FACING NEW CHALLENGES
BY MARY ANN LITTELL
The events of September 11, 2001, destroyed what was arguably the worlds largest office complex. On that morning, millions of people across the New York metropolitan area were settling in at their desks, getting coffee, talking to co-workers, or turning on their computers when the planes hit their targets. Thousands of workers would not return home at the end of the day. Those who died at the Pentagon were also on the job, as were hundreds of firefighters, police officers, and other emergency personnel. In fact, most of the victims of 9/11 lost their lives while working. It was the ultimate insult to the American workplace. * In the aftermath, thousands of jobs have been lost. But for some, there are fresh challenges. Many UMDNJ faculty and emergency, public health and public safety personnel have new and expanded work responsibilities. Here are profiles of a few.
DAVID PERLIN, PHD
David Perlin comes from a long line of activists. "I was a non-activist for many years, but thats changed now," he says.
Perlin was in Boston presenting a lecture on the morning of 9/11, where he has informed of the unfolding tragedies in New York and Washington. He scrambled to get home to his family and was anxious to return to his office at the Public Health Research Institute (PHRI), a non-profit organization devoted to biomedical research into the nature of infectious diseases and their underlying molecular processes. At the time, PHRI was located in New York City, across the street from Bellevue Hospital and not far from the Twin Towers.
As a New Yorker, Perlin was particularly struck by the tragedy and loss of that day. "I watched people wander around Bellevue clutching pictures of their missing loved ones," he recalls. "It had a profound impact on me." As a scientist, he wondered what he could do to help. The answer became apparent a few weeks later, when the first anthrax letters were mailed.
"A year ago, I never would have been interested in anthrax, smallpox, or other issues pertaining to bioterrorism," says Perlin. "They just werent relevant. Those things did not happen in the U.S. They were not serious scientific issues." All that changed in early October. After the first anthrax-related death, some of the suspicious letters were taken to a New York lab for testing. The lab happened to be in Perlins own building, which also housed the Department of Health and other testing facilities. Several government agencies, including the CDC, FBI, and Department of Defense, came in and took over to conduct the investigation.
"They did not appreciate the dangers of those letters," says Perlin. "The lab was contaminated inadvertently and it was a hazardous situation. They just were not prepared to deal with it."
Perlin says it also took far too longup to three or four daysto test the letters for the presence or absence of anthrax spores. PHRI has technology that could have speeded the process. They offered to help, but were rebuffed. Shocked at this response, as well as the governments lack of preparation, Perlin spoke out. He went on radio and television talk shows and wrote a series of letters to major newspapers, including The New York Times, criticizing federal agencies for not handling the anthrax properly and misinforming the public. "The research community was not being utilized to help with this situationand it had something to offer," he says.
In April, PHRI moved to a new facility in Newark: the International Center for Public Health (ICPH), a joint venture of the state, UMDNJ, and Newarks Science Park. (The story of their move, in the dead of night, trucking 40 years worth of pathogens through the Lincoln Tunnel with a heavy police escort, requires a separate articleor perhaps even a book.) From the other side of the Hudson, Perlin continues to work towards improving preparedness for potential bioterrorism attacks. Scientists at PHRI are collaborating on several pathogen studies with the UMDNJ Center for BioDefense, the NJMS Department of Microbiology and Molecular Genetics, which is now housed at ICPH, and other NJMS faculty.
With a grant from the New York Community Trust, PHRI scientists, in collaboration with NJMS researchers, are developing rapid detection probes for anthrax and other bioterrorist organisms like plague, tularemia and botulism. Plans are underway to test the probes before the end of the year and eventually make them available to health departments and hospitals. These probes will greatly reduce the time currently needed to identify potential bioweapons.
In the past year, Perlin has continued to speak out about bioterrorism and our need for preparedness. He has been a consultant for the Senate Finance Committee, writing one of the primary critiques of the response of federal agencies to the anthrax outbreak. "We have an obligation as scientists and citizens to do what we can to help," he says.
MITCHEL A. ROSEN, MS
When Mitchel Rosen heard about the attack on the World Trade Center, his immediate concern was for people he knew at the Port Authority, many of whom worked at the Twin Towers. An occupational safety expert, Rosen had trained many PA workers over the years in everything from hazard materials emergency response to safety and health in confined spaces.
