The Belfer Center for Science and International Affairs and the Harvard-Sussex Program of CBW Armament and Arms Limitation present the CBW Colloquium:
Preparing for Chemical and Biological Terrorism: the New York City Model
A discussion with Jerome M. Hauer, former Commissioner, Mayor's Office of Emergency Management, New York City

Cambridge, Massachusetts, 1 March 2000. It was a pleasure for ASA to attend this important discussion with Dr. Jerome 'Jerry' Hauer, former Commissioner Emergency Management for New York City. The discussion area for this colloquium was CB Terrorism as perceived and acted upon in one of the world's largest and most important cities. What most others at the national and international levels could only hypothesize, Jerry handled, on an almost daily basis, in real life. He was, as we would say, "down where the rubber meets the road". And the perception and response is different. Why? The immediacy of the event, whether the event is natural, man-made as in an accident, or man made with a purpose. At the national and international levels the alert, or upward flow of information received, has had at least one triage and a picture of the event is at beginning to form. At the event venue, local actions, actions by the first responder, must supersede the national and international response by hours to perhaps many days.
            Although terrorism may be considered a national and international issue, at the city level the response to terrorism is considered a local issue with national and international implications. To ensure their response is timely and adequate, cities and local entities must continually assess their capabilities to respond to chemical and biological incidents. This assessment will assist in developing the expertise needed to more closely define what is real and what is not in a possible chem/bio scenario. It will also help identify what systems can be employed for detection and decontamination - two of the most important elements of a capability to respond. Local government must be prepared to be totally responsive, and be perhaps the only response for up to 12 hours or longer.
            There is a window of opportunity in which responders can reduce casualties from acts of terrorism. This window may be considered, as an example, one to three hours for chemical terrorism, such as organophosphates, and days for bio terrorism, two to three days for anthrax.
            In acts of terrorism, chemical agents pose the greatest threat for the first responders. Because it is vitally important that first responders not become victims, the local level must focus on training and equipment, education and preparedness. A note of caution is that this first line in life saving, the first responder and local governments, stay away from toys. What is important for acquisition is decontamination, personal protection equipment and detection technology.
            High on the list of mandatory stockage at the local level are medical kits. As an example, New York City acquired over 120,000 MK 1 medical kits and then ensured that each ambulance in the city was equipped with multiple MK 1 kits.
            At the local level and based on New York City experience, the chemical threat agents are considered as:

• phosgene
• commercial organophosphates
• chlorine
• other commercially available chemicals

From a local perspective, chemical terrorism requires a lights and siren response, i.e., an immediate response.
            The bio threat agents of concern or focus for New York City are:

• anthrax
• Q fever
• tularemia
• brucellosis
• Yesinia pestis
• small pox
• Marburg
• VEE
• SEB

            Unlike a chemical agent incident with only hours to respond, a bio incident may take days or weeks to develop into a full-scale public health emergency and like chemical - the first responders could be amongst the first casualties.

Summary

• A chemical terrorism incident is a hazardous materials incident. Within this area, secondary devices including bombs may be a threat.
• Unlike chemical, a bio terrorism incident may take several days to develop.
• Disease surveillance is a requisite to reducing casualties.
• Education and training is mandatory.

Future Issues
            There must be an increased public health infrastructure. Part of this calls for coordinated epidemiological investigations between public health and law enforcement. Both duplication of effort and non-coordination of efforts undertaken are waiting disasters in any chem or bio event. Also and most important, Dr. Hauer points out that we really need closer ties between the medical and public health communities. With closer cooperation, response times could be more adequate and expedited and without the cooperation, response times and public safety are jeopardized. How best to achieve this cooperation is being worked on now.
            And lastly, public information is a key to public health and safety. Basically, how to inform without misinforming, without causing an undue stress to the individuals and their families and to the system. Never an easy task, adequate and timely public information is extremely difficult in either a chemical or biological incident where rumor, fed or led by false reporting, easily outruns common sense.
            Editor's Note: Today, Dr. Jerry Hauer is a Vice President with Science Applications International of McLean, Virginia. His fax is: (703) 288-5401 and e-mail: jerome.m.hauer@saic.com

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