# Presentation: 786872

## CLEANUP AND RECOVERY OF PASSENGER TRANSPORTATION FACILITIES AFTER A BIOATTACK

**Dr. Aviva Brecher**
**Volpe Center CTUG PRESENTATION **
**Jan. 30, 2006**

## CLEANUP AND RECOVERY AFTER BIOATTACK-OVERVIEW

**A Bioattack involves the release of viruses, bacteria or other toxins through air, food or water, with the intention of killing or harming as many people as possible. **
**Federal agencies have accelerated and expanded R&D and preparedness programs on bioterrorism since Oct., 2001. **
**DOT, State an local authorities must respond appropriately to any bioterror attack:**
**Shutting down the transportation system to extent necessary to limit and mitigate the damage from epidemics and diseases**
**Activating public health emergency preparedness and response  plan (shelter in place? Evacuate or quarantine? Wash those exposed?  Administer drugs? Provide food, assistance and shelter facilities?)**
**Response must be based on bioagent identification, on its nature (contagious or not), amount of bioagent contamination, and the  location of release and extent of contamination. **

## CLEANUP AND RECOVERY AFTER BIOATTACK-RISK

***CLEANUP AND RECOVERY AFTER BIOATTACK-RISK***

## CLEANUP AND RECOVERY AFTER BIOATTACK- 2001 HISTORY

## CLEANUP AND RECOVERY AFTER BIOATTACK- RESPONSE

## CLEANUP AND RECOVERY AFTER BIOATTACK- PANIC, CLEANUP OF POST OFFICE AND SENATE BUILDINGS

## CLEANUP AND RECOVERY AFTER BIOATTACK

**CDC definition of Category A Diseases/Agents:**
- The U.S. public health system and primary healthcare providers must be prepared to address various biological agents, including pathogens that are rarely seen in the United States. **High-priority agents include organisms that pose a risk to national security** because they:
- can be easily disseminated or transmitted from person to person;
- result in high mortality rates and have the potential for major public health impact;
- might cause public panic and social disruption; and
- require special action for public health preparedness.* *

## CLEANUP AND RECOVERY AFTER BIOATTACK-Highest threat

**Category A **
- _[Anthrax](http://www.bt.cdc.gov/agent/anthrax/)_** (*****Bacillus anthracis*****)**
- _[Botulism](http://www.bt.cdc.gov/agent/botulism/)_** (*****Clostridium botulinum***** toxin) **
- _[Plague](http://www.bt.cdc.gov/agent/plague/)_** (*****Yersinia pestis*****) **
- _[Smallpox](http://www.bt.cdc.gov/agent/smallpox/)_** (variola major) **
- _[Tularemia](http://www.bt.cdc.gov/agent/tularemia/)_** (*****Francisella tularensis, or rabbit fever*****) **
- _[Viral hemorrhagic fevers](http://www.bt.cdc.gov/agent/vhf/)_** (filoviruses [e.g., Ebola, Marburg] and arenaviruses [e.g., Lassa, Machupo])**
*Note:*
**Ricin toxin is Category B**
**Emerging infectious diseases- Category C**

## CLEANUP AND RECOVERY AFTER BIOATTACK-THREAT 1

## CLEANUP AND RECOVERY AFTER BIOATTACK- THREAT 2

## CLEANUP AND RECOVERY AFTER BIOATTACK- CHALLENGE

**CRITICAL INFRASTRUCTURE PROTECTION (CIP) CHALLENGES FOR TRANSPORTATION SYSTEM:**
**- Enormous Annual Influx of People and Goods: **
**500 million people enter the United States, of whom 330 million are non-citizens **
**16 million cargo containers arrive by truck and ship **
**7,500 foreign-flag ships make 51,000 calls in U.S. ports **
**Millions of people seek entry to U.S. facilities at home and abroad **
**Thousands of airports, ports, multimodal rail and transit terminals and stations, and all vehicles are open to all and very vulnerable to terror or sabotage**

## CLEANUP AND RECOVERY AFTER BIOATTACK- CHALLENGE

- Identify key transportation system vulnerabilities
- Develop Emergency Preparedness and Response plans
- Reviewed state-of-science in:
**Bioagents detection sensors (briefings from Lincoln Lab, Idaho Technologies, SAIC, TSWG, SENSORNET AT ORNL)**
**Cleanup and decontamination materials and methods**
- Outreach and Education
**Harvard School of Public Health W/S in Feb 2002**
**3 Security-related workshops in 2004**
- Developed training and web resources (Biodefense) for RITA, FTA, FAA, DTRA, others
- Analyzed the economic impacts of bioattack and nuclear attacks on transportation (2 Abt studies)

## CLEANUP AND RECOVERY AFTER BIOATTACK-RESPONSE

- WHAT DO WE NEED TO DO?
**Develop Plans and procedures, on-call help**
**Continuity of operations plans (COOP)**
**When and how to issue notifications and emergency warnings? **
**Mobilize resources in response to emergency incidents: **
**Evacuate? Shelter in place? Quarantine?**
**Food and drinks, beds, PPE and medical supplies**
**Suppress secondary hazards (fire containment, contamination and disease spread via air or direct contact, panic reaction) **
**Contact help (who?) to provide medical assistance and relief specific to bioagent type or natural epidemic **
**Detection, Identification, Search and rescue, forensics**
**Clean up to recover normal operations  requires toxic  gas fumigants, liquids, foams- no Standards available**
- ARE WE READY??

