Atlantic Storm was a ministerial exercise simulating the top-level response to a bioterror incident. The simulation operated on January 14, 2005, in Washington, D.C. It was created in part to reveal the current international state of preparedness and possible political and public health issues that might evolve from such a crisis. [1]
The project was sponsored by the Alfred P. Sloan Foundation, the German Marshall Fund of the United States, and the Nuclear Threat Initiative. Organization efforts were provided by the Center for Biosecurity of UPMC, the Center for Transatlantic Relations of Johns Hopkins University, and the Transatlantic Biosecurity Network. [2]
In the scenario, smallpox was released in the following major cities in a covert attack: Istanbul, Rotterdam, Warsaw, Frankfurt, New York City, and Los Angeles. Cases were initially reported in Germany, Turkey, Sweden, and the Netherlands, but the pathogen was exported to other nations within hours. Specifically, the 51 cases confirmed in these four nations grew to 3,320 cases with transatlantic spread after no more than 4.5 hours. This rapid spread of disease forced the attending representatives to grapple with a quickly escalating crisis and revealed difficult tensions between domestic politics and international relations, revealing the need for improving response systems for such a crisis. [3] The scenario was propelled by continual briefings by "Summit Staff", breaking news segments from the “Global News Network”, and private updates for representatives from their “national advisors”. The scenario assumes that the viral ingredients were obtained from a bioweapons facility in Russia. [2] The terrorist group responsible used publicly available knowledge as well as training in US and Indian universities in order to create the strain of smallpox. [2] To spread the virus, members walked around public areas with canisters releasing the virus in high traffic areas. [2]
Participants in the exercise include: [4]
Participant | Role |
---|---|
Barbara McDougall | Prime Minister of Canada |
Erika Mann | President of the European Commission |
Werner Hoyer | Chancellor of the Federal Republic of Germany |
Bernard Kouchner | President of France |
Stefano Silvestri | Prime Minister of Italy |
Klaas de Vries | Prime Minister of the Netherlands |
Jerzy Buzek | Prime Minister of Poland |
Jan Eliasson | Prime Minister of Sweden |
Madeleine Albright | United States Secretary of State |
Sir Nigel Broomfield | Prime Minister of the United Kingdom |
Gro Harlem Brundtland | Director General, WHO |
Eric Chevallier | Executive Secretary of the Summit |
Nik Gowing | Discussion Moderator |
Tom Inglesby | Deputy National Security Advisor of the United States |
Daniel Hamilton | Director of the Center for Transatlantic Relations |
Tara O'Toole | CEO and Director, Center for Biosecurity of UPMC |
The initial problem facing the participants was whether to use a ring vaccination strategy over a mass vaccination one in order to deal with the small number of those thought to be infected with the smallpox virus. [1] While ring vaccination is recommended for initial control over an outbreak, states may quickly choose to switch to mass vaccination if it is unsuccessful. [1] In addition, the participants for countries with no infected persons faced pressures to share available vaccine resources with countries currently experiencing outbreaks. [1] As more countries began to experience outbreaks, domestic pressures forced participants to withhold the sharing of vaccines in order to preserve their supply for their own citizens. [1] Other strategies, such as vaccine dilution, became necessary as the amount of those suspected to be infected grew. [1] Participants also considered the viability of closing borders to prevent the further spread of the outbreak to their own countries. [1] Certain dire measures, such as the use of military quarantines, were considered as participants also had the obligation to ensure public safety in civilian populations. [1]
Conclusions from the exercise's published documents: [1]
At the end of the exercise, participants were given an opportunity to share insights gained during the scenario. The lack of current international strategy and planning represented a shortfall in bioterrorism protection. [5] In addition, members with defense backgrounds warned against the widespread unawareness that bioterrorism presented to safety at home and abroad. They believed that states without adequate protection would pose a dangerous threat to neighboring states with sufficient resources and infrastructure. [5]
Atlantic Storm highlights the importance of international communication and coordination in responding to a bioterrorist attack. [6] Participants of the exercise indicated that the WHO would be the ideal entity to coordinate an international response. [6] In addition, Atlantic Storm proved that most countries lack the structure and resources to handle such an outbreak. [6] Therefore, the establishment of more resources and infrastructure is a necessity for the success of future response. Next, entities like the EU and NATO should further develop plans of action for bioterror incidents. [6] Strong international coalitions would ensure that response time in an epidemic is not slowed by complications between neighboring countries. Additionally, many politicians are unaware of the threat of bioterrorism and require more information regarding safety and defense implications. [6] Inclusion of knowledgeable defense authorities and scientists would give politicians the capability to form a response. Finally, the international community should do more, as a whole, to bolster developing countries' resources for defending against epidemics. [6]
