I am talking about something that's never been part of this course, and that's chembioterrorism, and I'm going to attempt to talk from both the chem and the biosides of the house. This is an experiment for us. We've never included a block of instruction on this material before. At this moment, or a few minutes from now, over at RID, your counterparts will be getting a rather similar block of instruction from Colonel Ed Eitzen, who clearly has been doing this more than anybody in the faculty of either of the two courses. I've only been here relatively short time. Colonel Eitzen's really been doing this nonstop since, I think, 1992. And why have we decided to include it? It's not really part of the mission, either of the Institute of Infectious Disease or the Institute of Chemical Defense. If you look at our mission statement, we train military professionals like yourselves, and we do research. So why do we care about terrorism? The answer is pretty obvious. We are told by our hires up, by the press, by Congress, by everybody that the terrorist threat is probably greater on a given day in this country than even the military threat that we face from foreign adversaries. We've already seen it attempted in New York City, as I mentioned, the World Trade Center bombing. And if we had any lasting doubt, the Tokyo subway attack in 1995 certainly brought that home. And, of course, Larry Wayne Harris was just arrested, I think, only four weeks ago in Las Vegas and accused of potentially trying to build anthrax weapons here in the United States. But then you might ask, well, why do we in the military have to care about that? Isn't that a law enforcement function? And the answer is, well, yes, it is, but we've been doing this a lot longer than they. And when all of this started coming down in the 1990s, people in the FBI, people in the Congress and so forth, they started saying, who's got the expertise? And guess who? It really was only the military. Almost nobody was doing research on this except the military for the last number of decades. So that's one reason why we talk about it. And the other reason is even more germane to you folks. I am about to show you that pretty much all of you, I would wager a good amount of money that at least 80% of the people in this room are actually in line to receive chem, bioterrorist casualties, totally exclusive of any wartime role you may have as an active duty or reservist military member. How many people in this room are active duty military? The vast majority. How many of you who just raised your hands are not affiliated, either full-time or part-time with a military hospital? No one. One, two, three, four people. Five. So all but five of you automatically are part of the National Defense Medical System, which although it was set up for wartime casualties, can be activated in case of domestic, biological or chemical terrorism. Now, those of you who are not active duty military, how many of you are there? Do we have too many reservists in this group? We have only two, three. Okay.  How many of the three of you are hospital-based? One. You, sir, I know, are connected with an academic medical center. And you are what, Fleet Marine Force? Okay. I think I can account for all three of you. The civilian community doesn't realize that it's in line for this. One being, of course, if you have it in your backyard, but even if you don't have one of these things going off in your backyard, the National Defense Medical System may deliver these patients to you. I will tell you a true story which exemplifies this. During Desert Storm, I didn't go to Southwest Asia because I was back doing a fellowship. I was a fellow at the Hospital of the University of Pennsylvania, which is a large academic medical center, which is particularly well-known for its neurologic expertise. It is one of the largest departments of neurology in the country. And it's located across the street from the Philadelphia VA Medical Center, and it's located only about three miles from Philadelphia International Airport, which at the time was the Air Mobility Command Airhead for the Eastern United States. Isn't any more of it, it was then. And, you know, the hospital is going about its business and we're reading the news like everybody else.  And he says, I've just come from a meeting with Dr. Kelly, the chief executive officer of the hospital, dean of the medical school, and the chairman of a couple of departments. Guess what, guys? We are a National Defense Medical System hospital. Nobody ever told me that. I've been the chairman here for five years, but we are. Not only that, our service, the neurology service, is listed as a receiving service for war casualties because we're supposed to know all about nerve gas. And he turns to me and he says, tell me about nerve agents. You're the only person in the entire department who has any connection with the military. Well, I had not had this course at that time. And I remembered all the stuff that they had taught me in Officer Basic, which wasn't a lot. In fact, what there was, I had largely forgotten. It turned out in this enormous department of neurology, I was the only person who had ever had any instruction on them. And that chief of papers was what they had just given him. Why does the hospital have a connection with the military? Because they get money. Hospitals in this country are paid to be members of the National Defense Medical System. So what that tells you is that there are a lot of civilian hospitals out there that are going to be shipped these things, whether they really want it or not. And I'll give you another example of how this can hit you. My friend, Lieutenant Colonel Jim Knowles, is the head of, or was at the time, the head of the Aeromedical Evacuation Squadron at Grand Forks Air Force Base in North Dakota. And he was preparing last year to go off to Wilford Hall and do an ophthalmology residency. In fact, he had started to pack up his house when suddenly every hospital in Grand Forks closed because of the floods. Grand Forks Air Force Base Hospital went from 12 beds to 500 in one week. And he, as chief of the medical staff, because he was the senior physician, found himself in the process of shuttling patients back and forth, getting all the ICU patients in Grand Forks Aeravac to Minneapolis, St. Paul, and so forth. And this simply got dumped on the Grand Forks Air Force Base Hospital because all the other hospitals had been closed. Well, what would have happened if that hadn't been a flood, if that had been, say, a mustard exposure, which essentially rendered the small area of Grand Forks where all the other hospitals were located uninhabitable? Grand Force Air Force Base would have been the only hospital left. The reason that it became the receiving hospital is that it was a little bit far away from the city and it was actually on higher ground. So we're all online for this. And that's why when actually Mr. Hettinger and Ms. Pike and I came to the other members of the faculty of both institutes and said, let's do a terrorism block, they all said, yep, it's overdue. So that's why we're going to spend a little time talking about this. Now, I'm really proud of this slide. Also, Mr. Hettinger should be proud of it because actually the graphics are his. But the pictures were taken by me. Major Shaw, do you remember where these were taken? Major Shaw is not going to report me to the mayor of the city of New York. These are pictures that I took at the largest field exercise that I think anybody has held. This was in November of 97 in New York City. The city of New York Mayor's Office of Emergency Preparedness decided to have an exercise where you had a simulated, actually this was a nerve agent exposure. At the top of the slide it says mustard attack. You'll see why. That's the scenario that I have on the next slide. But the actual one that they used was a nerve agent exposure. In fact, it was kind of funny. What they did was they had somebody dressed up as Mayor Giuliani giving an alleged political speech. You have a crowd of people who I think were high school volunteers.  And then the city of New York police and fire rescue first responder people came in. There's some of their vehicles and you can see the people in the level A suits picking up the casualties. Now this wasn't a perfect exercise by any means but it was the first one done to this extent. They had 200 vehicles. They had about 2,000 people involved I think. It was really quite massive. New York is probably as I will say several other times the most advanced city in the country in terms of being further ahead in their preparation. But look at the amount of money that was spent on this. I mean, the city of New York doesn't have all the money in the world and certainly most cities don't even have the amount of money New York has. So this is becoming a big thing in the civilian community. In fact, since you're all medical or medically related folks I will tell you they had 40 different hospitals in New York City that were playing into this scenario. However, none of those hospitals got more than 6 or 10 casualties during that exercise. There's only one hospital that's done an exercise with a lot more than that and that's Walter Reed and Dr. Natook is going to talk to you about that. Now the scenario on the next couple of slides is not mine. It was created by Jerome Hower who is the Mayor Giuliani's Office of Emergency Preparedness. And Jerome Hower put this together. I've modified it slightly but this is the sort of scenario that the civilian community is looking at. I'll read it through.  And although the warehouse is empty when they arrive, it's booby trapped, explosives go off, the building collapses, it collapses onto a subway line running underneath which kills a certain number of people and releases a plume which is yellowish and the plume, most of the prevailing winds almost everywhere in the United States are from the west so this goes eastward, goes across Manhattan, northern Brooklyn into Queens. And in this scenario, within minutes people are observed coughing on the sidewalks within an hour you have people walking into hospitals in Manhattan and the other boroughs complaining of a variety of complaints, some of which are clearly hysteric, others of which may not be, all irritation, difficulty breathing and then later on you see people with blistering and skin erythema. And this is thought to be the way that say a mustard attack might look. At 0800, the Mayor of New York declares a state of emergency. I'll tell you something about states of emergency in the city of New York. New York is my hometown so I can say this. I remember when we had a subway strike several years ago and Mayor Koch was out spending most of the morning shaking hands with people walking across the Brooklyn Bridge, getting to work despite the fact that the subways were done. City of New York has a mayor who always will grant stand but that's going to be the case almost all the time. Where do you want your mayor? Well, the mayor here has to get the heck out of his office because his office is located in Lower Manhattan. Lower Manhattan is now being evacuated because it's not safe. Everything's in Lower Manhattan. The FBI office is in Lower Manhattan. Why is that important? Because they're the ones who have to deal with the crime scene, okay? The Emergency Operations Center, the fire department, the police department, all those have to be evacuated and reconstituted. And in Lower Manhattan is only one hospital but the other hospitals are now filled overflowing. Lower Manhattan is an unusual place. We have two and a half million people who work there and the vast majority of them do not drive. They take buses. They take taxis. Most of them take trains. How are you going to get word to these people not to go to Lower Manhattan? It's kind of hard. So tremendous logistical problems. And meanwhile, New York is also the capital of the world. We have the United Nations in town. And it's not inconceivable that the same day we could have a security council meeting plan where you have the Prime Minister of Great Britain, President of China, President of France, Prime Minister of Russia on their way to New York or in New York. New York happens to have more embassies than any city in the western hemisphere, more than Washington, because the United Nations is there. And these embassies start calling the president, saying, should we get our people out of New York? By the way, this could have been worse. It could have been Friday evening and Fourth of July weekend. Okay? This is just morning rush hour, just typical normal day. And here are some of the questions that come out the way this was proposed to us. In fact, major show it was Colonel Gerber, who is the facilitator for this discussion. So he can tell you more about it.  