IP: Smallpox War Game - NEWS Report - WP - 24OCT01

[David Farber <dave () farber net>]

> Smallpox War Game Spreads Chill
>
>    Roxanne Roberts Washington Post Service  Wednesday, October 24, 2001
>
> WASHINGTON On the off chance you don't have enough to obsess about these
> days, here are two words guaranteed to give a chill: Dark Winter.
> .
> That is catchphrase that is popping up everywhere these days. Dark Winter is
> the name of a war game conducted in June at Andrews Air Force Base, near
> Washington: In this two-day exercise, terrorists release smallpox virus in
> three American cities, and the object is to track the disease and the
> response to it.
> .
> The cast of players included Governor Frank Keating of Oklahoma; former
> Senator Sam Nunn; a former presidential adviser, David Gergen; a former CIA
> director, James Woolsey, and a former FBI director, William Sessions.
> .
> The endgame, so to speak, was sobering: The government is woefully
> unprepared for biowarfare, as Mr. Nunn testified to Congress in July and
> again in September, just days before the World Trade Center and Pentagon
> attacks. Now, although there has not been a confirmed case of smallpox in
> America in more than 50 years, Dark Winter is a hot topic on talk shows, in
> planning meetings and at dinner parties.
> .
> "We intentionally picked the absolutely worst-case scenario," said Randy
> Larsen, director of the Anser Institute for Homeland Security, a nonprofit
> research institute in Arlington, Virginia, and a retired air force colonel
> who devised the game in January. "The purpose was to magnify the fault lines
> between federal and state responses and shortfalls in resources."
> .
> The point was to get the attention of government officials so they would
> take "appropriate actions" and think of public health as an important
> element of national security, he said. "If you look at the lessons learned
> from the game, the word 'smallpox' does not appear. We're talking about
> biological warfare in general."
> .
> But suddenly, "smallpox" is a threat. On Wednesday, the secretary of health
> and human services, Tommy Thompson said he needed $509 million to obtain 300
> million doses of vaccine for the virus. The United States stopped
> vaccinations in 1972 because the naturally occurring disease was virtually
> eradicated worldwide.
> .
> Today, the deadly virus is known to exist only in government laboratories in
> the United States and Russia. "The good news is that smallpox is hard to get
> and it's fragile," said Jay Farrar, a former Marine and military analyst at
> the Center for Strategic and International Studies. "The bad news is that
> there's no treatment once you catch it: 30 percent die, with survivors
> severely scarred and a large number blinded."
> .
> There are lingering fears, however, that the virus exists in clandestine
> labs in North Korea and Iraq. This made it the perfect disease for Dark
> Winter, a joint project of the Center for Strategic and International
> Studies, Anser, the Johns Hopkins Center for Civilian Biodefense Studies and
> the Oklahoma City National Memorial Institute for the Prevention of
> Terrorism. Working with Tara O'Toole, an epidemiologist at Johns Hopkins,
> Colonel Larsen selected smallpox because it is highly contagious, there is
> no treatment once the rash appears, the population is unprotected (vaccines
> administered decades ago afford little or no immunity) and there are few
> vaccines available.
> .
> "We wanted to overstress the system," he says. "We designed a war game they
> could not win."
> .
> The game, which was played on June 22 and 23 in a conference center at
> Andrews Air Force Base, spans 13 days. Day 1: Dec. 9, 2002. The place: a
> National Security Council meeting. The cast: Mr. Nunn plays the president of
> the United States; Mr. Gergen, the national security adviser; Mr. Woolsey,
> the CIA director; and so forth - all people who had been present at real
> Security Council meetings. Suddenly, the secretary of health, (Peggy
> Hamburg, a former New York City health commissioner) informs the meeting
> that the Centers for Disease Control and Prevention have confirmed one case
> of smallpox in Oklahoma and suspect there may be as many as 20 more.
> .
> What no one at the meeting knows is that three two-man terrorist teams
> (spookily prescient, they are identified as being from Qaida) released the
> virus via aerosol spray in shopping malls in Oklahoma City, Atlanta and
> Philadelphia eight days before. Unknowingly, 3,000 Americans have been
> infected.
> .
> "No one really knows how smallpox or any other highly contagious disease
> will spread among a densely populated, highly mobile, unvaccinated society,"
> Colonel Larsen said. (In 1947, a single confirmed case in New York led to
> vaccinations for 6.3 million people. The last case reported in the world
> came in 1978.)
> .
> Suddenly, the game players are faced with terrible decisions. Medical
> experts tell them the outbreak can be contained with isolation and
> vaccination, but who should be isolated and which U.S. citizens get the
> existing 15.3 million doses of vaccine?
> .
> "President" Nunn refuses to give the vaccine to all military personnel;
> instead, he decides to administer it to military, security and medical
> personnel at the scenes of infection. He calls for accelerated production of
> more vaccine and asks for surplus from other countries.
> .
> The game was structured to examine the roles of the federal and state
> governments in a health panic. In the game, Governor Keating of Oklahoma
> asks for vaccine for everyone in his state; the president refuses. By the
> sixth day of the crisis, all of the vaccine is gone. The question of
> isolating citizens who may be infected is addressed; there are no good
> answers. In the following days, riots for vaccine break out, interstate
> commerce has halted, the stock exchange stops trading.
> .
> The war game ends Dec. 22; the disease has spread to 25 states and 15 other
> countries. In 13 days, 2,600 have died; more than 11,000 are infected. The
> future is grim considering the game uses the current international standard
> for transmission: Smallpox can pass to anyone standing within six feet (two
> meters) of an infected person.
> .
> The participants were shocked by the results, Colonel Larsen said. Mr. Nunn,
> now board chairman of the Center for Strategic and International Studies,
> testified to Congress; other briefings were held for top government
> officials. One senator told Colonel Larsen it was "the most troubling
> presentation he had seen in 23 years." And the phrase "Dark Winter" crept
> into conversations, especially after Sept. 11.
> .
> Scary? Maybe this will help you sleep at night: "We are so much better
> prepared today for a biological attack than we were in June," Colonel Larsen
> said. "Because the enemy has lost the element of surprise."


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