15 May 2003

Hot Wash

I am going to deal with the impending death of exercise Top Officials 2 today. It doesn't know it is dying, but most of the press conferences are over, and Governor Ridge is going to have the limelight up in Chicago today. The senior people are going to stop going to the videconferences, and the rats will start leaving the ship. I fully intend to depart before the last meeting of the day lurches into the reconstruction that is scheduled for tomorrow. They call it a "Hot Wash," a preliminary reconstruction on how things worked, for good or for ill. TopOff cost $16 million, and a lot more if you count the salaries of all the players who have government day-jobs.

The Scenario will grind on from Master Control. But I will not miss it. The Command Center was humming all this week. We had liaison officers assigned from the alphabet soup of our component agencies assigned to desks: CDC, SAMSA, HRSA, FDA and ATSDR and IHS were all there with shining faces. NIOSH wasn't, but we had a good phone number for them. People that we work with were there, too. The new DHS, NORTHCOM, USDA and the VA were present and accounted for, each linked back to their own emergency operations centers. Everyone with a stake in responding to a major public health disaster showed up, except EPA who apparently had taken a long lunch.

According to CDC estimates, we are going to have 900 simulated dead today in Chicago. The Master Scenario Event List has a photo-op for Governor Ridge, since the last element of the game is the issuance of Cipro to thousands of anxious Chicagoans from the simulated National Strategic Pharmaceutical Stockpile. We are already collecting the information for the Hot Wash tomorrow, so you can imagine just how important the photo-op is.

The exercise has had its moments, good and bad. Our Department was in the spotlight yesterday. The activity surrounding the simulated detonation of a dirty bomb in Seattle was winding down as our desks played out their part in the game. Should State of Washington agricultural products be banned from Canada due to radiation? The Borders sealed? Why does the Department of Energy have its own stockpile of anti-ration drugs? Do they know something we don't? E-mails and phones calls flew across the continent. At the end, when activity was dying down, the conclusion was that no one had died from exposure to the Cesium in the bomb and the only casualties were those who were in the building that collapsed. But someone was going to have to track everyone down and monitor their health for a long time. A very long time.

The Plague is a different sort of animal. It is fast-spreading and can be deadly. The outbreak was reported in Chicago, and really caught our attention. The vector location was identified was identified as O'Hare. At the evening videoconference we were told that some control-freak had sequestered 20,000 airport employees and 50,000 travelers. Simulated, of course, but I imagine the make-believe snack bars were running pretty low on hot dogs. The level of play and the number of e-mails and phone calls emanating from DC got some of the local people in a snit. We got notification around noon that the Illinois Department of Health was cheerily telling us all to go to hell and not to call them anymore unless we had something real to talk about.

In the midst of it all we hosted a few dozen tour groups of varying stature. We had a few corporate CEOs troop through, a handful of Governors, and many concerned citizens of indeterminate origin. On the whole, I think it was a good thing. It certainly went a lot better than the last of these exercises, which was a debacle in charitable terms.

There is always a context to these things, and response to bio-terror is only one of the things in play. In the background was a struggle for control of the Nation's medical response capability. Played nicely, of course. Tom Ridge's DHS scooped up parts and pieces of many departments and agencies in the establishment of his new Homeland Security organization. Not all of them went willingly, and others, like the Federal Emergency Management Agency, considered themselves the center of gravity of a new Cabinet-level department. If you can imagine the donut-eating FEMA guys in charge of security. They got a little greedy, helping themselves to other peoples lunch.

Including ours. The health response mission is one of them where the division of labor wasn't clear. Our response units-the Disaster Medical Assistance Teams and the Emergency Mortuary folks went over with all their budget lines on the first of March. The Stockpile of drugs went, too, which didn't make a great deal of sense, since the Center for Disease Control which manages it still works for us, insofar as they acknowledge they work for anybody. The Agency for Toxic Substance and Disease Registry is a congressionally mandated organization chartered to track Superfund sites. They are a jolly bunch of bureaucrats in search of a real mission and often fail to recognize they work for the CDC. And so it goes. The Secretary has done his level best to bring all the fractious components together, and this TopOff exercise has been a good demonstration of that.

One of the guys asked me if we ought to bring the Command Bus around front to greet the visiting dignitaries and media types. I agreed. The Bus is a thing of wonder, filled with computers and satellite phones. The guys gave it a good scrub before they brought it around in front from its underground hiding place. It is shiny and white and the crew put up the satellite mast and the meteorologic sensors and the VHF/UHF antenna field for short-range communication with first responders festoon the front part of the roof. It is an impressive thing, the command bus, and it was designed to provide on-scene command and control capabilities for the Secretary or his designee during an emergency. The Homeland Security guys were lusting for our bus in the Great Divide that surrounded the establishment of DHS. But we didn't give it to them.

The bus became part of our Continuity of Operations architecture, one of the crown jewels, in fact, since in the event the Department's leadership must relocate from the Headquarters we must retain the capability to be in constant contact with our components. The Secretary might have to issue everyone's Medicare checks at 80 mph on the Beltway, headed south.

The Bus is a symbol of our ability to be a dynamic, responsive department. Vehicles are funny things around here. Arlington County came to the building and demanded to see the registration of all vehicles domiciled on the property, which is essentially what DHS tried to do about the bus. Virginia taxes personal property for residents each year, part of a barbaric tax code that goes back to the beginning of the Republic. The auto is the number one thing of value most people own, after their house, and the tax man is increasingly desperate to scoop up every penny. Cars being mobile, people have taken a creative approach to where they register them to avoid the tax.

I'm not going to tell you where the bus is domiciled. And I think we ought to take it to the Hot Wash.