What do you do when the mayor says, Doc, I can't deal with this? Do we call Albany? Do we call Washington? Do we call the National Guard? Do we call the Air Guard? Do we call the mayor of Jersey City or Newark? Can he help me? Can I get people out? What do I need to know medically in order to get them out safely? When is it safe to go back in? How do I get the information out in a way that doesn't panic people? In the case of New York, I don't think there's any way you can do that, but there are ways that you can minimize that. And what do the hospital people know about this? How can I get the word out to them? Everybody in this room right now knows a great deal more about biological and chemical agents than 99% of the hospital people in the United States. I'll say that again. You are now more expert than 99% of the population in your fields. Now, you've heard that our intelligence estimate is that the threat is gradually increasing domestically, both Bio and Chem. And the reasons should be pretty obvious to you now. The FBI files, I said on the slide that they show a gradual increase in numbers of threats. Actually, the source of that statement is an FBI agent named Chris Breesie who invited me and some of the folks at RID to give briefings down at the FBI Academy. He's in charge of the Weapons of Mass Destruction Subcenter in FBI National Headquarters. Interestingly, most of the threats that they pursue at least this year are Bio rather than Chem. Luckily, as I think you've learned from Lieutenant Colonel Cislak, it's hard for the bad guys to get Bio right. And we haven't had much in the way of biological terrorism that's gone beyond the planning stage, the one big exception being which? The Rajneeshi attack with Salmonella on the salad bars in the Dolls, Oregon. But it's not clear that any others have been terribly successful. But the Bene Brith episode, which I think the folks at RID discussed with you at some length, it shows that the level of knowledge of these agents is relatively low and the panic that they cause can shut down the center of the capital of the United States with absolutely no agent, whatever. I'll show you one of Colonel Itzen's scenarios later on where you actually do have an agent. Now, this is something I went over before. I think in this class maybe, definitely in the other class, what are Chem and Bio agents good for? In the case of military situation, you can deny terrain, you can render a fighting force ineffective, you can kill people. But the terrorist doesn't have to do either of those things. All he has to do is to sow fear and panic. Both of these agents, Chem and Bio, are really good for that. They also paralyze your medical system. So you get a lot of what Prime Minister Thatcher of Great Britain used to call the oxygen of publicity. And how do you deliver them? This again you've already learned the various methods of delivery listed on the slide. I want you to pay particular attention to the one that says enclosed spaces. That's of particular relevance because especially with Bio agents, it's so unpredictable what your weather is going to be like and how far they're going to travel. An enclosed space is wonderful. And what's a great enclosed space? An enclosed space where people in large numbers are traveling through. So an airport terminal, a subway, a central station, Union Station, Washington, D.C.  The Pentagon. The New York Stock Exchange. And the one that nobody ever seems to mention, but I still have this thing in my ear about it, a tourist site, Opryland in Nashville. Some of the, an indoor ball game, an indoor sports stadium. Or some of the big country western places in Branson, Missouri. I guarantee you a town of 3,000 people is not equipped to handle this. Okay. So now I'm going to bore you to death, but I really feel I need to a little bit because this is like a language familiarization course. You are going to hear about the legislation that's come down and the programs for training that have come down in domestic terrorism. The president in the early part of the Clinton administration, I think it was 94 thereabouts, the presidential directive, establishing lead agencies for the federal component to any response. And it was basically just an assignment of tasks. One nice concept to remember if you ever read anything about this in the lay press is the distinction between crisis management and consequence management. I don't happen to like those terms, but we're stuck with them. Crisis management is defined as what happens before the bomb goes off. Consequence management is described as defined as what happens after. Lead agency for crisis management in the United States is the FBI. Basically, you're investigating a potential crime that's about to go on. Outside the United States, the lead agency is supposed to be the State Department, although I've noticed since I've started working with the State Department a little bit, the FBI always seems to be involved and the FBI believes that they have primary responsibility for an American installation overseas. Why is that important to you guys? Because you're military. So for example, when I flew over to Saudi Arabia two weeks after Khobar, the guy in the seat next to me was the FBI station chief in Detroit. And they were sending him over to do some investigation because they regarded that as an American federal installation on a foreign country. For counterespionage, I suppose, would be CIA, but that's not what the PDD says.  The lead agency for consequence management is the Federal Emergency Management Agency, FEMA. Although what happens actually in the plan is that FEMA starts farming out responsibilities, and I'll have a slide about that later. But the training responsibility was given to the Department of Defense. Again, that may not seem all that obvious until you remember where you are. We in the Department of Defense really were the only people who were doing training on this at the time that President Clinton came out with this directive, and so the Department of Defense got the training budget and that turned out to be where all the money was. The next thing that happened, and this is something you will hear about, and on a lot of news coverage that I've seen, anybody ever heard of the Nun Luger Money, or the NLD, or the Nun Luger Amendment? Three senators, none of Georgia, who's no longer in the Senate, Luger of Indiana and Domenici of New Mexico, co-sponsored an appropriations amendment, which came out in 1996, and it is out there for five years, and who knows, it may be extended. And this established what we called the Nun Luger Program, which mandates that the Department of Defense as the lead agency for training establish a domestic preparedness program, and it set out the parameters of that program. That legislation mandates that the program have an awareness block where we familiarize people with the threat, that it have an operator block, which is where we train people who are going to be incident commanders. There's an incident commander block, there's a hazmat folks, incident commander is the person who's going to be running it, usually a fire chief, an EMT block for paramedics, and a hospital provider block, which was intended originally for emergency physicians and nurses. This, the responsibility for developing this program was given to DOD, DOD kicked it down to the Army, because the Army has almost all of the resources, and the Army kicked it down to the chemical and biological defense command. That's called CBDCOM, recently renamed. CBDCOM is headquartered about two blocks from here across the airfield. Most of the buildings you see around here are owned by CBDCOM. They also have a large presence at Fort Dietrich. They are what was the offensive program. We don't have an offensive program or chem or bio anymore, but they're the people who now mostly make their living developing countermeasures that are not medical. They develop most of the things that Mr. Hettinger lectured to you about. They are the people who develop level A suits and so forth. So they had this responsibility, several perambulations that's been farmed out further to a bunch of subcontractors, and we now have these four courses or five courses going around. The legislation stipulates, and this is a political decision, that it be taught at the level of cities. Not counties, not states, not federal. It was taught at the level of cities, and it stipulated in order to avoid offending anybody that the 120 largest cities in the United States would be the first ones to be trained, and they would all be trained within five years. Here is a list of the cities that have received this training already. This is fairly accurate. There have been a couple of changes to this list. San Jose got added, I know, and I think Baltimore hasn't had it yet, but this gives you a rough idea. They're roughly going down decreasing population size. And on the next list, you'll see the next group. There's going to be a break sometime this summer. A break and regroup. But this is an ongoing program, and you guys are paying this. The amount of money that this program costs is $50 million this fiscal year alone. Now, there are all sorts of political choices that were made. If you're training the 120 largest cities in the United States, you're automatically skewing it. For example, the state of Connecticut was left out. Why was Connecticut left out? Because in Connecticut, which is a New England state, the cities have not swallowed up their suburbs. The way Memphis and Jacksonville and Nashville have done so. So no city in Connecticut was big enough to make the list. Counties are not involved. In the case of New York and Boston, the city governments filled up the classes with people who were employed by the city. In Los Angeles, I think very sensibly, they said really the level of government we should be working with is Los Angeles County, because that's larger and we're really a metropolitan area, so they did get some people from the suburbs. Same thing happened in Washington, D.C., surprisingly enough. So there's a real political thing here. The Americans Association of Chiefs of Police has made a big point that we could do a better job than the Army. There's a lot of politics behind this. Another interesting thing that came out when Colonel Hurst and Colonel Eisen and I came to review the program, we said, well, gee, you're trying to reach, talking about the hospital folks, now we're trying to reach doctors and nurses. Where's your CME? What's that, they said, because they're not medical. And the institutes, RID and ourselves, we're not primarily in charge of this program at all, but as federal agencies that are charged with teaching this material to federal people like yourselves, we felt that we at least needed to make sure that what they were putting out was accurate. By the way, how long is the hospital provider course? It's eight hours. As two hours on nuclear, two hours on bio, two hours on chem, okay? So obviously it's a very broad brush program. We succeeded in getting CME for the program. In fact, it was Rosalie Holland who got it, because she has a nice tie-in with the AEMED Center in school, which is the accrediting agency that's giving you your CMEs for being here today, and we were able to do it faster than any of the universities. So guess what, I'm actually the CME director, because they needed to have a name. We're trying to get that transitioned over to a civilian agency, the organization we're trying to get to take over is the American College of Emergency Physicians. But to give you an idea, this is a very political process, and it's coming soon to a city near you. If it hasn't gotten there yet, there's no place in the country except Connecticut, Maine, where there isn't any city that's going to be trained. Now, there's another big issue that nobody has solved. What do we do after we train them? I'm in favor, this is, again, editorial. A lot of this talk is my personal opinion, having gone to a lot of these meetings. I think that what we should do is to follow the American Red Cross model and have some sort of certification, very much like BLS. Well, to get people to agree to that is very tough. I think the best organization to do it is probably going to be the ACEP, the American College of Emergency Physicians. From here on in, this is all concepts. How do you apply the basic principles of disaster management to the chem or bio context? Remember I said that crisis management is the agreed upon definition of what happens before the bomb goes off. Crisis is conceptually defined into two parts, planning and preparation. Really, they go on at the same time. And the major thing here is training, and the important actors are your police, your fire, hazmat teams. Let me tell you what it's like to train these people. The fire chiefs don't really have difficulty conceptually with this. They just have to learn the data. It's interesting, they're used to dealing with hazmat. They regard chem as essentially a special case of hazmat. In fact, many of them that I've talked to, the fire chiefs, feel that we are with chem agents about where we were with hazmat ten years ago. Bio is very different for them. It's a whole new world, and the whole concept of incident command that they're used to dealing with just doesn't quite apply. I remember I was at one meeting, and there wasn't anybody from RID at that meeting.  