March 15, 2001When you walk into clouds of poisonous gas for a living, it helps to have a sense of humor--even a morbid one. That's why fire department hazardous-materials specialists often call their police colleagues "blue canaries." It's a reference to the songbirds that old-time miners took with them underground as living--or dying--indicators of bad air in the shafts. The joke goes like this: "There's a policeman down there, he doesn't look like he's doing too well, I guess that's not a safe area," explained John Eversole, chief of special functions for the Chicago Fire Department.
In their oxygen masks and all-enclosing plastic suits, "hazmat" specialists such as Eversole can approach industrial spills with confidence--and they do, dozens of times a day, all across the country. Fortunately, so far, they have not had to don those suits in response to some terrorist group that has doused an American city, subway, or airport with lethal chemical weapons. But the John Eversoles in cities and counties around the country are getting ready for just such an eventuality. And, unfortunately, they have one large-scale, real-world example to learn from: the Aum Shinrikyo cult's 1995 release of sarin nerve gas in the Tokyo subway system. Although a crude attack, it nevertheless killed a dozen people, injured scores more, and panicked thousands.
No group has attempted a similar feat, and governments want to keep it that way. But toxic chemicals, and the know-how and skills to brew them, permeate industrialized societies in a way that the prerequisites for biological or nuclear weapons do not. So, although potentially less deadly than an artificial plague or atom bomb, chemical terrorism is also far more likely. And, despite all the Hollywood movies portraying secret government teams in moonsuits and black helicopters arriving at a disaster scene within minutes, in truth, federal forces may not arrive until 10 hours after an attack, as occurred in the 1995 Oklahoma City bombing. Not because they are incompetent, Chief Eversole said, but because "they are just too far away."
So, federal officials have increasingly turned their attention to preparing their state and local colleagues for the first critical hours that follow a terrorist attack. But in the event of such an unprecedented disaster, what would the police, fire fighters, and medics really need? What are they actually getting from the feds? In interviews with emergency responders from a dozen cities, small and large, plus many more with Washington officials and experts, National Journal found some surprisingly hopeful signs about the nation's readiness for a terrorist attack with toxic chemicals, and some causes for worry.
Among the hopeful signs are a new awareness among cities and towns across America that they have to do more to get ready, and a growing ability by localities to use federal money to buy new communications equipment and emergency gear. Also helpful is that America is fortunate to have well-trained fire departments with extensive experience in handling hazardous materials--and chemical weapons are just more-intense hazardous substances. On the downside, the array of federal programs is confusing and often arbitrary, and this has lent a disjointedness to antiterrorism efforts. Further, the country's medical community seems to be playing catch-up in its preparations to effectively handle mass casualties.
Prepared or not, one thing is clear: It will be the local blue canaries who catch the earliest whiffs of chemical terror, and who become the first professionals to put their lives on the line. "As a citizen, you are not going to pick up the phone and call the federal government and say, `Hey, President Bush,' " Eversole said. "You're going to pick up the phone and dial 911."
After terrorists attack, the first line of defense is the telephone line. Emergency dispatchers get little attention or respect, but their ability to realize just why the phones are ringing off the hook can save crucial minutes, and many lives. In the Tokyo attack, it took more than an hour of emergency calls from 15 different subway stations before authorities understood there was a single cause, not just a spate of awful coincidences. By then, so many police, paramedics, and firefighters had rushed in without proper protection that a tenth of the rescuers became sick themselves.
But in America today, extensive training efforts--some funded federally, others locally--have inculcated in many cities at least a basic awareness of what could happen. The Boston subway, for example, is experimenting with high-tech toxin detectors created by the federal Energy Department. But the best defense is still common sense: "If you get a call for five or six or eight people down on a platform having difficulty breathing, that's a clue right there," said Detective Peter Pasciucco of the Massachusetts Bay Transportation Authority. "[You] shouldn't rush in.... You can't help anybody if you're lying there next to them."
Spreading such awareness was one achievement of the otherwise controversial Domestic Preparedness Program--also called Nunn-Lugar-Domenici, after the Senate authors of the 1996 act--that ordered the Pentagon to train the nation's 120 largest cities to protect themselves against chemical, nuclear, and biological terrorism.
