Massachusetts Institute of Technology
Date: July 25-27, 2011 | Tuition: $2,200 | Continuing Education Units (CEUs): 1.7

OVERVIEW
The threat of bioterrorism poses new challenges for governmental agencies that now have the added responsibility to ensure biosecurity. For a bioterrorist attack is both a public heath emergency, and a criminal act whose perpetrators need to be apprehended. And the terrorists involved may or may not be part of an international network. Thus public health, law enforcement and national security agencies all face new priorities, including learning to collaborate with each other.

Implementing these new priorities will require substantial organizational learning and change. But agencies have deeply embedded professional norms and organizational culture, and they are resistant to change even in times of crisis. Each agency responds with its own routines, and its own distinctive view of “the threat,” which dilutes new initiatives and impedes effective collaboration.

The 2001 anthrax letter attacks provide many cases of unresolved organizational issues. The Federal Centers for Disease Control and Prevention (CDC) brought its own organizational style to investigating the outbreaks. It focused on the pathways of exposure, establishing an index case, and other public health procedures. The FBI though, faced with the same incident, saw a crime scene that needed to be secured, evidence that needed collection by its procedures, and perpetrators who needed to be identified. But the Bureau agents lacked the relevant scientific background. The military had studied anthrax for decades, but much of its information remains cloaked in secrecy and unavailable to other agencies. Thus, while the need for collaboration is great, the potential for differing organizational styles to produce conflict is high.

TOPICS COVERED
Among the specific course topics that will be included are:

Swine flu 2009
How do we define a pandemic? Can we predict the behavior of the new virus? How do severity and spread interact? What would be the rationale for a worldwide immunization campaign? Who should it be targeted for, and where will the resources come from? Who will decide, and when? How will the responses differ from country to country?

Swine flu–lessons for mass immunization 1976
In 1976, the CDC mounted a national immunization campaign against a projected new influenza virus that was feared to be unusually virulent. However, the virus never arrived. Instead 25 people died from unexpected side effects from the vaccine itself. What can we learn from this program about decision making with fragmentary evidence; about probing medical assumptions; and about accurate public communication?

Learning from SARS / Avian Flu
The SARS epidemic and the threat of Avian Flu are striking reminders of how infectious diseases can spread in unexpected ways. What can we learn from these experiences about the problems of disease surveillance, accurate diagnosis, effective treatments, and the detection of novel viruses? How would the SARS outbreak have been different if it had been a deliberate release?

Impediments to Organizational Change: professional norms, organizational routines and culture
Is reorganization an effective response to these issues? Is the Department of Homeland Security part of the solution or part of the problem?

Case Study: the US postal anthrax outbreaks
The 2001 anthrax letters caught all the federal and state agencies off guard. What are the lessons for anthrax detection and treatment; for interagency cooperation; and especially for clear, consistent risk communication to the public?

Rethinking the Public Health Approach
A classical CDC investigation includes defining the scope of the epidemic; looking for environmental sources; and establishing treatment regimens. How should these activities change when both the virulence of the biological agent and its spread may have been intentional?

Case Study: the smallpox immunization program
How can we estimate the risks of an outbreak? How do we model the potential spread? What should be the risk threshold for policymakers evaluating immunizations? Who should bear the medical and financial burdens of the anticipated side effects? Does one public health program divert resources from other priorities?

Expanding the Law Enforcement Approach
The standard FBI and other law enforcement approaches stress careful examination of the crime scene and a search for the perpetrators of the crime. However law officers were not trained in the identification of biological agents, nor in the capabilities needed to make or spread bioagents. How do we expand law enforcement routines to respond to bioterrorism? How do we organize law enforcement and scientific capabilities to work in harness?

Biological Weapons and National Security
Why did governments develop biological weapons? How did their militaries forsee the benefits and costs of battlefield use? Why were the programs so secretive? Why did the major powers never make use of biological weapons? Why the Iraqis did develop them? What is the potential for transfers of expertise and materials to terrorist groups?

Barriers to Bioweapons: the Case of Filoviruses
Filoviruses (marburg- and ebolaviruses) are feared and lethal viruses on an individual level, but they are not very communicable and have never killed more than a few hundred people per outbreak. How realistic is it that aggressors could modify these viruses by genetic engineering to become more effective bioweapons? Are the resources and expertise needed for this within the likely reach of terrorist groups? Or is it all just threat inflation?

The New Focus on Vaccine Development
Many of today’s vaccines were first developed and tested in the military. Is this a good model for future efforts? How does the military perception of appropriate vaccine use differ from civilian policymakers? The new national vaccine initiative foresees a major federal role in the development and purchase of the next generation of vaccines. Who should manage this ambitious effort? What should be the roles of public health agencies ad the private sector?

LEARNING OBJECTIVES
Describe impediments to organizational change: professional norms, organizational routines and culture.
Appreciate the following case studies: the 2001 U.S. postal anthrax outbreaks; the smallpox immunization program; the 1976 swine flu outbreak.
Analyze the public health approach: a classical CDC investigation including defining the scope of the epidemic, looking for environmental sources, and establishing treatment regimens.
Investigate expanding the law enforcement approach.
Assess biological weapons and national security.
Interpret the new focus on vaccine development.
Examine learning from the SARS/avian flu.

COURSE SCHEDULE AND REGISTRATION TIMES
Class runs 9:00 am – 5:00 pm every day except Wednesday when it ends at 4:00 pm. There will be a dinner for course participants and faculty on the first evening.

Registration is on Monday morning at 8:30 am.

Hotels located on the east side of the MIT campus, within walking distance of the course location are: The Kendall Hotel, Cambridge Boston Marriott, and Cambridge Center Residence Inn. Hotels within a short cab ride are: Royal Sonesta Hotel, Hyatt Regency Cambridge, and Le Méridien Cambridge. Please see our Accommodations page for more information.

It is highly recommended that you apply for a course at least 6-8 weeks before the start date to guarantee there will be space available. After that date you may be placed on a waitlist. Courses with low enrollment may be cancelled up to 4 weeks before start date if sufficient enrollments are not met. If you are able to access the online application form, then registration for that particular course is still open.

For more information and registration, visit here.