[House Hearing, 113 Congress] [From the U.S. Government Publishing Office] CONTINUING CONCERNS OVER BIOWATCH AND THE SURVEILLANCE OF BIOTERRORISM ======================================================================= HEARING BEFORE THE SUBCOMMITTEE ON OVERSIGHT AND INVESTIGATIONS OF THE COMMITTEE ON ENERGY AND COMMERCE HOUSE OF REPRESENTATIVES ONE HUNDRED THIRTEENTH CONGRESS FIRST SESSION ---------- JUNE 18, 2013 ---------- Serial No. 113-56 Printed for the use of the Committee on Energy and Commerce energycommerce.house.gov ______ U.S. GOVERNMENT PRINTING OFFICE 85-446 PDF WASHINGTON : 2014 ----------------------------------------------------------------------- For sale by the Superintendent of Documents, U.S. Government Printing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512-1800; DC area (202) 512-1800 Fax: (202) 512-2104 Mail: Stop IDCC, Washington, DC 20402-0001 CONTINUING CONCERNS OVER BIOWATCH AND THE SURVEILLANCE OF BIOTERRORISM COMMITTEE ON ENERGY AND COMMERCE FRED UPTON, Michigan Chairman RALPH M. HALL, Texas JOE BARTON, Texas Chairman Emeritus ED WHITFIELD, Kentucky JOHN SHIMKUS, Illinois JOSEPH R. PITTS, Pennsylvania GREG WALDEN, Oregon LEE TERRY, Nebraska MIKE ROGERS, Michigan TIM MURPHY, Pennsylvania MICHAEL C. BURGESS, Texas MARSHA BLACKBURN, Tennessee Vice Chairman PHIL GINGREY, Georgia STEVE SCALISE, Louisiana ROBERT E. LATTA, Ohio CATHY McMORRIS RODGERS, Washington GREGG HARPER, Mississippi LEONARD LANCE, New Jersey BILL CASSIDY, Louisiana BRETT GUTHRIE, Kentucky PETE OLSON, Texas DAVID B. McKINLEY, West Virginia CORY GARDNER, Colorado MIKE POMPEO, Kansas ADAM KINZINGER, Illinois H. MORGAN GRIFFITH, Virginia GUS M. BILIRAKIS, Florida BILL JOHNSON, Missouri BILLY LONG, Missouri RENEE L. ELLMERS, North Carolina HENRY A. WAXMAN, California Ranking Member JOHN D. DINGELL, Michigan Chairman Emeritus EDWARD J. MARKEY, Massachusetts FRANK PALLONE, Jr., New Jersey BOBBY L. RUSH, Illinois ANNA G. ESHOO, California ELIOT L. ENGEL, New York GENE GREEN, Texas DIANA DeGETTE, Colorado LOIS CAPPS, California MICHAEL F. DOYLE, Pennsylvania JANICE D. SCHAKOWSKY, Illinois JIM MATHESON, Utah G.K. BUTTERFIELD, North Carolina JOHN BARROW, Georgia DORIS O. MATSUI, California DONNA M. CHRISTENSEN, Virgin Islands KATHY CASTOR, Florida JOHN P. SARBANES, Maryland JERRY McNERNEY, California BRUCE L. BRALEY, Iowa PETER WELCH, Vermont BEN RAY LUJAN, New Mexico PAUL TONKO, New York Subcommittee on Oversight and Investigations TIM MURPHY, Pennsylvania Chairman MICHAEL C. BURGESS, Texas DIANA DeGETTE, Colorado Vice Chairman Ranking Member MARSHA BLACKBURN, Tennessee BRUCE L. BRALEY, Iowa PHIL GINGREY, Georgia BEN RAY LUJAN, New Mexico STEVE SCALISE, Louisiana EDWARD J. MARKEY, Massachusetts GREGG HARPER, Mississippi JANICE D. SCHAKOWSKY, Illinois PETE OLSON, Texas G.K. BUTTERFIELD, North Carolina CORY GARDNER, Colorado KATHY CASTOR, Florida H. MORGAN GRIFFITH, Virginia PETER WELCH, Vermont BILL JOHNSON, Ohio PAUL TONKO, New York BILLY LONG, Missouri GENE GREEN, Texas RENEE L. ELLMERS, North Carolina JOHN D. DINGELL, Michigan JOE BARTON, Texas HENRY A. WAXMAN, California (ex FRED UPTON, Michigan (ex officio) officio) C O N T E N T S ---------- Page Hon. Tim Murphy, a Representative in Congress from the Commonwealth of Pennsylvania................................... 1 Prepared statement........................................... 3 Hon. Diana DeGette, a Representative in Congress from the state of Colorado, opening statement................................. 5 Hon. Michael C. Burgess, a Representative in Congress from the State of Texas, opening statement.............................. 6 Hon. Henry A. Waxman, a Representative in Congress from the State of California, opening statement............................... 7 Witnesses Michael Walter, Ph.D., Biowatch Program Manager, U.S. Department of Homeland Security, Office of Health Affairs................. 9 Prepared statement........................................... 12 Answers to submitted questions............................... 307 Toby L. Merlin, MD., Director, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention 16 Prepared statement........................................... 18 Answers to submitted questions............................... 324 Submitted Material Document binder.................................................. 48 Majority supplemental memorandum dated June 18, 2013............. 280 CONTINUING CONCERNS OVER BIOWATCH AND THE SURVEILLANCE OF BIOTERRORISM ---------- TUESDAY, JUNE 18, 2013 House of Representatives, Subcommittee on Oversight and Investigations, Committee on Energy and Commerce, Washington, DC. The subcommittee met, pursuant to call, at 10 a.m., in room 2322 of the Rayburn House Office Building, Hon. Tim Murphy (chairman of the subcommittee) presiding. Present: Representatives Murphy, Burgess, Blackburn, Scalise, Harper, Olson, Gardner, Johnson, Long, Ellmers, Bilirakis, DeGette, Butterfield, Tonko, Green, and Waxman (ex officio). Staff present: Carl Anderson, Counsel, Oversight; Sean Bonyun, Communications Director; Karen Christian, Chief Counsel, Oversight; Andy Duberstein, Deputy Press Secretary; Brad Grantz, Policy Coordinator, Oversight and Investigations; Brittany Havens, Legislative Clerk; Sean Hayes, Counsel, Oversight and Investigations; Alan Slobodin, Deputy Chief Counsel, Oversight; Phil Barnett, Democratic Staff Director; Stacia Cardille, Democratic Deputy Chief Counsel; Kiren Gopal, Democratic Counsel; Hannah Green, Democratic Staff Assistant; Elizabeth Letter, Democratic Assistant Press Secretary; Stephen Salsbury, Democratic Special Assistant; and Roger Sherman, Democratic Chief Counsel. OPENING STATEMENT OF HON. TIM MURPHY, A REPRESENTATIVE IN CONGRESS FROM THE COMMONWEALTH OF PENNSYLVANIA Mr. Murphy. Good morning. I convene this hearing of the Subcommittee on Oversight and Investigations on Continuing Concerns Over BioWatch and the Surveillance of Bioterrorism. We will be examining the effectiveness and efficiency of BioWatch, a Department of Homeland Security program that relies heavily on the Centers for Disease Control and Prevention, and the State and local public health laboratories that are members of the CDC Laboratory Response Network. BioWatch is an early warning system designed to detect a large-scale, covert attack that releases anthrax or other agents of bioterrorism into the air. The program was launched in January 2003 as this country was preparing for war against Iraq when many believed that state-actor programs had stockpiles of anthrax, smallpox, and botulinum. BioWatch deploys collectors in 34 of the largest U.S. metropolitan areas in outdoor locations, with indoor deployments in three sites, and special event capacity. These collectors hold filters that gather air samples. Every 24 hours, a government worker goes to these collectors, manually retrieves the filters, and takes them to a State or local laboratory for analysis and testing. If the lab testing shows a positive result, called a BioWatch Actionable Result, or BAR for short, government officials review other evidence and information to decide if it is an actual attack, or just the detection of a bacteria in the environment that has a similar DNA to the pathogen of concern. Since the program started, there have been 149 BARs, none of them being an actual attack. BioWatch costs about $85 million a year to operate, and over $1 billion spent since 2003. For 9 years BioWatch has sought to develop and deploy a more advanced type of technology that would include air sampling and analysis of the samples in the same device, a so- called lab-in-a-box. This technology, known as Generation 3, is estimated by GAO to cost $5.8 billion over 10 years. According to a senior CDC official, the cost is ``an abomination.'' Unfortunately, after much hype, versions of the lab-in-a- box technology have failed. One version, BioWatch Generation 2.5, was actually deployed for 2 years and then halted because it was ineffective. The latest version of technologies for Generation 3 failed testing. About $300 million has already been spent on these failed detection technologies. Last year, the Senate and House Appropriations Committees removed the $40 million requested by the Administration for Generation 3, and no procurement of this technology can proceed until after the Secretary of Homeland Security certifies that the science is proven. Almost a year ago, this committee opened this investigation after a National Academy of Sciences report in 2011 and an article in the Los Angeles Times in July 2012 noted that the BioWatch system was generating false positives or indicating the ``the potential occurrence of a terrorist attack when none has occurred.'' A DHS official responded, stating that the reports of false positives were incorrect and unsubstantiated, and that there ``has never been a false positive result.'' However, the committee's investigation found other serious problems with the BioWatch program besides the BAR false positives. Most troubling is whether we are better prepared to respond to bioterrorism than we were 5 years ago. Unfortunately, the answer would seem to be no. The public health workforce has been reduced by 21 percent over the last 5 years, with emergency preparedness being hardest hit. Several of the bioterrorism threats we thought we faced in 2003 no longer apply or have been lessened. According to the DHS experts interviewed by committee staff, recent threat assessments show that a large-scale catastrophic attack is less likely. However, the threat is still dangerous because of certain technological advances and the greater likelihood of smaller-scale attacks that would probably not be detected by BioWatch. Yet, if the science of Generation 3 is proven, DHS would be expected to pursue the multibillion-dollar Generation 3. We cannot afford another DHS boondoggle. This costly approach is unbalanced and misdirected. It makes no sense to expand outdoor monitoring for a less likely large-scale attack, while not addressing the declining number of public health responders who are needed in any kind of attack. If public health authorities lack the capability to respond, BioWatch will not produce a benefit. The committee's investigation did not find a strategy reflecting changes in the threat and the reduced resources in the public health workforce. Last July, the President put out a National Strategy for Biosurveillance. He directed that a strategic implementation plan be completed within 120 days, but there is no strategic implementation plan that has been publicly released, and the committee staff have been unable to confirm if this plan even exists. Once the role of BioWatch is appropriately analyzed in the context of an overarching biodefense strategy, tough questions need to be examined. After 10 years of operation, we still don't know if the current BioWatch technology can detect an aerosolized bioterrorism agent in a real-world environment. DHS expects to have this data this fall. We don't know if past management problems have been corrected. Bipartisan committee staff asked DHS to produce documents from an internal DHS investigation of a DHS official's conduct related to BioWatch, but DHS has not done so. There has been bipartisan and non-partisan concern over BioWatch, including the ranking member of the House Homeland Security Committee, Bennie Thompson, the GAO, the National Academies of Science, Congressman David Price, Democrats and Republicans on the Senate and House Appropriations Committees, House Homeland Security Committee Republicans, Congressman Gus Bilirakis, now a member of the House Energy and Commerce Committee, and Congressman Dan Lungren. Let us work together to get the right solution. We want to thank the witnesses for being here today. I would now like to give the ranking member, my good friend from Colorado, Ms. DeGette, an opportunity to give her opening statement for 5 minutes. [The prepared statement of Mr. Murphy follows:] Prepared statement of Hon. Tim Murphy I convene this hearing of the Subcommittee on Oversight and Investigations on ``Continuing Concerns Over BioWatch and the Surveillance of Bioterrorism.'' We will be examining the effectiveness and efficiency of BioWatch, a Department of Homeland Security (DHS) program that relies heavily on the Centers for Disease Control and Prevention (CDC), and the state and local public health laboratories that are members of the CDC Laboratory Response Network. BioWatch is an early warning system designed to detect a large-scale, covert attack that releases anthrax or other agents of bioterrorism into the air. BioWatch is an early warning system designed to detect a large-scale, covert attack that releases anthrax or other agents of bioterrorism into the air. The program was launched in January 2003 as this country was preparing for war, and it was intended to protect against threats of state-sponsored programs that may have had anthrax, smallpox, and botulinum. BioWatch deploys collectors in 34 of the largest U.S. metropolitan areas in outdoor locations, with indoor deployments in three sites, and special event capacity. These collectors hold filters that gather air samples. Every 24 hours, a government worker goes to these collectors, manually retrieves the filters, and takes them to a state or local laboratory for analysis and testing. If the lab testing shows a positive result, called a BioWatch Actionable Result, or BAR for short, government officials review other evidence and information to decide if it is an actual attack, or just the detection of a bacteria in the environment that has similar DNA to the pathogen of concern. Since the program started, there have been 149 BARs, none of them being an actual attack. BioWatch costs about $85 million a year to operate, with over $1 billion spent since 2003. For nine years BioWatch has sought to develop and deploy a more advanced type of technology that would include air sampling and