War game to send chills down spine Dark Winter was exercise conducted in June at military base to test response to hypothetical release of smallpox in 3 cities By Roxanne Roberts THE WASHINGTON POST Oct. 23 — 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’s the catchphrase that’s popping up everywhere these days. Dark Winter is the name of a war game conducted in June at Andrews Air Force Base: 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

‘We intentionally picked the absolutely worst-case scenario.’ — RANDY LARSEN director, Anser Institute for Homeland Security THE CAST OF PLAYERS included Oklahoma Gov. Frank Keating, former senator Sam Nunn, former presidential adviser David Gergen, former CIA director James Woolsey and former FBI director William Sessions.

The endgame, so to speak, was sobering: The government is woefully unprepared for bio-warfare, as Nunn testified to Congress in July and again in September, just days before the World Trade Center and Pentagon attacks. Now, although there hasn’t been a confirmed case of smallpox in the United States for more than 50 years, Dark Winter is a hot topic on talk shows, in planning meetings and, yes, even at Washington 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) and a retired Air Force colonel who devised the game last 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, said Larsen. “If you look at the lessons learned from the game, the word ‘smallpox’ does not appear. We’re talking about biological warfare in general.” A DEADLY POX But suddenly, “smallpox” is the threat du jour. On Wednesday, Health and Human Services Secretary 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 only known to exist in government labs in the United States and Russia. “The good news is that smallpox is hard to get and it’s fragile,” says 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 CSIS, 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, 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 over-stress the system,” he says. “We designed a war game they could not win.” GAME SCENARIO The smallpox virus has claimed uncounted millions throughout history, famously wiping out most of the native population in North America after the Spanish conquests.

The game, which was played on June 22-23 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: Nunn plays the president of the United States; Gergen, the national security adviser; Woolsey, the CIA director; and so forth — all people who had been present at real NSC meetings. Suddenly, the HHS secretary (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 al Qaeda) 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.

The news of even a single infection comes as a shock. The smallpox virus has claimed uncounted millions throughout history, famously wiping out most of the native population in North America after the Spanish conquests. It has killed more people in the 20th century than all the wars combined — 300 million — most in poor countries. But the disease was presumed conquered; the last case reported anywhere in the world came in 1978.

“No one really knows how smallpox or any other highly contagious disease will spread among a densely populated, highly mobile, unvaccinated society,” says Larsen. (In 1947, a single confirmed case of smallpox in New York led to vaccinations for 6.3 million people.) FACED WITH TERRIBLE DECISIONS The game was structured to examine the roles of the federal and state governments in a health panic

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 American 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, Gov. 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. SHOCKED BY RESULTS The war game ends on 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 of an infected person.

The participants — all seasoned government professionals — were shocked by the results, says Larsen. Nunn, now chairman of the CSIS board, testified to Congress; other briefings were held for top government officials. One senator told Larsen it was “the most troubling presentation he’d 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,” says Larsen. “Because the enemy has lost the element of surprise.” -------------------------------------------------------------------------------- CORRECTION This article incorrectly described Tara O’Toole’s professional background. She is a medical doctor with a master’s degree in public health, not an epidemiologist.

http://stacks.msnbc.com/news/646509.asp

-- Martin Thompson (mthom1927@aol.com), October 28, 2001

Answers

Martin,

Your post on 10/20 is a good example of how this could play out. Thanks for posting it.

-- John Littmann (johntl@mtn.org), October 28, 2001.

Gary North's REALITY CHECK

Number 87 October 29, 2001

[The importance of what I cover in this issue speaks for itself: bioterrorism. I have included URL's to the evidence I am relying on, so that you can verify anything that sounds exaggerated. I am not trying to exaggerate this story. I am trying to figure out how this nation can possibly deal with the threats that now confront us. I give you permission to send this issue to others, or to post it on a Web site, just so long as all of the URL's are included.]

DARK WINTER'S DARK MESSAGE

If the device that exploded in 1993 under the World Trade Center had been nuclear, or had effectively dispersed a deadly pathogen, the resulting horror would have exceeded our ability to describe it. Such an act of catastrophic terrorism would be a watershed event in American history. It could involve loss of life and property unprecedented in peacetime and undermine America's fundamental sense of security, as did the Soviet atomic bomb test in 1949. Like Pearl Harbor, this event would divide our past and present into a before and after. The United States might respond with draconian measures, scaling back civil liberties, allowing wider surveillance of citizens, detention of suspects, and use of deadly force. More violence could follow, either further terrorist attacks or U.S. counterattacks.