In the aftermath of the disaster, PA officials called Rosen to request technical assistance. Concerned that workers in the area were being exposed to hazardous substances, a team of environmental safety personnel went to New York to evaluate air quality and provide assistance with environmental issues. It wasnt the first time Rosen had been called in to help at the Twin Towers. Following the World Trade Center bombing in 1993, he and his staff provided hazard awareness and emergency re-sponse training to Port Authority personnel and contractors. "In fact, we were scheduled to go back and give a course on September 30, 2001," he says.
As director of the Office of Public Health Practice (OPHP) at the UMDNJ-School of Public Health, Rosen directs several public health training programs. One program, the Centers for Education and Training (CET), offers some 250 courses addressing such topics as asbestos, lead abatement, hazardous waste, occupational safety, environmental health and air pollution. The courses are designed for industrial hygienists, safety professionals, occupational physicians and nurses, construction workers, emergency responders, engineers, and anyone else who might be exposed to occupational hazards. In the past 15 years OPHP has trained more than 200,000 workers in the metropolitan area.
The New Jersey/New York Hazardous Materials Worker Training Cen-ter, established in 1987 at UMDNJ, is part of a consortium of universities, labor groups and government agencies that provide hazardous waste training. There are 17 such centers that cover the entire U.S. The training activities for all of New York and New Jersey come through this Center.
This training has taken on a new meaning since September 11, partially because the notion of occupational safety has been broadened to include security issues. In addition to the accepted notions of workplace hazardsasbestos, air pollution, chemicals, and hazardous wastethere are now other considerations. "A priority now is on bioterrorism and preparedness training," says Rosen. "It involves learning new security and emergency measures, developing new procedures for deliveries, and a host of other issues."
OPHP is preparing a seminar series on bioterrorism for industry, addressing such topics as hazard awareness, building safety, and mail handling. It has also provided instruction to the Coast Guard Auxiliary about inspecting vessels coming into New York Harbor, particularly smaller boats and personal water craft.
A new course on ICS (incident system command) is also underway. "Public health needs to be part of the response as well, but too often, its not addressed," says Rosen. "Work-ers coming to emergencies need to be trained not to put themselves at risk."
CAPTAIN RAYMOND JONES
UMDNJ is the size of a small city, so its no surprise that it has its own police department.
"Our mission is campus safety, but prior to September 11, terrorism just wasnt something we thought much about," says Captain Raymond Jones. "Since then, weve been thinking about it quite a bit, and reevaluating how we safeguard the university."
Training in terrorism has not traditionally been part of a police officers education. September 11 changed all that. Now, with the spectre of other attacks a reality, there is a great need for additional training for "first responders"which include firefighters, emergency medical technicians, public health officials and emergency management personnel, as well as police officers. "For years, police training focused on criminals," Jones continues. "Now there are a whole host of other factors to consider."
After September 11, nerves were on edge. The attack on the WTC had occurred in New Jerseys own backyard, in clear view of many on the Newark campus. Then the anthrax incidents occurred. Mailrooms everywhere were on guard and HazMat (hazardous materials) trucks called in repeatedly to check suspicious packages and envelopes.
The "top brass" of UMDNJs Public Safety Department met and agreed that they needed to take action. A new training program for public safety officers on all campuses would be implemented. Fortunately, Captain Jones had one person on his staff uniquely qualified to provide it: Police Officer Bobby Fields, Jr. Before coming to UMDNJ, Fields had been an emergency medical technician (EMT) for nine years. Hed also been a volunteer fire fighter for 11 years. "He covers all the bases: police, fire, and EMS," says Jones.
Fields became an instructor in four classes which included: weapons of mass destruction (WMD) awareness, operations, hazardous materials (HazMat) awareness, and law enforcement response to WMD. He travels from campus to campus, teaching classes of 10 to 20 officers per session. The courses were developed and sponsored by the New Jersey State Police and the Louisiana State University Academy of Counterter-rorist Education (ACE), which provides specialized training to law enforcement agencies on counterterrorist issues in cooperation with the Department of Justice. Prior to September 11, officers received only HazMat training. The ultimate goal is to train every public safety officer at the University by the end of the year.
To keep their new knowledge fresh, all officers will periodically participate in tabletop and live exercises. "With this type of training, frequent drills are important," says Fields. "People need to be of one mindset: that something will happen, not that it might happen."
