Cities Preparing for the Worst

MARGARET WARNER:

Elizabeth Brackett of WTTW-Chicago has the homeland security story.

ELIZABETH BRACKETT:

Had it been real, it would have been a devastating week for the United States– a week where the country coped with a radiological dispersal device, or dirty bomb, in Seattle and, in Chicago, a covert bio-terrorist attack that spread the plague as far away as Vancouver, Canada. The mock attacks: All part of a $16 million congressionally mandated training exercise called TOPOFF TWO. This was the second in a series of exercises devised to test the readiness of the nation's top officials to deal with a complex attack involving weapons of mass destruction. Homeland Security Secretary, Tom Ridge was in Chicago for the exercise.

TOM RIDGE:

The TOPOFF exercises are an important part of our national preparedness strategy. If we are going to make our response systems stronger, we first have to identify where the strengths and weaknesses exist. That is what TOPOFF is designed to do.

ELIZABETH BRACKETT:

The scenario began on Monday with the explosion of a simulated dirty bomb just south of downtown Seattle. The initial blast supposedly killed more than 100, and authorities found radiation in the bomb's crater. The detonation of the dirty bomb prompted action around the country. In the Midwest, the regional director of the Federal Emergency Management Agency was one of those in charge of the response in his area to the Seattle attack.

EDWARD BUIKEMA, Federal Emergency Management Agency:

The decision was made, in the context of the exercise by the secretary of homeland security, to raise the threat level in specific cities to red. Now when that occurs, then centers like this in those specific cities are implemented and brought up to speed.

SPOKESMAN:

They had an actual person die, and one's in critical condition.

ELIZABETH BRACKETT:

The regional operating center in Chicago opened on Tuesday, and brought together 19 federal agencies and the Red Cross. The red alert also triggered the opening of several other communications centers, where all levels of city, state and federal officials could gather to make key decisions. Monitoring the performance of the operations centers was a critical part of the exercise, says the agent in charge of the FBI office in Chicago, Tom Kneir.

TOM KNEIER, Federal Bureau of Investigation: Communication is always, you know, you can go back and look at any of these that you want and somehow, some way, in some shape, some form, somebody doesn't communicate, and somebody doesn't get the message and something gets left out. It's almost like an orchestra. They can be the best trumpeters and clarinet players in the world, but unless they're all on the same sheet of music, it's just noise.

ELIZABETH BRACKETT:

What the communications centers did not know on Tuesday was that as part of the drill, terrorists had released weaponized pneumonic plague at three locations in and around Chicago. However, it soon became evident that some illness was spreading when mock patients began coming into hospitals, and hospital microbiology labs began culturing samples. Lab director Dr. Roberta Carey.

DR. ROBERTA CAREY:

The microbiology laboratory is really the first line of defense at recognizing unusual bacteria and viruses that could be used as agents of bio-terrorism, and we're always looking every day for something that is suspicious.

ELIZABETH BRACKETT:

In order to simulate the impact of how the media could drive the story, the exercise created a virtual news network, complete with field reporters and anchor teams.

SPOKESPERSON:

…Confirm the diagnosis of the pneumonic plague.

ELIZABETH BRACKETT:

It was the virtual network that broke the story that the illness sending so many people to the hospital was pneumonic plague.

SPOKESMAN:

In real life, in hard scenarios, the press can either be your best friend or just a complete pain in the rear to you. And I think that adds a little more real life, you know, that here, somebody's got to go before and explain where you are in the situation. And in a situation like this, with a WMD, you've got to calm down the public.

SPOKESPERSON:

Bring your stuff with you, and we're going to bring you in and we're going to talk with you, okay?

ELIZABETH BRACKETT:

Eighty-seven mock patients arrived at Loyola University Medical Center in Maywood, Illinois on Wednesday. A simple triage plan was put into effect by the director of emergency services.

DR. MARK CHICHON, Loyola University Medical Center:

One of the first things I did was say, "all those who want treatment, come with me." And we walked them away. The least-injured patients that are the worried well at times, but those are the patients who typically will clog… bottleneck the emergency department.

SPOKESPERSON:

Do you have any problems at all?

ELIZABETH BRACKETT:

Those left behind were deemed to be the sickest patients, and were sent through a temporary fast-track admissions process. The system worked well at Loyola, but mock patient Max Margolis said it hadn't been like that at the other hospital he was sent to.

MAX MARGOLIS, Mock Patient:

They took us all at once and didn't ask what symptoms we had or any problems that were going on. So they just took us all together, so people were dying over here. People were dying over here, and they didn't even know what the problems were.

ELIZABETH BRACKETT:

By Thursday, the decision was made to distribute prophylactic antibiotics to prevent the further spread of the plague.

SPOKESMAN:

Do you have any question about your medicine?

ELIZABETH BRACKETT:

Several thousand mock participants were bused to five distribution centers to wait patiently for their antibiotics. But the director of disaster preparedness for the AMA, Dr. James James, says there may have been more panic in a real plague disaster.

DR. JAMES JAMES, American Medical Association:

What we had here today was the way you want the public to respond. You had an ordered set of people who, you know, who followed the instructions to show up at their treatment point and then went through the process.

ELIZABETH BRACKETT:

And that's not always the way it works?

DR. JAMES JAMES:

I don't think that's always the way it works. But that is the goal. >> Send me two companies…

ELIZABETH BRACKETT:

To further stress the system, the exercise included a mock crash between a helicopter and a passenger plane at Midway Airport Thursday evening. Over 100 dead and wounded mock passengers lay on the ground as emergency crews tested their response time. The exercise wrapped up Thursday night with the FBI and other law enforcement agencies discovering and destroying the terrorist lab where the pneumonic plague had been weaponized. A complete analysis of the exercise won't begin until next week. And the results won't be made public for months. But after the first four days of the exercise, it was learned that there was enough stress on the local public health system that reinforcements were needed to successfully complete the exercise.

TOM RIDGE:

Right now in the exercise, a lot of pressure on the public health system, here, a lot of pressure on your hospitals here. In the exercise today, we're bringing in outside medical help, outside nursing help, outside epidemiologists, because every city has a saturation point, and right now in this exercise, as good as you are in Chicago, we're beginning to feel some personnel stresses.

ELIZABETH BRACKETT:

The mock exercises found 5,700 cases of pneumonic plague that would have left 1,100 dead. While Ridge said the exercise was the best way to strengthen the nation's preparedness, University of Illinois at Chicago political scientist Matthew Lippman, who teaches classes on terrorism, says the exercise was not realistic enough to be helpful.

MATTHEW LIPPMAN:

Okay, we have an exercise in which we've named the pathology with which people are infected. We've given warning ahead of time to prepare for this. This has the air with all due respect of a potempkin exercise with an alphabet group set of agencies to reassure us that the United States is addressing homeland security. At the same time that we're spending roughly $16 million on this exercise, and where the public health system is central, we're not funding the public health system.

DR. JAMES JAMES:

This is shoring up the public health system and people have got to understand that. This is public health in action. We create plans. If we don't test those plans, if we don't go out and have exercises against those plans, we might as well never have written them. The worst place to train people and how to respond is during the event itself.

ELIZABETH BRACKETT:

Homeland security hopes to create more of these drills in order to build a permanent national terrorism exercise program.