Josh Marshall

Josh Marshall is editor and publisher of TalkingPointsMemo.com.

Articles by Josh

It's very, very hard to find any good news in the recent flood of ominous Anthrax developments. But one example is the seeming survivability of pulmonary (i.e., inhalation) Anthrax. According to established medical literature the survival rate for this condition ranges from the very low single digits to virtually zero.

Yet those statistics are based on data sets which are extremely small, of uncertain reliability, and in some cases simply out of date. And the rapidly and tragically growing number of new cases is giving at least some reason for hope.

The first victim of the recents attacks, Robert Stevens, died of Anthrax, as have two DC postal workers. Significantly, the two DC postal workers died before Anthrax was even suspected, let alone definitively diagnosed. But Ernesto Blanco, the other pulmonary Anthrax victim from AMI in Boca Raton, Florida, has now been released from the hospital. The two other DC postal workers with confirmed pulmonary Anthrax are in very serious, but apparently stable condition. Medical authorities in Virginia are expressing at least cautious hope that they'll pull through.

One doesn't want to be naive or foolishly optimistic. But this new evidence does lead to the conclusion that pulmonary Anthrax -- perhaps because of rapidly growing medical knowledge or a new generation of antibiotics -- is not the 99% killer we thought it was.

If memory serves, the last administration had a quite strict policy that the Treasury Secretary was the only person who spoke for the administration on certain key points of economic policy. I'm wondering if we don't need something similar from the current administration on developments in the Anthrax case. Actually, such a policy might profitably extend to Congress as well.

Our political leaders have been all over the place in the last several days on two key questions: 1) the precise quality and nature of the Anthrax spores contained in the letter to Tom Daschle, and 2) what if anything we know about connections between the Anthrax letters and 9/11.

This morning Dick Gephardt seemed to nudge the scale in a more ominous direction on both the weaponization question and the 9/11 tie-in issue.

The problem with all these different opinions and phrasings from Daschle, Gephardt, Fleischer, Ridge, Ashcroft, et.al. is that it's very difficult to get a handle on whether this is just Dick Gephardt's opinion (in which case, who cares), whether he's being freer with information the administration is holding back, or whether administration officials are using Gephardt to float new information which they themselves don't feel comfortable announcing publicly.

In normal circumstances, these sorts of differences just come out in the wash. But the necessity of getting clarity on these critical questions demands a bit more discipline and uniformity.

Oh, the infamy of it all!

Today I see that Howie Kurtz takes me to task for my brief post about a London Times article about the US possibly using torture against terror suspects. In that post I said news often appears in the British press which you never see in the United States.

Anyway, Kurtz points out that the article itself refers to a Washington Post article from which the Times had snagged most of the info.

So am I supposed to be embarrassed by this? Okay, maybe a little.

Anyway, back to the main point. I think the larger pattern is true, though this was admittedly a rather unfortunate example. A better example would have been the BBC's continued unexpurgated reporting of Al Qaeda threats and video taped messages after they had largely been squelched in the American press.

A few days after the 9/11 attacks, I remember watching an insurance company executive tell CNN's Lou Dobbs that he doubted any insurance company would try to use legal technicalities (such as an 'act of war' exception) to evade paying off claims to WTC policy holders. I thought of that interview when I saw this article in the Times describing how one of the major WTC insurers, Swiss Re, is now trying to do just that.

Shameless, right?

Well, maybe not. The surprise, if you read the article, is that the insurance company seems to have a pretty damn good case.

According to the Times article, the policy held by the folks with the lease on the WTC stated that every insurable incident would be covered up to $3.5 billion. But Larry A. Silverstein, whose company holds the lease to the WTC complex, wants $7 billion. His argument -- as the math indicates -- is that the 9/11 attack on the Twin Towers wasn't one incident, but rather two separate incidents, one for each plane.

Doesn't that seem like a bit of a stretch?

