Election Bio-Terror

Title: Doctors Play Out Bioterrorism Scenario
February 21, 1999

Abstract: Terrorists contaminate an auditorium with silent, odorless smallpox just before a political rally. Soon, emergency rooms see mysterious illnesses. By the time doctors diagnose smallpox, coughing patients are spreading the lethal virus around the globe.

This time it was a test-run.

Doctors, hospital workers and U.S. health leaders used that fictional scenario, set in Baltimore, to test how they would control disease if bioterrorists ever attack - debating step by step how to quarantine, shut down airports, control panic when vaccine runs out.

How did the trial run go?

"We blew it," said a grim Michael Ascher, California's viral disease chief.  If an attack really had happened, it would have taken just three months for 15,000 Americans to catch smallpox, 4,500 to die and 14 countries to be re-infected with a disease thought wiped out decades ago.

"We would be irresponsible if we left this room and didn't remedy this," said Jerome Hauer, New York City's emergency management director.

How can doctors prepare? The test-run offers clues.

The Fictional Scenario Begins:

April 1. The FBI gets a tip terrorists might release smallpox during the vice president's speech at a Baltimore college. The tip is too vague to warn health officials. Smallpox incubates for two weeks so no one has yet become sick.

April 12. A college student and electrician come to the emergency room with fever and other flu-like symptoms. Doctors suspect mild illness, maybe flu, and send them home.

April 13, 10 a.m. Both patients are back, sicker and covered in a rash. Doctors now suspect adult chickenpox. The two are hospitalized. 6 p.m. An infectious disease specialist is puzzled. That rash doesn't really look like
chickenpox, and it's popping up in places chickenpox normally doesn't afflict, like the soles of the feet. More testing suggests it might be smallpox.

8 p.m. Because smallpox is spread through the air, officials seal the hospital, telling visitors and staff they can't leave but not why. Frightened hospital visitors alert TV news crews, who report rumors of the dreaded Ebola virus.

3 a.m. The Centers for Disease Control and Prevention confirms it's smallpox, and ships some of the nation's 6 million doses of smallpox vaccine to Baltimore. The mayor will announce the bad news at noon.

Is this scenario realistic? It's optimistic, said Gregory Moran of the University of California, Los Angeles. A typical hospital would take at least another full day to even suspect smallpox. Labs would test for other diseases first, andmany don't have the equipment to hazard a smallpox guess.

"Half of the health care workers would try to leave the hospital out of panic," added Minnesota state epidemiologist Michael Osterholm.

Who's in charge? The governor should go on TV and tell the public the truth fast - what are the symptoms, who's at risk, how are doctors fighting back - to limit panic, advised former Minnesota Gov. Arne Carlson.

But a smallpox outbreak can only be terrorism, so watch Washington seize control, others say. After all,
the FBI has to hunt the terrorists.

Sealing the hospital actually fuels fear, Osterholm contends. Getting vaccinated a few days after breathing smallpox is soon enough to stay healthy and not spread infection, so let visitors and staff go home until the vaccine arrives.

No, get everybody vaccinated: "That's total damage control," Ascher argued.

Could anyone quarantine the city? If this happened in Minnesota, thousands would flee to Canada, Carlson
said, but the governor couldn't seal the state's borders. Canada might.

The scenario continues:

April 16, 7 a.m. FBI, CDC, White House and hospital workers are debating via conference call. Do they vaccinate everyone? No, just people who came into contact with sick patients.

Hospitals report other cases of mysterious fevers and rashes. By day's end, CDC counts 48 smallpox cases - 10 in nearby states, so it's spreading.

Noon. The president addresses the nation, saying the attack may have occurred April 1. It's too late for vaccine to help anyone exposed that day.

No wonder the fictional epidemic is spreading - notice that nobody closed the airport. John Bartlett of Johns Hopkins University can't believe that other cities would accept travelers from a region experiencing smallpox.

You're seriously underestimating public panic, Osterholm adds. He recalled watching a simple, tiny meningitis outbreak paralyze a Minnesota town, as traffic snarled while people demanded vaccine.

"Doctors need to know what to do," added Moran: Hospitalize everyone with mild fevers, or send them home?

Hospitalization would require rooms with special ventilation systems to keep the virus from spreading through the building. Such rooms are rare, 450 in all of Minnesota, for example.

Back to the pretend scenario:

April 18. The first victim, the college student, dies.

April 29. Two hundred are ill in eight states. Canada discovers two victims, Britain another. People with mild fevers jam hospitals. Doctors tell them to stay home so they don't breathe on others - there are no hospital beds left.
Unvaccinated health workers walk off the job. CDC announces there's not enough vaccine for the millions demandingit. Governors ration the shots. Public anger is fueled at press reports that the president, Congress and military were quietly vaccinated.

