SYLLABUS: EOH 2513 - [Issues in Biological Terrorism]{.smallcaps}

2007 Spring Term Class Sessions:

Mondays - January 8 through April 23, 2007 from 5:00 to 6:50 pm in A622
Crabtree Hall.

Faculty:

Margaret A. Potter, MS, JD, (Course Director). Associate Professor of
Health Policy & Management; Associate Dean for Public Health Practice;
Director of the Center for Public Health Practice; Co-Director of the
Center for Public Health Preparedness, Graduate School of Public Health.
Co-Director of the Center for National Preparedness of the University of
Pittsburgh. Office: 3109 Forbes Avenue, Suite 210 (Forbes Allies Center
-- FACNT). E-mail: <potterm@edc.pitt.edu>. Phone: 412-383-2400. Fax:
412-383-2228.

Michael P. Allswede, DO, Director, Strategic Medical Preparedness 4738
Bayard St., Pittbsurgh, PA., 15213 412-298-1696;
<Allswede@stratmedintel.com>

Felicia Wu, PhD. Assistant Professor of Environmental & Occupational
Health, Graduate School of Public Health; Core Faculty, Center for
Research on Health Care and Center for Bioethics & Health Law; Faculty
Advisor, European Union Center. Office: A732 Crabtree Hall. E-Mail:
few8@pitt.edu. Phone: 412-624-1306. Fax: 412-624-3040.

Diana Lenzner \[[DIANA: PLEASE FILL IN YOUR INFO]{.mark}\]

**[Course Description]{.underline}**:

This two-credit graduate-level course focuses on the governmental
response to terrorism related to biological pathogens. It is designed as
an integrative course relating public health policy and practice,
medical, legal and governmental disciplines. Students learn decision
making based upon integrated analysis of scientific, policy, economic,
and legal considerations. It includes a background in the history,
origins, motivations, and techniques used by terrorists. Methods of
preparedness, detection, response, and containment for biological
attacks are covered. The course is useful to students of policy, public
health science and practice, health administration, and clinical care.
Teaching methods include lectures, policy research and writing,
interdisciplinary classroom discussion, and a decision-making simulation
exercise.

**[Prerequisites:]{.underline}**

1.  Current enrollment in a graduate or professional degree program, or
    permission of the faculty.

2.  Access to a University of Pittsburgh email account, which must be
    used to communicate with the faculty and to submit written
    assignments through the "Digital Drop Box" on the course's
    Blackboard site
    ([**https://courseweb.pitt.edu**](https://courseweb.pitt.edu/)).

[**Relevance of course to academic programs and
curricula**:]{.underline}

This course takes a multidisciplinary approach to the topic of terrorism
using biological agents. It is relevant to students of public health
sciences and practice, public policy, international relations, health
administration, environmental and occupational health, and the clinical
health professions. It is a required course in the Graduate Certificate
Program for Public Health Emergency Preparedness and Disaster Response.
It is an appropriate elective for other qualified students who wish to
gain a basic understanding of the laws, policies, and practices relevant
to consequence management in the event of a biological attack on the
population. Much of the course content is also relevant to the
management of naturally occurring outbreaks of infectious disease as
well as accidental exposures to toxic agents.

**[Special Needs:]{.underline}**

University and GSPH are sensitive and accommodating to persons with
special needs. Please let faculty know of any special needs. The
University of Pittsburgh policy, "Accommodations for Students with
Disabilities," describes the University's accommodations under the
Americans with Disabilities Act of 1990 and Section 504 of the
Rehabilitation Act of 1973. Assistance is available through the GSPH
Office of Student Affairs (call 412-624-3003) and from the University's
Office of Disability Resources and Services can assist (call
412-648-7890).

**[Academic Integrity:]{.underline}**

Students' work must be their own. Every fact, idea, or concept drawn
from another source should be referenced accurately. Direct quotations
must be so-designated and referenced. Footnotes in text are preferable
to endnotes. An additional bibliography of sources consulted may be
added at the end of a paper. Direct contributions to a student's work by
any other person should be acknowledged explicitly in writing. Failure
to adhere to these policies and guidelines may be considered plagiarism
and subject to academic discipline including failure of the course.
Refer to University of Pittsburgh "Guidelines on Academic Integrity:
Student and Faculty Obligations and Hearing Procedures," September 1995;
and University of Pittsburgh "Student Code of Conduct & Judicial
Procedures," August 15, 2000 (especially note pages 7-8, Student
Obligations 1 -- 16).