And I was saying to them, well, you know what you really need? The concept that you have to have for a bio warfare terrorism incident is converting New York City with its 50 or 60 hospitals that tend not to talk to each other into Rochester, Minnesota, where the Mayo Clinic is, and everything's on one medical record, so that you could identify the epidemiology as fast as possible. That's not the way fire chiefs are used to thinking. So you have to sensitize them to that. Your health care professionals, not everybody in the country needs to take this course. Not everybody in this country needs to know how to treat plague. Once you know you have plague, you can just know where to turn. But we have to at least sensitize people to particularly the things that you don't have time to look up, and you guys know what those are. What are they? Probably nerve and cyanide are the biggies. And then to a lesser extent, some of the others. There are all sorts of problems with personnel protection, protection of health care facilities. Nobody has really dealt with this until very, very recently. And then you have to have a disaster plan. Now, every hospital in the country in order to be accredited has to run a mass cow. I would bet that 100% of the hospital-based people in this room have participated in mass cows. The best of my knowledge, Dr. Natook's mass cow is the first ever done for accreditation in Jaco in a chemical scenario. And I don't know of any that's been done in bio so far. How are we going to detect the agent? Remember that civilian community doesn't have the standoff stuff that we have here in the military. They don't have the protection, collective or individual. And they're not used to dealing with the public quite the way we are, although maybe we can learn something from them. And, you know, Ben-Abrith and Sarah are being good examples. So now the bomb has gone off. Now you've done all your training.  It's just like Desert Storm. What happens? Well, there's always an incident command if it really is a bomb. That's true if it's a chemical agent exposure. Unity of command is something that most places are pretty used to, but there are turf wars. And this is a wonderful story that Major Shaw probably can attest to. At the New York meeting, I showed up and I knew that there was going to be a Marine Corps presence there. I'll tell you about the Marine Corps in a bit. I make funny jokes about the Marine Corps. Actually, the Marine Corps in some ways is absolutely out in front and doing a better job than anybody else. And this Marine Corps unit I'll tell you about in a second that always sends somebody along. So they have Major Mike Malone, Marine Corps Major. And Mike Malone shows up to every meeting impeccably dressed. He has his uniform pressed. Everything looks great. He looks exactly like a Marine Corps recruiting poster. So I made sure I had my class A's, and it'll look really good because I knew I was going to be there with Mike. And he shows up wearing a sweater and T-shirt, sweater and jeans and sneakers. And I said, Mike, what are you doing in the cities? He says, this is New York. I said, why? He says, let me tell you what happened the last time I came here. They were setting up this field exercise and they had Mayor Giuliani and they have all the major players there and I'm there as an advisor. And I say, Mr. Mayor, you need unity of command. And the fire chief says, I'm supposed to do it. The police chief says, I'm supposed to do it. This one says, I'm supposed to do it. And I say to the mayor, Mr. Mayor, sir, my best advice to you is you have to pick someone to be in command. So they come back to the next session. Mayor Giuliani leans over and points to the fire chief, fire commissioner of the city of New York and he says, you are in charge, Mr. Commissioner. Well, he says to me, ever since then I do not wear my Marine Corps uniform or any New York City policeman can find me. Okay? Police don't like me because they blame it all on me. But the fact is that probably Mayor Giuliani made exactly the right decision. At least he made a decision. At least you know who's going to be in command.  Do you have a standoff capacity in the civilian community? No, you don't. So you're doing sentinel casualties. Our experience in Tokyo tells us that this may not work all that well. It took several hours before the Japanese doctors knew what they were dealing with. During that time, all of their hospitals had gotten contaminated. They made no attempt to decon on the outside. The physicians in Matsumoto a hundred miles away who had dealt with the same agent about six months before started making phone calls to Tokyo saying, we think we know what you're dealing with. The Tokyo doctors didn't listen to them for a while. So that's a communications glitch that we expect we're not going to do any better than the Japanese probably. How do you warn the population what's going on? What do you tell the media? What do you want the media to do for you? The media is not just your enemy. The media can really be your friend. You have to know how to use that. Now, the mayor may actually have a good staff to deal with his local media. In-place shelters. There's only one place that's really gotten into that other than Iraq, I suspect, and that's Israel. But we haven't really done much about that in the United States. Regulation, mass casualties. True story. Chobar Towers. Non-chemical, non-biological. This was an attack on American military base. Air Force is in charge. The Air Force is a military organization. Yes, it really is. They have, despite all the jokes, the Air Force in Saudi Arabia is very well organized.  People were assumed to be dead and found to be in ICU beds two days later. That's in the military. Imagine what it's going to be like in New York City. And then the other problem that we've hit you over the head with over and over again, the walking worried, the psychogenic patient or the barely involved patient who, at least in Tokyo, those were the first in-patients to show up to the emergency room. Information dissemination. Do you want to be a journalist? No. But you have to know how to deal with the media. Media is not necessarily your friend, not necessarily your enemy and unity of command. That's really stuff that we've already discussed. EVAC. How are you going to evacuate lower Manhattan? I personally do not want the responsibility for that. I don't think any of us is going to have the direct responsibility for that, but we all may be in a situation where we have to advise medically those who are responsible for evacuation. By the way, in the military, anybody here connected with a unit, Army, Navy, Air Force, Marine, that infills the Korean theater, how many of you? Good number. You all have to worry about that because we have 130,000 civilians to get out of that theater when we start having bombs going back and forth and it's probably going to be a chemical theater. And do you want to evacuate people who may be in line for the next round? Then there's something called the recovery phase, which, again, there's a continuum. We in the military probably will not be directly as connected with this unless we are local. If this is Washington, D.C. is the target, obviously, those of us who work at Bethesda, Naval, and Walter Reed, Malcolm Grove will still be involved. But this is something that is of less medical importance. One of the major things that we may have to advise on is when is it safe to go in? And that's where the stuff that you've learned about biological and chemical agents in this course may come helpful. Issue that's come up, respiratory protection for people. There is one place in the world that's really gotten into this in a big way and that's Israel. Israel is the only country in the world where everybody has their own gas mask. Now, there are problems with gas masks, protective masks. Did Saddam Hussein cause any chemical casualties in Israel during the Gulf War? Well, everybody says no because there were no chemical rounds, but people died. Several people died because they had heart attacks while they were in their protective masks. At least two children were asphyxiated by their parents because their masks did not fit and they died. So did the Iraqis cause Israeli deaths in the Gulf War? They may well have. And believe me, the Israelis have not solved this problem. Although I'll be very interested in going over there in a couple of weeks. We have a financial conference with them and this is one of the issues that we're going to be discussing with them. Well, we have time to train everybody and as Colonel Natuck mentioned to it, who's going to pay for all this? Fire chiefs, when you go and talk to the fire folks and the municipal leaders around our country about this stuff, they get these great ideas about we're going to buy this, we're going to buy that. New York City has a Fox vehicle. They really do. You know, just buying the equipment is a major budgetary drain and just as Dr. Natuck said, it's a relatively low threat over a particular fiscal year. How can you justify the expense? The logistics. Hospital mask cows are one thing. Yeah. Is the military going to get involved in any of that? I've been decorated. Rigidly flexible. Are we going to get involved? Obviously, I'm involved now. This civilian emergency, not military related, would the military still be responsible for responding to this? Hold that thought. That's three slides down. Yes. The answer is yes. I'll give you an idea of how that works. But although we may have hospital mask cow, we don't really stress a metropolitan area yet in any of our plans and obviously that's going to take even more money. Are we going to preposition stuff?  Who's going to pay for prepositioning it? Who's going to pay for the vaccines? Are the vaccines even in existence? You remember what Colonel Hurst said yesterday? Botulinum toxin, we have 5,000 doses available at any given moment in the United States. Well, we may need to have a lot more than that if we think that that's available, that that's something we really need. And the other thing is ventilators. One of the things that we're probably going to have to do a lot more carefully is medical regulation of ventilator beds for all the reasons that you've heard this week. So now, Lieutenant Fasano, we start talking about how this is actually going to work. I got reinforcements coming to deal with you later. In fact, I sent him out. I sort of anticipated we might need to deal with you. Don't go anywhere. Traditionally, immediate response is going to be municipal. That's the way American government is set up. We have local control. The cities guard their prerogative zealously.  