analysis of the samples in the same device, a so- called ``lab-in-a-box.'' This technology known as Generation 3, is estimated by GAO to cost $5.8 billion over 10 years. According to a senior CDC official, the cost is ``an abomination.'' Unfortunately, after much hype, versions of ``lab-in-a- box'' technology have failed. One version, BioWatch Generation 2.5, was actually deployed for two years and then halted because it was ineffective. The latest version of technologies for Generation 3, failed testing. About $300 million has already been spent on these failed detection technologies. Last year, the Senate and House Appropriations Committees removed the $40 million requested by the administration for Generation 3, and no procurement of this technology can proceed until after the Secretary of Homeland Security certifies that the science is proven. Almost a year ago, this committee opened this investigation after a National Academy of Sciences (NAS) report in 2011 and an article in the Los Angeles Times in July 2012 noted that the BioWatch system was generating ``false positives'' or indicating the ``the potential occurrence of a terrorist attack when none has occurred.'' A DHS official responded, stating that the reports of ``false positives'' were incorrect and unsubstantiated, and that ``there has never been a false positive result.'' However, the committee's investigation found other serious problems with the BioWatch program, besides the BAR false- positives. Most troubling is whether we are better prepared to respond to bioterrorism than we were five years ago. Unfortunately, the answer would seem to be no. The public health workforce has been reduced by 21% over the last five years, with emergency preparedness being hardest hit. Several of the bioterrorism threats we thought we faced in 2003 no longer apply or have been lessened. According to the DHS expert interviewed by committee staff, recent threat assessments show that a large-scale catastrophic attack is less likely. However, the threat is still dangerous because of certain technological advances and the greater likelihood of smaller-scale attacks that would probably not be detected by BioWatch. Yet, if the science of Generation 3 is proven, DHS would be expected to pursue the multi-billion dollar Generation 3. We cannot afford another DHS boondoggle. This costly approach is unbalanced and misdirected. It makes no sense to expand outdoor monitoring for a less likely large-scale attack, while not addressing the declining number of public health responders who are needed in any kind of attack. If public health authorities lack the capability to respond, BioWatch will not produce a benefit. The committee's investigation did not find a strategy reflecting changes in the threat and the reduced resources in the public health workforce. Last July, the president put out a National Strategy for Biosurveillance. He directed that a strategic implementation plan be completed within 120 days. But there is no strategic implementation plan that has been publicly released, and the committee staff have been unable to confirm if this plan even exists. Once the role of BioWatch is appropriately analyzed in the context of an overarching biodefense strategy, tough questions need to be examined. After ten years of operation, we don't still know if the current BioWatch technology can detect an aerosolized bioterrorism agent in a real-world environment. DHS expects to have this data this fall. We don't know if past management problems have been corrected. Bipartisan committee staff asked DHS to produce documents from an internal DHS investigation of a DHS official's conduct related to BioWatch, but DHS has not done so. There has been bipartisan and non-partisan concern over BioWatch, including: the Ranking Member of the House Homeland Security Committee, Bennie Thompson; the GAO; the National Academies of Science; Congressman David Price; Democrats and Republicans on the Senate and House Appropriations Committees; House Homeland Security Committee Republicans, Congressman Gus Bilirakis, now a Member of the House Energy and Commerce Committee, and Congressman Dan Lungren. Let's work together to get the right solution. # # # OPENING STATEMENT OF HON. DIANA DEGETTE, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF COLORADO Ms. DeGette. Thank you, very much, Mr. Chairman. Mr. Chairman, I am so glad we are here talking about this BioWatch surveillance program. Bioterrorism remains a threat to our nation, and BioWatch's detection capabilities are critical, and I agree with you, that is why we need to make sure that the program is operating efficiently. After the anthrax mailings of 2001, the federal government needed to act fast. In September 2001, the New York Times reported that the government's bioterrorism planning was so disjointed that the agencies involved could not even agree on which biological agents posed the biggest threat. Boy, we have come a long way since then, in large part because of the BioWatch program. BioWatch has been monitoring the air for potential bioterror agents like anthrax for the last decade. It is a valuable tool because it provides us with advanced warning of a biological attack. If a release of anthrax was detected before it began to adversely affect people, for example, public health officials could take action to mitigate its impact and prevent it from being spread. Local hospitals could be told to be on the lookout for certain symptoms and ensure victims weren't being misdiagnosed. Any time that we can buy through early detection could mean many lives saved. With this kind of biosurveillance system in place, the likelihood of a biological attack inflicting mass casualties and overwhelming our public health system would be greatly reduced. That is why biosurveillance is an essential activity and a national priority, and that is BioWatch is a beneficial program that helps meet our national security needs. But, Mr. Chairman, there is a big ``if'', and I agree with you: those facts only hold true if we can be confident that the BioWatch program works the way it says it should. Experts have in recent years raised a number of technical and management concerns with the BioWatch program. Mr. Chairman, you talked about some of those in your opening statement. This committee's job is to hear about those concerns so we can make sure that the program is on the right path forward. Is the federal, state, and local collaboration running smoothly? Are constructive recommendations being implemented? Is the program now being effectively managed? Is the current generation of BioWatch technology meeting appropriate standards, and is the next generation of BioWatch technology fiscally and technically feasible. I appreciate both of our witnesses today, and I hope they can help us answer these questions. We have heard from officials that Generation 3 that you discussed, which is the proposed new BioWatch technology, could provide more timely threat detection. Before we expend considerable resources on that, though, I think we can be in agreement, we have got to be confident that this technology works. If it can be tested and proven, Generation 3 holds the potential to provide continuous and autonomous detection and expanded population coverage. Unfortunately, the acquisition process for BioWatch Generation 3 has been married with difficulties, and serious questions remain about whether Generation 3 is a viable advance. Last September, GAO reported that decisions were made to go forward with this automation detection technology without the proper due diligence and without justifying the mission need. DHS didn't develop a complete and reliable performance schedule and cost information before approving the acquisition, and if there is one thing we have learned since September 11th, let us just stop throwing money around willy-nilly. Let us make sure that we target it to programs that work. Generation 3 acquisition is currently on hold as DHS tries to resolve these issues, and that seems like the prudent course of action to me. The delays and mismanagement that led us to this point, however, are unacceptable, and DHS must do better. I am looking forward to hearing from Dr. Walter about what has been done to rectify these deficiencies so that we can move forward. The BioWatch program is only a small part of our efforts to detect and to deter bioterrorism. That is why part of our discussion about BioWatch must also ask about broader biosurveillance activities and where this picture fits into the large picture. We obviously can't protect against every potential threat but we should be figuring out what the likeliest threats are, and if our current infrastructure meets the challenges of today as well as the future, given the limited resources. I look forward again to hearing from the witnesses about BioWatch, and I know we will be able to have a constructive discussion about where we go from here, and I yield back, Mr. Chairman. Mr. Murphy. The gentlelady yields back, and now I turn towards the vice chairman of the committee, Dr. Burgess, for 5 minutes. OPENING STATEMENT OF HON. MICHAEL C. BURGESS, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF TEXAS Mr. Burgess. I thank the chairman for the recognition. We have already heard this morning the result of the 9/11 attacks, the anthrax letters in 2001 of escalated bioterrorism from a concept to a reality. In response, the BioWatch program was launched as an early-detection warning system for bioterrorist attacks. Unfortunately, in the rush to launch BioWatch, the government failed to ensure the proper role for the program in the greater United States biosurveillance strategy. Public health is best administered at the local and community level. While BioWatch has the potential to provide valuable data to federal, State and local officials, the promise continues to remain one in theory. The Centers for Disease Control requires reliable, high- quality evidence in order to decide to respond to a bioterrorism event. The Department of Homeland Security, who is in charge of the BioWatch system, has failed to utilize BioWatch to gather the information necessary to guide the decisions of public health authorities. We have another problem. Since 2003, BioWatch has produced 56 false alarms. This unfortunately has the effect of destroying public confidence that public health officials may have had in the system. Federal, state, and local agencies already operate and maintain a wide variety of outdoor air monitoring systems across the United States. The 26th district of Texas, which produces a lot of natural gas through a process known as fracking, maintains a number of air quality sensors, both from the Texas Commission for Environmental Quality as well as the private sector as well. If private companies have the ability to capture real-time air quality data through remote sensing, why do we still lack the ability to detect that that came from a bioterrorism attack? Terrorist threats have changed since 2001. The enemies are developing new strategies that will circumvent our surveillance. Our surveillance and response strategy must improve at an even faster pace. We should identify and address the evidence gaps in our public health surveillance system, ensuring that all United States surveillance systems cooperate to achieve our biosurveillance strategy and prevent those threats before they become a reality. And then lastly, I feel obligated just to mention that back in the early 1950s, the United States Navy undertook a series of exercises that were famously declassified in the mid-1970s that provided evidence that yes, indeed there can be a problem. The dispersal of what was thought to be a harmless bacteria along the coastline in the United States ended up causing illness in a limited number of individuals but nevertheless illness all the same. So it certainly underscores the importance of undertaking this work but it is also important that we get it right. Mr. Chairman, I thank you for the consideration and I will yield back to you. Mr. Murphy. The gentleman yields back. I now recognize the ranking member of the committee, Mr. Waxman, for his opening statement for 5 minutes. OPENING STATEMENT OF HON. HENRY A. WAXMAN, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF CALIFORNIA Mr. Waxman. Thank you, Mr. Chairman, and my comments are going to be similar to my colleagues because we all understand what we are facing today. The history of this is that in 2003 in his State of the Union address, President Bush announced the deployment of ``the Nation's first early warning network of sensors to detect biological attack.'' Just months after this announcement, the BioWatch program was up and running. We have since learned that BioWatch, like other post-September 11 programs, was implemented too hastily and without appropriate long-term planning. But that doesn't mean that the program cannot be repaired. In fact, progress is already being made. In recent years, Government Accountability Office and other analysts have identified legitimate concerns with the management of the BioWatch program that should be addressed, particularly with respect to the acquisition of new early-detection Generation 3 technology. This new technology is promising because it could lead to faster detection in the event of a bioterror attack. According to GAO, however, the Department of Homeland Security approved the Gen-3 acquisition ``without fully developing critical knowledge that would help ensure sound investment, decision making, pursuit of optimal solutions, and reliable performance, cost, and schedule information.'' To protect taxpayers, DHS officials have now put the acquisition on hold until all the necessary steps are taken to ensure we are making a wise investment decision that is grounded in the facts, and that of course is a prudent approach. The L.A. Times, however, has brought other issues to light. In