April 30. A well-known college basketball player dies of hemorrhagic smallpox, massive bleeding instead of the more typical rash. TV stations get confused and report he died of hemorrhagic fever like Ebola. Doctors scramble for a correction.

This daylong role-playing is doctors' first chance to learn how complex fighting bioterrorism could be, said Hopkins' Tara O'Toole, who wrote the test case. Cities and states are used to dealing with earthquakes or plane crashes, but a spreading infection is totally different.

Who's in charge? How do you physically vaccinate 100,000 people in a day? How do you ration scarce vaccine so only the at-risk get it, not the hysterical healthy or the pushy politicians?

"If there's even a possibility this could happen, health departments have to prepare. ... But they've never looked at the big picture," O'Toole said. "You're hearing everybody confess they need to do a lot."

In the fictional scenario, a month has passed:

May 15. All U.S. vaccine is gone. The president declares the worst-hit states are disaster areas. Thousands more become sick before the epidemic finally slows in June.

The real-life doctors absorb the grim ending with brief silence. Then come calls for state health workers to plan how they would better fight bioterrorism in case it really happened.

"I don't want the audience walking away thinking, 'Damn, there's nothing we can do,'" Osterholm said. "If this meeting does nothing else, it should ensure we get an adequate supply of smallpox vaccine (stored) as soon as possible."  (SFSU, 1999).

Health Officials Watching For Unusual Diseases During RNC
August 16, 2012
Tampa Bay Times

Abstract: Police will be on a heightened state of alert during the Republican National Convention.

Doctors, too.

The Hillsborough County Health Department's epidemiology program is asking health care providers to be "extra vigilant" when reporting diseases to public health officials from Monday to Sept. 6.

This is because of "the nature of this high-profile event," according to a notice sent Wednesday.

In particular, health officials want to hear immediately from health care professionals who see any patients with:

• an unusual rash.

• a food-related illness.

• one case of bloody diarrhea.

• any unexplained severe infectious illness or death in an otherwise healthy person.

• any suspected illnesses from potential bioterrorism, such as anthrax, botulism, brucellosis, glanders, plague, Q fever, tularemia or viral hemorrhagic fevers.

Not surprisingly, health officials also want to know about clusters or patterns of death or illnesses.

That would include two or more patients with unexplained flulike illness, pneumonia, adult respiratory distress syndrome, sepsis, or neurologic, gastrointestinal or dermatological disease.

"We are also asking that providers report whether or not a patient is visiting for the RNC or has attended any RNC events," the Health Department's request says. "We understand that this information would not normally be collected, but it would be especially useful for us during this period."

Esquire's Tampa Bay Area Recommendations
In its September issue, Esquire offers these RNC recommendations: "The Refinery, for the John Denver breakfast. • El Puerto, for the steak sandwich. • For dinner: Remember that it's Cooters, not Hooters. • Mons Venus, if you have a little free time."

Last RNC Town Hall Scheduled Tonight
It will be from 6 to 8 p.m. at the Kate Jackson Community Center, 821 S Rome Ave. Information on road closings, traffic, downtown parking, garbage pickup, security plans, school bus routes and Hillsborough Area Regional Transit Authority bus and trolley service. Plus Q&A.

Curtis Hixon Park will be closed until Sept. 4
The convention this week took over Curtis Hixon Waterfront Park so a private contractor could build a "popup" nightclub.

The good news: It's an impressive structure, and it's going up fast. For a look from above, check out the Tampa Downtown Partnership's Facebook page.

The bad news: The park — including Curtis Hixon's section of the Riverwalk, its dog park, the playground and the kid's fountain near Ashley Drive — will be closed for nearly three more weeks.

Jamestown Entertainment of Washington, D.C., is partnering with the Butter Group of New York to create a Tampa version of the 1 OAK nightclubs found in Manhattan and at the Mirage Resort and Casino in Las Vegas.

The private club is expected to have room for 2,000 partygoers in a 30,000-square-foot, air-conditioned temporary facility, complete with its own concert space, plus cigar, scotch and video game lounges.

As part of its agreement with the Tampa Bay Host Committee, the city agreed to make Curtis Hixon and several other parks available for the convention's exclusive use.

Curtis Hixon is expected to reopen to the public on Sept. 4.

And if some lovers of the park grouse in the meantime?

"Just bear with us," Tampa Mayor Bob Buckhorn said. "As we have said from Day 1, there will be some inconveniences and we all have to understand that, given the magnitude of what we're attempting to do."

Tampa City Hall to set up RNC info call center
City Hall is setting up a call center to provide information about street closures, parking, directions and hospitality information during the Republican National Convention.
The toll-free RNC call center number is (866) 762-8687 .

The call center will start taking calls at 8 a.m. Monday and will stop at noon Aug. 31. It will be staffed 24 hours a day during that time, with someone who speaks Spanish available.