***Papers prepared for other courses may not be re-used for EOH 2513
without explicit permission of the faculty.***

Citations to on-line resources and publications should be complete
references with full attribution to source and authorship, including
date of access for the student's research and the URL providing direct
access to the cited material.

**[Audiovisual archive]{.underline}**:

The University of Pittsburgh Center for Instructional Development and
Distance Education (CIDDE) website offers access to archived audiovisual
presentations of past speakers and class sessions. Go to
[http://136.142.65.243](http://136.142.65.243/) and click on "EOH 2513
Issues in Bioterrorism" on the left-side menu; then select individual
lectures from the 2-page listing.

**[Student Responsibilities:]{.underline}**

1.  Attend all classes. If absence is unavoidable, request to be excused
    by contacting the course director (Potter) in advance of class time.

2.  Submit written assignments to course director prior to class on the
    due-date. Submit written assignments through the "Digital Drop Box"
    on the course's Blackboard site
    ([**https://courseweb.pitt.edu**](https://courseweb.pitt.edu/)).

3.  Late submissions are subject to down-grading at the discretion of
    faculty.

4.  If a meeting with faculty is desired, request an appointment by
    email. Faculty will make every effort to schedule meeting times
    promptly.

5.  Enroll in the website: ***Lessons Learned Information Sharing
    (LLIS.gov)***. This is the national network of Lessons Learned and
    Best Practices for emergency response providers and homeland
    security officials. *LLIS.gov*\'s secure, restricted-access
    information is designed to facilitate efforts to prevent, prepare
    for and respond to acts of terrorism and other incidents across all
    disciplines and communities throughout the US. *LLIS.gov* is an
    encrypted system and all users are verified emergency response
    providers and homeland security officials. All Lessons Learned and
    Best Practices are peer-validated by homeland security
    professionals. *LLIS* houses an extensive catalog of AARs as well as
    an updated list of homeland security documents from DHS, and other
    Federal, State, and local organizations.

6.  Optional: read *Biosecurity & Bioterrorism: Biodefense Strategy,
    Practice, and Science*. This is a periodical journal published
    quarterly and accessible online thru HSLS. (Go to
    [www.hsls.pitt.edu](http://www.hsls.pitt.edu/), select "Pittcat"
    from the resources list; then enter the journal name in the search
    box. The list of issues will appear.)

7.  Optional: Sign up for the e-Newsletter from the University of
    Pittsburgh Center for Public Health Preparedness. Go to
    [www.prepare.pitt.edu](http://www.prepare.pitt.edu/), and click on
    e-Newsletter "subscribe now."

8.  Optional: attend Lecture Series of the University of Pittsburgh
    Center for National Preparedness: **Where**: 5th Floor [Alumni
    Hall,](http://maps.google.com/maps?f=q&hl=en&q=4227+5th+Ave,+Pittsburgh,+PA&btnG=Search&ll=40.446294,-79.953904&spn=0.013717,0.043259)
    University of Pittsburgh. **Time**: 3:00 - 4:00 pm - Reception to
    follow. **RSVP**: <http://www.cnp.pitt.edu/seminar/>

    -   January 11: Carey Balaban, PhD, Professor of Otolaryngology,
        University of Pittsburgh, on \"Approaches to Enhancing
        Situational Awareness.\"

    -   Febuary 8: Jan Wiebe, PhD, Department of Computer Science and
        Director, Intelligent Systems Program, University of Pittsburgh
        (topic to be announced)

    -   March 8: Donald S. Burke, MD, Dean of Graduate School of Public
        Health, UPMC-Jonas Salk Chair in Global Health, Director of the
        Center for Vaccine Research, and Associate Vice Chancellor in
        Global Health, University of Pittsburgh (topic to be announced)

    -   April 5: Dennis K. McBride, PhD, President, Potomac Institute
        for Policy Studies (topic to be announced)

**[Course Learning Objectives:]{.underline}**

During this course the student will acquire and integrate knowledge and
be able to:

1.  Identify the origins, threats, and threat agents of bioterrorism.

2.  Compare, contrast, and differentiate various governmental programs
    of biodefense, including those that plan for, prepare for, and
    respond to bioterrorism.