its reporting, the Los Angeles Times exposed a series of false positives identified by BioWatch sensors. As the Times documented, BioWatch sensors have repeatedly indicated the detection of possible bioterror agents that were later found to be harmless, naturally occurring organisms. Fortunately, all of these false positives were identified before the public was needlessly alarmed. When the sensors went off, scientists were alerted to determine if these were legitimate bioterror agents or detections of benign agents. The Department is now working to lower the incidence of false positives, and this seems to be improving. There have been none so far this year. We have also heard about scientific disagreements within the program. Much of the debate about the program's path forward and particularly the acquisition of new Generation 3 technology revolves around complex scientific questions. These types of scientific questions are not surprising in a highly technical program like this. We can't answer the questions ourselves, but we can listen to the experts in biology, epidemiology and detection technology to become better informed, and I hope today's hearing will help in this area. While we hear criticism of the BioWatch program, especially today, we also need to bear in mind its important public safety objectives. BioWatch's early-detection capabilities and its role in facilitating communication between key state and local decision makers can help protect our communities. We should use this hearing as an opportunity to strengthen the program. That is why I am glad that Dr. Walter is here today to discuss the history of the BioWatch program and how the Administration is learning from past mistakes to make the program even more effective in the future. It shouldn't be all that hard, but if we are going to keep this program, let us make sure it is effective. Mr. Chairman, I thank you for calling this hearing, and I thank our witnesses for being with us today to help us answer these questions about this important Homeland Security program. I want to apologize to the witnesses in advance. We have another hearing going on simultaneously, and I am going to have to be going back and forth, but I will have a chance to review the record and my staff is here to learn all the information that will be brought out at this hearing. I yield back the balance of my time, and thank you for calling on me. Mr. Murphy. The gentleman yields back, and thank you for your opening statement. I would like to note and state that all those who just had opening statements agree that this is an area we are unified on in purpose, so now to our witnesses. First let me introduce the witnesses so everybody knows who you are. First, Dr. Michael Walter, welcome here. He is the Detection Branch Chief and BioWatch Program Manager with the Office of Health Affairs at the Department of Homeland Security. He works with labs, public health, law enforcement, and emergency management personnel to assist federal, state, and local governments in developing and testing response measures to biological attacks. In addition to directing operations of the current BioWatch system, Dr. Walter also oversees the testing, acquisition, and deployment of the newer technology referred to as Generation 3. Welcome. Our second witness is Dr. Toby Merlin. He has been with the Centers for Disease Control and Prevention since 2003. He is the Director of the Center for Disease Control and Prevention's Division of Preparedness and Emerging Infections and has been the CDC's main interface with the BioWatch program since 2011. Prior to his current role, Dr. Merlin served as the Deputy Director of the Influenza Coordination Unit during the 2009 H1N1 pandemic. I will now swear in the witnesses, and you are that the committee is holding an investigative hearing, and when doing so has the practice of taking testimony under oath. Do you have any objections to testifying under oath? Mr. Walter. No. Dr. Merlin. No. Mr. Murphy. So now the Chair then advises you that under the rules of the House and the rules of the committee, you are entitled to be advised by counsel. Do you desire to be advised by counsel during your testimony today? Both witnesses indicated no. In that case, if you would please rise and raise your right hand and I will swear you in? [Witnesses sworn.] Mr. Murphy. Both of the witnesses are now under oath and subject to the penalties set forth in Title XVIII, Section 1001 of the United States Code. You may now each give a 5-minute summary of your written statement. Dr. Walter, you may begin. TESTIMONY OF MICHAEL WALTER, PH.D., BIOWATCH PROGRAM MANAGER, U.S. DEPARTMENT OF HOMELAND SECURITY, OFFICE OF HEALTH AFFAIRS; AND TOBY L. MERLIN, MD., DIRECTOR, DIVISION OF PREPAREDNESS AND EMERGING INFECTIONS, NATIONAL CENTER FOR EMERGING AND ZOONOTIC INFECTIOUS DISEASES, CENTERS FOR DISEASE CONTROL AND PREVENTION TESTIMONY OF MICHAEL WALTER Mr. Walter. Chairman Murphy, Ranking Member DeGette, and distinguished members of the subcommittee, thank you for inviting me to speak with you today. I appreciate the opportunity to testify on the Office of Health Affairs' BioWatch program, and I am honored to testify alongside my distinguished colleague from the Centers for Disease Control and Prevention, Dr. Toby Merlin. My name is Dr. Michael Walter. I am the Program Manager for the DHS Office of Health Affairs' BioWatch program. Bioterrorism remains a continuing threat to the security of our Nation. A biological attack would impact every sector of our society and place enormous burdens on our Nation's public health with rippling effects on critical infrastructure. Biological attacks are particularly challenging because they can be so difficult to detect. Early detection is critical to the successful treatment of affected populations and provides public health decision makers more time and thereby more options in responding to, mitigating and recovering from a bioterrorism event. If a bioagent is detected and confirmed to be a threat to the public health, prophylactic treatment could be started prior to the widespread onset of symptoms resulting in a more cohesive response and more lives saved. The BioWatch program is the country's only nationwide program whose goal is to continuously monitor for aerosolized environmental agents. The program consists of planning, preparedness, exercising, training and early-detection capabilities. Deployed throughout the country, the system is a collaborative effort of health professionals at all levels of government. The program is operated by a team comprised of field operators, laboratory technicians, and public health officials from city, county, state, and federal organizations. The current detection capabilities used by the BioWatch program consist of aerosol collectors whose filters are manually collected and retrieved for subsequent analysis in BioWatch laboratories that are located in state or county public health laboratories that are members of the CDC laboratory response network. When a detection of a positive signal occurs, a BAR, or a BioWatch Actionable Result, is declared. A BAR is declared by the Director of the Public Health Laboratory or their designee, not by the federal government. To be clear, a BAR does not mean a terrorist attack has occurred, a viable agent has been released or that people have been exposed, additional information is needed to determine if an attack has occurred and if there is a threat to the public health. A BAR simply means that DNA of a select organism is present. Each BioWatch jurisdiction across the country has a BioWatch Advisory Committee, or BAC, made up of state, local, and federal partners who operate the program and are responsible for planning and leading response efforts. The BioWatch program has succeeded in bringing together state and local public health first responders and law enforcement personnel along with locally deployed federal officials, resulting in communities that are better prepared not only for a biological attack but for an all-hazards response. The BioWatch program relies heavily on our federal partners for expertise in public health, law enforcement, intelligence and technical support to ensure optimum operations throughout the program. To that end, the BioWatch is supported by federal partners including the CDC, the Federal Bureau of Investigations, the Department of Defense and the Environmental Protection Agency, and I would like to take this opportunity to thank Dr. Merlin and the CDC for their continued engagement in support of the program. Consistent with the National Strategy for Biosurveillance, we have been looking at new technologies that could shorten the time to detect including autonomous detection technology. The BioWatch program understands the importance of providing public health officials the timeliest information possible to help them make high-consequence decisions. Automated detection would reduce the time to detect significantly, handing back precious time to our public health officials faced with responding to a potential bioterrorism event. In addition, it would reduce cost of operations while providing continuous collection and analysis capability. The Department is currently conducting an analysis of alternatives consistent with Government Accountability Office recommendations prior to moving forward with a potential acquisition of advanced automated detection technologies. I appreciate the committee's interest in the BioWatch program and your continued partnership as we work to improve our Nation's biopreparedness. The Office of Health Affairs believes strongly in a comprehensive surveillance approach that includes environmental and clinical surveillance as well as point-of-care diagnostics. Thank you for the opportunity to appear today, and I look forward to your questions. [The prepared statement of Mr. Walter follows:] [GRAPHIC] [TIFF OMITTED] T5446.001 [GRAPHIC] [TIFF OMITTED] T5446.002 [GRAPHIC] [TIFF OMITTED] T5446.003 [GRAPHIC] [TIFF OMITTED] T5446.004 Mr. Murphy. Thank you. Dr. Merlin, you are recognized for 5 minutes. TESTIMONY OF TOBY MERLIN Dr. Merlin. Thank you, Mr. Chairman. Chairman Murphy, Ranking Member DeGette and members of the subcommittee, I want to thank you for the opportunity to speak to you today about the Department of Homeland Security's BioWatch program. I am Dr. Toby Merlin, Director of CDC's Division of Preparedness and Emerging Infections in the National Center for Emerging and Zoonotic Infectious Diseases. I am honored to testify alongside my distinguished colleague from DHS, Dr. Michael Walter, with whom I regularly work. CDC works 24/7 to save lives and protect Americans from health threats. Throughout its history, CDC and its local, national, and international partners have worked to detect, respond to and prevent health security threats. My remarks today will describe how CDC collaborates with DHS on the BioWatch program, explain the related role that CDC's Laboratory Response Network plays in this program, and discuss CDC's broader role in outbreak detection and response. All of these efforts are designed to protect Americans from infectious public health threats including threats of bioterrorism. In 2003, DHS initially launched the BioWatch program, which is a nationwide biosurveillance system designed to detect the intentional aerosolized release of selected biologic agents. At that time, CDC helped establish and staff BioWatch laboratories and develop and validate laboratory methods for detection of targeted biologic agents. Since the establishment of the BioWatch program, CDC has provided technical assistance to DHS by ensuring that scientific experts are available for consultations with the BioWatch laboratories and conducting additional laboratory testing at CDC when requested. CDC provides BioWatch laboratories with specialized reagents used in the testing and a system for secure electronic messaging of results. CDC also provides scientific expertise and guidance, especially as it pertains to laboratory methodology and analyses to DHS and states and localities that participate in the BioWatch program. In the event that a biological threat agent is detected through the BioWatch program and it is determined that a response is needed, CDC would coordinate any needed federal public health response. CDC's Laboratory Response Network, or LRN, has 150 member facilities and provides support to DHS's BioWatch program. The LRN is a network of local, state, and federal public health and other laboratories that provide the laboratory infrastructure and capacity to respond to biological and chemical threats and other public health emergencies. Participation in the network is voluntary, and all member laboratories work under a single operational plan and adhere to strict policies of safety, biocontainment and security. Laboratories also perform testing using LRN procedures and reagents provided by CDC, which allows for rapid testing, reproducible results and standard reporting. BioWatch laboratories are usually collocated with LRN sites in the states and they use LRN procedures and reagents in the second phase of testing of material collected from air samples. CDC and the LRN provide support to the BioWatch program by participating in this BioWatch testing and the review steps which are designed to detect a possible release of a biological agent into the air. Laboratory detection and epidemiological response to disease are the foundation of CDC's activities. In addition to managing the LRN and providing support to DHS's BioWatch program, CDC plays a broader, critical role in the detection of and response to local, state, national and international outbreaks of infectious diseases whether naturally occurring or manmade. CDC is home to the country's leading experts and gold- standard laboratories in infectious disease prevention and control. CDC's laboratories serve as an early warning system to rapidly