For online information about the convention, road closures, detours and city services, visit tampagov.net/RNC. City officials also encourage residents to sign up for the Alert Tampa messaging service to their email, mobile device or landline telephone. To sign up, go to tampagov.net/AlertTampa or call (813) 231-6184 (Tampa Bay Times, 2012).

Title: Tampa Health Officials Preparing For Bioattacks At Republican Convention
Date: August 20, 2012

Abstract: Epidemiologists with the Hillsborough County Health Department are requesting that health care providers in Tampa, Florida, quickly report diseases to public health officials before, during and after the Republican National Convention.

Public health officials expressed a desire to hear immediately from health care workers who see patients with food-related illnesses, bloody diarrhea, unusual rash or any unexplained severe illnesses. The officials also want to hear of any suspected illness from possible bioterrorism, including plague, brucellosis, botulism, anthrax or viral hemorrhagic fevers, the Tampa Bay Times reports.

“We are also asking that providers report whether or not a patient is visiting for the RNC or has attended any RNC events,” the request from the department said, according to the Tampa Bay Times. “We understand that this information would not normally be collected, but it would be especially useful for us during this period.”

Health officials also want to hear about two or more patients with unexplained adult respiratory distress syndrome, pneumonia, flu-like illness, sepsis, neurologic disease, dermatological disease or gastrointestinal disease, according to the Tampa Bay Times.

The convention will be held between August 27 and August 30 in Tampa. The officials want health care workers to be on the alert until at least September 6 (BioPrepWatch, 2012).

Title: Feds Warn Anarchists Could Blockade Roads, Use Acid-Filled Eggs To Protest Conventions
Date: August 22, 2012
Fox News

Abstract: Federal authorities are urging law enforcement agencies across the country to watch out for signs that extremists might be planning to wreak havoc at the upcoming political conventions -- by blocking roads, shutting down transit systems and even employing what were described as acid-filled eggs.  

The warning came in a joint FBI-Department of Homeland Security bulletin issued Wednesday.

The bulletin specifically warned about a group of anarchists from New York City who could be planning to travel to the convention sites to disrupt the events by blockading bridges.  

Anarchists "see both parties as the problem," so both conventions are prime targets for them, a federal law enforcement official told Fox News.

The Republican National Convention is set to open Monday in Tampa, Fla., and the Democratic National Convention gets underway a week later in Charlotte, N.C.

The joint bulletin, titled "Potential For Violent or Criminal Action By Anarchist Extremists During The 2012 National Political Conventions," says anarchist extremists likely don't have the capability to overcome heightened security measures set up by the conventions themselves. In addition, Tampa Police Chief Jane Castor said Tuesday that fences have been established around "some of the more attractive government targets."

Instead, extremists could target nearby infrastructure, including businesses and transit systems, according to Wednesday's bulletin.

The bulletin mentions possible violent tactics anarchist extremists could employ, including the use of molotov cocktails or acid-filled eggs.

In August 2008, federal authorities arrested a man who was planning to use a molotov cocktail during the Republican National Convention in St. Paul, Minn. In addition, authorities executed four search warrants and arrested eight others for planning to disrupt the convention, according to a 2010 FBI intelligence assessment posted online.

On Tuesday, Tampa police confiscated bricks and pipes found on a rooftop several blocks away from the site of the Republican convention. Graffiti associated with the anarchist movement was also found. Castor called the discovery "disconcerting but ... not surprising."

The bulletin issued Wednesday notes that in 2008, anarchists discussed trying to shut down roads and skyways in St. Paul.

In addition, the bulletin discusses anarchists' use of social media to inform each other of law enforcement actions and positions.

Even though activists associated with the Occupy Wall Street movement are planning to converge on both conventions to protest what one OWS group called "this political system that only works for the 1%," the bulletin issued Wednesday makes no mention of Occupy Wall Street -- focusing instead on "extremist" activities.

"We have said all along that the vast majority of individuals coming to the Tampa Bay area to demonstrate will do so peacefully but there is no doubt that there is a small percentage that will come bent on destruction and disruption, and those are the individuals that we will deal with very quickly," Castor told reporters Tuesday.

The conventions have each been designated a "National Special Security Event" by the U.S. Secret Service, which by law leads operational security plans for such events in coordination with federal, state and local law enforcement.

The Tampa Police department has been asking fellow officers from across the state to help provide security for the convention. Those officers would be paid from $50 million Congress has given both Tampa and Charlotte to offset security costs associated with hosting a convention.

The FBI has long warned of potential dangers posed by "anarchist extremism," particularly during global summits and big events hosted in the United States.

The federal law enforcement official told Fox News there is "no credible threat" tied to international terrorism, but there is always concern that big events such as the political conventions are "attractive targets" (Fox News, 2012).