And then you're going to have the police chief probably working for him. The EMS, all of us are going to fall in. All of us who work in a local locality, reservists and so on, we're going to fall in on the local fire chief and the emergency medical community. And that's going to be overwhelmed fairly fast. Doctrine states that at that point you go to the state government. Well, the state government may be helpful or the state government may not be helpful. If you are Billings, Montana, the state government may not have much to contribute. They may be too far away. They may not have much. One thing that the state governors have is a national guard. National guard can be very helpful if you happen to have the right unit. The problem is the national guard is spread out around the country according to where the army and the air force need those units and not because each state is supposed to be self-sufficient. So they may have a unit that's helpful or they may not. And then there's also this problem of city-state politics and this is exemplified. Major Shaw will attest that this actually happened in the New York pre-brief. Dr. Howard's assistant as mayor's office of emergency preparedness, we were working through that mustard scenario that I gave you at the beginning of the talk. And so he says, okay, I've got people dying in the streets. My hospitals are full. I'm going to call on the feds and I say no. What you really are supposed to do is to call Governor Pataki up in Albany. He has a New York national guard. He has various things. He has a state police. He has various agents. You're supposed to go through them. And he looked at me and he says, we'd much rather call the feds. We don't like to deal with Albany. There's a long history of that in New York City. New York City also has a lot of things that most state governments don't have. It has more money. It has its own medical examiner. So that may be an unusual situation. But the fact is that the state governor may not be able to help you. So at which point you call on the feds? Now how do you call on the feds? You call on the governor or maybe the mayor. Calls the president. The president declares an emergency. The FBI is mobilized almost immediately. The FBI regards this as a crime scene. I've given presentations on this stuff in front of FBI agents and I always have to tell them, don't get between me and my patient. Don't get between my nurse and her patient or my PA and her patient or my other physician and her patient. And I'm sort of beating them over the head on this because we don't want them to start dealing with it only as a crime scene. But when the government president declares an emergency, several things happen. The FBI is allowed to mobilize something called the domestic emergency support team, which is a, I guess it's a lynch mob size group of people. It fills up an airplane. It includes me. It includes somebody from RID, probably Colonel Christopher, possibly Commander Culpeper. It can include people from, it definitely includes people from FBI. It may include people from DOE, people from PHS, blah, blah, blah, blah, blah. A whole pile of people who go and assess the situation. And it can be tailored. But the RID agency for consequence management is supposed to be FEMA. And so FEMA opens up, they have this huge thing called the federal response plan. The federal response plan divides up into all sorts of different functional areas. ESF, emergency support functions. ESF-8 is medical. RID agency for medical is the Office of Emergency Preparedness of the Public Health Service, Department of Health and Human Services. They are mostly commission corps people. Person in charge of that is a Rear Admiral Knauss, Dr. Knauss, very nice guy. His operations officer is Commander Public Health Service, Kevin Tonat. Kevin is the person who's taught me all about this. And under them, they can pull in a very large variety of organizations, both civilian and military, all of which are in the federal response. But every time Kevin goes out and gives his presentations, he tries to impress some local communities, don't expect us in five minutes. They've done scenarios where they've responded to an emergency in Boise, Idaho. And it takes about a day to get all the feds in place in Boise. Because you don't have to just fly to Boise. You have to get them on the plane. And so it may take a while. The feds will come to the rescue and, of course, when we fall in, guys, this is important, we are not working for the President of the United States anymore. We are actually supporting the local community. So who are these military organizations? National Guard, we're not talking about here because National Guard has been used on the state level. We can be talking about active duty. Now, I'm an Army officer. The Army has by far the largest amount to bring to the table. In the case of the Army, this goes to Chief of Staff of the Army, kicks it down to the Office of the Surgeon General. There's also a Directorate, Two-Star General, Billet, Directorate of Military Support. It's commanded by General Soriano. But at our medical side, it goes through the Office of the Surgeon General, it goes through Major Shaw's boss, Colonel Fred Gerber. And he can pull almost anybody he wants from Army active units. He will pull us at ICD in the Institute of Infectious Disease. And he can mobilize the reserve, more about the reserve in a minute. The other side of the house there's a wonderful organization called the United States Marine Corps. The United States Marine Corps is an interesting organization. It's military... The way the military mission of the Marine Corps gets done is in a self-contained fashion. The Marine Corps goes out and they do everything themselves. They are very, very proud of the fact that they are self-sustaining. They are a short-term shock troop military force. And a few years ago, the commandant of the Marine Corps, General Crouac, realized that he had no internal, organic way of dealing with chem-bio-emergencies on the battlefield. He had to depend on the Navy because all of his medical was coming from the Navy. He had to depend on our expertise and so forth. And he said, we can't have this. The Marine Corps has to be able to stand alone. And so he created, under his guidance, an organization called the Chemical Biological Immediate Reaction Force, which is located at Camp Lejeune, North Carolina. It is commanded by Lieutenant Colonel Art Corbett, who is a Marine Corps infantry officer. He has, among his troops, 30 medical troops. The medical commander is a Navy Captain, 06. Captain Lori Belogurchik. She's not the only physician they have. They have a recon platoon. They have a decompatoon. They literally can do everything. Marine Corps really led on this. The people they have are superb. Sea Burf actually has its own, it must be the only military organization I've ever heard of, actually has its own board of directors and advisors, including one Nobel Prize winner, Dr. Joshua Letterberg. We are the advisors. In fact, Colonel Hurst and I are basically spelling each other at the next Reach Back meeting, which is next Monday and Tuesday. Yeah. Dr. Neymar, is this federal response, the same template that they use when active duty troops do disaster relief, for instance, when the 82nd... Very similar. Florida. Very, very similar. Yeah, because the Federal Emergency Response Plan covers everything. I'm talking only about ChemBio, but yes, this is a ChemBio application of the basic plan. But about Sea Burf, despite the fact that I give full credit to the Marine Corps for having done this, the fact is, I think that General Kroak almost did too good a job. He has created such a unique unit that it's probably never going to get used by the Marine Corps. When Sea Burf has deployed in the past, it's always been in support of a civilian emergency. They have deployed in support of the Atlanta Olympics, the Summit of the Eight in Denver, President Clinton's second inaugural in 1996 in Washington, 1997, actually. And so Sea Burf is a group that's going to get there too. They have their own airlift capacity. They won't be there in five minutes, and they can't sustain for terribly long, but Sea Burf is a major player. And then there's others. This is from an article, in fact all of these that I'm showing you are from an article that was written for U.S. News and World Report as a cover story. And what I really like about this is not just the level A suits, but the caption, because it says, even the Marine Corps has a chemical and biological response for us to deal with terrorist incidents.  Marine Corps has really pioneered a lot of this, and we're learning a great deal from them. Now, a comment about reservists. Sometimes we have more reservists in the class, and I didn't really know how many we were going to have. And the Air Force Reserve, to a lesser extent, plays a very interesting role here. First of all, the Army Reserve has almost all the civil affairs units we have. We have only one on active duty, and that's at Fort Bragg. So in the recovery phase, the Army Reserve may actually start being pulled in to assist in administration of areas that are being repopulated. It's part of the NDMS and the emergency medical system, because most of our reservists work in civilian hospitals that are part of the NDMS. But the reserve is now making, especially the Army Reserve and the National Guard Bureau, which covers both Army and Air Force, making a big play to take over perhaps part of the domestic preparedness program. Looking for new roles, I now understand that the regional medical commands on the reserve side, which are called RSCs, Regional Support Commands, the Army calls them, they want to have a response team comparable to the ones located at Army MedSense, of which Colonel Natoch is the commander of one. And then various backups for ChemBioResponse. For the next five minutes, I'm going to give you points that Colonel Eizen wanted me to give you. I am not a bio-expert, but Colonel Eizen is, and I have given him some points I wanted him to make, and he has given me some points that he wants me to make in front of you. So what you're now getting is the rid perspective of what Colonel Eizen considers to be important. Practically everything on this slide is stuff that you've seen before. It's been done before. It's going to be done again. Anthrax, Botte, and Reisen were in the Armamentarium of the Ome Shindikyo. We think in this country of them, in terms of Sarin, but they were very interested in Botte as well. And we have to be prepared to respond. Here's Larry Wayne Harris. Now, it's interesting. Larry Wayne Harris was in this course for years. Colonel Eizen always used to talk about Larry Wayne Harris, not because he had been under surveillance for years, trying to get hold of Anthrax in his house in Ohio. When we were in Fort Bragg about three weeks ago, Major Pavlin was with us, and she was really interested, because she'd been studying this guy for years, and here he was being arrested in Las Vegas. And here's the militia guys.  The first people convicted under the Chembioterrorism Act of 1989 were trying to use Reisen, which is, of course, the classic assassination weapon. A lot of interest, but not that many actual incidents. Remember that the Ben A. Brith incident was a misspelled Anthrax, and it turned out not to have anything in it. Here is a scenario that Colonel Eizen put together for the Summit of the Eight. This is sort of the complement to the mustard attack on New York City. This is the Anthrax aerosol attack on Denver, Colorado. And if you read through this, they do it in a shopping mall. It could have been worse. It could have been Denver International Airport. But 90% of the exposed people were started on antibiotics by the end of day, too, but they can't find 10%. If it's the airport, imagine that that 10% might be 20, 30%. And if you look at this relatively small-scale bioterrorism, Colonel Eizen's numbers, as he crunched them out, indicate that even this small-scale event completely around Denver's resources. And, in fact, the 13,000 military medical beds deployed for the Gulf War would not have provided enough ICU beds. So this is his idea. And then this is his take on pretty much everything that I've already discussed, which made me feel good because when I put my slides together, I hadn't seen Colonel Eizen's slides, so we basically came up with the same points that we wanted to make. What we wanted to mention was the question of readiness, public health infrastructure. We have no good answers for this. Colonel Eizen has no good answers for this. And it's really sensitizing you to it. The last thing I'm going to do and I think that you can probably fill in these blanks for me, is to mention three or four issues having to do with chem casualty care, which might be different based on the civilian terrorist scenario versus the military scenario that really is where all the course that you've had up till now comes from. We were always preparing against a chemical attack. In order to get into a chemically contaminated environment on the civilian side, if you are a fireman, you have to be in an OSHA level A suit. That's the big blue suits that I just showed you. They're not allowed to use mop gear. We in the military can get away with mop gear, which is a lot cheaper. They're probably about the same. We're trying to get OSHA to modify it. Here's one of the chemical terrorists. I've forgotten his name. Oh, James