identify, confirm and characterize new infectious disease threats. CDC often serves as a resource for our state and local partners during outbreaks and plays a critical role in identifying disease patterns and linkages across state and local lines. In closing, CDC and LRN laboratories are critical and unique laboratory-based assets to ensure that our Nation is prepared to detect and respond to biological and chemical terrorism. CDC and LRN laboratories are essential to assuring rapid detection of these threat agents and other infectious diseases that pose a threat to the public. The BioWatch program is an important component of this national effort at early detection of biological threats. CDC will continue to work closely with DHS to support the BioWatch program whenever requested specifically in the areas of laboratory testing and public health response. Thank you, Mr. Chairman, and I would be pleased to answer any questions. [The prepared statement of Dr. Merlin follows:] [GRAPHIC] [TIFF OMITTED] T5446.005 [GRAPHIC] [TIFF OMITTED] T5446.006 [GRAPHIC] [TIFF OMITTED] T5446.007 [GRAPHIC] [TIFF OMITTED] T5446.008 [GRAPHIC] [TIFF OMITTED] T5446.009 [GRAPHIC] [TIFF OMITTED] T5446.010 [GRAPHIC] [TIFF OMITTED] T5446.011 Mr. Murphy. I thank both the witnesses here. We want to find out if this BioWatch system actually works, and I guess this speaks to the old adage, we want to know what time it is and we are told how a clock is made, so help us. I respect both of your experience and your intelligence, so help us walk through this.Dr. Walter, this question is for you. In yesterday's Los Angeles Times, former Homeland Security Secretary Tom Ridge, who oversaw the start of BioWatch, stated, ``Everyone knew it''--that is, the BioWatch program--``was a primitive, labor-intensive, fairly unsophisticated attempt.'' That same technology for BioWatch is still out in the field. Do you agree with former Homeland Security Secretary Ridge that BioWatch is a primitive, labor-intensive and fairly unsophisticated tool? Mr. Walter. Thank you for that question, sir. With respect to Mr. Ridge, no, I do not agree with his assessment, and I think it lacks the insight of where the program has come from since the beginning of the program's origin. BioWatch uses the same collector technology that was deployed in 2003, that is true, and BioWatch is a labor-intensive process; that is also true. In the areas of laboratory analysis, our preparedness, our response and our training, Mr. Ridge is unaware of those advances to the BioWatch program and I think they have taken the BioWatch program to the next level and made it more effective. Mr. Murphy. Let me ask you, the BioWatch is designed to detect a catastrophic, covert bioterrorism attack. Is that correct? Mr. Walter. Yes, sir. Mr. Murphy. And for BioWatch to meet its mission, the DHS is supported especially by the state and public health laboratories, correct? Mr. Walter. That is correct, sir. Mr. Murphy. And do you agree that state and local health departments need to have the capability to respond with public health or medical measures to minimize illness and death? Mr. Walter. It is essential, sir. Mr. Murphy. OK. Well, the threat that BioWatch is detecting is a large-scale covert bioterrorism attack, so when BioWatch was launched in 2003, the threat assessment was concerned with large-scale threats posed by state actor programs or terrorists getting possession of biological weapons from state actor programs. Do you agree that there was a large-scale threat in 2003? Mr. Walter. There was a perceived threat, yes, sir. Mr. Murphy. And isn't it correct that the DHS official who conducts the bioterrorism risk assessment has found that under the current threat assessment, a large-scale bioterrorism attack is less likely and small-scale bioterrorism attacks are more likely? Mr. Walter. That is possible, but ``less likely'' doesn't mean impossible, and ``less likely'' means there is still a threat. Mr. Murphy. Let me go on to this. Dr. Merlin, if you could turn to tab 48 of that binder, and I will note while you are looking at that, in a May 23, 2012, email, you wrote, and I will quote it here, ``The Material Threat Assessment, or MTA, which DHS is required to perform by statute, these drive the downstream decisions about medical countermeasure acquisition, diagnostic test development, BioWatch testing and preparedness plans. But the MTAs seem to be developed without input from people who really understand the agents, the diseases or practical implications of these decisions.'' Do you still have these concerns about CDC having input in DHS threat assessment, sir? Dr. Merlin. Mr. Chairman, the answer is no. My concerns have been diminished. The Department of Homeland Security has been working with the Department of Health and Human Services to have a more inclusive process for developing the Material Threat Assessments, and this process is designed to address some of the concerns I addressed so that experts from Health and Human Services are more actively engaged in developing the Material Threat Assessments and Material Threat Determination. Mr. Murphy. Let me try to understand. So you are saying that you don't agree with that statement anymore or you do agree with that statement? Dr. Merlin. I believe steps have been taken to address my concerns. I believe what I said was true, and the existing Material Threat Assessments were performed by the Department of Homeland Security without the desired level of consultation with individuals from Department of Health and Human Services who have more knowledge of the agents. I believe this has been corrected by DHS. Mr. Murphy. Well, let me add a couple levels here and/or concerns. Dr. Merlin, isn't it true that more than 46,000 state and local health department jobs have been lost since 2008, representing nearly 21 percent of the total state and local health department workforce? Dr. Merlin. Yes, that is my understanding. Mr. Murphy. And Dr. Merlin, if you go to tab 34, this document is a presentation to the CDC Director on the quarterly performance review of NCEZID May 25, 2011. Is this your presentation? Dr. Merlin. Yes, it is. Mr. Murphy. And according to this internal CDC document, CDC has concerns about Gen-3 because of potential workload impact on LRN, or the Laboratory Response Network, from an increased number of devices that are continuously sampling and reporting. Do you agree that there would be concerns about Gen- 3 from the potential workload impact on the LRN? Dr. Merlin. Yes. Mr. Murphy. Well, I see I am out of time. I may have to come back to some of these, but I will turn to my ranking member, Ms. DeGette, for 5 minutes. Ms. DeGette. Thank you very much, Mr. Chairman. Well, let us keep talking about this Gen-3 for a while. As I noted in my opening statement, what we were told was this Gen-3 was supposed to provide automated biological threat detections so it would be sort of like a lab in the box, and there have been a number of issues around that. So I am wondering, Dr. Walter, first, can you describe briefly for us exactly what is BioWatch Generation 3? Mr. Walter. Yes, ma'am. I would be happy to do that. If you look at the parts that make up the BioWatch program--filter collection, laboratory analysis and reporting out the results-- and you were to take all of those pieces and put them into a machine, that is what Generation-3, the acquisition program, Generation-3, is to do. Ms. DeGette. And how does that differ from the existing technology? Mr. Walter. The existing technology is very labor- intensive. Somebody has to go and collect the filter, somebody has to bring it to the laboratory, somebody has to analyze the filter, and somebody has to make a phone call with the result. What Generation-3 would do essentially would automate all of that. Ms. DeGette. Right. So it would take the sample and it would do the test, and then if there was some abnormality, then they would notify the folks and then they would come in, right? Mr. Walter. That is correct, if it identified a detection, essentially it creates a BAR. The other thing that Generation-3 does, would also do, is it continuously collects and analyzes, whereas now we have got one sample---- Ms. DeGette. You don't have to go in and collect it? Mr. Walter. Right. Ms. DeGette. Right. So how much do you think it will cost to implement Generation-3? Mr. Walter. I currently don't know because the acquisition program has been on hold, and that would depend on what technologies are eventually selected for deployment. Ms. DeGette. Well, before it was on hold, did you get any kind of bids for it, any estimates? Mr. Walter. We had a lifecycle cost estimate that was done as part of the acquisition process. Ms. DeGette. And what did that show? Mr. Walter. That showed a 20-year lifecycle of $5.8 billion, and the lifecycle cost estimate number goes from initial testing all the way through disposal. Ms. DeGette. Of the 20 years? Mr. Walter. Yes, ma'am. Ms. DeGette. Now, the benefits of a system like this are obvious from your description but do you think that it would be worth the cost, given the fact that we haven't really found any--I mean, I agree, we need to have systems in place but given the fact over 10 years we haven't really had any large- scale bioterrorism, do you think it is worth the cost? Mr. Walter. I think it is. I think the advantages that we would gain from such a system would make the cost worthwhile. I think the increased flexibility that we would get from such a system would make the cost worthwhile. I think the ability to take the system indoors would make the cost worthwhile. And I believe that it would actually reduce the workload on state and local public health laboratories because currently we get a sample every day. With that system, we would only get a sample if something is seen. Ms. DeGette. So it might be really cost-effective over the long run even though there would be a big initial investment? Mr. Walter. Yes, ma'am. Ms. DeGette. Now, you mentioned that the program has been stopped for now. Why, and how did we get to that point? Mr. Walter. There was a Government Accountability Office review of the acquisition methods used as part of the acquisition program, and what they found was essential the Gen- 3 acquisition program straddled the implementation of MD-102, which is, I believe, the acquisition directive that garners how the Department does its acquisitions. When BioWatch Gen-3, the acquisition program, was started, they weren't being deployed or they were just being implemented, so we kind of started in the middle, if you will, and when the GAO came in and did its assessment, they said well, you followed the acquisition processes that were in place at the time but really it is a big program, you probably want to be careful and go back and kind of dot the i's and cross the t's. Ms. DeGette. Are you going back and dotting the i's and crossing the t's? What steps are you taking now to evaluate and develop Gen-3 in a way that will not just satisfy the GAO but will also satisfy the budget hawks on this committee? Mr. Walter. We have instituted an analysis of alternatives. That is being conducted independently of the Department. We have rewritten the mission needs statement and we have formulated what we call an acquisition con ops, which is part of the formal acquisition process, which essentially says if you had this technology, how would you use it. Ms. DeGette. And what kind of a timeline are you on? Mr. Walter. We are expecting the final briefing for the analysis of alternatives in the August-September time frame with a final report in September-October. Ms. DeGette. Super. Mr. Chairman, I would suggest we bring these folks back to talk to us about that timeline and see what they have looked at, see if they have looked at the alternatives, and see if they are planning to go forward with Gen-3. I yield back. Mr. Murphy. Thank you. I now recognize Dr. Burgess of Texas for 5 minutes. Mr. Burgess. Thank you, Mr. Chairman. Dr. Merlin, let me just start out by thanking you and your organization. The CDC has unfailingly been helpful on not just this issue but any time there has been an issue that has affected the public health and welfare of the United States, and your director, Dr. Frieden, has of course come to this committee and discussed with us the nature of novel flu, called me personally when West Nile virus was a problem in north Texas, and then the fungal meningitis outbreak occurred, CDC was in fact the only federal agency that would talk to me and answer the telephone, so I thank you for that. It is good to know that you are there and on the job. Dr. Walter, let me just ask you, you referenced something called the BioWatch Actionable Result and the role of the DHS. Could you kind of define for us what constitutes a BioWatch Actionable Result? Mr. Walter. That is an excellent question, sir. A BioWatch Actionable Result is an analytical result, a laboratory result, and what we do is, we conduct--we don't look for the actual bacteria, we actually look for the DNA of the bacteria and we look for very specific pieces of DNA that we do a two-step process. The first essentially is kind of a screen. We look for signs of the agent, and if it shows up, then we run additional--look for additional pieces of DNA using the Laboratory Response Network agents or reagents that we get from the CDC. And then---- Mr. Burgess. So you do some confirmational activity? Mr. Walter. Oh, absolutely, sir. Mr. Burgess. Now, just from that, you can't confirm or deny that a terrorist attack has taken place, correct? Mr. Walter. No, sir, and that is never the purpose of the BAR. The BAR is simply the detection of the DNA from the agent. Mr. Burgess. And will it show whether or not people have actually been exposed or it just detects the presence of the sentinel DNA in the environment? Mr. Walter. It just detects the DNA, and we have modeling that