Below are further exercises by other organizations with similar scenarios: [7]
Some observers raised concerns about the exercise how it was conducted. At the time, the World Health Organization, whom participants indicated to be the ideal response coordinator, lacked the resources and staffing to handle the effort. [1] Finally, leaders in today's world need to possess experience in homeland security and bioterrorist threats in order to handle a situation similar to the scenario proposed in Atlantic Storm. The credentials of some participating members were questioned due to a lack of experience in these fields. [8]
The rate of infection transmission used by the Atlantic storm exercise was higher than historical records of smallpox transmission. [8] As a result, most otherwise appropriate measures would still fail in the hypothetical scenario. This raises some concerns with conclusions of Atlantic Storm and its application to a real world scenario. In addition, some defense research questions the ability of terrorists to create and distribute such a virus. [8]
Bioterrorism is terrorism involving the intentional release or dissemination of biological agents. These agents include bacteria, viruses, insects, fungi, and/or toxins, and may be in a naturally occurring or a human-modified form, in much the same way as in biological warfare. Further, modern agribusiness is vulnerable to anti-agricultural attacks by terrorists, and such attacks can seriously damage economy as well as consumer confidence. The latter destructive activity is called agrobioterrorism and is a subtype of agro-terrorism.
Biodefense refers to measures to restore biosecurity to a group of organisms who are, or may be, subject to biological threats or infectious diseases. Biodefense is frequently discussed in the context of biowar or bioterrorism, and is generally considered a military or emergency response term.
Donald Ainslie Henderson was an American medical doctor, educator, and epidemiologist who directed a 10-year international effort (1967–1977) that eradicated smallpox throughout the world and launched international childhood vaccination programs. From 1977 to 1990, he was Dean of the Johns Hopkins School of Public Health. Later, he played a leading role in instigating national programs for public health preparedness and response following biological attacks and national disasters. At the time of his death, he was Professor and Dean Emeritus of the Johns Hopkins Bloomberg School of Public Health, and Professor of Medicine and Public Health at the University of Pittsburgh, as well as Distinguished Scholar at the UPMC Center for Health Security.
The Cobra Event is a 1998 thriller novel by Richard Preston describing an attempted bioterrorism attack on the United States. The perpetrator of the attack has genetically engineered a virus, called "Cobra", that fuses the incurable and highly contagious common cold with one of the world's most virulent diseases, smallpox. The disease that results from the virus, called brainpox in the novel, has symptoms that mimic those of Lesch–Nyhan syndrome and the common cold. The book is divided between descriptions of the virus and the government's attempt to stop the imminent threat posed by it.
The National Biodefense Analysis and Countermeasures Center (NBACC) is a government biodefense research laboratory created by the U.S. Department of Homeland Security (DHS) and located at the sprawling biodefense campus at Fort Detrick in Frederick, MD, USA. The NBACC is the principal U.S. biodefense research institution engaged in laboratory-based threat assessment and bioforensics. NBACC is an important part of the National Interagency Biodefense Campus (NIBC) also located at Fort Detrick for the US Army, National Institutes of Health and the US Department of Agriculture.
The Johns Hopkins Center for Health Security is an independent, nonprofit organization of the Johns Hopkins Bloomberg School of Public Health. The center works to protect people's health from epidemics and pandemics and ensures that communities are resilient to major challenges. The center is also concerned with biological weapons and the biosecurity implications of emerging biotechnology.
The Project Bioshield Act was an act passed by the United States Congress in 2004 calling for $5 billion for purchasing vaccines that would be used in the event of a bioterrorist attack. This was a ten-year program to acquire medical countermeasures to biological, chemical, radiological, and nuclear agents for civilian use. A key element of the Act was to allow stockpiling and distribution of vaccines which had not been tested for safety or efficacy in humans, due to ethical concerns. Efficacy of such agents cannot be directly tested in humans without also exposing humans to the chemical, biological, or radioactive threat being treated, so testing follows the FDA Animal Rule for pivotal animal efficacy.