FOREIGN AFFAIRS (Nov/Dec 1998), p. 81

FOREIGN AFFAIRS is the publication of the Council on Foreign Relations (CFR). It may be the most influential academic publication on earth. In an article, "Catastrophic Terrorism: Tackling the New Danger," three authors, including the head of the CIA (then -- not today), made the assessment you have just read.

What saved us in 1993 was the relative incompetence of the terrorists, who parked their van-bomb in the wrong location in the tower's parking garage, though wrong only by a few yards, according to the late Conrad Chester, who for 30 years ran the civil defense library at Oak Ridge National Laboratories. If the bomb had exploded in the right location, 60,000 people would have died in a matter of minutes.

There is no doubt that the authors of the 1998 article were correct about the potential watershed nature of that near-event. Their prediction of watershed status was fulfilled on September 11, 2001, with the very same target. Far fewer people died than would have been the case in 1993, had the attackers been a few yards more competent, but the 2001 event will surely be in U.S. history textbooks in a century or 200 years.

The three authors' predictions of what might follow this watershed event are now being fulfilled, day by day. The signing of the Anti-terrorist law last Friday surely qualifies as a prediction fulfilled with respect to surveillance and the loss of civil liberties. It is safe to say that once the Office of Homeland Security (or whatever they will call it) is funded, we will never recover the liberties we legally enjoyed last Thursday.

THE DARK WINTER WAR GAME

On June 22-23, 2001, a privately funded team of experts, including former U.S. Senator Sam Nunn, participated in a war game. It was held at Andrews Air Force Base. The game involved the hypothetical biological weapons attack on Oklahoma City. The attackers use smallpox.

The game was limited to the U.S. government's response to the attack over a two-week period. The game produced results that are horrifying.

The game was organized by the ANSER organization's Institute for Homeland Security. Interesting: this is the same name initially selected by President Bush for his proposed Cabinet-level agency. The organization has publishes THE JOURNAL OF HOMELAND SECURITY.

http://www.homelandsecurity.org/journal

The game assumed this international background: an agent of Osama bin Laden has just been arrested by the Russians. He had been trying to buy biological weapons produced by the USSR. Meanwhile, Saddam Hussein is massing troops on Kuwait's border. There is growing tension between Communist China and Taiwan. So, nobody knows who the perpetrator of the attack might be. The game's participants were assumed to by members of the National Security Council. The first meeting of the NSC is on December 9. Let the game begin!

The first outbreak of smallpox is reported in Oklahoma City. This is reported on December 9, the day of the NSC meeting. By the end of the day, there are 34 cases. Other cases are reported in Georgia (9) and Pennsylvania (7). The U.S. air transportation network has begun to do its work in spreading the disease.

The game considers what the government could do to slow the spread of the disease. By December 22, assuming only the initial attack in Oklahoma City, there are 16,000 cases and 1,000 deaths in 25 states. At that point, the game ended.

The team made estimates of what would happen next. Worldwide, one week later, there would be 300,000 victims, with one-third of them dead.

http://www.hopkins-biodefense.org/lessons.html

A chart on the expected spread of the disease indicates that by Feb. 6, three million people would have been infected worldwide, with one million deaths. This document warns, "These numbers are highly speculative" (p. 44). But close enough for semi-government work, I suspect.

http://www.hopkins-biodefense.org/DARK%20WINTER.pdf

(This is a PDF file: slow to download, slow to go from page to page. The key findings are on pp. 42-43.)

On July 18, Congressional hearings were held on the results of this war game.

http://www.house.gov/reform/ns/web_resources/briefing_memo_july_23.htm

Here was Sam Nunn's assessment:

And there are many tradeoffs. One of the biggest: We have 12 million vaccines; that's enough for one out of every 23 Americans. Who do we decide to vaccinate?

Other tradeoffs are: Do you take power from the Governors and federalize the National Guard? Do you seize hotels to convert them to hospitals? Do you close borders and block all travel? What level of force do you use to keep someone sick with smallpox in isolation? Do you keep people known or thought to be exposed quarantined in their homes? Do you guarantee 2.5 million doses of vaccine to the military; or do you first cover all health care providers? Do you take strong measures that may protect health, but could undermine public support or destroy the economy?