3.  Evaluate and synthesize information from a variety of sources across
    disciplines in addressing issues and problems pertinent to planning
    for, preparing for, detecting, responding to, and containing the
    effects of bioterrorism.

4.  Apply information to the needs of practical decision-making in the
    role of a responsible government or private-sector official acting
    in response to a bioterror event.

5.  Effectively and clearly communicate complex policy analyses of
    bioterrorism issues in both written and oral presentations.
    []{.mark}

[**Grading**:]{.underline}

Grade for this course (A, B, C, D, F, I) is based on written papers,
participation in class, and preparation and presentations for the
Decision-Making Simulation exercise, as shown below. The grading scale
is: A = 90-100; B = 80-89; C = 70-79; D = 60-69; F = below 60. In
addition to total point accumulation, a passing grade depends on
complete and timely submission or presentation of all assignments.

  ------------------------------------------------------- ---------------
  **Course Requirement**                                  **Grading
                                                          Points**

  **Class Participation:** engagement in weekly class     **20**
  discussions, presentation of topic and role papers, and 
  contributions to Decision-Making Simulation exercise    

  **Introduction statement** to give background and       **Not graded**
  contact information to faculty                          

  **Alternative choices for research topic and            **Not graded**
  decision-making role**                                  

  **Role Paper for** Decision-Making Simulation exercise  **20**

  **Issue Brief**                                         **25**

  **Options/Decision Paper:** Options/Decision Paper and  **25**
  presentation to class                                   

  **Lessons Learned Paper:** based on experience in the   **10**
  Decision-Making Simulation                              

  **TOTAL POINTS**                                        **100**
  ------------------------------------------------------- ---------------

**[Assignments:]{.underline}**

Students should submit all written assignments *by email from their
University of Pittsburgh email account* to
[**potterm@edc.pitt.edu**](mailto:potterm@edc.pitt.edu) prior to class
on the specified due-dates. Submission by hard-copy is welcome, but an
electronic copy is required for grading and feedback.

**[Class Schedule, Assignments & Learning Objectives]{.smallcaps}**

**Class \# 1 - Tuesday, January 8, 2007: Introduction and overview of
the course**

Includes history, origins, motivation, threats and techniques of
terrorism and biological terrorism. Discussion of requirements including
assignments, writing requirements, and decision-making simulation
exercise. Students will receive list of alternatives from which to
select research topic and decision-making role.

[Class 1 Learning Objectives]{.underline}:

1.  Comprehend course requirements.

2.  Identify and analyze the origins and threats of terrorism and
    bioterrorism.

3.  Develop and explain a definition of bioterrorism.

[Background Readings:]{.underline}

-   Arnold JL,Ortenwall P, Birnbaum ML, Sundnes KO, et al. [A proposed
    universal medical and public health definition of
    terrorism.](http://pdm.medicine.wisc.edu/18-2pdfs/ArnoldTheoDisc.pdf)
    *Prehospital Disaster Med.* 2003 Apr-Jun;18(2):47-52.

-   ICPO-Interpol. *Bioterrorism Incident Pre-Planning and Response
    Guide,* 2007.
    <http://www.interpol.int/Public/BioTerrorism/BioterrorismGuide.pdf>

-   Walden J, Kaplan EH. [Estimating time and size of bioterror
    attack.](http://www.cdc.gov/ncidod/eid/vol10no7/03-0632.htm)
    *Emerging Infectious Diseases,* July 2004, 10 (7): 1202-5.

[Assignment:]{.underline} Introduction statement -- due not later than
January 14, 2007 -- each student should send an email to
<potterm@edc.pitt.edu> with name, University of Pittsburgh e-mail
address, phone number, degree program including school and department,
and name of academic advisor. *NOTE: this is the only assignment
throughout the course that is due [after]{.underline} the class meeting
with which it is stated; all others are due before class on the
due-date.*

**No Class: January 15, 2007 -- due to Martin Luther King Holiday**

**Class \# 2 - January 22, 2007: Biological Pathogens**

Review of CDC Category A biological pathogens -- characteristics,
symptoms, treatment. Discussion of "Project Bacchus", a once classified
feasibility study on the manufacture of BW pathogens.

