Examination of bioterror exercises raises questions

A recent analysis of two senior-level tabletop exercises simulating the effects of a smallpox release concluded that questions remain about how leaders would react in a terrorist attack.

The first exercise, known as "Dark Winter," simulated the effects of an act of covert biological terrorism on the United States. The one-of-a-kind simulation, conducted in 2001, examined the ability of policy makers to deal with the challenges of a bioterrorist attack along with the outbreak of a highly infectious disease, according to MitigationJournal.org.

The second exercise, known as "Atlantic Storm," took place in 2005. It was considered a larger scale version of Dark Winter and focused on simulating the reactions of heads of state and international leaders to a simultaneous smallpox release in Frankfurt, Warsaw, Rotterdam, New York and Los Angeles.

Both exercises dealt with the ability of senior leaders to manage public health, medical services, diplomacy, domestic response and critical infrastructure. They were well-planned and well-developed, but unfolded in very different ways.

Dark Winter would now be considered a "worst-case" scenario and Atlantic Storm a "best-case" scenario.

"Dark Winter assumed a 30 percent fatality rate while deaths from smallpox were projected at 25 percent in Atlantic Storm," author Rick Russotti said, MitigationJournal.org reports. "Atlantic Storm also assumed that there was residual immunity among the affected population with 300 million doses of vaccine available. Dark Winter was somewhat less optimistic; simulating a CDC stockpile of 15.4 million doses of vaccine and allowing for up to 20 percent of stockpile loss due to contamination or improper use."

Ultimately, Russotti concluded that there has been no resolution to either exercise. The questions raised by the exercises, though they were conducted years apart, are strikingly similar and continue to be re-invented as the issues surface over and over again.