Indeed, it seems the program and its many imitators were almost too successful in training cities and counties. "We had so many agencies offering to train us," said JoAnne Moreau, director of emergency preparedness in East Baton Rouge Parish, La., "[that] our responders could have been trained to death." A National Domestic Preparedness Office, subsequently founded by the executive branch in 1998, was supposed to coordinate federal agencies in their efforts to train local governments, but the office was hamstrung by infighting and has only recently received full funding. In the meantime, multiple bureaucracies alternately compete, and cooperate, to offer training courses. Primary among these are the Justice Department--which took over the Domestic Preparedness Program from the Pentagon last fall--and the Federal Emergency Management Agency, which has long-standing links to local firefighters and disaster planners, but has less money to give out than Justice. Even federal officials agree that better coordination would help. There needs to be "one agency that serves as the single point of coordination," said Bruce Baughman, FEMA's director of response and recovery operations and planning. "We think that's us. Naturally, if you go over to Justice, they think it's them."
Although this duplication and lack of coordination can confuse and frustrate local officials, the federal money--some $315 million in fiscal year 2000--at least allows cities smaller than the 120 to piece together their own training programs from the various offerings. Take, as an example, Evansville, Ind., population about 120,000. With the help of the state government and FEMA's prestigious National Fire Academy, "All of our firefighters have been trained ... to always have their eyes and ears open" for chemical attack, Evansville Fire Chief John Buckman said, "[especially] when they're investigating what could be considered a nuisance-type call for irregular smells or irregular sounds."
But awareness alone can go only so far. Police officers are called the blue canaries because they usually lack protective gear, but the same could be said of paramedics. And the average firefighter has at best an oxygen mask and a heavy-duty slicker. A $78 million Justice Department grant program is now helping localities buy better gear. The most-prepared agencies, such as the one that runs the Washington subway system, have already supplied their personnel with basic "quick masks"--so called because of both how quickly they can be put on in an emergency and how quickly they stop protecting you. "It's not to be used more than 15 minutes," said Capt. Geoffrey C. Hunter, counterterrorism planner for the Washington Metropolitan Area Transit Authority. "The only thing we use a quick mask for is to get out."
That's perhaps the hardest thing for first responders to accept when training for a terrorist attack--they have to resist their first instincts to run to the rescue. "We've trained since the day we've become police officers to rush in," Hunter said. "In a chemical weapons release, if we're not equipped to go in there, we can't stabilize the situation, and someone will then have to go in and rescue us."
Most experts agree that until the hazardous-materials specialists arrive, ordinary police, paramedics, and even firefighters should stand back, upwind and uphill of the spreading poison, and use loudspeakers or public address systems to direct victims to safety. "Sometimes," lamented Hunter, "it may appear that they're heartless." But, for all concerned, not rushing in is the right thing to do. Detective Pasciucco, from Boston, agreed: "It's a terrible thing to say, but people are going to die. You can't save everybody."
Next to arrive after the ordinary police, firefighters, and paramedics will be the people in moonsuits. But this second wave still won't be federal: They'll be the local "hazmat" team, the hazardous-materials specialists. "The primary thing is to get the people who have the specialized expertise there," said Richard Sheirer, director of New York City's much-admired Office of Emergency Management. In New York, said Sheirer, "We can usually do that within five minutes."
That's the best case. In an isolated rural area--or during an urban rush hour--it may take much longer. But compared with the exotica of combating biological or nuclear terrorism, "we are in fairly good shape on the chemical side," said former FBI counterterrorism chief Robert Blitzer, "because most major metropolitan areas, and even the less-than-major areas, have hazardous-materials capabilities that are very, very good and can be called on quickly."
America's hazmat teams are so good because they get so much practice. "During peak times, we average about 150 calls a day [nationwide], all the way from a pint paint can to a major incident," said Carl Reynolds, director of the chemical industry's Chemical Transportation Emergency Center, a clearinghouse that local hazmat teams call on for advice. In a modern industrial state, many substances resemble the kinds of chemical weapons terrorists might use. Phosgene, today used by dye factories and in food processing, was originally developed as a chemical weapon; chlorine, the first gas ever used in war, now sanitizes reservoirs and swimming pools; and common pesticides mimic some nerve gases. Local hazmat teams have experience with most of these.
What civilian hazmat specialists most desire from the feds is hands-on experience with the military-specific chemicals they might encounter during a terrorist attack. "That kind of training is irreplaceable, and the only ones that can do that are the federal government," said Chicago's Chief Eversole. He and other locals especially laud the courses at the Justice Department's Center for Domestic Preparedness in Anniston, Ala., a former Army facility that houses the country's only sealed chamber for training exercises with real military-grade gases. "You actually go down there and you learn something, vs. sitting in a class where you've heard the same thing a hundred times," said Jennifer Harper, counterterrorism coordinator for New Hampshire's state Office of Emergency Management.
But most local fire departments cannot supply their Anniston graduates with the specialized equipment needed to detect and analyze military-grade chemicals. So, after a terrorist attack, while precious minutes passed, a sample--itself highly toxic--would have to be sent for analysis to a full-scale chemical lab. Sheirer, in Manhattan, actually has such a facility nearby. But most cities are not New York.