Dalton Bell, chemist in Vancouver, Washington, who was building a little chemical lab in his backyard. I think he's the guest of the government now, but I don't know. Here's one that I'm really interested in. Anakin Vulsons for nerve agent exposure. Remember we taught you diazepam, diazepam, diazepam. Really, Valium. Diazepam, diazepam. Sorry, I'm allowed to say that. But in the civilian community, we do not use diazepam as an Anakin Vulson to all that much anymore. If we want to use a benzodiazepine Anakin Vulson, we tend to use low-raise apams. Diazepam is approved. We use it in the military for a lot of reasons, including the fact that it's stable and it's active I.M. But in the civilian community, they've gone beyond that. We've never gone through the hoops of the FDA to approve any of the other benzodiazepine Anakin Vulsons, and they do actually work as well. In fact, my days of lab works even better in laboratory studies. So for the domestic preparedness program, Colonel Hurston and I have taught the instructors to give out the following word. Everything in the course talks about diazepam, because that's the only thing that we're allowed to talk about. But we see no reason why in your emergency room you can't use low-raise apam to approve benzodiazepines. But that's a disconnect, and we haven't really solved it. A much bigger problem is mass decontamination. What are we going to do with the little old lady at the church supper who may have had exposure to aerosolized mustard? She needs to strip down to her birthday suit and allow the firemen to hose her down. And what happens if she refuses? She's not a member of the military. We can't force her to do anything. Are we going to have the fire brigade in the local community? And it probably is going to be the fire brigade. They're not used to doing that to people, okay? They're out there to save lives. They're used to people being grateful for their presence, not used to people screaming at them, do they have the right to force anybody to do anything? We have a bill of rights in this country. Surprise, surprise. And Battelle actually has a big contract with CBD com right next door to work on this problem. And they have not solved it. They're working quite hard on this. They've gotten a lot of emergency medicine, emergency fire, and police folks from the Baltimore-Washington area working on it. There are problems with having the stuff to decon. You can usually get water in this country. Tuna and wankits, they're not funded for that. They're not even funded for bleach, although it's relatively cheap. What are we going to do with people who are children, older adults, people who have respiratory diseases? And then the other issue that's come up and only George Washington University Hospital in the whole country has really faced is the issue of how you prepare or alter your civilian emergency room to do mass decontamination so you avoid the problem that the Japanese had of a good deal of contamination carried in on the patients into the hospital. And the last one is a biggie and that's children. All of our antidotes are presupposing an adult. In fact, they're presupposing a relatively young adult. All of you who deal with patients are well aware of the fact that older people are more sensitive to any medication. You also realize the children are small. Am I going to give an atropine injector to a four-year-old girl with a child but still respiratory compromised nerve agent exposure? Well in Israel, they have an answer. They want a dilados injector. This institute actually did develop such a thing but to field it is not something that the military will pay for. Who's going to pay for that? Is the city of New York going to pay for that? Is the city of Charleston, South Carolina going to pay for that or the city of the streets? You see, this is an issue that nobody really has solved completely and there are all sorts of other issues that you can think about for pediatrics. I wouldn't be surprised, although I'm not an expert in bio warfare, that some of our vaccines that we work on have not been tested in children. Children, my pediatrician colleagues tell me are not small adults. They're actually a different species. The last issue and so I was told when I was in medical school and the last issue has to do with triage. We treat we teach the principles of triage, of course you learned how we approach that in the military. In the military we're not happy about it but we've gotten used to doing the triage. But in the civilian community they may not be. Is a mayor going to be willing to accept responsibility for things that military commanders do routinely accept that responsibility for saying you're expectant. The mayor may very well say airlift into another city that hasn't been hit. So the whole question of triage, nobody's really dealt with this and I have no great answers. My job is to leave you with the issues that I think are important. So that concludes pretty much what I had to say. The last word I would leave with you is as you've heard, it isn't a matter of if we are told. It's a matter of when and how and how prepared we all are to face it.


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So, my name is Christina Buffer and I'm working at the Framico Institute of Applied Polymer Research, which is located in Potsdam-Golm, close to Berlin, in the southwest of Berlin. And we are concerned with many types of polymers starting from bio-polymers up to electrical conducting polymers. And so, I am personally in the division of functional polymers and devices and we are working on organic electronic device development and also deep material development. At the Framhofer IAP? At the Framhofer IAP, yes. And, for example, behind you I see something to do with quantum dots, organic light emitting diodes, OLEDs, and what would you like to talk about first? As I already mentioned in the introduction, we are working on organic electronics in general and we have been busy in this field for 25 years starting this OLED research. So, we are working on development of OLED materials and OLED device stacks and this is a field that we are still working on. About 12 years ago we started to work on quantum dot development so we are focusing on the development of quantum free quantum dots, so-called eco-friendly quantum dots. Our focus is on materials based on indium phosphide, for red and green emission and on zinc-cellenite for blue emission. We have some examples here on the poster so you can see here devices that were made from red and green indium phosphide and the blue zinc-cellenite which was docked with a tellurium. And the second focus that we have besides the material development is the development of processing technologies. So one of the focus is setting up instrumentations and process technologies that are able to make processes for the manufacturing of organic electronic devices. And this is a combination of methods which are suitable to do large area processing such as a slotted coating or for lab-scale tests of spin coating or plate coating. And we also are using digital processes and our focus is on inkjet printing and EHD jet-printing. The inkjet printing is limited with respect to the ink formulations to low viscosity inks and a resolution I would say down to 20 to 40 micrometers. EHD jet has the advantage to be able to print a resolution. For instance here you see an example where we have a dot size of about 10 micrometers and also the same as here. And the second advantage of the EHD jet is that the viscosity range that is accessible is larger than the inkjet so we have a viscosity range that is covering 4 orders of magnitude and so in this case here we have been printed quantum dot materials into a band structure that we resolved in the resin and these structures have a height of a micrometer and we can even make them thicker if we have the right band structure to print in. And these are examples that may be used later on as color filters for instance for micro LEDs. So Fraunhofer is famous for developing, inventing a whole bunch of crucial stuff that's just being used by billions of people every day and it could be in audio and displays and a lot of stuff is happening in a nano technology world right? That's true, yeah. Yeah I may show just goes through some examples. For instance here we have been active in a binational project with a company in France and a company in Germany for developing processes for ambient solution processing of OLEDs in order to address by inkjet printing customized applications that could be used for also small scale and cheap or low cost production of OLEDs. Another example is shown here where we did a high resolution printing using the AEG Jet. This is an active matrix OLED and we printed one layer by AEG Jet into the pixel defining layer of this type of active matrix backplane and then finished the display by spin printing in this place and what you see is the local of this AU project and this system has 20, 60, 4000 single pixels that need to be printed and our goal is to make such a process scalable really to large scale that it may be used into production later on. This is all fascinating stuff and when you develop this stuff you have prototypes but then you work in collaboration with other companies that want to mass produce this. Yeah, that's true. There's one example shown here, this was a collaboration with different companies where a pilot line has been developed within this project in order to do a mass production of these types of barcodes and our goal in this project was to develop the printing processes by inkjet in a way that it can be scalable and can be set into mass production. The requirement here was to achieve a print process that allows printing of a substrate of 400 times 500 millimeters within two minutes to do the whole processing and printing, trying steps with this type of repetition rate. Alright, and we're just at one poster. You have another one? Another poster shows the capabilities that we have in our institute. So what you see here, this is a view in our clean room. We have a clean room capacity of about 300 square meters and this clean room is equipped with all the equipment that you need for the processing of organic electronic devices. So you see here, a picture of our pilot line, it's 50 meters long and we have the different deposition processes sent into the pilot line, we have the inkjet printing, we have the 38 coating, we have the PVE deposition, the lamination and we also have an atomic layer deposition for the encapsulation and we are carrying out different projects in the moment to use the AAG for either encapsulation of organic electronic devices where we need barrier performance properties of 10 to the minus 6 gram per square meter a day and we are also working on the deposition of noble metals for instance for applications of membranes for selecting for instance, for filtering for instance base. In addition is the equipment that we have at the different places like inkjet printers, printers that we are using, this is the AAG printer and we also have the equipment for the characterization like profilometry, bending test, AFM, 4 point probe and one of the center pictures what you see here is the need that is the requirements necessary to develop inks, the combination of requirements that are needed in order to get at the end an optimized printing result and the instrumentation that we have together with the characterization enables us to do the ink development for customers who are interested in also upscaling production with inkjet printing or other printing techniques. So you have the cutting edge best printed electronics like research facility? I think, I mean it's always nice to have something more but we have facilities for doing all the processes that are necessary to produce this type of electronic devices and also the characterization facilities for those and for us, these are the cutting edge facilities, yes. What kind of discussions do you have here at the nanotechnology conference? People want to work with you in all kinds of stuff? I have to think the moment before I talk into the camera. To come to nanotechnology for us it's important to meet people from the same area as we are working on for instance we had a long cooperation with the nanotechnology lab here in Kessaloniki and there is a close exchange of information this time that's an important task we have but it's also important to meet projects partners that we already have or maybe future project partners in the field of printing but also in the field of material development.