[Class 2 Learning Objectives:]{.underline}

1.  Identify, analyze and discuss CDC Category A agents of bioterrorism.

2.  [MIKE: CAN YOU STATE A LEARNING OBJECTIVE RELEVANT TO
    "BACCHUS"?]{.mark}

3.  Understand assignments to submit Information Brief topics and
    prioritized choices for roles in Decision-Making Simulation.

[Background Readings:]{.underline}

-   Center for Infectious Disease Research & Policy (CIDRAP). 
    [Bioterrorism:  History, Likely Agents, Perpetrators, and
    Dissemination.](http://www.cidrap.umn.edu/cidrap/content/bt/bioprep/biofacts/bioterr-overview.html) 
    University of Minnesota. 
    <http://www.cidrap.umn.edu/cidrap/content/bt/bioprep/biofacts/bioterr-overview.html>

### Nuzzo JB. The biological threat to U.S. water supplies: toward a national water security policy. *Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science*, 2006, 4 (2): 147-159.

### Rotz LD, Khan AS, Lillibridge SR, et al. Public Health Assessment of Potential Biological Terrorism Agents. *Emerging Infectious Diseases*, February 2002, Vol. 8, No. 2.

**Class \# 3: January 29, 2007: Legal Framework**

Constitutional and statutory framework within which the federal, state,
and local governments define their respective powers and duties in the
contexts of preparedness, response, and recovery. Highlights of
potential "disconnects" among agencies and organizations.

[Class 5 Learning Objectives]{.underline}:

1.  Explain and apply legal concepts, statutes, and cases to
    preparedness and response for bioterrorism.

2.  Understand the role of law enforcement authorities in relation to
    that of public health authorities.

[Background Readings:]{.underline}

-   Annas GJ. Bioterrorism, public health, and civil liberties. *New
    England Journal of Medicine*, April 25, 2002, 346 (17): 1337-1342.

-   Gostin LO, Sapsin JW, Teret SP, et al.. [The Model State Emergency
    Health Powers Act: planning for and response to bioterrorism and
    naturally occurring infectious
    diseases.](http://jama.ama-assn.org/cgi/content/full/288/5/622)
    *JAMA,* Aug 7 2002, 288 (5): 622-8.

-   [Hodge JG Jr](http://www.liebertonline.com/action/doSearch?action=runSearch&type=advanced&result=true&prevSearch=%2Bauthorsfield%3A(Hodge%2CJames+G.)),
    [Brown](http://www.liebertonline.com/action/doSearch?action=runSearch&type=advanced&result=true&prevSearch=%2Bauthorsfield%3A(Brown%2CErin+Fuse))
    EF,
    [O\'Connell](http://www.liebertonline.com/action/doSearch?action=runSearch&type=advanced&result=true&prevSearch=%2Bauthorsfield%3A(O'Connell%2CJessica+P.))
    JP. The HIPAA privacy rule and bioterrorism planning, prevention,
    and response. *Biosecurity and Bioterrorism: Biodefense Strategy,
    Practice, and Science*, June 2004, 2 (2): 73-80.

-   Kellman B. Notes from a BWC Gadfly. *Biosecurity and Bioterrorism:
    Biodefense Strategy, Practice, and Science*, 2006, 4 (3): 231-236.

-   Tucker JB. Updating the International Health Regulations.
    *Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and
    Science*, December 2005, 3 (4): 338-347.

-   Thomas CM. *Preparedness for Health Emergencies in Pennsylvania:
    Implications for Public Policy.* Status Report. Institute of
    Politics, University of Pittsburgh, March 2005.
    <http://www.iop.pitt.edu/archive.htm>.

**Class \# 4 - February 5, 2007: Risk Assessment.**

What are the risks to human health, animal health, and the environment
from bioterrorism? A four-step approach to assessing risks, and placing
them in the context of risk management and risk communication.

