by Jerome Hauer
President Obama should be commended for making nuclear nonproliferation a priority of his administration. At the 2010 Nuclear Security Summit in Washington, D.C., in April, the president was right to urge global cooperation on isolating non-secure nuclear materials that could be used to make a weapon.1
It is a fact the threat of nuclear terrorism
continues to grow. However, some proliferation experts disagree with the president’s assertion that nuclear weapons represent one of the biggest threats to U.S. security. They are concerned the White House’s focus on nuclear weapons will unintentionally draw attention and resources away from other, more likely terrorist threats, such as biological and chemical agents, conventional explosives, or a combination thereof.2
Two recent events in New York City validate these concerns. The first was an attempt by an individual to detonate an explosive device in midtown Manhattan using gasoline and propane.3 The second was the arrest of a suicidal college student wandering the city’s subway system with a backpack loaded with sodium cyanide and flares.4
Across the range of threats, security officials are most concerned with a lone offender with a conventional explosive.5 The use of chemicals with or without conventional explosives also is a serious threat, and not just military-grade nerve agents like Sarin or VX.5
Unlike nuclear or biological weapons, chemical weapons are relatively easy and inexpensive to acquire and deploy.5 Commercially available chemicals, such as malathion and parathion – organophosphorus pesticides commonly used in agriculture – are highly toxic and have the potential to inflict significant casualties in minutes, especially if used by someone willing to die in the effort.6,7 Pesticides, cyanide and other poisons are readily accessible in the U.S., traveling via road and rail through our cities every day.8
In the event of an organophosphate (nerve agent) or cyanide attack on a public transit system, indoor stadium, amusement park or office building, individuals who have been poisoned may have only minutes to benefit from treatment.9
Fortunately, firefighters and other emergency responders in the U.S. have access to antidotes for organophosphate and cyanide poisoning. The problem is that in many cities, emergency responders may have only enough antidotes to treat themselves and/or will not be able to treat victims in time.
Given the rapidity of symptom onset, and the logistical challenges of providing immediate medical assistance to potentially large numbers of victims – particularly if the antidote is not readily available – the response is likely to be too little, too late. To further complicate matters, federal government stockpiles of antidotes may not be accessible for immediate use, as they are intended for the most part for replenishment purposes only.10
Less than 18 months ago, the then congressionally mandated bipartisan Commission on the Prevention of Weapons of Mass Destruction Proliferation and Terrorism (now formed as the Bipartisan WMD Terrorism Research Center) issued a threat assessment: “Unless the world community acts decisively and with great urgency, it is more likely than not that a weapon of mass destruction will be used in a terrorist attack somewhere in the world by the end of 2013.”11
The findings of the Commission notwithstanding, state and city officials are telling me they’re under enormous pressure to “get back to basics” in training
. They should continue to evaluate their risks at the local level, including a review of preparedness for WMDs, and train and equip their police, fire
, and EMS
For chemical threats, this means arming first responders with personal protective equipment and in-date antidotes that keep them from becoming casualties themselves. And it means training and exercising specifically to deal with chemical terrorism. Specialized exercises by individual groups, and large-scale exercises that involve the medical community and local, state and federal agencies, help identify gaps in response protocols and strengthen partnerships between agencies so they work together more effectively.
Jerome Hauer is former assistant secretary for Public Health Emergency Preparedness at the U.S. Department of Health and Human Services. He also served as director of Emergency Management for New York City, and as director of Emergency Medical Services and Fire Services for the State of Indiana. Hauer is CEO of The Hauer Group, a consulting firm whose clients include Meridian Medical Technologies.
U.S. Department of Transportation Pipeline and Hazardous Material Safety Administration. Hazmat Safety Community: Risk Management. http://www.phmsa.dot.gov/hazmat/risk
. Accessed May 3, 2010.
Centers for Disease Control and Prevention. Office of Public Health Preparedness and Response: Strategic National Stockpile (SNS). http://www.bt.cdc.gov/Stockpile/
. Accessed May 11, 2010.