Starting with Claire Downey from the Rediscovery Centre based in Balli Munn, which focuses on recycling, sustainable fashion, education and research. And Claire is a researcher with a focus on reducing energy demand. She has a degree in chemical engineering from the University of Queensland, and he used to work with Indiver. Great. Thank you very much. Thank you to Tommy Simpson and John Gormley for the invitation to speak. I'm very pleased to be here to represent the Rediscovery Centre as the National Centre for Circular Economy. Also as a board member of Green Foundation Ireland, and to be part of the conversation about this really far reaching report. I'd like to make the connection quickly between the circular economy and reducing energy demand. And I think I'll start by illustrating it with an everyday product that we all have and use or most of us have in use. If you start to take apart a mobile phone, as we saw Minister Ishim Smith take apart a disposable vape interestingly on Twitter recently, you'll find 300 components and 85% of the stable elements of the periodic table.  So an average mobile phone costs around 80 kilos of carbon to produce, and there are 3.5 billion of them in use right now, excluding what we've already wasted. And that's just mobile phones, smart phones. It's not other types of phones. It's not your devices. It's not your IT equipment. When we start to think about one simple product, you can see very quickly how much goes into our products and most of that is around energy. When we talk about carbon emissions, we think about transport emissions, we're transporting products, and we think about agriculture, we're making food, it's not a thing farmers do for the crack, it's an actual production system that leads to food that leads to food waste and all of this adds up into our energy demand. And so the Ellen MacArthur Foundation estimates that around 45% of global greenhouse gas emissions are associated with the extraction and production of our goods, and around 90% of biodiversity loss as well is associated with this activity. So we absolutely need to talk about energy demand and reducing energy demand by reducing our consumption. And in Ireland, we have some statistics from Eurostat about what we're consuming here, and they are quite surprising. Our consumption footprint, which measures the impact of the goods that we use here that we import the energy imported through the products we use is the second highest in Europe. We know that we have extremely high textile consumption, where the fourth highest in Europe on that, depending on which figure you look, we know that we have the highest production of plastic waste and the highest production of plastic packaging is placed on the market here in Ireland. We're not exactly sure why that is perhaps it's the type of statistics we're declaring but I think it tells a story about our habits and our consumption patterns here that we absolutely need to address. There is obviously a lot behind all of this consumption there's huge budgets behind marketing that's driving it the linear economy is the economy at the moment that is still the most affordable the most accessible the most viable for business. As business as usual, and we are locked into this system at the moment. We know there are lots of other benefits to circular economy, not just environmental of course as community resilience we saw that through the pandemic there's skills there's jobs and well being so we need to make a shift urgently to this more circular economy, and keep our products in circulation and reduce demand for new products where the energy inputs are. We have seen a lot of change in Ireland recently we've seen huge shift in policy we have a new Minister for circular economy. That was good timing and a new circular economy unit two dedicated units in the department as well as a new strategy and new program. And soon we'll also see a new national waste management plan for circular economy so we have seen great momentum there. And now we just need to see that policy put into practice. We need to see how we can build on the vision to lead Europe in the circular economy, we need to see real focus on these prevention, the reduction piece on reuse and repair on the targets that we hope to see come through for reuse. And we need to see all the different ways we can make it as easy as accessible and as affordable and viable to be more circular. One area I just wanted to mention in particular that we're very involved in the rediscovery center is in communications and behavioral change and I know communications is only a small part of the picture. But we do think it's really important we have done a survey recently that found only 25% of people understand the term circular economy. I know there was a discussion earlier about language and use of language and we absolutely need to see how do we describe this better and communicate it better. And also how do we engage citizens in this journey how do we do more for example participatory decision making which I know is in the report as well. And we've done a little bit of work in that area recently with the food waste roadmap trying to involve people in how we design our policies and how it impacts them. So I think I suppose in terms of the recommendations in the report I thought it was really interesting that the same recommendations applicable very much to energy transport energy consumption also very much applied to circular economies so how do we avoid excess consumption. That's the very basic principle of circular economy how do we repurpose and share and keep our goods and circulation for as long as possible. And how do we supplement existing products with better design products that will last for longer that can be repaired. And I think all of those, as I said absolutely align with the, with the circular economy principles. So that's my reflections on the report and I hope that helps to stimulate some further discussion. Thank you.


Chuck Yeager was the first to break the sound barrier in the X-1. In October 1947, he reached 1,100 km per hour. We used Mach numbers to signify the multiple of the speed of sound a vehicle travels. This was Mach 1.06. The Lockheed SR-71A Blackbird set the current world's record for jet aircraft at 3,530 km per hour in 1976. That's Mach 3.3. The fastest rocket-powered manned aircraft was the X-15. It set the record at 7,258 km per hour in 1967. That's Mach 6.7. To graph the speeds these cars and aircraft have achieved, we'll need to adjust the units on the X-axis again. This time, we'll make each interval on the X-axis equal to the distance sound travels in air in one second. That's 341 meters. The line at 45 degrees that divides the area in half is the line that represents the speed of sound in air. We're now getting close to as fast as humans and machines can move. The last four we'll cover are all spacecraft. Apollo 10 reached 39,896 km per hour. That's 24,790 miles per hour. In 1969, as it paved the way for man's first landing on the moon. I remember watching this launch. The New Horizons spacecraft was launched in 2006, edit for Pluto. It is traveling at 58,536 km per hour. The record for unmanned spaceflight as measured relative to the Earth. It started sending back never-before-seen pictures of Pluto in July 2015. Helios A and Helios B are a pair of probes launched into orbit around the Sun in order to study solar processes. Launched on December 10, 1974 and January 15, 1976, the probes were notable for having set a maximum speed record for spacecraft at 252,792 km per hour. That's 157,077 miles per hour. But this speed is measured relative to the Sun, not the Earth. Note that the Earth's average speed around the Sun is 108,000 km per hour, or 67,000 miles per hour. But the current speed record, as of mid-year 2022, belongs to the Parker Solar Probe. On November 20, 2021, it reached a speed of 163 km per second. That's 586,800 km per hour, or 364,660 miles per hour, as it actually passed through the outer atmosphere of the Sun. It reached this speed after getting a gravity assist from Venus a month earlier. This is the first time in history a spacecraft has touched the Sun's corona, where it sampled particles and measured its magnetic fields. This record is expected to stand until September of 2023, when the probe will beat its own record on its 17th orbit of the Sun. At these speeds, we have to increase the distance intervals again. We'll set it at 10 km per mark. That's 6.2 miles. Parker is moving over 40 million times faster than the snail in my backyard.


