Most response protocols for unconventional incidents today are based on assumptions that are not necessarily accurate. Little or no scientific effort and operational assessments have been made to determine what methods are best; instead protocol is determined by what seems to have worked.

This situation becomes particularly obvious when WMD incidents are examined closely. Much that is handed down as fact is based only on supposition or best practices from small-scale hazmat and limited mass-casualty incidents. And training for these incidents, billed as “exercises” or “experiments,” is closely choreographed and marginally thought-out.

These drills are reminiscent of kabuki, traditional Japanese theater that incorporates stylized movements and elaborate costumes to reenact stories. The staged practices for WMD events are designed specifically to ensure positive and successful outcomes, regardless of their true functionality. Very little opportunity is left to experiment and make mistakes — or progress.

If at first you don't succeed

There are many reasons for this, but chief among them is senior leaders' lack of understanding of exactly what an experiment is and what defines failure in such an environment. Not achieving a specific objective in an experiment is not failure as long as something is learned, even if it is negative, from the process. There's only failure when nothing is learned.

There's also a pervasive fear that an uninformed public will perceive a failure when experiments successfully identify flaws in doctrine, process or technology that in reality could lead to positive improvements.

This is a significant problem; it precludes responsible organizations from actually learning and tailoring their response to optimize the implementation of both doctrine and technology. Instead, it sets up an environment of “box checking” to obtain federal funds with little long-term effect on their operations.

The defense has been made that it's the user's responsibility to maintain currency. The problem is that the end-user only has access to limited and diminishing information. This is not a problem that can be wished away or cured simply by throwing money at it. This serious issue will require a well thought-out and organized plan of action that provides a logical method of determining the user needs, the scope of the problem and the environment in which the problem must be addressed. To meet this objective, scientific methodology and true experimentation must occur to validate findings and recommendations.

While considerable dogma, doctrine and protocol exist for dealing with chemical warfare incidents, few departments have experience with such agents. The closest we come is working with the industrial emergency response community. Nonetheless, a plethora of “experts” on dealing with such incidents have appeared. Unfortunately, most of their expertise comes from hours of labor in an air-conditioned office or briefing room.

Chemical warfare incidents sorely lack an organized approach. Today's exercises — with limited exceptions — are planned and choreographed and have minimal basis in reality, again like kabuki. The scripts that are followed are seldom practical and rarely adhere to the standard operating procedures of the agencies involved in their execution. “Train as you fight and fight as you train” is a maxim as true today in domestic preparedness as it was when it was first conceived. Unfortunately, in today's rush to “do something,” this important lesson is one that often is forgotten.

Instead of logically building on the existing doctrine and structure of the various responder groups, the kabuki-like method artificially takes these skilled professionals away from what they do successfully every day and into a zone of unfamiliarity, presenting them with technology and procedures that haven't been optimized for their specific use and that may in fact have the unfortunate effect of hampering their overall performance.

Quantity, not quality

For years, first responders have been driven by doctrine, experience and tradition. In fact, one of the favorite sayings in this community is “200 years of tradition unimpeded by progress.” This statement is, in many cases, completely correct. This self-criticism should be used to encourage a change for the better. Maintaining the established traditions and permitting the different user groups to assimilate valid information to improve their performances is imperative.

For responder groups to optimize doctrine and technology for their specific use, they need to know what has been found to work best, how it is implemented and under what circumstances. Very few attempts have been made to compare various technologies or doctrines to similar scenarios to determine which is best, not merely which have worked.

It's a popular myth that chemical warfare agents are somehow magic and completely unique and thus can be addressed only by the military. This is a fallacy. There are certainly differences between chemical agents and industrial chemicals, but these are quantitative and not qualitative. The description of chemical agents as “hazmat with an attitude” often is dismissed out of hand by so-called professionals in the WMD arena, when in reality that's exactly what they are.

Set aside for the moment the fact that a threat involving standard industrial agents is much more probable than specialized attacks with chemical agents. While few industrial agents are as toxic as classic agents, most industrial compounds exist in quantities orders of magnitude greater than any known or hypothesized chemical agent.

