Responding Rather Than Preventing

Much of the blame for this current situation can be laid at the feet of former President Bill Clinton, a man who was more interested in making each citizen a dependent "victim" looking to the government for help and handouts. In keeping with this desire to have ever-greater government, Clinton’s thrust (when there was one) was toward responding to the needs of victims rather than the prevention of any attacks.

Thus, rather than try to prevent casualties by giving citizens protective equipment, the Clinton administration chose to react to attacks after the fact (all the while "feeling our pain" no doubt). Proof of this supposition can be found in Clinton’s presidential directive, PDD 39 (the text of which has never been released to the public), which directed government agencies to take steps to deal with a biological attack. Under PDD 39, the FBI, US Marines, and others have created rapid response teams for dealing with biological terrorism.

Note the word "response." The push was not toward showing citizens how to care for themselves, or even with an eye toward preventing an attack, but rather preparing to respond to the horrible aftermath of such attacks.

Nor is this a matter of saving money. Because responding to a disaster rather than preventing it is never a cheaper route to take. And it would always be cheaper to teach citizens how to take care of themselves, and how to avoid becoming victims rather than letting fatalities mount and then reacting to the problem.

But neither was done and the result was one very expensive undertaking that has done little to protect US citizens.

For example, in March 1998, Defense Secretary William S. Cohen, announced that the FBI and other response teams would be augmented by ten teams, each comprised of 22 full-time members from the US Army who would be backed up by 22 members from National Guard units. The cost, in addition to the money spent on US military units and previous expenditures to create the original response teams, was an additional $49 million dollars. Money spent to respond, rather than prevent attacks or educate the public on how to minimize their risks.

What did we get for these millions of dollars that were spent? According to federal records, almost nothing. Because this money was spent to train teams only to assess dangers, not to actually deal with them. Exactly who would deal with a large-scale terrorist attack, and where the resources would come from remain murky under Clinton’s plans. (Nor has this become any clearer as this is written under George W. Bush’s administration -- a situation that hopefully will soon change, though this doesn’t appear to be happening. Late in October, it was learned that Homeland Security Office Director, Tom Ridge, had failed to have even one meeting with any terrorism experts on what steps were needed to protect US citizens, instead spending his time reassuring the press and congressmen that everything was being done to protect the public. Such actions suggest that good PR may be more important than protecting US citizens.

Currently, the most one can say about US plans to deal with terrorism is simply to "clean up the mess after an attack" and perhaps limit the spread of disease through quarantines and the like. Hardly ideal, if you or your loved ones are in an area that has been targeted by terrorists.

As for the millions spent thus far, the reaction that one can expect from the federal government organizations currently involved would most likely be considerably inadequate to deal with the problem.

The US Army’s response team is set up to treat a total of four people with highly contagious bioterrorism diseases. That’s right, a total of four people!

Considering that thousands of victims might be exposed to a pathogen during the release of a pathogen over a ball game stadium or city, such preparations would be humorous if not for the loss of life that would result. (This lack of preparation is in spite of a 1993 White House estimate that an anthrax release in the nation's capital could kill as many as 3 million people.)

Things appear to be on the right track, though it is now a race against time as to whether or not things will be in place to deal with a terrorist attack. For example, the federal government has been quietly stockpiling the antibiotics and vaccines that would be necessary for dealing with biological weapons. According to the CDC, these supplies are stored in eight locations scattered across the US, with each site having enough antibiotics to treat several hundred thousand people. These can be delivered to a site within 12 hours, according to officials. But even here there’s a problem.

A dispersal of pathogens over a large city, such as New York or Los Angeles, might easily expose not several hundred thousand people to contamination but rather millions. And such attacks might well be mounted over several large cities at the same time to further increase likely victims. And, while many of those in an urban environment would probably be uncontaminated in such an attack, the catch is that without being able to determine who will become ill and who will not, all would likely have to receive antibiotics, as testing such numbers to determine whether or not they were actually exposed would be too time-consuming!

That means officials would be presented with the perhaps impossible task of figuring out who was contaminated and who was not, and perhaps with the choice of who to save and who to let die (and perhaps even be unable to do anything once the public panicked at the realization that supplies were inadequate). The decision would then have to be made to distribute the antibiotics on the off chance that some of those exposed would otherwise die.

And thus, what at first sounds like more than enough vaccines and antibiotics to protect our nation might in truth be too little, too late.

