Saturday, January 09, 1999
Tristate terrorism: What it?
Training begins on attack response
BY TIM BONFIELD
The Cincinnati Enquirer
Cincinnati firefighter Harold Lucas scrubs down firefighter Douglas Humphrey in a demonstration of equipment used in biological and chemical disasters.
(Tony Jones photo)
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It could start with a hissing suitcase at the airport or poisoned kegs of beer at Oktoberfest.
It could be as big as a bomb at a Bengals game or as small as a dust-laced letter to an abortion clinic.
Minutes later, possibly days later, the casualties would swell: several dozen, several hundred, possibly many thousands of dying victims of a terrorist sick enough to trigger “the poor man's atom bomb.”
Yes, even Cincinnati faces the threat of a chemical or biological terrorist attack. Yet like so many cities, Cincinnati is not prepared — at least not yet.
On Monday, Cincinnati joins a list of 120 U.S. cities scheduled to get anti-terrorism training from the Department of Defense. The Domestic Preparedness Program will teach local public officials and disaster response teams how to respond to weapons of mass destruction, which include nuclear, chemical and biological weapons.
“The first meeting will be a wake-up call (for city officials),” said Capt. Jerry Lautz, the fire department officer coordinating Cincinnati's domestic preparedness program. “You may think you're ready, but you're not.”
Imagine this: A psychotic with a plane and a tank of nerve gas swoops over the 500,000 people gathered along the Ohio River for the Labor Day fireworks. Suppose that just 50,000 people — a mere 10 percent of the crowd — breathe the toxic vapors. The toll would be horrific.
Greater Cincinnati only has 5,000 hospital beds counting every hospital from Williamstown to Middletown. Don't think about Oklahoma City. Think about Hiroshima or Dresden.
“I don't believe in scaring people,” said city Health Commissioner Malcolm Adcock. “But part of the dilemma we face is the gap between the public understanding of these scenarios and the actual potential for an event.”
Think terrorists have no reason to attack Cincinnati? Experts do not consider the possibility too remote for preparation. Cincinnati, they point out, is a “major league” city with nearly 2 million people living in the metropolitan area.
The city gets visits from presidents and is home to federal buildings, and international corporate headquarters. Cincinnatians are trying to bring the Olympics to town some day.
In late 1995, just 50 miles away, Dayton played host to high-level peace talks between warring factions in Bosnia. Some of those factions have shown no reluctance to commit atrocities.
Last month, the United States rained missiles on Iraq, a country with a history of using chemical and biological weapons that also refuses to cooperate with U.N. weapons inspection teams. Who can say where and how Saddam Hussein's loyalists might try to strike back?
American experts also fear the economic crisis in Russia, a known maker of weapons of mass destruction. Imagine, they say, how tempting it would be for ruble-starved Russian scientists, engineers and stockpile guards to sell secrets or even a few bombs to a well-financed terrorist.
If the threat wasn't clear before, the truck-bombing of the federal building in Oklahoma City made it obvious that no U.S. city is immune from terrorist attack.
“The possibility of a bioterrorist attack is unfortunately a very real one. If an attack happened today, in most places in the United States, the results would be devastating,” said Dr. Richard Levinson, associate executive director at the American Public Health Institute in Washington, D.C.
“The problem in the United States is there is a lack of infrastructure to do surveillance and follow-up should an attack occur,” Dr. Levinson said. “It's not in place at the national level, and it's certainly not in place at the local level.”
Dr. Donald Henderson, retired dean of the Johns Hopkins University School of Public Health, built an international reputation helping the World Health Organization eradicate smallpox as a naturally occurring disease.
Now, as director of the Center for Civilian Biodefense Studies, Dr. Henderson is concerned about Russian stockpiles of smallpox-based weapons as well as Russian weapons experts languishing in that country's economic crisis.
“For a long time, I chose not to talk about this at all, for fear of creating copycat terrorists,” Dr. Henderson said. “But it has become clear that the bad guys can find whatever they need to know about biological warfare over the Internet.”