we can look at to go back and look at where would this plume have gone. But the assessment as far as whether there is a threat to the public health, whether this is a terrorism attack or whether this is something that naturally exists in the environment is made following the BAR, and that is during the national conference call which brings a host of agencies together including the CDC that essentially discusses what the context of this detection is. Mr. Burgess. So I guess that leads to my next question. What process is then put in place? Poor Dr. Merlin is sitting there at the CDC. You give him this information that oh, my gosh, we have got a real problem here, so Dr. Merlin is then looped in through a conference call? Is that what---- Mr. Walter. That is correct. Dr. Merlin or his designee is part of the conference call, and that discussion is, what do we have, where was it found, have we ever seen it before, is there a lot of it, is there a little of it. It includes the FBI and local and state and federal law enforcement and emergency responders. Mr. Burgess. Now, you referenced in your testimony the preventive measures that might be instituted. At what juncture at those triggered? You referenced the prophylaxis that might need to be administered. Where does that come in? Mr. Walter. That would take place after this national conference call if the decision is made that we think this is a bioterrorism attack and/or there is a threat to the public health because they don't necessarily have to be linked. Mr. Burgess. Then Dr. Merlin, when at the CDC level, I mean, you referenced the Laboratory Research Networks. Is this what you do to confirm or to gain additional knowledge about the information that you are given from DHS? Because at some point you have got to tell the doctors yes or no. I mean, DHS can't tell the doctors to prescribe something. You all have to play a role. Is that correct? Dr. Merlin. Yes. We work with DHS and the local jurisdiction that has made the detection as well as other federal agencies to try to gather as much additional information as possible to determine whether the BAR represents an anomaly or a threat, and the sorts of things we will do is, we will ask the local jurisdiction to do additional testing on the sample that they have. We may ask them to go out and perform environmental sampling in the area where the detector was located. We will query intelligence agencies to find out whether there is any indication that there might be a threat with this agent. We will ask subject-matter experts in the field if there are other things they think might be causing this positive, and we will try to quickly gather the information we need to sort of make an informed decision. Mr. Burgess. Very good. In my opening statement, I referenced the data that was generated back in the early 1950s. No one want to see that type of testing go on again but I think it does--the lesson from that is, there is a vulnerability here from a biologic agent, and certainly the work--we want you to get it right, and I was called a budget hawk a minute ago. Yes, I am guilty as charged but at the same time, the primary role, my role defined in the Constitution is the defense of my Nation. I want you all to get it right. It is critically important that you do, and I agree with Ranking Member DeGette that we will need to hear from you again in the fall. So thank you. Mr. Murphy. Thank you. The gentleman's time is expired. We will now go to the gentleman from New York, Mr. Tonko, for 5 minutes. You are recognized. Mr. Tonko. Thank you, Mr. Chair. The whole issue of relationship between DHS and CDC and local public health partners is critical because the BioWatch program depends on local officials in order to execute many of these programs. In the very early days of BioWatch, as has been discussed, the relationship between federal agencies and local public health partners did not work as well as it should. Dr. Merlin, what would you cite as examples of improved communications amongst DHS, CDC and local officials over recent years? Dr. Merlin. There are several things. I think DHS has made a concerted effort to include public health officials and public health responders in their national BioWatch meetings. They hold regular webinars that I believe are monthly for all stakeholders including public health, and whenever they have working groups, they reach out to public health participants, and I am impressed they reach out to public health participants including those whom they know are not their fans. So they try to have those voices at the table. There is an IOM meeting scheduled, Institute of Medicine meeting scheduled next week to go over some BioWatch questions, and I notice there is a panel with a diverse range of public health officials on it. So I do think they actively reach out to include public health. Mr. Tonko. And Dr. Walter, in terms of the overview of DHS's communication efforts with local public health officials, can you give us a sense of how that collaboration has been improved on a day-to-day basis? Mr. Walter. I believe that it has improved in our routine communications because it does take place on a day-to-day basis. We spend a lot of time talking to our state and local partners, and it has been my business since coming into the program in 2009 to arrange the relationship that we have with our state and local public health community as partners in this program. I don't command the BioWatch program and they are not a subordinate command. We work in partnership with them. We have done our utmost to include them in all of the testing and evaluation that we have conducted so far in the acquisition program, the Gen-3 acquisition. We hold focus groups because we have noticed that when we get a large group of them on the phone, they don't say a lot, but when we bring them into a small room with a select group, they are very opinionated and there is a wealth of expertise that we can tap into there. We have brought their laboratories into the program. Prior to my coming into the program, there was--if technology improvements were put in, they were done at a national lab and handed to the state and local labs. Now we work with the laboratories themselves to bring those in. So we have done our utmost to make sure that they are part of the program and that communication is there. Mr. Tonko. Thank you very much. Last July, I believe it was, the President released a National Strategy for Biosurveillance, which outlined guiding principles for strengthening our capabilities, and it called for focusing on core functions, increasing integration and improving information sharing. To each of you, my question would be, how does BioWatch fit into the Nation's larger biosurveillance strategy? Mr. Walter. BioWatch complements the national strategy. There is nothing about environmental surveillance that precludes doing any other surveillance. BioWatch, I believe, complements medical surveillance, it complements syndromic surveillance, it complements point-of-care diagnostics, and it also provides the early detection that we would need because the downside of medical surveillance is, people have to get sick for us to be able to detect them using those methods. BioWatch provides us the opportunity to detect them before they show symptoms so that we get medicines to them before they are sick and start to overwhelm the public health infrastructure, integration as far as the exercising, but the big part of what we do too is the planning and preparedness side, and we know we are not going to be able to--or it is going to be very difficult to respond to a bioterrorism event on the fly. All of that has to be worked out in advance, and a big part of what the program does is work with our state and local jurisdictions to get them prepared, provide them exercises so we know their plans make sense. Mr. Tonko. Dr. Merlin, would you add to any of that? Dr. Merlin. Yes. I basically agree with Dr. Walter. When you look at the biosurveillance strategy, it addresses the spectrum of biological threats to the American population, and the threats can range from small threats that threaten a small number of people to very large threats. The BioWatch system addresses really the very far end of the threat spectrum. It addresses the catastrophic aerosol released, the sort of thing that would be really sort of an act of war, a nation-state type of action. And that is part of the threat spectrum that needs to be addressed. There are of course other things in there, and much smaller attacks like the anthrax letters of 2001, which were a much smaller attack, are a high risk and also need to be addressed in our strategy. Mr. Tonko. Thank you very much. Mr. Chair, I yield back. Mr. Murphy. Thank you. We will now go to the gentleman from Louisiana, Mr. Scalise. You are recognized for 5 minutes. Mr. Scalise. Thank you, Mr. Chairman. I appreciate you having this hearing. Thank you to our panelists. I want to really get into the BioWatch program, Mr. Walter. It is my understanding from the reports I have read that somewhere in the neighborhood of a billion taxpayer dollars has been spent on developing BioWatch since it started in, I think, 2003. Is that correct? Mr. Walter. I think a little less than a billion dollars has been invested in running the BioWatch program, not developing it. Mr. Scalise. How much total between both developing and running? Mr. Walter. Oh, I don't think a lot was put into developing it because the technologies that we use are developed technologies. So---- Mr. Scalise. Developed by whom, and how much money? Who gets the money? Where does that money come from? Mr. Walter. Most of the technologies we use were developed by the Department of Defense, the Centers for Disease Control and Prevention, the technical aspects. We are an operational program. We don't conduct research and development. I take what is available to accomplish the mission and use that. So most of the funding that---- Mr. Scalise. When I read that the Department of Homeland Security spent about $300 million developing this technology, you just said you don't develop technology. Mr. Walter. The BioWatch program doesn't develop it. A lot of that developmental work was done by the Science and Technology Group, which does do research and development and does develop. Mr. Scalise. So for a billion dollars, whether some of it was spent by the Department of Defense, I am sure you all coordinate because ultimately you are implementing it, the bottom line is, it hasn't worked yet. At least it hasn't worked the way it was supposed to. Is that accurate? Mr. Walter. I would respectfully disagree with that, sir. I think everything that we have shows that the process does work. We have instituted an extremely robust quality assurance program that tracks the ability of our laboratories to detect any agent that may be on a filter. Mr. Scalise. Do you get a lot of false positive tests? Mr. Walter. No, sir. What we get--what we have--what we detect are naturally occurring agents. All of the agents that we look for are naturally occurring somewhere in the environment. Most of them are out there endemic, and it stands to reason that we will occasionally detect one or two of them. Mr. Scalise. So I am looking at this report again. It says Department of Homeland Security spent about $300 million developing this technology as well as on Gen-2.5, which was deployed for 2 years and then pulled. Was it pulled because it was working so well or was it pulled because it wasn't working? Mr. Walter. That was before my time, sir. Mr. Scalise. Are you familiar with what the status is and why it was pulled? Mr. Walter. Everything I got was secondhand. My understanding, and this is just my understanding, was that it was pulled because it was expensive, it was pulled because of preparation for the acquisition program, the Gen-3 program. Mr. Scalise. Do you know how much we have spent on it? Mr. Walter. I do not, sir. I am sorry. Mr. Scalise. If you could get the committee that information? Mr. Walter. Sure thing, sir. Mr. Scalise. I wanted to ask you about the internal investigation. It is our understanding that there has been an internal investigation into BioWatch. First of all, are you familiar? Did you all do an internal--maybe before you were there, but I mean, are you aware of an internal investigation? Mr. Walter. I am not aware of an internal investigation into BioWatch itself. Mr. Scalise. Or an employee at BioWatch that may have been removed for mismanagement? Mr. Walter. It may have been but that is before my time, sir, and I can't comment on that. Mr. Scalise. OK, but I mean, you are there now, you are heading this up. We are trying to get more details. Again, a lot of taxpayer money is involved in this. If there was mismanagement by an employee, by many employees, if someone was removed and maybe somebody that was removed is now back working on the program, we are hearing about all this secondhand but supposedly there is an internal investigation that was done and some documentation about this that we don't have. I think it is real important that this committee get that information. Can you, number one, go and find out if there was an investigation done by your agency, and if so, can we get a copy of that information? Mr. Walter. I am aware of an investigation that was undertaken. I don't know really the details of why it was undertaken. Mr. Scalise. Can you at least assure us that you will get us a copy of that investigation? Mr. Walter. I give you my word, I will try, sir. Mr. Scalise. Why would you not be able to get it to us? Mr. Walter. I don't know. Mr. Scalise. If you tried, it would happen, so I am just asking if you can make it happen. Mr. Walter. I will make it happen, sir. Mr. Scalise. I appreciate that very much because, I mean, when we are hearing about all this and we are hearing that maybe there was an employee involved in mismanagement