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.”Ignatius, David, “When the 'bleed-out' begins; A state of unreadiness nearly 6 years after 9/11,” The Washington Post, July 5, 2007 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.”Shachtman, Noah, "DHS’ New Chief Geek is a Bioterror ‘Disaster,’ Critics Charge," Wired, May 6, 2009
At a Glance
Current Position: Undersecretary for Science and Technology (since Nov. 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
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.University of Pittsburgh Center for Biosecurity: Profile of Tara O'Toole web site
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.University of Pittsburgh Center for Biosecurity: Profile of Tara O'Toole web site
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.”University of Pittsburgh Center for Biosecurity web site
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."Six Years After Anthrax: Are We Better Prepared to Respond to Bioterrorism?"Senate Committee on Homeland Security and Governmental Affairs, Oct. 23, 2007 She said countries like Britain have electronic health records, which makes it easier for hospitals and doctors to communicate during crises."Hearing on Bioterrorism Preparedness and the Role of DHS Chief Medical Officer," U.S. House of Representatives Committee on Appropriations, Subcommittee on Homeland Security, March 29, 2007 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.“Creating the Department of Homeland Security: Consideration of the Administration's Proposal,” U.S. House of Representatives Committee on Energy and Commerce Subcommittee on Oversight and Investigations, June 25, 2002
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."Hearing on Terrorism Preparedness: Medical First Response," U.S. House Committee on Government Reform, Sept. 22, 1999
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.”"Hearing on Terrorism Preparedness: Medical First Response," U.S. House Committee on Government Reform, Sept. 22, 1999
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."Protecting the Homeland: Fighting Pandemic Flu from the Front Lines," U.S. House of Representatives Committee on Homeland Security Subcommittee on Emergency Preparedness, Science and Technology, Feb. 8, 2006
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."Hearing on FEMA's Role in Managing Bioterrorist Attacks and the Impact of Public Health Concerns on Bioterrorism Preparedness," U.S. Senate Government Affairs Subcommittee on International Security, Proliferation and Federal Services, July 23, 2001
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.O'Toole, Tara, "Roundtable on Public Health Preparedness in the 21st Century," Center for Biosecurity, March 28, 2006
The Network
At DHS, O’Toole will join a team that includes Secretary Janet Napolitano and Deputy Secretary Jane Lute. She will also work closely with FEMA administration Craig Fugate.