And finally: How do you talk to the public in a way that is candid, yet prevents panic -- knowing that panic itself can be a weapon of mass destruction?

There were no agreed-upon answers, nor will there be. The government would wing it. And millions of Americans would probably die within a year, as well as tens of millions of non-Americans. The great scourge of man, smallpox, would be on the loose again.

The fears of chemical weapons seem overblown to me. But the fears of biological weapons have underestimated the threat.

We cannot scientifically put probability numbers on the likelihood of an attack. We also cannot know how skilled the attackers might be -- "1993 tower bombers" vs. the "2001 plane bombers." But the terrorists' main limiting factor is not money. As far as an aerosol-based anthrax attack is concerned, a good microbiologist could pull it off with $250,000 or less. Once launched, the effects could be catastrophic, and not just the death toll. It would affect the delivery of basic goods and services.

TRUSTING THE STATE

Last Friday evening, I watched the British Broadcasting Corporation's evening international news show. Our local PBS affiliate runs this broadcast, since PBS doesn't offer a late-evening news show. I occasionally watch the show to see what the BBC, a State-funded operation, thinks its high-brow audience is interested in viewing. On Friday, it was another AAA show: Afghanistan- American-Anthrax.

The show had a video clip of a meeting of U.S. Postal Service employees in Washington, D.C. Another anthrax letter had rolled through. This time, the Supreme Court had been the target. A female postal worker was screaming at the managers about safety. "You haven't done anything to protect us!" or words to that effect. A beleaguered manager replied: "You can't see this stuff. You can't smell it. What are we supposed to do?" or words to that effect.

There is no way to reconcile these two opinions. The worker was correct: nothing significant is being done to protect her and her colleagues. Management's representative was also correct: nobody knows what to do.

The BBC broadcast did reveal that an analysis of the most recent packet of spores indicates that a Ph.D. in microbiology must have done the work. This indicates that the story is moving away from a theory of home-brewed anthrax by "right wing militia" or Al Quaida terrorists. The earlier version indicated that this was amateur night terrorism. The new version is scarier: an educated professional is now involved.

Note: the unconfirmed and wholly fact-free speculative theory about American right-wing terrorists who may be behind the recent anthrax attacks was originally offered an article by Jessica Stern, of the Council on Foreign Relations, "The Prospect of Domestic Bioterrorism." It was published in a special 1999 issue of EMERGING INFECTIOUS DISEASES, published by the U.S. government's Centers for Disease Control (CDC). She referred to neo-Nazi groups as the most likely biological terrorists. She made one brief reference to bin Laden in a paragraph devoted to a neo-Nazi organization.

http://www.cdc.gov/ncidod/EID/vol5no4/stern.htm

There aren't sufficient supplies of preventative inoculation materials to protect the American public. A few workers are getting the Bayer Corporation's Cipro; other workers want the drug. Last week, U.S. Health Secretary Tommy Thompson announced a deal: the U.S. will buy Cipro at a discount price of under $1 per tablet. At present, the wholesale price is $4.60/tablet. -- $1.80 for the government.

The current target is enough tablets to treat 12 million people for 60 days. At present, the limit is two million people.

This information comes from the BBC.

http://news.bbc.co.uk/hi/english/business/newsid_1617000/1617235.stm

What about the rest of us? Sorry; maybe later.

Over the weekend, one public health official in New Jersey suggested that other, more common, less expensive antibiotics will do the job. But "doing the job" assumes that the area under attack is contained -- inside a building, with a limited number of potential victims.

This raises the question of anthrax delivered by aerosol. What if a terrorist group releases a minivan full of the spores downwind from a major city? In the air, the deadly spores are tasteless and odorless. No one will know until it's too late. Unless they have already been inoculated, many people will die before public health officials know that an attack has been made on the local population.

And then what?

A PROFESSIONAL'S DEATH-TOLL ESTIMATE

Dr. Michael Osterholm was for years the epidemiologist for the state of Minnesota. In his book, LIVING TERRORS: WHAT AMERICA NEEDS TO KNOW TO SURVIVE THE COMING BIOTERRORIST CATASTROPHE (Delacorte, 2000), he writes:

As I will show, an attack with a highly contagious agent like smallpox could kill hundreds of thousands of people and could travel from city to city as easily as people do. Even a microbe like anthrax that doesn't spread from person to person could easily kills more than 100,000. We are, in other words, at the brink of a new age: what some experts call catastrophic terrorism (p. xix).