One of the persistently interesting aspects of the war on terrorism story is how much information ends up getting published in the British or other foreign press, but never seems to see the light of day in the United States. Here's one example from The Times of London about the FBI considering tactics that border on torture to get a few key suspects to talk. Sounds grisly; but the moral stakes involved are quite complex, and tricky.

I've also gotten a number of responses to the last post on Cipro. A number of readers make what seems to be a quite valid medical/public health point about the use or over-use of this drug. They note (as I did) that this strain of Anthrax is susceptible to a number of antibiotics. And that the one thing we don't want to do is use so much Cipro that we end up creating a plethora of new Cipro-resistant bugs.

There are a few possible flaws with this argument that come to mind. But I'm not a doctor. So I'm really not in a position to evaluate it on the merits. But the point I was making was political, not medical. And on that basis, I think the point stands.

Here's why.

Maybe we should be using more penicillin than Cipro. Who knows? But there's nothing we've heard from Tommy Thompson that would make us think that this is why they're supplementing the Cipro stockpiles with doxycycline and penicillin. The issue seems to be patent law. And what I'm saying that is that this decision needs to be made on the basis of scientific, medical and public health considerations, not patent law issues.

It's a little difficult to figure how any company could have flubbed an opportunity for good PR more than Bayer has in recent days.

As you probably know, Bayer is the manufacturer of the Anthrax-fighting drug Cipro. As it turns out, there are several antibiotics that seem effective against the particular strain of Anthrax popping up in media mail rooms around the United States. But apparently that's because this strain is quite susceptible to treatment. The point is that Cipro is the gold standard: it would apparently work against certain strains which other antibiotics couldn't handle. (To wit, if I get exposed to Anthrax of unknown provenance, I want Cipro; and you probably do too.)

So, in addition to helping a lot of people, Bayer could have used this as an opportunity to get a lot of well-earned good press. At the end of the day there's almost no way Bayer wouldn't end up making lots of money off this scare, even if the United States or Canada gave temporary permission for generic manufacturers to make Cipro also. Wasn't this a no-brainer? A way for a major drug manufacturer to demonstrate that it was fundamentally in the business of health, not simply interested in the bottom line?

The argument for loosening the patent isn't that the government couldn't afford buying tons of Cipro (though that too is an important issue), but that Bayer may well not be able to satisfy the almost incalculable demand.

So far Bayer has been issuing assurances that it can keep up with demand and resisting any efforts to enlist generic manufacturers to supply government stockpiles. But obviously their capacity must have some limits. And the country seems pretty obviously to be in a situation in which we shouldn't allow any arbitrary limit (the production capacity of a single company) to keep us from getting as much as we need of the choicest drug (Cipro).

What's a little distressing is that HHS Secretary Tommy Thompson seems inclined to make up the shortfall in Bayer's production capacity with drugs like doxycycline and penicillin, rather than allowing other manufacturers to make Cipro. Again these two other drugs seem to work fine against this strain of Anthrax. But everything I've heard to date indicates that Cipro would likely be effective against a broader range of strains. (Remember, everyone currently under treatment is getting the good stuff, Cipro. So why scrimp?)

Setting aside the Bayer patent -- perhaps to let generic manufacturers produce Cipro exclusively for government stockpiles -- would not necessarily mean abrogating the law. According to Senator Chuck Schumer, current law contains exceptions for just this sort of pressing national emergency.

So there are a lot of medical facts which are uncertain at this point. And it's possible that Thompson will adopt a stronger line. But at the moment at least it seems like he is letting an over-zealous concern for patent law get in the way of public health.

Just a thought.

Hey!?!?! What's the deal? Why so few Talking Points posts recently? Is Talking Points going under? Going out of business? Packing it in? Going the way of Polaroid?

No, just a busy week. What with buying gas masks and stockpiling supplies. And even some paying work. You know how it is.

Back to normal posting schedule next week.