What's going on, y'all? Chris from Jasper's Case Breaks.com. Both R&Bs are done. We are all set for 2021 Panini NT Baseball Two Box Half Case Break, number 28 PYT. We have our two boxes here, number 28 on the side. Here's sheet number one from all of our, all of our spots. There's Jordan and Diego. Diego bought the spot for Jordan, so Jordan if you are watching. Good luck if it's your first break with this little first break mojo, never hurt no one. Here's the R&B for the Angels and the Dodgers, and the R&B for the Yanks and Mariners. So two R&B breaks, thanks once again for getting these filled out. Let's have some fun though. NT Baseball Half Case Break. Nice, Jordan happy birthday man. Let's get you a nice one. Good luck to everyone. Just scared, didn't know Joe was on the outside. I was like, Joe's trapped in the mirror, trapped in the glass. Oh God. Yeah, I love Canyon, man. It was rad. Make sure, don't let me grab this to play on. Almost slid out. Good catch. Quit there. All right everyone, good luck. Let's have some fun. First card. Retro Materials, Raphael Parmero for the Texas Rangers. That's in our R&B. That is three out of 25. So for our Texas group, that is for the Yankees and Mariners to spot three. That'll go to, at 25, Colossal Patch 43 out of 99, Mickey Moniak, Phillies, R&B spot in the Angels, Dodgers group. Spot three goes to Steven, Steven White. Patch of Alex Bregman, Houston Astros, a straight up spot. Matt Arden with Houston Astros, 95 out of 99. Nice one, another patch. Missapia Black and White, Vladdy, 43 out of 99. Toronto, another number block team. And the Dodgers and Angels group. Once again, three goes to Steven. Nice. On-card Auto, class of 1994 Hall of Famer, Steve Carlson, 21 out of 25. Phillies, an R&B spot in the Dodgers and Angels, spot one goes to Steve, Steve H. So the Stevens clean it up here, 21 out of 25. And the Steve Carlson on-card patch auto. Three colored patch, auto of the 25, Sean Murphy, Oakland A's, 22 out of 25 A's. Once again, Angels, Dodgers, R&B spot. Spot two goes to Shannon. Shannon on the board here with a cool RPA. This patch, three colored. Five out of 25. RPA, three colored. Christian Javier. Astros bot, straight up by Matt Arden. Once again, Matt gives a nice one. This might not fit into a 180. Straighten this out a little bit. Don't fit into a 180. Thank you, Joe. Joe's the expert. Nice. Gain gear, patch auto. Ozzy Augusts. Seven out of 25. Atlanta brave spot, straight up by Corey S. He can't keep getting away with it, Wilgen. Seven to 25 on the Ozzy Augusts. Hope he gets well soon. We got to cut. We got to cut a booklet here. Wow, it is a cut. Cut signature is 8 out of 10. 1983 Hall of Fame class, Brooks Robinson. That's a nice one right there. Baltimore Orioles in that number block for the Yankees and Mariners. So 8 out of 10. Spot 8 goes to Jonathan S. Excuse me, no. It's Frank. Frank H. Last spot, Mojo. 8 out of 10 on the Brooks Robinson. Congrats. Poor Albie's indeed. I don't know how unlucky they're going to keep getting. Seriously. A true OG apparently comes back. It's very well preserved, as I was going to say. Our booklet there. Good luck. Here's getting a little crazy. These are working hard. Corey Alfaro. Two-color patch. 18 out of 99. Marlin's bought straight up by Steve L. Alfaro. Bulldog. Nice. 20 of 25 retro materials of Oral Hersheiser. Dodgers in that Angels number block. Spot 0 in there is Michael L. He is on the Padres now. Unfortunately, on the checklist, he is on Marlin. 20 out of 25. Spot 0 is Michael L. Another one for the Astros. Class of 2017 Hall of Famer, Jeff Bagwell. 47 out of 99. Straight up spot once again to Matt. That's a pinch sharp in the middle there. Roger Maris. 15 out of 25 Yankees. R&B. Spot 5. Going to go to Stephen K. Old school patch. Big old patch. Got a redemption. Let's grab that one. There you go. All right. It's all good. Him and me both. Good luck. Your redemption. Rookie material signatures. Two hollow gold. 236. Peraldo Perdomo. Arizona Diamondbacks. Rookie from last year. Arizona Diamondbacks spot. Straight up by Arthur. That's Arthur. Like the youngest player in baseball last year. Something like that. Pretty impressive. He backs. Pereraldo Perdomo redemption. Going to Arthur. Congrats, Arthur. Next up. Nice. For the Angels. And I ran a number block. 18 out of 25. 19 out of 25. Troy Glatz. So the Angels. R&B. Spot 9. That belongs to Lonnie. From our top triple threads filler. He's got a heck of a swing. That's a pop. That's what we're going to figure out. Game Gear. Patch Auto. Raphael Primera. 36 out of 49. Rangers in the Dodgers and Angels. R&B. So spot 6. 36 of 49. That's going to go to Allen. For the Primera. Nice. Evan White. Rookie Patch Auto on card. Big four color patch. Mariners and Yankees. R&B. So card 84 out of 99. Spot 4. That's going to go to Michael L. Looks like the L in Seattle. Next up. Wow. All favorite Tony Perez on card. 25 out of 49. Cincinnati Reds. And the Yankees. R&B. So card 25. Spot 5 goes to Stephen Kay. Once again Stephen. Congrats. Tony Perez. And the last card. It is a booklet. Good luck. 80 out of 99. So potentially spot 0 in redemption. Rookie. Signature Jimbo Material. Andy Young. So no. No randomizer. Let's go over to the Arizona Diamondbacks. Andy Young. 80 out of 99. Arthur. Alright. So that is our break. No Kimmelers. No randomizer at the end. Thanks very much for getting this filled out. Y'all appreciate it. Congrats to anyone who hit. We'll be back with another video very very soon. Jasper's Case Breaks dot com.


Being in a relationship with both of those guys and understanding, knowing how they was moving and dealing with them during that time. What were some of the things that you remember about their relationship for us with one another for us? I loved it because I know, you know what I'm saying? They came from the mud together and I always knew never to get, you know what I'm saying? Too far on one side about opinions or what they had going on. So if they ever was arguing or whatever disagreeing about stuff, man, man, whatever, you know what I mean? That's brothers. Yeah, we on boss talk one on one.  Yeah, yeah, plenty of times. Riding to and from Houston, you know what I'm saying? Just different trips. And we always connected on some grown man business. It always was about taking care of our kids and creating opportunities for others. It never was just frivolous conversation.  But a lot of times it was always about future plans and creating opportunities. Wow. Man, you know, like I said, man, to be in a relationship with him and bun like that, man. I wasn't in a relationship with him neither. Yeah, you are. But to be in a relationship with both of those guys and understanding, knowing how they was moving and dealing with them during that time. What were some of the things that you remember about their relationship for us with one another for us? I loved it because I know, you know what I'm saying? They came from the mud together and I always knew never to get, you know what I'm saying? Too far on one side about opinions or what they had going on. So if they ever was arguing or whatever disagreeing about something, man, whatever, you know what I mean? That's brothers. So, you know, the greatest thing is just understanding that both of them, how different they were and when they were in the mood to be approached or talked. It just took a lot of observation and placing yourself in the situation of being sought after.  They just see a star.  But that's another human being. That's another trill-ass nigger from Port Arthur. You don't just run up on niggers, you know what I mean?  You be heard before you're seen.   Yeah, yeah. Nigger, what's up, nigga? Save, man. Might get the wrong reactions. Man, so, you know, the Port Arthur, how far's Port Arthur from Houston? 90 miles. 90 miles. So that's a good drive for you and him when we have a conversation, right? Yeah, yeah, yeah, yeah. Yeah, to and from. Just going through different things like that Source magazine, Texas couple. Like we had left the hotel and went, did that and was at the ranch and then we left from there and went to Beaumont to his parole office. Then we left from there and went to PA. So we was always doing different things like that. Yeah, yeah. Just going and taking care of business. Yeah. Taking care of business. So the love in Houston, how was it when you guys would go up to Houston and visit and go different places? It's a different world. That's the country, right? Where y'all live. Where we come from. That's right. Yeah, yeah, yeah. Port Arthur is Port Arthur, man.  You know what I mean? Even though Pimp was one of one in that thing with two Bentley's in the mini mansion, they still trying to act like these niggas. He owed them something or something, you know what I mean? So when we got to Houston, it was just a different time, a different place.    Really? Yeah. What about same thing in Odessa? You was saying that earlier. Odessa is a different, shout out to Odessa. Odessa, man. He missed his seat. He missed his plane. Odessa, Odessa was mad in the motherfuckers ball.  They was mad. Yeah. We in the motherfuckers old school.  And then we in the old school.  They ain't no Pimp. We already know he didn't miss his flight.  I'm been to get out there. Hey, sorry, he missed his flight.  He be coming, he coming, he be down. Hey, nigga, get these CDs. So what about the, then we went perform. You know what I mean?