His chapter, "Tools of the Trade," covers the technology of delivering a killer virus or spore. As he writes, "a low-tech outdoor release of pathogens by plane or spray truck . . . is far easier to accomplish and could infect multitudes" (p. 104). D. A. Henderson, who ran the World Health Organization's program to eradicate smallpox in the environment (other than laboratories), says: "Even groups with modest finances and basic training in biology and engineering, could develop, should they wish, an effective weapon at little cost" (p. 105). It doesn't take Iraq to fund this.

His book covers several biological weapons agents. The worst by far is smallpox. He takes it seriously as a weapon of choice. He is not alone.

I was inoculated against smallpox. That shows how old I am. Old enough to remember the Edsel. Old enough to remember the Tucker. Old enough so than my smallpox vaccination no longer protects me, and hasn't for decades.

I am also old enough to remember a photograph in a long-since out-of-print high school biology textbook: a man whose face had been scarred by smallpox. The hideousness of that face has stayed with me for over 40 years.

How real is the smallpox bioterrorism threat? From the point of view of its effects, socially devastating.

In the June 2 issue of WORLD, a cover story went into detail about bioterrorism. The author interviewed a specialist at Johns Hopkins University's Center for Civilian Biodefense. I'm glad that such an organization exists. I am not glad about what that organization has concluded.

"You can't see a fermenter, or anything that you would need to make a biological weapon, via satellites," Ms. O'Toole pointed out. "It is going to be hard to see a biological weapon, it is going to be hard to track it before it's used, and it is going to be very hard to interdict before it's released," Ms. O'Toole told a gathering of policymakers in Washington last year.

This may sound apocalyptic, but a wide range of medical experts and scientists take the threat seriously. Johns Hopkins, whose research teams pioneered the smallpox vaccine, hosts smallpox war games to test whether medical communities are prepared to deal with a sudden outbreak. In a simulated terrorist attack conducted in 1999, health workers could not halt the spread of the disease. More than 15,000 hypothetical cases developed within two months.

Even at cutting-edge facilities like Johns Hopkins, reports Ms. O'Toole, it would be hard to treat 100 patients suddenly needing isolation and special care. . . .

The author offers this assessment:

It can remain dormant for 14 days, then victims show symptoms that begin with sudden high fever, headache, vomiting, and stiffness. A rash that develops into painful blisters and can lead to permanent scarring follows this. In the worst cases, smallpox leads to death within three or four days. Between one-third and one-half of victims die without vaccination, which must be given within the first days of infection (often before symptoms appear) to be effective. The disease scars or blinds most of those who do survive. In the past, one smallpox victim could infect up to 50 others. No known treatment exists for smallpox.

http://www.worldmag.com/world/issue/06-02-01/cover_1.asp

Dr. Tara O'Toole has written a frightening essay on how a terrorist smallpox attack could paralyze this country. For those of you who think I am exaggerating, I suggest that you click through and print out her hypothetical 30-day scenario. It was published in a CDC journal. Then read it. Get out your yellow highlighter. You will want it.

http://www.cdc.gov/ncidod/EID/vol5no4/otoole.htm

Think of this word: "Quarantine." When was the last time it was applied to an entire city in the United States? Think of its economic effects on a city. Those quarantined would have to be vaccinated. But is any region's public health system prepared to do this with 80,000 people, as the article suggests might be necessary? Not today.

This kind of expert information is readily available on the Web, but hardly American believes that a scenario like this is realistic. That's because it is all too realistic. There is no known defense against this. We are as helpless to this kind of attack as residents of Kabul are to U.S. bombing raids. The difference is, so far we have not had a sufficiently dedicated, skilled, and funded attacker. It will only take one.

There is today no reliable, safe smallpox vaccine available to the general public. There may be enough old vaccine in the United States for 15 million people, assuming the supplies still work. Samples have not been tested in several years. The number of useful units is probably closer to 7 million. This vaccine is still the old cowpox-based vaccine, a strategy which goes back to the 18th century. The vials are 25 years old. (LIVING TERRORS, p. 18).

Dr. Osterholm says that he doesn't think universal vaccination is necessary. He thinks that we must have large reserves of vaccine to deal with specific regional outbreaks. But there has to be an organized program to produce and distribute the vaccines to public heath systems. There must also be training of public health professionals to deal with mass vaccination after an attack. Such a comprehensive program will not be cheap, nor can it be organized overnight. The response must be rapid. The response program must be begun now.