"How long would it take us to get that outside kind of help?" said an emergency official from a small, isolated city (unnamed for obvious reasons). "It would probably be eight hours before we can have any kind of identification of what this unknown material is."
But what if labs came to the locals? That is the basic idea behind the National Guard's Weapons of Mass Destruction Civil Support Teams, a program that formerly sported the catchy acronym RAID. These 22-person units are specially trained to deploy by air or road with sophisticated analytical equipment for meeting a chemical, biological, or nuclear attack. An enthusiastic Congress has expanded the original 10-team pilot program introduced in 1998 to 27, and then to 32, teams nationwide. But not one team is yet certified as ready for a real emergency, and criticisms abound, most recently in a scathing Pentagon inspector general's report in January that called the teams' doctrine inchoate, their training inadequate, their equipment untested, and their role unclear.
"Congress thought it was such a good idea that they had us move a little faster than we were able to," one senior Defense official pointedly said. Still, the official insisted, the idea behind the original name, RAID--Rapid Assessment and Initial Detection--remains valid.
But the Guard units may not arrive rapidly at all. Some lucky cities have civil support teams just minutes away. In Los Angeles, County Deputy Fire Chief Darrell Higuchi says the local team has participated in several drills and could arrive within half an hour of an incident. But in Boston, which has also exercised with the nearest team, based in Natick, Mass., Transit Detective Pasciucco said, "I'd be surprised if I saw them in less than five or six hours."
In fact, this is a common complaint about federal efforts to help states and localities cope with terrorist attacks. The programs are patchwork, the decisions about who gets money are arbitrary, the requirements are sometimes onerous, and it all adds up to a randomness in which some communities fare better than others. Five years since his city's tragedy jump-started America's counterterrorism efforts, Oklahoma City Fire Chief Gary Marrs says, "My disappointment is that it still seems to be a somewhat disjointed effort."
Here are a few examples: When local governments complained that federal decisions about who would get aid were being made arbitrarily, Congress ordered the Justice Department to stop making equipment grants to selected cities and directed it to send its money through state capitals instead. Local officials don't like that fix either. By far and away, "the most effective program is one where federal money goes directly to local governments, without the state taking a cut," said Seattle Deputy Fire Chief A.D. Vickery. But Justice's goal is a comprehensive national plan of coverage: It will release federal funds only after states perform an exhaustive self-assessment and produce a plan to protect all their citizens in the event of a terrorist attack.
That self-assessment is a bear. New Hampshire sent several officials to a special training session just to learn how to fill the survey out, said state coordinator Harper, but "by the time the folks had gotten back here, the rules had changed."
Other state officials are more accepting. "It's good for us to sit down and go through this process of identifying targets and threats," said George W. Foresman, deputy coordinator of the Virginia Department of Emergency Management. And states can now spend Justice Department funds to fill gaps left by earlier federal programs. In Illinois, for example, the "biggest-cities" criterion channeled all aid to Chicago and its suburbs, leaving rural areas, small towns, and even the state capital, Springfield, uncovered. Now a Justice grant will help equip new state-controlled teams to respond anywhere in Illinois in less than two hours.
Although two hours is a vast improvement over federal response times, the time will still be too long for many victims who might otherwise survive an attack. That's why some members of Congress are pushing for more federal aid, so that nearly every emergency vehicle in the country can have some basic gear for detecting chemical, biological, or radiation weapons. "You need to have the basic detection tools on the first-in piece of equipment," be it a squad car or fire truck, said Rep. Curt Weldon, R-Pa., himself a former volunteer fire chief. "It's not there today."
Scientists at the Energy Department's national laboratories are working furiously on just such gear. A handheld detector already in the prototype stage can identify about a dozen chemical or biological agents. A detector with a wider range, say the labs, is some three to five years away.
Until then, what can the locals do besides wait? "At this current stage," said Seattle's Chief Vickery, "probably the best detection equipment we have--and it's a horrible thing to say--is the patients themselves, the symptoms they exhibit."
After identifying a chemical attack and getting federal or local hazmat crews in place, the next task for emergency workers is to decontaminate the victims. This is largely a local operation, although the federal government is providing training, helping local governments buy decontamination equipment, and disseminating lessons learned from the Tokyo attack.
For the local fire departments and hazardous-materials teams, however, decontaminating people is a thorny and awkward operation that presents all sorts of problems, and plenty of guesswork.
