Consideration should be given to the development of a common form to be used by both law enforcement and epidemiology personnel. This form should allow the sharing of necessary information while protecting the confidentiality of victims (Department of Defense. 2000)."
The criminal investigation is a critical step as it allows the law enforcement agencies and the health community to determine the cause of the attacks and the gravity of the situation. The "Federal Bureau of Investigation" plays a frontline role in conducting a comprehensive investigation; however, many other agencies are involved as well, as the Department of Defense notes: "The criminal investigation would be a joint effort involving many agencies and could complement the epidemiological investigation. It likely would entail conducting interviews with the sick in hospitals, fellow sick officers and others in the affected population groups. To facilitate these interviews, a checklist of basic questions to ask should be developed. The interviews can help determine the cause, perpetrators and other details of the attack (Department of Defense. 2000)."
After careful and methodical analysis of the results from the medical diagnosis along with epidemiological and criminal investigations, "Federal Emergency Management Agency" (FEMA) works in collaboration with the local health agencies to limit the influence of the disease. The Department of Defense notes: "Mass prophylaxis, the first emergency response component of the template, involves the distribution and medical application of appropriate antibiotics, vaccines, or other medications in order to prevent disease and death in exposed victims (Department of Defense 2000)."
Residual hazard evaluation and alleviation
The job of the "Environmental Protection Agency" (EPA) is to ensure that they work in collaboration with the Public health professionals, medical examiners, as well as, criminal investigators in order to not only protect the unaffected population but also limit the damage to the affected population. The task includes: "Assessment and mitigation may include environmental sampling of air, water and soil, as well as surface swipes and insect and animal screening for the BW agent (Department of Defense. 2000)."
Control of affected area and population
The control of affected area has been divided into two main categories, which are (1) Physical control (2) Public information control. As far as the physical control is concerned, it comprises: "crowd control and security at hospitals, emergency medical facilities, fatality handling sites and other vital installations such as airports, utility sites, bridges and tunnels. In addition, activities that control the affected area also provide excellent opportunities for isolation and preservation of the crime scene, if one is identified. Managing the affected area also involves management of potential evidence, such as contaminated materials and victims (Department of Defense. 2000)."
Similarly, limiting public information is also very critical as false rumors start to circulate, which cause unnecessary panic amongst not only the affected but also the unaffected. The typical activities comprise: "Establishing and operating a city hotline, providing information to the media and distributing self-help fact sheets. Strict management of information as well as ensuring that all information disseminated is timely and accurate are crucial activities of the command structure in order to prevent panic and maintain public cooperation (Department of Defense. 2000)."
Modular Emergency Medical System (MEMS)-care of existing fatalities and worried well
While many people may be affected from the spread of deadly virus, many people may not be affected from the virus at all. Unfortunately, these unaffected individuals ask for diagnosis and treatment at a very critical time, particularly, when the sick and the affected are being treated. Therefore, an appropriate plan has also been drawn to attend these "worried well:" "In order to manage this huge casualty load, the BW IRP team developed the Modular Emergency Medical System (MEMS) to address shortfalls in hospital space, equipment and medical personnel. The MEMS concept was developed to address the need of a BW response plan to expand and contract in size, based on casualty counts and acuity. Municipalities need a plan to receive large numbers of victims. The MEMS is an example of one way a municipality could begin to address this issue. Under the MEMS, public and private area hospitals would admit BW casualties until they approach full capacity while operating under their internal emergency operations plans. As the hospitals become full, local officials would determine that the medical emergency is overwhelming the community's medical care system and could decide on appropriate activation of a system similar to the MEMS (Department of Defense. 2000)."
Managing the Dead
While effective measures have always been taken to counter bio-terrorist attacks, one cannot guarantee the safety of the lives of all the people. It is highly probable that a huge number of people actually loose their lives. Therefore appropriate measures have been taken to ensure effective fatality management: "The template includes the use of morgues to provide rapid central processing of remains and the establishment of long-term storage facilities using refrigerated trucks, rail cars or other containers to hold remains until final disposition. Additionally, Disaster Mortuary Teams can be provided by the federal government through the Federal Response Plan. Local officials would need to make a decision on the final disposition of remains. Options for the final disposition of remains could include (1) mass cremation, (2) mass burial and (3) release of remains to families for normal disposition. Temporary interment is an option that might be used while awaiting final disposition (Department of Defense. 2000)."
Emergency Management Procedures
Emergency operations center (EOC) is activated when the health professionals determine a critical health crisis is about to emerge. On some occasions, when the threat is extremely severe, the health professionals establish a unified medical branch where all the local, state and federal health officials work round the clock to limit the threat of the disease. The Department of Defense highlights: "The key is early coordination among all departments and forging early relationships among police, medical practitioners, and emergency management and public health officials. Planning and conducting joint training exercises are effective in preparing strong unified command structures (Department of Defense 2000)."
Logistic and Supply Support
While the health professionals along with the law enforcement agencies work round the clock to manage the epidemic, they do need continuous logistic and resource support. This can be done by establishing distribution points for incoming personal and supplies for timely and hassle free delivery. "Supplies would be delivered to the response sites from the staging areas and distribution points. A central reception center would receive incoming mutual aid as well as state and federal support personnel and provide instructions, accreditation and assignments (Department of Defense. 2000)."
Stability of Critical Infrastructure
If there is interruption in the working of the fundamental infrastructure, such as electricity, drainage and telecommunication it will not only cause more panic amongst the people present in the affected area, but also negatively influence the treatment procedures of the sick. Therefore, the strategy has always been to ensure that there is no interruption in the working of the critical infrastructure: "Telecommunications would activate their emergency communication plan to establish priorities, call blocking and cellular augmentation. Electrical power generation, water and transportation would activate their emergency staffing plans as required based on absenteeism. Sanitation would augment disposal of biohazard material and provide sanitary facilities and pest control at Acute Care Centers and other emergency facilities (Department of Defense. 2000)."
Chapter 4 - Responsibility for an event of this nature
The steady presence of bioterrorism has been due to the lack of communication, cooperation and interrogation between the security services, intelligence agencies and the airport authorities. And the only way this form of terrorism can be detained or controlled is in the scrutinized collaboration of these forces. Furthermore, responsibility for the success of terrorists in staging a bioterrorist attack on American soil should be labeled on these institutions.
It is worth noting here that bioterrorism is not a new phenomenon, instead bioterrorism almost wiped out a large portion of European population after it found its origin in 1346, in a war between the Tatar and the Genoese armies and has existed through a conventional pattern since then. The Tatar armies had been suffering from a deadly plague that was dissipating a large number of the armed force, so in order to inflict the same misery on the antagonists, they hurled plagued dead corpses across the city borders. The Genoese army soon suffered from the same plague and retreated into Europe thereby causing the spread of the disease there. Due to its rapid and effective death rate, the disease soon became the Black Death in the Middle Ages for nearly depopulating the European States. (Derbes, V.J. 1966)
It was of course not until the present century that bioterrorism took a stronger turn out of the battlefield. There have been numerous cases which have led the governments to determine that the countries that are recognized as terrorist countries might be able to use them as a counter attack or an offensive attack against…