Jones says the training emphasizes a new way of looking at critical incidentsevents that require a response by law enforcement, firefighters, EMTs or other safety personnel. "All the rules have changed," he says. "In the old days, if you were on patrol and called to investigate five people lying on the ground, your first response would have been to go right over to them and see if they were dead or alive. Now you have to consider that they might be victims of a deadly gas or biological agent, in which case, you shouldnt go near them or you might become a victim too. This also has the potential to become a crime scene and the preservation of evidence is critical."
The first responders on a scene are taught to check for BNICE: Biological, Nuclear, Incendiary, Chemical and Explosive weapons. Officers will operate on the hands-off principle, responding safely and effectively to incidents. "While a police officer is always at risk, you don't want to send people into deadly situations without properly preparing them," says Jones.
Jones points out that the University-wide effort would not have been possible without the support of Chief Anthony C. Shelton, Deputy Chiefs Elyas Malik and John Bailey, and Assistant Director James A. Moretti. "Our main focus is safeguarding the University community," says Jones. "Our pledge is a standard of excellence."
NANCY CONNELL, PHD
Nancy Connell, Brendan McCluskey and Jessica Mann have one important thing in common: a keen interest in bioterrorism that began long before September 11. They were way ahead of their time. While they come from different backgrounds (Connell and Mann are scientists; McCluskey is an emergency manager), they are working together at the UMDNJ Center for BioDefense on new initiatives designed to protect against future bioterrorist attacks. Connell is director of the Center, McCluskey is deputy director, and Mann is a research teaching specialist. Some of this work is taking place at the Centers state-of-the-art biosafety Level III laboratory on the Newark campus. Other initiatives, which include education, preparedness and emergency response programs, are statewide.
Connells research focus has been tuberculosis, but her interest in biodefense goes back to the early 1980s, when she was a graduate student at Harvard. She says that learning about the political issues of science was part of her training. Her foresight and that of others at UMDNJ led to the development of the Center for BioDefense in 1999, two years before the terrorist attacks.
In 2000 and 2001 the Center received $3 million in government funding to establish a comprehensive approach to bioterrorism that includes basic research, emergency response, and clinical and public health preparedness. Their first major research project is designed to develop faster, more efficient methods for detecting biothreat infections. They are currently examining nine select agents: anthrax, plague, tularemia, glanders, hantavirus, dengue virus, influenza virus, monkeypox and multi-drug resistant TB. Current identification techniques are slow and can take from one to three days.
Having potentially dangerous pathogens on hand required reorganization of the laboratory, a huge task undertaken by lab manager Jessica Mann. A microbiologist by training, she came to UMDNJ in September 2000 fully expecting to perform experiments. Her role has turned out to be much broader. When the Department of Defense came to inspect the lab prior to its opening, they said it was the best one theyd ever seen in an academic setting. To maintain this high quality, Mann has catalogued everything in the lab, kept precise records, and written safety protocols for the new agents.
This year an additional $4.5 million in federal grant money was appropriated to the Center for education and emergency response training and equipment. Since last fall, McCluskey and Connell have conducted approximately 175 seminars on bioterrorism and weapons of mass destruction in four states (New Jersey, New York, Pennsylvania, Connecticut) and Washington, DC. Among those attending were police, the FBI, corporations, universities, public health facilities, and community groups. Connell presents the scientific issues involving bioagents, and McCluskey provides information about preparedness and emergency response. "We tailor the seminars according to whos attending," says McCluskey.
McCluskey and Mann are also involved with preparedness planning on the state level: McCluskey as part of a statewide domestic security planning group; Mann as a member of a pathogen security work group. The University is part of New Jerseys newly revised emergency operations plan, a detailed outline designating exactly who would do what in the event of another terrorist attack. UMDNJ is the only university included as part of the states plan.
Connell, who is also vice chair of research in the NJMS Department of Medicine, says her teaching activities have changed as a result of September 11. Before that there was only one ethics course distantly related to these issues. Now, she teaches a course in bioterrorism and weapons of mass destruction, as well as a medical microbiology course which addresses bioterrorism. Another course in microbial pathogenesis was originally a survey of existing literature on the subject, but after September 11, the students suggested changing the format to include listeria and anthrax.
Its a whole new world now, but not an unexpected one for Connell. "Truthfully, I could do without the extra attention were getting as a result of all these activities," says Connell. "To some people, it seems weve jumped on the bandwagon. But what they dont realize is weve been on it for a long time."
The magazine of the University of Medicine and Dentistry of New Jersey