[Class 3 Learning Objectives:]{.underline}

[FELICIA TO FILL IN]{.mark}

[Background Readings:]{.underline}

-   Raymond A. Zilinskas, Bruce Hope, D. Warner North. A Discussion of
    Findings and Their Possible Implications from a Workshop on
    Bioterrorism Threat Assessment and Risk Management. Risk Analysis
    Volume 24, Issue 4, Page 901-908, Aug 2004.

-   Charles N. Haas. The Role of Risk Analysis in Understanding
    Bioterrorism. Risk Analysis\
    Volume 22, Issue 4, Page 671-677, Aug 2002. 

[Assignment]{.underline}:

Research Topic and Decision-Making Role Selection. Each student selects
three items (indicating priority preferences as first, second, and
third) for a research topic and a role in the decision-making simulation
exercise. A list of the topics and roles needed to prepare for the
course's Decision-Making Simulation Exercise will be distributed in
class and posted on the course's Blackboard website. The research topic
and the role are conceptually related, thus allowing the student to
understand a selected issue in connection with a particular officer's or
official's responsibilities during and after a bioterror attack. To
assure coverage of all topics and roles essential to the decision-making
simulation exercise, s***tudents should not begin researching any topic
or role until their choices are approved by the Course Director.***

**Class \# 5 - February 12, 2007: Detection of Bioterror Agents**

Detection through use of electronic patient medical records and other
real-time data, sensors and diagnostics, microbiology laboratories and
autopsies.

[Class 4 Learning Objective:]{.underline} Explain various means and
modes of detection, pros and cons of each, and role each plays in
time-phased surveillance.

[Background Readings:]{.underline}

-   Reingold A. If syndromic surveillance is the answer, what is the
    question? *Biosecurity and Bioterrorism: Biodefense Strategy,
    Practice, and Science*, June 2003, 1 (2): 77-81.

-   Bravata DM, McDonald KM, Smith WM, et al. [Systematic review:
    surveillance systems for early detection of bioterrorism-related
    diseases.](http://gateway.ovid.com/ovidweb.cgi?T=JS&NEWS=N&PAGE=fulltext&AN=00000605-200406010-00013&LSLINK=80&D=ovft)
    *Annals of Internal Medicine,* June 1, 2004, 140 (11): 910-22.

-   Buehler JW, Berkelman RL, Hartley DM, Peters CJ. [Syndromic
    surveillance and bioterrorism-related
    epidemics.](http://www.cdc.gov/ncidod/EID/vol9no10/03-0231.htm)
    *Emerging Infectious Diseases,* October 2003, 9 (10): 1197-204.

-   Wagner MM, Dato V, Dowling JN, Allswede M. [Representative threats
    for research in public health
    surveillance.](http://dx.doi.org/10.1016/S1532-0464(03)00065-0)
    *Journal of Biomedical Informatics,* June 2003, 36 (3): 177-88.

-   M'ikanatha NM, Southwell B, Lautenbach E. Automated laboratory
    reporting of infectious diseases in a climate of bioterrorism.
    *Emerging Infectious Diseases,* 2003 Sept \[*date cited*\].
    Available from: URL:
    <http://www.cdc.gov/ncidod/EID/vol9no9/02-0486.htm>

**Class \# 6 - February 19, 2007:** **[Agroterrorism]{.underline}**

Learn about some of the most pertinent bioterrorism concerns to our food
supply -- an often underestimated source of potential risks:
vulnerabilities in U.S. agriculture; livestock diseases spread through
potential agroterrorism; and human diseases spread through potential
agroterrorism.

[Class 6 Learning Objective]{.underline}: Understand what sorts of
diseases can be spread through agroterrorism events, how they affect our
food supply, and how they can be counteracted.

**Class \# 7 - February 26, 2007**: **Federal, State, & Local
Preparedness Programs**

Overview of the policies, programs and roles of government at different
levels in countering, preparing for, and responding to bioterrorism.

[Class 7 Learning Objectives]{.underline}:

1.  Compare, contrast, relate, and differentiate state and local
    biodefense programs to prepare for and respond to bioterrorism.

2.  Apply the integrative aspects of planning, preparations, detection,
    response and containment for countering terrorism.