When dealing with a chemical or biological attack, a smart, quick response can sharply limit the deaths, Dr. Henderson said. A slow, badly coordinated response can send a dangerous situation spinning wildly out of control.
As of Dec. 14, the domestic preparedness program that starts in Cincinnati this month has completed class training in 41 other cities, with at least a dozen also completing their full-scale drills.
The program involves several train-the-trainer sessions scattered through the year, culminat ing in November or December with a full-scale drill complete with emergency crews practicing their safety, decontamination and treatment techniques on fake casualties.
Most of the training focuses on “first responders” — the police, fire and emergency medical teams that would be the first to handle victims from the hot zone.
The classes will teach first responders how to recognize signs of a chemical or biological attack, how to use personal protective gear, how to help victims without exposing themselves, and how to decontaminate an area without destroying evidence that investigators will need.
City officials also will begin planning other responses to a pray-it-never-really-happens attack. They will learn about setting up quarantine zones, emergency medical centers, media communications, even temporary morgues and large-scale body disposal.
In addition to the training, each city is eligible for $300,000 in five-year equipment “loans” to buy decontamination gear, protective suits, portable shelters, detection equipment and so on. Legally, the equipment is lent to the cities, but the DOD does not expect any of it to be returned.
Greater Cincinnati emergency agencies already go through training to handle hazardous materials from industrial chemical spills and leaks. Hospitals and paramedics also have a disaster radio network in place to share services when responding to victims of tornadoes, large fires, airplane crashes and other disasters.
Still, the need for first-responder training is powerful. In Tokyo in 1995, the Aum Shinrik yo cult set off a sarin nerve gas bomb in the city subway. The attack killed 12 people and injured more than 5,000.
Among the dead and injured were police and paramedics who tried to help victims without taking proper precautions.
Officials in Columbus, Atlanta and several other cities have said the training has been useful — especially for responding to fast-acting chemical weapons, such as a nerve gas or a blister agent.
But some critics have questioned how well the program is organized, citing examples of wasteful spending. Others say the program offers only limited training for biological attacks such as exposing people to the Ebola virus, smallpox, bubonic plague or other contagious killers.
The federal government spent about $7 billion in 1997 on anti- terrorist programs — not counting classified programs — according to the U.S. General Accounting Office (GAO).
Last month, U.S. Rep. Ike Skelton of Missouri, ranking Democratic member of the House National Security Committee, said there isn't enough coordination and too many of the programs overlap.
In a statement released Nov. 17, Mr. Skelton said: “This report validates my concern that the left hand may not know what the right hand is doing. Our strategic vision is poor.”
The GAO study questioned the way the Pentagon picked the first 120 cities to receive domestic preparedness training and the details of $300,000 equipment loans available to each city.
The cities were picked simply by size. As a result, training programs in some parts of the country are bunched together, while other entire states get skipped completely.
Of the 120 cities, 40 are in Texas and California. Four Texas cities that have scheduled their own training programs — Dallas, Fort Worth, Irving and Arlington — are located within 30 miles of each other. Minneapolis and St. Paul originally were scheduled for separate training sessions. So were Kansas City, Mo., and Kansas City, Kan., and Tampa and St. Petersburg, Fla.
Meanwhile, 12 states have no cities at all in the program — Connecticut, Delaware, Idaho, Maine, Montana, New Hampshire, North Dakota, South Carolina, South Dakota, Vermont, West Virginia and Wyoming.
Critics also have questioned the equipment loans, noting that cities as huge as New York get the same support as cities as small as Fort Wayne, Ind.
The loans are supposed to be used to buy decontamination gear, protective suits for rescue workers, chemical agent detector kits, portable emergency showers and shelters. In theory, the gear is just for training but in the event of an actual attack, cities will use the equipment.
The problem: City officials aren't sure how much gear they really need.
