Strategic Medical Intelligence

1. Strategic Medical Intelligence FBI-Pittsburgh

2. Terrorism Con Plan “Crisis management is predominantly a law enforcement function and includes measures to identify, acquire and plan the use of resources needed to anticipate, prevent, and/or resolve a threat or action of terrorism. In a terrorist incident, a crisis management response may include traditional law enforcement missions such as intelligence, surveillance, tactical operations, negotiations, forensics, and investigations, as well as technical support missions such as agent identification, search, render safe procedures, transfer and disposal, and limited decontamination. In addition to traditional law enforcement missions, crisis management also includes assurance of public health and safety

3. Bioterrorism Big Three

4. Big Three Domains

5. Homeland Security Analysis Critical Intervention Points Critical Capabilities Critical Resources EMS-Medical Establishment, Nat. Lab. Response System EMS-Medical Establishment, Public Health Security Services University R+D CIA, FBI, Analysts MMRS Symptoms in Target Deaths-Epidemic Pre-event Intel Release Illness in Target Detectors, Rads-existing Chem-developing Bio-R+D Syndromic Surveillance Medical Practitioners Quarantine Mass Treatment Strat. Med. Intel Interdiction Medical Practioners Lab Analysis

6. Strategic Biological Weapons

7. Detection Models ICBM Missile Defense Model CIA NORAD Anti-ICBM Civil Defense National Disaster Response Pre-Launch Intel Launch Detonation Deaths Recovery Current Public Health Model Public Health Response “Bad Day” Disease Diagnosis Symptoms develop in Population Deaths Occur Pre-Release Intel Release Recovery

8. Strategic Medical Intel

9. Populations Mass Transit Commuters Domestic Relations Spousal, Inheritances, Minorities Racial, Religious, Ethnic Political Right Wing/Left Wing Special Interest Abortion rights, Ecology, Fur Trade Homosexual, Alternative Lifestyles Services Medical Emergency, ID, Public Health, Police SWAT, Investigative, Homicide EMS Event Staff, Catchment areas Special Events Elections, Polling Places Sports Events Civic Events Cultural Events Federal ATF, FBI Judges, Officials Presidential VIP’s State, Local Opposition Leaders Labor Leaders City Service Bus Drivers, Garbage Collection Coroners Sentinel Groups

10. Suspicious Events Digital-Hand-Arm Amputations Sudden Deaths in Healthy People Toxidromes Unusual Culture Reports Behavior Reporting Recruitment Attempts Repressed, angry, Personality Ideaology of Concern Pre-Event Indicators

11. Reporting: Legal Basis • Similar to the MANDATED reporting of homocidal-suicidal ideation, and child abuse • “Impaired Physician” reports by physicians is common because of risk to community • Rights of the innocent outweigh the rights of privacy of the perpetrator • Foreign nationals probably have a different statute: Gitmo reference

12. SMI’s Team Response to WMD LINK ANALYSIS INTERVIEW ASSISTANCE TRAINING INVESTIGATIVE ASSISTANCE SYNDROMIC SURVEILLANCE WMD EVENT LIAISON LE/PH/HOSP HUMAN INTEL MONITOR TRENDS LIAISON LE/PH/HOSP EXPERT ASSESSMENT/EVAL PRE-EVENT THREAT ASSESSMENT POST-EVENT

13. Initial Goals • Provide Physician WMD advisement to regional MMRS-Public Health • Develop/Implement Syndromic Surveillance Target Groups • Provide real-time patient analysis • Develop Intelligence-surveillance

14. New Millennium Detection Pre-positioning Medical Assets Surveillance of at risk populations Law Enforcement Investigations Syndromic Surveillance Intelligence Sharing Public Health Response Symptoms develop in Population Deaths Occur Pre-Release Intel Release Recovery

15. Benefits of SMI • Formalized relationship with MMRS, State Police, and local Public Health authorities • Trained and credentialed network of mutually supporting physicians familiar with law enforcement, emergency management, and communications