Weapons of Mass Destruction & Bioterrorism Ronald R. Blanck, D.O. LTG, USA (Retired) President University of North Texas Health Science Center

WMD & BIOTERRORISM DUCT TAPE STOCKPILING ANTIBIOTICS GAS MASKS MAJOR BEHAVIOR CHANGE

Weapon of Mass Destruction “…any explosive, incendiary, or poison gas, bomb, grenade, rocket having propellant charge more than four ounces, missile having an explosive charge of more than one quarter ounce, mine or device similar to the above…poison gas…disease organism…radiation.” Federal Response Plan Annex THESE ARE THE TWO MOST COMMON DEFINITIONS OF A WEAPON OF MASS DESTRUCTION. NOTE THAT THE FRP DEFINITION IS MORE SPECIFIC IN NATURE AND INCLUDES CONVENTIONAL WEAPONS OF RATHER SMALL STATURE, WHEREAS THE NLD DEFINITION IS ESSENTIALLY GEARED TOWARDS THE NBC THREAT. FOR EFFECT, CPT LEONARD WILL NOW DETONATE A HOMEMADE 5KT THERMONUKE UNDER THE APPROACH END OF RUNWAY 15 AT NATIONAL. Nunn “…any weapon or device that is intended, or has the capability, to cause death or serious bodily injury…through the release of…poisonous chemicals…disease…or radiation….” Lugar Domenici Legislation

Large Conventional Explosive Device WMD : Significant casualties from terrorist use of: Nuclear Device Chemical Device ● Tabun (GA) ● Sarin (GB) ● Soman (GD) Biological Device ● Botulism Toxin ● Anthrax ● Plague ● Ricin There are several definitions for WMD, but these are the types of incidents which the DOD considers as WMD. The sub-bullets are only examples and are not exhaustive. Large Conventional Explosive Device

Terrorism Is… “Warfare deliberately waged against civilians with the purpose of destroying their will to support either leaders or policies that the agents of such violence find objectionable.” Lessons of Terror - Caleb Cobb

-- Tom Clancy The Sum of All Fears KILL ONE FRIGHTEN 10,000 -- Tom Clancy The Sum of All Fears

NATIONAL SECURITY COUNCIL Coordination of Federal Agencies Presidential Decision Directive 39 U.S. Policy on Counterterrorism June 21, 1995 PRESIDENT HOMELAND DEFENSE Governor Tom Ridge NATIONAL SECURITY COUNCIL Coordination of Federal Agencies FBI FEMA The World Trade Center bombing, the use of sarin gas in the Tokyo subway system, and the Oklahoma City bombing have increased our attention and spurred, significant improvements in our nation’s ability to respond to weapons of mass destruction. Presidential Decision Directive 39, issued in June 1995, directs that the Department of Justice and the Federal Emergency Management Agency are the Lead Federal Agencies for Crisis Management and Consequence Management of terrorist incidents. FEMA has led interagency efforts which identified areas requiring additional capability and subsequently developed the interagency strategic plan to correct those shortfalls. The Department of Defense, as a supporting agency for both the Department of Justice and the Federal Emergency Management Agency, has been a partner in these. Additionally, the Department of Defense was tasked, through the Nunn-Lugar-Domenici Defense Against Weapons of Mass Destruction Act to lead an interagency training program for first responders in cities across the United States. This ongoing “train the trainer” program will have helped jump start efforts in 49 or 120 cities. During this same time, many federal agencies, including DoD, have been improving our response plans. I must stress that the evolution of planning and response capabilities that is still underway at the local, state, and federal levels has been significant and remarkable. The World Trade Center bombing, the use of sarin gas in the Tokyo subway system, and the Oklahoma City bombing have increased our attention and spurred, significant improvements in our nation’s ability to respond to weapons of mass destruction. As Secretary Cohen and Assistant Secretary Lee have just emphasized, many local, state, and federal agencies are involved in the evolution of reponse plans and capabilities. DoD Supports these efforts and is working to ensure that our assets can response in an integrated manner with local, state, and federal teams. INCIDENT CONTINGENCY PLANS FEDERAL RESPONSE PLAN Crisis Management Consequence Management

Definitions ● Crisis Management ● Consequence Management - Measures to anticipate, prevent, and/or resolve a terrorist threat or incident ● Primary Responsibility: Federal Government ● Lead Federal Agency: FBI ● Consequence Management - Measures to alleviate the damage, loss, hardship, or suffering caused by incident ● Primary Responsibility: State/Local Government ● Lead Federal Agency: FEMA, coordinating Federal ● Consequence Management support to the state

Programs ● Domestic Preparedness - Interagency effort directed by Congress - AKA: Nunn-Lugar Domenici City Training ● Consequence Management Program - DoD efforts directed by SECDEF (DRID #25) - Improve DoD support for response to WMD attacks - Integrate National Guard and Reserve components

Purpose of Nunn-Lugar-Domenici ● To enhance the capability of the Federal Government to prevent and respond to terrorist incidents involving weapons of mass destruction ● To provide enhanced support to improve the capabilities of state and local emergency response agencies to prevent and respond to such incidents at both the national and local levels