In Greater Cincinnati, Capt. Lautz said the federal money might be enough to equip all the terrorist response teams the area needs. But there isn't any money to replace equipment. Nor is there money for stockpiles of antidote or antibiotics, storage facilities, vehicles or personnel.
In San Francisco, a much bigger city than Cincinnati, police officials estimated in October that being properly equipped for a bio-chemical attack will cost closer to $4 million.
Then there's the issue of biological attack.
The federal Centers for Disease Control and Prevention is working on a program to improve the nation's ability to spot emerging infectious diseases — be they natural or sinister in origin. Dr. Henderson said the work cannot go fast enough.
“Let's say somebody released smallpox in Cincinnati. You wouldn't know it happened until two weeks later,” when victims get sick enough to seek medical care, Dr. Henderson said. “Say a victim shows up in the ER. How many doctors there have ever seen a case of smallpox?”
Unlike a nerve-gas attack, where victims could die within minutes, the casualties of an infectious agent could take weeks to show up.
Say a terrorist managed to spread Ebola virus through a planeload of people landing at Cincinnati/Northern Kentucky International Airport. Departing passengers would scatter widely in the two to 21 days it would take to get sick. Some would go to their homes near Cincinnati, passing their illness to family members and other close contacts. Some would fly off to many other cities, spreading the virus as they go.
Soon enough, victims with uncontrollable hemorrhages would be rushing to hospitals. Anybody who touches the infected blood or other body fluids could become a secondary victim: family members, paramedics, emergency room staff. Then they could pass it on to others.
Averting a full-scale epidemic with tens of thousands — possibly millions — of victims, depends on quickly diagnosing the weapon, tracing its source and containing the spread.
The problem: The technical capabilities of the nation's public health departments — the agencies armed with the legal power to declare quarantines — range widely.
Cincinnati boasts a sophisticated public health department, with a health commissioner trained in microbiology and a physician serving as full-time medical director. Many smaller health departments do not have as much medical expertise, nor as much computer and communications power.
Yet a terrorist could hit anywhere.
Dr. Henderson wants to see more training for doctors to spot the symptoms of rare diseases that can be used as weapons. He also has been urging federal officials to rebuild at least some stockpiles of smallpox vaccine and other antidotes and antibiotics to be better prepared for bio-terrorism.
The Defense Department has bristled at the criticism from the GAO report.
“We had to start somewhere,” said Suzanne Fournier, spokeswoman for the U.S. Army Chemical and Biological Defense Command. “The idea was to go to the largest population centers first.”
The program already encourages nearby cities to train together, she said. The Army also has rescheduled some training sessions to move up some cities believed to face a higher terrorist threat. But even Ms. Fournier acknowledged that $300,000 won't be enough for many cities to be prepared.
The ultimate goal is to help cities integrate anti-terrorist training into their overall hazardous materials response programs, she said,not necessarily to fully equip the cities.
“The idea is to prepare those first responders. If it's a catastrophic event, local resources will be overwhelmed very quickly. They'll have to call on all kinds of outside support,” Ms. Fournier said.
That second wave of response — the cavalry, so to speak — has its own set of problems, according to GAO reports.
The Army, Air Force, Marines, FBI, Federal Emergency Management Agency and other agencies have sometimes overlapping terrorist response programs that would be involved in a bio-chem attack. Meanwhile, the National Guard is forming a new batch of 10 regional response units.
Despite overlapping programs and federal bureaucrats racing to look tough on terrorism, Cincinnati officials say terroristic threats are much too current and much too local for comfort.
In November, abortion clinics in four Midwestern states — Indiana, Tennessee, Kentucky and Kansas — received letters with Cincinnati postmarks containing an unspecified substance and notes that said: “You have just been exposed to anthrax.”
The FBI concluded that the threat was a hoax, the material in the envelopes wasn't anthrax. Next time, who knows?
“The community cannot absolutely protect itself against everything,” Dr. Adcock said. “On the other hand, we can get better prepared.”
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