and that the employee was maybe removed but now the employee is back over there, I mean, that raises a lot of questions that we have about the program. Mr. Walter. I can tell you that no one currently on the BioWatch program was removed and then brought back into the program. Mr. Scalise. So as long as you are going to get us that information, that will at least help answer a lot of these questions. We shouldn't have to wonder and speculate about it if you have got an investigation somewhere in your agency, you can get that to us and then that will remove the cloud of speculation and we will know exactly what is going on to be able to proceed from there. So I appreciate that, and I thank the chairman for his discretion and yield back the balance of my time. Mr. Murphy. The gentleman yields back. We will now go to the gentleman from North Carolina, Mr. Butterfield. Mr. Butterfield. Thank you very much, Mr. Chairman, and let me thank both of the witnesses for their testimony today. Mr. Chairman, I always begin whenever I can asking witnesses questions about the impact of sequestration is having on their agency because so many of our constituents really don't fully understand the full impact that sequestration is having on the functions of government, and so let me just start with sequestration and start with you, Dr. Walter. It is my understanding that many DHS programs are exempt from the impact of sequester but certain programs related to the implementation of the BioWatch program may be impacted. What impact has sequester had on DHS programs related to the BioWatch program? Mr. Walter. The BioWatch program was not exempt from sequestration. It has decreased our contact with our state and local jurisdictions in that our travel budgets have been reduced. It has decreased our ability to bring state and local public health and emergency responders in for focus groups and discussions with them. And it has decreased our ability to carry out certain improvements to the program that we had planned. Mr. Butterfield. Can you quantify this by percentage? Is it 8 percent, 6 percent? Mr. Walter. We are looking at around--I think we are looking at around 5 to 10 percent, in that range. Mr. Butterfield. And you do realize that unless sequestration is reversed or repealed, this is a 10-year proposition? It is not a 1-year deal. Mr. Walter. I understand. Mr. Butterfield. And does it have long-range implications for the program? Mr. Walter. Yes, sir, it does. As we move over time, obviously we have contracts that have inflation clauses built in that we will have to cover, and we will basically have to pare the program down to doing just the basics of what we need to do and not improve the program as we would like to. Mr. Butterfield. And I understand the GAO has made some recommendations to you that you would like to implement that this may impact. Has the GAO made any recommendations? Mr. Walter. Not that I am aware of, not relative to sequestration that I am aware of, sir. Mr. Butterfield. I mean to the actual programmatic part of your work. Mr. Walter. They have done that, and we have implemented them. This primarily was geared towards the acquisition program, the so-called Gen-3 program, and we have implemented those recommendations. Mr. Butterfield. And Dr. Merlin, can you speak to it from the CDC aspect? Dr. Merlin. Yes, Congressman. I can tell you about the immediate impacts it has on the work in my division. We have decreased the number of proficiency testing challenges that we provide to the members of our Laboratory Response Network because those are--each one has a cost associated with it. We have also had to decrease the amount of reagents that we keep for surge, a potential surge in demand in reagents that we would need in a large-scale event, and in terms of the funding that we provide to state and local health departments through my division and other parts of CDC that contribute to the ability of those health departments to respond to outbreaks in bioterrorism, the amount of money has gone down. It has gone down through our budget constraints because most of the money that CDC receives goes out to state and locals. The response of the cut to us passed on to state and locals. Mr. Butterfield. Are we talking between 5 and 10 percent as DHS has experienced? Dr. Merlin. For us, the number is around 5 percent. Mr. Butterfield. All right. Back to you, Dr. Walter. Is it possible that newer and more efficient biosurveillance technologies could reduce costs enough to enable the expansion of the BioWatch program to new municipalities? Mr. Walter. Yes, sir, it is. Mr. Butterfield. And Dr. Merlin, the number of false positive BAR results in 2013 has decreased to zero, and that is probably good. Can you explain the CDC's role in eliminating false positives and elaborate on the success of the serial testing strategy? Dr. Merlin. We worked closely with Department of Homeland Security to try to effectively reduce the number of false positives that were being caused by an organism related to one of the target organisms, Francisella tularensis, and together we have implemented three changes in the testing protocol that have caused a reduction in false positives. One is that we reduced the number of cycles of reaction that is used for detection. Another thing we have done is, we have--DHS has actually implemented use of another reagent for screening. They have used the Critical Reagents program reagent rather than a CDC reagent for screening. And the third thing and importantly---- Mr. Butterfield. I think the chairman is tapping on the table there. Can you just give us the last sentence? Dr. Merlin. They have put in a test that distinguishes this near neighbor from the target, which enables us to say no, that is a near neighbor, and we know it is not a target, and to not react to it. Mr. Butterfield. Thank you. Yield back. Mr. Murphy. The gentleman yields back. Now we will recognize the gentleman from Texas, Mr. Olson, for 5 minutes. Mr. Olson. I thank the chair, and welcome to the witnesses. Dr. Walter, Dr. Merlin, welcome. I am concerned like we all are about an attack by a biological weapon. I am a Member of Congress from Houston, Texas, about to be the third largest city in America. There is no better target for biological attack than Houston, Texas. We are the largest foreign tonnage port in America lined by the largest petrochemical complex in the world. We have the largest medical center, the Texas Medical Center, just south of downtown. There is no better target for biological attack by terrorists either with conventional bombs, sort of dirty nuclear weapon, chemical weapons or a biological weapon, and the scariest of these may be a biological attack. Say let us go to the Texas Medical Center and launch that weapon in the air conditioning system and disappear, long gone before anybody realizes that you have been attacked. The biological weapon flows through the air conditioning system all over the Texas Medical Center. Within hours, days, weeks, people are becoming infected, and that is a big problem. Most importantly, it is not just people being infected but the people that are infected are the professionals that are needed to recover from this attack. And so one other point for my colleagues: If you want to lose some sleep, come down to Galveston, Texas, to the Galveston National Laboratory on the campus of the University of Texas medical branch. It is one of two bio 4 labs in America, a very, very secure place with all sorts of very dangerous chemical and biological weapons, mostly biological. I have been down there on a tour. I put on this pressure suit, negative pressure, went through a couple of locked doors and watched these men and women working on agents that if they got out in this room right now, many of us would not walk out of here alive within minutes. So this is a very, very scary proposition, and we need--it is so important that we spend our limited resources on products that work. I am concerned about Gen-2, more importantly, Gen-3. And my first question is for you, Dr. Walter. Is there a concern that the BioWatch program doesn't fully understand how the current generation Gen-2 works, that these concerns are real? How we can be confident that Gen-3 will work? Mr. Walter. No, we are very confident in the way the Generation-2 system works, sir. We track our performance under our laboratory analysis. We know what we can detect at what concentrations and with what statistical confidence. We have recently actually just completed another test of our collection and analysis operations out at Dugway, Utah, where we looked at what is the minimum number of bacteria we could collect in the atmosphere using chambers, of course, and then how would we-- how does that number translate through our analysis. So we have a very good understanding of what our technology is capable of doing. Mr. Olson. And you mentioned Dugway, sir. The analysis on alternative testing done by this fall includes a cost-benefit comparison between Gen-2 and Gen-3 but DHS won't have the data from Dugway until sometime in the fall of this year so you are bringing up online before you actually have the data. Mr. Walter. No, the data that will be produced from Dugway will be the technical performance of the technology. That will be done in the July-August time frame. We expect the analysis of alternatives that is going to include the Gen-2 system to be done about the same time, and any information that the performer for the AOA is requesting, we are making sure that they get it as quickly as we can get it to them. Mr. Olson. Dr. Merlin, how about your concerns about Gen-3? Dr. Merlin. Congressman, my concerns about Gen-3 have primarily to do with lack of information about the performance of the assays, and Dr. Walter and I have had and his staff have had exchanges about a number of concerns that my colleagues at CDC had about particular technical aspects of what was in the phase I of Gen-3, and we are just concerned that the technology be right and that we know what the limits of detection are likely to be and that we know what the limits of detection are going to be in a performing area. So my concerns are basically about the availability of data on the performance and an appropriate review of the data on the performance. Mr. Olson. I share those concerns. I am out of time. I yield back. Mr. Murphy. I thank the gentleman from Texas. Now to the other gentleman from Texas, Mr. Green, for 5 minutes. Mr. Green. Thank you, Mr. Chairman, and again, I thank our witnesses for being here. I also have a district just north of Galveston, and I have been to the bio lab. I was impressed in watching it being built, and in 2008 when Hurricane Ike literally went over that area, that was the one building at the University of Texas Medical Branch that was not damaged, and there was no issue because we have learned in Texas, you don't put your generating equipment on the bottom floor when you have four or five foot of water. So you put it on top. But again, I am pleased that we are taking the time to examine BioWatch because of how importance it is. Last Congress, I worked with colleagues on this committee on the legislation, the Pandemic and All Hazards Preparedness Act. We worked together to make sure the relevant agencies had the tools to identify threats including those originating from terrorists and address those threats effectively, and I know at the bio lab, as my colleague and my neighbor talked about, the National Lab there in Galveston, does tests and working on developing vaccines for SARS, West Nile encephalitis, avian flu, influenza as well as microbes that are being deployed by terrorists. That topic is important to me. The relationship between DHS, CDC, and local public health partners is critical because BioWatch programs depend on our local officials. They execute many of the program's most important functions. But in the early days of BioWatch, the relationship between federal agencies and local public health partners did not work as well as it should have. Dr. Merlin, have communications between DHS, CDC, and local officials improved in the last few years? Dr. Merlin. Congressman, I have been with this program at CDC for 2 years, and I personally think there has been substantial improvement in the communications. I believe that we now regularly have very candid discussions about concerns from local public health and that we have very candid discussions about concerns that my colleagues at CDC have about technical aspects of the BioWatch assays. I admire the fact that Dr. Walter includes, as I mentioned earlier, includes people in these discussions that he knows are critical to the program, and I think that is a good thing. Mr. Green. Do local public health labs have proper federal guidance on what to do in the event of what appears to be initial positive test result known as a BioWatch Actionable Result? Dr. Merlin. Congressman, I think the answer to that is both a yes and a no. The BioWatch program recently released a new version of its outdoor guidance, which is guidance to the BioWatch jurisdictions on how to respond to an outdoor release. There is--and Dr. Walter is aware of this, there is no indoor guidance, which means that there is no formal guidance on how jurisdictions should respond to an indoor release, and I know the program is working on that. There are also a number of important issues related to environmental sampling and how to conduct the appropriate environmental sampling that had been worked on collaborative by DHS and EPA and CDC for a number of years but there is no formal guidance out there that I think the locals really need. Mr. Green. I only have another minute. Obviously the partnership between the CDC and locals is very important. In fact, just as we came up, welcome to the Gulf Coast in summer, we have some our mosquitoes that have been tested and found to have West Nile encephalitis, not