Some of that was revealed in last year's "Topoff" exercise in Portsmouth, N.H., in which local, state, and national officials simulated an attack by terrorists using chemical weapons. With victims "dying," and the National Guard team's mobile lab still en route, the local fire chief decided that the odors and the patients' symptoms indicated mustard gas. So, recalled New Hampshire state coordinator Harper, "he made the call to do `gross decon': Run `em through water, strip `em, get `em to the hospital, and treat `em."
That procedure sounds simple enough. It's not. The first step in any incident is to set up a perimeter to prevent more civilians from wandering into harm's way. But in a chemical release, the danger zone itself may move. Although the most volatile agents will evaporate quickly, "persistent" chemicals form clouds that can last for hours, drifting with the wind--even indoors or underground. Air conditioning can spread the poisonous gas throughout a building, and the rush of subway trains can send it down tunnels. Several federal agencies, including the Energy Department, offer to local governments computer simulations that can quickly predict where the chemical will spread. Without these, police manning the perimeter at an ostensibly safe distance may become blue canaries.
It's not only air currents that will spread the poison, though: It's the victims as well. Every person fleeing the scene can carry the chemical on clothes and skin, where it continues to endanger not only the victim, but everyone the victim touches or even approaches. In Tokyo, where authorities were slow to set up a perimeter, so many contaminated victims rushed to hospitals or doctors' offices that several medical facilities became contaminated in turn and had to close down. Tending to poison-soaked patients in cramped ambulances or ill-ventilated wards, some paramedics and nurses became sick themselves. And most hospitals, in Japan and America alike, can decontaminate only a handful of patients at a time.
That means decontamination must take place before victims reach the hospital. People who are exposed to the chemicals or simply standing near the danger zone--all of them frightened, many of them sick, blinded, or choking--must be directed, even dragged, to "decontamination corridors" where they can be cleaned. But a crowded rush-hour subway can produce hundreds of victims; a packed sports arena, perhaps tens of thousands. Pretty soon, decontamination is a logistical nightmare. Most federal and local experts agree that the best first step to take when decontaminating large crowds of people is to strip off their outer clothing--which will be permeated with poison--and shower them off. "We can do a tremendous amount of good by just taking the clothes off you," Eversole said. But to persuade a panicky and mixed-gender crowd to strip off their clothes and leave behind their valuables--"What chaos," he sighed.
Many cities have bought special decontamination trucks or trailers with showers inside, but these are expensive and take time to set up. Other cities plan to roll in ordinary fire trucks and set the hoses for a gentle spray. "We can move literally hundreds of people through that fairly quickly," said Seattle's Deputy Chief Vickery. But that exposes patients not just to public view, but to the weather as well--which in winter may merely convert the victims' problem from poisoning to hypothermia. Vickery plans to improvise protective tarpaulins; other departments, such as Los Angeles County's, actually have inflatable, heated tents. And some officials speak bluntly of their intention to commandeer the nearest large building that has showers. "As soon as an incident goes down, one of the first things I will do ... is look to see where the closest junior high school, high school, or college is," one official said. "I'll shut that place down."
When a chemical victim is clean enough to be treated safely, the medical problem has just begun. Especially in this efficiency-minded age of managed care, no city has much slack in its medical system. On even a normal night, many cities must institute "bypasses" when an overloaded emergency room refuses to accept more patients. In a true mass-casualty disaster, doctors, drugs, and even space will run out fast.
In most hospitals, "they're running at max most of the time," said Battalion Chief Michael Arras of the St. Louis Fire Department. "It's going to be mass havoc if you have a thousand people [injured]." As one health expert put it: "If push comes to shove, you put people on the floor. Nobody says that, but that's what happens." Many cities plan to set up field hospitals in parking lots or public buildings.
Harder to address is the shortage of supplies. Nerve gas antidote, for example, includes the heart drug atropine, which most ambulances already carry--but in doses less than a tenth of what a nerve gas victim needs. Other agents do their damage and are gone, with no need for an antidote. But to keep the victims breathing while their ravaged lungs repair themselves may require rare and expensive ventilators. Even basics such as blankets and intravenous bags will run short.
Some cities have used federal grants and their own resources to stockpile such supplies. Chicago, for example, has "triage vans"--literally truckloads of blankets, stretchers, and medical supplies. Still, in the long run, drugs expire, and gear breaks down, and the cost of stockpiling expensive, specialized supplies in mass-casualty quantities is more than any single city can bear. So the federal Health and Human Services Department has a two-tiered system of stockpiles. Enough supplies for 5,000 victims can be ready to fly within hours to the site of a terrorist incident--in theory. More medicine will be en route the next day.