There is not a public word about this from the President. No such campaign is visible. Congressional spending bills on everything imaginable are being promoted in the name of anti-terrorism, but not a bill on the one thing the government has a moral obligation and the Constitutional authority to do: defend this nation against an attack, which now includes biological warfare.

For a campaign to be successful, Americans would have to be persuaded. The persuasion would involve fear. To scare voters about anything that is really a threat is generally not politically correct. The public today is being told that we can pay for this war on terrorism by going out and spending on consumer goods. We are not only going to spend ourselves rich (Keynesianism), we are going to spend ourselves safe. This attitude must change if an effective public health response is to be put in place, city by city, before an attack takes place. We see no hint of any such change in presentation by the government.

But how likely is an attack? What person would unleash a weapon that is universal in scope? Smallpox doesn't care where you live or where you worship. So far, no one has used such a weapon. No nation has vaccinated its people. For a government to vaccinate a nation would indicate that its leader may be planning a smallpox attack, which I suspect is one reason why the U.S. government no longer vaccinates for smallpox. It's a biological version of Mutual Assured Destruction. That's why Nixon shut down the U.S. biological weapons research facility in 1969. Inoculating Americans would be like violating the ABM Treaty. It would de-stabilize the balance of terror.

Most Americans are not bothered much about these threats. They watch TV, but the anthrax reports do not scare people. The reports only fascinate them. The government will protect them, they think. Yet, day by day, terrorists are sending us a message in the U.S. mails. They can kill people. They can shut down offices for weeks at a time, while a handful of public health employees dressed in spore-resistant suits and masks spray the inside of the building.

I realize that these envelope attacks are mainly nuisances except for the handful of people who have died. But it's not the envelope-delivered attacks that are the problem. It's aerosol-delivered attacks (LIVING TERRORS, p. 12).

I now ask you to do something that will take you some time. If you're at work, don't read all of the following article. Wait until you get home. But download the article now, and print it out. It's by Richard Preston, author of THE HOT ZONE. It was published in THE NEW YORKER (July 12, 1999). It's called, "The Demon in the Freezer."

I'm asking you to read the first two pages. If this doesn't get your attention, then skip the rest of it.

You may want to skip pages 4-6, on the descriptions of what happened in the last outbreak, in 1972 in Yugoslavia. I skimmed these pages very fast. Some things you just don't need to know.

I offer this statistic, from page 3. In the 20th century, the second half of which was generally smallpox- free, the disease killed at least 300 million people.

You are no longer immune, if you ever were. Neither am I.

I also offer this statistic, provided by D. A. Henderson, the man whose World Health Organization team eradicated smallpox except for two research laboratories: the CDC's and Russia's (we hope). He says that an outbreak of 100 cases in any U.S. city would require the inoculation of 100 million Americans.

http://cryptome.org/smallpox-wmd.htm

LIVING TERRORS recommends this article (p. 197). Yet the author of LIVING TERRORS says that he doesn't think all of us need to be vaccinated. He actually recommends against it. As for me, I want to be vaccinated. Now. But it's not possible, nor is it likely to be possible until after the disease has become an epidemic. Then it will be too late for this visit of the demons. This is because of the rate at which the virus spreads. Preston describes this:

A rising tide of smallpox typically comes in fourteen-day waves -- a wave of cases, a lull down to zero, and then a much bigger wave, another lull down to zero, then a huge and terrifying wave. The waves reflect the incubation periods, or generations, of the virus. Each wave or generation is anywhere from ten to twenty times as large as the last, so the virus grows exponentially and explosively, gathering strength like some kind of biological tsunami. This is because each infected person infects an average of ten to twenty more people.

MEANWHILE, BACK IN AFGHANISTAN. . . .

Meanwhile, the air war is not going well in Afghanistan. Our satellites can't locate bin Laden. Thousands of Pakistani civilians are now crossing the border into Afghanistan, armed, to fight on the side of the Taliban against U.S. troops.

http://news.independent.co.uk/world/asia_china/story.jsp?story=101774

The jihad has begun. Every day that our bombs fall on Afghan civilians in what remains of their cities, the jihad's recruiting gets easier. "The action is the reaction."

If you'd like to suggest Reality Check to a friend, please forward this letter to them or point them to:

http://www.dailyreckoning.com/GetReality.cfm

-- PHO (owennos@bigfoot.com), October 29, 2001.