The threat of bioterrorism is real and serious. The highest priority should be focused on connectivity and communications. Communication in the middle of a public health crisis must become a strategic priority. The ability to link local, State, and Federal health officials with practicing physicians in a real-time communications network is critical to bioterrorism response. The need for a new level of connectivity applies to communicating from the field--the physician’s office--to the central public health agencies, and vice versa. There is also the need to create the surge capacity of State and local health departments to rapidly investigate and track disease outbreaks and to contain the spread of contagious diseases. Each State health department should then develop a reporting hotline staffed by a medical professional. The Johns Hopkins Center for Civilian Biodefense Studies (JHCCBS) has produced the immediate cost of starting to build the bioterrorism defense system--$1.9 billion, plus $2 billion for pharmaceutical stockpiles. There is also a need for a communications infrastructure. Each public health department needs Internet access and email. JHCCBS also proposes the establishment of a Physicians’ Biodefense Network based on Internet Web sites and satellite-connected handheld devices. The network would assemble listservs, hold teleconferences, and set up interactions with clinicians. In addition, a Community Alerts and Risk Communication network would be created to deliver timely, accurate, and credible information. In addition, there should be rigorous and rapid training in epidemic response and containment to the exiting public health community. And finally, curricula needs to be created to train physicians, nurses, mental health, and other professionals to diagnose and treat disease caused by the most likely biological agents of the future.