Current Position: Undersecretary for Science and Technology-designate at the Department of Homeland Security (since May 2009)
Boss: Department of Homeland Security Deputy Secretary
Jane Lute
Credit: University of Pittsburgh
Why She Matters
According to O’Toole, the U.S. “lacks a coherent plan for conduct of operations to guide the health care sector's response to mass-casualty care in the event of a bioterrorist attack or other large-scale catastrophe.” In her new position, the George Washington University-trained doctor will be charged with fixing this problem. O’Toole has been nominated to serve as the undersecretary for science and technology at the Department for Homeland Security (DHS).
Her fans say O’Toole has the perfect background for the position – she has both an M.D. and a master’s in public health and her most recent job was CEO of the University of Pittsburgh’s Center for Biosecurity. She also led a series of influential disaster response exercises that showed America is woefully unprepared to handle a bioterror attack.
But critics charge that O’Toole is a fearmonger who is overhyping the threat of an attack, leading to an increased amount of research labs handling deadly agents. “O’Toole is as out of touch with reality, and as paranoiac, as former Vice President Cheney. It would be hard to think of a person less well suited for the position,” Rutgers University microbiologist Richard Ebright told Wired Magazine. “She makes Dr. Strangelove look sane.”
At a Glance
Current Position: Undersecretary for Science and Technology-designate (since May 2009)
Career History: Director, University of Pittsburgh’s Center for Biosecurity (2003 to 2009); Director, Johns Hopkins Center for Civilian Biodefense Strategies (2001 to 2003); Member, Johns Hopkins Center for Civilian Biodefense Strategies (1998 to 2001)
Birthday: N/A
Hometown: Norwood, Mass.
Alma Mater: Vassar College, B.A., 1974; George Washington University, M.D., 1981; Johns Hopkins University, MPH, 1988
Spouse: N/A
Office: The Center for Biosecurity of UPMC,
The Pier IV Building
621 E. Pratt Street, Suite 210, Baltimore, MD 21202; (443) 573-3304
Email N/A
Web site
Path to Power
O’Toole grew up in Norwood, Mass. She earned a B.A. from Vassar College in 1974 and her MD from George Washington University in 1981. She completed an internal medicine residency at Yale University. She also has a masters’ in public health from Johns Hopkins University, which she received in 1988.
In 1984, O’Toole took a job as a doctor at community health center in Baltimore. In 1988, she moved to Washington to study the health impact of nuclear-weapons production as a senior analyst at the Congressional Office of Technology.
In 1993, O’Toole moved to the Clinton Department of Energy as assistant secretary of energy for environmental safety and health. There, she advised then-Secretary Hazel O’Leary on environmental protection and health safety for workers in nuclear facilities. She also created the first management plan for highly-enriched uranium, plutonium and spent fuel and led a delegation to Russia to create a cooperative effort to study radiation exposure in the U.S. and Russia.
Biodefense Expert
In 1998, O’Toole joined the Johns Hopkins Center for Civilian Biodefense Strategies. She became the director in 2001. The center focuses on the study of how to prevent the use of biological weapons and protect the U.S. population from potential attacks.
In 2003, she founded the University of Pittsburgh’s Center for Biosecurity, which aims to “reduce the risk of biological attacks, epidemics, and other destabilizing events, and to improve the nation’s resilience in the face of such events.”
In 2009, DHS Secretary Janet Napolitano nominated O’Toole as undersecretary for Science and Technology.
The Issues
O’Toole has long been a proponent of the creation of the Department of Homeland Security. However, she said that bioterrorism research and preparedness requires different structures than most other preparedness work. A bioterrorist attack “would not be a ‘lights and sirens’ event with firefighters, police and emergency rescue teams rushing to the scene of attack,” she said at a 2002 congressional hearing. “We will know we have been attacked with a biological weapon when victims become ill and report to doctors' offices and emergency rooms.”
O’Toole has called for investments in rapid diagnostic tests, electronic health records and digital links between hospitals and public-health agencies. She said countries like Britain have electronic health records, which makes it easier for hospitals and doctors to communicate during crises. She would also like the U.S. government to better fund its bioterrorism work and to improve recruitment of talented scientist to join the public sector.
Medical First Responses
O’Toole warns that public health agencies at the local, state and federal levels are not prepared to respond to a biological attack. “During a bioterrorist attack, health professionals will be the first responders,” she said at a 1999 congressional hearing. “Yet, this critical component of the nation's response capability has thus far received no funding or targeted attention from any federal preparedness program.” The problem stems from two issues: a lack of coordination and a lack of planning for potential disasters.
To remedy this, O’Toole has called for an expansion of the Center for Disease Control’s Bioterrorism Preparedness and Response Office. She would also like the federal government to require states to develop coherent emergency management plans.
O’Toole would also like to better train hospitals and first responders to respond to biological threats through professional societies. Additionally, O’Toole has called for the development of a media strategy. “The media's impact on the epidemic and its concomitant potential to generate or quell public panic has great salience for any practical response planning,” she wrote in 1999. “Consideration should be given to advance preparation of educational videos, and briefings for reporters.”
Fighting the Flu
Even before the arrival of H1N1 or “swine flu” in spring 2009, O’Toole argued that the single best strategy for fighting the flu is having a vaccine and treatment available. O’Toole also emphasized the importance of having facilities to isolate sick individuals. She has called for a full-time federal appointee and a staff of between 50 and 100 to address flu preparation. She also believes Congress should fund a national education campaign on the risks of the flu.
FEMA
FEMA’s role in handling a bioterror attack will be vital, but the agency is hampered by a lack of training, eliminated hospital surge capacity, limited equipment and a poorly developed response team, O’Toole has said. To address this, O’Toole suggests engaging the medical community in bioterrorism response planning, establishing a substantial research-and- development program for the prevention and treatment of infectious diseases and testing responses with drills and exercises.
Recruitment
O’Toole has also emphasized the importance of recruiting top doctors and public-health experts to government. To do so, she proposed creating a program that would fund tuition for students of medicine, public health and nursing who commit to serving the government.
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