Date: July 3, 2003
Abstract: Inside the situation room of a nuclear weapons lab, Alameda County's public health officials witnessed an attack that exposed gaps in their new, 300-page bioterrorism plan and left 9,000 people dead.
Although the anthrax attack on Berkeley Marina was only a computer simulation, health officials were shaken and could only look to Congress for money for biodetectors and emergency staff.
For three critical days, doctors and epidemiologists puzzled over an apparent flu outbreak, knotted around the marina. The first diagnosis of anthrax sent them racing to turn high schools into mass hospitals and handing Cipro to every human they saw.
Antibiotic stockpiles in Oakland, Fremont and elsewhere held enough pills to save thousands. But what Alameda County lacked was enough time, people or uncontaminated places to dole them out.
By the 11th day, the county needed a special mass-fatality team of the U.S. Department of Homeland Security to handle the contaminated corpses.
Scientists created this nightmare in just a few hours June 12 inside WMD-DAC -- the Weapons of Mass Destruction Decision Analysis Center at Sandia National Laboratories-California -- where computers test officials on their responses to horrific attacks.
WMD-DAC's designers use the latest Pentagon war-gaming technology and they pride themselves on realism.
It was quite real for Alameda County Public Health Officer Tony Iton, on the job four weeks before being thrust into the exercise.
"It was disheartening," Iton said. "The scenario was devastating. We're just not re sourced to deal with any devastating, national-level disaster."
The nighttime anthrax attack was Sandia's second largest simulation to date, hosted inside a windowless room of giant, floor-to-ceiling screens that flashed disease and death reports from local hospitals.
County officials entered Sandia's simulation after spending months writing their latest game plan for bioterrorism and other fast-moving infectious diseases, such as SARS.
Alameda County had tested its plan in several drills, but local officials said the Sandia exercise was the most realistic: The 26 participants didn't know the scenario beforehand, and the scenario changed as they acted.
"They play it out on the computer and it plays out your decisions," said Dan Guerra, emergency preparedness manager for Contra Costa County, which also lost several thousand people as the anthrax cloud crept up the San Ramon Valley. "We can see the consequences of our actions."
The county figured its major hospitals -- Kaiser, Highland and Alta Bates -- probably would be overwhelmed in a bioterror attack. So public health authorities planned to close schools and turn high schools into mass antibiotic-distribution centers.
The anthrax cloud -- just two or three ounces of expertly dispersed, weapons-grade germs delivered at Berkeley Marina -- wrecked that plan. Anthrax spores carpeted high schools in the neighborhoods where drugs were needed most. By sending thousands of people there for preventive drugs, public-health authorities risked exposing healthy people for weeks after the original release.
"So the question becomes, how contaminated is too contaminated?" Iton said. No one really knows. Scientists haven't figured out the absolute "safe" dose for inhalation anthrax.
County officials left Sandia sobered.
"Despite the best of our plans, even with everything operating the way we would want it to operate, we still lost 9,000 lives in Alameda and Contra Costa counties," Iton said.
Sandia's scientists have tested dozens of officials nationwide. "The credibility of the public health officer is very important. And this guy was very credible, very articulate," said Howard Hirano, a systems engineer and integrator who works on WMD-DAC.
Alameda public health officials now are looking to Washington for faster access to federal emergency personnel for drug distribution. And they want biowarfare detectors, both to sniff the air in cities continuously and to check for contamination on the ground.
Local officials concluded that early detection and faster antibiotic distribution could drop the death toll into the hundreds, less staggering to the sensibilities of public health officials.
"I think the emotions were real," said Jim Morrissey, disaster coordinator for Alameda County's emergency medical services division.
it was theoretical. But even if the planning was reasonable, you know that
thousands could die and that the public is looking at you to prevent it and
it's something you just can't do" (UCLA, 2003).