On September 23, 2001, several congressmen called for at least a billion dollars of the $40 billion emergency package passed following the attacks on the WTC to be earmarked for use in preparations for a biological attack on US citizens. One can hope that finally the US government is getting serious about protecting more than four citizens at a time from biological weapons. Yet, to date, the federal government has not done anything that approaches protecting individuals from attacks employing biological weapons.

In the meantime, the tests to determine what sort of response government workers will make to save your skin in the event of a terrorist attack have not been at all reassuring.

Dropping the Ball

The state governments in the US have taken a few actions to protect state legislatures and office buildings. But in most states these precautions are superficial at best. Instead, most of the response to emergencies has been left to local responders such as the police and firefighters. While many departments train police and fire department workers to have at least a superficial understanding of the potential to use pathogens as a weapon, and while the federal government has also had seminars and training for these groups, these preparations generally are seen only as training exercises and seminars with little review or determination as to whether or not the information has been assimilated by those involved. Additionally, equipment like gas masks and protective suits remain in short supply.

Those responding to what could have been biological weapons attacks have too often failed to take adequate actions to prevent its spread. Perhaps the most spectacular failure occurred in Washington, DC, in 1997, when a package was delivered to the B’nai B’rith, just a few blocks from the White House. The package was leaking red liquid (which apparently didn’t bother those who delivered it), the B’nai B’rith called the police department, which responded by sending an emergency response team. Yet rather than treat the package as if it might contain pathogens and isolating workers who had been exposed to the liquid, the police proceeded to open the package without protective equipment, only to be confronted by a container inside labeled quite simply, "Anthrax." Only then did they start to take precautions -- which would have been sadly too late for many of those involved.

The box proved to be a hoax, which was fortunate for all involved. Yet it demonstrated that the police were poorly trained, and that those who are first on a scene may take actions that spread, rather than limit, the pathogens that could be employed as a weapon. And once such a plague was started, the response by the federal government would be with units equipped to deal with only a handful of victims.

Likewise, the coordination between first responders and state and federal organizations is nothing short of non-existent during the first critical hours of a possible terrorist attack. In June 2001, officials from federal and state governments took part in a two-day war game code-named "Dark Winter." The exercise simulated a smallpox terror attack on Oklahoma City. The game revealed a disastrous response on the part of public-health officials, as well as state and federal governments, along with the military.

Those conducting the exercise found that, rather than manage to contain the disease in Oklahoma City, officials late responses would permit it first to spread by aircraft and motor vehicles to 25 surrounding states, and from there to 15 countries before being contained. After the exercise, Oklahoma Governor Frank Keating, noted somewhat sheepishly that "doctors and nurses in my state know nothing about anthrax and smallpox."

That lack of knowledge would have killed hundred of thousands of people had Dark Winter been the real thing rather than a game.

Dark Winter lived up to its name, even when enacted in a city that was relatively small, and which has limited national highways running in and out of it. Imagine such an attack mounted on a city with a much larger population and an international airport, shipping, or other operations that entail large numbers of visitors and travelers, and you start to see the magnitude of the problem and the likelihood that federal, state, and local officials will fail to contain the spread of a disease initiated by a bioterrorist attack.

It gets worse.

Currently, the race to get money and the authority to fight terrorism has led to obscene rivalries and infighting between government agencies. As Time magazine recently noted about our efforts to fight terrorism,

At present, coordination simply doesn't happen; homeland defense is a patchwork quilt made by an inept seamstress. Some stories would be funny if they weren't being told against a backdrop of tragedy. There was the recent joint exercise of the FBI and the Bureau of Alcohol, Tobacco and Firearms, during which agents argued for an hour over who was in charge, while actors playing the dead and dying got hypothermia. There is the sad tale of the Center for Defense Preparedness run by the Department of Justice, which "trains trainers" to respond to toxic emergencies--and whose current budget allows it to operate at 25% of capacity. There is the rivalry--or is it hatred? -- between the Immigration and Naturalization Service and the Customs Service, neither of which seems ever to have willingly shared a piece of information with the other.

The sad truth is that as things stand at the time of this writing, many government agencies charged with helping you survive a terrorist attack are so busy fighting among themselves that they’re apt to simply let you die of exposure, rather than give up turf. If you’ve been pinning your hopes of being protected from biological terrorism on the federal government’s efforts, you’d best rethink things. The likelihood of help coming in a timely manner seems iffy at best as things now stand.

Maybe that will change in the near future. The question to ask yourself is this: Do you want to risk your life and the lives of your loved ones on that hope?