemiologists at the Centers for Disease Control (CDC), the nation’s premier federal public health agency, are often dependent on reports reaching them via city or county public health agencies that have, in turn, been alerted to a problem by a sharp-eyed physician in a hospital or clinic who noticed something strange.
As with other areas of homeland security, the system is only as good as the links that make up the chain of information. An isolated bit of information in a specific location can sometimes have implications with truly profound consequences for the nation and the world.
For some interesting background information on pandemics, see the TED Ed presentation: How Pandemics Spread.
Next week we will look at the history of pandemics and the possible impact of a major pandemic on the nation and the world.
Image credit: Flickr/Nathan Reading