in the Galveston area but further north, and so this is important. And I know from your testimony you have had to cut back some of your public health meetings with local officials because of the budget constraints but I know you also do conference calls. Have you all increased that since you can't do the physical presence? Mr. Walter. That is correct, sir. We have increased our conference calls. We have started a webinar series. And we are doing our best to keep our communications open. We also have a number of liaisons, we call them jurisdictional coordinators, who are in all of our BioWatch jurisdictions who also serve to keep us informed and keep the program and our state and locals informed as to what is happening. Mr. Green. And again, from a military perspective, the troops on the ground are those public health agencies, so obviously the more we can relate from what we do here and CDC and what you all do. Thank you. Mr. Murphy. The gentleman's time is expired. Now we will go to the gentleman from Ohio, Mr. Johnson, for 5 minutes. Mr. Johnson. Thank you, Mr. Chairman. Dr. Walter, I will try to look around you here and still get to my microphone. According to the information provided by DHS, there have been 149 BioWatch Actionable Results, or BARs, since the BioWatch program started in 2003. is that correct? Mr. Walter. That is correct, sir. Mr. Johnson. And these BARs represent naturally occurring biological pathogens detected from environmental sources. Is that correct? Mr. Walter. Yes, sir. Mr. Johnson. In a July 12, 2012, DHS blog posting, DHS Assistant Secretary for Health Affairs, Alexander Garza, wrote this. He said, ``Out of these more than 7 million tests, BioWatch has reported 37 instances in which naturally occurring biological pathogens were detected from environmental sources.'' Given the figure of 149 BARs reported to the committee, the 37 instances was an incorrect number. Is that correct? Mr. Walter. That is correct, sir. Mr. Johnson. OK. Were you involved in writing the blog posting for Dr. Garza? Mr. Walter. I reviewed it, and I missed that. Mr. Johnson. OK. Were you the one that provided him with those statistics? Mr. Walter. No, I don't know where those statistics came from but I should have caught it, and I didn't. Mr. Johnson. As the BioWatch program manager, didn't you know you had over 149 BARs by July 2012? Mr. Walter. Yes, sir. Mr. Johnson. You got any thoughts if you reviewed it, how did we miss it? I mean, this is an important system. Mr. Walter. I missed that number in his blog. I am very aware of the performance of the system, and I am very aware of any issues that come up with the system that impact its performance. Mr. Johnson. Did you provide the correct statistics--or let me go back. When did you find the error? When did you realize that there was an error? Mr. Walter. It was shortly after the blog was posted. Mr. Johnson. Did you provide the correct statistics to Dr. Garza? Mr. Walter. Yes, sir, I did. Mr. Johnson. Do you know if they corrected the record? Mr. Walter. I believe they did. Mr. Johnson. Dr. Merlin, would you please go to tab 36 in your material? In this June 24, 2011, e-mail, you discussed, and I quote, ``the squishy definition of a BAR.'' You go on to write, ``What is the action here? Who has made the final determination of the action to take? What is that determination? There seem to be different definitions of a BAR according to the jurisdiction, e.g., New York City versus Houston.'' How do definitions differ between New York City and Houston? Dr. Merlin. Congressman, the primary source of the problem, I believe, is use of the word ``actionable'' because without defining specifically what actions are taken on the basis of this, it leaves it to the mind of the jurisdiction on to what the appropriate action is, and I personally believe that we should do a better job of defining of what an appropriate action is and based on concerns like this, the Department of Homeland Security in this most recent outdoor guidance has become much more specific about what they mean by an action. In the absence of a definition of an action, some jurisdictions may feel that this means that the area where the BAR is detected should be cordoned off and evacuated. Other jurisdictions may simply feel that it means that they send in a team to do sampling, and I think because we know technically what testing is being done, I think we need to tell people what we think is appropriate. Mr. Johnson. Are there still different definitions of BARs today based on your concerns about ``actionable''? Dr. Merlin. I will defer to Dr. Walter. He may know better than I do. I think we have gotten closer with the most recent outdoor guidance in terms of situational assessment but I am sure that all of the BioWatch jurisdiction committees are on the same page. Mr. Johnson. Mr. Chairman, I yield back. Mr. Murphy. The gentleman yields back, and now to the ranking member of the full committee, Mr. Waxman, for 5 minutes. Mr. Waxman. Thank you, Mr. Chairman. Last October, the Los Angeles Times reported on the failed deployment of BioWatch Generation 2.5, which was supposed to provide interim automated detection capability before the deployment of Generation 3. The technology suffered from delays and issues related to scientific validation and I would like to hear from our witnesses today about how this happened and what steps have been taken to ensure that it won't happen again. The Los Angeles Times reported that the BioWatch program put new testing assays called multiplex assays into use without adequately validating them. According to the article, the tests were used for 2 years from 2007 to 2009 before it became clear that they were so insensitive to the presence of bioterror agents that they were unsuitable for BioWatch. Dr. Walter, I know these programs occurred before you became the head of the BioWatch program. Still, I would like to get your views on the allegations of the L.A. Times story. Was the BioWatch program relying on inadequate tests for two full years? Mr. Walter. I honestly can't answer that question. I would like to think they are not, but what I can tell you is that before we deploy assays now, we have a very robust testing and evaluation process in place. We track the performance of those assays on a daily basis. We conduct proficiency tests of our laboratories periodically throughout the year and we conduct independent audits of our laboratories periodically throughout the year. Mr. Waxman. And what actions were taken when the program officials discovered these problems? Mr. Walter. I believe the system was withdrawn but, like I said, this is before my time and I really can't speak to it. Mr. Waxman. Well, this is an important development, and it is like being told that the salesperson that defrauded you was no longer here and therefore you don't know anything about it, but you are the head of the program and you ought to know what happened not that long ago, 2007 to 2009. Well, there was a problem. What corrective measures were taken to ensure that something like this won't happen again? Mr. Walter. For the Gen-3 program, which is the acquisition program, which is the technology that would be deployed in place of the Gen-2.5, we have instituted a multiple-phase process that has an enormous amount of testing and evaluation attached to it. That testing and evaluation is decided upon in a committee that includes our interagency partners including the CDC. Those results are made available to all of the members of that group, and nothing goes forward unless it meets the requirements that we have set forward for the deployment of this technology. Mr. Waxman. Can Americans have confidence now that the tests used in the BioWatch programs are capable of detecting a bioterror attack so public health officials can act quickly? Mr. Walter. I believe they can, sir. We have done our best to make that happen. Mr. Waxman. You have done your best to make sure that doesn't happen but you don't know what happened in the past. Mr. Walter. I mean, I am hesitant to speculate on what happened to the program before I was here. I understand that the technology was deployed. My understanding was that it was essentially initially thought to be kind of a pilot to look at developing con ops. It was then actually deployed, from what I understand, and then there were issues that developed relative to some of the assays that were used. I am sorry I don't have the details of that. Mr. Waxman. Well, the BioWatch program has been plagued by technical and management problems, and I hope you and your team have put these problems behind us so that the program can move forward. Mr. Walter. We are doing our best. Mr. Waxman. Thank you. Mr. Chairman, I yield back my time. Mr. Murphy. The gentleman yields back. Now to Mr. Harper for 5 minutes. Mr. Harper. Thank you, Mr. Chairman, and thank you, gentlemen, for being here, and Dr. Merlin, I know we have had a lot of concerns obviously and work done on the state and local level as they try to look through this, and I would ask if you would go to tab 35 in your notebook there. In a May 26, 2011, email, CDC scientist Michael Farrell wrote this in part in that email that you are looking at: ``Bottom line for me is that despite whatever changes they have done or assay or systems validation that they performed, the Gen-3 system with these assays is going to be dead on arrival at the public health service labs, especially and importantly at NYC. This will be simply because of a lack of confidence due to previous experience with environmental cross-reactivity and the problematic APDS, or Gen 2.5 deployment. Confidence in the system is going to be paramount with the current actionable nature of the signal that is intended. I just don't see how this is going to be possible.'' Now, Dr. Merlin, do you agree with that statement or disagree? Dr. Merlin. It is difficult to give a yes or no answer. My colleague, Dr. Farrell, was talking about what he knew about the development of Gen-3, the basis of the testing and the signatures that were being used, and the similarities of that system to the multiplex system that was just referenced that had been withdrawn, and because that previous system had failed, Dr. Farrell was very concerned that this was going down the same line. What Dr. Farrell didn't know at the time and we found out subsequently was that this system was the first phase of a multi-phase development for Gen-3 and was not intended to be the final product, and that is what we found out in a meeting with Dr. Walter and his staff. I am benefited by having people who report to me who are quite candid about their concerns, and I take them forward to the BioWatch program. Mr. Harper. Dr. Merlin, let me ask you this. Has prior mismanagement by DHS and extended scientific disputes with DHS negatively impacted the confidence the CDC and the public health laboratories in working with BioWatch Gen-3? Dr. Merlin. I think the scientific community wants to see data. They want to see data, and it needs to be conveyed in a fashion that isn't ``trust me, I have the data, it supports that this works.'' They really want to see the data. Mr. Harper. Can you go to tab 46 and let us look at that for a moment? And this is a May 2012 email where you stated about the historical tensions in the BioWatch program, and you said, in part, ``I think the bottom line is that NYC public health feels that public health is struggling to be heard in a program that is dominated by DHS and law enforcement but which has huge implications for public health departments.'' Is this still the case? Dr. Merlin. This references the particular situation in New York City and the New York City jurisdictional BioWatch Advisory Committee, and I know that both Dr. Walter and I have struggled with this. New York City specifically asked me to become personally engaged and to go there as a CDC representative because they thought there wasn't a sufficient scientific voice at the table of these discussions. It is the nature of the constitution of these individual BioWatch Advisory Committees and I think they vary from jurisdiction to jurisdiction. Mr. Harper. So is this still the case? Dr. Merlin. I think it is still the case. Mr. Harper. Thank you. I will yield back the balance of my time. Mr. Murphy. The gentleman yields back. Now to the gentlelady from North Carolina, Ms. Ellmers, for 5 minutes. Mrs. Ellmers. Thank you, Mr. Chairman, and thank you to our two gentlemen who are with us today. I am listening to the testimony, and I am listening to the questioning, and you know, sometimes I end up with more questions after I hear the discussion. I am concerned about some of the issues with false positives or no false positives, what has been detected in the past, what has not, and you know, basically is this an effective system, and are we, you know, developing a system for future use but not necessarily taking into account things that have happened in the past and making it the most effective plan as possible. Going back to some of the discussion that has already taken place in association with Assistant Secretary of Health Affairs, Dr. Alexander Garza, Dr. Merlin, do you agree with the way that Dr. Garza articulated the performance record of BioWatch by stating that BioWatch has never had a false positive result? Dr. Merlin. No, Congresswoman, I do not agree with that characterization. Mrs. Ellmers. OK. Great. Dr. Walter, according to the GAO, in order to build user confidence in the system, BioWatch has established a stringent threshold of one in 10 million for the false positive rate. That is the rate at which the system is allowed to indicate a pathogen is present when one is not. Is that still the threshold and is that correct? Dr. Merlin. I believe it is, yes, ma'am. Mrs. Ellmers. OK. Moving on, in that thinking, a pathogen, we mean the threat agent to be detected, not the near neighbor