NCJ Number
189844
Journal
Clinical Infectious Diseases Volume: 32 Issue: 3 Dated: February 1, 2001 Pages: 436-445
Date Published
February 2001
Length
10 pages
Annotation
This article offers medical and public health observations and lessons discovered during the bioterrorism component of the exercise called TOPOFF.
Abstract
TOPOFF was an exercise engaging key personnel in the management of mock chemical, biological, or cyberterrorist attacks. It was a drill that tested the readiness of top government officials to respond to terrorist attacks directed at multiple geographic locations. The exercise, which took place in May 2000 in three cities in the United States, simulated a bioweapons event in Denver, Colorado which centered on the release of an aerosol of Yersinia Pestis, the bacteria that causes plague. TOPOFF was intended to be “player driven,” which meant that the participants’ decisions and the subsequent consequences were to be the primary drivers in the shaping of the exercise. Also, the exercise was intended to be a “no notice” drill, where participants were given no formal advanced notice of the nature and timing of the event. Issues surrounding leadership, the role of authorities, and the processes of decision-making were widely considered to be highly problematic and deserving of careful review. Overall, leadership roles and the role of authorities in the crisis were uncertain. The decision-making process, facilitated by conference calls, was inhibited by a number of substantial difficulties. As the exercise progressed, many health department officials became exhausted and a feeling of hopelessness quickly overwhelmed a number of public health officials as well as those participating at medical facilities. The flow of information was another major concern of the participants. Several sources of incoming information and data that were made available, by injects, to decision-makers in the exercise would not have been readily available in a real epidemic. Other areas of concern were prioritizing and distributing antibiotics, handling the large numbers of ill persons seeking medical care, and the series of containment measures that were undertaken to control the spread of the epidemic. 5 references and 5 appendices.