The worst chemical incident of modern times occurred on Dec. 2, 1984, in Bhopal, India. As a result of a series of errors and poorly designed equipment, a cloud of methyl isocyanate, hydrogen cyanide and other gases settled on an area encompassing 40 square kilometers and resulted in more than 4,000 fatalities in the first 24 hours and 500,000 casualties total. Eight months later, a similar incident occurred at a Union Carbide plant in Institute, W.Va, though on a much smaller scale.

The threat for accidental or intentional exposure to chemical agents is considerable, due to the large quantities of chemicals produced in the United States. For example, phosgene gas, a breakdown product of chloroform, was produced originally as a choking agent in World War II. Though the agent is no longer stockpiled for military use, the United States produces more than a billion pounds of phosgene per year for industrial uses.

Every year multiple incidents of poisoning occur involving various organophosphate agents; these are compounds with many of the same properties as nerve gases. Between 1993 and 1996, nearly 63,000 reports were made to U.S. poison control centers regarding unintentional residential exposures to organophosphates. Of these, nearly 13% of the exposed individuals visited a health care facility and 2% required hospitalization, representing approximately 300 patients annually. While this is not a large number, these incidents provide a unique opportunity to train first responders and medical care personnel on the proper procedures for dealing with chemical agents.

Despite training, however, there are clear lapses in adherence to protocol. From 1987 to 1998, the National Institute for Occupational Safety and Health identified 46 health care workers who had acute pesticide-related illness after providing care to a pesticide-contaminated patient. This clearly indicates that proper training in identification and handling of infected patients could aid health care providers for responding to terrorist events as well as everyday chemical incidents.

Recommendations

Public and senior policy officials must be educated as to what experimentation is and why it needs to be performed. Three steps must be taken to avoid the dangers inherent in stylized, scripted non-experiments:

1. Implement the scientific process. We all learned the scientific method when we were in high school; now apply it. There are many questions: How do we perform decontamination? What is the best design for a hot zone transfer process? How should new incident command systems be implemented? On the positive side, there's a real body of experience on which answers to these questions can be based.

2. Identify key issues. First and foremost is ensuring and maintaining the health and safety of the first-response community. Injury or incapacitation resulting in the inability of first responders to perform their functions will manifest itself as a multiplied effect on overall operations. Depletion of this resource will have a far more severe overall effect than if limited numbers of the general public become incapacitated.

   The issues that directly relate to this problem must be identified and addressed aggressively. Such programs as the Force Medical Protections and Homeland Security Advanced Concept Technology Demonstration are just beginning to address this, but there is no medical data on which to base the parameters of safety or to define the goals of such a program. More work needs to be done in this area. Technologies that may have real value to meeting the needs of maintaining the safety and functional status of the response (military and civilian) community must be identified, and those that need to be evaluated and have doctrine developed for them must be prioritized.

   However, identifying and providing such technology isn't enough. The most important aspect of such an undertaking is to carefully formulate doctrine for implementing the selected technology in a manner that enhances and improves the ability of the user to integrate new capabilities into the array of existing resources and methods.

3. Provide for a center for experimentation and operational assessments. There has been an enormous proliferation of centers of expertise. Each of these, however, generally is focused around the knowledge and skills necessary to obtain funding from Congress, as opposed to those associated with a WMD response.

It's time to have a center of expertise specifically based on the functional requirements for homeland defense. A center should be established to develop, evaluate, and test doctrine and methods of employing new technologies and processes. Reliable information then can be provided to the end user groups, not as recommendations or direction, but as observations that can then be appropriately applied by civilian or military responders to meet the needs of their own specialized situations.

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Michael J. Hopmeier is the chief of innovative and unconventional concepts at Unconventional Concepts Inc., an engineering and scientific consulting firm providing research, organization, and technology integration services. He's a technical adviser and operational consultant to numerous governmental agencies including the DARPA Defense Sciences Office, U.S. Army Medical Research and Materiel Command, National Center for Infectious Diseases-Centers for Disease Control and Prevention, and the U.S. Air Force Surgeon General. His project areas include chemical/biological incident response, combat-casualty care and medical support, crisis response and management, unconventional pathogen countermeasure programs, federal agency protective measures, counter-terrorism, and integrated federal/civilian disaster response. Hopmeier holds bachelor's and master's degrees in mechanical engineering from the University of Florida.