Back in 2003, in the wake of the 9/11 terrorist attacks, Annie Jacobsen explains (in Biological War), the Centers for Disease Control and Prevention established a multibillion-dollar national syndromic surveillance system called BioSense:
Under the BioSense platform, the CDC collects biosurveillance information on Americans from 7,200 healthcare facilities across fifty states, Washington, D.C., and Guam. This includes near-real-time data from emergency departments, urgent care clinics, ambulatory care centers, and other registered facilities, all of which feeds into centralized servers at the CDC for rapid analysis.
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But the program does not include any data from any of the nation’s homeless shelters or clinics. None. This means that the entirety of America’s ~800,000-person homeless population is left out of the CDC’s national syndromic surveillance program.
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Across America, the phenomenon of mass overdose in homeless camps has gone from rare to commonplace. In July 2025, police in Baltimore responded to a “mass casualty” incident in an open-air drug market, after twenty-seven people overdosed on fentanyl mixed with what was reported to be some kind of powerful sedative. Thirteen medical units and four fire trucks were sent to triage people on-site, with dozens of officers trying to locate more potential victims.
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More than twenty years ago, the U.S. Army’s Edgewood Chemical Biological Center wrote a handbook for police officers describing what to expect in a biological incident or attack. It acknowledges a merciless truth. Unlike U.S. military personnel, who are trained and equipped to enter contaminated battlespaces in protective gear and gas masks, local law enforcement officers and first responders will face biological threats unprotected.
Since the publication of the U.S. Army’s guide, hundreds of billions of dollars have been spent on what the government calls BioDefense.
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Biological attacks are invisible. Silent and odorless, they won’t be detected until people start dying and contagion levels are already out of control.
An aerosolized pathogen is the ultimate nightmare scenario. Humans must breathe air to stay alive; with an airborne pathogen incident or attack, breathing becomes the primary dispersal mechanism of death.
Law enforcement, first responders, doctors, and nurses will be exposed. The people best equipped to respond and help will become sick and die, leaving few professionals left to care for the sick and the dying.
Mass panic will likely collapse the medical system. The sudden onset of dying people will lead to a crushing wave of infected people and not infected people (“ the worried well”), overwhelming local emergency medical systems before diagnoses can be made. The noninfected will become infected while waiting for aid.
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The system is flawed to the point of breaking. A 2022 after-action report following a terrorist-attack exercise in Los Angeles found that L.A. County’s Emergency Operations Center was “unable to coordinate the dissemination of emergency public information” effectively, and that it “did not take any corrective action to establish an alternate method” after it was clear the system had failed.
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The Los Angeles County Department of Public Health is “[ a] corrupt, bloated, inefficient bureaucracy,” the Los Angeles–based AIDS Healthcare Foundation insists, and it is not alone in its assessment. A 2025 audit of the agency dedicated to Los Angeles public health found that hundreds of millions of dollars of Los Angeles’s $ 875-million-a-year budget for the homeless (which has since been raised to $ 953 million for fiscal year 2025–2026) had been spent recklessly and without transparency. “It’s now been verified by two audits that [the city] cannot produce an account for the work that they are funded to do,” City Council member Monica Rodriguez told the Associated Press, “and that, to me, is an egregious breach of taxpayer trust.”