background organism? Dr. Merlin. That is correct, ma'am. Mrs. Ellmers. OK. That is two yeses. Wonderful. So keeping that in mind with the development of Generation-3, DHS has changed the definition of false positive from the one used in Generation-2 in which the definition of false positive means the system indicated the DNA of the bacteria including those of the near neighbor. Is that correct? Is that the change--has that change occurred in relation to the Generation-3 or is that yet to be determined? Dr. Merlin. No, I think that has yet to be determined but when we look at a detection, we believe we are detecting the actual organism, not the near neighbor. With Francisella tularensis, the DNA assays we had deployed weren't specific enough to go down into what are known in--and I am sorry I am going to throw microbiology at you but the subtypes of these organisms that actually cause the disease, and so what we were detecting was actually there. It was Francisella tularensis. It is not a near neighbor. It is potentially not the pathogenic form, that subtype of Francisella tularensis. Mrs. Ellmers. I guess that brings me to the question of specificity. So the Generation-3 operational requirement document defines specificity as the ability to detect strains of the target species without detecting near neighbor or background organisms. So under that definition, the BioWatch systems detection of near neighbors would be false positives? Dr. Merlin. That is correct. Mrs. Ellmers. That is correct? OK. And then one last question, I have about a minute left. Dr. Merlin, during the interview with the committee staff, you compared BioWatch to the Magna Line. What did you mean by that? Dr. Merlin. I compared it to the Maginot Line, which was a French defensive line built prior to World War II to protect against a German invasion where the French general staff believed that the Germans were most likely to invade. Ms. Ellmers. Right. Dr. Merlin. And it was a wonderful defensive mechanism. The problem was, it wasn't where the Germans chose to invade; they invaded through Belgium and the Netherlands into northern France. And I made the comparison because we need to be careful that we build our defenses across the entire spectrum of where attacks might come, not where we think, you know, this is going to be, and that is what--in reference to the earlier strategy, biosurveillance strategy, we need to a strategy that cuts across a spectrum of threats. Mrs. Ellmers. Right, not just where we might assume something would happen. Dr. Merlin. Or we most fear. Mrs. Ellmers. OK. Thank you very much. Thank you both very much. I yield back the remainder of my time. Mr. Murphy. On your time, I want to ask a follow-up question to what she said. Do we have actual numbers on the specificity and sensitivity of the Gen-2 and the Gen-2.5 and Gen-3 in term of these, you know, similar to other medical tests that we have some sense of, is it 20 percent, 50 percent, 80 percent? Where are we with those? Mr. Walter. We conducted--as part of the first phase of the Gen-3 acquisition, we conducted a number of assay evaluations using the CDC assays and the critical reagent assays that we employ operationally to test the assays that were being proposed for the first phase of the Gen-3 systems that we were testing, and that data essentially looked at the specificity and the sensitivity of the assays that we employ under laboratory conditions, and that information was compiled and actually transferred to the CDC for their use as well. Mr. Murphy. Well, do we have those numbers? Dr. Merlin. Yes. We have turned over to the committee staff information related to the testing we performed on the LRN assays that are used in the Generation-2 system, and you can certainly--if you don't have it---- Mr. Murphy. We will put it out then. Thank you. I now recognize the gentleman from Florida, Mr. Bilirakis from the full committee, for 5 minutes. Mr. Bilirakis. Thank you, Mr. Chairman. I appreciate it very much. Thank you for allowing me to sit on this panel. I have been actively interested and involved in oversight over BioWatch, the program, for a couple years now. We all wish to ensure a comprehensive biosurveillance capability. However, we must be smart about how we accomplish that goal. I think we all agree, this capability must be reached in the most effective and efficient manner, must be based on sound science and must ensure an appropriate return on taxpayers' investment. We must not lose sight of the greater goal of overall preparedness by harnessing all of our resources toward a single static technology. I have a question for Dr. Walter. When it used this report on BioWatch last year, the GAO confirmed that there has been no comprehensive cost-benefit analysis done to ensure that the $5.8 billion that have been spent over BioWatch's lifecycle will buy down risk sufficient to justify such a large expenditure. Doctor, can you please update the subcommittee on any efforts to measure the cost-effectiveness of the BioWatch program? Mr. Walter. We are currently conducting an analysis of alternatives relative to the Gen-3 acquisition, and part of that analysis of all alternatives will include a cost-benefit analysis. Mr. Bilirakis. OK. When are we going to have any---- Mr. Walter. We should be getting the final briefing on that in August. We expect that with a final report in the September- October time frame. Mr. Bilirakis. And you will report back to us? Mr. Walter. I will do that, sir. Mr. Bilirakis. OK. How much more certainty is gained from Generation-3 machines? Do we know the decrease in human morbidity and mortality? I know most of the members have touched on this, but if you can expand. Mr. Walter. Currently, there is no Gen-3 program, acquisition program. It has all been placed on hold. So that would depend on the acquisition, the technology that would be eventually deployed. As originally advertised, we would be increasing the number of systems that were deployed and actually increasing the number of cities to which the systems were also deployed in and then also taking the system indoors. Based on all of that, you would expect that our resolution of where the attack took place would be better because we have more sensors out. We would be getting more frequent analysis during the day. We would be getting up to eight analyses as opposed to one, so our timeliness would be improved and we can take the system indoors so we would know a lot more a lot faster and able to reduce morbidity and mortality if we can respond appropriately. Mr. Bilirakis. Dr. Merlin, do you want to comment on that? Dr. Merlin. I agree with Dr. Walter's assessment that the transition from Generation 2 to Generation 3 would increase the testing frequency and increase the number of testing sites, and would decrease the amount of time available, and those are essential features. What we need to know is how sensitive the system would be, what its lower limits of detection would be, and how specific it would, how many false positives it would give in an operating environment in order to know how it truly performs. There are a number of determinants of performance. One is how many you have, how often you do it, and the other is how well it works, and what we don't know is how well it would work. Mr. Bilirakis. OK. Thank you. Next question. BioWatch comprises about 80 percent of the Office of Health Affairs' budget but constitutes just a single niche of the very broad mandate that is biosurveillance. Aside from BioWatch, are there other things we need to be doing to fill other capability gaps, Dr. Walter? Mr. Walter. I think we need to make sure that BioWatch is not mutually exclusive of other surveillance systems. BioWatch needs to complement medical surveillance. BioWatch needs to complement syndromic surveillance. BioWatch needs to complement point-of-care diagnostics. Also, out of the detection realm but into the preparedness and training realm, we need to make sure that our jurisdictions, our state and locals, know what they are going to do in the event of a biological attack, which is a major part of what the BioWatch program spends its time doing. It is not our responsibility nor do we want to develop their response cutoffs but we do provide them with guidance documents, points to consider, and we do provide them with a robust exercise program to see if those plans they put in place make sense. All of that together is a big part of how we are going to--what we need to do improve biodefense in the country. Mr. Bilirakis. Very good. I understand that Gen-3 BioWatch system uses local laboratories to manually analyze filter samples for the presence of suspicious bacteria. I can imagine that there are likely several hundreds of scientists and laboratory technicians involved in this activity across the United States. If Gen-3 technology works as planned, then the need for manual analysis would be most likely eliminated. Would this result in reduction of BioWatch laboratory workforce and thereby saving taxpayer dollars, or does it not save money because the system is so expensive? Either one of you. Mr. Walter. I think that is probably mine. You are correct in that as we envision it, the only laboratory analysis that would need to be done is in the event of an automated system detecting something, and either going forward and collecting additional samples or getting an archived sample from the unit or units that have shown a positive in doing that analysis. So we would actually need less support on our field operations and also less support in our laboratory operations. We would still need to support state and local public health because we would basically be trading the manual part in for interpretation of results. What is the machine telling us? Who do I need to make sense of that. So there wouldn't be a wholesale--we couldn't subtract off the funding that we need to support the field and laboratories but I believe that would be reduced. Mr. Bilirakis. What do you think, Dr. Merlin? Do you think we will save some money? Dr. Merlin. I think the jury is out on that. I think almost invariably new technology programs are offered with the promise that they are going to save money by saving labor and decreasing costs, and often that doesn't turn out to be the case. One question will be the actual acquisition costs, and from the numbers I have heard, the actual acquisition costs and operating costs are greater than the current Gen-2 costs. I don't see how there could be a net savings of money. There is going to be an increase anyhow. And then there is a question in the rollout period once it is rolled out what the implications are of the downstream effects on public health departments and the need to support it. I think it is just very hard in a program like this to speculate what the operating costs are truly going to be. Mr. Bilirakis. I appreciate that. Thank you very much. I yield back, Mr. Chairman. Mr. Murphy. Thank you. Just a quick question. The President in July 2012 released the National Strategy for Biosurveillance. He said he would have a strategic implementation plan in 120 days. Do either of you gentlemen know if we have one yet? Dr. Merlin. On the way here yesterday from Atlanta, I got an email saying that the implementation plan had been posted. I didn't have a chance to look but it should be--if it is there, it should be on the Executive Office of the President Web site. Mr. Murphy. Would you please help make sure we see that too? And also about the costs. On July 16, 2008, the GAO testified at the House Homeland Security Subcommittee hearing that the Generation-2.5 lab-in-a-box units would cost $120,000 per unit and $65,000 to $72,000 annually per unit to operate and maintain. According to a slide from DHS scientists in December of 2011, the cost estimates for Gen-3 showed $117,000 per unit, which is comparable to Gen-2.5, but a much higher $174,000 per unit for operation and maintenance for Gen-3 lab- in-a-box services. So Dr. Walter, why is the operation and maintenance for Gen-3 devices more than $100,000 higher per unit than the Gen-2.5? Do you know? Mr. Walter. I do not know that. Like I said, Gen-2.5 predates me. I know Gen-2.5 was a fairly expensive system to maintain but we are also looking as part of the acquisition to reduce the costs of maintaining those systems. Most of the costs in maintaining or fielding an automated detection system is going to be in operations and maintenance, and anything we can do to reduce those costs is going to work in our favor. Mr. Murphy. Well, thank you. I think we heard today on both sides of the aisle the concern about these costs, the effectiveness, the sensitivity and specificity, and we will want to continue to work with you to make sure that we have that information. I ask for unanimous consent that the written opening statements of members be introduced into the record, and without objection, the documents will be entered into the record. I also ask unanimous consent that the contents of the document binder be introduced into the record and authorize staff to make any appropriate redactions. So without objection---- Mr. Tonko. Without objection. Mr. Murphy. The documents will be entered into the record with any redactions staff determines are appropriate. I also ask for unanimous consent to put the majority staff's supplemental memorandum into the record, so without objection, this memorandum will be put into the record. So in conclusion, I would like to thank the witnesses and the members for their hard work and thoughtful participation in today's hearing. I remind members they have 10 business days to submit questions for the record, and I ask that the witnesses all agree to respond promptly to the questions. So with that, the subcommittee is adjourned. [Whereupon, at 11:49 a.m., the subcommittee was adjourned.] [Material submitted for inclusion in the record follows:] [GRAPHIC] [TIFF OMITTED]