Sunday Edition: Addressing The Chemical, Biological, Radiological And Nuclear Threat

In 2015 and beyond, U.S. Virgin Islanders demand new and enhanced levels of communication, transparency, and accountability. If the territory is proactive about answering that call, our islands will truly be transformative. If not, everything is at risk. – Teri Helenese.

The threat of chemical, biological, radiological and nuclear events (CBRN) within the United States, its territorial borders, and across the globe is real. As a result of the Fukushima Daiichi nuclear disaster in Japan, the threat posed by chemical weapons in Syria, the Ebola outbreak in Western Africa and the diseases expansion and reach beyond geographical areas that were previously limited and easily contained—and of course with consideration for the September 11 terrorist attacks — there is justifiable and increasing concern for terrorist incidents including CBRN. In medicine, basic health can be measured by the efficacy of one’s digestive system and so can preparedness, wellness visits, and preventative measures.

In a world where CBRN is replacing rifles, America’s health is dependent upon its communication links toward addressing the threat of chemical warfare. Fundamental steps to comprehensively address the threat of CBRN should focus on local preparedness and response capacity, not panic, chaos or forces of entropy. From catastrophes with mass casualties, to smaller and home-grown events using low technology — yet generating civil disorder and sickness — organization, planning, coordination, preparedness and crisis management must be thematic in discussing the threat of CBRN.

When it comes to crisis management and crisis communications, every second counts. In 2015 and beyond, U.S. Virgin Islanders demand new and enhanced levels of communication, transparency, and accountability. If the territory is proactive about answering that call, our islands will truly be transformative. If not, everything is at risk.

The Ebola outbreak cases and the mammoth challenges faced by the United States in Syria in its attempt to destroy stockpiles of chemical weapons, and doing so only after weapons had been deployed with fatal and toxic consequences, underscore both the gravity of the threats and the need for authorities to be aggressive and expansive on matters of public health, public safety and public information.

However, authorities alone must not be left to bear this challenge. Citizens must share in the duties of planning and thinking thoughtfully, strategically, deliberately, and meticulously, through the different types of scenarios that might occur, including the announced release of CBRN agents, person-to-person transmission of smallpox, or a real-time attack on Diageo USVI, Cruzan Rum, or the tourism industry in the U.S. Virgin Islands. The long arms of the rum and tourism industries have more immediate roles in Virgin Islands life than what might be imagined.

Crisis management and crisis communications cannot be addressed in the way emergency plans have traditionally been for hurricanes. CBRN is indeed a different beast. To many people, Ebola, smallpox and an attack on the rum and tourism infrastructure must seem a distant unfamiliar case. We would feel comfortable and much prefer to rule out their likelihood, as smallpox remains confined at the Centers for Disease Control Prevention in Atlanta, Georgia, and in Russia, and as the territory has remained virtually untargeted in the terror waged against America on the mainland.

While this is true, it will only help to consider several scenarios as precautionary and proactive measure because CBRN covers a myriad of concerns.

Preparing for a crisis is the most important part of any crisis management response plan. Thinking through scenarios and hoaxes for that matter, will help to develop Standard Operating Procedures (SOPs) that generate procedures that are effective in real-time crisis. In a scenario involving Ebola or smallpox, what hospitals are identified as the smallpox hospitals? What are the details of local quarantine and the distribution of medicines to the patients? When a patient shows up at the Governor Juan Luis Hospital on St. Croix, and tells the emergency room receptionist their symptoms, what is the official response that must be instituted?

Is vaccine immediately available to doctors, administrators, health care workers and staff? What are the communication protocols for communicating with the Centers for Disease Control, the Environmental Protection Agency, the Federal Emergency Management Agency and the Federal Bureau of Investigations?

What are the protocols for informing the public and educating them? How will intelligence be maintained? Who maintains intelligence? How is intelligence coordinated at the investigative level, among shared services?

It is agreed that the emergency response to the Ebola outbreak in West Africa could have been better executed if response delays, poor communication, scant consideration of local practices regarding burials and a general lack of organization were not key factors. As we consider the U.S. Virgin Islands, we must not be caught with our pants down. An informed public can enhance, promote, and safeguard control strategies and limit crisis.

A sleeping giant has awakened. Now more than ever, we must live out the true meaning of the term “united we stand,” forging working relationships across shared services.

There is an immediate need for baseline information on capabilities to respond to threat of CBRN at all levels. A comprehensive plan necessary to provide effective coordination across political authorities for organizing, training, exercising and responding to a bonafide CBRN terrorist incident, including a strategic plan for developing and sustaining fully interoperable capabilities, coordinating training exercises, evaluation procedures, and risk mitigation plans.

There is also a need to prioritize the use of the transportation infrastructure to ensure rapid movement of critical and time sensitive responses. Unless proactive planning and prioritization of critical life-saving responses and human and technical resources are in place, and appropriate discipline is maintained, critical elements of immediate response, supporting St. Croix, St. Thomas and St. John will not be available if needed, and only be wishful thinking and pie in the sky.

When a crisis springtides, the fallout can be instant and merciless. As a measure of proactivity and just doing the right things, we should practice sharing common understanding and knowledge, and do so each and every time. Communication is vital. Identify assets, capabilities, shortfalls, critical players and stakeholders to develop a shared understanding and mechanisms of communication. Proactive measures are best undertaken before a potential emergency crisis in the U.S. Virgin Islands.
Develop a framework of understanding and support required to effectively respond in crisis mode. If there’s a bioterrorism outbreak, determine where we should go, especially if this question finds us null and void. Know that suitable respiratory protection is the single most important item of personal protection against exposure to a chemical or biological agent.

Understand that certain deadly bacteria are not contagious and, where possible, participate in civilian exercises and focus groups that are used to test and improve crisis management response capabilities.

If these initiatives do not exist, lobby and encourage our elected officials to spearhead these proactive measures and activities. These initiatives help to address the need for improved civilian understanding and interoperability between response plans at various levels of government. These efforts also help to respond to multi-agency and multi-jurisdictional training, which will help to clarify roles and responsibilities and improve SOPs.

Beyond these initiatives it is mandatory that we outsmart terrorists in the laboratory.

Planning and coordination alone cannot remedy these problems. Given that a bioterrorist attack is low probability and high consequence for the territory, prevention is always better than cure. As such, new and better drugs for the treatment, prophylaxis, and new vaccines are not only necessary, they are urgent. Policies against the nefarious use of CBRN agents need to continue to be developed, revised, updated and implemented. Support of legitimate research, and the support of our scientific and medical communities is crucial to our continued existence.

In the face of a potential CBRN attack, these risk mitigation efforts address crisis management issues and help foster a solid understanding of potential terrorism, hence, also helping to systematically improve countermeasures to prevent and respond to such incidents.