A Plague on All Your Houses

Last June 2, emergency teams gathered for a closed-door meeting at the Colorado Convention Center and learned that deadly anthrax had been released at a Sixteenth Street Mall food court. The dissemination had been subtle -- 10,000 to 20,000 spores, a microscopic amount, is all that is needed to infect a person -- and apparently no one noticed as a fine dust of spores settled on women's hair and businessmen's fast-food lunches; no one looked up as the dust swept through the exhaust pipes and drifted through downtown. Skateboarders whiffed the poison as they wove in and out of pedestrian traffic. Workers returning from lunch-hour shopping forays walked through anthrax-laden air.

Initially, those infected displayed no symptoms. But within a few days, people across the metro area began calling in sick to work and showing up at doctors' offices. They complained of fever, stuffiness and aches -- unremarkable symptoms shrugged off as the cold or flu. They were told to rest, drink plenty of fluids and take some aspirin, then were sent home.

In many cases, the symptoms were followed by a brief "eclipse," during which the victims began to feel better. Some even went back to work. Soon, however, the victims experienced more severe signs. Some developed dark swellings on their chest and neck. All had trouble breathing.

Area hospitals were overwhelmed. It took days for doctors to realize what they were dealing with -- pulmonary anthrax -- and once they did, they had to acquire massive amounts of penicillin and streptomycin and administer it quickly. Pulmonary anthrax is not infectious, and antibiotics will stop the progress of the disease -- but only if administered before the first symptoms appear. After that, the drugs have little effect.

By the time victims began exhibiting second-stage symptoms, they were the walking dead. Their lungs slowly filled with fluid, gradually cutting off their supply of oxygen. Their skin took on a bluish tint. They choked, convulsed and died.

The outbreak's toll: 1,500 people dead and 10,000 or so affected (including those with psychosomatic illnesses).

It was the job of the emergency workers meeting in Denver to handle the crisis, to figure out who might have been affected, to transport and treat the ill, to arrange for burial of the dead, and to get the word out to the public in such a way as to prevent panic.

It was a daunting task.

It was also completely theoretical, a six-hour tabletop exercise designed to help local agencies learn how to respond to a crisis situation involving a weapon of mass destruction (known bureaucratically as a WMD).

This month -- at this very moment, perhaps -- local and state health-care and emergency workers are participating in a much more vast exercise, a ten-day "no-notice" test of their responses to another hypothetical act of bioterrorism involving a different WMD. A similar scenario will be played out concurrently in Portsmouth, New Hampshire, while federal agencies conduct a third exercise in the Washington, D.C., area. This trio of tests -- the largest mock bioterrorism disaster ever in this country -- involves top officials from at least eleven federal agencies, including the FBI, the CIA, the Environmental Protection Agency and the Department of Defense, a lineup that inspired the overall mission's name: TOPOFF.

Why Denver? Because area officials volunteered for the job, with Arapahoe County Sheriff Pat Sullivan -- also a major proponent of preparing for the nonexistent millennium meltdown late last year -- leading the way. Although the exercise will involve many volunteers, there are certain to be hard costs, too. For starters, actors will be hired to play victims of bioterrorism. But so far the budget, like the test scenario itself, remains top secret.

The probability of Denver being hit by a real, large-scale act of bioterrorism is low, admits Major Chris Petty, deputy commander of a specially trained bioterrorism response group attached to the Colorado National Guard. "But the consequences are so high," he says, "that we have to address it in a reasonable way."

A reasonable and extremely expensive way. This year alone, the federal government has authorized expenditures of $1.4 billion to protect Americans from chemical and biological weapons. (In 2000, the feds will spend a total of $10 billion on terrorism, up $3 billion from 1999.)

Some scientists argue that the United States is over-preparing for bioterrorism, creating a worst-case-scenario response for a hypothetical threat. Weapons experts with the Center for Nonproliferation Studies claim U.S. officials have drastically exaggerated the danger of mass-casualty attacks involving chemical or biological agents -- after all, they point out, over the past hundred years, just one person in this country has died as a result of such an incident.

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Karen Bowers