1. The Good, The Bad, and The Ugly TOPOFF2 Lessons Learned

2. Half Full or Half Empty...

3. TOPOFF2 Overview... May 12-16, 2003 Largest Terrorism Response Exercise Designed to Identify Vulnerabilities in the Nation’s Incident Management Capability Radiological Dispersal Device (Seattle, WA) Pneumonic Plague (Illinois) Open Exercise to Enhance Learning and Preparedness

4. DHS After Action Summary... Marred by Communications Problems Serious Shortages of Medical Supplies and Hospital Rooms Lack of Federal, State and Local Preparedness Confusion Over Where Radiological Residue would Spread

5. The Participants…

6. Major Activities… Disease Investigation and Surveillance SNS Distribution and Dispensing SWMDT Takedown Hospital Play JOC/JIC Operation

7. Many Positives from T2… Critical Decisions by Governor and Top Staff SNS Distribution and Dispensing Activities SWMDT Takedown of Terrorist Cell Disease Investigation and Surveillance Utilization of ILEAS – 1,200 law officers Public Information and EAS Activation Rapid VMI Re-supply

8. Future Preparedness Needs… Coordination Between Many Command Centers Joint Decision-Making/Information Sharing Mass vs. Targeted Prophylaxis Prophylaxis of First Responders Consolidate Conference Calls Further Development of JOC/JIC Streamline Electronic Communication (E-Mail) No Prioritization of Information Shared

9. Future Preparedness Needs… Wider Distribution of State Situation Reports Blast-Faxing of Information Slow Need for Effective Staging Areas Communication with SWMDT During Event

10. Public Health and Hospital Review and Critique

11. Public Health Activities… Disease Surveillance and Epidemiology Laboratory Confirmation and Technical Assistance Strategic National Stockpile Distribution Hospital Response and Collaboration Legal Authorities and Review

12. The Good (i.e. Successes)… Preparedness Activities and Pre- Planning First Responder and Hospital Coordination Strategic National Stockpile Distribution State and Local Public Health Collaboration Legal Team Development and Review Defined Public Health Role During Emergency

13. The Bad (i.e. Concerns)… Coordination with Command Centers Sending Voice and Electronic Communications (Alerts) Monitoring News Reports (VNN) Highlighted Resource (Personnel) Needs Input in Major Decisions (Schools and O’Hare)

14. …The Ugly (i.e. Critical Issues) New Concept of JOC/JIC Multiple Points-of- Contact with Federal Government Time Compressed Activities Produced Unrealistic Scenario

15. Lessons Learned… Importance of Surge Capacity Critical Role of Regional Planning (Mutual Aid) Electronic Reporting is Mandatory Core Surveillance Standards are Needed Public Health is from Venus and EMA is from Mars

16. Next Steps… Further Define SNS Strategies (Mass vs. Targeted) Upgrade Voice and Electronic Communication Systems Integrate Public Health and Hospital Preparedness Activities Conduct Additional Exercise (No Notice)

17. Questions/Comments… Donald Kauerauf Chief, Division of Emergency Preparedness and Response Illinois Department of Public Health