My previous TPM post notwithstanding, subsequent developments tend to point away from an Iraqi Anthrax connection. First, it seems there is a growing pool of admittedly quite circumstantial evidence pointing in the direction of domestic terrorism. Either a purely domestic operation a la Tim McVeigh, or one in sympathy with bin Laden et.al., operating without close coordination with people overseas.

One of the most interesting pieces of evidence can be found in this article by Scott Ritter, a former weapons inspector, permanent hot-head, but never someone who you'd expect to be exculpating Saddam if the facts didn't unmistakably point in that direction. He makes three points: 1) that the weapons inspectors did a pretty good job destroying the Iraqi bioweapons operations, 2) that it simply wouldn't make sense for Saddam to involve himself in something like this since he's already making progress on his major goal, lifting sanctions, and 3) that the strain of Anthrax that the Iraqis worked with isn't the same as that found in Florida, DC and New York. (The not-unreasonable counter-argument from the Iraq hawks would be that the Iraqis have now had three years of unmonitored time to hatch new plans and perhaps new microbes.)

Taken together, Ritter makes a pretty strong case that there's at least no good evidence for an Iraqi connection to date.

I must confess to you that with many friends working on Capitol Hill (and myself living only a few miles away), it's not so easy to get a critical distance on these most recent disclosures of Anthrax-tainted letters.

Regular readers will also know that I've been skeptical of the 'bomb Iraq now' crew inhabiting the middle-ranks of the Pentagon. But these new reports raise some very serious questions.

We now seem to be getting conflicting reports about the nature and quality of the Anthrax which arrived at Tom Daschle's office. First we were hearing that it was high-quality, weapons-grade material. Now authorities seem to be partially backing off those statements, noting among other things that the strain seems highly susceptible to various antibiotics, etc.

Still it seems increasingly likely that someone has Anthrax that is the product of a quite sophisticated operation.

What happens if we find out, upon further testing, that this Anthrax was the product of a sophisticated production system which could only exist as part of a state-sponsored bioweapons program or with the complicity of some state? And let's cut to the chase, what if the evidence points to Iraq?

We needn't assume high-level Iraqi state complicity in giving terrorists anthrax to believe that the Iraqi program was the source of the material. Perhaps it was stolen. Perhaps some Iraqi intelligence officers gave a small amount to Mohammed Atta. Who knows? And perhaps more to the point, who cares?

I say this neither to be flippant nor to discount the possibility of direct Iraqi involvement. I say it only to focus our attention on what I take to be the real question at hand. That is, can we allow the continued existence of production facilities and large stocks of chemical and biological weapons in Iraq once we know, or strongly suspect, that some of them have made it to our shores? Once you put it that way, I don't think it really matters whether Saddam Hussein or Tariq Aziz signed off on the transfer. And if the question is, can we allow it? I think the answer is pretty obviously that we cannot.

That conclusion leads to some dizzying and troubling implications. But I'm not sure they're ones we can any longer ignore.

Just a quick update on the media consortium's comprehensive recount of last year's presidential election in Florida. When I cited the Globe and Mail article which said the recount story had been spiked, I hadn't yet seen Howie Kurtz's article which said the recount analysis had only been delayed by the war, not canceled. Mickey Kaus makes a similar point, quoting the Wall Street Journal's Alan Murray.

So consider this post a partial correction of yesterday's.

But only partial.

Mickey's evidence comes from a bureau chief of one of the news organizations. And Kurtz provides no quotations. The only quotes I've been able to find are in the Globe and Mail piece. And those seem at least ambiguous about the fate of the mega-recount analysis. A New York Times spokeswoman told the paper that the recount analysis had been "postponed indefinitely."

I assume the recount probably will proceed at some later date. But considering the importance of the matter at hand, it still seems to me that the media outlets in question are being deliberately vague. I think they're hedging. And bureau chiefs giving personal assurances to friends in the business (absent quotes) really doesn't cut it.

As mentioned yesterday, a delay in the project seems entirely reasonable. But if it's only a delay, the whole consortium should issue a press release stating that this is only a delay, and that the complete survey of disputed ballots will be completed and published as originally planned.