## CLEANUP AND RECOVERY AFTER BIOATTACK-SYMPOSIUM

- _[http://www.](http://www.volpe.dot.gov/ourwork/dimensions/workshops.html)__[volpe](http://www.volpe.dot.gov/ourwork/dimensions/workshops.html)__[.dot.](http://www.volpe.dot.gov/ourwork/dimensions/workshops.html)__[gov](http://www.volpe.dot.gov/ourwork/dimensions/workshops.html)__[/](http://www.volpe.dot.gov/ourwork/dimensions/workshops.html)__[ourwork](http://www.volpe.dot.gov/ourwork/dimensions/workshops.html)__[/dimensions/workshops.html](http://www.volpe.dot.gov/ourwork/dimensions/workshops.html)_

## CLEANUP AND RECOVERY AFTER BIOATTACK- ISSUES 1

**Ongoing federal (DHS, EPA, OSHA), state and transportation agencies efforts to prepare and respond- institutional challenges, resource constraints **
**Lessons learned from response to the DECLARED anthrax letters, ricin attacks**
**Scenarios of bioattack, building and people protection strategies**
**Natural epidemic (SARS, Nile virus) vs bioattack- time lag to detect, respond **
***Major knowledge gaps for decontamination technologies*****, materials and application processes persist**
**DOT modal efforts, Volpe Center support**

## CLEANUP AND RECOVERY AFTER BIOATTACK- ISSUES 2

**Current plans for recovery and cleanup at the national, state, regional and local jurisdictional levels**
**Who will pay for restoration (scarce resources, disaster aid-federal role and partnerships)**
**Which agency has primary responsibility for cleanup? (NRP and NIMS may not work)**
**How clean is clean enough? Concerns over exposure to residual bioagents and to toxic cleanup materials in decontaminated facilities**
**Existing EPA, OSHA, CDC or other standards**
**Economic impacts of bioattack prevention, response and mitigation **
**Time to restore normal operations and regain public and workers confidence**

## CLEANUP AND RECOVERY AFTER BIOATTACK- ARE WE READY?

***No one's in charge, the plan's incomplete and resources aren't sufficient if we suffer mass casualties in an overwhelming disaster. ***
**As the White House and Congress grow increasingly alarmed over the possibility of a deadly flu pandemic and scramble to spend billions on vaccines, health experts say the United States is incapable of delivering mass care. **

## CLEANUP AND RECOVERY AFTER BIOATTACK- ARE WE READY?

**"Ready or Not? Protecting the Public's Health from Disease, Disasters, and Bioterrorism," which found that both federal and state preparedness for major health emergencies must be accelerated in order to adequately protect the American people. (Trust for America’s Health (TFAH) Dec, 2005) **

**Federal government received a grade of D+ for post-9/11 public health emergency preparedness, for key indicators of health emergency preparedness, such as capabilities to test for chemical and biological threats and hospital surge capacity to care for patients in a mass emergency. ****Strategic National Stockpile received a C+ grade.****Federal initiatives including the Cities Readiness Initiative, BioSurveillance activities, pandemic flu planning, and overall management of federal funds and programs received C- grades. Coordination among federal agencies, the establishment of measurable goals and directions, BioWatch, and the federal health response to Hurricane Katrina received a grade of D. The Smallpox Vaccination Initiative received a D-.**

## CLEANUP AND RECOVERY AFTER BIOATTACK-MITIGATION

- WHAT IS THE CONNECTION BETWEEN BIODEFENSE PREPAREDNESS AND THE AVIAN FLU PANDEMIC PLANNING AND READINESS?
**DUAL USE OR MULTIPLE USE PLAN- “ALL HAZARDS APPROACH” MAY NOT WORK**
**DHS NATIONAL RESPONSE PLAN (NRP) “CATASTROPHIC INCIDENT ANNEX” APPLIES, BUT WHO IS IN CHARGE? DHS/FEMA? HHS/CDC?**
**LOCAL VS STATE AND FEDERAL “FIRST RESPONDERS” TRAINING AND RESOURCES **
**MEDICINES FROM THE NATIONAL STRATEGIC STOCKPILE MUST BE RAPIDLY DISTRIBUTED IN AN EMERGENCY (TRANSPORTATION LOGISTICS PLAN NEEDED), BUT EVEN FLU VACCINE DISTRIBUTION IS PUBLIC HEALTH SYSTEM IS INADEQUATE**
**DOT HAS A DRAFT PLAN, NOT YET APPROVED, POSTED OR DISTRIBUTED- NO TRAINING**
**VOLPE CENTER HAS NO BIODEFENSE PREPAREDNESS PLAN **

## CLEANUP AND RECOVERY AFTER BIOATTACK- RESPONSE

**HANDOUTS:**
**RAND CORPORATION 2005 POCKET GUIDE:****“What You Should Do to Prepare for and Respond to Chemical, Radiological, Nuclear, and Biological Terrorist Attacks”**
** **
**  ****This ****Survival Guide**** focuses on simple steps individuals can take to prepare for and respond to terrorist attacks with chemical, biological, radiological (“dirty bomb”) and nuclear weapons. The guides contain both preparatory steps and specific response guidance. This includes what individuals will experience, what their goals should be, and what they should do during each type of attack.**
**FAS AND NAS FACT SHEETS ON BIOWEAPONS**
**CDC AND MEMEA AND MASS DPH HANDOUTS ON AVIAN FLU AND FLU PANDEMIC**