3.  Understand and describe Federal biodefense programs and policies.

4.  Identify potential areas of disconnect and/or overlap between the
    federal and the state/local authorities.

[Background Readings:]{.underline}

-   Centers for Disease Control & Prevention. Strategic National
    Stockpile - What it means to you. April 14, 2005.
    <http://www.cdc.gov/print.do?url=http://www.bt.cdc.gov/stockpile/>

-   Centers for Disease Control & Prevention. [National Electronic
    Disease Surveillance System](http://www.cdc.gov/nedss/) (NEDSS).

-   Association of State & Territorial Health Officials. *Preparedness
    Planning for State Officials. Exercising the Strategic National
    Stockpile. Lessons Learned and Tools for Application.* ASTHO
    (January 2004).

-   National Association of County & City Health Officials. *The
    Strategic National Stockpile (SNS): A Reference for Local Planners.*
    <http://archive.naccho.org/documents/NACCHO-NPS-Guide.pdf>

-   Robert T. Stafford Disaster Relief and Emergency Assistance Act
    (Public Law 93-288) as amended, 42 UNITED STATES CODE, CHAPTER 68.
    DISASTER RELIEF. <http://www.fema.gov/about/stafact.shtm>

-   U.S. Government Accountability Office. *Hurricanes Katrina and Rita.
    Preliminary Observations on Contracting for Response and Recovery
    Efforts.* GAO-06-246T. November 8, 2005.
    <http://www.gao.gov/new.items/d06246t.pdf>.

**No Class: March 7, 2007 due to Spring Recess.**

Class \# 8 - March 12, 2007: Interagency Cooperation & Coordination.

Understand the legal and analytical challenges to forensic epidemiology
investigations as seen in the SMI model. Understand the Pittsburgh
Matrix for hospital decision-making and preparations and how medical
systems fit into the national strategy for preparedness.

Class 6 Learning Objectives:

1.  Understand and apply legal and logistical strategies to a forensic
    epidemiology investigation

2.  Understand the factors that drive threat-based hospital preparedness
    efforts. .

[Background Readings:]{.underline}

-   Benedek DM, Holloway HC, Becker SM. [Emergency mental health
    management in bioterrorism
    events.](http://home.mdconsult.com/das/journal/view/43671695-3/N/12446835?ja=288879&PAGE=1.html&ANCHOR=top&source=MI )\
    *Emergency Medicine Clinics of North America,* May 2002, 20 (2):
    393-407.

-   Burkle FM Jr. [Mass casualty management of a large-scale
    bioterrorist event: an epidemiological approach that shapes triage
    decisions.](http://home.mdconsult.com/das/journal/view/43671695-2/N/12446836?ja=288880&PAGE=1.html&ANCHOR=top&source=MI)
    *Emergency Medicine Clinics of North America*, May 2002, 20 (2):
    409-36.

-   Grow RW, Rubinson L. The Challenge of Hospital Infection Control
    During a Response to Bioterrorist Attacks. *Biosecurity and
    Bioterrorism: Biodefense Strategy, Practice, and Science*, September
    2003, 1 (3): 215 -220.

-   ICFO-Interpol Incident Pre-Planning and Response Guide,
    <http://www.interpol.int/Public/BioTerrorism/BioterrorismGuide.pdf>

[Assignment:]{.underline} Submit Role Paper by email prior to class.
This paper describes the student's role in the Decision-Making
Simulation. This is a one-page researched statement explaining the
responsibilities and interests of the student's selected role *both*
under normal circumstances *and* in relation to preparedness, detection,
response, and recovery from a bioterrorist attack.

**Class \# 9 - March 19, 2007: "Jeopardy"**

Come to class prepared to answer questions in a game of "Bioterrorism
Jeopardy!" We will divide the class into teams, and field questions on
topics we have already learned in class.

**Class \# 10 - March 26, 2007: Medical & Law Enforcement Operations**

Guest Lecturer Rossi will describe the operation of the National
Disaster Medical Response System (NDMS) and the Metropolitan Medical
response System (MMRS). Guest Lecturer Smith will describe the FBI's
role in bioterror response.