Hey y'all, what's up? My name is Sonali, welcome to a new vlog and this is going to be an exciting week because we're in New York City and we just unpacked in our small little hotel room slash Airbnb. We found it on Airbnb but it's kind of like one of those hotel Airbnbs because there's like a front desk where you can leave your luggage which is so clutch. Our room was actually ready way earlier than it said it would be. So that was also really nice and we took an Uber over here. I think we got an Uber XL for $54. I don't know why I thought this but I thought it was going to be like $100 so in my mind it was like oh my god $54, that's nothing. She's pretty hangry right now. We're going to get some pizza, little print street pizza, made the top 100 pizza places of all time or something. Top 100 is kind of a lot but Ryan loves pizza, I for one don't like love it as much as him but we're in New York so we're probably going to eat it a couple of times at least. So let's go find this place and do a little bit of exploring because we literally just got out of the Uber and went straight to our hotel room so there's a lot of exploring to do. Best part about this trip is that I'm going to be seeing my college roommate and we haven't seen each other since 2018 and so I feel like I'm going to probably be really emotional and cry just because I'm like that but I don't know if I'm going to see her today or tomorrow. I think where we're staying is like near Soho but she lives uptown I believe. I'm also looking forward to finally understanding the areas of New York because I feel like everyone's like oh Soho, Nolita and like all that and I'm just like I don't know where the hell that is so it'll be a very fun week of just exploring, eating and all the things so if you guys are not subscribed definitely do so because I'm going to have a bunch of these New York vlogs. Our first sight of Christmas and then also the trash that I've heard so much about. It's not that bad I guess but I feel like people are like oh the tiktokers don't show the trash you know. Good truck. Taste it. Yeah. Now it's melted. It's good but I think I burned my tongue. First bite. A rookie mistake huh. The sprite was like $23 is that like a good price? You're always like $10 a dollar. $1 slice pizza in New York so I'm excited to try that. What's the rating you get the pizza place? 7.5. The first piece wasn't very good. Why? The second piece was good. It's kind of hard. Not very saucy. We're going to walk around now but like the trees here are so pretty. I'm glad there's a little bit of fall still here. Oh the Christmas tree.  Christmas trees. Look at how pretty these flowers are. Just got ready to do a little bit of makeup. Ryan shaved. And now we are going to make our way to BH Bodo. I honestly just want a neck strap for my camera because I only have this little wrist strap and I feel like it would just be more convenient if I had a full neck strap and then we can just explore up there. But we have a reservation at Bond Street Sushi. You guys know how obsessed I am with sushi and I haven't really had it very much when I've been home for the holidays so very excited to be getting my fix. Ryan's a new man when he shaves. Let's go. A minute, two minutes and we saw this cool thing. I was like what the heck is that? It's a freaking disco ball tree and I think this is public hotels because those elevators or escalators or whatever they are. It's like famous on Instagram I'm pretty sure but I'm not sure if this is actually public hotels so I could be totally wrong.  It was going so fast. You got to go, go. There we go. Cheers, cheers, cheers. Go fast. It is so fast. Babe, look. Any station down there? Look at it. We're here at BH Photo just across the street but you guys just don't understand how big of a deal this is. Do you even understand, Ryan? What is this? This is BH Photo. This is like where I bought all my lenses. I didn't know that. Guys, look at all the lighting. This is freaking insane. Yes, we should buy a FHG film. Also we're going to the Leica store sometime during this trip. This is insane. If only I had this at my fingertips in Austin, huh? One day I'm going to buy Leica even though, wow, does that say $11,000? $11,000, yeah. Okay, so that's it. Goodness. This one's $10,000 also. Wow. One day, one day. Not today. So we're going to try out a lens. The one that I just saw, it was like $11,000 to $20,000. It was like, wait, there's even wider. But then he said that it was like full frame. But he's bringing me out something to try. I'm not sure if it's going to be like heavier though, because that's the issue. I feel like this lens is probably like one of the lighter lenses. So we'll try it. Look how wide it is. Wow. It does look really, yeah, I know. But it's a lot heavier too, feel it. Not a ton heavier though?  That's exactly what I'm looking for. Look at this guys. You can fly drones in here. Look at that giant drone in there. What the heck? These are so cool. Is this the one I have? I have this drone right here. The A2S. Thank you. Look how cool. New strap. And it's a lot more convenient than my wrist strap, like literally weighing my wrist down. But we walked over to Hudson Yards and the vessel. I've seen this. Well, I feel like I've seen everything on Instagram, and now I'm seeing it in person. It's kind of really cool. Yeah, it's the most popular reaction. What? Yeah, actually. You got a point. The buildings are so tall. It's insane.  Like from the buildings in Austin, like probably so tall. Probably the most double. Double? It is the next day in New York. We're upright and early. It's 7.30 a.m. And we're on our way to meet my friend from college. It'll be the first time we're seeing each other in so long. And I also have a package to pick up because I sent my fashion pass to her house. And then Ryan has some calls afterwards. I don't know why I'm out of breath right now. But we're trying to find the... What's it called? Subway station. I always want to call like every public transportation barter for some reason, because we're from Atlanta. We're probably just going to find a coffee shop around Lawrence Place. Ryan's got his backpack on, my tote bag, with my laptop, and my headphones. I did not forget it this time. Hi. Oh no. Hey guys. Welcome back to my channel. Her apartment is so freaking cute and cozy. Got the Christmas decorations up. Okay, she's giving me a little designer bag tour. Okay, so this was my first. I loved her to death. Wait, the gold one? This one. Okay. And then I was like, I want brown. So then I got this one, which isn't like a classic.  I got her for a really good deal. Okay, legit. I can barely tell the difference. It's like barely brown. It literally looks black. Well, Ryan's colorblind, so don't ask him, but... They're slightly different. Okay, okay. And then I was like, oh my god, I need one for spring and summer. So I got this one. And I needed... Oh. Okay, I like that color. I love the color, but I thought it was going to be like this size. Yeah.  I was like, am I a mother? Yeah. But then I like grew to love it. Wait, so do you get them online? Yeah, I do them. I get them on like the real, real or best year. I've heard of that. But not in store. They probably have all those stores here, right? They do, but like I never go in there. Because on the app, you can like filter low to high. Yeah, yeah. Yeah. That's my favorite thing to do. Smart. And then I'm like, which one's the cheapest? We just left Laura's apartment and it is so cute and so cozy. And now we are going to some little cafe that she recommended. Because like I said, Ryan has some calls to do and I also have a lot to edit. So we're going to do a little work and I think it's going to rain on us. So, TBD on plans for today. Just kidding. They had a sign. No laptops allowed and no Wi-Fi. So we're going to walk to Starbucks.  But now we're going to go downstairs. They have like a really nice coffee shop workspace with like a lot of seating. So we're going to go over there because Ryan has a call at 1 and then I'm just going to upload a YouTube video. Coming up for tonight, what is it? So it's Christmas tree lighting. Ryan keeps telling me that this is too much. I also brought gloves, but I know I'm just going to be happier if I'm not cold. So I'm just a little over-prepared. Should I wear my white scarf? Should I wear my white scarf instead? I decided to switch the scarf. I think it looks a lot better. I think we're about to get a rice roll. It's on my bucket list. I think it's from Joe's steamed rolls. But we have to walk like 16 minutes to Chinatown area. Then we got this Thai tea from Lazy Sunday. This is from Mok Tee Nori. We got a yellowtail roll. And what was the other one, Ryan? Toro. Then a shrimp steamed rice roll. And then a beef... Joe's special. Oh, Joe's special. Is it good? Thai tea? Oh, me too, yeah. Thank you for... How are the directions on the bottle used to go? It's saved some room for that. And I'm not really sure... I feel like I want to walk around first and see everything and then decide what we want for dessert. But I think Laura's going to meet us here at 6.30. I'm not even sure what time it is. It's 8.00. Let's see. It's 5.47. And tonight the tree lighting might be at like 8.00 or 9.00. So we're going to get blue bottle coffee. So I recommended it. She's a big coffee drinker. So I trust her opinion. He's lying. I just haven't heard of it. It's right across the street. How convenient. We got some pork. Pork and beef. Yum. It's the moment. Beautiful. We're here at 7.49. Try to find somewhere where we can see it. Vino's bungee. This massive tripod. This guy right over the bus. You know why the bus is right in front of it though. I have to say hey guys every time.  We're now going inside of Cooran's Central Station. XOXO. Gossip Girl. So last night we didn't actually get to see the Rockfeller tree because like I said they were closing it down because it was at capacity. But we were trying to go like to see a sliver of it being lit. And it was like on a sidewalk where they were just like keep on moving, keep on moving. So we didn't get to see it at all. So we're just going to have to see it another day which was sad. But honestly we didn't get there early enough. So I mean what do you expect? It's like New York. Like everyone's here to see the freaking tree light up. I am going to end the vlog here and start a new one. Definitely hit that subscribe button. If you guys are liking this content and if you guys want to see real-time content you can go over to my Instagram and TikTok which is so underscore gnarly without the G. And I will see y'all in my next vlog. Bye.