That leaves the hardest shortage, the human one: With hundreds or thousands of patients, where do the doctors and nurses come from? East Baton Rouge Parish, which contains the city of Baton Rouge, is actually developing a database of nurses and doctors who have retired, moved to administrative work, or changed careers, so it can call them up in an emergency. The nation's largest medical system, the Veterans' Affairs Department, is finishing a similar list of its personnel who can help out in disasters. Health and Human Services actually has the largest such reserve. It can call up from across the nation more than 70 disaster medical assistance teams, each comprising up to 100 medical personnel who have volunteered to deploy to disasters that range from earthquakes to terrorist attacks.
While doctors are rushing in, the National Disaster Medical System will bring overflow patients out, transferring them, by military airlift if necessary, to VA facilities or 2,000 participating private hospitals nationwide.
But all of this would still take time. In the first awful hours after an incident, as on a battlefield, the only option is triage. "Every life is important, and there is no acceptable number of deaths," said Clark Staten, director of the Emergency Response & Research Institute in Chicago. "But reality may set in as you are faced with larger and larger numbers of casualties, and you're going to have to make realistic choices at that point about who can be saved and who can't."
Triage is not a solution anyone is happy with. But the fact is that the medical community is where fire departments were a few years ago--just beginning to prepare for encounters with weapons of mass destruction. The emerging model is HHS' Metropolitan Medical Response System. Originally intended as yet another rapid-response team, the program evolved into a far broader effort, one that links government-run emergency services with private hospitals, thereby creating a coherent community disaster plan. Although the program is providing 97 cities with an average of $600,000 apiece, HHS and outside experts agree that that is only seed money. The cities must spend their own funds to continue the programs. The grant's greatest value is as an incentive to get all parties to come together and plan. Said Oklahoma City Fire Chief Gary Marrs, "Just the fact that we've got the MMRS designation and got that group working [means] we've got them at least coming to the table and talking."
Now that federal, state, and local officials are talking, the challenge is to maintain the momentum. The Domestic Preparedness Program's original list of 120 cities will be trained by 2002, but federal officials are just now brainstorming about how to maintain and freshen the capabilities the program created. Indeed, since the program's October transition from the Defense Department to Justice, East Baton Rouge Parish's JoAnne Moreau noted that her city had received no funding or follow-up from either department. "We're in the black hole now," she said.
Even HHS' Metropolitan Medical Response System provides only an initial infusion of funds; it doesn't offer continuing support to train and exercise people, or to maintain equipment. The Justice Department envisions that its requirement that each state conduct a self-assessment will become the foundation for a comprehensive national plan, but the interagency coordination is still lacking to carry out such a strategy. Also lacking is a national library of best practices, which would provide such information as how best to do mass decontamination, or the most important lessons learned from past exercises. The nonprofit Emergency Response and Research Institute says, based on its own efforts to create such a database, that one could be had for less than $250,000. After Oklahoma City and Tokyo, the United States, in its eagerness to get on top of the terrorist threat, leaped over such simple but important steps. That initial sprint to safety accomplished a great deal. But now the marathon lies ahead.
So Where's the Military?
When chemical terrorism first hit the national agenda after the Tokyo sarin gas attack in 1995, the military was front and center. But it really didn't want to be. The 1996 Nunn-Lugar-Domenici law volunteered the Pentagon to train local emergency agencies for such events--and did so largely by default, because no one else had the technical expertise. But, with the prominent exception of the National Guard, the armed forces have long been uncomfortable shouldering domestic duties. Said one senior Pentagon official, "It's not a traditional role, it's not a desired role."
So when the domestic training program shifted last year to the Justice Department, many in the military felt not defeat, but relief. Now they could get back to their core business, preparing for battle overseas. Some of the resources formerly used to train civilians against terrorism are already being shifted to help safeguard the military's own bases against terrorist attack.
That's not to say the armed forces are AWOL in the defense against terrorism. Elite teams that can be called on in an emergency include the Army's Technical Escort Unit, founded in 1943 to handle chemical weapons, and the Marine Corps' Chemical-Biological Incident Response Force, formed in 1996 and expert in caring for contaminated casualties. These special forces are backed up by a wide array of detection and decontamination units in the regular forces. And at the base of the pyramid, the military has unequaled logistical muscle, able to deliver everything from food, to blankets, to field hospitals. There is now even a special standing headquarters, the Joint Task Force-Civil Support, to coordinate all military contributions to the aftermath of a major terrorist attack.
But the Task Force would deploy only when requested by a state's governor, and even then only as one subordinate part of the Federal Emergency Management Agency's overall response. Said the senior Pentagon official, "We view ourselves as the federal asset of last resort."
March 15, 2001