[Class 9 Learning Objectives]{.underline}:

1.  Understand how emergency medical systems interface with public
    health authorities during scene management and urgent response to an
    overt event.

2.  Understand how federal law enforcement operates in relation to state
    and local authorities.

[Assignment:]{.underline}

Submit Issue Brief prior to class*.* This Issue Brief and the subsequent
Options/Decision Paper together provide the foundation for the student's
participation in the Decision-Making Simulation exercise. The selected
Decision-Making Simulation role for that exercise provides his or her
perspective on and knowledge base for the exercise. The student writes
both major papers as if the person in the selected role (or as a staff
person in the office of that role). Complete instructions for the Issue
Brief will be provided in class and posted on the course's Blackboard
website.

**Class \# 11 - April 2, 2007:** **Student presentations**

Students will present the results of their Options/Decision Paper from
the perspective of their selected decision-making role.

[Class 11 Learning Objectives]{.underline}:

1.  Demonstrate ability to explain orally the operational decisions
    around a selected topic in planning, preparations, detection,
    response, and/or containment of bioterrorism.

2.  Demonstrate ability to explain and analyze the biodefense
    preparedness and response responsibilities and perspectives of a
    specific institutional actor or official.

[Assignment:]{.underline} Submit Options/Decision Paper prior to class.
For this, the second of the two major papers for the course, the student
further develops the Role Paper Issue Brief. Once again, the role chosen
for the decision-making simulation exercise is the recommended
perspective for Issue Brief. The student states and analyzes various
options for resolution of the problem as defined in Role Paper and then
recommends an option or options for implementation. Here, emphasis is on
defining and analyzing options and providing well-reasoned
recommendations for decision. Complete instructions for the
Options/Decision Paper will be provided in class and posted on the
course's Blackboard website.

**Class \# 12 - April 11, 2007: Decision making simulation**

Students will play roles of local, State and Federal officials, private
and community sector officials, hospital and public health officials,
and other stakeholders. Simulation will be guided by faculty to bring
out pertinent teaching points.

[Class 12 Learning Objectives]{.underline}:

1.  Analyze the biodefense preparedness and response plan for a specific
    institutional actor or official within an organizational or local
    context.

2.  In the context of a notional bioterrorism case, argue the role of
    organizations and actors to demonstrate an in-depth understanding of
    bioterrorism and biodefense.

3.  Demonstrate an understanding of the relationships and required
    coordination and inter-organizational preparedness plans and
    responses to acts of bioterrorism.

[Background Readings:]{.underline}

-   Andress K. [A postevent smallpox mass vaccination clinic
    exercise.](http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B73G1-48BTDDM-7&_user=88470&_handle=B-WA-A-W-AU-MsSAYWW-UUW-AAUDVADWCV-AAUVEEYUCV-YBZWAZUVD-AU-U&_fmt=full&_coverDate=06%2F30%2F2003&_rdoc=6&_orig=browse&_srch=%23toc%2311513%232003%23999989997%23418066!&_cdi=11513&view=c&_acct=C000006998&_version=1&_urlVersion=0&_userid=88470&md5=fd3e856cc9ee66deb622e7cce5323b87)
    *Disaster Management & Response: DMR,* Apr-Jun 2003, 1 (2): 54-8.

-   Inglesby TV, Grossman R, O\'Toole T. [A plague on your city:
    observations from
    TOPOFF.](http://www.journals.uchicago.edu/CID/journal/issues/v32n3/001347/001347.html)
    *Clinical Infectious Diseases,* Feb. 1, 2001, 32 (3): 436-45.

**Class \# 13: April 16, 2007:** **Decision making simulation**.

Continuation of Class #12.

[Class 13 Learning Objectives]{.underline}: Same as for Class #12.

**Class \# 14 - April 23, 2007:** **Summary, conclusions & course
evaluation**

Discussion of course learning objectives; evaluation of insights and
achievements; course evaluation.

[Class 14 Learning Objective]{.underline}: Explain and evaluate insights
at the intersections science, policy, economics, and law in the
practical aspects of preparedness for and response to bioterrorism.

[Assignment:]{.underline} Lessons Learned from the Decision-Making
Simulation. This is a one-page statement summarizing the student's
experience with the decision-making simulation exercise.