Domestic Emergency Continuum Most Likely Least Likely Greatest Least Probability -- Aircraft Accident HAZMAT -- MAJOR FLOODING IED -- STATE & LOCAL FEDERAL HURRICANE -- IND WMD ICD -- IBD -- Civil Demo -- Severe T-Storm -- Civil Disturbance -- Impact Local and state governments routinely respond to a wide array of domestic emergencies without any federal assistance. Even some WMD incidents may not overwhelm local officials that are properly prepared. However, a large scale incident, may not only overwhelm state and local responders, but also overwhelm federal assets prepared to respond. 32

Tiered Disaster/Emergency Response Federal Response State Response Local Response Incident Commander If local responders are overwhelmed by any disaster, they request additional support from neighboring communities and the state. If the state, including its National Guard, does not have sufficient assets to meet the needs, the Governor may request federal assistance. The President directs the federal response to disasters, both natural and man-made. For most disasters, the “all hazards” Federal Response Plan, guides the cooperative process that orchestrates the actions of 29 federal agencies. ● Full response requires local, state, and federal assets ● State response includes National Guard ● Military support requires Total Force involvement

Federal WMD Response Assessment Information Capacity Command Equipment Logistics Comm. Overall Plans Scenario Radiological Threat (Plutonium) Summary: Terrorists place a radiation Dispersal Device which distributes plutonium over a populated area. Nuclear Explosion Threat (Uranium) Summary: An improvised nuclear device (1.5KT) is exploded at midday in the vicinity of a state capitol building. Biological Agent Threat (Anthrax) Summary: 100 grams of anthrax released into the air distribution system at a major airport. Chemical Nerve Agent Threat (GB) Summary: 10 Gallons of Sarin is released on a busy morning in trash canisters at 5 Subway stations in a major city. Chemical Nerve Agent Threat (VX) (Persistent) Summary: M23 Land mines (.8lb) placed in suitcases at major airport and exploded at midday It’s not IF, It’s WHEN and WHERE? * Bottom Line - we are not ready! 2 17

Biological Warfare The intentional use of microorganisms or toxins derived from living organisms to produce death or disease in humans, animals, or plants

Biological Warfare History ● 14th Century: plague at Kaffa ● 18th Century: smallpox blankets ● 1943: USA program established ● 1953: Defensive program established ● 1969: Offensive program disestablished ● 1979: Sverdlovsk Anthrax incident ● SE Asia: Yellow Rain ● London, Virginia: Ricin

BW Agreements ● 1925 Geneva Protocol ● 1969 Nixon renounces BW ● 1972 Biological Weapons Convention ● 1975 Geneva Conventions Ratified

Biological Weapons Policy ● No use under any circumstance ● Research limited to defensive measures ● We possess NO weaponized biologicals ● Previous weapons stocks destroyed ● Destruction supervised: - USDA - DNR of AR, CO, MD - Dept of HEW

Destroyed U.S. Biological Warfare Agents ● Lethal - B. anthracis - Botulinum toxins - F. tularensis ● Anticrop - wheat stem rust - rye stem rust - rice blast ● Incapacitating - Brucella suis - Vee virus - SEB - Q fever agent

The Sverdlovsk Incident ● April-May 1979 - 66 Anthrax fatalities ● 1988 - Soviets present data: ● 96 cases ● 79 gastrointestinal ● May 1992 - Yeltsin admits “military developments”

Soviet BW Priorities “Agents Likely to be Used” ● Plaque ● Anthrax ● Botulism ● VEE ● Tularemia ● Q Fever ● Marburg ● Influenza ● Melioidosis ● Trphus

“There were more INSTITUTES working on Plague in the USSR than PERSONNEL working on Plague in the USA” -- Dr Ken Alibek

Advantages of BW: Are Biologicals the Ultimate Weapon? ● Agents easy to procure ● Inexpensive to produce ● Can disseminate at great distance ● Agent clouds invisible ● Detection quite difficult ● First sign is illness ● Overwhelms medical capabilities ● Simple threat creates panic ● Perpetrators escape before effects ● Ideal terrorist weapon

Acquisition of Etiologic Agents ● Multiple Culture Collections ● Universities ● Commercial Supply Houses ● Foreign Laboratories ● Field Samples or Clinical Specimens

Hazardous Biologic Material ● Letters ● Packages ● Cultures ● Person – to – Person ● Airborne Distribution

Response ● Not Typical First Responders ● BIO First Responders - Health Providers - Public Health ● All Organizations Involved

Issues ● Rapid Detection ● Public Health ● Hospital Capacity ● Stockpiling ● Vaccine Production

Health Providers’ Responsibilities ● Awareness ● Presumptive Diagnosis ● Reporting ● Epidemiology ● Response -Triage -Prophylaxis -Immunizations -Treatment ● Risk Communications

RECOMMENDATIONS Be aware Do not over – react Listen to authorities Take common sense precautions - radio and batteries - 3 - 5 day supply of food and water - full tank of gas - location of shelters Participate in planning 6. Continue usual behavior

It’s not a question of if... 26 February 1993, New York 20 March 1995, Tokyo It’s not even a question of when… It’s a question of when next… 19 April 1995, Oklahoma City 11 September 2001, New York