The Biomedical Advanced Research and Development Authority(BARDA) is a U.S. Department of Health and Human Services (HHS) office responsible for the procurement and development of medical countermeasures, principally against bioterrorism, including chemical, biological, radiological and nuclear (CBRN) threats, as well as pandemic influenza and emerging diseases. BARDA was established in 2006 through the Pandemic and All-Hazards Preparedness Act (PAHPA) and reports to the Office of the Assistant Secretary for Preparedness and Response (ASPR). The office manages Project BioShield, which funds the research, development and stockpiling of vaccines and treatments that the government could use during public health emergencies such as chemical, biological, radiological or nuclear (CBRN) attacks.
In 1974, smallpox killed 31,000 people and infected 188,000 in India.
Operation Dark Winter was the code name for a senior-level bio-terrorist attack simulation conducted on June 22–23, 2001. It was designed to carry out a mock version of a covert and widespread smallpox attack on the United States. Tara O'Toole and Tom Inglesby of the Johns Hopkins Center for Civilian Biodefense Strategies (CCBS) / Center for Strategic and International Studies (CSIS), and Randy Larsen and Mark DeMier of Analytic Services were the principal designers, authors, and controllers of the Dark Winter project.
Tara O'Toole served as the Under Secretary of Homeland Security for Science and Technology from 2009 to 2013. She is currently a senior fellow and executive vice president at In-Q-Tel.
Biosecurity in the United States is governed by the Bureau of Western Hemisphere Affairs, which is part of the US Department of State. It obtains guidance and advice on specific matters relating to biosecurity from various other government agencies.
The United States biological defense program—in recent years also called the National Biodefense Strategy—refers to the collective effort by all levels of government, along with private enterprise and other stakeholders, in the United States to carry out biodefense activities.
The Bipartisan Commission on Biodefense, formerly known as the Blue Ribbon Study Panel on Biodefense, is an organization of former high-ranking government officials that analyzes US capabilities and capacity to defend against biological threats. According to the Commission's mission statement, the organization was formed to "provide for a comprehensive assessment of the state of U.S. biodefense efforts, and to issue recommendations that will foster change."
The Alliance for Biosecurity is a consortium of companies that develop products to respond to national security threats, including bioterrorism pathogens and emerging infectious diseases. It is headquartered in Washington DC.
Daniel R. Lucey is an American physician, researcher, senior scholar and adjunct professor of infectious diseases at Georgetown University, and a research associate in anthropology at the Smithsonian National Museum of Natural History, where he has co-organised an exhibition on eight viral outbreaks.
The 2003 United States smallpox vaccination campaign was a vaccination program announced by the White House on 13 December 2002 as preparedness for bioterrorism using smallpox virus. The campaign aimed to provide the smallpox vaccine to those who would respond to an attack, establishing Smallpox Response Teams and using DryVax to mandatorily vaccinate half a million American military personnel, followed by half a million health care worker volunteers by January 2004. The first vaccine was administered to then-President George W. Bush.
Rear Admiral Kenneth Bernard is an American public health physician and expert on biodefense and health security policy. He served at the George W. Bush White House from 2002-2005 as Special Assistant to the President for Biodefense and as Assistant Surgeon General.
Planning and preparing for pandemics has happened in countries and international organizations. The World Health Organization writes recommendations and guidelines, though there is no sustained mechanism to review countries' preparedness for epidemics and their rapid response abilities. National action depends on national governments. In 2005–2006, before the 2009 swine flu pandemic and during the decade following it, the governments in the United States, France, UK, and others managed strategic health equipment stocks, but they often reduced stocks after the 2009 pandemic in order to reduce costs.
Crystal Watson is a senior scholar at the Johns Hopkins Center for Health Security and an assistant professor in the Department of Environmental Health and Engineering. She is an expert in health security, biodefense, and risk assessment and preparedness for emerging infectious diseases. She is currently working on the public health response to the COVID-19 pandemic.